37-064 (7) 06/02/2014 8:21AM FAX 14135278469 RCI ROOFING Z0002/0002
R.C.I. Raafin
LLP
6 Line Street,Southampton,MA 01073
Phone:413-527-4775 Fax:413-527-8469
April 27,2013
Mr.Jim Dean,General Manager
Phillips Enterprises,Inc.
149 Easthampton Rd.
Northampton, MA 01060-4199
Re: Roof replacement Proposal
Dear Jinn;
Thank you for the opportunity to provide the following estimate for installing new
roofing system on your front building area.The existing EPDM roof has many problem
areas including active Ieaks,leading to deteriorated of the fiber board over built up roof
and gravel. As reviewed with you yesterday. Our scope of work is outlined below.
Scope:
Strip Epdm roofing, flashings, edge metal and fiber board to bur and gravel
(Leaving bur and gravel in place) and properly dispose
Furnish&install P.T. wood hailers as needed
Furnish&install I" poly iso mechanically fastened to wood deck AS peg 6ue�
Furnish &install .060 TPO Rhino bond fastened
Furnish&install penetration flashings lit Furnish&install�2)roof drain flashings y
Furnish&install .032 Aluminum edge metal -AAl Ad
Provide owner with R.C.T. Roofing 5-year workmanship warranty
Provide owner with a 20-year membrane warranty
R.C.I. Roofing will obtain all permits
Price: $29,800.00
Ke-1
05/30/2014 4: 1OPM FAX 14135278469 RCI ROOFING 1a0004/0004
JUN - 2 2014
t
--° _S inspections
Electric. Initial Construction Control Document
0E0 P' n �.`h 1
To be submitted with the building permit application by a
Registered Design Professional
for work per the 8h edition of the
Massachusetts State Building Code,780 CMR,Section 107
Project Title: P Date; 2
Property Address: / �% � 7
Project: Check one or both as applicable: New construction *Existing Construction
Project description: jC�41 J jEW'5 e
l /jL,MA Registration Number: Expiration date: / 1 am a
regi-te/,rd design pro}essiana4 and I have prepared or directly supervised the preparation of all design lens,
computations and specifications concerning:
Architectural [ ] Structural [ ] Mechanical
[ ] Fire Protection [ ] Electrical [ ] Other_
for the above named project and that to the best of my knowledge,information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manger consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official. .ra
��R�D qpC
Upon completion of the work,l shall submit to the building offtci AGOD Control Document'.
a o
Enter in the space to the right a"wet"or
electronic signature and seal: 4
N. MA
Phone number: 41 3-27-7K.3�
Mai "'Y OF M
Building Official Use Only
Building official Name: _ Permit No.: Date:
Version 06 11 2013
Phillips Enterprises, Inc. VENDOR:
Purchase Order Number 72000 RCI Roofing
149 Easthampton Road
Northampton, MA 01060
413-586-5860(phone)
413-585-8708 (fax) PO Date: 4/24/2014 Date
Part# Description UOM
Order Price Ext Price Job# Stock Qty Re Qty Recd Date Rec'd
Roof Per quote letter 4/27/14 ;ea 1 $29,800.0 $29,800.00 stock 0 5/15/2014 0
Notes:: Entire upper roof complete as discussed. To be completed immediately following the adjacent shingled peak
:roof for 5 Star
The Commonwealth of Massachusetts
Department of Industrial A ceiden ts
Office of Investigations
600 Washington Street
Boston, MM 02111
mm.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
applicant Information Please Print Legibly
'lame (Business/organization/Individual):
Address: Co L- (\�e_ 1 �
amity/State/Zip: Ma • o Q)-7 3 Phone #: (q1.3)
.re you an employer? Check the appropriate box: Type of project (required):
❑'I am a employer with Z O 4. ❑ I am a general contractor and I 6. ❑ New construction
employees (full and/or part-time).* have hired the sub-contractors
❑ I am a sole proprietor or partner- listed on the attached sheet. t ?• ❑ Remodeling I
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity• workers' comp, insurance, 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required,] officers have exercised their 10.❑ Electrical repairs or additions
❑ I am a homeowner doing all work right of exemption per MGL 11.7 Plumbing repairs or additions
myself [No workers' comp. c. 152, §1(4), 'and we have no 12, Roof repairs
insurance required.] t employees. [No workers' 13.7 Other
comp, insurance required.]
ny applicant that checks box X11 must also fill out the section below showing their workers'compensation policy information:
omeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit uidicating such.
>ntractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers' comp.policy information.
,m an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
''ormadon.
>urance Company Name: � � '"� n�� r�L>�
licy#or Self-ins, Lie, #: Expiration Date: 10 1 y
b Site Address: ,LAA r���_ C, City/State/Zip; A-,_ , AA 4 p\VteC�
tach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
ilure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
to up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
vestigations of the DIA for insurance coverage verification,
io hereby certify under the pains and penalties of perjury that the information provided above is true and correct:
gnature: Date:
tone#: 3
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2.Building Department 3, City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone#:
Vcrsionl.7 Comincicial 1uilding PCI'mll lNla), 1 , 2(1O(1
SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes O No O
SECTION 11 . OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I• � � � , as Owner of the subject property
t
hereby authorize /If 1E��� �L'-\ S`e l� C�t"� gyp` ���(' to
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner pale
as Owner/AuthotizE;d _
Agr tat.-hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and p Ilies of perjury.
Print Name
Signature of Owner/Agent Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: (� Not Applicable
Name of License Holder: j f S� ����,��L �.�_ -GD�� �cl 1_��' L� j3 ro
Licensee Number
I.-S V CkQ
Address Expiration Date
Signature Telephone
SECTION 13 -WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M,G.L, c. 152, § 25C(6)) 7'
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 0
\Versiunl.7 Commcicial BUildinO Permit MaV! Ii.2000
SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE)__ _
9.1 Registered Architect:
----- — — - .- - Not Applicable ❑ ---- I
Name(Registrant):
Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address — Registration Number —
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number--- ---
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
05/30/2014 4:09PM FAX 14133276469 RCI ROOFING
a0003/0004
.. S�C''1['IiQ11i 9:. l}�O�ERTY O'VV�T�R AU',I1`�QI�,IZA�'ION
Name and Address of Property Owner
Name(Print) No.and Street City/town tY'/ Zip
Property Owner Contact Information: q)
Title Gie n. 0\A.-Sr-r Telephone No.(business) Telephone No. (cell) e-mail address
—
If applicable,the property owner hereby authmize`s� `
RMC4rl II L C"'e- `�. '�ha ��'1 AAA 016-73
Nam Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized b this building permit application.
' NTROL(I eagi�>1itl uuf;� di
�Z)
SECIrIDI�T Q'V, N T7i�(JCI'IO Cif
t£builcln lx 9,4 tlo0 ed'fk ae1c)becd s
c�o C.rmue�l thc*n check blare D and€3dp Sc=edan�o��
�— '-
to t R.e' stered;Professib R'e� bi'I;anr.iC6���on Cgirtrol Conetru I:, "
cN� IZ ��t�� T T epho a No. e-mail a �e Lion Number
r
'Street Address City/Town fate Zip Discipline E pira on Date
10.2 Ce�+�ra1.Go��tfor:?
,
Company Name
Name of Person Responsible for Construction License No. and Type if Applicable
Street Address City/Town state zip
Telephone No, business kele hone No. cell e-mail address
..:. cx�lVl e N T1CiN jkA=AFFWAV 1T` T
Afire.
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submutted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a siRned Affidavit submitted with this a lication? Yea(3 No'D
5I3ty I iOl�2 CC1NS]'RUCTTQN OSTS AN
. . PPR14M1 T"I'B8'
Item Estimated Costs.(Labor
and Materials) Total Construction Cost(from Item 6) $
I'B ldmg $ 29 $w. 40 Building Permit Fee-Total Construction Cost x_(Insert here
2.Electrical $ appropriate municipal factor)_$
3.Plumbing $
4,Mechanical (HVAC) $ Note:Minimum tee $ (contact municipality)
5.Medumicei Ckher $ Enclose check payable to
6.Total Cost $ $d6.00 contact munici all)and write check number here
M.
TIONJ3' �NATU t7PBTJTI.�Lt1T'
l?fiR�,
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the best of my knowledge and understanding.
mm(VN 530
Please not and si name Title Telephone No. Date
Street Address City/Town State Zip
I4xusu�# a1 l nseol'{tr to f 'ou Ilui � p upsipg�lcal�onl app;oval
,,., _. .�.,. ., .,
Version 1.7 Commercial Building Permit May 1-5, 2000
8. NORTHAMPTON ZONING
Lsisling Proposed Required by Zollill
I'his column w be Iillcd in by
BLlild IIIL I)cpunnlcni
Lol Si/c
I'I'Untage
Setbacks Front
SI(IC L: R: L.: R:
Rcal
Building Height
131c1g. Square Footage
Open Space Footage `%I —
(Lul urcli minus bldg&paved
i,rkinq
H of Parking Spaces
I7ill:
vulumc'\
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DON'T KNOW O YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DON'T KNOW O YES O
IF YE:S; enter Book Page and/or Document N
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW O YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained 0 Date Issued:
C. Do any signs exist on the property? YES O 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 O NO CJ
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 O NO O
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Version 1.7 Coil urnrcial 13uildink Pcrniit i\/l�iy I�, 2000
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs ❑ Roofing R' Change of Use❑ Other ❑
Brief Description Enter a brief description here.
Of Proposed Work: �rc rood
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-I ❑ A-2 ❑ A-3 M _
A-4 ❑ A-5 ❑
B Business ❑ _ _ iA CT
E Educational L) _ {B----k---C]
F Factory ❑ F-1 ❑ F-2 ❑ r �9
H High Hazard ❑ — — _J- —
Institutional ❑ 1.1 ❑ 1-2 ❑
M Mercantile ❑ — �—
R Residential ❑ R-1 ❑ R-2 ❑
S Storage ❑ S-1 ❑ S-2 ❑
U Utility ❑ Specify: ---
M Mixed Use ❑ Specify: -----_
S Special Use El Specify: _
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor (sf)
15i
1 sl
2nd
,2r�d
d
3'd 3r
411,
4 u,
Total Area (sf) Total Proposed New Construction (sf)
Total Height (ft)
Total Height ft
7. Water Supply (M.(;,.L. c. 40, § 54) 7,1 Flood Zone Information, 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone M■MMIMm spn ys em(❑-
Veisionl.7 Commercial Buildiii g Permit May t5,2000
Department use,only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic.Availability
MAC 23 s Room 100 Water/Well Availability
kC,a �n�-PO Northampton, MA 01060 Two Sets of Structural Plans _
1e°tr F t' .� F p gone 413-587-1240 Fax 413-587-1272 Plot/Site.Plans
Other Specify
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
(q l CR 3` V'0' __ Map Lot Unit
/lJC1(' AW��1� Zone Overlay District
Elm St. District C6 District
SECTION 2 • PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
o Q ,
Name (Print) l 1 1t ��v-pry �, "nL ' Current Mailing Address: 1"Aq
Signature Sit- Telephone C4 (" w('p
2.2 Authorized Agent:
c�tt�t
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3• ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. 0+Iding a0 v (a) Building Permit Fee —
2. Electrical c, (b) E ,tfmated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Q. GU Check Number ^
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/inspector of Buildings Date
File#BP-2014-1248
APPLICANT/CONTACT PERSON RCI ROOFING
ADDRESS/PHONE 6 LINE ST SOUTHAMPTON (413)527-4775
PROPERTY LOCATION 149 EASTHAMPTON RD
MAP 37 PARCEL 064 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out nr !(Sig
Fee Paid
LTeof Construction: NEW ROOF
New Construction
Non Structural interior renovations
Addition to Existing-
Accessory Structure
Building Plans Included:
Owner/Statement or License 74334
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF MATION 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
'tion Delay
Signature of Building 4dficial 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.
149 EASTHAMPTON RD BP-2014-1248
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 37-064 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-2014-1248
Project# JS-2014-002101
Est. Cost: $29800.00
Fee: $180.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): 451717.20 Owner: PHILLIPS WILLIAM L TRUSTEE
Zoning: Applicant. RCI ROOFING
AT. 149 EASTHAMPTON RD
Applicant Address: Phone: Insurance:
6 LINE ST (413)527-4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON.61212014 0:00:00
TO PERFORM THE FOLLOWING WORK.-NEW 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 6/2/2014 0:00:00 $180.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner