Loading...
32A-229 (3) BP-2024-1385 48 POMEROY TERR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-229-001 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-2024-1385 PERMISSION IS HEREBY GRANTED TO: Project# 2024 ALTERATIONS Contractor: License: Est. Cost: 7500 RICK LIGHT CONSTRUCTION CS-056457 Const.Class: Exp.Date:01/08/2025 Use Group: Owner: COLLEGE CHURCH INC THE Lot Size(sq.ft.) Zoning: URC Applicant: RICK LIGHT CONSTRUCTION Applicant Address Phone: Insurance: 25 BOYDEN RD (413)253-9492 PELHAM, MA 01002 ISSUED ON: 10/22/2024 TO PERFORM THE FOLLOWING WORK: REMOVE 3 EXISTING WINDOWS, REPAIR SIDING, INSULATION & WATERPROOFING AS NECESSARY POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector t nderground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: 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: 72_ Fees Paid: $125.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner a c-, s The Commonwealth of Massachusetts T Office of Public Safety and Inspections HH 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 NumbV ?.4-1386 Date Applied: Building Official: SECTION 1:LOCATION if S PawuNoy Tie ov ypA-, rill- (itclz. tt' 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 Buildinal Repair ili Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No 0 Brief Description of Pro•• .• Work (X..: IN J` ?-v 1-`f ► -., fY�-Q � •9 � Gc ' Jew.p 1 �U t 3 k5 --(,•Jcp+ 5/2 �f kiv t-r9�l 4( tnA 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) D Existing Use Group(s): (Xc.,-o,, &. 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 0 Nightclub 0 A-3 ❑ A-4 0 A-5 0 B: Business Pi E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4❑ 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) uJOoa( Fife ,Q IA 0 IB D IIAD IIBO IIIA0 IIIBD IV 0 VAX, VB 0 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 Public 0 Check if outside Flood Zone 0 Indicate municipal 0 required Cl 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❑ 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 Addrof Property Owner ce t� 2 * 176, crd y 7:04vp d v(� ^, Will /Nob 0 Name�t) No.and Street City/Town Zip Property Owner Contact Information: ct- 4t dtp qa - - Oo 1 - Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: j R1d- Ll°ice z-s- ,�/ -Tt Of P42/t1 --, I41I1 otom - ?21 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 O. 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 10.2 General Contractor Company Name P2.(,'.G- L 44- c-4 05oi-tg? If Name of Person Responsible for Construction License No. and Type if Applicable Street Address City/Town State Zip '113 -`fl7- 32,76 jc'ek l 1•11,1- (e!s 0 wla i( _ cevvx Telephone No.(business) Telephone No.(cell) e-mail ad 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$L No CI SECTION 12•CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ '�r L? d, aBuilding Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)_$ . 3.Plumbing $ . o a 4.Mechanical (HVAC) $ Note:Minimum fee=$SZ� (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ 7f 5 ) - 07) (contact municipality)and write check number here-0 5 it 31 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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 m knowledge and understanding. riCii4-0( II--- L(14 2-ix/lie et‘okiVc:?-(C"r iii3_IP- 32A ty,11 .2-5-BPlease_p t signannd _name r>4201/4 %" /'Vt tle 17t CC — el_ho�c a. A e 1 t�fN„` Street Address {I Dr'�` City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: /7/.2 ID-22-ZQZ� Name Date The Commonwealth of Massachusetts )' Department of Industrial Accidents L ....71 Congress Street,Suite 100 1 x, Boston,MA 02114-2017 t.,. Y s i .. ww .w mass.gov/dia 11'wters'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. i'O BF:FILED Willi 7"HE PLRMITI'IM AtriHORITli. AomIieant Information ls Please Print Letib Name 4Rusiness•(hgaru�aticrt Itdividuall: V I{�L t-s. /1 . t tjv (uf'- Address: 25..s goyd(s... te City/State/Zip: p.QCtt6w-4{ 44.1 - OI Phone#: 1{(3 107-37-74 _ Are yam se employer?Cheek the appropriate hat: Type of project(required): ICJ I am a ennploy.c VAsth employees(full and of part-tine)_• 7. 0 New construction 2r am a soh proprietor or purtnetabip and haw no empllly ors working for me in 8. 0 Remodeling am e-apacity.[No worker,'comp.Iwuran.x required_j 9. ❑Demolition 30 I am a homeowner doing all work myself.[No weaker.'comp insurance requinsl.)' 4.0 I am a homeowner and a all he hiring contractors to conduct all work on my property. I will 10 o Building addition envun that all contractor,either have workers'compensation rnsuranet or are sole i I fJ Electrical repairs or additions prupnet,rrs w nth no employees 12.0 Plumbing-� � repairs or additions n 50 I am a general contractor and I have hued the sub-coitraetu listed on the attached,beet }3- Roof usThese sub-contractor,liars employees and have workers'comp.insurance. / 6.0 We are a corporation and its alums have exerciaal thew right of esemptkm per 5L 1(. c. i 4.�()ther 152.41141.and we have no mtployees.(No workers'camp.eestsance required.] *Any applicant that duals boa a I mud oho fill out the section below show ing their workers'compensation policy information 1 homeowners who srlbttut this affidavit indicating they are doing all work and then hire outside contractors rnu,t suhnut a iww ut'frsfav it indicating such. :contractors that cheek this boa must attached an additional sheet show ing the name of the sub-cwnutrae'tors and state whether tr not those enutli's luv e rrelployee, lithe soh-contractors have cmpluyces.they must pro,.ide their a,rkcr,'comp pohcy number I am an emplul•er that A providing►sorAers'compensation insurance far my employees_ Beton'is the policy and jolt site information. insurance Company Nam,: Policy#or Self-ins.Lic. »: Expiration Date: Job Site Address: City/StateZZip: 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 S 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 S250.00 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. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Allip.1 Stdnatwe: J2 z '. Date: It)((7/2-Y Phone c: q13 'I Z?' A A'i Official use unIt'. Do not write in this area,to be completed by city or town official (-it) or i-unn: Permit'1.icense d Issuing.tutharit Icircle one): I. Hoard of[health 2. Building Department 3.('its+'rossn clerk 4. Electrical Inspector 5. Plumbing inspector 6.Other contact Person: Phone 0: Initial Construction Control Document vtil To be submitted with the building permit application by a �l Registered Design Professional '� #1 for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Misc Maintenance&Repairs for 48 Pomeroy Terrace Date: October 15,2024 Property Address: 48 Pomeroy Terrace,Northampton,MA 01060 Project: Check(x) one or both as applicable: New Construction X Existing Construction Project Description: Misc.maintenance&repairs for 48 Pomeroy Terrace Northampton MA I,Curtis A.Edgin, MA Registration Number:7352 Expiration date: 08/31/2025,am a registered design professional,and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerningl: X Architectural Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a'Fig . Con // ' • ocument'. Enter in the space to the right a"wet"or S electronic signature and seal: ! . J 10 - r ," Phone number:(413)594-2800 Email:cedgin@cbaarchitects.net r Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an'x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen,provide a description.Version 01_01_2018 RICKL-1 OP ID:PM ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YVVY) 10/16/2024 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(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 413-788-4531 CONTACT Goss McLain Insurance Goss&McLain/Chase Clarke PHONE FAX Physical: 59 Bobala Holyoke MA (A/C.No.Ext):413-788-4531 I(NC,No):413-214-6160 PO Box 9031 E-MAIL SS:spremo@chaseins.com ADDRE Springfield,MA 01102 Chase Clarke Stewart INSURE R(S)AFFORDING COVERAGE MACS INSURER A:Atlantic Casualty Insurance 42846 INSURED INSURER B: Rick Light DBA Rick Light Construction 25 Boyden Rd INSURER C: Pelham, MA 01002-9721 INSURERD: 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 TIIIS 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. NSR ADDL SUER POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INS- WWI POUCY NUMBER (JaMpDfyyyY) IMMIDDryyyY1 LASTS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAMS-MADE X OCCUR L261008304 02/232024 02/23/2025 DAMAGE TO RENTED 100,000 PREMISES(Ea oxurrence) S MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEM_AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY n mt. LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER, S AUTOMOBILE LIABILITY (Ea a acccident)SINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ — OWNED — SCHEDULED AUTOS ONLY _ AUTOSUµ� BODILY INJURY accident) $ AUTOS ONLY _ AUTOS ONLDY (Per nt) GE -S S _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S OFF10ERl1 EMBER EXCLUDED? N/A (Mandatory InNHH) E.L.DISEASE-EA EMPLOYEE S If yes.describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be 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 City Of Northampton ACCORDANCE WITH THE POUCY PROVISIONS. 212 Main Street Northampton, MA 01060 AUTHORIZED REPRESENTATIVE Chase Clarke Stewart ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORO® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/16/2024 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(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 CONTNAME. Peggy Pay Marshall CHASE CLARKE STEWART&FONTANA (NHONN Ea* (413)788-4531 FAX No): E-MAIL , d ADDRESS: _ ha PO Box 9031 INSURERS)AFFORDING COVERAGE NAICa Springfield MA 01102 INSURER A: CONTINENTAL CASUALTY CO 20443 INSURED INSURER B LIGHT RICK INSURER C: DBA RICK LIGI IT CONSTRUCTION INSURER D: 25 BOYDEN RD INSURER E: PELHAM MA 01002 INSURER F: COVERAGES CERTIFICATE NUMBER: 1055102 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 POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -AXXP LTR TYPE OF INSURANCE INSp wv POUCY NUMBER (NMIIC YYPOUCYYYYY) (M/D VPOUCY EYYYY) LDS n COMMERCIAL GENERAL LNBRITY EACH OCCURRENCE-DAMAGE TO RENTED S CLAIMS-MADE OCCUR PREMISES tEa occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEM AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE $ POLICY PRO- IECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED — SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS ONLY __ AUTOS HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLABAS-MADE N/A AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION x ME ER AND EMPLOYERS'LIABILITY A nY TERLUoX Si-EACH ACCIDENT $ 100.000 OFFIC MBREXCD N/A NIA 6S59UB1K76768A24 03/12/2024 03/12/2025 (Mandatory In NH) El DISEASE-EA EMPLOYEE $ 100,000 II yea describe under DESCRIPTION OF OPERATIONS below El DISEASE-POLICY LINT $ 500.000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/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/Iwd/workers- compensation/i nvestigations/. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POUCY PROVISIONS. 212 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 Daniel M.Crowley,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 City of Northampton oQtN Mi- S`5'.JM..SIC �'� Massachusetts F. .4•- 'e ,t G : t 4 . 4 DEPARTMENT OF BUILDING INSPECTIONS �k, " ,,x, �:'_ .%la" 212 Main Street • Municipal Building yv `a� Northampton, MA 01060 rye . ‘ 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: Vc ' ( p C Location of Facility: 2-5-f 6.s -[ 0/ LAW G�,y/ ,-i 1y1$ The debris will be transported by: Name of Hauler: tCk, L1 e)r Signature of Applicant: /,--)4/ 2t ,V!/ Date: ( / 4vl ? 2- v` rF ti k r k sinstall remove window & =, > < 3siding #3 — flashing, PVC trim & x `. ,1wt4 ~- =siding siding #2 err ..r. no room for adequate . r, remove & replace trim board roof flashingat window • t t,-� N with PVC & provide flashing siding #1 _ j ��� L a .' �r , along this roof line y �k leaks inside vestibule w '- , z;. x , along this wall . H R _�^_ remove & replace tri .. „ € with PVC & provide along this roof line r• der e.s. � $ __".'.a-.......+•.#.f`�' �-"'w,.°--' ,± a ........ '.wM'. • 3 4 i . : --- ,.- , v "'..' ‘° '" Vj 17' .-- L-ll',".1.‘:4::::: * VK s. „ ... r< k