25A-041 (2) .. Roofing D ate
6 line St. Est i m ate
Southampton. Ma, 111073 5/31/2011
Phone (413) s -4775
Cas 41 3) 527-346)
Name / Address Job Location
David Pascucei 26 Marshall St.
26 Marshall St. Northatr)pton., Ma. 01060
Northampton, Ma. 01060 (413) 531-0937
Terms Rep
Estimate valid for 30 days Daye
Description Total
Remove existing rooks. 13.400.00
Furnish (Kt install aluminum drip edge. pipe !lashings. chimney (lashings and step (lashings.
Furnish & install new lead counter !lashings.
Furnish cX.: install CcrtairfCced Wintereuard ice & water harrier along eaves and valleys.
Furnish and install synthetic underlavment over existing deck.
Furnish and install 30 year Certaint eed Woodscape Series shingle.
Furnish and install Certain'Ceed approved ridge vent.
All exterior roofing related debris to be removed by R.C.I. Rooting.
All work will be performed according to manufacturers' specifications.
All work will be performed according to new OSHA 6/1 5/201 I standards.
30 year Certain teed material warranty included.
All related permits will be obtained by R.C.I. Roofing.
Add .$2.50 per sg. It. for wood decking replacement it needed.
Add: $ 1.400.00 for Certainteed Landmark Woodscape 50 year premium shingle.
A Certainteed Sur Plus extended warranty will be included with a tee of ($560.00)
absorbed by RCI Rooting if signed within 7 days. This extended warranty means that 20 of the
30 year warranty is covered (or labor and material. The last 10 years of the 30 year Certainteed
warranty would be covered fix material only.
WE 1.00K FORWARDTO DOING 13IISINI SS WITII
Total $13.-4000)
"('ERNS OP P \ \" MINT
5`/ Deposit
Balance upon completion Customer Signature
Registration t) 126731
Construction license ft 074334 -I D, le /_ / /
Insured by I'ickerr Ins.
(413) 527 -2700
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i Ile Lommonotilih 0,1 Nassuchusetts
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l)epartinent (y Industrial Acculeitts
-.4 - '2,721"/ , '' ,
OffiCe (II InveSlii;(ition,s'
'•:1 ';--1.)\ Tr::: - 600 Washington Street
B)SIO/1„11A 02/1/
4'. MUSS. go w`dia
rs/Contractors/Electricians/Plumbers
\\ ori,.ers' Compensation Insurance Affidavit: 'Wilde
Alipiicalii Information Please Print Legibly
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;ii. cw Check the appropriate box:
'I of 'ni( uir • I
LIni ,t ''.:ene;al con;racior ., " ce( re ( 1 " )
H ;,,, c mred :lie , c u i) .. con t ra , :tt „,. ; () Li New e
LH;,., L'-.:. ,!..i, aH,f,o:' p, •
ie:ol or ;)itilne; - ii Lit on the ;ittached sheet. 1 I 7 Li Remodeling
l'hese sul-contractors have I i S. 1 Demolition
‘J-,,.: ;',: me ;I; any capacit\ employees and have workers'
, 9. LH Building addition
t WtitlIZUICC
t.."(Allp, illsuNIJICe.' I 1
tit''.
", L _ are a corporation and its i 11).7 Electrical repairs or addition':
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officers have exc,vcisecl their 1 ; I I .r_ Plumbing repairs or addition:.
right exemption per NThi.
" ork ol . ,..:.ornp. i 2oof repairs
, • c. ifs:, §i(4), and we have no 1 I
1 1 _ employees. No workers 13.D Other
comp. insurance required. j i
,,., ..he,k. H lli imillSf :11til fill out the section below showing their workers' compensanon pk)hey informAtion.
Ai lifilIVII Illtili.M111F 1f)C1 are titling all rk and ICI) Sure outside Cu mnictorti must submit a new lltidnyit isidicamq Skik:f;
•";., : : ..:,:,‘ ;L' ■',•■ Olt0( ■WitChl!fi All Atifilf1011ili sheet showing the ;tame ml the stib-etmtruetors miti state whether Of not those C.1)6(105 hour
, ::•:+,■-•,' • .' ' •itON t/: cmp:oyees. they :111./,0 p(M Ide their \4(111iCt . t2omp. policy number
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: „ • , r 1 ,Jr, em(t ,,,',., ih,i; is proridid:: no!):ers compensation insuronce far emplorees. Below is the policy and lob site
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ENpiration Date._ / _p_ f,--.-.2.±. ,c)
S\-- cdyisiiiiezipsAk,--A4AckmfVoq VV.- eloc,o
■It:i,:ii :, cop, it the ■vorkers' compensation policy declaration page (showing the policy number and pirs.tiun date),
;0 -;c: ,1 ens come is required under Section 2.5A or N c. 1.'32 can lead to the imposition of criminal penalties o; a
do ,;ndior onc-vear imprisonment, as w e l l as c i v i l penalties i n the Corm H a STOP WORK ORDER and a irl
: :S.2.t, ,'q) ;1 ja apinst the violator. Be advised that a cops or this statement may he Corwarded to the Office or
,,l' the DIA Or ifISUrtinCe coverage verffica(ion.
/ ■I1 h(V ■ .'if r rimier thc:plainS find pentthieS of perjury that the information provided above Lv true anti correct.
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''h'2,!.ici ''--,'‘; ,..'i ,.,..'— TA - -,. 1
()Indio' ,,‘, it ft 110 11(11 write in this area, to be i.'ompleied by city or to 'n o//1c1.
PiirmitiLicense r4 _
1 : 0NS RUC 10N SERVICES
License;; construction Supervisor: Not Applicable 0
M '1/ k le.1.1E
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License Number
i
L , s . • W . e • — t� 3 - 12
—.
Expiration Date
(1.13)__ - 7 75
//I/ Teif:pnone
R ea tstu Home Im ,rovement Contractor: Not Applicable 0
C I. 2 235
D?''_ n. : Registration Number
-\"". 5- - 1a
Expiration Date •
11,11 r — MCi..._Q LL17 3 — 7elephonr013)3,2 _4 715
SECTION t WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
n;sation insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will re_sutt
'h_ cer,00 he issuance of the building permit
,,cached Yes No LI
l 1. - Home Owner Exemption
C.Al'rli(�;ion for -homeowners- was e.Atended to Inc O w ncr•occupicd Dwetiines of one (I) or two(2) families
nomcowner to engage, an individual For hire, who does not possess a license, prQYIdtd that the owner actl
,t.upervisor. C; ,MR 780, Sixth Edition Section 108.3.5.1
ir_ inition of homeowner: Person (s) who own it parcel cif land on which heishe resides or intends to reside, on which there
, intended to he, a one or two family dwelling, attached or detached structures accessory to such use and / or farm
,\ person who constructs more than one home in a two -year period ;.hall not, be considsred a homevn•tisr.
om,coivner shall submit to the Building Official, on a form acceptable to the building Official, that hcthe }h✓AU bF
c for all such work performed under the buildinE permit.
o o: ;%; Construction Supervisor your presence on the job site will he required from time to time, during and upon
of the work•tor which this permit is issued.
, he advisee,! ;hat with reference to Chapter 152 ( Workers' Compensation) and Chapter 153 (Liability of Employers to
, ovecs Co; injuries not resultin in Death) of the Massachusetts General Laws Annotated, YQtt ma7 Qt li #bk for person(s)
to perform work for you under this permit.
,macrsi ned "homeowner certitles and assumes responsibility for compliance with the State Building Code, City of
t:,;t;ni;;,�r t)ruinances,
State and l Local 7,oning Laws and State of Massachusetts General Laws Annotated.
nro •ncr signature
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5�CT]lN5. DESCRIPTION OF PROPOSED WORK (check all applicable) -------- ----- -- _ ____ l
Xew Hoos� [—� � Addition �� | Replacement Alteration(s) --| Ro nO»q -----|
Or Doors L� � ' / ' / '
= —1 i F -- ----'---
:cccs`nrvzY , l 1 Demolition L_J New Signs ([]) Docko([] Siding '
_ ___ ___ __'-_l ^______ \ --' _
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H:'! :Sc:;1 »f Pmp
`�`��� _______—____ ir'� __�
. .u.x,'u'. a, ..^x`� ,,:mon` ,c` NO ' Adding new No
x
.;uc�cc ec.o"=
Renovating unt firs basement Yes No
z,:a�nnc,. ` xo/ 5xeet '--
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U Now l and or addition to existing housing, complete the following:
^ :,c at /`` .^"`;
One ppm./y _______ Two Family __ ______ Other . . —
. x..``b, � rooms in each family unit Number of Bathrooms .,
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i. � :*,o ;o'oc a:acxcu7 ,
; p/nrn`".: Sn.p'o footage
of new construction Dimensions
c w./m�c':
xe/xoc .i ncu,: ' Fireplaces or vvoouotovno _ __ Number of each _____
; �nc,y� 1 ` `c■^:vc (,:o.nnuonoc Wa»xcxocx Energy Compliance form attached?
,do z;:^avvc:on
/sc�os - mr, w*m 100 ft, ofweVungs7_Yes ___ _wo Is construction thin 100 yr. floodplain Yes No
D^p:",l: cellar floor below finished grade ___
______
�v« ::.�ir; �i: o :nc 3:,|d.ng and Zoning ,ryv/ahnns7 Yes No
Sopt,cr^ �.�y5cwc, ------ Private --- City __
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5EcT>Ow Ti. OWNER AUTHORIZATION ' T0 BE COMPLETED WHEN
Jv)IwERG AGsuT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
___ _ ________
. & _ {-C v ________�__�__ __________ _ . 83 (Miler of the subject
! �:apeny
,e/m/ ^"rc �) ___
.c s/ on c. �.`a: m an matters '�a:vc to authorized by m / s� w.m/ng permit application. |
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/ a o _ . wsO°n~o�Amhndood
! '`�� � —�!� i��r information on the foregoing a hcatinn are true and accurate, to the best of my kno*hmd9e
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. !D'gneuunue e pains and penalties of pequry.
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:CNING Ak r must Be anokqed. Permit Can Be Denied Due To Incomptete Information
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ilmSling , Proposed Required by Zoning
, , 1 This column to bc fillei oi by
litilkfing Department
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a Special Permit/Variance/Finding ever been issued for/on the site?
riO 0 DON'T KNOW 0 YES 0
,F YES, date issued:'
IF if.r., ',Vas roe permit recorded at the Registry or Deeds?
—• Q -•
,0 DON'T KNOW 0 YES 0
;F YES enter hook Page ' and/or Document #
the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0
IF YES. ' a permit been or need to he obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued: !
-. Do any signs exist on the property? YES 0 NO 0
I
IF YES, describe size, type and location: i
, .
At' there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0
IF YES, describe size, type and location: I
: .•ri';, iu construction activity disturb (clearing, g excavation, or tilling) over I acre or is it part of a common plan
, ,.i3; ..s,di disturt over I acre? YES 0 NO 0
Normarnoton Storm Water Management henna from the DPW is required
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City of Northampton ..,, i
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Stattit'o(*),1'
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,Nc'46 Building Department Curb C
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212 Main Street
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Room 100 WitpitW :1.";\
. 4 ± -0,,,01.1. n. . ,. . .
Norlhampton, MA 01060 . . .
,,,,, •, ,„,, wi . ,,„ ,. , • ' ' , ..'ir ".. . r . .
413-587-1240 '.ax 413-587-1272 Rlot/Site FM A 0.. ,4444i."....,0,,` .. ,t '"*
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Other SpoOttr . ult ., , 4 .• i • •,.• ,,, .• 1 .,. "0
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APP. ,:ATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - %;TE INFORMATION i
I
Propert iress This section to be completed by office
1.1 yA::(
--S\ Ma p _ ' Lot Unit
NG 1..t.-Vai •-(1 Zone Overlay Dlattict -
— Elm St. District _ Cli Mt/WO
ECTION "ROPERTY OWNERSHIP/AUTHORIZED AGENT i
C)wner ot ,:ecorci:
2,6 tYla_rs\-,A1 I % ,A
- \ - A A \,,,,, ..,4 04,„ A.
-- - ------ --- -- i
';,)(11c• " Current Mailing Address:
tt C. h e.,....... 1,4k 5 1 - 0a3..
____
Telephone
Signature
C Authorize Agent:
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Mark 1) e.. 1 e, - ...(1,1.., • ______ - ,
- el . • • a • DS D •
(Pnnt1 / Current Mailing • ddress: 0 1 6
C3) ,_ 21- 4/
....
(alai:it
___— • ---
SECI;ON 3 - F- CONSTRUCTION COSTS I
i
:en Estimated Cost (Dollars) to be 7 ---- Official Use Only
completed by permit applicant I
Bung ,
' i ril 34 t3 L k 04 . C. (a) Building Permit Fee I
i*.. (b) Estimated Total Cost of
Construction from (6) .._j
___ _......._
P!,irrt(r,,,T. Building Permit Fee
4. mechan)u HVAC) ,
5. Fire Protec: n c ..J
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2 . 3 . 4 * 5) $ 1 °C) Check Number I 1( a I
_
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This Section For Official Use Only .-
Date
Building Pe ,...-: Numt,t _________ issued:
;.;i
Riliktine ComMISalonerAnspector of Bulkiings Dote
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26 MARSHALL ST BP- 2011 -1088
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25A - 041 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 -1088
Project # JS- 2011- 001752
Est. Cost: $13400.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq. ft.): 10193.04 Owner: PASCUCCI DAVID E & DIANNE MACK
Zoning: URB(100)/ Applicant: RCI ROOFING
AT: 26 MARSHALL ST
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 -4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:6/23/2011 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 6/23/2011 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner