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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:
, A Y � � (Is2eC / H '70) -0 W:
Street / Email:
a l C i [` i - c e
City, State, Zip Code 77 Special Requirements:
A 0 /oL. � ,�• >`c � i' ,,T�r !.a lr+. ...- C, 4—x?
❑ Recover LK Strip
Complete Roof System
N We shall acquire all appropriate permits for all work
1�q Home exterior and landscaping to be protected
�41 Strip existing roofing to existing decking and dispose of. Do not Do. Est Gtr
Z. Deteriorated existing decking will be replaced at $3.47 per sq.ft. after full inspection.
.fk� Install Ice & Water Barrier at all eaves, valleys, chimneys, pipes and skylights
VC Install (151b. felt _ n etic underlayment over remaining decking area
N Install Metal drip edge at eaves and rakes 5 ") (white row copper)
K Install manufacturer's starter shingle on all eaves and rake edges BBB
N] Install new pipe boot flashing stan ar_ copper) / vents �—
lJ lnstall Snow Count or Cobra rolled vent ridge vent Win
2oiof the
L ; Install proper soffit ventilation TORCH AWARD
Shingles: _ ( 6 nails per shingle)
Shingles ❑ 25 year Y 30 year ❑ 50 year Color
Ridge cap shingles
Warranty Options:
,K We guarantee our workmanship for 10 full years (see our warranty coverage)
GAF System Plus warranty
❑ GAF Golden Pledge warranty
Chimney Options:
I Lead Counter Flashing ❑ Water Seal & Tuckpoint ❑ Rubberized Crown ❑ Metal Chimney Cap
We propose hereby to furnish materials and labor - complete in accordance with above specifications for the sum of: Total Due ($ / S�7 N )
ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are ( Down Payment ($
satisfactory and are hereby accepted. You are authorized to do work as specified.
Payment will be 1/3 down at start of job, and balance due upon completion. Balance Due Upon Completion ($ - )S O )
Dater /
I Signature:
Date: /d /r / Estimator: (Print Name) r -. .�r°ti _ (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 Ouenneville Roofing will not be
responsible for debris or dust in the attic or storage areas.
Jun -23 -2011 09:43 AM Remillard Insurance 1. 413 - 538-
OP 10. LL
ACCORDIr CERTIFICATE OF LIABILITY INSU RANCE
THIS CERTIFICATE 18 ISSUED AS A MATTER OF NVOIWTION ONLY AND CONFERS NO ROtt'S UPON THE CERTIFICATE HOLDER THIS
CERTIFICATE DOES NOT AFFWJMTNELY OR NEGATIVELY AMEND, EXTEND OR ALT M THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS cmrrwICATE OF MMAWE DOEti NOT CONSTiTIJTE A CONTRACT BETWEEN THE SWAM 9MMER(S), AUTHOP MD
2EPE9flP rATNE OR PRODUCER AND THE CERTIFICATE HOLDER.
gNPORTANT: It #0 C WWIcM lwidrr is an ADDIT AL INSURED, the poagQee) roust be endwse& ff SUBROGATION 18 WANED, U*JW t O
the tes., and ooadidons of 010 poliap, Caron Pow may >eWm an endorsement A sbdarnent an this oerttflaft does notcon6r rt" to the
csrtJtmb holder in Neu of suds
PaoOLM t 4113- 638 -7852
RgMOIarri Insu1♦ me Agcy, Inc 413-638 -7178 Tans
79 Lyman Street
South Haft, MA 01078 ADAtUCH
Stephen E. Radon APMmwa sAac
IIaum Adam Quenne'VIl*AoVIIRIg & A, NM Meal klaNMCM CiOM
S)dbv Inc a: Travelers Ins. Co.
160 Old Lyman Road mac:
South Hadley, MA 01075 ggw a-
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COVEMES CERTICAM I ER: RENI9ION .
THIS IS TO CIRTIP'a' THAT THE POUCIES OF PWAUNCE UBTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME) ABOVE FOR THE POLICY PERIOD
="TED. NOTIMTfWANDW ANY T, T81M OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTBTCATE WAY BE ISSUED OR MAY P9tTAIN. THE INSURANCE AFFORDED BY THE POLICIES OMR®ED HEWN IS 8ULIECf TO ALL THE TERMS,
EXCLUS10lN AND CONDI M OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS.
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SHOULD ANY OF THE ABM DES POLICUM DO CANCELIM BEFORE
THE WW RAMN DATE TH6lE:OF, NVnCE WILL BE DfsLlMf<MtD IN
A6CORDAW= V4M TM POLICY PROMS NA L.
AUfiiMNIM 11sPm�WTA71VE
a 19MM ACORD CORPORATION. AN tights reserved.
ACORD 25 (2009/08) The ACORD name and logo are mgistered marks of ACORD
The Commnweat& of Massachusetts
DeparflneW of Industrial Accidents
Office of Investigations
600 Washington Street
IF Boston, MA 02111
www mass:gov/dia
Workers' Compensation Insurance Affidavit BndderslCorttmtors Mec€riciansRIJ tubers
Applicant Znforulation PIease Print Legibly
Name (B -
J J d & t/\ y�.c� I i V `� Y t I �.0 o V o 1 I i - , LB li
Ad&ess: 1 ( O I J �g yn a n .
city/ SwElzi : , V M A 0 /07 phow #:
Arc you as employer'! Check the approp tt bo= Type of project (required):
1. DI I am a employer with _ _(,__ 4. [] I an a general eobractor and I
employees (full and/or part = brut).# have hired the, sub- cotrtracbors 6- ❑New constrttchou
2. ❑ I am a sole proprietor or partner listed on the anacbcd sbmt. y- Q Rcmodclmg
ship and have no employees - These sub - contractors have S. [] Demolition
working fAr me in anY capacity employees and have workers' 9 ❑ Building addition
[No worlass' wmp_ iostu OM Comp- fima
rewix-cd-] 5.0 We are a corpomf m and its 10-El Mectrical repairs or additions
3. ❑ I am a homaeownar doing all work of=zz bave w=cmd their 11 -[] Plumbing repairs or additions
Mystz right of a xe�uption per MGL
� ] f comp 4 152, §I(4). imd � no 13 -0 Otter
cmpkgcm [N
gyp hwuw cx ]
'My xWliasnt that dMci o box 91 ab+st also fill oat the section below showing them wonloae naaVCVJStwn podiiY b damns! oo.
T Romeownus who mboa t this affidavit md aradoag tbe3r am doing all work and then hie oxide conttactom weft submit :new aTwj nit iodiaig A,1,
1 Conttacloa that chock Ibis box mast att:ehed as addmootd sheet s6awing the name of tha and stage a nnR those have
=wwyees. if the sub•coahadona hive eagiloyc=. dwy aorat provide their wwkwe comix policy naomber.
I am an employer dud isprnvidvrg worl!rs' con p&wudon vtsurimce for my auploy Selow 1s thepo5cy and job site
urform-aEiom-
Instnan= Company Name: )4 T M m u t Q. :L n Sa r'a 11 e-L
Policy 9 or Self -ins. Lie. #- g W C r i 1) 11 k 6 I U &*moon l[zft: i 4 ! a q — d 61 ' d
1
Job Site Address: ' "1 / � �� t f ��i Fie (- /l ° - tT,ty/SMe/Zrp: If 0 �-
Attacll a copy of the workers' compensation policy declaration Page (s4owiiag the polity number and expiration date).
Failure to secure coverage as requited uodrr Section 2SA of MGL r 152 can lead to Ere imposibicu of crhvival penalties of a
fine tp to S I. 500.00 and/or one-year as well as civil penalties in the farm of a STOP WORK ORDER and a fmc
of up to $250.00 a day against the violator: Be advised that a copy of this stft meat may be ft-warded to &,- Office of
Investigations of the DIA for insurance coverage vesificationa
I do herby certify / krr f e r pains and penakfes ofPa7UrY shat the inform Mlon provided abow is true and corrert
5ieaabue i J `'` Date: C�
Official use onnly. Do rsot tvrsto in this be cv"V &d by c&y or tomm affin ttl
City or Town- PermMucense #
Inning Authority (rsrde one)_
L Board of Health 2- Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Fnspector
6. Other
Contact Person- Phone Ih
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor / J _ Not Applicable ❑
A �
Name of License Holder �km- a VIne ri Le r I � b'
f , License Number
6 1 11 c G � m-a `t P t - d , So ap - M 14LLeI `G 4- F - k ,30 1`3
Address Ci / u/ 5 Expiration Date
Y13 6 —�v SS J
Si t re Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
C q cl
Company Name � Registration Number
160 0W Lyme Rood 3 - -.3 s— j
Address N th Hadk MA 01075 ' f Expiration Date
Telephone
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
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
MAI
Ahejomf� MAO
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing C ,
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding [o] Other [d]
Brief Des ption of Proposed `� / A[
Work: r` n e ix n �i`i -fi��t Gx'LQ S S�/ f
Alteration of existing bedroom Yes No Adding new bedroom Yes X No /
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a. If New house and or addition to existina 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.
1. 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, r(/.{ tT t1 (�- ��'j�t? as Owner of the subject
property V 1
hereby authorize A dis �ai Reefi®l & Not 11t
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
1 Abe Onn Ro& a Sk lit as Owner /A u� ize
P,it 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.
Print Name
� //1114- /U - w
Sign at Owner/Agent Date
Department use only
City of Northampton Status of Permit:
uilding Department Curb Cut/Driveway Permit
212 Main Street Sewer /Septic Availability,
ROOM 100 WaterNVell Availability,
OF ON r rthampton, 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
This section to be completed by office
11 Propert Address /`
�4(ee Map Lot Unit
c to ; Zone Overlay District
Elm St District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record
_ 1 - � a r I 111j
Name (Printy
/ _ (��.1" l e Current Mailing AoAress:
5 c��T7 'e%�dtlS F'G Telephone —
Signature
2.2 Authorized Aaent:
Adam &Lanyu-V& A-0 6aLmill
Name (Print) Current Mailing Address:
s t re Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
1. Building 14 (a) Building Permit Fee
2. Electrical [ d (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) - P""Qd Check Number
This Section For Official Use On
Date
Building Permit Number. Issued:
Signature:
Building Commissioner /inspector of Buildings Date
29 CORTICELLI ST BP- 2012 -0425
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Bloc 22B - 024 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 -2012 -0425
Proiect # JS- 2012 - 000669
Est. Cost: $15780.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ADAM QUENNEVILLE 070626
Lot Size(sq_ft.): 13895.64 Owner: MESSECK EARL T & MARY E
Zoning: URB(IOO)/ Applicant: ADAM QUENNEVILLE
AT. 29 CORTICELLI ST
Applicant Address: Phone: Insurance:
160 OLD LYMAN RD (413) 536 -5955 () Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON :1012512011 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 Sisnature:
FeeType: Date Paid: Amount:
Building 10/25/20110:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner