38A-072 RE. 1. Roofing
51B Holyoke Street
P.O. Box 309
Easthampton, MA 01027 Estimate Date
Phone (413) 527 -4775
Fax (413) 527 -8469 8/24/2007
Name / Address Job Location
Harriet Diamond 141 Grove Street
141 Grove Street Northampton, MA
Northampton, MA 01060 Home: 584 -1412
Cell: 320 -7192
Terms Rep
Estimate valid for 60 days Rich
Job Description Total
Remove existing roofs. 5,600.00
Furnish & install aluminum drip edge, pipe fleshings, chimney fleshings and step fleshings.
Furnish & install new lead counter fleshings. i
Furnish & install CertainTeed Winterguard ice & water barrier along eaves and valleys.
Furnish and install 15 Ib. felt 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.
15 year CerainTeed Surestart Plus extended material and workmanship warranty included.
30 year CertainTeed material warranty included.
All related permits will be obtained by R.C.I. Roofing.
SPECIAL ITEMS NEEDED / , J•, ` C, .` `�.-_. 1 C, C; f
Add $2.50 per sq. ft. for wood replacement if needed. -�
f / C_. �' 6 ��.a -t.--,- -, ( � '
ADD $550.00 for 50 year shingle. c.2-"-Y , I ` ! _ i,
[ - i
THE OWNER HAS THE RIGHT TO CANCEL THE CONTRACT WITHIN (3)
THREE BUSINESS DAYS OF DATE OF SIGNING. Total $5,600.00 i
TERMS OF PAYMENT
5% Deposit � ,
Balance upon completion Customer Signatufe L' r ` i_
Registration # 126235
/
Construction License # 074334 �/ /
Insured by Reynolds, Barnes & I !ebb, Inc. 413 -447 -7376 Date (: / ! /
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g4wa e (x 7 of Ni rtliampthu = *_;,_
;t n"C:06 Alassachnsetta' -_
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-cfl DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, Mass. 01060 1r0'
W ORI ER' S COMPENSATION INSURANCE AFFIDAVI'T
J of Fte.I. Roo try
a p�l�) J
'.rith a principal place of business/residence at:
•
51 B Holyoke 5t .1 Fastham 1h i Pia. a.Ioai ( phone # J rn5
st reet dty/statd2ip)
io hereby certify, under the pains and penalties of perjury, that:
v) Tam an employer providing the following worker's compensation coverage for my
employees working on this job:
American }tome A ssuranef. we IN b b 1 115 0
- (Insurance Company) (Policy Number) (E ira on Date)
) 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired
the 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)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional thect if ncccsiary to inchl& information pertaining to all ooa rectors)
( ) 1 am a sole proprietor and have no one w orking for me.
( ) 1 am a home owner performing all the work myself.
NOTE: please be aware that while homeowners who employ pasoas to do Qaintenme.', ooastructioa or rWair work oo a dwelling of
not more than throe units in which the homeowner resides cc oa the grounds appurtenant thereto are not gcncnlly aooriclacd to be
employers under the worker's compensatica Act (GLI52,u 1(5)), application by a bomeownet for a license or permit may evidence the
legal rt =h, of an employes- under the Wor$ee'a Cocnpoosaiion Act.
I undastaad that a copy of this unseat may be fotwerdrd to the Deportmool of Industrial Accideet' Moe of teeuranor for the
coverage verification and that failure to secure ooverngo =mice nation 25A of MIL 152 can lad to the imposition of crianioal peaaltie
consisting of a free of up to S1,500.00 andfor imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fire of S1.00.00 a day against me.
•
For dcpctmesbl use O°b'
Permit Number
Maps Lot #
c.� Signature of LicenseeRconitt,ee Late
:. " �L i��'•�. _ _ t:
,
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
J.�
Name of License Holder : ay I<1 Del 151 e. (" 1 33 " 1
\\ j License Number
51$ Aolj oke. Street - 'East 11 a rnp1bn N a . 01027 5-03-08
Address Expiration Date
( j 113) 5 aft - 1 -17 75
Signature Telephone
'Witittral 1 ■7u ri m n ' . , , , Not Applicable ❑
oof,n 1 at 2.35
ComUany Name 9 Registration Number
5113 oky oKe. Street. - et). BOX 3b9 5 - O b - OS
Address r� 1 Expiration Date
Easthamp on, M. n 1D 27 _Telephon��'113) 527u�f "'1-175
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 ❑
1t)' jr i 0 " ` e . ' 111 1'
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 a„tt,aahe(,i
SECTION'S= D
ESCRIPThONOF °PROPOSED WORK (check applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing V
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other [ ]
Brief Description of Proposed Work: - 4 - i - a 1
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative ❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ Sheet ❑
sa °If NeW house�"a. fitri M edditiion toyexistinrhousing,; t?ie fdllbWi 'g:
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 Ccnservation Compliance. Mascheck 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'ORCONTRACTOR APPLIES FOR BUILDING PERMIT
I, Harr i efi 'Diamond + , as Owner of the subject property
•
hereby authorize J'►aYK DeX is�e, O f .C. I. Roofing o act on
my behalf, in all matters relative to work authorized by this building permit application
attach ecl l o 1 aJo7
Signature of Owner Date
I, Mark 1Dp1ts1L as autlior�z.erl agent , as Owner /Authorized Agent
hereby declare that the statements and information on the foregoin application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
,Math sLL
Print Name
to f /a/o7
Signature of Owner /Agent Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF 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 & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
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 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES _
No
IF YES, describe size, type and location:
City of Northampton.��ti�t
Building Department
212 Main Street e
Room 100
Northampton, MA 01060�t���
phone 413-587-1240 Fax 413 - 587 -1272
fi
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE-OR Df !S.A FAMILY DWELLING
SECTION 1 - SITE INFORMATION I. OCT 1 2 ' :1.207
t _ , his sec ix '
1.1 Property Address: �! ¢ aTT. ' ' y '
1 l7IL0V6 5 �
la
Elm St. District CB Di trict
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
}-larri et 'Di amoY1 d w 1 Grove Gtr ' - N'th r?
Name (Print) t Curre a ling A d ess:
attach ' D ' ` � ` �� '
Telephone
Signature
2.2 Authorized Agent:
• • ;
• •
• — . • ell • id P.O.Box309 - Eastharnptor Ma
Name (Print) Current Mailing Address: f 010a/�
(411) 5a?- ligg5
Sig ature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building Roofing 4 5600.00 (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 g
6. Total = (1 + 2 + 3 + 4 + 5) ' St Check Number /lj 6
This Section For Official Use Only
Building, Permit Number: Date Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
S t
BP- 2008 -0400
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- 2008 -0400
Project # JS- 2008 - 000584
Est. Cost: $5600.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq. ft.): 17380.44 Owner: DIAMOND WILLIAM D & HARRIET R
Zoning: URB Applicant: RCI ROOFING
AT: 141 GROVE ST
Applicant Address: Phone: Insurance:
P 0 BOX 309 (413) 527 -4775 Workers
Compensation
EASTHAMPTONMA01027 - 0309 ISSUED ON:10/15/2007 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 10/15/2007 0:00:00 $25.0011010
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
A