23B-008 (5) 04/23/2015 11 : 14AM FAX 14135278469 RCI ROOFING Z0003/0003
04/23/2015 10:35 14135871272 NTGN $LD DEPT PAGE 03/03
Czty o`No��thampton 2.1.2 Main Street, Northampton, MA 01060
Solid Waste Disposal, Affidavit
In accordance of the provisions.°ali�debr s e,u t�n If om thelcognstruction
a condition of the building permit
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL,c 111, S 150A.
Address of the work: ��
The debris will be transported by: Co Yvv�
� receive b l a -
t
The debris will Y
Building permit number;
Name of Permit Applicant
Date Signature of Permit Applicant
04/23/2015 11 : 14AM FAX 14135278469 RCI ROOFING Z0002/0003
RCLRoofiri
I.I.P
6 Line Street,Southampton, MA 01073
Phone:413-527-4775 Fax:413-527-8469
City of Northampton
Building Department
212 Main Street
Room 100
Northampton,MA 01060-3189
Job: Silk Mill Condo's
267 Locust Street
Florence,MA 01062
To whom it may concern:
I request that you grant a modification to waive the requirements for control construction for the
Silk Mill Condo's#3 &4 re-roofing project at 267 Locust Street, Florence, MA because the
work is of a minor nature,will not affect health,accessibility, life and fire safety, or structural
requirements and is impractical in that the cost of control construction is considerable when
compared to the cost of the proposed work. Thank you for your consideT4fion. "Mass
Amendments, sections 107.1 allows for an exclusion from construction control .fax this project"
Respectfully,
/4��
Chris Thompson/Mark Delisle
RCI Roofing LLP
6 Line Street
Easthampton,MA 01073
y
(2)
All work to be performed according to manufacturer's specifications
All exterior roofing related debris to be remove by RCI Roofing
Provide owner with R.C.I. Roofing 5-year workmanship warranty
Provide owner with a Carlisle 20 -year membrane warrantv
R.C.I.Roofing will obtain all permits
R.C.I Roofing will provide crane as needed
Terms:
Start date to be 4/20/2015 weather permitting and completion date of both roofs
5/8/2015 (weather permitting).
50% deposit at delivery of materials for each roof section$13,000.00. And balance of
each roof$13,000.00 due on completion.
References and insurance certificates will be provided upon request.
We hope that you select R.C.T. Roofing to do this work for you. To accept this proposal,
please sign in the space below and return a copy to us with your deposit. A
construction contract will follow.
Sincerely,
Keith Hanel
Estimator Commercial Accounts
Accepted by �er l
---��-- date
R �■■■s®` �o-
�l Ay j■f.°.■A.�p.�■�M0 SLY V iiA.<g11.4
6 Line Street,Southampton,MA 01073
Phone:413-527-4775 Fax: 413-527-8469
April 9,201.5
Silk Mi11 Residential Condo Trust
C/o The Data Foundry
George Danziger
31. Tara Circle
Florence,MA 01062
Re: Roof Replacement Proposal
Sawtooth #3 &4
267 Locust Street
Florence, MA 01062
Dear George;
Thank you for the opportunity to provide the following estimate for installing new
roofing system on the above referenced property. Our scope of work is outlined below.
Scone:
Remove and properly dispose existing roofing to wood T&G decking(cricket areas)
Remove and properly dispose existing roofing to OSB sheathing nailboard (sloped
roofs)
Furnish &install 3.3 "polyisocyarnura.te insulation mechanically fastened (cricket areas)
Furnish &install 112' high density polisocynurate insulation (sloped roofs)
Furnish &install Carlisle .060 TPO (Gray)fully adhered
Furnish&install wood nailers
Furnish &install wall(lashings
Furnish& install drain inserts
Furnish&install Rtu and penetration flashings
Furnish& install wood curbs for a/c units
Furnish& install walk pads for a/c units
Furnish& install .032 Aluminum edge inetal
Price: $26,000.00 Each Total $52,000.00
The Commonwealth of Massachusetts
Department of Industrial`,Accidents
jOffice of Investigations
600 Washington Street
Boston, MA 02111
mirw,mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
.pplicant Information Please Print Le gib
lame (Business/Organization ndividual): kZ)Q % r\g U-C'
�d.dress; Cp 1_ --
mo_ of o-7 3 Phone #: (�Q) QO`t5
re you an employer? Check the appropriate box: Type of project (required):.
�ri am a employer with 2,O 4. El am a general contractor and I
6, ❑ New construction
_ employees (full and/or part=time),* have hired the sub-contractors
_J I am a sole proprietor or partner- listed ou the attached sheet. $ 7 Remodeling
ship and have no employees These sub-contractors have S. ❑ Demolition
working for me in any capacity. workers' comp, insurance. g, ❑ Building addition
[No workers' comp, insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repairs or additions
❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions
myself [No workers' comp, c. 152, §1(4),'and we have no 12. Roof repairs
insurance required.] t employees. [No workers' 13.❑ Other
comp, insurance required.] --
iy applicant that checks box#I must also fill out the section below showing their workers'compensation policy information:
:)rneowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit bidicating such,
ntractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy information,
man employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
'ormation,
urance Comp any Name: � �
liry#or Self-ins, Lic, #; W 0 � Q o' IIq O 5 Expiration Date: ADS
Site Address: City/State/Zip:
tatch a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
ilure to secure coverage as required under Section 25A of MGL c, 152 can lead to the imposition of criminal penalties of a
,e up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
up to $250,00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
vt:stigations of the DIA for insurance coverage verification,
io hereby certify under the pains and penalties ofperjury that the information provided above is true and correct:
piature: Date:
Lone#, ��13 •�`�l`1 `T
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License #
]]issuing Authority (circle one):
:l. Board of Health 2,Building Department 3, Cityrrown Clerk 4.Electrical Inspector 5. Plumbing Inspector
15. Other
Contact Person: Phone#:
Veision1.7 C'ommcicitiI IimI(Iin PcimiI M,i%, 1>. _'000
SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes _0_ No
SECTION 11 - OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I
I, as Owner of the subject property
I
I
hereby authorize to
act on my behalf, in all flutters relative to work authorized by this building permit application.
Signature of Owner t)I e
as Owner/Authorized_
AgQlt.t_hereoy 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 pa�insu and pperjury.
Print Name
Signature of Owner/Agent Date
SECTION 12- CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: ( Not Applicable ❑ —
�/
Name of License Holder: n K \`�5\� 'h L l c �L�+ •, t'�c l.y.ft tom' 1
ict nse Number
.c.
�ai 1 ti {3'S' �.'�C �c`.'y��r,C�vvr, �C:',l'1 q �`�l'-'L• t.`ti�',G � ,) ) "r
Addiess Expiration Date
Signalure Telephone
SECTION 13 -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.
Signed Affidavit Attached Yes No O
vi ,it fit!7 (i)fit o,vix| UvUJio-, | em'i/ kJx 15 Zmm
8. NiDwrl]ANIIITON ZONING
SidC R.
A. Hasa Specia| Permit/Va/iance/Finding ever been issued |or/oo the site!
��
NO \_/ DON7KNUYV \.7�� YES \.��
�
|F YES, date issued:
IF YES: Was the permit recorded at the Registry ofDeeds?
�� ��
NO \���� DON'T »Y \`�KNOW YES \`�
IF YES: er.ter Book Page and/o/ Document
D. Does the site contain a b/ook, body of water o/ wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has permit been of need tobe obtained frum the Conservation [onnnissio/`?
Needs tobeobtained /—\ \��Obtained /—� Date Issued:
\_/ '
C. Do arty signs exist on the pi YES \�� NO \`��
�
IF YES, describe size, type and iocation:
D. Are there any proposed changes toor additions o( signs intended for the p/oporly ? YES /—\ NO «~��
-
IF YB, describe size, type and location:
E. Will the oonmwroon activity d)omm (r|eanog.S'adio0. e t n. o/ 0|}nU> over 1 vr'vo. `sit part ofacommon plan
that will disturb over 1acre? YES ( ) NO
��
|F YES, then a Northampton Storm Water Management Permit from the oPvv .o ,aqu^cu
Vcrsimi 1.7 Cmii micitiI Iiuildiu"; PC III Iit Mai° I�, 21111(1
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE —
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
i
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing El' Change of Use❑ Other ❑
Brief Description I'IItcr a bricl,(ICSCrlptioll I1C1C.
Of Proposed Work:
SECTION 5- USE GROUP AND CONSTRUCTION TYPE -USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly A l ❑ A-2 El A-3
❑ A-4 ❑ A-5 ❑
B Business ❑_ —?IV -.-. --- —
E Educational ❑ -- - -_ ---- - - —� t--❑--
F Factory ❑ F-1 ❑ F-2 ❑
H High Hazard ❑ — _ -3A �- �❑-� -
I Institutional ❑ 1-1 _❑ 1-2 ❑
M Mercantile ❑ - --
R Residential ❑ R-1 ❑ R-2 ❑
S Storage ❑ S-1 ❑ S-2 ❑
U Utility ❑ Specify: - — —— -
M Mixed Use Specify: -- - -
S Special Use E-1 Specify: -- -- --_
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA �- —
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor (sf) T
i"
2.,,,
2.,a
3
4 u,
41f'
Total Area (sf) Total Proposed New Construction (sf)
Total Height (ft)
Total Height ft
7. Water Supply(M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone Cosa- system❑- -
_ --- Vursion1.7 Gommcriial Buildim, Pcnnil Mav 15, 11100
Department use only
t� ity of Northampton Status of Permit:
JJ wilding Department Curb Cut/Driveway Permit
APR 2 + 212 Main Street Sewer/Septic Availability
1 11 � Room 100 Water/Well Availability
� ',ng&Gas Inspecions
Elecvic,Piu do ham ton, MA 01060 Two Sets of Structural Plans
Northampton,MA 01060 p
p one 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
--t—#5�0ap Lot Unit
�C 5o Zone Overlay District
Elm St. District CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
5'rIk r� lrl ( �2es�d >�tiz1 CaN�v` a�7 � G�s' s r''z'--e-7-
Name (Print) Current Mailing Address:
Signature Telephone
2.2 Authorized Agent: )
Name (Prins) Curret}n�tlMailing Address. ry
Signalure Telephone
SECTION 3- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
1. 8u+ld4lg 12NOOCk vIc1 ��/ 006 (a) Building Permit Fee
2. Electrical �1 (b) Estimated Total Cost of
Construction from (6j _
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5)
00 L Check Number
JUM &S/41L-
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2015-0995
APPLICANT/CONTACT PERSON RCI ROOFING
ADDRESS/PHONE 6 LINE ST SOUTHAMPTON01073 (413)527-4775
PROPERTY LOCATION 267 LOCUST ST-#3 &4
MAP 23B PARCEL 008 000 ZONE SI(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinp,Permit Filled out -�
Fee Paid
Typeof Construction: INSTALL NEW CARLISLE MEMBRANE ROOF
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 74334
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
proved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Dela
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
267 LOCUST ST-#3 &4 BP-2015-0995
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23B-008 CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ROOF BUILDING PERMIT
Permit# BP-2015-0995
Project# JS-2015-001915
Est. Cost: $52000.00
Fee: $312.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): Owner: SILK MILL RESIDENTIAL CONDO
Zoning: SI(100)/ Applicant: RCI ROOFING
AT. 267 LOCUST ST - #3 & 4
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527-4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:412312015 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL NEW CARLISLE MEMBRANE 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 Sitnature:
FeeType: Date Paid: Amount:
Building 4/23/2015 0:00:00 $312.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner