31A-143 IW . 1. • R
6 Line St.
Southampton, Ma. 01073 Esti m Date
Phone (413) 527-4775
Fax (413) 527 -8469 11/20/2.009
Name / Address Job Location
Jane O'Riordan
34 Forbes ave. 34 Forbes Ave.
Northampton, Ma. 01060 Northampton, Ma. 01060
(413) 268 -3643
i l,. s
Terms Rep
Estimate valid for 30 days Mike
Job Description Total
Remove existing roofs. 14,700.00
Furnish & install 1/2" plywood over existing decking.
Furnish & install aluminum drip edge, pipe fleshings, chimney fleshings and step
fleshings.
Furnish & install new lead counter flashings.
Furnish & install CertainTeed Winterguard ice & water barrier along eaves and
valleys.
Furnish and install synthetic underlayment.
Furnish and install 30 year CertainTeed Woodscape Series shingle.
Furnish and install CertainTeed approved ridge vent.
Coat lower metal roof over basement exit.
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.
30 year CertainTeed material warranty included.
All related permits will be obtained by R.C.I. Roofing.
*Estimate does not include newly roofed lower porch on driveway side of house.*
Add: $1,050.00 for Certainteed Landmark Woodscape 50 year premium shingle.
Add: $420.00 for Certainteed Surestart Pius extended warranty (included if signed
estimate is returned within 7 days).
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total $14,700.00
TLRMS or Ni \YME3NT
S`, %r I)cposil
Balance upon completion Customer Signature ?
Registration # 12623
Construction License # 074334
Date •
Insured by Reynolds, Barnes & Ilebb. Inc. 413- 447-7376 }
SECTION 3 CONSTRUCTION SERVICES
Licensee hnstruotion Supervisor: Not Applicable ❑
NI'dYk s
license Number
� I
` Expiration Date
Registers::: Horne Improvement Contractor: Not Applicable ❑
n (� 126235
ft _- 1 lQ SQ _. __
Registration Number
— I2 __
Expiration Date
0 Qh. i c - inn .l-on __lrlrl� L1 Ln � — i elept ion 57* 41 7
SECTION u- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 26C(6))
n•urance affidavit must be completed and submitted with this application Failure to provide this affidavit will result
:ssuarice of the building permit
acr r i Yes No Li
1 1. - Home Owner Exemption
l()r "hiiIOCownCrs riffs C.v■ended to iii Bide QWntr- OCCUpied DWsitink) Of OnC (I) or two(2) families
sues homeowner to engage an individual liar hire who does not possess a license, prQyidcd that the (Miler act
■• L upo - visor. CMR 780, Sixth Edition Section 108.;1.5.1.
!)rllnition of homeowner: Person (s) who own a parcel ()Claud on which he/she resides or intends to reside, on which there
intended to be, a one or two funnily dwelling, attached or detached structures accessory to such use and /or farm
A oe:rson who constructs more than one home in a two -year period shall not be constdervd r! t1anitvr. acr.
niiinenivi ier • shall submit to the Building Official, MI a form acceptable to the Building Official, that htAhe 7haU In
: i for all such work performed under the building permit.
Construction Supervisor your presence on the job site will he required from time to time, during and upon
il�ie ion of the wsirk.fbr which this permit is issued,
de advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
cols ti,r injuries not resulting in Death) of the Massachusetts General Laws Annotated, yQt1 may bt Habit for peraon(s)
tri perfhrnt work for you under this permit.
n'.crsiane,l "homeowner" certifies and assumes responsibility for compliance with the State Building Cock, City of
Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
!i..:nc�r�tincr Signature . -. -at.a.. il
e. �_ -.... _..... - _...-
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, I )11) [ uMini)Thqui111 0 111(1■S■SllehliSellS
,.......-..... .............., De/Mil/WM q Industrial ,Accidents
Off l . • ,
vila' of in vesligaiwns
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600 H'ushingion .Cireet
BOSIO/li ji. 02111
tt'K. //iii.:+s. go will('
\\ ■)rkers' Compensation Insurance Affidavit: Builders/ContractorsiEectricians/Plumbers
\_ 1„1 Please Print Leaiblv
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cillidNci Check the anpriipriate box: I 1
Type of project (required).
, ,-----, ,
•• Li i ;lin n ',_ contractor and
ha e itred ;he s ---; Ne " "rnstructi"n
or ire:- 1 I 7 ____, e
listed on the .ittached sheet. L Remodeling
H.,\ e no employees I'hesc suh-contractors have l 1 N • j Demolition
L.___ mo
ernifloyees and have workers l
.,o1...,. :o: me :k :my cap Building addition
insurance.:
'',‘.... ,:, ,, ke: :i . insurance comp.
\•1c:. are a corporation and its Itt. 1 Electrical repairs or addititw .
llic have their ! ',
ad work o ers ave exercised I 1 1 Plumbing repairs or addition:
, ,..,,
ght ot exemption per 1 1
',,, .Aorkeis' ,,•oint ri
l. l2.[_oolrepairs
c 152. § 1( ), and we have no
—
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einplo■ ces. i No workers' 3
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comp. insurance required.) 11
- — — _
1111.1i also in; viii ;he section below showing their workers' compensation isidiey inlormitlion
it indicann Mc:, are doing iii) \,,,r )... and then hire outside contrActors most submit a new atrnitivit inilientint4 such
....:.. .. ' .. . .. s ;;. ;,,,, mos; Aitaincii an additional sheet show it)i the naint; of the suh-eontraetors and irate „ lic(her or riot thosc entities have
,'■.'
• ', , ,' . ,` s ■ ■11 ellIp;O■CeS, :Ilt.7 111■1:“ )Ills IlIC iheir ,sortKers' comp i'it1hey /11,1n1t)CI,
...... .__
,:irt -IT i Crli: ,,,,' :ha: di liToWiiii11 worker,‘' COMpenSall■011 inSIIILUICC for my employee.s. Belo K' /A the po/itv arid job site
,n:'ormiltion
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.1H107
'' ' . ''' ''' '' ::''''' 1 '-`- ” : ,:!+) \.,.■ C. C_L 5'3 0 _33. L.,xpiration Date: / 0 7 5 - 2, Q
3L1, c.f.: c \c) r.S, c4 Q. c,t i me., 0(c.
.\ [(,,,l, It c), ,,1 i he workers' compensation policy declaration page (showing the policy number A 11 d expiration date).
i, ,,,,,,, ,I:: ,.:,, \ ci.,q. is required under Section 25A ot C. 1)2 can lead to the imposition olcriminal penalties tii it
C- 210 ,w,tor one-vent imprisonment, as well IS civil penalties in the Form urn s 1 op WORK ORDER and a :),..
; J;I:, ;tQamt the \ toator. Be advised that a cop or this statement itiny he Forwarded to the ()Ince yr
H ,,cst, :h, I )H\ tor insurance coverage verincation.
.•,-,•,,') i,?1,1et thc_pains id/id pendities ol perpir that the in/ormation provided 11 in) VC Ls true arid correct.
_ _____
,,,,,., . 1), not wfile in this ii T CO, 10 he completed hr cur or 1)) hil Orlielat
____
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� [�`!CA J � SCD|DT\OWOF PROPOSED WORK (check all a0DUC8b|Q\ | -------------- ____ 1
House i | Addition , Aop|acnment AkomUun(o> Roofing
Or Do [] E"/
`
: ' Demolition. �
` ` _' New S Decks [[] SIdI»Q(0) Othn'|[Dy '
„ . `�_`cv ��f- a \
` ���L(���
vcs No Adding new bedroom Yes ___ _wo
Renovating unfinished basement Yes No
Sheet
O If New house and or addition to existing houuing, complete the following:
of Oxe Family Two Family Other . _
.,"nn(' �� .ocms .o each family :n: Number of Bathrooms
= r:o, /a/vScoopcxed?__
; p .Square footage of new construction Dimensions
-------------------------- |
p replaces u/vvoousmves Number of each
_____
wao,cx,cx Energy Compliance form attached?
•!, n o/ wenanu»7_ Yes No Is construction thrn 100 yr nooUp|u|n Yes No
3cr�, ./ u,* or cellar floor below finished grade
cax(nxr me Building and Zoning regulations? Yes No
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S,ct.c �z^ Coy 3n^e, Private well City water Supply
— _�______-
SECTION 7a JvvwER AUTHORIZATION - TO BE COMPLETED WHEN
JvvmERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
i
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0 ��^6 , ����� no ,o/tpwwuupct
__'
all �^xc,, relative m work authorized uv this ou/m/ng permit application } i
~ /
' Owncr Date
as
here',' and information on the foregoing |icohon are true and accurate, to the best of my know4ede
Signed vouer pamx owu penalties of pequry
\
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....—...---..."
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.:,.. ,' k i*r7( NAM Be ace, Pen Can Be Denied Due To Incomplete Information
Propoed T Required by toning
This column to tic filled in by
ituilding Department
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Ha,s a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW 0 YES 0
'F. YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
N° 0 DON'T KNOW 0 YES 0
!
IF YES. enter Book Page and/or Document #,
the !Ite contain a nroo'r„ body of water or wetlands? NO 0 DONT KNOW 0 YES 0
IF YLS, nas a permit L) e C fl or need to be obtained Iron) the Conservation Commission?
Needs to be obtained
0 Obtained
0 , Date Issued: I
,.. Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and location:
■'■€' there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0
IF YES, describe size, type and location:
:
'y'lli, the construction activity disturb (clearing, grading, excavation, or hlling) over 1 acre or is it part of a common plan
Inat will disturb over 1 acre' YES 0 NO 0
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REcEIVED — —*—
I .,4 4. 1 , I ,
Ai ''' 1 1 .1 i City of Northampton
. 0 - t . v. . s ,
i„
1 Ruilding Departmen! Curt 'C' 0 ''''''' I f). ;,' , .41:„.4. . „ ,,,,
, ,, 1 ,
pan oF aust??, IV?" .1
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1 ROOM 100 '‘."...ncul",d1`..,
11-i c t .:7T,I . I t g\1 , , ,i4 .• !:':T - r . -.' , - . :.• - , .
Northampton, MA 01060 Tw ' t.... • . - ' ‘ -
9,14 ....., ' . ' . . ' ..
„,,',.,,,tiv j?..*
PhOne 413-587-1240 Fax 413-587-1272 novoec 1 J.,t4:0<
i ,• pvpo,,srisc:Tiliiiir.iy-0;14,`:„0,,) I: :: 1 ,4,., .,‘ rt ';' , . ; p "f.
Other Sped.ty tiffigk..,..i , ... :,... 1 — t A
,.._ ,..,, ,... , -_, . '..0,.., %,..,......, ., :.,„. ,...,,. 0..,• ,
APP, CAI i 0 N TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
— — -
SECTION 1 - Dili INFORMATION i
Prop ------ This section to be compkited by office
1.; er :
3( Co kA) e-S 13-') Ma p _ ‘ Lot Unit
MO ( \--- A Zone Ow r is y Dletrkt
Elm St. District__ C8 DistrIct
' EC TON -,. - - -ROPERTY OWNERSHIP/AUTHORIZED AGENT
:.1 Owner at -:ecorcl:
—.10.-Kve_ 0 I &.‘ o'c (- _____ ...__ _ .%.'`13 S. 6 taS\t f C■ c .e& . \'W. est. .M
‘iillt• 'Prilt) Curfent Mailing Address: --30't(zicid
, c_41.3)
att:a ah cd Telephone
Stgrmturp — —
2 2 Authorize:: Agent:
_ • • . • • • filli • • ,
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`. tirnfi (Print' 4 Current Mailing • ddress:
(-----.._._ (A13) 5_21_L,±1 ITS
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Eci ioN .3. 1-STIMATED CONSTRUCTION COSTS I
1
Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
-- -
1
i (a) Building Perrnit Fee
,.., 1 _ 1 4 kt4 ._
__
(.., 0 F .--(. 00
,
2 Eecanc J 1 (b) Estimated Total Cost of
- Construction from (6) I
...,
3 Plumbing Building Permit Fee
. .
, 4. Mechanical HVAC)
I
5. Fire Protec1Ion .....1
* 3 * 4 4. 5) $ I L k 1 0° ' L Check Number ) k Of 1 ft3C _1
.
This Section For Official Use Only ---
1
Date
Building '-'e,” ' ------ issued:
!
:.;ignature ______ _—
_ .
Date
34 FORBES AVE BP- 2011 -1018
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31A - 143 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: roofing BUILDING PERMIT
Permit# BP- 2011 -1018
Project # JS- 2011- 001649
Est. Cost: $14700.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): 6708.24 Owner: ORIORDAN JANE
Zoning: URB(100)/ Applicant: RCI ROOFING
AT: 34 FORBES AVE
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 -4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:6/7/2011 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 it 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 6/7/2011 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner