Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
29-117
• Roofin� LLI' 6 Line St. • Southampton, Ma. 01073 ESti m ate Date Phone (413) 527-4775 2/23/2010 Fax (413) 527 -8469 Name / Address Job Location Steven Lucey 88 Forrest Glenn Dr. 88 Forrest Glenn Dr. Florence, Ma. 01062 Florence, Ma. 01062 (413) 584-1626 Terms Rep Estimate valid for 30 days Dave Job Description Total Remove existing roofs. 7,600.00 Furnish & install aluminum drip edge, pipe fleshings, chimney fleshings and step fleshings. 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 to be 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. Add $2.50 per sq. ft. for wood decking replacement if needed. Add: $950.00 for Certainteed Landmark Woodscape 50 year prernium shingle. f qa c S ti/ It' Add: $380.00 for Certainteed Surestart Plus extended warranty (included if signed estimate is returned within 7 days). Furnish and install Velux Model #TMF - 014 -0000 flexible sun tunnel skylight with 330.00 acrylic dome through roof only. WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total $7,930.00 TERMS OF PAYMENT 5% Deposit Balance upon completion Customer Signature , L { --` ' Registration # 126235 Construction License # 074334 Date Si / Q p 0 Insured by Reynolds, Barnes & Hebb, Inc. 413- 447 -7376 Ae eans4nan 0/ ✓160eaciu4a.azt j Board of Building Regulations and Standards I , . Construct* Supervisor License V Li cjr►s� CS 74334 1 i7 s ( 2010 Tr# 23520 ( , it �.: ice? - t , MARK T DELISLE i . 33 FIRST AVE e T . d . . " e . . . — _ - E A S T H A M P T O N , MA 01027 Commissioner g lee eatwmanu ia a/..%�Laaaac esadas Board of Building Regulations and Standards .: i ; � HOME IMP( OVEMENT CONTRACTOR i (j iF .. Registration: 126235 Expiration: Expir 5/� 010 Tr# 266063 Type: Partnership R.C.I. ROOFING MARK DELISLE 51 B HOLYOKE ST. ._.. —_ EASTHAMPTON, MA 01027 Administrator The Commonwealth of Massachusetts -,---- Department of Industrial Accidents r =Mr... Office of Investigations 600 Washington Street we • 11111111 ' I Boston, MA 02111 w ww.mass.guv /cliu Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): t l aQ N- A ddress: (\,. \ e.. ityi State %Zip: , ,. • • a •13, Phone #: ' L 1 :e you un employer? Check the appropriate box: Type of project (required): I ani a employer with 20 4. ❑ 1 am a general contractor and 1 employees (full and /or part - time(.' have hired the sub contractors 6. El New construction I an a sole proprietor or partner- listed on the attached sheet. 7. [ ' Remodeling ship and ha ve no employees These sub - contractors have g P � [1] Demolition working for me in any capacity. employees and have workers' 9. Li Building addition No cc orkers comp. insurance comp. insurance.: C We are a corporation 5. oration and its 10.[D Electrical repairs or additions t. l I I arts a homeowner doing all work officers have exercised their I I .❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[ Roof repairs insurance required.(' c. 152, §1(4), and we have no employees. [No workers' 13. ❑ Other comp. insurance required.] '.•any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. f iotncowners %, ho submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. •Cuntraetors 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. trill,: th,: sub- umtractors have employees, they must provide their workers' comp, policy number. 1 cart an enrployer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy 0 or Sell -iris. L.ic. t1 rat{ 5'$ 0 35 ( � — Expiration Date: 1 0 " ,j - aQ 0 Job Site Address: g' 'rcGtr-e.c. 6 t ,n ". City /State/Zip4V t (►'�a' Maio :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 tine up to $I,:SOO.00 and/or one -year imprisonment, as well as civil penalties in the form ofa STOP WORK ORDER and a ti or up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under the ins and penalties of perjury that the information provided above is true and correct. _ Date; __ Date; ` 1 2. —1 d i'horie#:' ?)) - Official use only. Do not write in this area, to he completed by city or town official. Town: Permit/License # g Authority (circle one): tl : d rd of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector t 4, .e,st 1 Phone r�: SECTION 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ p Name of t 1co s N 4lt74r y i License Number `lne� o • 4,11 s. •• It . . 171 5-03-/0 peeress Expiration Date 0413) 52/7- ti + g alo re Telephone 9, Registered N■rne Improvement Contractor: Not Applicable ❑ Ft. C. I. ot7 126235 Company Name j Registration Number i 1T`- -Lb yccrC�� t� M n 1 t1 �/ Expiration Date Sala liarnpTYt Mar 0103 Teiephon�yl f75 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.(LL. c. 162, § 26C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result +n the denial of the issuance of the building permit. Signed Affidavit Attached Yes. _ QK No ❑ 11. - Home Owner Exemption rho current exemption for "homeowners" was extended to include Owner- eccunied Dwellings of one (1) or two(2) families :+nd to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner ac( as supervisor. CMR 78O, Sixth Edition Section 10$.3.5.1. Definition cif Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there >. or is intended to be, a one or two tinnily dwelling, attached or detached structures accessory to such use and/ or farm . ructures. A person who constructs more than one home in a two - year °cried shall not be considered a homeowner. ;ugh ''homeowner" shall submit to the Building Official, on a Corm acceptable to the Building Official, that be/she shalt be r far RII suct_work performed under the building permit, \; acting Construction Sung -visor your presence on the job site will he required from time to time, during and upon completion of the work.tbr which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to ':. +npiovecs fix injuries not resulting in Death) of the Massachusetts General Laws Annotated, You may be Bettie for person(s) you hire to perform work for you under this permit. 1'!,c 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 _ al.t 0 heC1 -------.._, ____..---- -- _------- ---- .� - -__- SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House l l Addition n Replacement Windows Alteration(s) n Roofing ryi Or Doors 0 . Accessory Bldg. l Demolition [ i New Signs [D] Decks lQ .. Siding l0) Other [0] Brief Descnl>ron of Proposed ',:rock attaeherl __ Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll • Sheet 6a. If Newhouse and or addition to existing housing, complete the followins;l: J Use of bL;dding One Family Two Family Other _ P Number of rooms in each family unit. Number of Bathrooms I c Is there a garage attached? '•'' u Proposed Square footage of new construction. Dimensions i e. Nurnbe of stones? Methoo of heating? Fireplaces or Woodstoves Number of each . Energy Conservation Compliance. Masscheck Energy Compliance form attached? Type of construction _ Is construct on within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No Depth of basement or cellar floor below finished grade k Will budding 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 - as Owner of the subject property nereby authorize L ►ar - D e � 1 S ,, of b • ci. ►+ . RV0c1 n to act on my behalf. in all matters r lative to work authorized by this ui ding permit application. 9 At ached 3- Iz. -1C0 Si O Date I 1'r ! Z ' - ' g « I ,0 , es Owner /Authorized .agent hereby declare that the statements and information on the foregoing ..•lication are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. k S lied Print Name 3 -1Z-10 Signature of Owner /Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Dented Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department L Size I. 1 I I I l F; ontagc 1 1 1 Setbacks Front I I' . 1 Rear E.._____ _I BJilding Height ! I rill B i dg. Square Footage % I I i ODcn Spacc Footage (L area minus bldg 4 paved 1 i IS of Parking Spaces ( 1 Fill: (volume & L.peation) ( l - 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 O DONT KNOW 0 YES 0 IF YES: enter Book ! Page � and /or Document # B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES O NO 0 IF YES, describe size, type and location: IL i D Are there any proposed changes to or additions of signs intended for the property ? YES O NO O IF YES, describe size, type and location: _ L 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 () IF YES, then a Northampton Storm Water Management Permit from the DPW is required. r City of Northampton S 1 "'�'i „` , , ' ) Building in �r, Department box t i s 212 Main Street ,±1,,$,,,,,i-,,„ , r t, , 1 R 2010 Room 100 4 s A "`'''` J Northampton, MA 01060 i ' • ,' phone 413- 587 -1240 Fax 413 - 587 -1272 pt.oi } ,Y APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION This section to be completed by office 1 .1Pr 1 Property AsiUrubs CS O - CC ) C \g-'Rn ' c- Map • Lot Unit, . 0 .0 Ce. YZC..� Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: . U t_' _ ��.C- • 175g 'CU C ::S,\-- C�,� f_ �.4 c" c . _ ci0 c r_ikcc, Name (Print) Current Mailing Address: - 4 . a checl ( -it3) 5 -I - 1(02.( Telephone Signature 2.2 Authorized Agent: �.i� l .lr,:: •_ •q.... • Name (Prim) J Current Mailing •dress: O i On3 - - - - (q13) 52'1 - 4 215 Signature Telephone SECTION 3 • ESTIMATED CONSTRUCTION CASTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant _ 1 Building Rooft 4 ` © , p© (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) ' c'? 7 0 • 60 Check Number /5‘ V >Yr3 S This Section For Official Use Only Date Building Permit Number. Issued: Signature. Building Commissioner /Inspector of Buildings Date • x 4 BP- 2010 -0803 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 -0803 Project # JS- 2010- 001185 Est. Cost: $8880.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 74334 Lot Size(sq. ft.): 14157.00 Owner: LUCEY STEVEN E & STEPHANIE MARTIN -LUCEY Zoning: URA(100) / /WSP II Applicant: RCI ROOFING AT: 88 FOREST GLEN DR Applicant Address: Phone: Insurance: 6 LINE ST (413) 527 -4775 Workers Compensation SOUTHAMPTONMA01073 ISSUED ON:3/1 6/201 0 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 3/16/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo