23A-014 A D A\ ......,
VISA MasleF era DIJCOVER
NIN■li
aU EN .i „MLLE www.1800newroof.net
ROOFING & IDING, INC.
160 Old Lyman Road, South Hadley, MA 01075 We Are Licensed
1 -800- NEW -ROOF • 413-536-5955 Fully Insured
Email: info @1800newroof.net Factory Trained
MA Construction Supervisors Lic. #070626 MA Registration #120982 Factory Certified Installers
Member of the Home Builder's Association of Western Mass. CT Registration #575920
Member of the Building & Trade Association Member of the Better Business Bureau P.P.C. 38710
Proposal Submitted To: Date r/ Phone #'s Work:
,.. t- „„„/ 1 y /3 /ri H: 7 s--7s-_ 9, Cell:
Street Email:
as PAL./ S7
City, State, Zip Code Special Requirements J
/oRriic.e iii oijoz_a £ Ptove�t + vr,� SLPc al v. ( >/y
f` (c)— OP S " Cok Nf evQ/ / i
F ( r
Complete Roof System
IX We shall acquire all appropriate permits for all work
[-1 Home exterior and landscaping to be protected
21 Entire existing roofing materials to be removed to existing decking
N Deteriorated existing decking will be replaced at $3.47 per sq.ft.
[N Install Ice & Water Barrier at all eaves, valleys, chimneys, pipes, skylights and sidewalls 3
M Install (15 Ib. felt - i underlayment over remaining decking area
Ni' Install Metal drip edge at eaves and rakes() / 5" whit / brown / copper)
1`29- Install manufacturers starter shingle on all eaves and rake edges
ti Install new pipe boot flashing 'standar• / copper)
g Install new step flashing where necessary standa/ copper)
O Install Hand nailed rigid baffled continuous ridge vent
❑ Install proper soffit ventilation
Shingles: (6 nails per shingle)
CA' r Shingles ❑ 25 year NY 30 year ❑ 50 year Coloree - - 4-L
(;A T= Ridge cap shingles
Warranty Options:
® We guarantee our workmanship for 10 full years (see our warranty coverage)
g GAF ELK System Plus warranty ' ' \A a I i
Ill GAF ELK Golden Pledge warranty ' O /
Chimney Options: �' ',
(c �f`1cs S I
IZ Lead Counter Flashing ❑ Water Sea, & Tuckpolnt j Rubberized Crbw ❑ Metal Chimney Cap
We Propose hereby to furnish materials and labor complete in ac or an a with above spe / ifications for the sum of:
Total Sale Price $_ //; '100 Down Payment $ 4 Upon Completion $ –. 2 r l U 0
ACCEPTANCE OF PROPOSAL: The above prices, specificktions and conditio re satisfactory and are hereby accepted.
You are authorized to do work as specified. Payment will be and balance due upon completion.
Unpaid balances shall accrue with interest at 18% per annum. Purchaser(s) will pay for all costs, expenses and reason-
able attorn fees incurred by Adam Quenneville Roofing and Siding, Inc. to recover any sums due under this contract.
Date: V/ / Signature: /° � Phone # 7 / 3 `S7"5 ° //
Date: Y�3 //d Estimator's Signature: .f�✓ ��
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.
1/09
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑ `G�
Name of License Holder : ‘'g
Adam Quenneville Roofing & Siding Inc. License Number
160 Old Lyman Road ,% 2 7-
Address South Hadley, MA 010(5 Expiration Date
Signature Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
Company Name Registration Number
Adam Quenneville Roofing & Siding Inc. ? ` .5 - r ��
Address 150 Old Lyman ROaO Expiration Date
South Hadley, MA 01 0 5 e
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (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 ❑
11. — Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (I) 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 ierformed 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
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Ea Siding [0] Other [01
Brief Description of Proposed
Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a. If New house and or addition to existing housing, complete the following:
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. Masscheck 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
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
■
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, erni Q it) e n , t`C ( 1 1/ 7= fl60 / f / f' as Owner /A
Agent hereby declare that the statements and information on the foregoin plication are true and accurate, to the best of my knowledge
and belief.
Signed un r the pains and penalties of perjury.
A
Print Name . -_ q /'
Signature of Owner /Agent Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete 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 Q DONT KNOW Q YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ; DONT KNOW 0 YES t
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
R� ���� 2 '6 2 t1,0 _
212 Main Street Sewer /Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413 -587 -1240 Fax 413 -587 -1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
2 Map Lot Unit
(apri � S` 7
Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: � evil'
r�� f ' ie Stow l aZ
Name (Print) Current Mailingr,sy J 2 , g'
Telephone //
Signature
2.2 Authorized Agent: _ j
/ (�'r rh av r rr �� f ' i ✓ j fi ecla t('yr / kook/ l / ✓h tt t1 Rc SCE: gethy
Name (Print) Current Mailing Addres
X3
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building qila , (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) / r Check Number /7/97
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
•
BP- 2010 -0970
GIs #: t COMMONWEALTH OF MASSACHUSETTS
,` U ap: lock: 23A - 014 ' CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -0970
Project # JS- 2010- 001432
Est. Cost: $11900.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ADAM QUENNEVILLE 070626
Lot Size(sq. ft.): 17598.24 Owner: STOWELL JETT E JR & SANDRA
Zoning: URB(100)/ Applicant: ADAM QUENNEVILLE
AT: 22 PARK ST
Applicant Address: Phone: Insurance:
160 OLD LYMAN RD (413) 536 -5955 () Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON:4/29/2010 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & 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 4/29/2010 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo