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36-227 r Ell i QUENNEVILLE ELKW 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.180onewroof.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 _ \ itt ,k �1en `-HIV"04 H: S?S 051� Cell: X81 i Streett +I�\� Mail To: sd, W,YI k&, Ce eLj lcl�)c City,State,Zip Code ` -- Special Requirements rT MN 0lo,0 Proposal to furnish and install the following I ❑ Re-Roof (!f Tear Off ❑I Gutter Complete Roof Preparation ff Home exterior to be protected by tarps and plywood [Shrubs, landscaping,trees to be protected [Entire existing roofing material to be removed to existing decking, including flashing,etc. /Site to be cleaned everyday with roll magnet debris removed at project completion L�,Deteriorated existing decking replaced at 2.50 per sq.ft. R1 hite Brown 8 inch metal drip edge installed at eaves and rakes ❑ White/Brown 5 inch for re-roof only New flashing will be installed where necessary(see Special Requirements) [nstall new pipe boot flashing [We shall acquire all appropriate permits etc.for all roofing work Complete Roofing System [9'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 [15 pd. reinforced underlayment installed over entire decking Shingles: `t [[ELK Prestique®Series e30, ear ❑ 50 year Color � E!rNailable ridge vent will be installed [[ELK ridge cap shingles Warranty Options: 3 We guarantee our workmanship for 5 full years ❑ ELK10-Year Umbrella Coverage Limited Warranty upgrade. �. ❑ ELK15-Year Umbrella Coverage Limited War y upgrade:` v � We Propose hereby to furnish materials and labor-, mplete in ccFordance with a ye specifications for the sum of: 01 i Total Sale Price$ S9�5 W Dow Payment$ gqO.00 Upon Completion$ 1�5 UO ��d a '� ACCEPTANCE OF PROPOSAL:The above pri s,sp�clfications and conditions/are satisfactory and are hereby accepted. You are authorized to do work as specified.Pa ent will be 113 down upon s' ing,and balance due upon completion. Unpaid balances shall accrue with interest at 18% nnum. Purc will pay for all costs,expenses and reason- able attorney's fees incurred by Adam Ouenneville Roofing and Siding,Inc.to recover any sums due under this contract. Dater C1 Signature: -'t=:,. Phone# Date: Estimator's Signature:__ yZ Estinnates are fair o`red for 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 Ouenneville Roofing and Sidings will not be responsible for debris or dust in the attic or storage areas. May-U4-•GUUb Uy:41 AM tcemlilara insurance 141J.'DibbUlU 1 1 4 a_CC IRD CERTIFICATE OF LIABILIW INSURANCE CSR RL DATE(MWIIDIYYYY) ADAM -1 05/04/06 PRODUCER 1 THIS IF ff�is A MATTER OF INFORMATION ONL N N UPON THEE CERTIFICATE Remillard Insurance Agcy„ Inc HOL ES NOT AMEND,EXTEND OR 79 Lyman Street ALTER E C ED BY THE POLICIES BELOW. South Hadley MA 01075 1 Phone:6613-538-7862 Pax:413-538-7179 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Nntionnl Sire 6 Marine Tnn. co Adam Quenneville Roofing INSURER B: Arbella Protection Ins Co bt am Siding Que Inc,& INSURER C; AID!Mutual ineuranoa Camp=7 Adam Quenneville Roofing Inc P 0 Box 612 INSURER D: South Hadley MA 01075 ERE* COVERAGES THE POUCH'S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MWD DATE MMIDRDIY ) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERALLIABIUTt' 72LPE703070 06/23/05 06/23/06 PREMISES Eaocct IDence $50000 CLAIMS MADE I OCCUR MED EXP(Any one person) $5 00 D • Contractual Liab. PERSONAL&ADV INJURY $ 1000000 • Waiver Of SubrO. GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG s2000000 POLICY J� LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1000000 $ ANY AUTO (Ea accident) ALL OWNED AUTOS 54906400002 11/01/05 11/01106 BODILY INJURY X SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY $ X NON-0WNEOAIJTOS (ParaccidenQ PROPERTY DAMAGE $ (Per accident) GA RAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO IOY P OTHERTHAN ACC S AUTO ONLY: AG6 i S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE I$ OCCUR CLAIMS MADE AGGREGATE Is DEDUCTIBLE RETENTION S S WORKERS COMPENSATION AND X TORY LIMITS ER C EMPLOYERS'LUU3ILITY ANY PROF'RIETORIPARTNERlEXECUTIVE AWC7'012861012006 04/29/06 04/29/07 E.L EACH ACCIDENT $100000 OFFICERIIAEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE S 100000 Pas,describe under ECIAL PROVISIONS below E.L.OISEASE-POLICY LIMIT S 500000 OTHER DESCRIPTION 01:OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS This copy of certificate is for use by sales reps only. If job is obtained please call for a new certificate that will show the property owner whoop the work is being done for, this will then become a legal document for proof of insurance. CERTIFICATE:HOLDER CANCELLATION A�AMQF+ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1 dam Quennevi l l e Roof ing & DATE I L ENDEAVOR TO MAIL DAYS WRITTEN ;tiding Inc & Adam Quenneville NOTIC DVIA MED TOTHE LEFT,BUT FAILURE TO DO SO SHALL Roofing Inc IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR �'0 Box 612 South Hadley MA 01075 REPRESENTATIVES. r [AUTHORIZED REPRESENTATIVE Ste hen E. Radon ACORD 25(21)01/08) ©ACORD CORPORATION 9888 J� Board of Building egulations One Ashburton Pface, Rm 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. PS-CA1 Co SOM-04/05-PC8698 g g Board of Building Re ula 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. DPS-CAI 0 50M•04/05-PC8698 7 Address F-1 Renewal L] Employment 7 Lost Card 211 IN"mill STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION j Be it known that ADAM QUENNEVILLE s 78 W STATE ST f is certified by p the De a rtm t_k6gst .P'i, ection as a registered HOME IMP kbQVE T CO,tiTTRACTOR I € `9traQ ADAM QUENNEVILLE ROOFING arssr,cr� i Effective: 12/01/2005 Expiration: 11/30/2006 c i a �•�Lv.x rTa �� 0 ��'' - y (iii-17 kill �c\lorillaillpfolt = � 6 fi?asaachuartts' L)EPARTMEN7 OF WILD?} G INSPECTIONS 212 Main Street Municipal Builcbng ' P.Torthainpton, macs. 01060 ` WORKER'S COMTENSA'MN MSUIZANCE AFFIDAVIT tll a prineipa.l place of busiresshn dent; r do her"cby ccrtiil,. u-n(i ;r dic p."'.ns ilud penaiiiCS Chi pc III-Y, 'h,'.! ( am an calp'loyer providing thL ol!o.v;nc, V,'(A'r;CF`s COrnncnsation covcra c `0r my eiuployees wordng on diis job: Ly (Insurancx. Company) (?ciwc:NTU=be r) (Expirvaoa Dart) ( ) I and a sole proprietor, gcn--rL cOrlt722c:Cr C" CQIIiCO«21t r (CIICIc' OIIe) dII� ::2V I17trC] the contractors listed bz:ow -;,-ho t1he `011 ••:^2 v.�'0:kP"'S COu�eIIti Oit ;�!iC:�S: (Name of--O IL 1CL0 ) 0'as ancc (E-x! n u,c-, Datc) (Name of C.ontrctor) _ (lrlsor ncc Com v(Pc!ic; Number) CE::p 'non Dart) (Name of C.orancior) 5 Dat6 (Name of Contractor) J- (Insumncz Con,! -..a -f Numl;s) (L,:ri-:tio-Da(c) (attach aAiiti ctital i:;.:Ct::.._-... _�._�_.... ...:-r:-:,:._. ._.... ..r.ii�_<.�_...,..•l t 1 Lull a ;;ole jvopricLUi i:a l have no Oi: J!"l jii4 l0i ii? ( I :nn a home 0�'i!lC': NOTE:plcaac be Ltat•.t—uc 6c<-4:.),In-3 u'„o ;a ct> s �:�nc�cc%: r C m u:-,;a r:"c•,.^_ .ct!_ c. not uxrc than duno units in«', dl he k ti>::err_r cs a; `.•_:.s x •ticr_r1 L,cYC e rx<Cclrralty cr.:t;;;::-':0 h: catploycs un:rr ttw.,vu 1:c7 z cc x�: icn.'•r(Ci;!Sc�•1(51 ,n _a:ic::!,y a 6tx•tco+,-tcr cr: -- 11Cga1 natur of an eg7aproyaer undar t2to W,,kCea Cart.pa_.,.tion A•CIL M I u.ndc-stand thi4 a copy of Uia ctatrn:-Mt auy bo fot�w�n dtJ to tin Dltw,-,4 t of lnd u i:l fot'tfK ooveazge vcsifiGtion tttt6 that failtzrt to un tre coti r;to d: caiM 25A of I.tGL 152 can land to the iaipcsitia olr si.1 Pn il:n C—istifg or a fun or up to S 1�QWoo a:t&'c1c of..-p to rn:)-u e:.f civil p=zulties in de f nn Of-S'c.' fm of 5100.00 a day agzin:l m:. Fur dg:uamesl u,o utly 1 Permit Ntuntxx _.___--_•---_.__._� 1Oi�F � C1rN SERI/ICf5 8 1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone Not Applicable ❑ MAIM a r,ompany Name Registration Number 1 CM Address `� Expiration Date Telephone 53 s f�Ls 3 # ieatF� '5p 3' CTIa 13 y: L T FrID"IT MsG L t ]52,§2:5� - 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 Lcense,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"homeowrier" shall submit to the Building Official,on a form acceptable to the Building Official that he/she shalt 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 New House O Addition ❑ Replacement Windows Alteration(s)❑ Roofing Or Doors ❑ Accessor!/ Bldg. ❑ Demolition❑ New Signs [ J Decks ( ) Siding[ J Other[ J Brief Description of Proposed Work: �T Alteration of existing bedroom_ Yes No Adding new bedroom Yes No Attached Narrative O Renovating unfinished basement Yes No Plans Attached Roll O- Sheet O a • "�S'�st i�g� n + �f1a'"�,lYe;e "`�"l� trig: 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 L 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 Zonini3 regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply O QE:CONJPLE7ff(i �I 4 r;..'�4R4 AC�iES'FOR BUfi,D_Dff�G [?1=RIVC1�= � � I• as Owner of the subject property hereby authorize to act or my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date 1. I r? �x' � �w 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 Signature of Owner/Agent Date owl Y 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 addn #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 pr')perty ?YES No IF•YES, describe size, type and location: ty f Northampton Bulldlhg, Department „r 2 Nf In Street ` --,)Roo 100 L 'h' Nor'thb�-np o-A, MA 01060 pn -i 40 Fax 413-587-1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFIP..W1111)N is;s ttko b 'om m fie,. 1.1 Property Address: 1 .YZQ +C 'EliZSt District = k�._ B< c ----K -r .. - . SECTION 2 - PROPER TL Oif1(NEE;a:SHIPIAUTtIORiZED:AGEN7 2.1 Owner of Record: Name(Print) Current Mailing Address: ,sue (2)s F Telephone Signature 2.2 Aythorized Agent: B a L 4YY3 _IX VCYII�Pt)i �� c C U Name(Print) Current Mailing Addrress. Signature Telephone 5EC 10N 3 ES77 MATED:coNs TMJGr Item Estimated Cost(Dollars) to be .Official Use Drily completed by ermit applicant 1. Building �, (a) Building Permit=Fee zSy��5 00 2. Elec.rical (b) estimated Total Cost of Lonstruction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total=(1 + 2 5 .00 Check Number This Section For Official Use Only Biailding,Permit-Number: _ Dater Issued:_ signature: Building Commissioner/Injipector ofBuiidings Date r t 110"M BP-2006-1281 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-1281 Proiect# JS-2006-1886_ Est. Cost:$8975.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Adam Quenneville 120982 Lot Size(sq. ft.): 60984.00 Owner., RIFKEN SHELLY L&DAVID L Zoning: SR Applicant. Adam Quenneville AT.• 52 WINTERBERRY LANE Applicant Address: Phone: Insurance: P O BOX 612 (413) 467-2426 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON.512412006 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 5!24/2006 0:00:00 $25.006814 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo