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17C-223 (27) BP-2021-2030 76 MAPLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-223-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-2030 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: " License: Est.Cost: 78000 FLORENCE ROOFING 071107 Const.Class: Exp.Date:04/24/2023 Use Group: Owner: SHEA TIMOTHY E TRUSTEE Lot Size (sq.ft.) Zoning: GB Applicant: FLORENCE ROOFING Applicant Address Phone: Insurance: 405 RYAN RD WC2-31S-374455-041 FLORENCE, MA 01062 ISSUED ON:10/14/2021 TO PERFORM THE FOLLOWING WORK: STRIP AND RESHINGLE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: sill' I ✓^ 0 Fees Paid: $546.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildinc Commissioner fr 60-ailed 030 / 0 , � e mmonwealth of Massachusetts ffice of Public Safety and Inspections �� � assachusetts State Building Code(780 CMR) > �tt„ Permit ppli ation for any Building other than a One-or Two-Family Dwelling ��'� ��� 's Section For Official Use Only) Building Permit Number: - iv /e':-• Applied: Building Official: SECTION 1:LOCATION Parsons Block No.and Street City/Town Zip Code Name of Building(if applicable) 76-96 Maple St Florence 01062 Assessors Map# Block#and/or Lot # t 1G 13 SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other Sj Specify:Roofing Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No q Is an Independent Structural Engineering Peer Review required? Yes 0 No El Brief Description of Proposed Work: See attached Proposal. SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4 BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2❑ Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 1$ E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3 0 I-4 0 M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA 0 IIB ❑ IIIA ❑ IIIB ❑ IV 0 VA 0 VB SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information Sewage Disposal: Trench Permit Debris Removal: Public 0 Check if outside Flood Zone 0 Indicate municipal 0 A trench will not be Licensed Disposal Site kl required 0 or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA historic Commission Review Process: Not Applicable 0 Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No IRI SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Michael Shea 76-96 Maple St. Florence, MA. 01062 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Michael Shea 971239.6849 _ - Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Florence Roofing 405 Ryan Rd. Florence MA 01062 Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10. eneral Contractor (,1- e Company Name P9 Name of Person Responsible for Construction License No. and Type if Applicable Street Address City/Town State Zip Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and su ' d with this-appfiCation. Failure to provide this affidavit will result in the denial of the issuance of the building permit. "-"—is-a signed Affidavit submitted with this application? Yes la No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $78,000.00 Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate mu 'cipal =$ . 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee- 64 (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ (contact municipality)and write check number here C 77 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By ring name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this a plication is true f my knowledge and understanding. C. i ip Andrikidis/ Florence Roofing Sole Proprietor 413-262.8007 7/28/21 Please print and sign name Title Telephone No. Date 405 Ryan Rd. Florence MA 01062 florenceroofing©gmaiicom Street Address City/Town State Zip Email Address 3 11 Municipal Inspector to fill out this section upon application approval: rivirii Ftlw ' -� ► `l i �O 1 Name D to The Commonweahh of Massachusetts to= *in Department of Industrial Accidents =. • I•_- ` 1 Congress Street,Suite 100 " a Boston,MA 02114-2017 -I /6" www.macs.gov/die )l utkers'('ompensation Insurance Affidavit:Builderx/Contractor lectriciansiPlumhers. 'it)BE I.WED WITH THE PERMITTING AUTHORITI'. Applicant Information. Please Print I_eeibls Name(lHusinessiOrgatwation Individual): Florence Roofing Address: _ 405 Ryan Rd. City"Suite/Zip: Florence, MA. 01062 Phone#: 413-262-8007 Sr you an oynpluter'(leek the appropriate hai_ Type of project(required): 1.®I am a employer Mrdr 5 employees 1full and Of pan 41112)• 7. 0 New construction 2n 1 am a soh proprietor or partnership and have cur employees M(Pik Illy fin ore in B. n Remodeling y'an capacity.[No%takers'eranp.insuranel required_' IJ 9. 0 Demolition 301 am a ham emi net dinar all u oil my self_(No nutters'comp.insurance required.)" 10 Q Building addition 4.0 I am a hone oo net and Mill be being ex n[ruaors to conduct all Murk on my property. I M ill orison:that all contractors either have worlrn'con poisatmrr insurance or are sole I I EleGtrneal repairs or addit ions s prVl>rleiof%w rrr][h no eplavees. 12.0 numbing repair' ooraritions 50 1 am a general contractor and I Inv c hired the sub-contractors listed on the attached sheet 13 QRoof repairs These sub contractor have employees and inv c Mullen'comp.insurance_ 14.fother New roof b.L]Vie are a cuiporation and its officers have exeiciscd their right of exemption per Moil_c_ 152,ys 144).and Me have no employees_INu Marken'comp_insurance required_' 'Any applicant that crocks boa VI Mini alio fill out the section below showing then nurkcr.«compensation polity imtnrionios. t Ha.ncuMtwn who submit this affidavit Militating tin"are doing all work and then bite outside contrreturs meet submit a new affidavit indicating stick IC'onlrac[ors that cheek this harp must attached an nhhtioml sheet showing the name at the soh-contractors and state whether or not those entities have employees. If the sutrcantrariurs have enniluy5om they mint panicle their workers'omnp_policy number I am an ttmplolier that is providing workers'compensation insurance for my employees. Below is the policy card lobster information. Insurance Company Name: Liberty Mutual Fire Insurance Company Policy#or Self-ins.Lie.#: WC2-31 S-374455-041 Expo Dom: 1/25/22 City/State/Zip:Site Add 76-96 Maple St Ci Florence, MA. 01062 /sta _ Attach a copy of the workers"compensation polio declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c_ 152_ §21 A IN a criminal >rotation punishable by a fine up to SI,5(I()_(NI and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement pray be fitr's aided to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify underMitts a milli"of pe perjury that the information provided above is true and correct sikmature: Date 1/28/21 Phone#. 413-262-8007 Official use onit: Do not write in Sins area.to he completed by citl•or town official (its or Town: PermiUl.icense# Issuing Authority (circle one): I.Board of health 2.Building Department 3.('ity./Tossn Clerk 4.Electrical Inspector 5.Plumbing Inspector b.Other Contact Person: Phone#: Appendix 1 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing(include local connections) 9 Gas(Natural,Propane,Medical or other) 10 Surveyed Site Plan(Utilities,Wetland,etc.) 11 Specifications - 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investigation 16 Energy Conservation Report 17 Architectural Access Review(521 CMR) 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Registered Professional Contact Information C.Philip Andrikidis/ Florence Roofing florenceroofing@gmail.com Name(Registrant) Telephone No. e-mail address Registration Number 405 Ryan Rd. Florence MA 01062 CS-071107 4/24/23 Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Please follow this link for construction control forms to be used by Registered Design Professionals. � � City of Northampton .'' r Massachusetts Sys , r� w, ; is { DEPARTMENT OF BUILDING INSPECTIONS yt 212 Main Street • Municipal Building J� -�f Northampton, MA 01060 �` 4••�'��0 �a 3I7 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Valley Recycling Location of Facility: Northampton St. Easthampton, MA. 01027 The debris will be transported by: Name of Hauler: Florence Roofing Signature of Applicant: Date: 11998124 _ CONSTRUCTION CONTROL WAIVER From: n, f- l uv&v e e- I' 00—►06 '* 1? c,✓i Rd AwtviC,e,i M 4 . 6)0(o) To: Jonathan Flagg Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, I request that you grant a modification to waive the requirement for construction control of the project at ? r3ov15 e)oCIC - to -9!v /A (.9)- 54--. I(ovem C-C1 /9 4 because the work is of a minor nature, will not affect structural elements, health, accessibility, life or fire safety, and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, FLORENCEROOFINWMA.COM C.PHILIP ANDRIKIDIS • 405 RYAN ROAD, FLORENCE, MA 01062 • INSURED BY KING 8 CUSHMAN 413-584-5610 HIC #150673 � � -� ( CSL # 171107 V 5 MSL# 11282 i a ' _ 413-262-8007 July l; - Prupoail fire. Make Sires Job Locsidaric -6-4116 littople St Florence MA 01062 Description; - Erect scaffolding with stairs in rear outside corner of building. - imp 3 layers of existing roofing system to wood deck on building including parapet walls. +'- 14.2(X) sy tt • install wood nailer to root edges to same thickness as insulauon. \lc.hanically attach(2)layers of 2.6"polyisocyanurate for a total thickness of 5.2"and an R-value of 30 to entire roof per building code. Mechanically attach Versico VersiWeld.060 white TPO membrane to entire roof and parapet walls using Rh►noBond induction weld system - Brake form 24g Kynar finish gravel stop to roof edges.Color Green • All"TPO related[lashings and terminauons installed per manufacturers specifications. - Remove 01 existing skylights from roof. Frame existing openings,sheath with ,."plywood to cover permanently. Interior finish work to be performed by a contractor other than Florence Roofing. - Install(2)new 4"rctroftt roof drains to existing plumbing. - Fabricate and install new overflow in existing opening and down spout to stop erosion of brick wall from 24g Kynar finish.Color.Green - All permits tiled by Florence Roofing - Area cleaned and all roof debris removed to landfill andlor recycled to proper facility. - Any broken rotted roof decking replaced @ S4.75:sq.ft. - Versico 20 Year Total System Warrant • All permits included. - All material furnished and installed by Florence Roofing