31B-184 RC.I. Roofing,
51B Holyoke Street
P.O. Box 309
Easthampton, MA 01027 E s t ■ m a to Date
Phone (413) 527 -4775 1/17/2006
Fax (413) 527 -8469
Name / Address Job Location
Mark Mantegna Main house roof only
107 State Street 107 State Street
Northampton, MA 01060 Northampton, MA
445+703—
Ceit# 695 6860
Terms Rep
Estimate valid for 60 days Mike
Job Description Total
Remove existing roofs. 8,250.00
Furnish & install 1/2" plywood over existing decking.
Furnish & install aluminum drip edge, pipe flashings and chimney flashings.
Furnish & install new lead counter flashings.
Furnish & install ice & water barrier along eaves and valleys.
Furnish and install 15 lb. felt.
Furnish and install 30 year Tamko Heritage Series shingle.
Furnish and install Cor -A -Vent ridge vent.
All roofing related debris to be removed by R.C.I. Roofing.
All work will be performed according to manufacturers' specifications.
5 year R.C.I. workmanship warranty included.
30 year Tamko material warranty included.
All related permits will be obtained by R.C.I. Roofing.
SPECIAL ITEMS NEEDED
Deduct $2,250.00 if plywood is not needed.
WE LOOK FORWARD TO DOING BUSINESS WITH YOU IN THE SPRING.
Total $8,250.00
- 500 , 00
TERMS OF PAYMENT 7 - 50 00
30% Upon delivery of materials
70% Upon completion Customer Signature
Registration # 126235
Construction License # 074334 Date 2. /0 b
Insured by Reynolds, Barnes & Hebb, Inc. 413- 447 -7376
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041_41, - t pa a n 164:0" DEPARTMENT OF BUILDrTNG INSPECTIONS _
. 212 Main Street • Municipal Building '+ �
Northampton, Mass. 01060 ��
WORKER'S COMPENSATION INSURANCE AF1.t'IuAVIT
1, J4rDe)tsle. of fi.Q.I. Ctoofin
(licensedpermitt.ec) J
with . principal place of business/residence at:
5113 Hol ok St/Esthamp10 n .Ma. o.a7 (phone #113) 5a7 wigs
street/c /stalthi
h' P)
do hereby certify, under the pains and penalties of perjury, that:
0 / I am an employer providing the following worker's compensation coverage for my
employees working on this job:
Amefiean(Int`1 Group 681bb10 10/5 /Ob
(insurance Company) (Policy Number) (Expiration Date)
( ) 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) (Expirntion 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)
(atta:h additional sheet if necessary to include information pertaining to all oocdrectors)
(; 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 whilo homeowners who employ persons to do maintenance, construction at repair work on a dwelling of
not =cc than throo units in which the homeowner resided or on the grounds :pputteonnt thereto are not gcxa'alry ooariclaod to be
cm,;! oyc. under the twcicer's compcosstina Act (G1.152,s3 1(5)), application by a homeowner for a lisps cc permit may evidcacc the
1ett1 status of en omployec under Me Workout Compensation Act..
i uzkicrsund that a Dopy of this ctsicme3 may bo forwarded to the Depertmcot of Industrial Amide:Ms' OfSoe of Imur aOe for du
coverage verification and that failure to securer coverage) under s ction 25A of MOL 151 can lad to tho' imposition of aitainal ptxtaldt:t
oorisrzng of a &tx ofup to 51,500,04 l eer of tip to am year ind civil penalties In the toms ors Stop Wee( ()tier red t ' ''
fire of 11. OO.Q0 a day igxiast me.
, ,_0%'>A: •
Foe depsrttaedal tun only
P Number
gyp# Lot # \ •
•
;` SiP> of Lic Permittce Its ;
•
0
SECTION 8 SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑ f.�
Name of License Holder : yavi si e. q J
'7 " 33 ",
License Number
l of bke_ St reel ast�►ampion Na bIoa7 5 -b3- 0b
Address Expiration Date
(13) 5an"
Signature Telephone
_ R ; $, r r w - men r . Not Applicable ❑
"
�
.�. S. R oof, n9 1 lb 2.35
Com anv Name Registration Number
51 R }1oly olte Street - P.D. Box 3O f 5 - 0 b - Ob
Address rfrf Expiration Date
k a stham pion , Ma. a IDart Telephont�1 ?) 521 -H 'J5
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 ❑
tf ir 1;om W F r I iI,Q
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 tinder this permit.
The undersigned "homeowner " 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—an/lei!)
/lei
•
R �
SECTION -5= DESCRIPTIONIOF PROPOSED (ch!ckkall applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing [p'
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs { 1 Decks
[ ] Siding [ ] Other [
Brief Description of Proposed Work:__________________
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative D Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet D
.0a lflNew housetdf dZ dd n v completbitkiblfi6fa=Nn
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. 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 BECOMPLETED WHEN
OWNERS AGENT OR'CONTRACTOR APPLIES FOR BUILDING PERMIT
1, .,1Y % . aftP -q 1 a , as Owner of the subject property
hereby authorize arVcsu el isle, •C. 1. Roc2.J,nQ to act on
my behalf, in all matters relative to work authorized by this building permit application.]
attaelied 3/ 31)019
Signature of Owner Date •
•
I, • : ! _ / • • . g 'e , 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.
N aY sle
Print Name
3/3 01
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:
f
City of Northampton t6� 01' ir? -
Building Department
212 Main Street ; ': 4 Q
Room 100
Northampton, MA 01060
phone 413-587-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT, ALTERLR, , RENEE OR DE • "tSH A ONE OR TWO FAMILY DWELLING
SECTION 1 SITE INFORMATION 3
is sect , � . . � . . .,
1.1 Property Address: �'�h * x
101 State, Stv,et'
F � '� �, ` z L: `� �� �� �fz
Zon � � ��i� `� � 0 erla b c � �� , b
EIm' St. "District k ,CB Districts ., ..
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
�NIaY plant € - 101 State, StYet / N
(Print) C grgt Ma l / /pp ,8ress:
attaehe�l Telephone
Signature
2.2 Authorized Agent:
Mark el i Sle, - . . I. Roain9 P.O. Box 309 - Easthampton, Ma
Name (Print) Current Mailing Address: O'oaq
(pt) 521- xigr15
Sig ature Telephone
SECTION 3 ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building Roofing 'T75o.o0
(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 •
6. Total = (1 + 2 + 3 + 4 + 5) 1 '7g Q Check Number 7.,
This Section For Official Use 'OnIy
Building Permit Number: Date Issued:
Stgnature.
Building Commissioner /Inspector of Buildings Date ,
Animmommemennommommommmommumonimow
7 $TAATE.ST BP-2006-1041
GIS #: COMMONWEALTH OF MASSACHUSETTS
_�. CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit # BP -2006 -1041
Project # JS- 2006 -1543
Est. Cost: $7750.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq. ft.): 4051.08 Owner: MANTEGNA MARK D
Zoning: URC Applicant: RCI ROOFING
AT: 107 STATE ST
Applicant Address: Phone: Insurance:
P O BOX 309 (413) 527 -4775 Workers
Compensation
EASTHAMPTONMAO1027 - 0309 ISSUED ON:4/4/2006 0:00:00
TO PERFORM THE FOLLOWING WORK: STRIP, PLY & 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 4/4/2006 0:00:00 $25.008478
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo