32C-131 (14) AMM-
- ,
J.®. Rivet & Go., Inc.
ROOFING• SHEETMETAL
1635 PAGE BOULEVARD • '
SPRINGFIELD.MA •
March 12, 2008 P.O.BOX 51068
INDIAN ORCHARD,MA 01151
TEL. (413)543-5660
FAX(413)543-3373 •.
Service Properties
P.O. Box 60522 •
Florence, MA 01062
Attn: Jack Fortier
Re: Replacement of additional section of sloped shingle roof @ Webb Yarn,
Northampton —approximately (8,750 sq ft including flashing)u d-e_ e
I
1. Furnish and install JPS Elastomerics Hi-Tuf white ck) EP mechamcally�"`°
attached roofing system complete with all associated flashings.
2. Furnish and install new .040" painted aluminum edge metal in accordance with J.P.S.
Elastomerics requirements 50 lin. ft. total.
3. Properly tying into 2 areas of existing Stevens EP membrane and shingle roof.
4. Furnish and install new snowguards at eastern edge to prevent snow slides.
5. Clean jobsite of all roofing debris.
6. Furnish owner with a 15 year JPS Elastomerics labor and material warranty.
PRICE=$32,250.00 (Thirty Two Thousand Two Hundred Fifty Dollars)
James . Trask, President
Acceptance of Proposal-The above prices,specifications and conditions are satisfactory and are hereby accepted. You are
authorized to do the work as specified. Payment terms are net 30 days unless otherwise agreed in writing.All material is guaranteed
to be as specified. Any alteration or deviation from above specifications involving extra costs will be executed only upon written
orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays
beyond our control. Owner to carry fire and other necessary insurance.Owner responsible for all building permit fees. All
accounts not paid within 30 days are subject to a late charge of 1 ''/z%per month on the unpaid balance. In the event that legal action
is instituted to collect any sums due under this agreement,the undersigned agrees to pay all costs incurred including reasonable
attorney's fees. NOTE:THIS PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED WITHIN 60 DAYS.
Signature:
Date:
yi�we 1,9 60
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: General Businesses
Applicant Information Please Print Legibly
Business/Organization Name: J, L) Ue_-r �HV
Address: I�3� f A(ye LV D
S P�� M 0 1 U`/ Phone #: q,,
City/State/Zip: �
Are you an employer?Check the appropriate box: Business Type(required):
1. I am a employer with employees(full and/ 5. ❑ Retail
or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment
2.❑ I am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales(incl. real estate,auto,etc.)
employees working for me in any capacity.
[No workers' comp. insurance required] g• Non-profit
3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. 152, §1(4),and we have 10.❑ Manufacturing
no employees. [No workers' comp. insurance required]* 11.F] Health Care
4.❑ We are a non-profit organization, staffed by volunteers,
with no employees. [No workers' comp. insurance req.] 12.❑ Other f24)0 F'•I A i G- S-eP C
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
**If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an
organization should check box#l.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information.
Insurance Company Name: 0 W A)0-TUi�L F( l-P W
Insurer's Address:
City/State/Zip:
Policy#or Self-ins.Lic.# �- - ����� Expiration Date: S [
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 certi de a pain and penalties of perjury that the information provided above is true and correct.
Si nature• Dater
Phone#: f
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.Licensing Board 5.Selectmen's Office
6.Other
Contact Person: Phone#:
www.mass.gov/dia
���ie �am7no�nurealC�i a����a:;.ta��zu��
BOARD OF BUILDING REGULATIONS
icense: CONSTRUCTION SUPERVISOR
Number: CS 050230
3irthdate: 07/21/1952
Expires: 07/21/2008 Tr. no: 29169
Restricted: 00
JAN N DREYER
44 LAKESIDE DR
MONSON, MA 01057
Commissioner
Version 1.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes O No O
SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property
hereby authorize to
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
l �!/r" 4�+��`/l �� l�-a`�- v�• '1 v as 9wwm*Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print Name s
Signature of Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: 3
License Nu ber
�-l�{ � Ke s,r�� �� �N i�y i Mid Q�u � . 7 T �c1
Address ''~ Expiration Date
gi Telephone
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 of the issuance of the building permit.
Signed Affidavit Attached Yes No O
Version 1.7 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 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Registrant):
Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor , / ��
Tb e %. t "� t_-Cl, �--Not Applicable ❑
Company Name:
Responsiblp In Charge of Construction
J(o3 A�Te b-vo , "n Oi ji
Address
SignAT6 Telephone
Versionl.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
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 O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO t�( DON'T KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
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 O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version 1.7 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 El Accessory Building El
Exterior Alteration El Existing Ground Sign F-1 New Signs❑ RoofingA Change of Use❑ Other❑
Brief Description Enter a brief description here.
Of Proposed Work: t�►LMS kt I SA't-L S i N(r(C� �l.`{ f�( 1►V
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly E] A-1 El A-2 El A-3 El 1A
A-4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H Hi h Hazard ❑ 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
OFFICE USE ONLY
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION
Floor Area per Floor(sf)
151 1 St
2nd 2nd
3 rd 3rd
41n
4m
Total Area(sf) Total Proposed New Construction(sf)
Total Height(ft)
Total Height ft
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑
Version 1.7 Commercial Building Permit May 15,2000
Department use only
City of Northampton µ at�r o��e ',it:�'� I'
Building Department "._ibetfBrrveway Permit
212 Main Street Sewer/Septic Availabilit
Room 100 I�terPNgll lWability..= "
Northampton, MA 01060 4 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272
Plot/Site-Plans
Ott er Specifi
APPLICATION TO CONSTRUCT, REPAIR,RENOVATE,CHANGL-THE-tJSE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property
,.�Address: '�^ 7
.X-lKv( G `- Map ✓ � Lot / / Unit
N 0i<, f i+APA PTd y NA- Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Sekvi cc-
Name(Print) Current I'ling Address: 0
f
Signature I /-' elephone
2.2 Aut rized ent:
Name( ", Current Mailing Address: _
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building J as, (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) Check Number `
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
BP-2008-0869
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-2008-0869
Project# JS-2008-001321
Est. Cost: $32250.00
Fee: $161.25 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: J D RIVET & CO INC 050230
Lot Size(sq. ft.): 137649.60 Owner: SERVICE PROPERTIES INC
Zoning: GB Applicant: J D RIVET & CO INC
AT: 75 SERVICE CTR- 82 CONZ ST
Applicant Address: Phone: Insurance:
P O BOX 51068 (413) 543-5660 Workers
Compensation
INDIAN ORCHARDMA01151 ISSUED ON:41812008 0:00:00
TO PERFORM THE FOLLOWING WORK.-FURNISH & INSTALL SINGLE PLY ROOFING
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 4/8/2008 0:00:00 $161.2527313
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo