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24C-182 (5) RC '. Roofing 6 Line St. Southampton, Ma. 01073 ESti � at a Date Phone (413) 527 -4775 7/16/2010 Fax (413) 527 -8469 Name / Address Job Location Tom Lowry 212 Crescent St. 212 Crescent St. Northampton, Ma. 01060 Northampton, Ma. 01060 (413) 584 -6168 Terms Rep Estimate valid for 30 days Dave Job Description Total Remove existing porch roofs. 2,500.00 Furnish & instal! aluminum drip edge. Furnish & install new lead counter flashings. Furnish & install CertainTeed Winterguard ice & water barrier along eaves and valleys. Furnish and install synthetic underlayment over existing deck. Furnish and install 30 year CertainTeed Woodscape Series shingle. All exterior roofing related debris to be removed by R.C.I. Roofing. All work will be performed according to manufacturers' specifications. 5 -year RCI Roofing workmanship warranty included. All related permits will be obtained by R.C.I. Roofing. Add $2.50 per sq. ft. for wood decking replacement if needed. WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total $2,500.00 TERMS OF PAYMENT (7://2 5`h Deposit Balance upon completion Registration # 12(1235 Customer Signature f � Construction License # 074334 Insured by Banas & Rickert Ins, Date 7/2, ,/ t D 4 7----NN 413 - 527 -2700 ss f „,,,,,,, ....„.,, ,:.„ gp Lic■-1 (;6 74334 Resirttletl to. 00 MARK T DELISLE 33 FIRST AVE 1 4 4 1 EASTHAMPTON, MA 01027 -44gre.,44” L .pr ritp)r) 5/3/2012 ( o•■111111,,I..11,./. r I %, 26357 . I .... - - - OHICe Or Con.iiiner .%ITairs L'■.: linsint.s. It cgtilatilin ...t. . ., HOME IMPROVEMENT CONTRACTOR Registration: 126235 Expiration: 5/6/2012 Tr# 293949 •,„ , Type: Partnership R C.1 ROOFING MARK DELISLE 6 LINE ST SOUTHAMPTON, MA 01073 ruder oat _ .13q4m9 Jopadrai Mutquinid .s 10)3arlvtil pot..131 't- Itm".12 Itt; :Otto apit3 ainta:Tifittuiad :(1,4“) um) JI) Id,W0,) ;1(1 Of 't1Pir) 11 ?111 ,■I )011 (1(1 '.1 — • -- - — T 11 I/17 gl1JJ ;Mow) 1,),711 ?If! 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Ott! . _ _ , 1_ - :t; • A • . _ u o )(pt ,qcp73 agnaid Itm)ii(i(tv cia cittIng,uslittpprrar,i/:r.lopv.imoD/N.ropitnli :JI,Ntql11J Diirinctil ttottitctrvittto) I /17() 111" ` 1/017f1/110"4 1 009 5 y1iofinXii.vd,11/1 fi) _fo 1 / JOS' q1itiettlii014474(/) • SECTION 5 - CONSTRUCTION SERVICES ^ l 3.1 Licensee; Construction Supervisor: Not Applicable 0 Nirne of Lip , ..0 Nu1C1Cr I. 1:d Y_i.Y.— ._.V_e. lJ.- l,f _..1._.YL _ r License Number ( l) ne 5 +, 4.1 ... u . • b .03 - A 4ddrr,ss (ru \ - ry (7 Expiration Data j nlephonii Im Registerr.d Horne pr ovement Contractor: Not Applicable 0 1 26235 C ompany Name — Registration Number 5 -ob "curt- 1 ��' v� M �1' ] ] �1 11 !J Expiration Date .A.1.11_p10,1 , 1 0,t _ 3 — Telephonr �J 3).5x'.41 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G,L. c. 152, § 26C(6)) VorKers Coo :;ensatton Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result he denial c he issuance of the building permit Stoned A Afficiavit attached Yes No 0 [ 1. Ronne Owner Exemption �.eirrcnt exemption for - homeowners - was extended to include Owner - occupied Uwelrinus of one (1) or two(2) families allow such homeowner to engage an individual for hire who does not possess a license, provided (hit the owner act; ;r ,upervisor, CM R 7$0, Sixth Edition Section 108.3.5.1. U,iinitinn of Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there v is intended to hc, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm :ures. -\ person who constructs more than one home in a two -year period shell not be considered IV howeowner. homeowner shall submit to the Building Official, on a form acceptable to the Building Official, (hak he/she shall be tronsibic for all such work performed under thc building permit.. sctin5 Construction Supervisor your presence on the job silc will he required Iron) lime to time, during and upon ,..;mddction of thc work.for which this permit is issued, be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to ! ;: : for injuries not resulting in Death) of the Massachusetts C;eneral Laws Annotated, you may be Bible for peraon(s) �',..; hire tct perform work for you under this permit. undersigned "homeowner" certifies and assumes responsibility for compliance with thc State Building Code, City of ''',irtttamttton Ordinances, State and Local Zoning laws and State of Massachusetts C;eneral Laws Annotated. lnnrenwncr Sii;naturc a�e, ---- . , r ---- ------- - ( SECTION 5- )ESCRIPTON OF PROPOSED WORK (cbeck all apIIcabIe) | _ _____ _____ _-- 1 __-__ _ — NW youo, Addition | ] Replacement Windows Alteration(a) | l Rooting '�� Or Doors [ii ' ' ' ' ^ `__ r ----- 1 r—' Accessory 5;,1g ,mnotion L- � New Signs ([z) Decks i[] Siding K]| Other [0] ' _____ __•____ _�_� __. — _____ _ ___ : �^c! Dcsc,'./; '):1,7 Proposed vox ---`----' ___ .xovxn,* c..mn; bedroom Yes No Adding new bedroom _____ Yes _ _____ wo Anacxed wa'..*vc Renovating unfinished basement _____�Yoo No Hans Attache:: Roo Sneet . Oa If Newhouse and or addition to existing hmuminq, complete the Yp|koWdntl: ,. yse af :,"/:mo One pon./y Two pam./v Other . _ . xomu: each mm/ly ono Number o/ Bathrooms _` ` ! :: /s there a p attached? ' ! c1 Proposec Square footage of new con,:umoo o"vvnamn, _ ______ c momorco/�nnu? -- ------- --- --- • Me ;hoc 0/ nc":^g7 Fireplaces or Woodstoves Number of each 7, E^c,g c..nmp^/.c: Masscheck Energy Compliance form attached? __ ! Type o/qo:sn;c . is cons 100 r of wetlands? _____ Yes _ No Is construction within 100 y, 8vvopain Yes No , . Depth wr,ovment o, cellar floor below finished grade ^ vVU/bu/ia`�g conform mme Building and Zoning regulations? Yes No / Septic r^,,`______ City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORILATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPUES FOR BUILDING PERMT __- __—_____-_ ��~~� _ _ ___ __ - . as Owner o|mw sub �,oprnv ^ �J T� • • ne,ob'a"mo'`�, ' >;���y J�/�� . • ^ ' It • • 0 • a act on my � � xao in +omnnom/ authorized uythis "uUuing permit application. \- i `-1-Z g''/[) ; Sig*Qi Owner Date _ _ \ \ \\�n\L` `� ~a�� � a [}TMnr ,� __ .as Cwn Owner/Authorized ' � ^-- ,e �h��xo and information on the foregoing 41ic^\ion are true and accurate, to the bast of my knowledge and belief Signed under 0e pains and penalties o'penury ~ . �� ��*� II ��° Print N*ma -~^� _�~����-l� | _ L' ' ~~ " | �� } Signature of on/ Date ._ _____ Se'Ction �I. ?ONINO ; all Information Must Be Completed. Permit Can f%c Denied Due To Incomplete Information i'.vsttng Proposed I Required by Zoning I i 1 his column to be rilicd in by Ituilding !)cr>wrtment i l ont;t�;r 1 �S:bilc,:s (-runs i j Side I.: K: I.: K: ' i Roar I , i ---- --- ---- .._ - - -- 1 !l riidi 1 ng lfeighl I — — —__ — k ;fg. Square ['ot)tage i % 1 • cs , en S1iaCc� F()outge �r % t1 +t area minus bldg ,'C naval Diu u - ._ j L___.__. t— _ _ -�._ __. —� --, ___ -_ —__ 1 ;trkin1 Sjutccs I i,, iunl SZ I,'cau0r) ___ ,a Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued:,' IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW 0 YES O IF YES: enter Book Page; ■ and/or Document A'1 Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained f roln the Conservation Commission? Needs to be obtained 0 Obtained Date Issued: Do any signs exist on the property? YES 0 NO Q I IF YES, describe size, type and location: i D Are there any proposed changes to or additions of signs intended for the property ? YES O NO O IF YES, describe size, type and location: E - \ 'iiI 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 O NO Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. •, City of Northampton st Building Department CurtC" P*4 .". f:•=4,it 1 • " V ` ' . " ' 4 • • V "..• ' 212 ,Main Street 7.717/.!*1744'''. Room 100 Wit. 'qt • V • • " • • Northampton, MA 01060 TwS� • - phone 4 13-587-1240 Fax 413-587-1272 .•• :;544,10w-_ erg • • , • • • , • e •' her S• - _ APPL (".',ATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property ddress This section to he completed by office .. S\--7 Map ■ Lot Pc f Zone Ore fie y District Elm St. Distric(_ C8 District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: '! 40'06 V. V 2. 1.• 7 rikr-\mc,_,A„s Name (Print) 3 Current Medlin Acl Teepnone Signature 2.2 AdthOrized Agcnt: *thint9-- v . • ... 4% • MI la • Name (Print) Current Mating •dress: 0 1 CS ( 521 4115 Slonature Telephone SECTION 3 - ESTiMATED CON$TRUCT)ON COSTS Item Estimated Cost (Dollars) to be Official Use Only completed btpermit applicant (a) Building Permit Fee Building 1 4 2500 . 2. Electrical J (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit F . 4. Mechanical (HVAC) 5:- Flre•Protedion 5. Total = (1 - 2 + 3 + 4 + 5) $2501.)—CLO Check Number This Section For Official Use Only Date Building Pern•-; Issued: Signittire: _ Building CommkSsiOner/inspector of Buikiings Otte 2t a# :.: ,� BP- 2011 -0076 GIS #: COMMONWEALTH OF MASSACHUSETTS 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- 2011 -0076 Project # JS- 2011- 000128 Est. Cost: $2500.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 74334 Lot Size(sq. ft.): 13503.60 Owner: LOWRY NANCY N REVOCABEL TRUST Zoning: URA/URB(100)/ Applicant: RCI ROOFING AT: 212 CRESCENT ST Applicant Address: Phone: Insurance: 6 LINE ST 413 527 -4775 Workers Com , ensation SOUTHAMPTON MAO 1073 ISSUED ON: 7/29/2010 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE PORCH ROOFS 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 7/29/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner