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25C-234 David Brown Estimator Page 2 This proposal is accepted by _ , A4 . .....1.L.4.,-.4 Date l > D i 2-- (Signat re) .�. . Roofing,,, 6 Line Street, Southampton, MA 01073 Phone: 413-527-4775 Fax: 413-527-84 Date: July 3, 2012 Ref: 177 Bridge St Northampton, MA 01060 Attn: Amy Perrier Thank you for the opportunity to provide this proposal for slate replacement at 177 Bridge St., Northampton, MA. The following is the scope of work that RCI Roofing LLP will provide. Scope ## 1 Slate Replacement Remove existing roof on main house Remove wood shacks under slate roof Furnish $ install %z" plywood over existing decking. Furnish & install aluminum drip edge, pipe flashings, chimney flashing and step flashing. Furnish & install new lead counter flashing if needed. Furnish & install CertainTeed Winterguard ice and water barrier along eaves and valleys. Furnish & install synthetic underlayment over main house. Furnish & install 30 year CertainTeed Series Shingles, Furnish & install new ridge cap to home. All exterior roofing related debris to be removed by RCI Roofing. 30 year CertainTeed material warranty included. All related permits will be obtained by RCI Roofing. 2 year RCI Labor Only Warranty Issued Price: $10,700 Terms of Payment 5 % deposit due upon signing contract and the balance upon completion of project. We hope that your will select R.C.I. Roofing to do this work, and if there are additional questions to be addressed, please contact us. To accept this proposal, please sign the below and return one copy to us. We will call you about the schedule of work. Sincerely; SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: p Not Applicable ❑0 Name of License Holder : Mar De i s i pp s l ? "I 3 34 License Number 51 B 1-loh St.- Easth a m pion Ma. o 1 o at/ 5- 03-1 Address Expiration Date (4 i3) 52?- Ljq 75 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ f1�. oof; 1.26235 Company Name J Registration Number 51g No1yoke Street - P. O. Box 309 5- o,b - Address t1 Expiration Date Easthrnpron Ma. Q 1 o eZ. r R Telephon��'}I 3) 52/ 4715 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 No ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied 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 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 attached • SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) "'oofing Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [El Sidin [0) p Brief Description of Proposed Work: (, � }tanhed 4fii 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 PST c e_r , as Owner of the subject property hereby authorize t May h .d l sl e of P 0.T. Roof, n to act on my behalf, in all matters relative to work authorized by this - building permit application. 9 att ached I 12., Signature of Owner Date I, ,far i "Del ► sl e,, as au t1IoY i 7ed agupt , as Owner /Authorized Agent hereby declare that the statements and 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. Nlayk Print Name 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 (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Lpcation) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? ., • NO 0 DON'T KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW 0 YES 0 IF YES: enter Book Page and /or Document # Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES Q NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 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 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Department use only - -. City of Northampton Status of Permit: _ Rt ., �� ' P Building Department Curb Cut /Driveway Permit _; 212 Main Street Sewer /Septic Availability JUL P 2112 Room Water/Well Availability Northampton, 100 01060 MA Two Sets of Structural Plans 1 �i=_ : c� eu,,_ piRa 4'13 -587 -1240 Fax 413- 587 -1272 Plot/Site Plans NOR1HAMF MA 01060 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 ill EST kNZ, ‘ \-- . Map Lot Unit N 0.M (Th X10. Zone Overlay District a `E' i Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: \ 1 ` 'e- ♦ \ 'fi x ` I to rsi ' . - t5'k -• !J0 IL&0. !yea a . P t 11:.11 Name (Prin Cu e.ailing +. a rss: e a attac hed X 41 nt M -) t3 CIA —3 t d e Telephone Signature 2.2 Authorized Agent: Malk 17e. ' le, - q.c.i. )oof; n 6 Li e — E,Soab arrp_ nii, ,Ma. Name (Print) Current Mailing Address: 4101x. - ∎— t-. (q13) 521- 4115 ��:+ Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building RO Of t 4 I U I O0 00 (a) Building Permit Fee 2. Electrical 7 (b) Estimated Total Cost of _ _ Construction from () _ 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) lit 1 "1, 00 , V© Check Number d V This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date 177 BRIDGE ST BP- 2013 -0057 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25C - 234 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit # BP- 2013 -0057 Project # JS- 2013- 000085 Est. Cost: $10700.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 74334 Lot Size(sq. ft.): 18513.00 Owner: GOLOB BERNARD M C/O AMY M PERRIER Zoning: SC(64)/URC(36)/ Applicant: RCI ROOFING AT: 177 BRIDGE ST Applicant Address: Phone: Insurance: 6 LINE ST (413) 527 -4775 Workers Compensation SOUTHAMPTONMA01073 ISSUED ON:7/16/2012 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 7/16/2012 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner