22B-043 (9) FEB -02 -2010 05:49 From:RCI Roofing 4135278469 To:14135862492 Nage:2f2
RC • Roofing
P Line Estimate]
Southampton, Ma. 01073 Date (4
Phone (413) 527 -4775 2/1/2010
Fax (413) 527 -8469
Name / Address Job Location
Nonotuck Mill LLC
c/o McDonough Realty Services 296 Nonotuck St.
270 Exchange St. Florence, Ma. 01062
Chicopee, Ma. 01013 (413) 537 -9109
Terms Rep
Estimate valid for 20 days TEG
Job Description
Loading Dock roof: {/ 4,000.00
Furnish and install 1/2" fiberboard over existing roof surface.
Furnish and install .045 TPO membrane, mechanically fastened.
Furnish and install all associated wall and penetration (lashings.
Furnish and install .032 aluminum box gutter.
Service Net Roof: /AVM 9,800.00
Furnish and install 3" polyisocyanurate insulation, mechanically fastened.
Furnish and install .045 TPO membrane, mechanically fastened.
Furnish and install all associated wail and penetration flashings_
Furnish and install .032 aluminum box gutter.
Service Net Roof #2: 447E 7,800.00
Furnish and install 1/2" fiberboard over existing roof surface.
Furnish and install .045 EPDM membrane, mechanically fastened.
Furnish and install all associated wall and penetration flashings.
Furnish and install .032 aluminum edge metal.
All Roofs:
Provide membrane manufacturers 15 year material warranty.
Provide R.C.I. Roofing 5 -year workmanship warranty.
Ali work to be performed according to manufacturers' specifications.
All exterior roofing related debris to be removed by R.C.I. Roofing.
All related permits will be obtained by R.C.I. Roofing.
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total $21,600.00
TERMS OF PAYMENT i /
5% Deposit
Balance upon completion Customer Signature '..
Registration # 126235
Construction License # 074334 Date Q.- - /0
Insured by Reynolds, Barnes & Hebb, Inc. 413-447-7376
✓fre eowednanwectai or,Ygmoa Maui
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Board of Building Regulations and Standards
Constructian Supervisor License . T. - it - S. Li CS 74334 y .. c
1.. - 10 Tr# 23520
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MARK T DELISLE 4 , f'
33 FIRST AVE -,'_: '' "- ��'e" - i-
EASTHAMPTON, MA 01027 Commissioner ;
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glee eciffromonevealGi o�✓tizrooac4uei
Board of Building Regulations and Standards
'G _ Ai; �/ HOME IMPROVEMENT CONTRACTOR
6 *1 f . Registrd 126235 " '
Y ^�._. E irariiEon. 51/2010 Tr# 266063 •
`i 'hype Partnership
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R.C.I. ROOFING '� 4 - « - . '`
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MARK DELISLE i .
51 B HOLYOKE ST. =. +4�-
EASTHAMPTON, MA 010 _ Administrator
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The Commonwealth of Massachusetts
Department of Industrial Accidents
t Office of Investigations
—= — 600 Washington Street
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IMO., t_ 111111.0•
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t = r j . Boston, MA 02111
7 www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information {� Please Print Legibly
Name ( Business /Organization/Individual): R . l 0 -\-- n \A`
Address: 4 L ■ A .
City /State /Zip: ..� . Phone #0131,14,A - 4115
Are you an employer? Check the appropriate box: Type of project (required): L�
1. I am a employer with 2,0 4. ❑ 1 am a general contractor and I
employees (full and /or part-time).* have hired the sub - contractors 6. El New construction
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
These sub - contractors have
ship and have no employees 8. 0 Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.: 9. ❑ Building addition
❑ We are a corporation 5. oration and its 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.RRoof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
Homeowners 'v ho submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Co?npany Name: _, .
Policy # or Self -ins. Lic. #: C,'4 58 d'1 3S l Expiration Date: f 0 - 5 - 010
Job Site Address: City /State /Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,00.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the ins and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone #: (y,[ 3) 5Z.1 — L:1715
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 #:
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Versionl.7 Commercial Building Permit May 15, 2000
SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No
SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, - i, as Owner of the subject property
hereby authorize .. e' . ominQ
J _. to
act on my behalf, in all matters relative to work authorized by this building permit application.
attached
Signature of Owner Date
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_J' t k Ji� 1 f •e:X. in/ 1 Agent , as Owner /fluthorized
agea1hereby 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.
!_ ._at'K isk
Print Name
Signature of Owner /Agent Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : J'.1. 1C .i eii s G .._ 3 L
License Number
>8 Roijohe, u - Easthampton Ma o1o211 i 0 5 - 0 - 1 0
Address Expiration Date
Signature Telephone
SECTION 13 - 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 cf the issuance of the building permit.
Signed Affidavit Attached Yes • No 0
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Version1.7 Commercial Building Permit May 15, 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 ❑
Name (Registrant): k
Registration Number
Address
I
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s): .
I
Name Area of Responsibility
Address Registration Number
1
Signature Telephone Expiration Date
I I.
Name Area of Responsibility
i I
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
1
Address • Registration Number
i
Signature Telephone Expiration Date
i
Name Area of Responsibility ' ...._______ ........._ .
, r ..
......" :,..,, ..
E ____
_
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
_ _ . . _ . . . _ , _ . . . , _ _ _ . _ _.... Not Applicable ❑
Company Name: _
Responsible In Charge of Construction
Address
Signature Telephone _
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Version 1.7 Commercial Buliding Permit May 15, 2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
Ths column to be filIed in by
Building Department
[ ot3br
Frontage
Setbacks Front
.-- /---/
Side L � PL - L: Ft r- _ | [---| [---
Rear
Building Heigh
Bldg. Square Footage
Open Space �
(o`:�» '-=-
parking)
/-1 i [
,=of Parking Spaces '---' `---/ �---
FiU: � - -- -- l[ -- -'- - — l
( Location)
A. Has a Special Permit/Variance/Fi ever been issued for/on the site?
0 0 0
NO v DON7KNOYV �~� YES �~�
| '|
IF YES, date issued: | i
IF YES: Was the permit recorded at the Registry of Deeds
NO «-� ' DONT KNOW 0 YES ��\
v_� "��_ _ "��
�- --- --- -----'------�
IF YES: enter Book | Page | and/or Document #
-_-___
��« �~�
B. Does the site contain a brook, body ofvvuterorwetlands? NO �~� DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission? •
�-� »�� | |
Needshnbmp�t�n�� Obtained Date «�� ' «�� ' `|
�
C. Do any �gnsexist on the proper� ~� property? YES «�� NO �~ x��
�
IF YES, describe size, type and location:
D. Are to for �� NO ��
' proposed intended �~� ���
IF YES, describe size, type and Location:
E. NVill the construction activy disturb grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES � � NO � �
»�� ^��
|FYES. then oNudhompton Storm VVoterK8onogomwntPermit hnmthe DPVVio�qui�d.
Versionl.7 Commercial Building Permit May 15, 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 Change of Use ❑ Other ❑
Brief Description ;Enter a brief description here.
Of Proposed Work: '.
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
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USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly E3 A -1 ❑ A -2 ❑ A -3 ❑ 1A ❑
A-4 ❑ A -5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ —
H High Hazard ❑ 3A ❑
I Institutional ❑ 1 -1 ❑ 1-2 ❑ 1 -3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑
S Storage ❑ S -1 ❑ S -2 ❑ 5B I ❑
U Utility ❑ Specify:
M Mixed Use , 0 , , . • Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN.US 1 Existing Use Group: ! Proposed Use Group i _._... . _ ._..__
Existing Hazard Index 780 CMR 34): I Proposed Hazard Index 780 CMR 34): ._ .. _ i
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor (f)
151 I a
i1 st �.._ __
2nd
mm 3 rd
3ro _. .
4 m
4 w 1 .
Total Area (sf) 1 j Total Proposed New Construction (sf) ,"
r x
Total Height (ft) ; � 4 `
Total Height ft 1 r
9.
7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone ry lnformation: 7.3 Sewage Disposal System:
Public 0 Private ❑ Zone 1 ,_ I, Outside Flood Zone❑ Municipal ❑ On site disposal system
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Version1.7 Commercial Building Permit May 15, 2000
City of Northampton "
Y P Status 'of Pam � � s ., � �� � �� 4
Building Department Curb Cu
212 Main Street �` _ . s �"' � :444, , `'
se werlS�. � 4 . � 4 .��� � 3 =b %� � � � "
Room 100 ,,:c4. 7 -, .. _
Water15Ne c° ra 4 � 1 '� $4, ' � ,; ,
' - ' ;roil `~ ' Northampton, MA 01060 Two s of { . . , - n '� . 0 :
phone 413- 587 -1240 Fax 413- 587 -1272 Plot/Site`Plalt . 3
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
Z e f c, JJ o no k(a.(A k- Map Lot Unit
c10 r'F.m..C., , M.ck .
Zone Overlay District
i
t__ .. __ . _ I Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
oonUi c K •
►1 5 , L,LC� • lam JJo�bAt�+� �- ._ c\o �' ,
Name (Print) Current Mailing Address: OtOtoZ
(y , ►3) 31 - 9109 1
Signature atta e h ed Telephone
2.2 Authorized Agent:
i
„Vim
li
'Delis 0 . Bolt 309 fast ah1 o •
Name (Print) Current Mailing Address: J
( l i 3) Sal'
Signature / ` ^� Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building — — (a) Building Permit Fee 1
g
00 � 21 �,. � 0o a o I
2. Electrical (b) Estimated Total Cost of
_ _ _ Construction from (6) _ ,
3. Plumbing i Building Permit Fee
,
4. Mechanical (HVAC) 1
5. Fire Protection i..___.. . _.
6. Total= (1 +2 +3 +4 +5) 0 2, A l X00. o0 Check Number /5g7�j $0,d--
This Section For Official Use Only
Building Permit Number Date
Issued
Si
BIding"Commissioner /Inspector of Buildings Date
/
k-ST BP- 2010 -0715
GIS #: COMMONWEALTH OF MASSACHUSETTS
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 -0715
Project # JS- 2010 - 001065
Est. Cost: $21600.00
Fee: $132.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): 130680.00 Owner: NONOTUCK MILLS LLC
Zoning: GI(100) / /WP Applicant: RCI ROOFING
AT: 296 NONOTUCK ST
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 -4775 Workers Compensation
SOUTHAMPTONMAO1073 ISSUED ON:2/9/2010 0:00:00
TO PERFORM THE FOLLOWING WORK: INSTALL NEW MEMBRANE 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 2/9/2010 0:00:00 $132.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo