38B-226 . 'RC. . Roofing,,,
51B Holyoke Street
P.O. Box 309 ESti m ate Date
Easthampton, MA 01027
Phone (413) 527-4775 1/11/2008
Fax (413) 527-8469
Name/Address Job Location
Andrew Crystal 51 Fairview Avenue
51 Fairview Avenue Northampton, MA
Northampton, MA 01060 (413) 427-2942
Terms Rep
Estimate valid for 60 days Rich
•
Job Description Total
Remove existing roofs. 6,000.00
Furnish & install aluminum drip edge, pipe flashings, chimney flashings and step flashings.
Furnish & install CertainTeed Winterguard ice & water barrier along eaves and valleys.
Furnish and install 15 lb. felt 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 R.C.I. workmanship warranty included.
30 year CertainTeed material warranty included.
All related permits will be obtained by R.C.I. Roofing.
SPECIAL ITEMS NEEDED
Add $2.50 per sq. ft. for wood decking replacement if needed.
ADD $85 for Lifetime shingle. a
,ADD $1,600 for garage roof. /IL-AD
\\ V^l'l t�
VIN
5-„cat S\iti����-�
1 )
THE OWNER HAS THE RIGHT TO CANCEL THE CONTRACT WITHIN (3)
THREE BUSINESS DAYS OF DATE OF SIGNING. Total $6,000.00
TERMS OF PAYMENT
5%Deposit
Balance upon completion Customer Signature I • •
Registration 4 126235
Construction Excuse 4 074334 Date ,,'(C_\f\ \ aasco
Insured by Revu lds. Barnes&Hebb,Inc.413-447-7376
B"1'1'04,fl Crxt of N •t ntpfnttt ' _*�-
8 erg.`% 1 B ..asfarllnsrtle' __"–'...=___
Q,– DEPARTMENT OP BUILDITjG INSPECTIONS • — _ _
• 212 Main Street ' Municipal Building \1147---.77--
Northampton, Mass. 01060 MI'.`�
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
i, Tel isle of Et C T. itoof
N l )
with a principal place of business/residence at:
•
51B Holyoke ASt./Fastham to to Pia. 1.102.7 (phone4k1413)52'l_�t??5
frtreeUc?ty/s taielzi p)
do hereby certify, under the pains and penalties of perjury, that:
(\l(I am an employer providing the following worker's compensation coverage for my
employees worldn on this job:
The.insuyance mpanu d
-the State,of Pennsylvania We 1887325 0 05 D
- (Insurance Company) (Policy Number) iration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(aua<h additioml shoes if neazsary to include information pertaining to all contractors)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while bomcowncrs who employ persona to do nnintrn,Dr.-,oousruction or repair work on a dwelling of
not morn than throe units in which the homeovmcr raidcs or oa the grounds appurtenant thereto arc not generally masider d to be
employers tinder the worker's onalpeasation Act(GL152,ss 1(5)),application by a homeowner for a Grease cc permit may evidence the
1eg21 stator of an employer under the Worms Compensation Ad..
I understand that a Dopy of this statement may be forwarded to the Depattmsot of Leduutrial Aaidalla'Office of Insurance for the
coverage verification snd that failure to secure coverage under section 25A of MGL 152 can lead to tb•inspoaition of criminal peualfies ,
eoasisting of a fine of up to S1,500.00 and/or of up to one year and civil penalties in the form of a Stop Work Order and a
firto of 5100.043 a day against tae.
Fos•dcputmrnv1111D°Oh'
11/408 P *t Number
1,o1#
• Signature of Licensee/Permittec late
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
•
M
Name of License Holder: aY li 11:11S le. 7J4 33 1
R c} ^^ License Number
51r6 Hok ohe. St.- Easthampton, Ma. nio2.� 5 - 03 - aS
JJ Expiration Date V
Signature Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
ft e. I. /Roof, 126235
Company Name Registration Number
51 )lolyoke Street - P. 0. $ox 309 5-06 I-, o
Address {• ^ �/ Expiration Date
Easfli mpton Ma. oioe.. / Telephon�Lit3)527•4/t5
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
TI-e 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.
A 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 attaahed
•
•
ti -
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing
Or Doors O
Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [Q Siding[0] Other[0]
Brief Descriptor of Proposed 2}}ach C
Work: 'Rip_ new J on3
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, i\I lcF( i.t ( f S-ta,I ,as Owner of the subject
property
•
hereby authorize LM ar x i s1 e of R. Roof■n
to act on my behalf, in all matters relative to work authorized by this uilding permit application. 9
attached �! 1 glio8
Signature of Owner Date
I, jAaY l e, aS aU t11oY► as unt , as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing alication are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
•
Print Name
fa►fo8
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 Ileight
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
pal king)
#of Parking Spaces
Fill:
(v(.Iwne&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW 0 YES C
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW 0 YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , 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,
212 Main Street Sewer/Septic ater�lNell Avait Availability ability•
Room 100
W
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
5 F IN(N11 cc.] J 'fi • Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
kndr e_v1 Dry sla l 51 FaIY v i evJ.A ve . / N 'ton
Name(Print) Curre� ing A d
attached Telephone
Signature
2.2 Authorized Agent: � Roof;n Current
n 1la.V � st�am fi o oloa
c1 1l( ' J6 ` .•C• • Mail°gAddress:NamPi
( 1I3) 52'1- 4115
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building Roofi 4 10000.00 (a)Building Permit Fee
2. Electrical wj �MJ (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection Cf 75.06
6. Total =(1 +2+3+4+5) 6000.00 Check Number i f y 6w Z5-00
This Section For Official Use Only
Building Permit Number: IDs as ate ed:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2008-0935
APPLICANT/CONTACT PERSON RCI ROOFING
ADDRESS/PHONE P 0 BOX 309 EASTHAMPTON (413)527-4775
PROPERTY LOCATION 51 FAIRVIEW AVE
MAP 38B PARCEL 226 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
F':ft Paid
✓Buil ing Permit Filled out > 9
ePaid tl7bg .Sc)
Typeof Construction: Replace Roofing
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
N RMATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission _ Permit DPW Storm Water Management
Demolition Delay
c 4/z-3(05
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
51 rAikvtgWAW BP-2008-0935
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NvORTHAMPTON
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-2008-0935
Project# JS-2008-001398
Est. Cost: $6000.00
Fee: $25.00 PERMISSION IS HEREBY GRANDED TO:
Const. Class: Contractor: License: _ -
Use Group: RCI ROOFING
Lot Size(sq. ft.): 5532.12 Owner: CRYSTAL ANDREW J
Zoning: URB Applicant: RCI ROOFING
AT: 51 FAIRVIEW AVE
Applicant Address: Phone: Insurance:
P 0 BOX 309 (413) 527-4775
EASTHAMPTONMAO1027-0309 ISSUED ON:4/23/2008 0:00:00
TO PERFORM THE FOLLOWING WORK:Replace Roofing
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 4/23/2008 0:00:00 $25.0011968
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo