31A-324 (2) RC.I. Roofing
6 Line St. E Date
Southampton, Ma. 01073 2/6/2013
Phone (413) 527 -4775
Fax (413) 527 - 8469
Name / Address Job Location
SMITH COLLEGE Paradise Rd.
Physical Plant Northampton, MA 01060
Rick Konopka
126 West Street
Northampton, MA 01060
Terms Rep
Estimate valid for 30 days Chris
Description Total
Remove existing garage roof. 3,800.00
Replace rotted decking.
Furnish and install copper drip edge.
Furnish and install synthetic underlayment.
Furnish and install CertainTeed Hatteras Shingles (grey).
Furnish and install custom copper pipe boot on weatherhead
All work to be performed according to manufacturers' specifications.
All exterior roofing related debris to be removed by R.C.I. Roofing.
5 -year R.C.I. workmanship warranty included.
All related permits will be obtained by R.C.I. Roofing.
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total $3,800.00
TERMS OF PAYMENT
5% Deposit
Balance upon completion Customer Signature
Registration # 126235
Construction License # 074334 Date
Insured by Banas & Fickert Ins.
(413) 527-2700
/
r ' r
40 SMITH COLLEGE
reason not the sole fault of Smith College; or (b) Contractor fails to perform any other obligation owed
to Smith College pursuant to the approved Proposal; or (c) it is determined that any representation
made by Contractor herein is untrue; or (d) Contractor attempts to assign its obligations hereunder
without Smith College's prior written consent; or (e) a petition in bankruptcy is filed by or against
Contractor; or (f) a receiver is appointed for Contractor; or (g) an assignment is made for the benefit of
Contractor's creditors; or (h) Contractor becomes insolvent. In case of default, in addition to the
remedies at law and equity available to Smith College, Contractor agrees to pay to Smith College the
amount of all costs, expenses, damages, and reasonable attorneys' fees incurred by Smith College in
order to achieve the purpose of the approved Proposal, or for substituted performance, or for any
proceeding, claim, or action associated with the approved Proposal.
43. ASSIGNMENT: Neither this agreement, nor any payments to be earned pursuant to this Agreement, may
be assigned by Contractor without the prior written consent of Smith College.
44. NO WAIVER: The failure or delay of the College to exercise any of its rights under this Agreement for
breach thereof shall not be deemed to be a waivier of such rights, and no waiver by the College, whether
written or oral, express or implied, of any rights under or arising from this Agreement shall be binding on
any subsequent occasion; and no concession by the College shall be treated as an implied modification
of the Agreement unless specifically agreed in writing.
45. LIMITATION OF LIABILITY: Smith College shall not be liable for any incidental, special, or consequential
damages of any nature whatsoever (even if Smith College has been advised of the possibility of such
damages.)
46. GOVERNING LAW AND DISPUTE RESOLUTION: the laws of the Commonwealth of Massachusetts shall
govern This Contract and its terms and conditions. The parties irrevocably submit to the jurisdiction of
the Superior Court for the County of Hampshire over any action or proceeding arising out of this
Contract.
47. ADDITIONAL TERMS: Additional terms, if any, will be set forth on the Proposal and made a part thereof
or contained in a separate letter of acceptance.
48. ENTIRE AGREEMENT. This agreement represents the entire agreement of the parties, and may not be
modified except in writing signed by both parties.
CONTRACTOR: COLLEGE:
R.C.I Roof }rrg r ,./ The Trustees of the Smith College
Signatur f _ Signature: 1, ..lr
Title: 3 tki. ' I., J" Title: Assoc 'F' cilities Mana.ement
Date: a - N /3 Date: At a:
10
The Commonwealth of Massachusetts
Department of Industrial Accidents
:' ►= Office of Investigations
600 Washington Street
*mo t:: = 4,
_ r Boston, MA 02111
••4�
wysrw.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers
Applicant Information Please Print Legibly
Name ( Business /Organization/Individual): R c ', n U.?
Address: .
City /State /Zip: ,�� r�,� � i N . 01 (r•7 3 • Phone #: (yl3) 5 . 4`I - (("(
Are you an employer? Check the'appropriate box: Type of project (required):
1, [g 1 am a employer with Z 0 4. ❑ I am a general contractor and I
6. New construction
employees (full and/or part - time).* have hired the sub - contractors
2. ❑ I am a sole proprietor or partner- listed on the attached sheet, 7. ❑Remodeling
ship and have no employees These sub - contractors have 8, ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9, E Building addition
[No workers' comp. insurance 5, _ We are a corporation and its 10. Electrical repairs or additions
required.] officers have exercised their
3. ❑ I am a homeowner doing all work right of exemption per MGL 11. Plumbing repairs or additions
myself. [No workers' comp. c. 152, § 1(4), 'and we have no 12. Roof repairs
insurance required.] t employees. [No workers'
13. Other
comp. insurance required.]
'Any applicant that checks box t/1 must also fill out the section below showing their workers' compensation policy information:
r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such,
lContractors that check this box must attached an additional sheet showing the name of the sub - contractors and their workers' comp. policy information.
i am an employer that is providing workers' compensation insurance for my employees, Below is the policy and job site
information.
Insurance Company Name: 7 o..- `1,
Policy # or Self-ins. Lic. #: \,) Q. UlolS :3 <4 0 5 Expiration Date: i 0 ' $ . 12,
Job Site Address: g (�c�< eC > (2,A. City /State /Zip:,0elt\c‘c>,wnOti7■ Imo 0 01
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
Fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of 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.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: - Date: 3 -le _ /3
Phone #: � 1 ) - L(`1 'T 5
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License #
•
Issuing Authority (circle one):
1, Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
SECTION 8 - CONSTRUCTION SERVICES
8,1 Licensed Construction Supervisor: Not Applicable ❑
M � 17741334
Name of License Holder : 1 ' 1 ar e 1 ! is le,
License Number
5 , 8 ` E asth m ton M a, d I o arl
Address Expiration Date
(41 521-
Signature Telephone
9,. Registered Horne improvement Co:n:tractor, :. Not Applicable ❑
Ft. e. �. / RQO ' � ng 126235
Company Name �/�) Y (h� Registration
) /� ) Number
+``,;
$16 No1yoke Street - Pi V• 'Box 301 5- Ob -
Address Expiration Cate
Ease -1 vnpron Ma. ( Q a,.? TelephonceJ 3)sz J.5
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 '1 No ❑
11.. - Rome Qwi1ef 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 \A'ith 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 at.taeh •
•
•
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House E Addition ❑ Replacement Windows Alteration(s) Roofing �.
Or Doors ❑
Accessory Bldg. ® Demolition ❑ New Signs [D) Decks [i❑ Siding [D) Other [D)
Brief Description of Proposed }-
Work: di LafnhPil ere_ ere_ re
"
Alteration of 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 arid 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 is - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
u ` as Owner of the subject
property
hereby authorize AI' T 1 I SI t. QT • C. 1. Roo'i n9
to act on my behalf, in all matters r lative to work authorized by this uilding permit application,
at,t ached - k --1:3
Signature of Owner Date
•
I, Y i 1 • a f • • '' • / A as 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.
.
s � i .] 'e.
Print Name
Signature of OwneriAgent 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 i (i I
•
Frontage j 1; l i I
Setbacks Front 1
Side L :l ; R: L:k . R:I I 1 1 1
Rear 1 i
1
Building Height i i i ,
Bldg. Square Footage 1 { %
.Open Space Footage
(Lot area minus bldg & paved 1 1 I 1 ' !
parking)
# of Parking Spaces
Fill, I 'I i l i
(volume & Location) ,,
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 :j
•
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book l i Pagel I and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES i
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued: 1
C. Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and location: I
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: ;
I
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.
Department use only
City of Northampton Status of Permit
Building Department . Curb G.ut /Driveway Permit
MAR — 8 20 212 Main Street 'Sewer/Septic Availability
Room 100 Water/Well Availability
,___._ Northampton, MA 01060 Two. Sets of Stru :otural Plans
DEPT. OF BUILDitri INgi _ TIONS
NORTHAMPTON da o,og 13- 587 -1240 Fax 413 - 587 -1272 ;Plot/Site Plans
Other Specify
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
1.1 Property Address:
Map Lot. Unit
Aj r��,�c ��, �� - Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: QQ
Sm� - t kk.r o,�, I Z k �- JuteAk.... l0,c Nla Not,
Name (Print) Curre�,ddrs
ang Ai O / g
2 tta eh e 61 Telep h \one ) 5
Signature
2.2 Authorized Agent:
q.C.Z. R oofi n g - .i am rOn Na.
Name ( Print) Current Mailing Address: 0101.3.
` -�-- (113) 521- 4115
Signature Telephone
SECTION 3.- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building q yoo c,c1 (a) Building Permit Fee
2. Electrical J (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) 1. ‘, 0 0 0 Check Number ,,�� 11111111FI 5
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
p..
8 PARADISE RD BP- 2013 -0809
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31A - 324 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 -0809
Project # JS- 2013 - 001387
Est. Cost: $3800.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq. ft.): Owner: Smith College
Zoning: EU(106)/URC(85) /RR(21)/WP(21)/ Applicant: RCI ROOFING
AT: 8 PARADISE RD
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 -4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:3/8/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE GARAGE 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 3/8/2013 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner