25C-159 Roorm g, LLP
51B Holyoke Street
P.O.Box 309
Easthampton, MA 01027 Estimate Date
Phone(413)527-4775 6/20/2006
Fax(413)527-8469
Name/Address Job Location
Michael Kirouac 186 Bridge Street
186 Bridge Street Northampton, MA
Northampton, MA 01060 584-1907
Terms Rep
Estimate valid for 60 days Mike
Job Description Total
Remove existing roofs on house and two porches. 1 5,200.00
Furnish&install 1/2" plywood over existing decking.
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.
Furnish and install 30 year Tamko Heritage Series shingle.
Furnish and install Cor-A-Vent 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
Price WITHOUT porch roofs.........deduct..........$2,000.00
WE LOOK FORWARD TO DOING BUSINESS WITH YOU THIS FALL.
Total
TERMS OF PAYMENT I3,bQaO�
30%Upon delivery of materials
70%Upon completion Customer Signature
Registration# 126235
Construction License#074334 Date
Insured by Reynolds,Barnes&Hebb,Inc.413-447-7376
C GiiLl laf Wlarilibllllptoll
d°
I)PPARTMENT OF BUIL MC; INSPECTIONS
212 Main Street a Municipal Building
Northampton, Mass. 01060
'WORICER'S COMTENSATION INSURANCE AV-IT
--Yard T_eli
crrnittcc)
j rincipal place of business/residencc at:
At#7175
btlCCt/C ty/staidnip)
ciO eby certify, under the pains and penalties of per}wy, that:
(Y; i a;n an employer providing the following worker's compensation coverage for my
clnr:;�,ccs Wor-�ng on this job:
A► ,eE�'iean 6816bIO l0 5 07
(,.isu_mnc:, Company) (Policy Number) _ (Expiration Date)
a sole proprietor, general contractor or homeowner (circle one) and have hired
the `o:!tractor;; 11StCl below who have the following worker's compensation policies:
�I-r1" of Contractor) (Insurance Conipany/Policy Number) (Expiration Date)
;Name of Contractor) (Insurance Compauy(Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compwylpolicy Number) (Expiration Date)
she..;(if nceesury to include infoeatation pertaining to all ooatrneton)
( I fail a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
*
i0' plc-.ac lx aw1tG that"vhilo hancowocn wtw cmplay Fcrtom to do tnaiuicnance axowacuon or mpair work on a dwt:Uing of
::'CCC trim thmo units in'A ilidi the lwmoowncr raider oc oa the grounds:pputtenant thatto ate riot cmernlly considered to be
c:r'.or::a unr'.s the�wrkcrs ccurpc=iatica Act(GL152,ss t(5)},aWlication by a borneow=fare Uccax or pemid may evidence the
ra;ctntua of an eaxployoc under the Wor$oda CAmpematipn Act.
i u:, X,- and that a oopy of this ctitc—A maybe fotwwdad to tho Dcpautmcut of Industrial AociderAY offioe of I,ntranoe for the
Cr vcugc vt:-M atioo and shat failure to sauce covcta tinder soctioa 25A of MOL 152 can lard to tbo itnpoution of txit3 i pWAwes
«c it g of a fare of up to S 1,300,00 wdor of up to one yw tend dvil p=llia in the totm of it Stop Work(h'de ad t
o f S 100.00 a day cgninsi mr
For d Paft w too only
permit Number
Map4 Lot#
._ ���",... - �-s,�atzlrc of LiccnscrJPcrmittcc �.
w
w
SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Colstructiori-Sup visor Not Applicable 0
Name of License Holder 'r7 rl 4 3 31
License Number
.5 % hasl6m ti -1, 101027 08
Address Expiration Date
Si p Telephone.,
nature
Not Applicable 0
Corn-�any Name Registration Number
Address 1-� Expiration Date
araaw _
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.
Tile current exemption for^homcovmecs'was extended toinclude Owner-occupied f one(l) or two(2)bunJiem
and to allow such homeowner to engage an individual for hire who does not possess u|imenxo. provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person(o)who own u parcel o[|undun*hicbhcbhornoidomoviutmndo\o/eaide,uow6icbtburu
is, or 's 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
rcspoisibic for all such work performed under the buildinLy permit.
As actim�Constructioi Supervisor your presence oil thejob site will be required from time to time, during and upon
compiction of the %vork for which this permit is issued.
Also he advised that with reference to Chapter |52(\Yorkxm' Compensation) and Chapter \53 (Liability o[Employers/o
Cmpk`yocs for injurio uotrom\|ing in Death)o[the Massachusetts Ounoru| io,/s Annotated, you may be liable 6urporoon(x)
you h:roto pxr5onn work for YOU under this permit.
The Llzdersigncd"llonicowner" certifies and assumes responsibility for compliance with tile State Building Code,City o[
Northampton Ordinances, �/nmonJ Local Zoning Laws and State o[Massachusetts General Laws Annotated.
Homeowner Signature__
'
SECTION 5- DESCRIPTION'OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other [ ]
f �� �.
Brief Description of Proposed Work: a�� " s!r i --
j Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrat ve Cl Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet ❑
sa.'If Ne'w'l o=,use and'or"addition'to'existing housing;compleWthe follov"i�in :
a. Use of building : One Family Two Family Other
b. Number of ooms in each family unit:___ Number of Bathrooms
c. Is there a garage attached?
i d. Proposed Square footage of new construction._ _ Dimensions
e. Number of stories?
i
j 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
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
h�sell You as as Owner of the subject property
Fherebyauthorze .Mark to act on
imy behalf, in <II matters relative to work authorized by this building permit application.
Signature of Owner 4eAS _
1 )to_ 1 s1 e_— as ;ai j tl'1DY I LCLI_ d as Owner/Authorized Agent
[hereby declar,: that the statements and information on the foregoin application are true and curate, to the best of my
nowledge and belief.
Signeedd under the pains and penalties of perjury.
�_1_�
Print Name
—
� 101Q5&6
Signature of Owner/Agent Date �— _�
w
S
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,)
ti of Parking Spaces `
Fill:
volun;e&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 C r
.212 Main Street
Room 100
Northampton, MA 01060 et
( `= phone 413,587.1240 Fax 413.587-1272 PI �Slt�e
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
This sectio it be completdd c
1.1 Property Address: � �� �° z�� ,
N aE` Fi
Zone Overlay District: ..r.
j �.
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
iAchael Hinuac — I 9L 'RrJaep- St.- I Xfon
I Name(Print) C t aili Vdj—es s:
Attaehed _, Telephoner
Signature
1 2.2 Authorized Agent:
28. u aA M
` Name(Print) Current Mailing Address:
0102'j
=� (ji rM 5 Q?- �i17?5
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
` item Estimated Cost(Dollars)to be Official Use Only
com feted by ermit applicant
1. Building Roof i n -4 )3' b0o.00 (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
_ Construction from 6
1� 3. Plumbing Building Permit Fee
j 4. Mechanical (F-'VAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) 3 Check Number ✓
This Section For Official Use Only
Building Permit Number: Date Issued:
i
Signature:
Building Commissioner/Inspector of Buildings Date
186 BRIDGE ST BP-2007-0485
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map Block: 25C- 159 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2007-0485
Project# JS-2007-000707
Est. Cost: $13600.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq. ft.): 12414.60 Owner: KIROUAC MICHEL&THERESE M&
Zoning.URB Applicant: RCI ROOFING
AT. 186 BRIDGE ST
Applicant Address: Phone: Insurance:
P O BOX 309 (413) 527-4775 Workers
Compensation
EASTHAMPTONMA01027-0309 ISSUED ON.1012612006 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP, PLY & 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 10/26/2006 0:00:00 $25.009466
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo