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29-557 . . 6 Line St, E stimate Date Southampton, Ma. 01073 8/17/2012 Phone (413) 527 -4775 Fax (413) 527 -8469 Name / Address Job Location Mike Mikalean 597 Ryan Rd. 597 Ryan Rd. Florence, Ma. 01062 Florence. Ma. 01062 (413) 210 -6376 Terms Rep Estimate valid for 30 days Dave Description Total Remove existing roofs. 8,600.00 Furnish & install aluminum drip edge, pipe flashings, chimney tlashings and step flashings. Furnish & install new lead counter (lashings. Furnish & install CertainTeed W interguard ice & water barrier along eaves and valleys. Furnish and install synthetic underlayment over existing deck. Furnish and install 30 year CertainTeed Series shingle. Furnish and install CertainTeed approved ridge vent. All exterior roofing related debris to be removed by R.C.I. Roofing. All work will be performed according to manufacturers' specifications. 30 year CertainTeed material warranty included. All related permits will be obtained by R:C.1. Rooting. Add $2.50 per sq. ft. for wood decking replacement if needed. Add: $950.00 for Certainteed Landmark 50 year premium shingle. A Certainteed Surestart Plus extended warranty will be included with a fee of $380.00 absorbed by RCI Roofing if signed within 7 days. This extended warranty means that 20 of the 30 year warranty is covered for labor and material. The last 10 years of the 30 year Certainteed warranty would be covered for material only. WE LOOK FORWARD "1'O DOING BUSINESS Wfl'I I YOU. Tota I $8,600.00 'l FRMS OF PAYMENT 5% Deposit Balance upon completion Customer Signature !, /=� Registration B 126235 Construction License 4 074334 Date / tn � { Insured by Bangs & Fickert Ins. (413)527 -2700 • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: pp Not Applicable ❑ Name of License Holder : M aY � �P 1 i s) e. 174133 '+ License Number 5) 5 l{ol St.- Easthampton Ma. o1o21/ 5 - 03-1 1 4 Address 1 Expiration Date ( 13) 527 - LjrJ 75 Signature Telephone 9. Registered Home Improvement Contractor Not Applicable ❑ fte c. /Roof; J 126235 Company Name Registration Number 51 B Kol Strett - P. 0. 600x 369 5- ab - Address Expiration Date Eastharn pion Ma. ©1 0 a.? TelephonE611 Z ?' 775 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 'g No ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) 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 performed 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 a't.`.aahee1 • SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing ai Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [l ] Decks [Q Siding [o] Other [0] Brief Description of Proposed at }- achPl� Work: L 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 1, ` 1 \k`f_. O t 1h'k C_C.n , as Owner of the subject property hereby authorize J r h -IJel 51 t o f Ft c. I . Roof; nq to act on my behalf, in all matters relative to work authorized by this uilding permit application. J a tt ached' 2 1 - 1 2_ Signature of Owner Date 1, , ..Male 1) s 2S a(ft(IDY aL ent , as Owner /Authorized Agent hereby declare that the statements and information on the foregoing lication are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. s1e Print 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 DON'T KNOW 0 YES 0 IF YES, date issued:, IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW Q YES Q 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 Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Q Date Issued: C. Do any signs exist on the property? YES Q 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 Q NO Q 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 Q NO Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Ammommenommommommonnemow - _ Department use only . r VP City of Northampton Status of Permit: 1 Building Department Curb Cut /Driveway Permit i;. 232012 212 Main Street Sewer/Septic Availability I Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans piton 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 3 (C y,r\ Q1 c. Map Lot Unit 0.6v— C'C-,, Y .., 01 Co Zone ____ Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: C& ■ K( 'M'tk Oa- l'e-.0%. 591 G c e-a.. - Clbv act . Ma . otoG,, Name (Print) Current Mailin ress: T attached - elep �yone � ) 4I0 .( Signature 2.2 Authorized Agent: y .: - • • 1 1 I . .4- Li ne +.7-orki ill ampron ?1a. Name (Print) ,,./ Current Mailing Address: l O, (J113) 521- tT75 1 �f. Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building Roofi rki 4 ig W 0 0 . Ov (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) Ig ( OCR , 0 Check Number 49 0 77 a5 36 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date 597 RYAN RD BP- 2013 -0205 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29 - 557 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit # BP- 2013 -0205 Project # JS- 2013- 000336 Est. Cost: $8600.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 74334 Lot Size(so. ft.): 20037.60 Owner: MIKAELIAN MICHAEL J & DEBRA M PETCEN Zoning: Applicant: RCI ROOFING AT: 597 RYAN RD Applicant Address: Phone: Insurance: 6 LINE ST (413) 527 -4775 Workers Compensation SOUTHAMPTONMA01073 ISSUED ON: 8/23/2012 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 8/23/2012 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner