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25C-155
RC.1. 'RoOfi`�� n LLP g� 51B Holyoke Street P.O. Box 309 Easthampton, MA 01027 Estimate Date Phone(413)527-4775 3/16/2005 Fax (413)527-8469 Name/Address Job Location Melissa Lampron 5 Orchard Street 584 Burts Pit Road Northampton, MA Florence, MA 01062 584-7288 Work: 587-1295 Terms Rep Estimate valid for 60 days Mike Job Description Total Remove existing roofs. 4,000.00 Furnish& install aluminum drip edge,pipe flashings and chimney flashings. Furnish& 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 Tamko Heritage Series shingle. Furnish and install ridge vent. All 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. ADD.......for side porch.........$700.00 Note: Small back porch roof is not included in this estimate. WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total $4,000.00 TERMS OF PAYMENT 30%Upon delivery of materials 70%Upon completion Customer Signature Registration# 126235 L, Construction License#074334 Date A Insured by Hackworth Insurance(413)527-9907 G0.ttn3 t n�O R E Crif-L) of Nortiluill Poll _ — � ' f aa sit chncclla' DEPNtTMEN7 OP DU[Lor),C [NSPPCf101.'S 212 Main Strect ' Municipal Dodding Northampton, Mass. 01060 NVOTUCER'S C0*'Q'ENSA770N bNSUTZAh'CE AFTIDAVI-1- 0;0cnscdpertnittcc) 9 with a principal place of business/residencc at: 518 HDIqohe, St, � nfm MA Ol6ad/ ( niMJT-1an) do hereby certify, under di'c pains and penalties of pc*w-y, !hat (� I am an employer providing the following worker's colnocns-ntion covemge or im etuployces wor�ong on'tJtis job: v a� 3tS=3��1'a -044 10 o� _ Corer s,) (Folic:NtL :r) (r.ptruor, D=) O Lath a sole proor,ctor, general contractor or homeowner (c c;e one) and have hired the contractors listed below wbo hzve the following workers compe-n_sation policies: (Namc of Co.ni-mci0r) (Illsunllcc Companylt�Gbc-., NkLmh,: ) { \J1iJu^i gate) (Name of Coaa-ac ior) Onsura.n= ComoanyRolin• Numcco (L»irauon Dale) (Name of Conaaelo") (Lasurancz Compaoyoouq- Nwnbcr) (Expiration Date) (N-Mc of Conaaetor) Gamrancc ComcanyaoUcy Numb:r) (Expitauon Date). . (laAcb iddit:oc2i shed JGnO=L y b rnt:}udc informaa00 Penns .l0 a.0 OoG7sC'-0^1� ( ) I am a sole proprietor and have no one wot-L-Log for me. ( ) I am.a home ovmer performing all the work myself. NOTE:pl=jc be aw-arc the N-tite bomco,4mcra vbo cmpltry pcsoas w J,a-. • . —e 00 cr rcpa r•• rk oo a d.• of ant mace the a L`:rm=rJ is-hicb the bosaowocr r=d.or oo the V-ou 6 x9purtew=tbeeo c.:c ox C---,Calty oeoidacd Lo be c Ploycs u0de the"ukr{=c P=m.Wo0/yet(GL152-=1(5)�applinaoa by a hormcow=for:6a=--.cr pamil r>^y--id—the Ic1PJ ftanu of an*=Player uoder due WorUez Ce�on Art 1 uodaYtaOd dat a Dopy o(th,6 ante**:may b.(or'.ard.d to tho pcq.rtmaoa of O{S,oe of trr.+,r.00a for th. cova-l.ec va'iraaio0 and that i:ihae to seaucicovaTyZc under soetioa 25A of MOL 152 ern led a the imposition 0reimi—I Pcaallies eoosisiag of a rrnc of up to S 1300.00 and/or im�at OC up to ooc year end coil PmaJtio i0 TSc form of►Stop wort Order and. Gm 0(5100.00 a dsy epjaA arc For d�.rta-�,r u.e only Pcsmtt Numbcr j Y i.cap., Lot K Signatttrr of Liccasevpermiucc — I ,J .:. �'�� Al , iRll 50_ l7rT40N S;ERVICfST .. . 8.1 Licensed Construction Supervisor: Not o _ 1I Applicable ❑ Name of License Holde 7A I33—Y License Number 7 5 - 3 - 04 Address Expiration Date - g7g5 Signature Telephon y Not Applicable ❑ R. C• 1. R f� no 12b215 Company Name Registration Number -q() Main AverluP- - Rbo AaX -.3o1 5 - 6 Address Expiration Date Telephone /3 -J 77jr WOMAN. � ,...-r wY yW R �ER OMPEISA10I 9N °V3 RANGEAFFIDAVIT(MgG L c 152, §25tr(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"homeoNvner"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 f6,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 CIIL�}pd ' fi T Y � 0 5. P 0, O R P..O EQ IVO:RKl c eck' f l;ER: n New House ❑ Addition ❑ Replacement Windows [Alteration(s) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition❑ 11� New Signs [ ] Decks [ ) Siding[ ] Other [ ] Brief Description of Proposed Work:_ d Ci,aL�P© Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll D• Sheet 0 0R ''Ij'd tlon t0 ex:stinger=housing,co p7'e ,e*th'e folio 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 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 SEIO W BE GOMPEP!_IES#1=0R BJILDI(jG P1=R I�' 1 ss Lam=n as Owner of the subject property hereby authorize I to act on my behalf, in all matters relative to work authorized by this building s/permit-�appl cation. (Ilia 6A of 1— ^r— Signature of Owner Date "1�x L)PL 6LP• Q S Q lthDYlLd 19 QM as Owner/Authorized Agent hereby declare that the statements and information on the fcIpbgoing 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 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: -� f-Vorthampton [Jil j a rng Department 23' Main Street n �h Room 100 i a t JUL 2 Ir'tham�ton, MA 01060 e phone 413-587,-1240 Fax 413-587.1272 t . AP.P-U-CATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION; v Thissecti`. "Mal h: 1.1 Property Address: X O1P1 y EI`St D 5tnct GB�Dis t .. _ �_.. .._ - SEGTION 2 - PROPERTRY 0. UT IZED AGENT. ..:. z 2.1 Owner of Record: _.M e l 55a-I yaw Mon 514 11t.5 Bit i?"aA - F lore=6 Name(Print) Cur n M� ling j¢r�ef� _ 0-- nil A pp(( Telephone Signature _ 2.2 Authorized Agent: 1yag.�7elisIf, - C. z. OnFi na Ro. 6px 3o9 - Ea AamptLrl NA Name(Print} Current Mailing Address: (,-113) .52,1- g x q 5 Signature Telephone _ : ,T �.... A7EG SETO:N RT N COSTSTM Item Estimated Cost(Dollars) to be Offrcial Use Or ay completed by ermit applicant 1. Building Roo? 1 n -4 000.00 (a) Building Permit Fee 2. Electrical l 7 (b) _:stimated Total Cost of Construction from.,.6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = 0 + 2 + 3 + 4 + 5) H 000 00 Check Number This Section For.Official Use;Only Building Permit Number: Date'I"ssued: - Srgnature: Building Co.r�missioner%In.spectotj f Build..ings Date L r 5 ORCHARD ST BP-2006-0086 GIs#: COMMONWEALTH OF MASSACHUSETTS a :Block:25C- 155 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0086 Proiect# IS-2006-0119 Est. Cost: $4000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 126235 Lot Size(sa.ft.): 6882.48 Owner: LAMPRON MELISSA J Zoning.URB Applicant: RCI ROOFING AT. 5 ORCHARD ST Applicant Address: Phone: Insurance: P O BOX 309 (413) 527-4775 Workers Compensation EASTHAMPTON MAO 1027-0309 ISSUED ON.7125105 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 7/25/05 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo