The URL can be used to link to this page

23D-141 D) VISA c..a DISCOVER h i 4 QU EN N E V I L L E www.1800newroof.net ROOFING ■ SIDING ■ WINDOWS We Are Licensed 160 Old Lyman Road • South Hadley, MA 01075 F ull Insured 1.800.NEW ROOF • 413.536.5955 y 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: Street // ^ } R H 3? S � Y Yf ` W: Email: City, State, Zip Code Special Requirements: • l l Recover Y Strip Complete Roof System [ki We shall acquire all appropriate permits for all work Home exterior and landscaping to be protected /7 [; Strip existing roofing to existing decking and dispose of. Do not Do. L Deteriorated existing decking will be replaced at $3.47 per sq.ft. after full inspection. Al Install Ice & Water Barrier at all eaves, valleys, chimneys, pipes and skylights [ Install (151b. felt / ynthetic underlayment over remaining decking area Install Metal drip edge at eaves and rakes (EP, / 5 " )(White� brown /copper) A Install manufacturer's starter shingle on all eaves and rake edges BBB Install new pipe boot flashing ( .tandardJcopper) / vents 'T -x_ Install/ Snow Count_ or Cobra rolled vent ridge vent Winner of the 2010 Install proper soffit ventilation TORCH AWARD Shingles: ( 6 nails per shingle) t Shingles [ -_ 'i 25 year [ - 30 year [ -_I 50 year Color __ / r " Ridge cap shingles Warranty Options: c] We guarantee our workmanship for 10 full years (see our warranty coverage) GAF System Plus warranty GAF Golden Pledge warranty Chimney Options: Lead Counter Flashing Li Water Seal & Tuckpoint L 1 Rubberized Crown ['I Metal Chimney Cap We T' e propose hereby to furnish materials and labor - complete in accordance with above specifications for the sum of: Total Due ($ , ›..s j ) ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are Down Payment ($ :! 5 ('i ) satisfactory and are hereby accepted. You are authorized to do work as specified. Payment will be 11 down at start of job, and balance due upon completion. f Balance Due Upon Completion ($ ) j 1 '3 ) Date Signature: k Date ;'y - Estimator: (Print Name) r l ( ) (Sign Name) 4<_ ( r, �� •1 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 Quenneville Roofing will not be responsible for debris or dust in the attic or storage areas. The Commonwealth of Massadtusetts ' Department =',+ _ o fox " vestigations k= 600 Washington Street = Boston, MA 02111 - '5i'''' www.mess.ginfifta Workers' Compensation Insurance Affidavit: Builders/Contractors&E bers Analicant Information Please Print Legibly/ 1 Name ( )- ■ 46.1. .a e. i __ . r - ' s • • & • tit Address: 1 6 0 n(A L.Y in a rt CA. City/S :I .. li g. - • I t ►7 Phone#: i - - __ Are you as employer? Cheek the appropriate bon: Type of Proms (required): t.� lam a employer with l 4. ❑ I am a general contractor and 1 employees (full part-time).* have hired the sub - contractors 6. ❑ New construction and/or 2. ❑ I am a sole proprietor or partner- listed the attached shed 7. ❑Remolding ship and have no employees These sub-contractors have S. ❑ Demolition working for nee in any capacity. y = ve workers' 9. ❑ Building addition comp. insurance. [No workers comp. insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] have ecercised their 11. 3. ❑ I am a homeowner doing all work � ❑ Plumbing repairs or additions [No ' comp. right of exemption per MGL 12,Roofnpairs insurance required.] t c. 152, §1(4), and we have no I3.❑ Other employees. Pio workers' comp. insurance required.] Any option that dudes boat /r mast also till oat the suction below showing their woden' comtpeas -'-- policy information t Homeomnea aim sdwitkis Admit indicating they am doing all weak ad dekko amtale ammo= most smi a a Dew affidavit i•diapioaseck neumwaiRitt cleat tbie hoc mot aldehiden adenoid shat ehowiagthe moo cobra b•eomaelots tadee me wbetherar et those amides have andoyen. lido c ab- comaetoo have empioyae, they not provide their workers' wimp- policy _. ti I am ma employer !teat pus workers' compasne Tanya a for my employees. Beim w is the a .. _ ._ _ . . Insurance Company Name: (} k M A u a t J y U at n __ / Policy # or Self -ins. Lic. #: F} IBC., rip I��,1c, l 0 t Expiration Date: 4 / a 9 1 Job Site Address: i O ( I i n ek let S'1. tin ctAcL r N A City/State/Lrp: ©l OG a, Attach a copy of the workers' compeasation polity detdaradon page (showh•s the ley amber and dare). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the inquisition of criminal penalties of a fine up to 51, 500.00 and/or ono-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 sit may be forwarded to the Office of lnvestiptions of the DIA for insurance coverage verification. I do hereby eerily ouster the wed peai es ofpe ismy Out the isfirmattost provided - above Fs free nod comma %Moire; Date: `f - . I - ( 1 Phone #: '1I 3 -53 (0 - 59 S Wad nee only. Do mot write li t ores, to be completed by dly town w o r City or Tows: Permit/License # Imo* Authority (circle one): 1. Board of Beath 2. Big Department 3. City/Town Cleric 4. Electrical Inspector 5. Phonbmg inspector - 6.Other Contact Person: Phone #: 011 1;1 I II' i■z'"i'r 7 4ih;: 1 qitU (ItAtir SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Adas Quinndk Roofing & Siding, Inc. 766ac, 169 Old Lyman Road License Number South Hadley MA 01075 g a ' a `( Hadley, Expiration Date X413- 53G — SIS5 Signa ure Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Adam Quennevi&e Roofing & Siding, Inc. I aogcs z Company Name 160 Old Lyman Road Registration Number South Hadley MA 01075 3—,/c- ID_ Address Expiration Date Telephone 4 - 5 C.-S — 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 l' No ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied Dwellines 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 Amp 6orsvcitilc Kole 4z tr Ma *IV NOP: f SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) I I Roofing J] Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding [0] Other [0] Brief Description of Proposed Work: $ c: p `t, \ o- A S 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 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 I, PC4C - v' 'n e — , as Owner of the subject property (� .,- hereby authorize Q� $ R • lot to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date Ada Qum* I Siding, Inc, , as Owner /Authorized Agent hereby declare that the statements an 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. Aw. n ;lee- Print Name u -al -t1 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: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage ° ro (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW e/ YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW • YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES © NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES ® NO 3 IF YES, describe size, type and location: E. Wiil 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 0 N O IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 1 g y ) ) Y .. :. 1 �a➢f � X 41 �13 t�tf !1` ..'M.vn. a.�ur.�.�wrlYMIIYm 1 Department use only R E EIVED city of Northampton Status of Permit: Ant 26 UN Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability Room 100 WaterNVell Availability DEPT. OF BU Northampton, MA 01060 Two Sets of Structural Plans • ne 13- 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 1.1 Property Address: This section to be completed by office ( 0G N Ind<te( S 4-, Map Lot Unit lover MA 0 LOCI_ Zone Overlay District _ Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: peAfec e 10 HG tcLc1c s F(oreince_ 01156 Name (Print) Current Mailing Address. Sk6 — O Telephone Signature 2.2 Authorized Accent: Mut *neat Whig & Siding Inc. voo oo..t.„D"0-v1 Soo 1,44 Noat.- or 07s- Name (Print) Current Mailing A'd ress: G 413 -.5-3G —sass Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building ga S , O Q (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= (1 +2 +3 +4 +5) 1 7 . 1 4 8' 6 60 Check Number ;le 9 0 yC��S This Section For Official Use Only Building Permit Number: Issued: s g I Signature: Building Commissioner /Inspector of Buildings Date 106 HINCKLEY ST - BP- 2011 -0879 w GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D - 141 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 -0879 Project # JS- 2011- 001437 Est. Cost: $7825.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq. ft.): 11717.64 Owner: IRVINE PETER R & MARIA C Zoning: URB(100)/ Applicant: ADAM QUENNEVILLE AT: 106 HINCKLEY ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536 -5955 () Workers Compensation SOUTH HADLEYMA01075 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