24C-186 (2) R .C. . Roofing
6 Line St.
P hone a (413) 52 7- 47 77073 5 Estimate Date
P hone (413) 7 -7
Fax (413) 527 -8469 5/19/2010
Name / Address Job Location
Meryl Cohn
27 Dana St. 211 Crescent St.
Northampton, Ma. 01060 Northampton, Ma. 01060
(516) 398-8486
Terms Rep
Estimate valid for 30 days Dave
Job Description Total
Remove existing roofs on House. 7,800.00
Furnish & install aluminum drip edge, pipe flashings, chimney flashings and step
flashings.
Furnish & install new lead counter flashings.
Furnish & install CertainTeed Winterguard ice & water barrier along eaves and
valleys.
Furnish and install synthetic underlayment over existing deck.
Furnish and install 30 year CertainTeed Woodscape Series shingl
Furnish and install CertainTeed approved ridge vent. ` ' C)K C/c'
All exterior roofing related debris to be removed by R.C.I. Roofing. V
All work will be performed according to manufacturers' specifications.
--- .-mar RCI Roofing workmanship warranty included.
30 year CertainTeed material warranty included.
All related permits will be obtained by R.C.I. Roofing.
Add $2.50 per sq. ft. for wood decking replacement if needed.
Add: $800.00 for Copper Valley's.
Add: $120.00 for 2 courses of ice & water barrier along eaves & valley's.
Add: $300.00 for ice & water barrier on entire roof.
Add: $500.00/$800.00 for Baffle Vents between rafters if needed.
Add: $500.00 for Soffit Vents.
Add: $800 for Certainteed Landmark Woodscape 50 year premium shingle.
A Certainteed Surestart Plus extended warranty (additional 5 years) will b includ
with fee ($320.00 absorbed by RCI Roofing if signed within 7 days. .-,_. i'eqC
WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total "�.
bl 2901 o -
TERMS OF PAYMENT
5% Deposit
Balance upon completion
Registration # 120235 Customer Signature
Construction License # 074334 7/ C)
Insured by lianas Fickert Ins. Date
413 -527 -2700
Page 1 rp
v Sao(/ 0
riiii id
74334
Restricted to 00
MARK T DELJSLE
'
33 FIRST AVE „
r 'r *
EASTHAMPTON, MA 01027
26357
IJIcl' of ■■ttNutilur e4, 1111■In1 Rt
HOME IMPROVEMENT CONTRACTOR
• 174 . Registration: 126235
Expiration; 5/6/2012 'fro 79394t
Type: Partnership
RC I ROOFING
MARK DELISLE
LINE ST
:30UTHAMP TON. MA 01073 t 11 eta!
• •
The �� x of �.\ /n�[ Commonwealth 8� U�P/�
'� '---'~^..~~^,,"
Department of Ivdu^tr/u/Accidents
' Office ^/{nvesti u/iox�
600 1V«rh' . o Street
Boston, 311 02111
*' *V4 1 . o/a/xI/vt1/2/11/
\\ mt ' (_ou1 Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant information Please Print Le 'b/y
7
xm�(H^""wx/rS�o,uv"/^hu".�vxV� r`\
`.
/`dJrc/ / '
~~ _-__
( ti 1 4 - ��]-\ ��
--------- -- ------ '='___- =r
all employer? Check the appropriate box:
_ ' Typo of project (required):
! u`^ u:yi``yu `.:h | I an « general contractor and i
- ---- | hired b 6 New construction
ccv([uUooJ/o,pao'/imc).` have xr� c/u 'cun�ucm/�
2 l | xn, .' /v>c proprietor or partner- listed on Mc attached sheet. 7. [ Remodeling
ship ;1101 have no employees [hose sub-contractors have X �] Demolition
�.',kv`g for o`' in an capacity workers'
and have vw,ko' —
insurance.:
Y� �� 8oi[JixgmdJiouo
(N"````'kco comp. insurance comp. ' '
, u;ox` ` i| i ri \Vc are u corporation and its 0. n Electrical repairs v,additions
| ^"` .. h.1111(20woc, doing all work o[8cca have exercised their I I - Plumbing repairs or additions
x`■/c!: /N, workers' comp. right of per k16L 12.c-��oofrurxin
mmnx., ru(vi,u! � c. }52. §1{4). and wc have ou ^~
�J -7 Nhcr
employees. [No workers'
�-�
comp. insurance required.
h.x «| must also Wi out the section »,/nv`b^wio* their ~vrkxm' compensation policy information.
^/` ""^°"' 'u.` affidavit indicating ou' w" doing, all work and then hire outside *mouuvrs must submit x new affidavit indicating such
• "oo"u.v,ou'u,ukmxbox must attached m additional sheet showing the name "f the sub-contractors and state whether w not those entities have
"",l"/",s� /h' "^
trill,:
n�w have ^mpox*u. �p/mm/provide m m
*�/ �^mm' ump.pvUcynumber.
/.v,' (In /xy//orc/ that i/y,o,idin workers' compensation insurance for myrnp6 xex Below ix the policy and job site
/ '//'/n'/o/i'//.
/l � -
��".'`p,m!� �omc�/�C �, !���� � \��� --_-- �L�� • _____
." Si | .'"���L�� C) ^l_ 3 3 _ /~ ___ ______ Expiration Date: / 0 \ [)
� | | ~� ('i� /��u�c/Zi
.` '�x�_�^ ^���~ _ - y p
Attach , cops of the workers' compensation policy declaration page (showing the policy number And expiration date).
h.v coverage ,a required under Section 25/\uf M6Lc. |j2 CLIII end (0 the tllpOSi(L01l 01 Cri1fl1fla penalties ot 11
v|` w Si `UU/N xoJ/o/unc`>m/ imprimomocot, as well as civil penalties in Ole Form or STOP WORK ORDER and a In
o: up /.` S2j1) On ^ `b) against A`c violator. Hu advised that 0 copy .`(/his statement may he forwarded to the Office of
:vx/tigx:ox`.`fthe O|A for insurance coverage verification.
/^\' hereby .,r/ify under the zpains and penalties ()./ perjury that the information provided above b true and correct.
'__�~
��'x � ___ __ -
yborie• ��i`�i - ��_^�
Official 1o0 o/'/r. 8v x^/ °rite in this area, to he co/ny&x*/hy City or town official.
Permit/License
(circle one):
of Health 2. Building Department j. O/ Clerk 4. Electrical inspector f. Plumbing 1poP«cunr
u,
Phone #:
•
SECTION 8 - CONSTRUCTION SERVICES
•
3.1 Licensed Construction Supervisor: Not Applicable ❑
•
NATO Of LIG0j):•e HOlder .l. - adl -DDelis - 1. .+_- --------- ._-- -. - - -- r ? 33 1
License Number
� � � _� _� O _ • • • •..�• 1 . • . �5 - 03 - o
.,. ddress Expiration Date
(4 13) 527 -
1 signature — • -- - -- Telephone
i 9. Registered Home Improvement Contractor: Not Applicable ❑
_tom �_ —�- 1217235
Company Narne Registration Number
t �5�.. 5- D6 -10
``OOte C Expiration Date •
\CO LLAil 01 ' • 11 V - • r • 3 Telephont61 5 " 4775
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 162, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
1n the denial of the issuance of the building permit
: Signed Affic;avit Attached Yes - -. No. - ❑
11. - Home Owner Exemption
i i tc current exemption for "homeowners" was exlended to include Owner- occupied Dwelline3 of one (1) or two(2) families
,,.,i to allow such homcowncr to engage an individual for hire who does not possess a license, provided that the owner actt
;Is ,upervisor. CMR 780, Sixth Edition Section 108.3.5.1.
I)clinition of Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there
..ir i.. intended to he, a one or two family dwelling, attached or detached structures accessory to such use and / or farm
,.,,ctures. A person who constructs more than one home in a two -Year period shall not be considered a homeowner.
;;,:h homeowner" shall submit to thc Building Official, on a form acceptable to the Building Official, that hclshe shall be
re ponsible for all such work performed under the buildinE permit.
.\ acting Construction Supervisor your presence on the job site will he required from time to time, during and upon
completion ofthe work•fbr which this permit is issued.
- \,Io he advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
I; for injuries not resulting in Death) of the Massachusetts General Laws Annotated, Yq,4aa,y be liabk for person(s)
,,,•,, hire to perform work for you under this permit.
Th.: undcrsiened "homeowner certifies and assumes responsibility for compliance with thc State Building Code, City of
Northampton Ordinances, State and � Local Zoning Laws and State of Massachusetts General Laws Annotated.
•
llnmcowner Signature -_ attacked - - - - -
}
SECTION 5 - DESCRIPTION OF PROPOSED WORK (check all applicable)
New House 1 ) Addition Replacement Windows Alteration(s) n Roofing
Or Doors C7
•
Accessory Bldg Demolition 1 New Signs (0) Decks [(] Siding (DI Other (Q)'
Brief Descnh; )n of Proposed
• 'work attar hei-1
Alteration of e.sting 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 budding One Family _ Two Family _ Other
Number c rooms in each family unit of Bathrooms
j :: Is there a arage attached?
d Proposed Square footage of new construction. Dimensions
e. Numbe of stones?
Methoo of neating? Fireplaces or Woodstoves Number of each
Energy Conservation Compliance Masscheck Energy Compliance form attached?
Type of construction
. Is constru, tlon within 100 ft of wetlands? Yes , No. Is construction within 100 yr. floodplain Yea No
Depth cif ts3sement or cellar floor below finished grade
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
e.-.0 as Owner of the subject
property
hereby authorize J O ar 1.J L I sii P of 1(• c, T. O i I
act on my behalf, in all matters r ative to work authorized by this uilding permit application.
a•t.tgchPd 6
Signif11 1 df Owner Date
•
' • • ' • • .1 _, as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing .•.lication are true and accurate, to the beat of my knowledge
and belief
Signed under tf,e pains and penalties of perjury.
Print Name T�
"-- 7C, -1
Signature'of Owndr /Agent Date
Section 4. ZONING Alt Information Must Be Completed, Permit Can Be Denied Due To Incomplete Information
N.xisting Proposed Required by Zoning
This column to be filled in by
{iuilding [kpertmcnt
F JfIeKC �' , i
thacks F ront i
Side 1 . : I t . 1 1Z: i
Rear 1
/3 iilding Height
,
B dg. Square footage % f
0 )cis Soacc Footage "/o
(1 )1 ar ea ■)H)U bldg & paved , , I
I Parkins, Spaces —_
l;i:
i; 1
� ,,lumc,� lf xauonl __ __�__
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:;
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O YES 0
IF YES: enter Book Page and /or Document tit
5. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW O 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:
C Do any signs exist on the property? YES Q NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO O
IF YES, describe size, type and location:
E Will the construction activity disturb (Gearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO t )
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
City of Northampton suits ol , .
x , * r • t,
, L Building Department
212 Main Street Cewer �' y �'°
Room 100 Wit • :'`!
Northampton, MA 01060 Two+ sf ' °k ``'�
phone 413-587-1240 Fax 413 -587 -1272 Plot/Site ,��t , ; r •
Other S• foLk. f °��` ; ` ai ` ^:
APPL;CATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION 1
This section to be completed by office
1.1 Property address
r Map Lot Unit
AO rQMpAtYC Zone Overlay District
Elm St. District CB District
I SECTION 2 - ''ROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
e s\-- •
Name (Print) Cu not Maiung Addres rilofod
_attleht‘i TeWrione `1
Signature
2.2 Authorized Agent:
l ater 1 q.e,i. - . • _ 1• 1111 •
Name (Print) Current Malang • .dress: Q 1 O'
U413) 52'7- 4175
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building 13.00fI 4-si q 00 . 00 (a) Building Permit Fee
2. Electrical v (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical HVAC)
f
::: : Fa 3 + 4 + 5) ( c Check Number / ag/ $33
This Section For Official Use Only
Date
Building Perm t Number. Issued:
f _
Signature: ,_
Building Commissioner /Inapector of Buildings DWI
VOWiti maw T r` BP- 2010 -1085
GIS #: COMMONWEALTH OF MASSACHUSETTS
V.6i 24C - 186 1
A 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 -1085
Project # JS- 2010- 001592
Est. Cost: $7800.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): 5924.16 Owner: COHN MERYL
Zoning: URB(100)/ Applicant: RCI ROOFING
AT: 211 CRESCENT ST
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 - 4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:5/28/2010 0:00:00
TO PERFORM THE FOLLOWING WORK:STRI P & 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 5/28/2010 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo