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18D-055 (20) BP-2024-0806 137 DAMON RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18D-055-001 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-2024-0806 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2024 Contractor: License: Est. Cost: 15000 RCI ROOFING LLP Const.Class: Exp.Date: Use Group: Owner: EASTHAMTPON MAHADEV LLC Lot Size(sq.ft.) Zoning: GB Applicant: RCI ROOFING LLP Applicant Address Phone: Insurance: 6 LINE ST (413)527-4775 VWC10060226472023 SOUTHAMPTON, MA 01073 ISSUED ON:D6/2 6 12 0 2 4 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF FRONT MIDDLE SECTION ONLY 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: /77. Fees Paid: $105.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Lr �YFtt �3 �+-2tc, • L I The Commonwealth of Massachusetts N F Office of Public Safety and Inspections _� (T Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number. ) f• 500 Date Applied: Building Official: SECTION 1:LOCATION L 141 Damon Road Northampton 01060 No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # 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 l>ix Repair 0 Alteration Cl Addition 0 Demolition ❑ (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other &)c Specify: roof replacement Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No I Is an Independent Structural Engineering Peer Review required? • Yes 0 No Cox Brief Description of Proposed Work remove existing shingle roof and install new shingle roof of front middle section only 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) 0 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 Cl A-2 0 Nightclub ❑ A-3 0 A4 0 A-5❑ B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 Hal 0 H-5 0 I: Institutional I-1 0 I-2❑ I.3❑ I-4❑ M: Mercantile 0 R: Residential R-ID R-2❑ 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&CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ HA El IIBO MA 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 A trench will not be Licensed Disposal Site 0 Public 0 Check if outside Flood Zone 0 Indicate municipal 0 `l oham Rd required Cl or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 E Windsor CT-USA Waste 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❑ Yes❑ or No 0 Yes 0 No 0 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 Easthampton Mahadev LLC PO Box 389 Easthampton 01027 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Naresh Patel tit; _aft - eiy.‘ _ - Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: RCI Roofing LLP 6 Line Street Southampton MA 01073 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 CI. 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) Mark Delisle 413_204 _3207 mdelisle@rciroofing.com CS-074334 Name(Registrant) Telephone No. e-mail address Registration Number 32 Old County Road Southampton MA 01073 5/3/2026 Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Company Name 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 submitted with this application. 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® No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Estimated Costs:(Labor Item and Materials) Total Construction Cost(from Item 6)=$ 15,000 1.Building roofing $15,000 Building Permit Fee=Total Construction Cost x$7 (Insert here 2.Electrical $ appropriate municipal factor)=$105 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$100 (contact municipality) 5.Mechanical (Other) $ Enclose check payable to City of Northampton 6.Total Cost $15,000 (contact municipality)and write check number here 3 G$20 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest and pains and penalties of perjury that all of the information contained in this application is true and accurate to the best dge and understanding. Mark Delisle Partner 413 204 3207 6/19/2024 Please print and sign name Title Telephone No. Date 6 Line Street Southampton MA 01073 mdelisle@rdroofing.com Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: ,///0 (O'Z(v'WZ/ Name Date City of Northampton Massachusetts 4�5 1� rem < z DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Jti OD Northampton, MA 01060 Js,-,Y �^J 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: Shoham Road,E Windsor CT Location of Facility: The debris will be transported by: Name of Hauler: USA Hauling&Recycling Inc Signature of Applicant: Date: 6/19/2024 6/19/24, 10:42 AM Google Maps Go gle Maps 141 Damon Road, Northampton MA- Easthampton Manaaev LLC y p f' ,"t j go .. }per l o ;'''s '; •� t J'''G/1 b t �!+. ♦.- ►l ,}n • -"+97f" ! '34, '''"•..,,...' A .41. ' .4't. '‘IN\ Niscif,e' 4' ' a > `r _ ! _ " 4`1t itA "-s-' Jyy-4 ". , * y " lit " . 1. • !. 1.: +'.. 4 Ow e - ,. i i. _ r • 1,1 r . 91 ti ••••• ' 0 7, ..,. „ ,..,......, ,„,,.. r .,... ,,,„.., .r ,,, .` •. gig -._ r _ IL"'1' - -� - . yak'r ... "ir .,�\ Google .,91 --i Imagery©2024 Airbus,Maxar Technologies,Map data©2024 Google 50 ft only the area outlined https://www.google.com/maps/@42.3381781,-72.6305607,162m/data=!3m 1!1 e3?entry=ttu 1/1 Estimate# RCI, Roofing1 , Estimate 6 Line Street Date 6/13/2024 Southampton MA 01073 Phone(413)527-4775 Fax(413)527-8469 Job Location 141 Damon Road Northampton MA Easthampton Mahadev, LLC Naresh Patel PO Box 389 Easthampton MA 01027 Terms Estimate valid for 30 days Description Total Estimate For Entire Roof-- 73,000.00 Remove existing roofs. Furnish&install aluminum drip edge, pipe flashings,chimney flashings(if needed)and step flashings. Furnish&install CertainTeed Winterguard ice&water barrier, 6 feet along eaves and 3 feet in valleys. Furnish and install synthetic underlayment over existing deck. Furnish and install Lifetime CertainTeed Landmark Series shingle. Furnish and install CertainTeed approved ridge vent. All exterior roofing related debris to be removed by R.C.I. Roofing. All work will be performed according to manufacturers'specifications. Lifetime CertainTeed material warranty included. All related permits will be obtained by R.C.I. Roofing. ***Due to fluctuating material prices,any wood decking replacement needed would be an additional charge based on the material price and additional labor at the time of installation. Front Middle Roof ONLY-estimate wo • be$15,400 4d1 eg-::(1-1)1) Total $73,000.00 RCI Roofing LLP- Customer Signature: Registration# 126235 Construction License#074334 Insured by Banas&Fickert Ins.(413)527-2700 Date: Customer is responsible for any costs associated with collections including attorney fees. AC� DATEIMMDDYYYY) ��. CERTIFICATE OF LIABILITY INSURANCE 10/31/2023 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(ies) 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 endorsement(s). PRODUCER CONTACT Michael Banes NAME: BANAS&FICKERT INSURANCE AGENCY (A/O N FAX No. (413)527-2700 (A/C,No): _ E-MAIL ADORES: so@banasinsurance.com 63 MAIN ST INSURER(S)AFFORDING COVERAGE I NAIC1 EASTHAMPTON MA 01027 INSURER A; AIM MUTUAL INS CO 33758 INSURED INSURER B: RCI ROOFING LLP INSURER C. INSURER D: _ 6 LINE STREET INSURER E: SOUTHAMPTON MA 01073 INSURER F: COVERAGES CERTIFICATE NUMBER: 946271 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 ADM SUER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MWDDIYYYY) (MM/DDIYVYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE , OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ _r MED EXP(Any one person) S N/A PERSONAL&ADV INJURY S GEM.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY JET n LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE N/A AGGREGATE S DED RETENTION$ �/ H $ WORKERS COMPENSATION STATUTE ER /PAND EMPLOYERS'LIABILITY Y N ANYPROPRIETORARTNER/EXECUTIVE ! E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? ® N/A N/A VWC10060226472023A 10/05/2023 10/05/2024 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 II yes.describe under J DESCRIPTION OF OPERATIONS below ,E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage- Coverage Verification Search tool at www.mass.gov/lwd/workers-compensationfinvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Reference Copy ACCORDANCE WITH THE POLICY PROVISIONS. Reference Copy AUTHORIZED REPRESENTATIVE Southampton MA 01073 Daniel M.Crowlly,CPCU,Vice President—Residual Market WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACC)RDJ CERTIFICATE OF LIABILITY INSURANCE DATE(M'd CD YYVv) 03/21/24 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 policy(ios)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 endorsement(s). aRODUCER CONTACT NAME: Michael R.Banas Banas&Flckert (A/C.PHONo.Extl: 413-527-2700 AX (A/C,No: 413-527-0849 Insurance Agency E-MAIL 63 Main Street ADDRESS: mb@banasinsurance.com Easthampton,MA 01027 INSURER(S)AFFORDING COVERAGE NAIC S INSURER A: Admiral Insurance Co. 24856 'INSURED INSURER B: Safety Insurance Co. 39454 RCI Roofing,LLP INSURERC: Admiral Insurance Co. 24856 6 Line Street INSURER D: Southampton, MA 01073 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 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. ILTR ADDLBR POLICY EFF POLICY EXP TYPE OF INSURANCE INSD MD POLICY NUMBER MI(MDDlYYYY) (MM/DDlYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE TRtN CLAIMS-MADE n OCCUR PREMISES(Ea occu� rtence) $ 50,000 MED EXP(Any one person) $ 5,000 A X CA000020963-10 03/04/24 03/04/25 PERSONAL 8 ADV INJURY $ 1,000,000 GM.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 nPOLICY PECOT- LOC PRODUCTS•COMP/OP AGG $ 2,000,000 OTHER: ____ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ 1,000,000 B OWNED x SCHEDULED X 6207761 09/30/23 09/30/24 BODILY INJURY(Per acddent) $ 1,000,000 _AUTOS ONLY ` AUTOS x HIRED x NON-OWNED PROPERTY DAMAGE $ 1,000,000 AUTOS ONLY AUTOS ONLY (Per sccidenll X UMBRELLA LIAB x OCCUR EACH OCCURRENCE $ 5,000,000 ` C EXCESS LIAB CLAIMS-MADE X GX000000385-08 03/04/24 03/04/25 AGGREGATE $ 5,000,000 DED X RETENTIONS 10,000 $ WORKERS COMPENSATION PER W- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNERIEXECUrIVET N/A E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ROOFING CONTRACTOR. 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. Reference Copy AUTHORIZED REPS, S IIIVE I . 4 8t..$15 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD vis o Occupational ofa Massachusetts Construction Supervisor Division of Occupational Licensure Unrestricted-Buildings of any use group which contain less than Board of Building Regulations and Standards 35,000 cubic feet(S91 cubic meters)of enclosed space. Consio �nt 61), r isor CS-074334 cpires: 05/03/2026 cr MARK THOMAS DELISLE s 6 LINE STREET O SOUTHAMP1N MA 01073 r . G• 1U/,; Failure to possess a current edition of the Massachusetts State Budding Code Is cause for revocation of this license. C / ' ! s^— Contact OPSI:(617)727.3200 or visit www•mass.gov/dpilopsi Commissioner ..�"^^'^Q W CONSTRUCTION CONTROL WAIVER From: _ i--thee 5 4- S Dvt.1/44 a m.p-}a r !Y1 O, c>-7 3 To: 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 I y Da&ton d It i-4- 1a.m,Q4an A'1 A 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,