29-527 (2) • , • 0
.
RoOf--�
l1g, LLP
51B Holyoke Street
P.O.Box 309
Easthampton, MA 01027 Estimate Date
Phone(413)527-4775 3/14/2007
Fax(413)527-8469
Name/Address Job Location
Jane Venanzini 31 Gregory Lane
31 Gregory Lane Florence, MA
Florence, MA 01062 Home: (413) 341-3705
Cell#: (347) 579-6468
Terms Rep
Estimate valid for 60 days Chris
Job Description Total
Remove existing roofs. 4,500.00
Furnish&install aluminum drip edge,pipe flashings and chimney flashings.
Furnish&install new lead counter flashings.
Furnish&install ice&water barrier along eaves,valleys and entire back dormer.
Furnish and install 15 lb.felt over existing deck.
Furnish and install 30 year Tamko Heritage Series shingle.
Furnish and install Cor-A-Vent ridge vent.
All exterior 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
Add$2.50 per sq. ft. for wood replacement if needed.
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total $4,500.00
TERMS OF PAYMENT
30%Upon delivery of materials l
70%Upon completion Customer Signature
Registration# 126235
Construction License#074334 Date 406
Insured by Reynolds,Barnes&Hebb,Inc.413-447-7376
e
$ 6 �asaachnartla'
' DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street < Municipal Building '
Northampton, Macs. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
mark
(licenserJpermittec)
1.1,-ith a principal place of business/residence at:
31 B JF25t (phone# -.t??j
ty/=Wzip)
o hereby certify, under the pains and penalties of perjury, that:
N/I am an employer providing the following worker's compensation coverage for my
:mployees working on this job:
AmeYlcan }domeAssuranee_ WCSU 4I D
(Insurance Company) (Policy Number) ira on Date)
; ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
Lhe contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Coi4pany/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(aciarh additioml sheet if neocis�to iacllde infocmatioo pertaining to&H o005redon)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plcww be awxrc thst whilo homcowmm who emplay pc==to do maintcmacr,eonswictioo or repair work on a dwelling of
not mote than throo units is winch the bomoowncr resides oc on tb.e grounds sppurteuaa4 thado w oot teamily ooandcmd to be
employers under the Ymckces ration Act apptim6oa by a homeowou for a license or permit may evideam the
legzi ctnnsa of an employee under the Wukcea Compo xw-ion AaL
I undorstaad that a ooyy of this caat=aa may be fwwwt ad to the DVut wal of ladustritl Aod&o&OfBoe of tom for dw
covcngc verifieatioa and that failtme to s=n 00%m+o tutder secdoa 25A of MOL 151 an lad to the inxpasition of crimkd pemlties
coasistin of a fine of up to S1.500.00 and/or impzisommcn2 of up to ooe year and civil penaltia io the fonm of a Stop Walt Order and a
film of 5100.00 a day against mo.
pa departsn-W uao only
permit Number
Signature of Lica serypermitiee �—
Wet
SECTION•5="DESGRIPTIONibF PROPOSED,WORI (che�k,aU applicable)
New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ]
Brief Description of Proposed Work: eA ! I
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ . Sheet 0
' 01 tee,, b dtIBW :5s m '
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 o; 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 3E COMPLETED WHEN
OWNERS.A GENT'0R�CONTRACTOR APPLIES'FOR BUILDING PERMIT
I, -am �cnatli Z- ni as Owner of the subject property
hereby autho,ize A aY K of i slr o7 R• to act on
my behalf, in all matters relative to work authorized by this building permit application.
__attaehed 81-29 07
Signature of Owner Date
I, 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.
Print Name
.3 a9 D
Signature of Owner/Agent Date
V
SECTION 8'-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : e ��5 / !
License Number
5 �
- oa7 5 - 03 08
Address Expiration Date
.�e e hone hone
-
� 7!;Signature _tt�`
s
,;. r__ � Not Applicable 11 e. a._ _ � me�� . r r
tZt 235
Com any Name Registration Number
o vo e Street P.D. Sm 3r)l 5- ob - OS
Address J Expiration Date
Telephon (7 ftf
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...... ❑
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 helshe 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`ipon
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 injurile h t oui ing in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform 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
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)
#,0f V iA dce&4 1 ,Z ! . . •k°
S
�
b • •
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
Building Department
212 Main Street
Room 100
Nlorthampton, MA 01060
i
phone 413.587.1240 Fax 413-587.1272
k PLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This,sec i0"
INay .
.31 0-4yeaN Lane,
Zone
Elm St District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
ne enan7i n nce.
Name(Print) Curr t i ress-
attach�l Telephone 70 9
Signature
2.2 Authorized Agent:
ay V-1)el i SIe e-T. Roo�irlq � -EX-A i - EasthamT t w_ Ma
Name(Print) Current Mailing Address:
� (413) 527- ;!'175
Sig ature Telephone
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building Roofin .4 q50o.0o (a) Building Permit Fee'
2. Electrical J (b) Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanica' (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) �,(,� Check Number 6S-
This Section For Official Use Only
Building>Permit Number: Date Issued:
Signature:
Building.Commissioner/Inspector of Buildings Date
Aft
X GAWY LANE ` BP-2007-0931
GIs#: COMMONWEALTH OF MASSACHUSETTS
4 :29-527 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-2007-0931
Project# JS-2007-001517
Est. Cost: $4500.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq. ft.): 6098.40 Owner: VENANZINI JANE
Zoning: URA Applicant: RCI ROOFING
AT. 31 GREGORY LANE
Applicant Address: Phone: Insurance:
P O BOX 309 ,(413) 527-4775 Workers
Compensation
EASTHAMPTONMA01027-0309 ISSUED ON:41412007 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 Sienature:
FeeType• Date Paid: Amount:
Building 4/4/2007 0:00:00 $25.0010100
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo