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11C-010 (5)
BP-2022-0668 7 BERNACHE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 11c-o10-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0668 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: DAVE MINER EXTERIOR HOME Est. Cost: 15924 IMPROVEMENTS LLC CSSL099953 Const.Class: Exp.Date: 10/20/2024 Use Group: Owner: OQUENDO-TIRADO VANESSA Lot Size (sq.ft.) DAVE MINER EXTERIOR HOME IMPROVEMENTS Zoning: URA Applicant: LLC Applicant Address Phone: Insurance: 264 SOUTHAMPTON RD 6ZZUB9F45112621 HOLYOKE, MA 01040 ISSUED ON:06/08/2022 TO PERFORM THE FOLLOWING WORK: STRIP AND RE-SHINGLE 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: T IT ! , Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildinc Commissioner 19; �c The Commonwealth of Massachu s VGA /� `,. W Board of Building Regulations and Staridr x TY Massachusetts State Building Code, 780 CMIt.9 _ �yeG, �'O SE • /77 Building Permit Application To Construct,Repair,Renovate �° h a Rev' ed M 2011 One-or Two-Family Dwelling o',;h) This Section For Official Use Only �'os'oti9 / Building Permit Number: e 1P- - 04 I Date Applied: / �. /4/1/..i/Z3 //(7.7 6-5-ZOZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro erty Addre s:Gh S 1.2 Assessors Map&Parcel Numbers � 1„Address: °f lG 10 1.la Is this an accepted street?yes no Mail Number ParceINumber 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private 0 Zone: _ Outside Flood Zone? Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: 11� Vet/1z'S5A , ' °fury'vU Zee's "*l,-- CJi 0X-1 Nam�ee(Print) City,State,ZIP flies chz- S1.- 5- `1984'D 4. ....,4 . Morin e (j0c%,4-t19,L ,co' No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: 5 y L/ /r1---,A sAenyirs SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Total All Fee Suppression) • $ Check No.41N Check Amount:1 40 Cash Amount: 6. Total Project Cost: $ / Sr9"'r 0 Paid in Full 0 Outstanding Balance Due: / SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) oggq3 (O a_,i i `"'tt'��TT `� (t_v M i ►l er License Number Expiration to Name of CSL Holder Poact�Qotlia. n 4on List CSL Type(see below)No.and Street ) Type Description 1101. o K e Pia 0 lV _T i 10 U Unrestricted(Buildings up to 35,000 cu.ft) City/TowState,)ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofmg Covering WS Window and Siding u `�ly�o� SF Solid Fuel Burning Appliances �� 4 / .9() cbe due ux I Vle ee I IL, aovi I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvemi nt Contractor� (MC) (p '1 4 2 ab° ��I��Lx ►y` � r t��0�e .Ii rotieiviei i5 HIC Registration Number ExprratitnDat)e I-�C Comp. Na`n'd�or HIC Re Registrant e A(40 stir�X�tTrli�( i/YY1►'4-bt'L c oad. 80.vne eet N n (VCR i VOA cc o 10 t'�'U '1 13 3 7140 716 Email address City/To n, State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .. 4Q No 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property,hereby authorize_ l 1Qlf P �`t Y e to act on my behalf,in all matters relative to work authorized by this building permit application. vQ✓1 Y $A O L 4do b Print Owner's Name(Electronic Signature) Date • SECTION 7b:OWNER1 OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. 6 AG /a 2 MUST BE SIGNED by Owner or Authorized Agent Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will ad have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at ww.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage" may be substituted for"Total Project Cost' _ The Commonwealth of Massachusetts * /, Department of Industrial Accidents 1 Congress Street, Suite 100 �G E= Boston, MA 02114-2017 www.mass.gov/dia \\crkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WTTH THE PERMITTING AUTHORITY. Applicant Information Hen _ Please Print Legibly Name(Business/Organization/Individual): c E �iOr 6 ene T J VYl� CyY1P�l°� Address: L109- SOACAP6ii- LQadiL City/State/Zip: r'1U yC) e Ma 01040 Phone#: 14 t S 14 • (� 11 aO Are you an employer?Check the appropriate box: Type of project(required): 1.VI am a employer with employees(full and/or part-time).' 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. gRemodeling any capacity.[No workers'comp.insurance required.] 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have em to ees and have workers'co t 13.❑Roof repairs p y r,�.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. `� Insurance Company Name: .L 1 ('l L-V' �z .•UP)d1 � I• I a� �) I ii0Gn�] '� Policy#or Self--ins.Lic.#: O -t Expiration Date: y 4 Ou Job Site Address: 7 ,3 t"(/l Ci ck r- .0" City/State/Zip: L rJ /"j Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: ii 4 Aa. Phone#: 4 .� 14 © 'V 10 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Wa-m."2?,0-rmeiecaiere)eicc,c te6-J-e/i,f)1 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC DAVE MINER EXTERIOR HOME IMPROVEMENTS, LLC Registration: 186552 347 NEWTON STREET Expiration: 02/04/2023 SOUTH HADLEY, MA 01075 Update Address and Return Card. SCA 1 0 20M-05//117�7 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 186552 02/04/2023 1000 Washington Street -Suite 710 DAVE MINER EXTERIOR HOME IMPROVEMENTS,LLC Boston,MA 02118 DAVE MINER 347 NEWTON STREET • SOUTH HADLEY,MA 01075 Not Valid without signature Undersecretary9 Commonwealth of Massachusetts ••i, . Division of Professional Licensure • . " Board of Building Regulations and Standards o • CSSL-099953 • Expires: 10/20/202': DAVID MINER 347 NEWTON STREET SOUTH HADLEY MA 01075 Commissioner ("IT\ of Northampton 212 Main Street, N.irittanipton, MA 010o0 Solid Waste r)isposal Affidavit In accordance of the provisions of MGL c 40 S54 I acknowledge that as a condition of the budding permit all debris resulting from the construction activity governed by this Budding Permit shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111 . S 150A Address of the work The debris will be transported by The debris will be received by Budding permit number Name of Permit Applicant Date Signature of Permit Applicant 11Lti DAVE MINERI Date: lat--/ Exterior Home Improvements (413) 533-0481 www.DaveMinerRoofing.com 264 Southampton Road,Holyoke,MA 01040 MA Registration#186552 r ,, . q., /� Customer Name: �� I ' Telephone Number ' V �t., Address, City/Town, State: P1 Ge.r y\ j, l CertainTeed Roof System • Strip off existing roof and remove all debris from worksite • Line all edges with 8" aluminum drip edge • Install feet of WinterGuard ice & water barrier along eaves and up any valleys • Install Roof Runner Diamond Deck synthetic water resistant underlayment • Install CertainTeed Landmark Landmark PRO Landmark Premium Other shingles to manufacturers specifications. Color: • Install SwiftStart starter strip along eaves eaves and rakes • Install using 4 nails 6 nails for maximum wind coverage up to 130 mph • Install a ridge vent along the length of house approx. 15" in from edge of roof • Install new vent stack collars • Replace step flashing as needed along walls and chimney • Re-flash chimney with lead flashing as needed. Install Cricket at chimney. • Plywood Install 1/2" CDX plywood Install 1/2" CDX plywood as needed @ per sheet • CertainTeed SureStart Plus 4;-4-Star y 5 Star Warranty Coverage • All workmanship is guaranteed for 10 years unless otherwise specified. • Protect siding and exterior of house • Protect trees and shrubs • Magnet ground for loose nails • See Other below for any additional work or comments • Other: Contractor is not responsible for any damage to interior of home.Any loose articles on walls/shelves should be removed before work starts We Propose hereby to furnish material and labor-complete in accordance with the above specifications for the sum of: - ^!' dollars($ ) A deposit of 1/3, $ ,is to be paid before materials are ordered. o A Payment of$ is due at the halfway point,and the balance of$ paid upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the above specifications involving extra costs will be executed upon written orders,and will become an extra charge over and above the estimate. Our workers are fully covered by Workmen's Compensation Insurance and Liability Insurance. Authorized Signature: Note: This Proposal may be withdrawn by us if not accepted within 30 days Acceptance of Proposal—The above prices, specifications and conditions are satisfactory and we hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature: Signature: Date of Acceptance: This agreement may be cancelled by Customer within 3 days of acceptance for any reason as detailed in the accompanying Notice of Cancellation Customer's Initials -