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23B-021 BP-2006-0064 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0064 Project# 3S-2006-0083 Est. Cost: $12500.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Adam Quenneville 070626 Lot Size(sq. ft.): 10454.40 Owner: SIMPSON JANE M Zoning:URB Applicant: Adam Quenneville AT: 208 NORTH ELM ST Applicant Address: Phone: Insurance: P 0 BOX 612 (413) 467-2426 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:7/18/05 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP, PLY & SHINGLE ROOF 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. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 7/18/05 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo •J� ff� (�a Q �' City of Northampton $ a *mt) b) t + \Building Department ' d'd ,b 4" '� -'X''+sk?s._ 7 212 Main Street -4"x f . rtraimmr 1).\; i du 1 8 2005 Room 100 t(0.-� 1§4- i0,1, _ LN rthampton, MA 01060 1 `_ ' :a o--• z °� _ cm 413 587.1240 Fax 413.587-1272 ,P. JS+tef'a r PT()f Bt1ilD4tIG, k ,.,, - '�-— a ` yaq:�p�', 04,MA t3 per;"Lpecr�. ' APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION l SITE-INFORMATION , 1.1 Property Address: "r s F 114 sect-of -61iV omRrdt7d;iWbfaf c'6;4 +,/��(' �// D �n/� ((\� /�� -[ N i "✓"fir - 4 w, z" rn -+}g4 v 1,-; A- t • k r 'r uT L i fit . -4::: '.:-• /1) 1 /4 /1 v la t tr ct _ � :. T., &� yam.;v ., Tye "K ',.V_ I ist_ict � 1,"Y r tie:AC6 ?i Ect` v SECTION`2- PROPERTY•OWNERSHtP%AUTHORIZED AGENT r .,. - 2.1 Owner of Record: --S�C�anP ' �995C)� aOCC )004 CAPA &1•1' Name(Print) Current Mailing Address: Telephone 5&L,( 7.7 0 9 Signature 2.2 Authorized Agent: A ckam O veil ncu,,tic "Roof,J Rv 6 I ,ffc 114 ol0s Name(Print) Current Mailing Address: -- 63(Q- S `5 Signature Telephone SECTION•3 ESTIMATED CONSTRUCTION-COSTS . Item Estimated Cost (Dollars) to be Official Us Only _ completed by permit applicant I. Building i1 (a) Building Permit Fee - 2. Ele;:rical (b) Estimated Total Cost of Construction from,(6) 3. Plumbing Building Permit Fee i4. Mechanical (HVAC) I 5. Fire Protection 6. Total = (1 -+ 2 + 3 + 4 + 5) ('2. 500 J,-, Check Number .This Section.For Official Use Only Building-Permit Number: Date.Issued: signature: Building Commissioner/inspector of Buildings Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear • Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF-YES, describe size, type and location: S{ N 'FkRO OSED OR: 4 •ccAa#ij a.115a.i tg :Ig ,,44... ...:..0,,..s f,, F4'>`,,vm ,-CC ` ''",;;, ,. at,,r' -Z7«. _ :"'947X1..tr. :K.:`.�.ua4'. New House 0 Addition 0 Replacement Windows Alteration(s) 0 Roofing X Or Doors 0 Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] `Brief Description of Proposed Work: IUtW AS H S1y,c \e Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet 0 6a" i:..i e1.',1" 6.n We;:777 dr" °ddi3#ronit0`e istiti ta'otsrn' .o fatefe the rL1.owtng: a. Use of building: One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes _ No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply (� Y � ' ^. R�Z/�'f��ON TO BE COMPtE?ED`1NHEN eaF ,T ? � �� AlLeot N to A EN 0 GTQf7, PINES FOR BULILptoG PERIVI7T' I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, 4(40or, C .)' e-P,.n le ( P\C5`)I , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. `_gym ne .i.I le" Print Name 7- 1y-oS Signature of Owner/Agent Date • €S ON to NS "RUCT OLN SERVICES fire 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder : ! JcOm ()kW MeV\\\P- O Oce."`7 License Number _ PU (All &cJiAl 14CtaM 01076 Fs!a Ios Address Expiration Date Signature Telephone -"R •,(6.. 40f°l:5sE1'-":krie-srd e �Y'�'1Ce'8:T� ,-- -- �.. Not Applicable 0 A(kem C v���ev�tIC Rot, tom`] 12.OcTh Company Name Registration Number GAL Sc 14C11a )14 0)o7s 3JA�1o( Address Expiration Date Telephone - 9.SL,p yryEe y :. SECTS 0: OR €3 5't OMPENSAITION /4SURANCE.AFFID•AVIT(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 No 0 ke r � 1. The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner" shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature �_ • �tnnN•rp. — �_ ��o •b (rite of Tttrtli�ulip f alt - � / .tq ���4 jatasracEfusrtta =!' ��'+ DEPARTMENT OF BUILDING INSPECTIONS 4%IR '212 Main Street ' Municipal Building Northampton, Mass. 01060 r' WORKER'S COMPENSATION 1NSUTRANCE • i AVIT i -NfAtiv - nes�k l k._. ------ - - -- - - -- -__ (li censcdperni ittcc) with a principal place of businesslresidence at: �t (a l 2- `�SoL kot A (phone � 3lC S •-- ---------.�..-------- (SiTCC(�C7Ci!'>tciC.�lip)- — .5 ..---- do hereby certify, un(ler the pains and penalties of-perjury, that: - kf I am an employer providing the followinc worker's cornpcnsation coverage for my employees working on this job: 1 r Po 4 ( A c7olaisItlofac 'S 1--l/D-cl a(r - (Iastl.ran=Comp:m) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Ittsurncc Compa r Potici Number) (Expiration Date) (Name of Contractor) (Insurance. Company/Policy Number) (Exoir,Lion Date) M(Name of Contractor) (Insurance Com;.any/Polic:Number) (Exp:radon Date) _ (Name of Contractor) (Insurance Compa yrfoUcy Number) (Expi !tio r Date) (attach additioatl e;sKt if ncrit•.ar:.o i:,e'.•.r'e or::t,::ct:•,_._.n:fir,-...,ii c:<.-ra--:c::•) ( ) I am a Sole proprietor anti have no one r::orkmn f4 for me. ( ) I am a home owner performing all the Wor- nws::lt. NOTE:please be aware this while hc<r<o«ir-...1 v o r.--:t toy;r u:tb TA ,:mane;cereerzeion Cr moan-....-"it., t dwel!i-^F,- not anece then throes units in which the r>^r..+:raoc rain or on:Se ;%.:3 spF•.uten.nt thacto e tt not cc:mm.1 y coca tin-:d:o lh employ=under the won er's care----..t:tiara,.c (l•;L!51.=1(5)) arl.limtien by a homeowner fora LC:CISC or p:f:ri:may r.4.'crre t: legal rtatoa of an employer um:or the Workers taruparatiea Act 1 undue-rtaad the a copy of this etatcm s way bo for worded to the D-:Portnm:of Industrial Aecn4att'Office of Insurs000 for the Coverage veti6C1100 and that failure to tsdaue coverage tusdcr:ec,icn 75A of MOL 152 can lead to the imposition of r-oir:1 per-‘lii oomitting of a fine of up to S 1_500.00 ondtor ir.:p risxarc.:of up to ore yczr neat civil pair-Pica in the form of n Stop Wcri Order sad fine of S100.00 t day sztinat m: . For dkparurtestal uoo tray ` Yt t mit Nttmr tx tl Lot" h4ap 1 = S',Y l -'I A D A/llok k)S r r 71S QUENNEVILLE ,U `,1 ELKS ROOF I N G The Premium Choice' 78 West State Street, Granby, MA 01033 We Are Licensed 1-800-NEW-ROOF • 1-800-4-SIDING Insured Email:info@1800newroof.net Website:www.1800newroof.net Factory Trained MA Construction Supervisors Lic.#070626 MA Registration#120982 Factor Certified Installers Member of the Home Builder's Association of Western Mass. CT Registration#575920 Y Member of the Building&Trade Association Member of the Better Business Bureau PPG.38710 Proposal Submitted To: Date Phone#'s J'9;Ve S:\nap so#J 7/0 H:S - 7(�9 Cell: Street Job Location C'g t/U0(4-P/lh S')/, Ivo 6Aolse No gkei City, State,Zip Code Special Requirements 0 N`rite sS YY�F Proposal to furnish and install the following lker,..,?o gcsc-9 S ❑ Re-Roof ,Tear-Off ❑ Gutter !c , p. P'RG,„-f c> Pile F Complete Roof Preparation tJ e- 5 f1 Ar e e ;p `/I / O Home exterior to be protected by tarps and plywood` he e 'S-1 LLB S T rS h'1 - 0 ��Shrubs, landscaping,trees to be protected from damage c2 2 k,eo `f S 1,,.,c,/v4 P 3 - Xc Entire existing roofing material to be removed to existing decking, including flashing, etc. N Site to be cleaned everyday with roll magnet debrisri removed at p_rpjec%completion skj Deteriorated existing decking replaced at J..a per `a t/t tT/),x /� PC'"f(' t 8 inch metal drip edge installed at eaves and rakes ❑ 5 inch for re-roof only Cti'i y UPPAt`Ai. • New flashing will be installed where necessary(see Special Requirements) "`-____________ pWe shall acquire all appropriate permits etc.for all roofing work Complete Roofing System ELK Leak Barrier installed at all eaves to protect from ice dams(and meet codes in the north) ELK Leak Barrier installed in all valleys, around penetrations, and chimneys to protect critical areas N-15 pd. reinforced underlayment installed over entire decking Shingles: ' ELK Prestige®Series eiti 30 year ❑ 40 year ❑ 50 year Color t k '/r/r 67 - - Nailable ridge vent will be installed 1 y X ELK ridge cap shingles .4-( /4 SG C Warranty Options: 311 0.4.4F.1�S ` Yoo e- X'We guarantee our workmanship forefull years �(` 3 1`1 C� ❑ ELK10-Year Umbrella Coverage Limited Warranty upgrade. I Cp L CCa4'p�'i'CAS 0 c: AELK15-Year Umbrella Coverage Limited Warranty upgrade. �t 1 j DI1C•VER P Y completebrae h p /�`�'e Propose hereb� t materials and labor- in acc t It above specifications for the sum of: 14JL*Cr L 0 S _ own , i J Upon Com I ion $ Q'- R` 'A/o`Fiosc.' /-j -S00 . .tip// 0c0f�n�r.# 44/�S/f <> C© 0 • - EPTANCE OF PROPOSAL:The above •rices s•e ifications and conditions are satisfact• and are'hereby accepted. You are au • -• - •• -•. as specified.Payment w be 1/3 •own ••• •• ..::: on comple Unpaid balances shall accrue with interest at 18%per ann.. . Purchaser(s)WI •.' or all costs,expenses a reason- able attorney's fees incurred by Apne_A;;Iljgenrxville ogfin an. •' •, .to recover any sums due under this contract. Date: 1 12 1f,LJSignature. Phone#<if3-,5 3-'I' 7 7(�i Date:_71��ec- Salesperson's Signature: /j� Estimates are hono d for • (60)days from above date ATTENTION HOMEOWNERS:Please cover all personal belongings in the attic,garage or storage areas due to the possibility of roofing debris or dust coming in through cracks of the wood.Adam Quenneville Roofing and Sidings will not be responsible for debris or dust in the attic or storage areas.