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29-596-003 BP-2024-0767 60 MATTHEW DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-596-003 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-2024-0767 PERMISSION IS HEREBY GRANTED TO: Project# roof 2024 Contractor: License: Est.Cost: 14500 HERNAN CEPEDA 110336 Const.Class: Exp.Date: 12/01/2025 Use Group: Owner: HONIG JEFFREY B Lot Size (sq.ft.) Zoning: WSP Applicant: HERNAN CEPEDA Applicant Address Phone: Insurance: 1 RIGHMOND ST wcv01572801 HAVERHILL,MA 01830 ISSUED ON: 06/14/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF 26 SQR . 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: 40/2. Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED JUN 1 3 2024 &, The Commonwealth of Massachusetts FOR OFPT OF �f;/,r�INSP c.rioNs Board of Building Regulations and Standards MUNICIPALITYNORT\ ,r:.MA O_ ''o Massachusetts State Building Code,780 CMR USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: ,4/ - y 7U 7 Date Applied: V I 4->7:1-C,5 L-il-zezy Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 60 Tr w ail s16—doa 1.1a Is this an accepted street?yes no Map Number' Parcct Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq tl) Frontage(ft) 1.5 Building Setbacks(tt) 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 0 Private 0 Zone: — Outside Hood Zone? Municipal 0 On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 wner'of Record: f#iVI y ,7F�` i/ la fLot6W AM Dl4*6 2. Nan (Pnnt) City,State,ZIP 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 ❑ Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work'-: Bea SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building $ / / 3"pp 1. Building Permit Fee:$ Indicate how fec is determined: / ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (11VAC) $ List: 5.Mechanical (Fire $Suppression) Total All F � Chcck No)U.20i Check Amount: 4 6.Total Project Cost: $ ! /�p ❑Paid in Full 0 Outstanding Balance Due: CvNuf I Jose e 0 o coo,hi C 7 tv'&r T SECT1ON 5: CONSTRUC I1ON SERVICES 5.1 Construction W/t'�r�Supervisor Weise(CSL) CS—I/° /2./. 24-- _t f-714\JANI License Number Expiration Date Name oWSL Hotd°r List CSL Type(see below) V / /24011 iJ0 Sr Na and Street TV° Destaipdos 1 hi erYLla luau. /1/14 t9/ o -11Restricted &2 m_ up ling n) City/Town,State,ZIP M Masonry RC Rooting Covering WS Window and Siding Is�o Burning Appliances oink 36I4 l�u # n Telephone Email address D Demolition , 5.2 Registered Home Improvement Contractor(RIC) � '/ ID.,,C- Z f�; ]u (/ ) i el HIC Registration Number Expiration Eke IOC Co an Name a BIC Re�a.t Nam /� '�itf Name, A/t! S '"� ea,f ovl erg ''n 'I- !.aril J��u4-/A4 D/W30 ` .1 /- 61 I?�at7 address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT @LG.1.e.152.;2Sg6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit mil result in the denial of the Issuance the building permit. Signed Affidavit Attached? Yes No O 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 um-I m ono /Jr L �C/�� Pc ) 4001111" to act . behalf,in all relative to work authorized by this building permit apph m. t::/(i„._ t°i40 29 r,�s 4 (Blectronic Signature) , Date SECTION 7b:OWNER'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 ap licati i true and accurate to the best of my knowledge and understanding. Ht z J4 fki 4079t04 b i 1 I/241 Print Owner's prized Agent's Name(Electronic Signatae) Date NOrI')E& 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an umagstered contractor (not registered in the Home Improvement Contractor(HIC)Program),will sot have access to the arbitration program or guaranty fund under M.G.L.a 142A.Other important information on the HIC Program can be found at www.masa.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dos 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 balflbstba Typo of heating system Number of decks/porches Type of cooling system Enclosed Open ••••• . •— • .n_..--- r__.___n_.._.L__.1....:......iIMwr,.blDmi.r.sCM," _ City of Northampton / O,At NAM =O- ,S •• Si /%?•. Massachusetts �,,, cc` (4 ` I 1 d �1���>• w * DEPARTMENT OF BUILDING INSPECTIONS ,, fi, e•. ` 212 Main Street • Municipal Building O ^`1. `Cv araJillO Northampton, MA 01060 I r)\ CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, 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: Location of Facility: L4/40 w OO/3Lc(--' 1k)4t j9WT' The debris will be transported by: Name of Hauler: N 7r '.° z67 c,vy Cr 1- "oLativ , AM- Sig nature of Applicant: Date: 6//��Zy The Commonwealth of Massachusetts 12 Department of Industrial Accidents ;111�.= 1 Congress Street,Suite 100 ifs Boston,MA 02114-2017 :r wwis mass.gor/dia - -• %%hikers'('ompensation Insurance ABidas it:Builders/('ontractorsiElectrici4ns:Plumbers. It)Lit.I IL[[a WitH 7 HE I'6:RJ11ITIN(:At'I IIUIt1 t!. Applicant Information e Please Print Leaihlx Name 10us uwssOntanizauon'IndividitaI►: fteadki ?'r aee bye A _ Address: / IZiHMo I✓D gr City/State/Zip:th#Y /U'1A,W 030 Phone#: A76. 361 .761y 1re you an rniptoyor?('hick the appropriate bet: T)pt of project(required): I.©I am a ciaployer with ernpluyeestfull and'ur part-timer• 7. 0 New construction ant a sole pnspnetur ur partnership and have no employees working for me in K. CI Remodeling any upacrty-[Nu workers'eump.insurance reipmed.) 9. 0 Demolition 30 I and a homeowner doing an work myself.[No%osiers'comga insurance required.)' 4.0 l am a humevwnet and w ill be luting wine%tors to conduct all%utk on my property I wilt 10 El Building addition ensure that all eontraeturs either hale workm'cuenvensa non Imsurarer ur an sole 11.0 Electrical repairs or additions proprietors with no employees 12.0 Plumbing repairs or additions 5 i n a general eunuaetur and I hose hued the sub-euntractuts listed on the attached sheet. These sob-cuntraetots has.:employees and hose Ns takers'rump.insurance.: 13 roof repairs 6.0 we are a corporation and itsall'kers base exe eised their nght of exemplum pet MU e. 14.0Other L'2.i IIat and w e have no empk yecs.[No%corkers'comp.Insurance sequiril1 *Any applicant that checks box aI must also rill out the seetwn below showing their workers'compensation policy tnfsxnutiun. t ltumeu%ices whir submit this atlidasit indicating they are doing all work and then hire outside contractors must submit a new official.it indicating such. :Cuntra:tors that cheek this but must attached an additional sheet shooing the name of the sub-contractors and state whether or not those entities hale cnipstuyeees If the sub-contraetcus hose employces.ties must pro„idc their wotkcrs'comp,policy number s- I am tut employer that is providing worriers'compensation insurance for my employees. Below is the polity and job site information. ,r,-� Insurance Company Name: ,4 woe.!e. --)z" INS 417 Policy#or Self-ins.Lie.ts: W' V 0I5 7 2 j _ Expiration Date: WI iJ .S' Job Site Address: 60 meill'ittwv me. City:start fzip:P rIM*4Rl V ivy LMA 0106 Z Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under t1CGL c. 152,§25A is a criminal violation punishable by a line up to S 1.500.00 and:'or one-year imprisonment,as well as civil penalties in the limn of a STOP WORK ORDER and a tine of up to S250.00 a day against the s tolator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ........-.. t do hereby e tiff't ,r the and penalties of per jury t t.hat the information provided above is true and correct. Signature: D.Ite 6/11/4 Phone s:: et k 'g6I 76 Official use only. Do not write in this area,to be completed by city or town official. ('its or Foss n: Permit.'l.icense ti Issuing.%uthority (circle one): I.Board of Health 2. Building Department 3.('ity - ossn Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other ('intact Person: Phone#: THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration fYt . Type: LLC Registration: 206651 CCM DESIGN STUDIO LLC Expiration: 10/05/2024 1 RICHMOND STREET �--1 HAVERHILL. MA 01830 y. Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS J Office of Consumer Affairs& Business Regulation Registration valid for indivi al us only fore the HOME IMPROVEMENT CONTRACTOR expiration date. If found r urn to: TYPE:LLC Office of Consumer Affai and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 206851 10/05/2024 Boston,MA 02118 CCM DESIGN STUDIO LLC HERNAN CEPEDA ;2 Hernan Cepeda 1 RICHMOND STREET ,%/�/•ta' HAVERHILL.MA 01830 Undersecretary Not valid without signature DATE(MM'DD/YYYY) ACCcROJ CERTIFICATE OF LIABILITY INSURANCE 06/11/24 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the poiicy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsoment(s). PRODUCER CONTNAME ACT Destiney Hannan Armand P.Michaud Insurance Agency,Inc. „j HONE No.EMI 978.685-2549 FAX NO 978-794-0822 105 Havorh(II Street E-A1AIL Methuen,MA 01844 ADDRESS: destiney@michaudlnsurance.com INSURER(S)AFFORDING COVERAGE NAIC e INSURERA: Evanston Insurance INSURED INSURER B Hernan Cepeda INSURER C: CCM Management INSURER D: 1 Richmond street -- " Haverhill,MA 01830 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. __ IETR TYPE OF INSURANCE INSO ADM .WDtIhR POLICY NUMBER PMJODIYOLICY FF POLICY EXP LIMITS INSD WVD_ {MMIDDIYYYI� (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMACLAIMS-MADE n OCCUR PREMISEES(Ea oca:rrance) S 100,000 MED EXP(Any one person) S 5,000 A 3AA850879 03/10/24 03/10/25 PERSONAL&ADV INJURY S 1,000,000 GEN�T AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY n PEa LOC PRODUCTS-COMP/OP AGO S 2,000,000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Ea accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Par accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY ^AUTOS ONLY (Per actWent) S UMBRELLA LIAB OCCUR EACH OCCURRENCE S - EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION S _ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y IN STATUTE ER ANY PROPRIETORJPARTNER/EXECUTIVE❑ N f A El EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Florence Florence,MA 01062 �,'/�J AUTOO REPRESENT ME' /%��+`�II�t Q/ L I / g ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Prepared For —�' �— Jeffrey B Honig UNLIMITED 60 Matthew Drive Florence, Ma 01062 Unlimited HS LLC Estimate # florence2 267 Cady St Date 06/10/2024 Ludlow, Ma 01056 Phone: (786)750-2758 Email:jose@unlimitedhomeroofing.com Description Roofing per square Unlimited to replace the roof in Its entirety in REMOVE ALL LAYERS DOWN TO THE DECKING AND REPAIR AS NEEDED CUT IN 1 INCH EACH SIDE OF RIDGE AND INSTALL HIGH FLOW RIDGE VENT INSTALL UNDERLAYMENTTO ENTIRE PROJECT TO GO UNDER DRIP EDGE UP RAKES ICE&WATER IS TO GO ON TOP OF DRIP EDGE ALONG EAVES&2FT INTO LIVING SPACE INSTALL NEW DRIP EDGE AND LEADING EDGE STARTER TO ALL EAVES&RAKES INSTALL SHINGLES IN THE COLOR OF MUST INSTALL ALL NEW STEP FLASHINGS,COUNTER FLASHINGS(CUT INTO BRICK) INSTALL NEW APRON FLASHINGS AND ALL NEW PIPE BOOT FLASHINGS 25 year manufacturing Warranty 15 year labor warranty 50%deposit prior to install Paps 1 o1 3 Remaining balance upon completion All checks made to Unlimited HS LLC Su btota I $4,940.00 Tota I $4,940.00 I'. ,•2 cf 3 DATE(MM/DIIYYYY) '4�R�� CERTIFICATE OF LIABILITY INSURANCE 4/2/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. 11 SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Rcnata Gaiotti Associated Insurance Agency,LLC PHONE o �): (203)748-9272 FAX No): 50 Newtown Road,Suite I (A/C ADDRESS: RenataAIA-DAN a BURY.COM C? t INSURER(S)AFFORDING COVERAGE NAIC Danbury CT 06810 INSURER A: ATLANTIC CAS INS CO 42846 INSURED INSURER B: LIBERTY INS CORP 42404 Unlimited HS LLC INSURER C: 267 CADY ST I INSURER D: INSURER E: LUDLOW MA 010562169 j INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AUULbUHH POLICY EFF POLICY EXP LIMITS LTR INS() WVD POLICY NUMBER (l.1M/DD/YVYY) (MMJDD/YYYY) x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE x OCCUR PREMISES(Ea occurrence) S 100,000 MED EXP(Any ono person) 5 10,000 A Y Y L377000759-0 11/20/2023 11/20/2024 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 KPOLICY PRO- /► JECT LOC PRODUCTS•COMP/OP AGG $ 2,000,000 OTHER: S 'AUTOMOBILE LIABILITY 'LOMBINED SINGLE LIMIT S (Ea accident) ANY AUTO BODILY INJURY(Par parson) S OWNED —SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PHUPLHIYUAMAGE AUTOS ONLY _AUTOS ONLY (Per occident) UMBRELLA LIAB _OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DEO RETENTIONS S WORKERS COMPENSATION x STATUTE ERA AND EMPLOYERS'LIABILITY 1-3 OFFICER/ME BEER EXCLUDED?ANY ECUTIVE YY N/A Y WC5-33S-B24Q4R-013 11/20/2023 11/20/2024 E.L.EACH ACCIDENT S 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 II yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE.POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may bo attached It more apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Rrnalo.GninHi, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Construction Supervisor 111 Division of Occupational Licensure Unrestricted-Buildings of any use group which contain less than Board of Building Regulations and Standards 35,000 cubic feet(991 cubic meters)of enclosed space. COOSkii010. !lf 44 rvisor CS-110336 47 >)cpires: 12/01/2025 HERNAN CEPEDA e 1 RICHMONDSTREET HAVERHILL IAA 01830 ' Z i) �0 ?G • • 0 �Uf 17641P A Failure to possess a current edition of the Massachusetts State Building Code Is cause for revocation of this license. Commissioner eldau; r 0� Contact OPSI:(617)727-3200 or visit www.mass.gov/dpl/opsi