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50-002 1228 FLORENCE RD BP-2010-0967 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 51 - 002 CITY OF NORTHAMPTON 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- 2010 -0967 Project t# JS- 2010 - 001429 Est. Cost: $11300.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 74334 Lot Size(sq. ft.): 68737.68 Owner: GADOMSKI GEORGE J & FLORENCE L Zoning: SR(100)/ Applicant: RCI ROOFING AT: 1228 FLORENCE RD Applicant Address: Phone: Insurance: 6 LINE ST (413) 527 -4775 Workers Compensation SOUTHAM PTONMA01073 ISSUED ON:4/29/2010 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 4/29/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo City of Northampton S tatia of P.m9 __,....1., ,,,,„. Building Department !Curb Cut 1, 1 ..1 tij; ' .,* . ., tsil.**41 212 Main Street r Sewert$fil; 4 - . ROO ..,,..- ROOM 100 WatIttlYY01 * * ti tiit.t:) it:ii‘ •L'. -, t'. :, t. i " "' t. , .. . ,,- 4.1..._ . -,, i , -,,..,: :: ' ,, t, - . Norlhampton, MA 01060 I TwO'Setli:gttfttr '7', -, l'irtqtyicrigooleiANA,,,, ,.,.i v .,; lti10:)it 41 3 - 587 - 1 240 Fax 413-587-1272 Pio VS lie Other Specify, APP:JCATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING l _ - - -- --- — l SECIJON 1 - :t(TL INFORMATION _. _ . _....___________ This section to be completed by office 1 ' t Property ,`..ddres4, Map _ -, Lot Unit a ----- --- l Zone Overlay District_ I Elm St. District _ CB District SECTION 2 - -)ROPERTY OWNERSHIP/AUTHORIZED AGENT I " ---- --- - - ----- ---------- - -- - — 1 2.1 Owner ot Record: 1 1 ,_. . -- ' — — --- - — ° ---'-- Current Ad MailaN dress: tt C :te.C.1 , 1?") T eiephone '..3ignat(;a , 2,2 Authorized nt: l laY.3.. - D41-61e, - ,..C.i... . .1."cke.ii n9 4 (--- ... ,pnrit' ...." Current Mailing Address . [3)_ 52'7- /15 Teleohtrit* .1 SECTION 3 - Ft.STIMATED CONSTRUCTION COSTS l ____ !titin l Estimated Cost (Dollars) to be l Official Use Only ; completed by permit applicant l -I - —71. (a) Building Permit Fee ---- ______ J 1 (b) Estimated Total Cost of l Construction from (3', Pftli . Building Permit Fee 1 _ " ----r. — ------- 4, fvierThan.c4 HVA,C) i ; I 5. Fire Prolec' i - -- .1 I Check Number "y __ This Section For Official Use Only _._ _ 1 Date Litaiiling Per ': Numer _..... ---- ' Signature. BuilduN Commissloneranspodor of Buildings Date ZONING i .th Information Must Be Comutrted, Perot Can r',e Denied Due To Incomplete Informatioe , T _ --- ----------- ------ 1 Proposed Required hy - toning Ihok column to -. K.- filln1 in t)•, ! ! , litlildmk DcrArtrilcn■ -- --- L . i i' — 17 , v; ■;1;..',4• I__ _____ ___ 11 R: k: , , . , 1 } — iici:■ZH 1 . 4 ---- t • I ; —t-- .--,_ .... I ----ir- , 1C,(..' H701;f{,L{: 1;.: & ___ _ ( Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES Q ,FT YES, date issued:, IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page i i and/or Document #i , i'. Does the site contain a brook, body of water or wettands? NO 0 DONT KNOW 0 YES 0 If YES, has 3 permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date issued: 1 , an signs exist on the property? YES 0 NO 0 IF YES, describe size, type and tocation: ;or? mere any proposed changes to or additions of signs intended for the property ? YES Q NO 0 ir YES, describe size, type and location: _1 ivViii tne construction activity disturb (clearing, grading, excavation, or fillIng) over 1 acre or is it part of a common plan mat witi : over 1 acre? YES (2) NO 0 YES. then a Northampton Storm Water Management Perrnit from the DPW is required SEC: (. 5 DE., OF PROPOSED WORK f check all applicable) i _ — 1 Ren|ammen/Vvo`oo°o /w Or Doors [] | ` � ~ ��� _ | L_ �cu � � sso.: L� [—� New Signs |[]} Decks |[] Siding [DJ Other |[� l �� ��_ _ -___.___-- ". �`.� . ' p:ro,cx ''—' _ _-_ attach mo Auu.n8 new bedroom _ ____ _Yes ______wv �`ac^~: xc.a', Renovating unhn.sxeu baoemnn! __Yes wo '",,` ; no„ ;Sheet .aif New +,,,Duse andoraddidonkrcxinhnqhousing.co/np}etathefoUovvinQ Two Family Other ________ , Number n'e^m,onms , t_r' , : ;^'a;co:*cnco?' ' : ` rmc ', :xa , u /;,ma;, o/ new construction D r/,epmccro.vvnous/ovcn Number of each mnsznnd` Enogyt attached' ? ____________ : ::n`:' :.u` `p*." 'GC : r| wetlands"' Yes No Is construction within 100y, xooun|vm Yes No cmc .^ ' mr`,m or ncoa' floor bo(nw hn/xnod grade ' v/o : v.^`.,; :ox|nxv ;u t:c Bv|ldmg and Zoning regulations? Yes No Sc!1c a-. _ C/y 3owc.__ _ _ Private well _ City water Supply ______ ~ • �- SECTION , DWNFR UTHORIZATION TO BE COMPLETED WHEN owwExa;.6cwron CONTRACTOR APPLIES FOR BUILDING PERMIT ■ _�__ — ------------ --- -- --'---_ --------' ------ — ) ` - ~ as Owner u/the nuulect Y, ar - D.e.lisi e..._ 6c F(LC.,,L____Ro_a f1.119 . ,,_...,,,,,,_.„i., .,,a,:.,,,-1;te,s riative to work authorized by !HS Jtc..fing perrmt araolleation LM-8 Y k - Deiisle. _2.,S___alt.hori7.ezi____agent _ _____. as Owner/Authonzed 2. "ere: .. :•_: !nal !he statements and information on the foregoIng aQplication are true and accurate. to the best of my knowledge s.afled vo Y ., ',-,a.x, an; pc:ax of penury �_ ��-_-N�. ---- -- ----- ------ =,m/ Name ____- ________� /__- _ __' ------- � D am �.o^a*'co/� ________ SECTiON CONSTRUCTION SERVICES cerise _otistruction Supervisor: i Plot Applicable ❑ License Number } _ � Ezpiratinn Late 7,' (4t_ 3)__,5 7 - ?x tic r , Horne improvement Contractor: f Not Applicable ❑ _ _� __ ) 19,. E , 7.1]. /ROG fi n9 „1„21:2_23.5 - - - - - -- 7o01 Nr2, me Registration Number • i Expiration Date .1tI.t am ;T_or y Ma . c 1 _3 --- Te, tephon 4'-`-"` 2 477:, SECTION G- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(5)) 1 tns6ranc,2 affidavit must be compleied and submitted with this apoFCatinri Failure to provide this affidavit will result ;eri,,, iii iiiie a siiance of the buridincd permit l 1. - LIOUIe ()%vtler Exemption t cyr,i p,icin tie " h,uneuiv ncrs' was eytended to incluetc Ocaner occupied Dwellings of tine (1) or two( 2) farnilics ;t :Ioe. soot homeowner to enq.tage an individual feir hire who does ntit possess a license, provided that tit ow'Dtr acil .0 ,i> icrvisur. CNIIZ 780, Sixth Edition Section 108..3.5.1. i)i fmition of Itruncowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, nn which thcrc , , nde,1 to 1x, . nnc or two la dvscNing, attached or detached structures accessory to such use and/ or )arm ,....nc . A Berson w constructs more than one home in a OA' n —w ear period shall not be conaidered_a homeowner. ii„..c shat1 submit to the Building 01 on ft forest acceptable to the Building O(Ticiai, that he/she shall be ,..1>uu�11)lefor Ali such work performed under the building permit. ink (nnstruetion Supers isur cnur ptesencc tin the inh .itr-. ,ail! he required hunt time to time, during and upon t,l it,c ` it 0.■1011 this permit is issued. s.iscd that "itf; reference: to Chapter 152 ( Workers' (:nmpcnsatinn) anti Cbalder 151 (Liability of i {mpoycrs to ;il,i.cc to intones nr,, rc iiitin i in t)cath) of the. Nlass teIlusetts Gunerto Laty> Annotated, you may he liable for persons) .ire tl, perform t'eirk ■1 y ou un der !his permit. , e i i s r.nc_' • . ) ) C 0 ' r 0e r' ecrittles and assumes responsihiht■ t)ir compliance with the State Building (`ode, City of Eton ON :rancc , State anti Local 7onirtp I.00s tine) State of Massachusetts General Laws Annotated. 't,inien),ncr Signature .aCkec - - ' ~^ 7�� /' �&^/ �� y/�� \ ,''� /�M��/�A/�D''x ~y � usetts ` /nw�^ �// �u/ '---- Ve,t)urttnrn/of Itteitistr/o/JCc/tiewts � /)/Y�[(o//or�� ' o//ooJ ,, / ''o ' 600 /lia>h/ttgl0VStyeet Boston, i11/1 02/11 ''''' -.'!-� w'`r ".ox/xx&.ow\/il/ \\ [omycoNu|ioo lnxoruuuc Affidavit: Bui|ticry/Cootrwctorx/Hcu(ricimnx/>'luod/crx /`pyhc y|caso Print [e 't)}v R . � (----- �umc .:'.u.,,'x�^:`/s^`x,|o.hriJv^|)��� �r\ \__\ __ T\ .s- __ \_\--- _ __. \ < .\�\�\/rs` / _ l _, � Y\� . `—J-��' \re , ■:!tti ;lit ttini)1() Cited: the appropriate box: 1 - - ,1ap doi na.\ ;„; no employee., These sub-contractors have ; ; . r ---- 1 comp. insurance.: 5. --- We are a corporation and its 11 1 11,Lj Electrical repairs or additions officers have exercised their 1; 1 1 .L Plumbing repairs or adciitions C(/1111). ItISUralleC reqllItCd.1 _. __^ --_-___�-__-____-____-_-__��-�__ `'.: ..:^.` /°`"I xiti■. alSC3 l OW m,`cui,mxck`xdwviog their *vkco'^mpeou" /..".,""c.` `'° ..M./ o..` ^/S^:.i/ v`uiwm`g. 'x^x mre d"i"p ao .° and 6c" Mre ",/situ u*'muvp most mhn"/ ^ new aQ.|^..' .uo`'mmF.,"u. .","``,� [..'', No. "m,/^/*Ju/ao^Q^i""^| sheet u^miog the omm,./uu ,,/*-c^o/no^w and state °|uoz"' *^o " ,«nmomw.c :",../u` [x, `"^'�"xcu.`uxx'co*|,r,n,mx/ must provide their wvtcn' comp. policy number. ==_ _—_ / ,on o '/ ^ .xy'' , 'o',/nx//^yr",idat,t, , `.,'rA''r/'u`vyro/u/ion insurance /O,oycvyleirr,s 8J'`"'is the yo8c.ir(Ira.' job site information .,.otx/,`z .`,p::! N'xnc: , ,, ,), �.[� Tv7 N'� --- 1_`�� • — - - - ---- '.`{^ % :``/*/;'i:` \ 1, " A,)\ c45 ? _ 0^T_3 3 __/~ ,__-_- Expimtim`|]utx. / [) - 5' -2 City/State/Zip:. �_ , . ��„--1�� \uud, ^ m,. (d' th ..rk,rx' compensation policy declaration page (showing the yviicy number and expiration date). /u!o/,..'`u ^c``^�c��e'u required ooucrScctinn25/\v()1OLc. )52 can lead m the imposition o[ criminal penalties of ^ ;is:. .;�" �| 'x` /m x/|"r000-!cxr imprisonment, as `,c; as civil penalties in the Corm or STOP \VURK ()RUNK and a tine '/ xy » � .x/ x .|x! against Me ,i"(u\o/. He advised Mm o copy o[this statement ma: he forwarded to the ()nice .,[ |,xxig,x,.`rih' NA for insurance coverage verification. == - /d' If'r'h!. .riiir wider /h' iv/ and penalties o/ perjury that the inV",mu/iow provided above is true and correct. ' , / . `/�i��n�. - ��c"��_���_� =____�_____��__________= ==^________�___________ /')!!g` j;� �� __ � ==----=====-- --- .0iYici'J /,`/ ',///r. &/ //'/r write in this area, to he completed by city or /own official. ■ i Purmi��iu�nsa { Cit�orl __ ___. �auio� �o/honty (circle one): 1. Board .`[|b U xi|h 2. Building eyxr/mro( 3. Ot!iTv*o Clerk 4. Electrical Inspector �. Plumbing (n*Pector | li 6.[hko, || _ H Contact l',rs^o:___ _ ibonc#:__ ____ _ ____ -- - ,.... foo- An 'no It46.« (V' it Board of Building Regulations and Standards .4" t •,,,:' Constructicw Super License 1 ; Il If License:‘ CS 74334 E)cpiriticin: 5/3/2010 TrAt 23520 , 1. 11 * Restriction: 00 MARK T DELISLE 33 FIRST AVE EASTHAMPTON, MA 01027 Commissioner -■.,, . t m "no nit wal (( , it Board of Building Regulations and Standards .....__ ... T' * AP ! HOME IMPROVEMENT CONTRACTOR Registration: 126235 Expiration: 6/6/2010 Tr g 266063 Type: Partnership kOL ROOFING MARK DEL1SLE 51 B HOLYOKE ST EASTHAMPTON, MA 01027 Administrator RE 1. Roofing 6 Line St. Southampton Ma. 01073 Date � Estimate -- phonc(4/3) 5Z7 4775 20�0 Fax (413) 527-8469 4/14/2010 Name /Address Job Location George Gadomski 1228 Florence Rd. 1228 Florence Rd. Northampton, Ma. 01050 Northampton, Ma. 01060 (413) 584 1248 Terms Rep Estimate valid for 30 days Dave Job Description Total Remove existing roofs. .00 _- Furnish & install alurninum drip edge, p|peflashings, chimney Mashingsand step flashings. Furnish &ixstaU new lead counter flashings. Furnish & install CertainTeed Winterguard ice & water harrier along eaves and valleys. Furnish and install synthetic underlayment over existing deck. Furnish and install 30 year[ertainTeed Woodscape Series shingle. Furnish and install [ertainTeedapproved ridge vent. AU exterior roofing related debris to be removed by R.C.I. Roofing. All work will be perforrned according to rnanufacturers' speci 5-year R[I Roofing workmanship warranty included. 30 year CertainTeed material warranty included. All related permits will be obtained byRIl Roofing. Add $2.50 per sq. ft. for wood decking replacement if needed. Add: $1,50.00 for Certainteed Landmark Woodscape 50 year premium shingle. x[ertnintccd Suresta Plus extended warranty (additional 5 years) will be included with fee ($600.00) absorbed by RCI Roofing if signed within 7 days. WE LOOK FORWARD TO DOING BUSINESS WITH YOU Total $1 -00 I[KmS 0FYAYNcN[ 5% Deposit � , D.|x . !Ton completion Customer Signature Kegixm/"m 12423; , ^/ Construction iim``r»o7.1J]4 Date h`m/ud Reynolds, Barnes l\,+, Inc, 48~447'7576 / ,