17C-114 (2) Rci--�OofmgLLP
40 Maine Avenue
P.O.Box 309
Easthampton, MA 01027 Estimate Date
Phone(413) 527-4775 4/12/2004
Fax(413) 527-8469
Name/Address Job Location
Sue&Bob Rice 50 Stilson Avenue
50 Stilson Avenue Florence, MA
Florence, MA 01062 Phone: 586-2861
Terms Rep
Estimate valid for 45 days Chris
Job Description Total
Remove existing roofs on front roof only. 3,000.00
Furnish&install aluminum drip edge,pipe flashing and chimney flashing.
Furnish&install ice&water barrier along eaves and valleys.
Furnish&install 15 lb.felt over existing deck.
Furnish&install 30 year Tamko shingle.
Furnish&install ridge vent.
Furnish&install IKO Modified bitumen roof system on flat roof section.
All roofing related debris to be removed by R.C.I.Roofing.
All work to be performed according to manufacturers'specifications.
5 year R.C.1. workmanship warranty included.
30 year Tamko material warranty included.
All related permits will be obtained by R.C.I. Roofing.
SPECIAL ITEMS NEEDED
Add$2.00 per square foot for wood replacement if needed.
ADD for flat roof in back............$2-,000-00-
ADD for 50 year shingle..........
- 989
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total $3,000.00
TERMS OF PAYMENT
30%Upon delivery of materials
70%Upon completion Customer Signature
Registration# 126235
Construction License#074334
Date
Insured by Hackworth Insurance(413)527-9907
i
o4TIw-r�TO'
f �i.I.Rthncrtta' _
DEP&RTMEIJT OP 13 UILDrNI C INSPECTl01.'S —
212 Main Strcet - Municipal Dudding
Northampton, Mass. 01060
«'0 RIQ:R'S C 0 tYM EN S A`X'I O N LN S URA_N CE A I,FM A VII
I
01 ccasc&permj ticc) 9
�viLh a principal plat. of business/residencc at:
JI o MM�J�te—It E mnfan MA 01,00-07
( a tyisZa.tc/a p)
do hereby cerdi -, under Lh.e pacts and penalties of pc'ury, '.hal
(� I am an employer providing die following workcr's comncnsado,) coverage for my
employees worlJng on this job:
t�I Ajtjod Vu 5-31s- 3igiaj4-o33 ►o 0
Conrsy) (Folic: Nucor) (a-pi Dal.^.) '
( ) I,am a sole proprietor, general contractor or homeowner (circ;e one) and have hired
the coon-avtors listed below who have the 'oUo%viaQ worker's coopen-",-tion pe!icies:
(Nam-, 01 Co:,.i cior) (1n urancc Cotnoxipli oUc NuD7_Gr) (r\JInauon Dite)
(Namc of Contractor) (bis-rangy Company/Po!im, Numcrr) (-Ex-p ruion Disc)
(N� e of Conuaetor) (Insuraac; Compao)•/Polic)' N-,jmb�-r) ()=xpim6oa Datc)
(Na.mc of Contractor) CLosurancc Comrzay/Pobcy NumbJ) (Expiration Darr),
(ntl.ach zdu ocaJ tuG iIaccti=slry w cicvKjz inform.Eoo pertniain�w.0 ocm- -3 -
O I am a sole proprietor and have no one wor4bng for me.
( ) I am-a home O%vner performing all Lhe work myself.
NOTE:ple;e be ew irc t v t le bomeouvcn ubo caplay Deiom w to �^ c--.:e oo r rcaait work oo,d.•eSLZ of
ad more then L'uw-tMAJ is-Each the borzoovwoc rezido or oo the Qo=43 zppurtcn.r_+tben-..n c��ocK to be
cmploye�u�..e the�.�;,dz�-_.�•,��AL+{GL132,�1(3)�npplin.000 by.hamm4w fet:Go-. .or permit ra^y c.ideo�the
Ic-PJ ctaau of as c ;>Ioyw undo dao Wockzeg C*capem..dioo.Act
I uod—d d-a copy a tbi,mtrcoea m..y b.ror—,dsd to Lb.Dopertmao¢of w Arodaat_•f ozoe or 6z--AC-ror th.
eovcrT v=iGc:aiov and U"U-=s-to sea=`eovcru,;c undo souioa 23 A of MOL 132 na Ie d Io the imp=2ioo oraimiazl pca Wcz
°O�8 of a Czoc of'+p w S 1300.00 atldrOr¢>�.t*iwesu�!oCup to oat year god avil pcazttio m t'x form of.Stop Wort Order aad.
fl=of 3100.00.dzy apl=me
For uyc�'Y
Pcrmit NUMbcr
✓ r
Lot ,
S'&MZW :of LiO=Iscx/permiucc — Date
SECTION 8t TCONSTR,UCTION SERVICES
un
8.1 Licensed Construction Supervisor: Not Applicable ❑ L
Name of License Holder :_ llf�'/S l e. T7'7 33-1I T
License Number
-►o - Easib afon. .X6 0/0027 5 - 2 - 04
Address /r Expiration Date
�1T�7- �!7'I5
Signature Telephone
' R tTUrffe11T1nD r v risen" Con rac Not Applicable El�P
R• c • Rnofinq � ab � 35 .
Company Name Registration Number
-Io Main A\1wLJPj - Pbo OX �� 5 - 6
Address Expiration Date
Fa sl am otn In NA 0160_�7 Telephone 1 3 50,q-'P77jr
SEGTl0N10VIGOt10ERS' COMPENSATION INSURANCE AFFIDAVLT(M GL 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...... ❑
Aom; . Qs l r gem ;t71M,
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)fami5es
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 far 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 a an her]
r
�A6'°�k's ��ea � 1�� , 2' _f�;� u � yj I
ECr 0 0 O PROPO E�ORK chec is hca a
New House C3 Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work:-Qeynoye, 1
Alteration of existing bedroom Yes No Adding new bedroom Yes No shl�les.
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0•Sheet 0
6a_ = VOW o d or a di ron to is in ho"s ng, co'Tm e a the ollow�
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
S ® ER : HOR 12A„TrI�ONrT40BECOMPLETEDWHT '
0 . E... Q' CO TRACTOR APPLIES FL1FB17LD1G PENT §
I. oh�Yt �IC`O as Owner of the subject property
hereby authorize I 1 to act on
my behalf, in all matters relative to work authorized by this building permit appl cation.
(2I a n 9 3D-(A-
Signature of Owner Date
,�'IQrrk- SIP„ as Cl I Zed� QQPn�' as Owner/Authorized Agent
hereby declare that.the statements and information on the fo going application are true and accurate,to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
I
Print Name
cl- 3 -
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 bt 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
Building Department
212 Main Street
Room 100 ;
Northampton, MA 01060
ho.A.e..4_ 3.587.1240 Fax 413-587-1272
5 ;�' - i e
APPLI�4T EPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
"O'CT 4 2004
SEGTIO.N SATE
1.1 Property A�dess: -'-r' ��n?�h'�� di06 is�sectign to bie co p
-5o 'Son AV e,
SECTION 2 PfOPERT�Y OWN ERSHIP'fAUT10,fjIZED GENT.
_.
. . . ..
2.1 Owner of Record:
Sue,4 &6 R1 ce-. 5D Sti lson .Avp,. FloY'exe,
Name(Print) _ 1 Cur r n lvaailirlgig ess:
att P-A Telephone bb
Signature
2.2 Authorized Agent:
1)elisle, - R. C. z, oofi na 'e-6, tpx 3o9 - &asft am iotn JMA
Name(Print) Current Mailing Address:
X113 5p7- jfqq
Signature Telephone
,��Cx1013a3� ES�1'IM"A'T'ED �O'I�STR�CTI`ON COS'LS�
Item Estimated Cost(Dollars)to be Offrcial Use f7rly
completed by ermit applicant
1. Building (a) Building Pe rmit Fee
Roo ' n 30oo-oo
2. Electrical
(b) -Estimated Total Cost:of
Construction from,'6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) 00o00 Check.Number p?.
..This S'e.ction:For Official Use:O.ftl .
Bwldmg'Pet mit Number - Date
'I"ssued;
f
no,ure: t4'
Building Corlimissioner/Inspector;of Buildings. . Date, .
I
N A BP-2005-0402
GIs# COMMONWEALTH OF MASSACHUSETTS
M I sock: 17C- 1'14 CITY OF NORTHAMPTON
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-2005-0402
Project# JS-2005-0535
Est. Cost: $3000.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groin RCI ROOFING 126235
Lot Size(sa.ft.): 11979.00 Owner: RICE ROBERT T&NANCY FABIAN
Zoning:URB Applicant. RCI ROOFING
AT. 50 STILSON AVE
Applicant Address: Phone: Insurance:
P 0 BOX 309 (413) 527-4775 Workers
Compensation
EASTHAMPTON MAO 1027-0309 ISSUED ON:1017104 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• Receipt No: Date Paid: Check No: Amount:
Building 10/7/04 0:00:00 6011 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo