18C-119 (2) 0 visa ®�
Q U E N N E V I L L E www.1800newroof.net
ROOFING W SIDING W WINDOWS We Are Licensed
160 Old Lyman Road•South Hadley, MA 01075
1.800.NEW ROOF 413.536.5955 Fully Insured
Email:info@ 1800newroof.net Website:www.1800newroof.net Factory Trained
MA Construction Supervisors Lic.#070626 MA Registration#120982 Factory Certified Installers
Member of the Home Builder's Association of Western Mass. CT Registration#575920
Member of the Building&Trade Association P.P.C.38710
Proposal Submitted To: Date Phone#'s C:
H:-11)-586 - 0.711 W: — 1
Street Email:
30
City, State,Zip Code Special Requirements:
rJOCi4.a �or rrl (Z OIObc)
❑ Recover A Strip ❑i Layers
Complete Roof System
We shall acquire all appropriate permits for all work
Home exterior and landscaping to be protected °`QJ` / P°"~
Strip existing roofing to existing decking and dispose of. Do not Do. 0-wr- oC On,— kov)c-
Deteriorated existing decking will be replaced at$3.47 per sq.ft.after full inspection. tr
install ice&Water all eaves,valleys,chimneys, pipes and skylights
Install(151b.felt Synthetic) u derlayment over remaining decking area
Install Metal drip edg aves and rake (8"/5")(white brow copper)
Install manufacturer's starter shin le on all eaves and rake edges BBB
Install new pipe boot flashi ndard/ opper)/vents --T-
�4'-Jnstali Snow Country r Cobra rolie vent ridge vent Winner of the
2010
F1 Install proper soffit ventilation TORCH AWARD
Shingles: ( 6 nails per shingle)
Shingles ❑ 25 year / I�] 30 year [1 50 year Color S karcwoa
Ridge cap shingles
Warranty Options:
We guarantee our workmanship for 10 full years(see our warranty coverage)
GAF System Plus warranty
❑ GAF Golden Pledge warranty
Chimney Options:
Lead Counter Flashing ❑ Water Seal&Tuckpoint ❑ Rubberized Crown ❑ Metal Chimney Cap
We propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of:Total Due($ 1/V00•Ou )
ACCEPTANCE OF PROPOSAL: The above prices,specifications and conditions are P Down Payment($
satisfactory and are hereby accepted.You are authorized to do work as specified. a l a3 a70o.c,o
Payment will be 1/3 down at start of job,and balance due upon completion. Balance Due Upon Completion($ )
Date: (7 y�y_Signature: —� 11
Date:'b 1`1 )4 Estimator:(Print Name) )ca i `Je C�O L-- _(Sign Name
Estimates are honored for sixty(60)days from above date
ATTENTION HOMEOWNERS:Please cover all personal belongings in the attic,garage or storage areas due to the
possibility of roofing debris or dust coming in through cracks of the wood.Adam Quenneviile Roofing will not be
responsible for debris or dust in the attic or storage areas.
The Commwwofth of MaijarAxictli
DepapoweW pf Industrial A cciden is
Oflke of 1XV0561afton-'F
600 Waskinglon Street
Boston, At,! Q1111
Workers' Compensation haurance Affidavit: Buikiars/Contractur3A Ject 'cLaisiPlumbe".
Please Print LA b
AV at Information
Name(BuAw L,
e,,0rg,, ,Uowb1&v,am1) Adam Quemieville Roofing & Siding Inc
A"ess. 160 Uld [yM,W Road
MA 01075 (mac t 13-536-5955
Art YVU MA employer?C-beck the Appropriate VP*1: Type of project(required).
I am a COW40yer with 15 4 E] I am a &I CCUK*CkX and 1 6. ❑ New construction
have humd the mA>-��x aod/cx pat-time).,employees(&B
Usted oa the attacbed sheet Reakodeling
I am a sole P"* agleot of Prwer-
These sub-conwacw"have L] Dcmobwn
thrp" w w ha no employees
COMPIO)Ves and twvt workers
wcwtuig for aw w"cry capacity- 9, ❑ amjdms addition
[No workers' comp. twwance
10.F' Bectncsl r"t,1 04 addibons
5 ❑ We wr a corporation and lu J
req--ed. offum"hive exemsed them ❑Flumboxg repairs or 6"
3,❑ I am a boweawoft dotag all work
myself of exanipeou Per MGL :2"
f [No workiii comp
c. 152,§1(4), and we have oo
nsurance requa-ed.) 13.❑Othes
eapkaye". [No wortws'
co-W. ma-soce r-p-ed.
'Ai"WPkMw but Cb*CU bm 0 1 atasr also dU ow at*Kdm bobw dww*g db4ft wicken'MIMPONIAdm POUcy uLfDr"K*w
I Heawboarbol who VAb""&MA&Vt imd*CJKbkg dWY NM 4044 AM sold MW 6010 WM 00M*&cwatta Wn swast ' ' 'Mew amArrh Wd%CMg coca.
�Cwwbclwl am cbeck dug tb=XWO wtw-w.660"Mal dwo oawntg dal asaw of ad oak-ceeetnrcftn"d Mft w%maw C.,0.1 ►0"earMtles ka"
eowwy— It dw R64ARN--be"MapW7406,dray saw des bak wad",COW.Percy
I am do ffAV;1"wr the/ji pr,"4An(w#r*dr3r I cow9mosalloo Insuramcwfor my employer& Blow ft Me po&Y ant job S&f
ipt/or"&d00%.
Lasuirmcc Company Name AIM Mwwaf Insurance
poll.-y x , SqAf-uu Ljc x A�V�,400701286 I�O 14A Expusbon Dale. 15
Job Site AAdreu: 30 YV A C)
Anock •copy of the workers'compawsation po&7 docllarot6an pop(abowing Elbe PWICY womber and expiration dote).
Failure to wcum covwage as requinW under Seebou 25A of MGL c, 152 cae lead to the naposibon of cnmmnl penal as of a
hoe tip to 51,500.00 and/oir one-yaw umptisonawat,as wall as civil pawlbes to/tae form of a STOP WORK ORDER and a fine
of up to 5250.00&day against the violator- Be advised that a copy of this stateuxxd may be forwarded to the Offlic-r. of
LovestgAticau of the DIA for wxwxncc coverW verificatux.
I do herob),C*rfol Under rkf pains amdponabin eporJusy that the hiforwat6►ft prvv4APd abow i3 to mod correct.
st mature. —------
413-536-5955
offici-I o-w voly. Did nor m7irr in!Iris area,AP be c*xwpletsd by dry•r lown efficial
City or Iowa: -L-L----------
Issaiag Authority(circle one):
1. Board of Health 2.BoWAag Department J.Cityf f a" Clerk 4. Electrical Inspector S. Mumbing Lnxp-ec teir
6.Ocher
Contact Person: Mont
SECTION 8-CONSTRUCTION SERVICES 7
8.1 Licensed Construction Supervisor: Not Applicable ❑
Adam Quenneville CS 070626
Name of License Holder:
License Number
160 Old Lyman Rd South Hadley MA 01075 8/21/15
Address Expiration Date
413-536-5955
Signature Telephone
9.Reaistered Home Improvement Contractor: Not Applicable ❑
Adam Quenneville Roofing 120982
Company Name Registration Number
160 Old Lyman Rd South Hadley MA 01075 3/26/2016
Address Expiration Date
Telephone 1 SI
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 buil ding permit.
Signed Affidavit Attached Yes....... I?/ No...... ❑
11 - Nome 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
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑✓
Or Doors 13
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [M Siding[O] Other[0]
Brief Description of Proposed
Work: strip existing roofing on front slope only and install new asphalt shingles on front slope only.
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 X 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
Laurie Meunier as Owner of the subject
property
Adam Quenneville
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Cunt, a AJhg
Signature of Owner Date
Adam Quenneville
as Owner/Authorized
Agent 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 penalties of perjury.
Adam Quenneville
Print Name
/o/� N
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:1 L.— .._. R:--
.-_
Rear F
Building Height
Bldg. Square Footage %
Open Space Footage % - - -(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
d :
volume&Location ................... `
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW YES
IF YES, date issued::
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page, and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued.
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
i
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO
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 e
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
_ Department use only
"",i {� " (--_-.-{ ! " 'it ►i City of Northampton Status of Permit,
Building Department Curb'Cut/Driveway Permit
AUG 9 (_UI4 '� 212 Main Street Sewer/SepticAvailability
Room 100 Water/Well Availability
►®otric,Piurn in I&Gas Inspections Northampton, MA 01060 Two Sets,of Struc€utal Plans
Northampton,MA 01 13-587-1240 Fax 413-587-1272 Plot(Site Plans'.
Othar 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
30 Allison St Map Lot Unit
Northampton MA 01060 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Laurie Meunier 30 Allison St Northampton MA 01060
Name(Print) Current Mailing Address:
413-586-6917
Telephone
Signature
2.2 Authorized Agent:
A a rw Clil oo old � n " � � . d/0 t� p
ame(Print) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 4,400 (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=0 +2+3+4+5) 4,400 Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
30 ALLISON ST BP-2015-0204
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18C- 119 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-2015-0204
Project# JS-2015-000389
Est. Cost: $4400.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ADAM QUENNEVILLE 070626
Lot Size(sq. ft.): 7492.32 Owner: MEUNIER LAURIE A
Zoning: URB(100)/ Applicant: ADAM QUENNEVILLE
AT. 30 ALLISON ST
Applicant Address: Phone: Insurance:
160 OLD LYMAN RD (413) 536-5955 O Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON.812012014 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE FRONT SLOPE 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 8/20/2014 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner