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25C-138 (4) BP-2024-1372 185 NORTH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25C-138-001 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-2024-1372 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2024 Contractor: License: Est.Cost: 13000 099565 Const.Class: Exp.Date:05/28/2025 Use Group: Owner: LABATO THERESA S TRUSTEE Lot Size(sq.ft.) Zoning: URB Applicant: Applicant Address Ph ne: jnsuranee: ISSUED ON: 10/18/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF 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: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 172. Fees Paid: S135.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner & The Commonwealth of Mpachtpsett®cT 1 8 2024 1 Board of Building Regulations landStandards I FOR Massachusetts State Building el,t80 CMR l MUNICIPALITY t".:'T hF F.tif ��'ri 1NFPCCTIONS USE Building Permit Application To Construct,Re air,ftenoNatle�s'tt, ernottos a Revised Mar 201I One-or Two-Family Dwelling .._._ /` This Section For Official Use Only 4r A`Building Permit Number: f.' 13 Date Applied: 7 41.11 2ditrrgWial(Print Name) azure Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers / 8� �� 1.1a Is this an accepted street.yes no Map Number Parcel Number 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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: ��✓k ,fi� / t TVI{1rQS`'I Lci iV 1 ' Name(Print) City,State,ZIP 'c IJOAw—, Se)' (o ,e,3 77l No.and Street Teleishonr 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 Cl Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed W kk2: rl 4 S t r 1( vV-e-v )-0 . 4- de 4,4 i't 4- 5-0-f c SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: '\', AN Check No q1 Check Amount: Cash Amount: 6.Total Project Cost: $ q i 0 W•W ❑Paid in Full 0 Outstanding Balance Due: -N �ko\SZ c=—S2-Q_ SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Sup sor License(CSL) 079565 0 /a,101 as �(.�Vv J1 Lit in 1..�./ License Number Ex irauone Name of CSL Holder n c(O �, 1 CQ� � ct 1 ./ • List CSL Type(see below) No.and S eet A Type Description u 1 r Oi Jr U Unrestricted(Buildings up to 35,000 cu.ft.) ✓•\�'�'f R Restricted l&2 Family Dwelling ityrfown,State,ZIP 1 Masonry RAC Roofing Covering WS Window and Siding ��2�� 6 3S 1 I Solid Fuel Burning Appliances Insulation elephone Email address D Demolition 5.2 Registered H me Improvement Contractor(HIC) 1 /-y 94, ( O. , ,� FlI,l �1 /lJ iS 1v1� HIC Registration Number Expiration 1. Company Na a c}HI Registrant Name iiS at&reet , (� _ �� 1' atl a dd ress s5Toint ga,q131/1 Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be mpleted and submitted with this application. Failure to provide this affidavit will result in the denial of the lssu e of the building permit. Signed Affidavit Attached? Yes No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize kJ f)I / V 'J7j ) f ( • to act on • .1 alf,in all matters rel t or authorized by this buil ing permit application. ,p — 1 / /!i ..kla /0 (7- )C ( Print Owner's Name(Electronic Signature) 1)atc 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 i this application is true and accurate to the best of my knowledge and understanding. tnt wner's or Authorized Agent's Name(Electronic Signature) Date NOTES: I. 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 not 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 www.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" City of Northampton bs' � ))k j ,\y 4/ ,/: Massachusetts , ' f1DEPARTMENT OF BUILDING INSPECTIONS r 212 Hain Street • Municipal Building ', /- Northampton, MA 01060 144, .3...10 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: Location of Facility: ( Cr (( 1 C,A,5d-( 11, O/IA / oi The debris will be transported by: w Name of Hauler: (Gi n ilc; 6Lk Signature of Applicant: . Date: /4)-/-7, The Commonwealth of Massachusetts i ` • I Department of Industrial Accidents U) ��? ! ik• 1 Congress Street,Suite 100 \,c ,::iP., ,F, Boston,MA 02114-2017 " �,�'• www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Name(Business/Organizational/Individual):nrb exteriors Inc Address: 510 new ludlow rd City: so hadley State: ma Zip: 01075 Phone s: 4135636354 Are you an employer?Check the appropriate box: Type of project(required): I 11. I am an employer with 1 0 employees(full and/or part time)* 7. New construction a2. I am a sole proprietor or partnership and have no employees working for me in any 08. Remodeling capacity.(No workers'comp.insurance required.) i9. Demolition 03. I am a homeowner doing all work myself.[No workers'comp.insurance required)t 010. Building addition ❑4. I am a homeowner and will be hiring contractors to conduct all work on my property. 011. Electrical repairs or additions I will ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 1112. Plumbing repairs or additions n5. I am a general contractor and I have hired the sub-contractors listed on the attached n 13. Roof Repairs sheet. These sub-contractors have employees and have workers'comp.insurance.t 06. We are a corporation and Its officers have exercised their right of exemption per MGL. 014. Other c.152,§1(4),and we have no employees.[No workers'comp.insurance required.) *Any applicant that checks box N1 must also fill out the section below showing their workers'compensation policy Information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit Indicating such. iContractors that check this box must attach 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: american Zurich Policy a or Self-ins.Lic.#: 6zzub9f59768624 Expiration Date: 02-13-2025 Job Site Address: ' S ," J/ '�C" �• l`'+ ton rrte-^ 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$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ✓ I do hereby certify under the pains and penalties of perjury that the information provided above Is true and correct,and that clicking this checkbox and typing my name In the field below will act as my signature. \\ Name: nicholas bernier Date: Iv 17 Phone#: 4135636354 Email: nrbexteriors@comcast.net ACC)RD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIVYVY) 06/12/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Denise Sawicki NAME: AMHERST INSURANCE AGENCY INC PHONE (413)253-5555 FAx LA G.No,ExU (AIC.Nol: E-MAIL_ADDRESS: dsawicki@ nathana9 encies.com PO BOX 48 _- INSURER($)AFFORDING COVERAGE NAIC• AMHERST _ MA 01004 iNSURERA, AMERICAN ZURICH INSURANCE COMPANY 40142 INSURED INSURER B N R B EXTERIORS INC INSURER C: INSURER D 72 WOODBRIDGE TERRACE INSURER E: SOUTH HADLEY MA 01075 INSURER F: COVERAGES CERTIFICATE NUMBER: 1017437 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 ADDL STAR —POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/ODIYYYY) (MM/DDM'YY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ TO RENTED CLAIMS-MADE OCCUR PREMISES(Es occurrence) S MED EXP(Any one parson) $ N/A PERSONAL 6 ADV INJURY S GEN1.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY n JECT n LOC PRODUCTS.COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ma accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED N/A BODILY INJURY(Peraccident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _AUTOS ONLY (Per accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE _ S DED RETENTIONS _ $ WORKERS COMPENSATION X STATUTE ER H AND EMPLOYERS'LIABILITY — - A OFFICANYPR PRIET ERE CINERIE ECUTIVE Yj—, WA WA 6ZZUB9F59768624 02/13/2024 02/13/2025 E.L.EACH ACCIDENT S 100,000 (Mandatory In NH) l 1 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1 N/A DESCRIPTION OF OPERATIONS/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/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF SOUTH HADLEY BLDG DEPT ACCORDANCE WITH THE POLICY PROVISIONS. 116 MAIN STREET AUTHORIZED REPRESENTATIVE SOUTH HADLEY MA 01075 1" 0 L .9 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 1�) urvision oT occupational Licensure Board of Building R ulations and Standards Constructir uuppei4 r Specialty 7 U\ c )s CSSL-099565 spires:05/28/2024 4 NICHOLAS _ �� rj I " Q�� QC) 510 NEW Ll1pL• SOUTH HADetY • I fv Commissioner U+ THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingtori $treet - Suite 710 T Boston Massachusetts:-02118 - Home ImprovemeaCWaofRegistration Type: Corporation NRB EXTERIORS INC _Registration: 147961 Expiration: 08/22/2025 510 NEW LUDLOW RD SOUTH HADLEY, MA 01075 _ - • Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE::Corporation Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 147961:.7, 081 (2025 Boston,MA 02118 RB EXTERIORS ING ICHOLAS R.BERNIER 2 WOODBRIDGE TER __ t,,e.c✓% 'aGosok' " /� OUTH HADLEY,MA 01075 I InriorcPrretary '� Not valid without sianature rutty LICeuatu aim -usut eU .W -'''"'C4(gn/ -.-- •.-.. ------- MA fteg#20-2015718 1�IRB South Hadley,MA 01075 ,_.-M Lic#: 147961 MA CSL#:99565 !1' 0 , '4 A Cell:413-563-6354 � Office:413-707-ROOF(7663) • v �i 413-707-ROOF (7663) /.:'i•, � 1� SHINGLE a RUBBER 1 GUTTERS.- NICHOLAS BERNIER s-'�+—"'l• RoofPros413.com (Owner) RoofPros@comcast.net Pro al submitted Itoo Phone# h: fl?"tj& Y r 7 7( c: V9�!-7d y.S` lies �4 Special requirements Street � ,w ; Ds^ City ate,zip code NW 1'i—n fzi- 1/7, � �I` Otis f wCti �,6a Proposal to furnish yid install the following F e,�a. eHt,,,1 C�.,`to j'..�.�-.5 NJ-Y/4- 0 A�`t I ❑-,/Re-roof Tear-off 0 Gutters (0fCO)4,4' iA.d� C7 We shall acquire necessary permits for all work *(°6 eke C4 "t(ft� �D /�., f Complete Roof Preparation L U/2'' l-�. L 1 cQ /c'l 5 U� 0- Home's exterior to be protected by tarps and plywood 8r Shrubs,landscaping,trees to be protected,roofers buggy used gr Entire existing roofing materials to be removed to existing decking,including flashing,etc. EC Site to be cleaned on a daily basis with roll magnet,debris to be removed at project completion by dumpster 2' Deteriorated existing decking to be replaced at per sheet of plywood go,0 ci p2Z 1 .�.. Complete CertainTeed Integrity Roof System Vie,t)l) P / u 4,0 04' t� gf Install Winterguard ice&water barrier along bottom 0 3 ft.of all roofs,ff 6 ft. Er Install Winterguard ice&water barrier around penetrations,in valleys and all critical areas C4/ Install CertainTeed Synthetic underlayment to entire decking Install 8"perimetef metal flashing to all edges of all roofs,E%hite ❑brown V Install SwiftStart starter shingle to bottom and rake edges of all roofs Q( Install CertainTeed shingles to manufacturers specifications,0 6 nails El4 nails 12' Install CertainTeed PVC ridge vent to all peaks in heated areas [" Install Shadow Ridge to all hips and ridges,over ridge vent where applicable (r Install new lead counter flashing to chimney ( New flashing installed where necessary [ Install new pipe flashing to waste vent stacks Warranty options L47/We guarantee our labor/workmanship for 20 years * ❑ pgradc CertainTeed 4-Star Sure Start Plus,50Tyear nonprorated coverage 1 ' CertainTeed Landmark-color: 62//-1'a 14t D`34 ❑ CertainTeed Landmark Pro-color We propose hereby to furnish materials and labor-complete in accordance with above specifications for the suum otall���j��$ I tom" �'CIK ►�a ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions arc - 1/3 E1 Payment $ t}-S". D v?r? satisfactory and are hereby accepted.You are authorized to do work as specified. Balance due ,{ Payment will be 1/3 down at start of ob and balance due upp n fo pletii n. upon completion $ '�(, 00 Date:Oci,1a;WV Signature: INkisL 1 c 1 ' Date: /U fEstimator:(Print Name) ,/,`-‘)4/ / (Sign Na Estimates are honored for thirty(30)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 in through cracks of the wood.NRB Exteriors Inc.will not be responsible for debris or dust in the attic or storage areas. A Finance Charge of I '/%monthly(ANNUAL PERCENTAGE RATE OF 18%)will be added to the unpaid portion of the balance due.I agree to pay and/or guarantee payment of these charges.In the event of default of payment,I agree to pay reasonable Attorney's fees and court costs.This agreement does not constitute a release of liability.By my signature below,acknowledges an agreement of the above is hereby made AA,,'' Q��' Signature: l 'IQ .. 4. t agi9/4