29-059 (2) s
SWRI C.I. Roor_M,g, LLP
51B Holyoke Street
P.O.Box 309
Easthampton, MA 01027 Estimate Date
Phone(413)527-4775 3/29/2007
Fax(413)527-8469
Name/Address Job Location
Joe Bellmont 62 Gilrain Terrace
62 Gilrain Ten-ace Northampton, MA
Florence, MA 01062 586-1422
Terms Rep
Estimate valid for 60 days Chris
Job Description Total
Remove existing roofs. 9,240.00
Furnish&install aluminum drip edge,pipe flashings and chimney flashings.
Fumish& install new lead counter flashings.
Furnish&install ice&water barrier along eaves and valleys.
Furnish and install 15 lb. felt over existing deck.
Furnish and install 30 year CertainTeed Woodscape 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.
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
Add$2.50 per sq. ft. for wood replacement if needed.
ADD......for 50 year shingle.......$1,120.00
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total $9,240.00
10, 3b0.06
TERMS OF PAYMENT
30%Upon delivery of materials
70%Upon completion Customer Signature
Registration# 126235
Construction License#074334 Date 47-7
Insured by Reynolds,Barnes&Hebb,Inc.413-447-7376
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cp ' DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE DAVIT
A3rh lellsbo__ of R. 0.1 _ Roofinj
(licensaJpermittec)
-,with a principal place of business/residence at:
I B AQ6Wt F25 oto vi A a. o.i oart (phone# 1 -N??5
sect/ ty/staidap)
'o hereby certify, under the pains and penalties of per3ury, that:
I am an employer providing the following worker's compensation coverage for my
"mployecs working on this job:
Amerlcan 110 n&A5SUYane_ _ 10
(Insurance Company) (Policy Number) ire on Date)
; ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
`he contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurance Compaay/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurancz Company/Poky Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional shed if neccn to inchrdo information padsiniag to all ooatra r7)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be awue that whilo homoownm who employ peso=to do=Ljaten=cr,omstructioo or repair work oa a dwelling of
sot mote than throo units m which the homeowner rc ides or on the bounds:pwdcnaat thereto are not geocci ly aoosidered to be
cmploym under the worker's coaven&ation Act application by a homeowner for a Haase or permit tray evidenoo tho
I egal etatua of an employer under the Wori x Compaenation Act_
1 undastaad tbst a copy of this aat=ccd auy be farwadod to tbo Aagartmug of Ioiutid Aod4mW of800 of It>mm rrt tflr
covaxge wrificatioa and that failure to t oatre oowmgo=der sociion 25A of MOL 152 an lad to the 6posidoa of aimiosl P=Wd
000siAurg of a fine of up to S1,300-00 wNor imptisoomait of up to one year and civil p=tWel is the focm of a Stop Wort Order acid a
firm of 5100.00 a day against me
For deparW="1 tun ody
Permit Number
Map# Lot#
Sir of Li permittee
� r
SECT,tON'8-.CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder aY f]� 5 717433 -4
License Number
51 - � 0a7 5 -03 - 08
Address Expiration Date
(q13) 59; - 44175
Signature Telephone
efe�dN ip" o►eme tContract Not Applicable ❑
A-01- 1. Roof�na 12,62.35
Com an Name �` Registration Number
51 a kki bo e Street - P.t�Blox _ _ 15- 0 b - 08
Address Expiration Date
Telephon
75
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 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 mire 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
rM
FNew ION 5 DESCR�PTIONOPROPOSED WORK�(chec_kiall applicable)
Hous e ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition[] New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative ❑ Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet 1
.miff N- v0b'ouse'TaWd or d"dition°_tc exist"ngh-6-Ti- in x, core 16 a th .1':ho"'��I` :
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 BE`COMPLETED WHEN
0.WNERS'AGE47 OR�CONTRACTOR APPLIES fORtu,1 DING PERMIT
as Owner of the subject property
hereby authorize ,Mary Del,- e, n?R.C.I. to act on
my behalf, it all matters relative to work authorized by this building permit application.
attaC)n P-A J4-19-o7
Signature of Owner Date
I, Mark as au nY1mPA AQent- 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.
P=Name � �/ p
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
wilding Department
212 Main Street
Room 100
Northampton, MA 01060
phorrt2'413.587-1240 Fax 413.587-1272
F_APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION-1 - SITE INFORMATION
1.1 Property Address: Th�s s c
S
�a �;1 rain ],erra ee� Ma
p"
A`ion
Zone
EIrn t 'District ;CB�Di„tt�tt
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 ��Owner of Record:
s�c &Jywylt La Q Y i1'1�eYra P
Name(Print) Cu rM ailing A(Jdre s:
Attz6dj Telephone �f
Signature
2.2 Authorized Agent:
- P.1). RAY - Eastharaotm Ma
Name(Print) Current Mailing Address:
Sig ature Telephone •
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building Roof 1 Y1 )Qj So•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 Protect.on
6. Total = (1 + 2 + 3.+ 4 + 5) 10 3bo 00 I Check Number 0 '
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature:
Building Commissioner/inspector of Buildings Date ,
C
BP-2007-1018
GIs#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
z
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-2007-1018
Project# JS-2007-001646
Est. Cost: $10360.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq.ft.): 20995.92 Owner: BELMONT JODEPH&
Zoning:URA Applicant: RCI ROOFING
AT. 62 GILRAIN TERR
Applicant Address: Phone: Insurance:
P O BOX 309 (413) 527-4775 Workers
Compensation
EASTHAMPTONMA01027-0309 ISSUED ON:412712007 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 4/27/2007 0:00:00 $25.0010165
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo