38D-001 , . ..
ItC.i, Roofing i
Date
,�_�acSt. Estimate 1
Southampton, Ma. ((1073 4/14/201 I
('hone (413) -'7 --1775
Fax (413) 527 - 4try
Name ' Address Job Location
.le rr Cox 309 South St.
3(N South St. Northampton, Ma. 01U60
Northampton, Ma. 0I060 (413) 584 -3028
Terms Rep I
Estimate valid for 30 days Dave 1
Description Total
ftcm: existing r t i( -4
Furnish rA install aluminum dri a edge, pipe (lashings. chime flashangs and step (lashings. /2� f )"-
I � pipe I � `7�� ' � � „ti uoo - -
t
Furnish \ install ne,v lead counter !lashings. I
i
burnish .A install CertainTeed Winterguard ice & water harrier along eaves and valleys. ; , /Ih) , y/2 ' 6.r -.-_-;
Furnish & iarshall synthetic undertayment over existing deck. d ! ss
I'urnis'i & install 30 year CertainTeed Woodscape Series shingle.
(Furnish & install CertainTeed approved ridge vent.
furnish & install 1/2" fiberboard insulation on flat roof section.
Furnish & install .11=15 re- inbreed rubber root system, mechanically attached on flat roof section.
All exterior rcolint2, related debris to be removed by R.C.I. Rooting.
All work to he performed according to manufacturers' specifications.
5 -year RCI Roofing workmanship warranty included on flat roof only.
3(1 year CertainTeed material warranty included.
;Ali related permits wiii be obtained by R.C.l. Roofing.
Add 52.0 per square loot for wood decking replacement if needed.
Add. 5.`- 50.II0 for Certainteed landmark Woodscape 50 year premium shingle.
A Certainte.cd Sureslar t Plus extended warranty will he included with a ice of (5340.00)
absorbed by Rt'I Rooting if signed within 7 days. This cstrr!t warranty means that 20 of the
30 year warranty is covered for labor and material. The last I y ears of the 30 year Ccrtaintced
warranty would he covered for material only.
L FORWARD TO DOING BUSINESS WITH YOU.
`�/� �
Total y7 0 ()
1- FR1w; OF PAY rvtI N r
3! '4 Deposit
Balance upon completion Customer Si A...ell--ald--2 , 6 '
Registration )t I2u.235
Construction Licenser # 074334
Date r- f"Y0—l/
Insured by lianas & I ickert Ins. —
(413) 527 -2700
,+ ‘
' 1)11P1Di) iiJih I)/ 1111 S e 11S
,44N At
•
Deparlinen1 of Industrial Accidents
Office oj hi 'L'',IIJ'ilhIOfl
600 litashowton Street
" [)2111
t)'/(1111
\\ f I HSU ralICC Al fidavit: Builders/Contractors/El
LC 11ClitilSt lumbers
inlormation Please Print Letiblv
R (.1
\ Li;
_ .
/ Phone - 1 5
N ■.'111111t) CC. Check the 'A ppn)priute box:
Type of project (required)
o '■. [ Contractor and
New eonstrtien(H1
mpio ■,!;1; and,or part-titne) * 1live hired the sub-contractors Cl
or partner-
listed on the attached sheet. U Remodeling
.tm pi
Ha\ e no employees "(These sub-contractors have 1,11 Demolition
11■ employees and have workers
me in :1
() Li Building addition
comp. insurance..
vs nIsurancc. F-1
\,'(! are a corporation and its 0Li . Lit:eh repairs or addition
, ne oilicers have exercised their Plumbing repairs or addition.-
' Hod L s : ad work
riL2Jit otexemptit.yn per N'itlfl.
,)i-kci 2.2 repairs
c. 152, ,C1(4), and We have no
1,1.E1 Other
employers' `; workers'
c4.)inp insurance required. J
• must i■n ow Me section 1 shooing their workers' compensimon informaDon.
Ott ot uti ttuti they Aft: \s'OrK and theil Contractors must stilmm a new allidnyit 01411C4ffillg such
Iv- r-0.\ thiditiOnai Sheel .0)01 fitime /)1 Silb And Stutt 11C11)Cr Of it WOSC rrmtitc have
:!11 mmwe CtilPiOyCeN, they nmist provide Mel, workers comp. Hie) numtsci
mm „i, „ m'jJj ■$ ' r,v' compensation insurance !Or my employees. Belo 4' ir the policy and joh site
I.:.„‘piration Date: i_C.) c)
_ tate/Z. p:A ‘ ikAQ_. 0( 0(
(he o'orkel-s' compensation policy lecliiri page (showing the policy number nd expir*tion
ss , c, ;! eiage as ressioires.; under Section 25,.\ 01 MGI, c. 15 ca: ead to the imposition olcriminal penalties ci;
,,;` • wi,i.or one-year imprisonment, as welt as civil penalties in the roan of'a STOP WORK ORikR atz
ja:. ;t,..;ainst the violator. Be advised that a copy of this statement may he forwarded to the Office mo
;!;L. taq insurance coverage verification.
; 1 • r I i,•r nder th(.2ains and penalties of perjnry thin they injormation pro■ above is (rat! and correct.
i)01.c.L
)f/i.,„, „.‘r 1)o not ■true in this area, to he completed hi' city or town official.
Permit/License #
SECTION 9 - ONSTRUCTION SERVICES
License,: Tonstruction Supervisor: Not Applicable 0
lS_l_ _3
License Number
.5_ ., -_ Q _ �� ? �L Ma. n l Q 1 5 - O3-
Expiration Date
- I_3.)_ 52(1-11'775
r.�enhor r,
R eglsteri:.: Horne Improvement Contractor: Not Applicable 0
tL_ 126235
ornpanv Nnine Registration Number
Expiration Date
p n - .a= L i3 3__-_ - 1 elephonIJ� • 4 ! 7„
- YYY����"''
SECTV N tL WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 162, § 26C(6))
ierts.ition Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will resutt
:ssuance of the building permit
I st e ;. Yes V No ❑
l ! . - t -lone Owner Exemption
en, eyc;npt fo, --homeowners' was e tcndcd to include Owner-occupied Dwcllines of one (I or twri(2) familic;,
;u ;,I' such homeowner to engage an individual for hire who does not possess a license, provided that t °niter actl
:u ,cr isor. CNIR 780, Sixth Edition Section 108.3.5.1.
niiion of Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there
ntended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
A Lcr who constructs more than one home in a two -year period shall not bo considered A hpmcQtuier
. nncu■wwncr shall submit to the Building Official, on a form acceptable to the Building Official that helshc ih11 bE
_.t�onsiblc for all such work performed tinder the building permit.
; ur Construction Supervisor your presence on the joh site will be required Iron time to time, during and ufon
the work -for which this permit is issued.
,tdv,se,l that with reference to Chapter 152 ( Workers Compensation) and Chapter 153 (Liability of Employers to
i r,r injuries not resulting in Death) oldie Massachusetts General Laws Annotated, y ou WAY bt liable for persons)
perhino work or you under this permit.
"homeowner" certifies and assumes responsibility for compliance with the State Building Cade, City of
t?re:inanccs, State and Local Zoning laws and `state of Massachusetts General Laws Annotated.
�_.tache�
1. r
.
SE�T|^e��,� WORK applicable) ---'--- ---- ----- |
--- � !
'.,��oxs� � Addition �� RCV|��omen|V Alteration(s) --' R�p� _------,
— —� �-J 1 »0 i
!
O,Doors []
| |
� '� � ____ - __+
^z,``���.,:o � — Demolition L___.2 New Signs | Decks ([] Siding KZ)] Other [Or '
!
'_' ___ __-____'
` c:3os�.;� ,.`1 p/o�oS,u � /
`�
l
'------------ ____
.:z�/` -.,,.:` ,c^,nn"`_ ____ Yes wo Adding flew bedroom Yes _ No
Renovating unfinished basement Yes No |
/,s .: 5tcct
_________
a if New hDtrse and or addition to existing housing, complete the foUoyvinO
|
.eaf`.`"'"v Jnt;;am//v Iwo Family Om:, . _'
:.`:-^, : 'vn'xx in cacrl family unit Bathrooms - |
____ � / �
- ^ z^. .. ,^'a5c onaoeu7
-------- , |
i
` '`/,00^c �nc^'u footage o/ new cono*uctmm Dm��nmmn�
— ---'---- — -- --- |
u m.�e - �;^'''` )
.
• z:,/.• ' `,n,x�` Fireplaces or Woodstoves Number of each
�"o�` ' .s o�.*o��ompnn^cr Masscheck En:,gyCnmp|ianoohonnanocnnd?
' - ' --- ------- --' ------- |
' ,`eo! ,:.,2`u'`'c/3o 1
- ---- ---' |
x.�n^sn, m.`v:n.c 100 k of=eVangv? Yes No Is construction thin 100 y floodplain Yes No
]c;.. v ' �/scmcx; cellar floor below finished grade \
. r/.;;:,,.c, ; c�:x:'� Building and Zoning regulations Yes No
-------
,-;cb:.r . . :IN Sewer ______ pxva`r*r City water Supply ____
___ ___ ____ ___ __-_- --__
sFcnOw 7^ DWNER AUTHORIZATION - TO BE COMPLETED WHEN
ovvmERS �G: NT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
__ _
/r`� __________ __________ . as Owner of the wu�rm�
`cp �—'�� '--
� �
�/e,� �";x�'' , � of ��T __
.� :c c: ':` ,. `,' authorized by permit ' ^pplication. l
- |
b-?_(,:,-k (
- -- --
Date
___- _
__ __ _ —
\v��y k �� . as Owner/Authorized � here; ~ ^� . ;ha; m, ,/a�cm�x�s�����n m� /n,ogning �|imtinn are true and accurate, to the �uin/my h��
`c., '� ^ '"``
^:��cH^/
s/�ncu under ; pains and ve:ax�so/pono�
i \ c[| u ^��,
,rm! Name ~�' ~~
'
wNiNEi ,AU in!ormaiion ,NUS; Be Completed. Permit Can Be Denied Due to Incomplete Information
Lmsumt: Proposed Required by Zoning
This column to he filled in by
Building t)epomment
1
t,;nr I ,
— i
i
---
':1 ;' �; „<< i urta, e ;4
g t p''cd
Y,a
I,,s, a Special Permit /Variance /Finding ever been issued for /on the site?
0 0 DONT KNOW 0 YES 0
F YES, date issued
IF Y ES: Was the permit recorded at the Registry of Deeds?
N;' C> DON - 1 - KNOW 0 YES 0
IF YES enter Book Page, ` and /or Document I
ii l :oes the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued: i i
Do any signs exist on the property? ES 0 NO CD
J YES, describe size, type and location: . 1
tre t,'oere any proposed changes to or additions of signs intended for the property ? YES a NO 0
IF YES, describe size, type and location:
H v the construction activity distort (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
tnat we disturb over I acre? YES O NO O
r,en a Nortnamoton Storm Water Management Permit from the DPW is required.
tV111 1, y • # ' ' * • ,4
''-. ■ ' "... el, 1 .* # ,, ..k:. .
■ . i I , .
C Statitil
ity of Northampton ,, .
Of' ...Atil , . . , •
• -, ••! ' iir,xt"„ , I, , ,, i, . , . •
'. ..I
•-\ rt.%\\ Building Department Curt C ,:!
VS 11 Oil : ,i .1z); ' . :.*. . .`. • , I
1,.
j 4 , .- a it Fr ,
0 , c\ cOS ■L .r., I Street
. ''';'''''.' '' ) 0 7 ''• . * , .. -11"7.: . ' . ' ,
, 4
ROO fll 100 NieeeiVi: f • '‘'`i i ' ; * ' ' • '' ,,
to ,* Its ,,4
°I. • r .....- . r,„
Northampton, MA 01060 T,Avil$4*. %.37P:IP:.,. i .' _., • , . . .
olso e*of ° ,. - , ...4o.r : •.4 , ..,
,•' , ,,,, ,0 , ,. , , , P
phone -587-1240 Fax 413-587-1272 Olotitiii . i . .4..ikkki. e=t.,i '..',, V,,, .;'‘ , .;'' . •'.
, le. .,,,, ,i-i ta. ,`Vi l'i 'e4 } 1 — • i -.. i' k . " ' i
OtherSpeCrifyr ii.11. ‘ ..' `.•4•....4 ':,* ,i; '• 1 '.r. ' eji. t 1
APP. ,C; M
AON TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
– - ,
SECTION 1 - ' INFORMATION
This section to be completed by office - 1 .
3 o 0 -- Map __ _ t Lot _Unit__
Zone Overlay District
Elm St. District CB District
. ' , L0 ION : - ROPERTY OWNERSHIP/AUTHORIZED
Oxinerof;:lecort,1:
7 c 5- _
— -
Cu ant Mailing Address:
— 1
ca. :I.
_. Telephone I
S.ormair 9 . ___J
--
2 Auttiori Actent:
.
' Mariv • — I,.
. .. . • • .•-
(Pun,' e-7 Current Mailing • ddress: CD ■ Ci 7
i ■....)
,_.---/ •
.,/,..---- - - '.--------•.,.____ (q13)_522- 4715
4 ....– ..--
Telephone
•
S E TIMATED CONSTRUCTION COST
Estimated Cost (Dollars) to be Official Use Only
compisied_____Imit •
- , + _
(- ...,/. r (a) Building Permit Fee ,
1-14 le.c..,, (b) Estimated Total Cost of
Construction from (6) i
C Plumbin:: Building Permit Fee ,
4, MeCt'ainiU: HVAC)
1 i
5. Fire Protect,x,
.5. Total = (* - 2 . 3 -f- 4 + 5) , k \ Lt. 00 ,- ° (-) Check Number / 715e)
.._ ,
This Section For Official Use Only _I
Date I
Flii.IfIding (-- e,7, , ,",ir Imber._ Issued:
,—
S1g nat,ure: _ _ .
_
:-..lulidIns, CommM.slonerlinspector of Buildlno _ Doris
309 SOUTH ST
BP- 2011 -0867
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38D - 001 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: roofing BUILDING PERMIT
Permit # BP- 2011 -0867
Project # JS- 2011- 001425
Est. Cost: $11400.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): 9016.92 Owner: COX GERALD E & SHIRLEY J
Zoning: URB(100)/ Applicant: RCI ROOFING
AT: 309 SOUTH ST
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 - 4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:4/29/2011 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 4/29/2011 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner