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29-074 (4)
RC ". oof ing 51B Holyoke Street P.O. Box 309 ESti m ate Date Easthampton, MA 01027 Phone (413) 527 -4775 6/19/2009 Fax (413) 527 -8469 Name / Address Job Location Sheila Harlow 46 Acre Brook Drive 46 Acre Brook Drive Florence, MA 01062 Florence, MA 413 - 584 -1432 Terms Rep Estimate valid for 20 days Bob Job Description Total Remove existing roofs on House and Addition only- Recover Shed, Porch and 7,100.00 Garage. 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 shingle. Furnish and install CertainTeed approved ridge vent. All exterior roofing related debris tote removed by R.C.I. Roofing. All work will be performed according to manufacturers' specifications. 5 -year RCI Roofing workmanship warranty included. 30 year CertainTeed material warranty included. All related permits will be obtained by R.C.I. Roofing. SPECIAL ITEMS NEEDED Add $2.50 per sq. ft. for wood decking replacement if needed. Add $1,000.00 for Landmark - Woodscape Premium shingle. Add $180.00 for Certainteed Surestart Plus 5 -Star extended warranty (included for rip price if signed estimate is returned within 7 days). dr , ,p - 6 7 Vy e - WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total $7,100.00 TERMS OF PAYMENT 5% Deposit AL eoc...) Balance upon completion Customer Signature Registration # 126235 Construction License # 074334 Date ?� 0 .2(3-09 Insured by Reynolds, Barnes & Hebb, Inc. 413 - 447 -7376 ) , • • • Fite evon4nootwea/Ag o/../Maksaclutarla Board of Building Regulations and Standards • Construction Supervisor License LiceneeN CS 74334 (2010 Tr# 23520 1 -V /71 MARK T DELISLE 33 FIRST AVE EASTHAMPTON, MA 01027 Commissioner • gge -6 or.,./11.444aoltadata • Board of Building Regulations and Standards , g HOME IMPROVEMENT CONTRACTOR C. ad' ?, Registration:\ 126235 Expiration: 5/6/2010 Tr# 266063 • )TiPe: Partnership ," • R.C.I. ROOFING I MARK DELISLE 51 B HOLYOKE ST. , EASTHAMPTON, MA 01027 Administrator te..k • ti. • ' ' • ' "614141., P o�` a • ' • (i xi of Northampton �, ^ `. ti � . Y ... r g ,glssartd MI ; _ hi ;.ry> • DEPARTMENT OF BUILDNO INSPECTIONS - ` T . 212 Main Street • Municipal Building Y Northampton, Mau. 01060 • ' � `''' 4. WORKER'S CONIPENSAITON INSURANCE AFFIDAVIT I, - • • • • • i, 4 (liana /permittec) with a principal place of bi'sinesslresidence at: • - t - • . . ,.. _....._. 9, Ol0" '� (hone #k113) Sal -gerr5 • ,. • - city/state/zip) do `:ereby certify, under the pains and penalties of perjury, that: (.z an an employer providing the following worker's compensation coverage for my employees working on this job: IJo.) c o..\ ks.r:on f■ re, zns- co. oC. F•ksSo , Q 14, vje3(,3 \1os to (Insurance Company) (Polio/ Number) (Expizatib Date) ( ) 1. am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Eacpitation (Name of Contractor ) ' - (Insurance Company/Policy Number) (ExpiradoiDate) (Name of Contractor) (Insurance Company /Policy Number) (Expitatlos Date) • (Name of Contractor) ( Insurance CompanylPolicy Number) (Expiration Date) (�a.,.ch sdditiooal shoo if n000:ury to include iafonnatioa paainiat to an oodraetas) .. () x am a sole proprietor and have no one working for me. ( I am a home owner performing all the work mysei£ NOTE: please be wove that Ntkalo bom aecs aow w =ploy pioy pusom to do maiatmtacs ,coastrodi•o•or spaitwatk so tames at . :IV, more than throe waits is 'Midi the bomooaoer resides a oa the :I'ouodr spputteosottbetoto we ad row* coasidtt•4MM ca ?loyc: s uada . the vicckeel coa Act (GW2, t(S)). of ptiatico by a boateowait Ar a Bove a paemit atttasidetetti• c .1 etaau of as employee win.** Wodcoe's Coaopeoaatioa Ad. -;' ` ` • 1 aad•tstsad tbst a ropy ottbls r'kr' mt may b• Sorts d•d to dt• geno set etlidueld MAW/ NW d to solitib ovcsacveriMcatioo sod that Wks tos• aua romp ttoderseodoa2, SAatital ,IA lead ledrimpaeedablll pan ' ,• m sistiag dame bfup to SI,S00.00 indict ma imprisoat of tip to out ryas! peodess is t $ IMm eta /iep a I* teal a •' fiz3 of S I OO.00 t dsy t p art tea s' ' Y; i t • ? 'J , , .r.rrrrwlrl , .,, L :;. _ S im oftio=sec/Permittee Dste SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 • 1 ,�, Name of License Holder : My h eS le, /7 3 '3' • License Number • • . 5 -03 - ♦ am • O � 'a ay ILO 1 Address - Expiration Date 13) 521- 1 1 g ?5 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 fi• / Rh° Company Name Registration r N 235 Aaareaa Expiration Date S aYnp #on M . 0)0 Telephonki1 .47Z5 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) 1 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 e No ❑ 11. — Home Owner Exemption The current exemption for "homeowners" was extended to include Owner-monied Dwellings 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 actg as supervisor. CMR 780, Sixth Edition Section 198.3.5.1. 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 -near 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 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, von may be Sable 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 Statc of Massachusetts General Laws Annotated. � tad ' Homeowner Signature 2 t . . „ „vi W i {, ;4 1 k �.. {.. W, ,..t F r F • 1 3° • SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House 0 Addition E] Replacement Windows Alteration(s) ❑ Roofing EYI Or Doors 0 . . Accessory Bldg. ❑ Demolition ❑ , New Signs [D] Decks,[[] Siding [O) Other (Ci' • ' Brief Description of Proposed at a h Work: L Pl 1 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: j a. Use of but ding : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms .... - i . c. Is there a garage attached? - ♦'' r d. Proposed Square footage of new construction. Dimensions e. Number of stories? 1 f. Method of heating? Fireplaces or Woodstoves Number of each 1 g. Energy Conservation Compliance. Masscheck Energy Complianoe.form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No I. 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 1, , \A r \ ,k, \. 0.. `- V. - -C \ kJ , as Owner of the subject property ^� L° R hereby authorize caY 1> i S c �! 7 RooTly to act on my behalf, in all matters r atve to work authorized by this ui ding permit application. . d • `7 -7,4 —c 9 S'i- .,:,.c Owner Date I , 4 . a , - sus ' • • • .1 as Owner /Authorized . A gent hereby declare that the statements and information on the foregoing = , ication are true and accurate, to the befit of my knonlIedg• and belief. • Sigried:under the pains and penalties of perjury. Print Si! a.!'fOwner /Agent Date r Y 3 f J - - aF ,- 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 1 1 i �:� ._._.._._._ Frontage I 1 1 1 C . Setbacks Front I Side L: R:' I L:I... R:( .. _.__ Rear i I . _.._. .____.] Building Height i 1 B'dg. Square Footage , :% Ooen Space Footage tt (La area minus bldg & paved e _ 1 i pa-king) # of Parking Spaces ` I • , - Fill: i (volume & Lpcation)_.. _, _ ..J A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES IF YES, date issued:[ - . IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book f 1 Pagel and /or Document # -------- 1 B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO O IF YES, describe size, type and location: I D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO Q IF YES, describe size, type and location: E. Will 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 © NO Q IF YES, then a Northampton Storm Water Management Permit from the DPW Is required. 4 ■ r City of Northampton Sta , Building Department trurb'C III ,;. 212 Main Street '' �� `' ' Room 1 00 I f . Northampton, MA 01060 r, . -..! phone 413- 587 -1240 Fax 413- 587 -1272 Plotit .',4,-,,,:',.:',..., • OthertS .r 4s '1 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 :4 (p 0,C,«' bra b YN Map ' Lot Unit 't'" lG'��..X\ L.�.. Zone Owrtsy District _. ' . .. Elm St District CB DMbict SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Sei, \_ a A0 q C cwt) : Z . AortA , Name (Print) Current Malili dd :�_ - 2tta eh e 61 Telephone CC�� Signature 2.22 Authorized '� Agent: �{ c _ 1 �,� ; + Name Mal* nT 1 J P. ' . l e, - ft.0 .1.. loo 1 i : Cu�M Mailing Address: 4-. So � 1aM{ % 'e—.--.%__— (1I3) 521 4?15 Signature Telephone • SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Offidal Use Only completed by permit applicant I 1. Building R.00fi 4 1 , 00 . o c (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of . . Constriction from (6) 3. Plumbing Building Permit Fee 4..ailchanical (HVAC) 5;'F e¢Ptotection 6. T o t a l = (1 T 2 + 3 + 4 + 5) $ 1 1 c C.) • O 0 Check Number This Section For Official Use Only • � Permit Number. • Date • �ti�' I ssued:, .. �` ` .fi : 6r ; x I `, Building Commissioner/Inspector of Buadings p '_ '•. Si1r�YUrr yr , y s kN ltl • y # ' `* BP- 2010 -0090 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 -0090 Project # JS- 2010- 000099 Est. Cost: $7100.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 126235 Lot Size(sq. ft.): 14853.96 Owner: HARLOW PAUL J & SHEILA P Zoning: URA(100) / /WSP Applicant: RCI ROOFING AT: 46 ACREBROOK DR Applicant Address: Phone: Insurance: P 0 BOX 309 (413) 527 -4775 Workers Compensation EASTHAMPTONMAO1027 - 0309 ISSUED ON: :7/27/2009 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 7/27/2009 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo