36-053 •
R.C. I. Roofing LII' l��
' �,Cjyt. .1�C C�7.l,`
6 Line St.
Southampton, Ma. 01073 Estimate Date
Phone (413) 527 -4775 4/5/2010
Fax (413) 527 -8469
Name I Address Job Location
Edward Doyle
65 Redford Dr. 65 Redford Dr.
Florence, Ma. 01062 Florence, Ma. 01062
(413) 586 -0095
Terms Rep
Estimate valid for 30 days Dave
Job Description Total
Remove existing roofs. 5,700.00
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 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: $750.00 for Certainteed Landmark Woodscape 50 year premium shingle.
A Certainteed Surestart Plus extended warranty (additional 5 years) will be included
with fee ($300.00) absorbed by RCI Roofing if singed within 7 days.
* Add: $500.00 for repairs to chimney.
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total $5,700.00
Soo
TERMS OF PAYMENT - _ ( 00, o6
5% Deposit 7 / `
Balance upon completion Customer Signature �/ f7 v ° G f'
Registration # 126235
Construction License # 074334
/A (
Insured by Reynolds, Barnes & Hebb, Inc. 413- 447 -7376 Date
'I
Board of Building Regulations and Standards
Construct* Supervisor License
Licanssh� CS 74334
/2010 Tr# 23520
ii - - 17,4:: tityt:0:ii; ,
MARK T DELISLE
33 FIRST AVE /_" - 'y ''
EASTHAMPTON, MA 01027 Commissioner
Att 6 v a o/..if6iaoa�iwo•4
Board of Building Regulations and Standards
ilk ";± ;� HOME IMPROVEMENT CONTRACTOR
e If f i g Registration: 126235
": „ ► + 4 Expiration: 5/6 /2010 Tr# 266063
Type: Partnership
R.C.I. ROOFING
MARK DELISLE
51 B HOLYOKE ST. (::;).„4 4.c:......,_
EASTHAMPTON, MA 01027 Administrator
The Commonwealth of Massachusetts
Department of Industriai Accidents ■
'A ti r .. ~ Office of Investigations
E ..... 600 Washington Street
= "
k Boston, MA 02111
i
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicaiii Information Please Print Legibly'
N;iftle ( liusures >.'Urganizatronfindividual): c_ T C QQC I . \-\-g
A ddt ess: ■ Yv P.. ,
i 1> : Stittc1ip: L 1 . . � . . 9 . o t0,. . _ _ . Ph #: 0 //3) , ,1 - L i l l 5
\rc sou an employer:' Check the appropriate box: — � j
r Type of project (required):
I am .r cnrpioyer with 7O 4 . ,J I am a general contractor and I
employees (full and /or part- time).'
have hired the sub - contractors 6. J New construction
- 7 1 am a sole proprietor Of partner- listed on the attached sheet. 7. [1 Remodeling
ship and have no employees These sub - contractors have g, 0 Demolition
employees ees and have workers'
svuri:itt� for me in any capacity. E y 9. Ej Building addition
No v■,trkers' comp. insurance comp. insurtnce.
5 i We are a corporation and its 10.❑ Electrical repairs or additions
req u i real . j _ _
.__I I am a homeowner doing all work officers have exercised their 11.E Plumbing repairs or additions
rrtssel: 1No workers' comp. right of exemption per MGL I
12.ryrRoof repairs
instrrt:r,:c required.) ' e. 152, §1(4), and we have no
employees. [No workers' 13.E Other
comp. insurance required.]
\n. appilcunt i ;,,i checks box al must also till out the section below showing their workers' compensation policy information.
i h m:owners ,• 4o submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
oniractors the; :neck this must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
trf,Ioyecs ((thtu sub- contractors have employees, they must provide their workers' comp. policy number.
1 ,rrrr an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
ifr/ormatiorr. (� n
'tsurance Cho :npttnv Name: act _ T'C..c\ L Q- •5s4,n• -\ \- — I. r\ S s
Policy ;; or Belt -ins. Lie. ?i:At,,,)C C y. S? C? 25 to .____.- -_ - -__ Expiration Date: I 0 - 5- aco Q
!oh Site Add: ess: _ Of . City/State/Zip: 'Htc>tenr r rrla. 0l0(,2„
Attach a cup c 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. I 52 can lead to the imposition of criminal penalties of a
Mile up to $1,' and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a tir
of up to $250 00 a day against the violator. Be advised that a copy of this statement may he forwarded to the Office of
investigations of the DIA for insurance coverage verification.
i rtri hereby certify under the . ins and penalties of perjury that the information provided above is true and correct.
sig lure; ____ _______� ________ Date: Z� =� U Q
it,,66 • c�t3 __ ,.12.,l - -nn
i t
Official use wily. Do not write in this area, to he completed by city or town official
. " r 'Town: Permit/License #
i 4.
i , i, g Authority (circle one):
1" +'lord of Health 2. Building Department 3. CitvfI'own Clerk 4, Electrical Inspector 5. Plumbing Inspector
6$ber
� )=r . » . . . . ... Phone h:
SECTION 8 CONSTRUCTION SERVICES
3.1 Licensed Construction SuDervi5or: Not Applicable ❑
or 4,,4,•, Hoing, Mar -e.i 1s it, - -.. -. _.__ '7 ?Li 3 1
License Number
t_ ,S 3. h - ioi3 5 - 03 - io
varess Expiration Date
( 13) 527-11'175
��Gr.aturc T elephone
9. Registered Home Improvement Contractor: Not Applicable ❑
L. "Roo fi ncj _ 126235
Company Name Registration Number
`.}�_ Expiration Date
So u.'1t1aYJtpTQY\ M r J'la. 0 1 07 3 Tetephonkil3)527' 7
• SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 26C(8))
'orkers Compensation insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
v_ the denial of the issuance of the building permit.
S ned Ahirt,vit Attached Yes. No ❑
1. - Home Owner Exemption
I he current exemption for - homeowners" was extended to include Owner- occonisd Dweitinis ()Cone (I) or twv(2) families
.1r:d to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner WA
.0 su pervisgr. CMR 780. Si ;th Edition _Section I08.3.S.t.
i)efinition Of Homeowner: Person (s) who own a parcel of and on which he/she resides or intends to reside, on which there
or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and / or farm
■c:tures. A person who constructs more than one home in a two -YCar period shall not be considered a homeoyper.
:-.,ch homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be
rsponsible for All such wori4 Performed under the building permit.
itcting Construction Supervisor your presence on the joh site will be required from time to time, during and upon
..■qmpietion of the work.tor which this permit is issued.
:so he advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
!; Iplucees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, You MAY be liable for person(s)
u hire to perform work for you under this permit.
'. !ic undersigned "homeowner certifies and assumes responsibility for compliance with the State Building Code, City of
<. (ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature -___ t„tae_
•
SECTION 5. DESCRIPTION QF PROPOSED WORK (check ail applicable)
New House II Addition 7 Replacement Windows Alteration(s) n Rooting •
Or Doors ❑ .
Accessory Sidg H] j Demolition � ___. .i . N ew Signs ID) Decks l Siding [01 Other ICI]
Descrij,: a):
: et ----- _ -- = n — =— - attacheij _
r•iteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Mans Attacnec7 Roll - Sheet
oa If New house and or addition to existing housing, complete the following;
. se at :)i. 4ting One Family Two Family Other
'Jambe: c! rooms in each family urn! _� ��� Number of Bathrooms
is there a garage attached?
▪ Pr opos•sc Square footage of new construction Dimensions
-. N'urmbe' a' stories?
t�tetnoc C' neating? - Fireplaces or Woodstoves Number of each
Energy %unservatnon Compliance Masscheck Energy Compliance form attached?
• ype of Construction _
is construct on within 100 ft of wetlands? Yes No. Is construction within 100 yr floodplain Yes No
, Depth , t •asement or cellar floor below finished grade
Wilt bw,ding conform to the Building and Zoning regulations? Yes No
Septic 7anx City Sewer Private well City water Supply
SECTION 7a • OWNER AUTHORIZATION • TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
_ V Zo L t.� V , as Owner of the subject
�rcuedy 1 " 1 1 (�
rrereby authors: e JYlar - Del i s e. Qf t . c. I . ROOF' 1 nQ
:o act on my behalf, in all matters r ative to work authorized by this uilding permit application. J
l.tached _` 9 -io icy
Si g Atieol Owner Date
_ � y k P ! i s 1 e, as a u t 11or'i 7 eri ao _rnt , as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing azaDIication are true and accurate, to the best of my knowledge
and belief
Signed under tine pains and penalties of perjury
__.k
e.
li sl t,
Tint Name
Signature of Jwnar/Agent Cate
,
; jeon .4. ZONING 1 Ak informarion must etc Completcd. Permit Can be Dented Due to rocomp(ete Information
. ,
1 EA isting PropoSed Rcquircd by Zoning
I rhis column to be filial in by
t I ['whim; Dept/Imam
_ - -- — ___
! Ht; Sii,c iI I
11 I
1 f
S ;6;1c6 Front I
I f 1
. ... . 1
(
it Car
1
I ------- -7----. _
'3 .11:(tIng Hcighl
. ,
i
1 5.4. Square FootAge 1 , % .
1 ■ i i ;
Strafe Footage
: ;; ,; art4 ni ItlUD
h k A: p.tvoi 1 !
Narking Spticc.N. 1 ,
r
---
[ , .
.5.: [ ■
_ —
Has a Special Permit/Variance/Finding ever been issued for/on the site?
N ° 0 DONT KNOW 0 YES 0
;F YES, date issued:,
i..
,F YES: Was the permit recorded at the Registry of Deeds?
NC 0 DONT KNOW 0 YES 0
IF YES. enter Book Pagel I and/or Document /II
Does the site contain a brook, body of water or wettands? NO 0 DONT KNOW 0 YES C
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date issued: 1 ,
■ .. _ _, . ,
Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and location:
'.; Are there any proposed changes to or additions of signs intended for the property 1 YES 0 NO
IF YES, describe size, type and location: !
l _______________
wii( me construcuon activity disturb (c.i aring, grading, excavation, or filling) over 1 acre or is it pan of a common pi,
:hat will Oi2iur disturb over 1 acre? YES NO 0
!F YES. men a Northampton Storm Water Management Permit from the DPW is required.
City of Northampton Si ,r r
Building Department i '`
212 Main Street r `s
Room 100
Northampton. MA 01060 ` 1 '
phone 413 -587 -1240 Fax 413-587-1272 , , ir , :, ,
64140, APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Prooe Address
This section to be completed by office f,, 5 [1C. wL O Cpl O t Map • Lot Unit_
kbccnCr✓ 'net- , Zone Overlay District
Elm St. District CB District
SECTION 2 - ?ROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
c i tix�r'c�
C-)CAS (0 5 e 4 rt. r .
Name (Print) Current Mailing Address:
4
- r chCl c Lu Ufa- vo9S
Telephone
Signature
y.�
6uttlor;Ze Agent;
th D P. • l c? . - • , I . �4 • • _ ...... •
Name (Print) J Current Malang • •rest: p ■ 0"13
(.413) 521- 4 115
Signature Telephone
SECTION 3 . ESTIMATED CONSTRUCTION COSTS,
.'err 1 Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1 Building Q OO f O o . (a) Building Permit Fee
2 Electrical i ` 7 (b) Estimated Total Cost of
Construction from t8)
3. Plumbing Building Permit Fee
4. Mechanica (H`v'AC)
5. Fire Protection
�"—
5 Total = (1 - 2 • 3 • 4 • 5) 0 0 O . 0 O Check Number l 5169 (p 1 3 S
This Section For Official Use Only
Date
Building Perm; Number. Issued:
Signature.
Building Commissioner/Inspector of Buildings Date
u.
i t
6SSAREDPORD DR J `' BP-2010-0900
GIS #: COMMONWEALTH OF MASSACHUSETTS
r= 1 r 36 - > r 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 -0900
Proiect # JS- 2010 - 001331
Est. Cost: $6200.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): 12501.72 Owner: DOYLE EDWARD F & SHIRLEY S
Zoning: URA(100) //WSP II Applicant: RCI ROOFING
AT: 65 REDFORD DR
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 -4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:4/13/2010 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 4/13/2010 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo