29-390 (4) - � - M
QUENNEVlL.LE
ELK�#_
ROOFING INC. The Premium Choice•
160 Old Lyman Road, South Hadley, MA 01075 We Are Licensed
1-800-NEW-ROOF • 1-800.4-SIDING Insured
Email:info@ 1800newroof.net Website:www.1800newroof.net Factory Trained
MA Construction Supervisors Lic.#070626 MA Registration#120982 Facto Certified Installers
Member of the Home Builder's Association of Western Mass. CT Registration#575920 Factory
Member of the Building&Trade Association Member of the Better Business Bureau P.P.C.38710
Proposal Submitted To: Date Phone#'s
1 A � &'o1G-pfd H: (e 7Sri Cell:
Street 1J CT Mail To:
u RkC Q
City,State,Zip Code Special Requirements
Rom,ac,z P1 A
roposal furni ins I the following
oof0- .[ Tear tff ❑ Gutter
plete ration 3a oD
Home exterior to be protected by tarps and plywood
[�Shrubs,landscaping,trees to be protected ��� u"� g c�zct, _ O o
ETEntire existing roofing material to be removed to existing d mg, including flashing,etc.
[+Site to be cleaned everyday with roll magnet debris removed at project completion
[Deteriorated existing decking replaced at$2.50 per sq.ft.
R«
*�)/Brown 8 inch metal drip edge installed at eaves and rakes [ bite Brown 5 inch for re-roof only
[ New flashing will be installed where necessary(see Special Requirements)
Q"Install new pipe boot flashing
E 'Ue shall acquire all appropriate permits etc.for all roofing work
Complete Roofing System
['ELK Leak Barrier installed at all eaves to protect from ice dams(and meet codes in the north)
ELK Leak Barrier installed in all valleys, around penetrations, and chimneys to protect critical areas
PLC 15 pd. reinforced underlayment installed over entire decking
Shingles: ,)O" Ck-lc.<
ELK Prestique®Series Ej"3'0 year ❑ 50 year Color S11
C3'*'Nailable ridge vent will be installed
[ ELK ridge cap shingles
Warranty Options:
We guarantee our workmanship for 5 full years
❑ ELK10-Year Umbrella Coverage Limited Warranty upgrade.
V
[I ELK15-Year Umbrella Coverage Limited Warr uprgrad :e-- r� `
We Propose�hereby to furnish materials and labor omplete in accordance with abo' specifications for the sum of:
-- ��
Total Sale P' e$ 1�s_O� Do n Payment$ ' S U� Upon Completion$
ACCEPTANCE OF PROPOSAL:The above pric specifications and con ns are satisfactory and are hereby accepted.
You are authorized to do work as specified.Paymen Pon signing,and balance due upon completion.
Unpaid balances shall accrue with interest at 18%per annum. Purchaser(s)will pay for all costs,expenses and reason-
able attorney's fees incurred by Adam Quenneville Roofing and Siding,Inc.to recover any sums due un/d�er this contract.
Date:J�fl'�,//J!r Signature: �
_V Phone t �74 — nC3d_
Date: 5-a a -_O(e Estimator's Signature:___. \ _
Estimates are honored or sixty(60)days from above date
ATTENTION HOMEOWNERS:Please cover all personal belongings In the attic,garage or storage areas due to the
possibility of roofing debris or dust coming in through cracks of the wood.Adam Quenneville Roofing and Sidings
will not be responsible for debris or dust in the attic or storage areas.
t . J1ie
ANSEMI Board of Building epm ulations
IVOne Ashburton Place, 1301
Boston, Ma 02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 08/21/1971
Number: CS 070626 Expires:08/21/2007 Restricted To: 00
ADAM A QUENNEVILLE
160 OLD LYMAN RD
S HADLEY, MA 01075
Tr.no: 3761.0
Keep top for receipt and change of address notification.
'S-CA1 u 50M-04/05-PC8698
Board of Building Regula ions and Standards
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Registration: 120982
Type: DBA
Expiration: 3/25/2008
ADAM QUENNEVILLE ROOFING
ADAM QUENNEVILLE
P.O. BOX 612 ---- - - -- - —
SO. HADLEY, MA 01075 ---- - - - —
Update Address and return card.Mark reason for change.
'S-CA1 0 5OM-04105-PC8698 ❑ Address (--', Renewal Li Employment ❑ Lost Card
i
STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION
Be it known that
ADAM QUENNEVILLE
78 W S�:ArTE ST
i
is certified by the Departs nt Q o su i 1>*ction as a registered i
HOME IMP CQNTRACTOR
ADAM QUENNEVILLE ROOFING
i
Effective: 12/01/2005
Expiration: 11/30/2006 '
4ay-U4 f,jUUbp Uy:4/ HM Keml l lard Insurance 141,1J.idbulu
r.
RL ��(MMIDOlYrY�
A CERTIFICATE OF LIABILITY INSURANCE CSR_, 05104106
PRODUCIR THIS MIAMATTEROFINFORMATION
ONL N UPON THE CERTIFICATE
Remillard Insurance Agcy, Inc HOL ES NOT AMEND,EXTEND OR
79 Lyman Street ALTER E IED BY THE POLICIES BELOW.
South Hadley NA 01075
Phone:413-53.8-7862 Pax:413-538-7179 INSURERSAFFORDINGCOVERAGE NAIC#
BISURED INSURER A: Neti=ftl Sire F.xaxios US. co
Ada* Queuaeville Roofing INSURER B: Arbella Protection Ins Co
& Siding Inc &
A13am evil le Roofing Inc INSURER C: Aix Hatusl zasur"0e campww
P o Box 612 INSURER D:
South Hadley WA 01075
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWflHSTANDING
ANY REOUIRE181T,TERMOR CONDTITON OF ANY OONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE UIWTS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE POLICY NUMBER DATE MMJD DATE MMIOON LET$
004ERALLIABWTY EACH OCCURRENCE $ 1000000
A X COMMERCIAL GENEKAL LIABILITY 72LPE703070 06/23/05 06/23/06 P d ocoxeim $50000
CLAW MADE ®OCCUR MEDEXP(Any—pesos) $5000
X Contractual Liab. PERSONAL&ADVINJURY $ 1000000
X Waiver of Subro. GENERAL AGGREGATE S2000000
GEN'L AGGREGATE LWT APPLIES PER PRODUCTS-COMP/OP AGG S 2 0 00 0 00
POLICY JECT LOC
AUTOMOBRE LIABIUfY
COMBINED SINGLE LIMIT $100000D
8 ANY AUTO (EaacowsM)
ALL OWNFDAUTOS 54906400002 11/01/05 11/01/06 BODILY1NJURY
X SCHEDULEDAUTOS (Per Perm) $
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS ��{ (per ac ) $
`�...\ PROPERTY DAMAGE $
V (Perao6deM)
GARAGE LWBILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC S
AUTOONLY: AGG S
EXCESSAPARRELLA 11ABILTTY EACH OCCURRENCE $
OCCUR ❑CLAIMS 0WE AGGREGATE S
a
DEDUCTIBLE $
RETENTION S $
WOMRS COMPENSATION AND X I TORY LYNITS I I ER _
C EMPLOYERS'LIBLITY AWC7012861012006 04/29/06 04/29/07 E.L EACH ACCIDENT $100000
ANY PROPRIETOWPARTNERIEXECUTIVE
OFFI EIUMIEJIBEKIEXCX.IJOED4 E.L.DISEASE-EA EMPLOYEE $100000
AW40=6 psi. E.L.DISEASE-POLICY LIMIT S 50 0 00 0
OTM
o=mrT=OF OPERATIOM I LOCATIOM I YENICM f EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS
This copy of certificate is for use by sales reps only. It job iS obtained
please call for a new certificate that will show the property owner wham the
work is being done for, this will then become a legal document for proof of
insurance.
CERTIRCATE HOLDER CANCELLATION
ADAiRm SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPRATIO
Adam Quennevi l l e Roofing & DATE ENDEAVOR TO MAIL DAYS VMTTEN
Siding Inc & Adam Quenneville NOTIC 0 TO THE LEFT,BUT FAILURE TO DO 30 SHALL
Roofing Inc IMPOSE NO OBLIGAT OON:::T1ONN OR,LUIBILI F ANY WND UPON THE INSURER,ITS AGENTS OR
PO Box 612
South Hadley MA 01075 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Ste hea E. Radon
ACORD 25(2001108) G ACORD CORPORATION 1988
tMm ff
O
�{ � ((yzftj c�� �t7�tl1�ittt�.lfnn r -
• 6 '31 aSa ACh ltS ril!
m DEPARTMENT OF EtUILDDI G INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, ASaG5. 01060
Woma,R'S C01MTENSATI0N INSURANCE kFFM A,'V1T
(liccrs_�cf.nuiicc)
w th a principal place. of businessJr,_:�;dence
a,u�s �1tii3 �3i�s�S�
GO
OI Q•a __SAY` � c._ -- nh—_rp'''°nc` , --- - --
do hereby ccr-Z'. l:I1t1 i1 LhC pi.iilS ;iid 1)Cil,'.itic5 Chi ncglwy, ill2i
Irm an efnployer providing the folImvine v,orr_ci's comncnsalion covet�:ve `or lay
empl.oVCCS worldrig on this job: v
111M � Lwc`1o►a�s [ oL��cA&_ H-aq-07
ansuranG; Company) (i _i;C-;Nu_m-be r) Date)
( ) I am a sole proprietor, general con e, C,r homcow-ner (Curie one) ant' 'gave hired
the contractors listed beiow :t i;0 h2 c, tb° `.OJG':vL; vyo;ker s commens iiorl
(Name of Contactor) (LnSt__ncc Date)-
(Name of colmT io-) Onsur ncc Conlon Y/Po!ic,' N t I,'r) (Exr;- do Date)
(Name of Cownclor) (lIlsi!mmc (_Oui aa'i/i�0!;�: 1 iU1I)1i 7) - 'Xi;`. O Date)
(-Name of Contractor) —- (Insurulc- Cou1r,;._,y/Policy Numb,,-r) - (Expi itio-Date)
(r.ttactt:-ddtacrsl r rct:::..:r-;,^ :a rr�..._. .-..-<rut:.... , ._.... _<.i;.�.<__......•-)
( 11Ull a solC praprlewl— and ha v!-. 110 oll' ,: :!hint` to; i1-
� � � ?iiI C: l?oIl1C C�'r?1Cr l)LrtC"I17tI)� �?�� i'.., ':t•,. ., iii`tz:.lt.
1191`1--.:plcasc tic Al% c 011:.t�iic F�<r�=n�ir a t rro r. �l>y;r c a c:� _:sancc ar.:nc m cr:c,^:air•'•i;_ ,�•ct!i- c.
not ax<c th_a throo uni s in«{ eft he 1ti-ti :�z rte:_3 u a;`�4...s: •_ttcrent there z c r_{CcsYral2Y c<�:::s:::�:c tv
c�ploycs u.•-r'.tr the wtsr4;cr's ca:q:•,:_irn i•.C-(cL!5?.�--�1{511,np;.lica:ic:1 by n 1:ccnco..-rs`cr a 1:!'ctx rt p;l^:6:r a•,c•..'<r�c i..
legal rtatur of cn employor under uaa WockceL co.Lp=-ation '.Ct-
1 undc-stand ttu.'.a co?y of thu rtat=r o!1r y bo to cFn U--t�tnr e of L�dwfriJ At6dm:Y Off') °of for lSm
covert jr^,t�ttttd ittet L•itttre to t—ttc 152 can lent"to the impaztLton n;c tic 1 penal:cs
comistmg of a fur-of ttp to S1,300.00 an&`cr ,:-nrivx•Lv.=_,or::p to cn:y-J r.-.j eivit(xsuttia in dC f,nn cf A Sic",`:V^k a
film Of 5100.00 a dly agmird am
dci%utnxz1:l urc qtly l
•• Ycrmit rIufntx;r ______._---------___--�
Lot -- -
SCQ1!t'8 rtY: iiT¢ UC'g14sN SERVICES
8.3. Licensed Construction Supervisor:
Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
( � e Not Applicable ❑
Compahv Name Registration Number
R -as-ate
Address ` Expiration Date
C� t -7 Telephone _!�� \SL15 /`Y
W.A. (M G1. c 152, §25CS6)):
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 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
f"
�r�
EU. RK -. drat a I�cae ,: �
New House ❑ Addition ❑ Replacement Windows Alteration(s) O Roofing
Or Doors O
Accery Bldg. ❑ DemolitionO New Signs [ ] Decks [ ] Siding[ ] Other
o [ ]
Brief Description of Proposed Work: e_'M t• i flS 4ak '(�2� asp f S�fl��c c
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet❑
raj e d ��ton�o� Istr�l�g� singc�'"""�l� �I�r>�•
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
=R� l+
gN �O' E�COMPfDYHEN
.....,.t ,, .. �. ,�• .-, - ...'�rt=e` ,,, ,,, ,;,,,,,, , $ � ..,.,,..: ,...: ,- u �
I, as Owner of the subject property
hereby authorize to ac;on
my behalf, in all matters relative to work authorized by this Building permit application.
Signature of Owner Date
I, 1 I[ am Q�A,X)OCiJiy as Owner/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
0 4
Signature of Owner/Agent Date
}
i
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
arkin
#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:
qty of Northampton
C�` �� l� L� p'llding Department
�I
212 Main Street
i 2006
Room 100
1 ortHampton, MA 01060
4 _, phone 4 3.5i 7.1240 Fax 413-587-1272
n;[ginn
c-
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 SIT INFO JVtA"T:ION
,r MTh+s sectto 'ffc'er
1.1 Property Address: .
'Floe C P-,1`'r Zone v ria tit a
s a ti-
ElmrSt`�pistrict
SECTION 2 PgOPERTY Qt((jNERSF1.PrA�UTliOfiZED�QENT.
t
_: r-
2:.1 Owner of Record:
Name(Print) Current Mailing Address:
Ut� , 7�3
Telephone
Signature
2.2 Authorized Agent:
d ooy o Ola
Name(Print) Current Mailing Addre s:
q(3 8�4 �qS
Signature Telephone
�S�tr`irt°O(V 3 ESTIMA'f�ED COFISTRUGT�ON CQS1"S -
Item Estimated Cost(Dollars) to be Official;Use Qray
completed by ermit applicant
1. Building L44 75, (a) Building Permit Fee
2. Electrical (b) :stimated Total Cost of
_ Construction;fr-om:':b - _
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Totaf = (1 + 2 + 3 + 4 + 5) _0() Check Number
This Section For Official Use On.l
6:wldmgPermit',Numtier Date1ssued. _
-
%gnature. —
Buiilding Commissionet/lnspector of Buildings Date
s BP-2006-1389
GIs#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Cate :.�� BUILDING PERMIT
Pe BP-2006-1389
Project# JS-2006-2058
Est. Cost: $4475.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Adam Quenneville 120982
Lot Size(sq. £t.): 10541.52 Owner: MCCREARY HEATHER S&
Zoning.URA Applicant. Adam Quenneville
AT. 66 BROOKWOOD DR
Applicant Address: Phone: Insurance:
P O BOX 612 (413) 467-2426 () Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON:612212006 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 6/22/2006 0:00:00 $25.006994
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo