31A-156 R RCI "" o ►fing 6 Line St. • • Est. mate Date
Southampton,Ma.01073 5/29/2014
Phone(413)527-4775
Fax(413)527-8469
Name/Address Job Location
Lauren Shatz 61 Maynard Rd.
61 Maynard Rd. Northampton,MA 01060
Northampton,MA 01060 (617) 512-0353
Terms Rep
Estimate valid for 30 days Chris
Description Total
Remove existing roofs. 16,200.00
Furnish&install 1/2"plywood over existing main roof decking only.
Furnish&install aluminum drip edge,pipe flashings,chimney flashings and step flashings.
Furnish&install CertainTeed Winterguard ice&water barrier along eaves and valleys.
Furnish and install synthetic underlayment.
Furnish and install Lifetime CertainTeed Landmark Series shingle.
Furnish and install CertainTeed approved ridge vent.
All exterior roofing related debris to be removed by R.C.I.Roofing.
All work will be performed according to manufacturers'specifications.
Lifetime CertainTeed material warranty included.
All related permits will be obtained by R.C.I.Roofing.
A Certainteed Surestart plus warranty will be included with a fee of$560.00 absorbed by RCI
Roofing if signed within 7 days.This extended warranty means that 25 years of the Lifetime
warranty is covered for labor and materials.The remaining years of the Certainteed warranty
would be covered for material only.
Customer is responsible for securing interior items and-any-attic debris from-roof removal. Total $16,200.00
1t,KM6 UP PAYWItN1 �
I' !
,i Diu ui.kivoii
Balance upon completion I Customer Signature 1
Construction License#074334
]7atc
11b ULCU UY rialldb M rIu&VIL 111J.
((413)527-2700 �'
SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable O
Name of License Holder; t
M er i isle. f7(/ g 3 3 4
License Number
Address 4 Expiration Date
52q- !41775
Signature Telephone
9. Registered Home Improvement Contractor: Not Applicable 0
oo ;nQ
C mo pany,Name Registration Number
1 NOOreaa Expiration Date
� e lli -AYY1 tcm M21. Q L CL—j TeIephon 613) fl.Wit is
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 Wit result
in the denial of the issuance of the building permit,
Signed Affidavit Attached Yes....... ie No...... ❑
11. - Home Owner Exemption
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
,is 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 thejob site will be,required from time to time,during and upon
completion of the work-for which this permit is issued.
:\Iso 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, States and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
i
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House [7 Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs (0] Decks (M Siding[OJ Other[1]1
Brief Description of Proposed
Work: LL 1
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes !_No
Plans Attached Roll -Sheet
6a. If New house and or addition to exi ting housing, complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
I . 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. Masscheck 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 .
1. 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
LI, o-1, e 0 "Z as Owner of the subject
property
hereby authorize el d• •
to act on my behalf, in all matters relative i work authorized by this uilding permit application.
attaches] --I --i [ y
Signature of Owner Date
I, M Mayk )elisIt -AS as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing lication 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. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Rear
Building Height
Bldg. Square Footage %
.Open Space Footage %
(Lot area ininus bldg&paved
#of Parking Spaces
A. Has a Special Pennit/Vahance/Finding ever been issued for/on the site? ` ..
/—�
�-�
NO «_-/ DON'T KNO0/ �_� YES v+�
IF YES, dote issued; i
IF YES: Was the permit recorded at the Registry ofDeeds?
NO �� DON'T �� YES
�~� \_� �-/
IF YES: enter Book nnd/or Document �
.
B. Does the site contain a brook, body of water orwetlands? NO �_� DON'T KNOW �_/ YES
IF YES, has permit been or need to be obtained from the Conservation Commission?
Needs tobeobtained �-� Obtained /�� Date Issued:
i !
\_� \_� ' ' �
C. Do any signs exist on the property? YES t—��� NO \^��
�
— - — — - - — - — i
IF YES, describe size, type and \ocation: / |
D. Are there any proposed changes toor additions ofsigns intended for the property 7 YES 0 NO 0
IF YES, describe size, type and location: ! |
`
E. Will the construction activity disturb . grading, excavation, or filling)over 1 acre oriod part nfa common plan
that will disturb over 1acre? YEGK � NO � l
��
IF YES, then a Northampton Storm Water Management Permit from the DPW iorequired.
Tn wuLdnwKiIiiiiiallill
unadw%mm Z ime Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availabiflt
Room 100 Water MY,eI[Availabilit
03AI ti, Northampton, MA 01060 Two Sets of Structural Plans
one 413-587-1240 Fax 413-587-1272 Plot/Site Plans
,Other Specify_
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION I -SITE INFORMATION
1.1 Property Address: This section to be completed by office
VVN,-,— 0-C 14 Map Lot Unit
0 r4lo,vv\�\-6y) Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
La"c-ex-\ 11S'VX&-Az- U M"g —A LALALnnAAA 0)(j(,0
Name(Print) C rrqnt allin dress:
t -- �1 9,'�► I -0 3 S 3
tt'a Ch?-1� Ter�i3horT6
Signature
2.2 Authorized Agent:
f)Ag.I p C c Y770 to
Mly ]iA 1 4
Name(Print) Current Mailing Address:
) 11- 1477.5 010
013 52
Signature Telephone
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building &A 0c, (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Perm!,Fee
4. Mechanical (HVAC)
5, Fire Protection
6. Total =(l +2+3 +4 + 5) 00 O Check Number -?V0P?3o
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
61 MAYNARD RD BP-2015-0032
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31A- 156 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ROOF BUILDING PERMIT
Permit# BP-2015-0032
Project# JS-2015-000071
Est.Cost: $16200.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq. ft.): 7056.72 Owner: SHATZ LAUREN J&AMY
Zoning: URB(100)/ Applicant: RCI ROOFING
AT. 61 MAYNARD RD
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527-4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON.71912014 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 7/9/2014 0:00:00 $35.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner