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32C-182 (4) ,., of. vv iv...i� rr 1010 , ALYLAI.ROofing LLt 51B Holyoke Street •r -- �.� _.,— P .O. Box 309 Pro p osa E - asthampton, MA 01027 Date Phone (413) 527 -4775 6/ 11/2009 Fax(413)527 -8469 Name /Address �.._ Job Location . 001■-. Sackrey Construction .378 P/easa4 f John Sackrey - 3 Seut - P4sie Street 83 South Main Street , RTA4/407z J, m, Sunderland, MA 01375 413.563.6639 GVtxoo Terms Rap Due on receipt 1 RIC1� Job Description Total Remove existing roofs. 13,000.00 Furnish & install aluminum drip edge, pipe fleshings, chimney fleshings and step fleshings. Furnish & install new lead counter fleshings. Furnish & Install CertainTeed Wlnterguard ice & water barrier along eaves and valleys. Furnish and install synthetic underlayrnent 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 wsil 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. R e)6 pi4u CV4 -d lG : ++/ 'Cdt � c o G SC Pr 1P 1 . Creakka . U- (TO Lo Vet "Ca tkuPttisicg-tt • .1...,,,. _..1010. 100 WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total $13,000.00 TERMS OF PAYMENT 5% Deposit Balance upon completion Customer Signature C S , Registration # I26233 Construction License it 074334 Date $ IS /0 Insured by Reynolds, Barnes & Hebb, Inc, 413.447.7376 • • 1 9fie eammton ora./KQOOdddues i . / �i I . Board of Building Regulations and Standards Constructipn Supervisor License i Lic CS 74334 . 10 Tr# 23520 ," 04: ... � �., .\ MARK T DELISLE .. - ` ' -. ,: ,;: F. • 33 FIRST AVE ' {" ,-,-', ^ _a77....4._ ..---y EASTHAMPTON, MA 01027 Commissioner o/ Fie �om 4 n a� a.,eakr A zddac u d • , Board of Building Regulations and Standards 'G . .iii ? HOME IMPROVEMENT CONTRACTOR el -3 I S; I a Registratio \ 126235 1 "`R .'.. ; Expirat n. 51/2010 Tr# 266063 • Partnership , , S R.C.I. ROOFING z f i '{ t. j ' � : MARK DELISLE ` ` ., f. • 51 B HOLYOKE ST. •„4.L.•. EASTHAMPTON, MA 01027 Administrator ref $ ' . Y .. T S F . }.! $; ;1 ' it.; fix: M r -., '''',-1*;.- ..' 4 4 r 7 r i ,' . , @ -,,.A., ..., ,..,,,,, , .„, i �C c rT0 � ti .� • ..� G it �oxt�ttntnti tta _* • '3', i ks , . Otassacltasctts' ile �' 2 DEPARTMENT OF BUILDING INSPECTIONS • • . 212 Main Street • Municipal Building ~' Northampton, Mass. 01060' WORKER'S COMPENSATION INSURANCE AFFIDAVIT I •• II II (ii censte/permi ttec) ', i1 a principal place of business/residence at: 5] 3 4 '1 t , Eastham Tc Ma. o.ra'Y ( phone# - rifts `�� strcet/cS /statchi ty P) co hereby certify, under the pains and penalties of perjury, that: \' I am an employer providing the following worker's compensation coverage for my emolovvees working on this job: National - Union five. Ifs. Co. of fiitfishu c PA • WC3b31 JD10510't (Insurance Company) J' (Policy Number) (Expiation Date) I am a sole proprietor, general contractor or homeowner (circle one) and have hired ..e contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) . I (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) , (:.uach itioaii shock if necessary to include information pertaining to all =tractors) .. ' ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE: please be aware that while homeowners who employ persom to do maintesance, construction or repair wore co a dwelling of ant more than throe waits it which the homeowner resides cc cc the grounds appurtenant therdo are rot generally coosidaad to be employer under the worker's ooazQcasatiao Act (OL152fs 1(S)), application by a homeowner for a lio;ose cc permit may evideooe the 1egsl rt..tua of are employer under the Wodcds Compensation Ace. I and tared that a. copy of thin =tomcat may be forwarded to the Dcparttocol of Iodustrid Accideoti Offlos of Iowan for tbi cov vai rod that failure to soauti ooverago odor snake 2$Aof MQL 15 as letdto tbtt bootlace ofailli i1 peael eves ing of e of tip to S 1,504.00 tmdla ix risoamerst of tit) to one year nod civil penalties in the form of a Stop WatOtder and a : , s. •fin ac o(5100.00 a day again t tnc. Permit Number \ . Mai Lot # t Signature of Lia ,see/permittee Late • Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, S■ C. C C C? ' , f`l)k -C \ ∎ bNC) 1 , as Owner of the subject property /� hereby authorize ' Q L• f . �+ • 1 007 f i n 1 act on my behalf, in all matters relative to work authorized by this building permit application. 2ttached - LI ._-09 Signature of Owner Date I, _ isit r ^.` t k 'be lit e. / 1? . C I I oo n / aen l.. € , as OwnerOuthorized. cQ„ggpthereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Si i_ ned under the pains and penalties of perjury. a'4 isle 1 Print Name c ' - ' . .. -cog . _ ,..,...__:1 Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ �Nl eis G ._ ? 3 Name of Licen Holder . __ ____�..__� ! License Number t 8 Ko jo14e trat - as arnp on ... a 01027: I .... 45 _ _ Address Expiration Date H I 3 521° 4195 . Signature Telephone - 1 SECTION 13 - 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 cf the issuance of the building permit. Signed Affidavit Attached Yes • No 0 • Version1.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND' CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 36,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name (Registrant): ___....___ .. _ 1 I Registration Number Address ' i Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): I Name Area of Responsibility _ _,. __.____._ i Address Registration Number Signature Telephone Expiration Date t_.__ _ ._ Name Area of Responsibility � _..__ _"'.__.....__._._,.____ __. i Address Registration Number i Signature Telephone Expiration Date 1 Name Area of Responsibility i ! i • 1 * • Address • Registration Number Signature Telephone Expiration Date Name Area of Responsibility . ■ Address Registration Number 1, Signature Telephone Expiration Date 9.3 General Contractor Not Applicable ❑ Company Name: Responsible In Charge of Construction Address Signature • Telephone ' Version1.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department L ot Size Frontage F Setbacks Front Side L R: L: . R:l . .. ..i _..,._._.. Rear Building Height [ Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) F of Parking Spaces (. -... Fill: ( , olume & Location) r . 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 Pagel ( I and /or Document #1 B. Does the site contain a brook, body of water or wetlands? NO Q 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 Q NO 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 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • • Version1.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work: SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A - ❑ A - ❑ 1A I ❑ A - 4 ❑ A - 5 ❑ 1B ( ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ I -1 ❑ 1 - 2 ❑ 1 - 3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R - ❑ R - ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ — 5B I ❑ U Utility ❑ Specify: M Mixed Use , 0 .. . Specify: S Special Use ❑ Specify:. • 1 COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN Existing Use Group: I - • I Proposed Use Group: i 1 Existing Hazard Index 780 CMR 34): i Proposed Hazard Index 780 CMR 34): E SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (if) ( i I 1 s t 1 st I__.„___........ _ .r ...__m _.._._: - 2 nd .2nd i - . _... ..._ .__ ___..._...__._.y ..__.._. _._ „.... _. rd 1 3rd3 ._.._._. __ ._ ......_ ..__.. -._ N 4 i 4 I N Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) _._._. _ �.__ ___.•___..____ ' i',' Total Height ft ____ .._..._.__._______J 0i 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Floo Zone Information: 7.3 Sewage Disposal System: Public 0 Private 0 Zone F_ I Outside Flood Zone❑ Municipal El On site disposal system[] • Version 1.7 Commercial Building Permit May 15, 2000 . , - y ,,;. '� ,e s ` s a of r'`y - �� City of Northampton Status of PM.,-.0„, ' i -, ' `� � Street " 1 '' � fi , , p -.' - S�� 1 R oorn 100 W ater l A l - „; Z� . r , . Northam ptioA, MA 01060 Two Sets Est` ' .- z ... ' 1 ! a i t .� " 'k' ; . 7 . phone. 413 -587 -1240 Fax 413- 587 -1272 Plot/Site'Pia �'� APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office r _. 37 v 9 r e cu \-- S\-- - Map Lot Unit A)O c- ° "?" • r Zone Overlay District 3 € .. __. i Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: S O CY%t k C (6- i.0 t (S)s• 13 3o,.,vv , 5 Name (Print) Current Mailing Address: SC.,..n e C 1315 .1 Signature a Telephone yi 3 5(3 - ( 2.2 Authorized Agent - C3YK 'Delis r 1 P.O. BOX soi/EastbampN (Print) Mailing -. �,..m, Name Pnnt Current Mailm Address: -... _, .._ ....... _. _ �113� . 5277 Signature '�'�` Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building © ( a ) Budding Permit Fee Roo E _.._I f) n_ j3 _o . act i 2. Electrical _ i (b) Estimated Total Cost of I Construction from (6) L 3. Plumbing 1 Building Permit Fee i ! 4. Mechanical (HVAC) 5. Fire Protection ° 6. Total= (1 +2 +3 +4 +5) 413,000.00 Check Number /402 tiv7z'� This Section For Official Use Only Building Permit Number Date _ Issued Signature: . &iitding.' Commissioner /Inspector of Buildings Date • 1 • i BP- 2010 -0271 GIS #: COMMONWEALTH OF MASSACHUSETTS . ., CITY OF NORTHAMPTON a 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- 2010 -0271 Project # JS- 2010- 000121 Est. Cost: $13000.00 Fee: $78.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 74334 Lot Size(sq. ft.): 7361.64 Owner: POSNER RICE LYNN Zoning: GB(100)/ Applicant: RCI ROOFING AT: 378 PLEASANT ST Applicant Address: Phone: Insurance: 6 LINE ST (413) 527 -4775 Workers Compensation SOUTHAM PTONMA01073 ISSUED ON:9/10/2009 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 9/10/2009 0:00:00 $78.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo