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17C-102 (2) A, MOD I 11 I&WQ& AA visa Q V E N N E V I L L E www.1800newroof.net ROOFING 'W SIDING 'V WINDOWS We Are Licensed 160 Old Lyman Road•South Hadley,MA 01075 1.800.NEW ROOF 413.536.5555 Fully Insured Email:info@ 1800newroof.net Website:www.1800newroof.net Factory Trained MA Construction Supervisors Lic.#070626 MA Registration#120982 Factory Certified Installers Member of the Home Builder's Association of Western Mass. CT Registration#575920 Member of the Building 8 Trade Association P.P.C.38710 Prop osal Submitted To: Date Phone#'s C:(y� ��_a>06 4ex L H:yo) 4-Rto°I W: Street // A Email: S '31 A�,e City,State,Zip Code Special Requirements: a,c me c /t fF O f 06 a MAr✓ V PPP X ,eoo r- 0-4-Y 6 r fco�..Re rGi o� e,.,.e ❑ Recover fia Strip m Layers Complete Roof System We shall acquire all appropriate permits for all work ® Home exterior and landscaping to be protected ® Strip existing roofing to existing decking and dispose of. Do not Do. Alo �owEi[ ,�aot�s S Deteriorated existing decking will be replaced at$3.47 per sq.ft.after full inspection. r! � ® Install Ice&Water Barrier at all eaves,valleys,chimneys,pipes and skylights ® Instal 151b.f /Synthetic)underlayment over remaining decking area b§ Install Metal drip edge at eaves and rake (8"/5")(white brown/copper) Install manufacturer's starter shingle on all eaves and rake edges BBB Ej�Install new pipe boot flashing tanda copper)/vents _1- © Install Snow Country o Cobra rolleo ent ridge vent Wtnaer of the 2010 ❑ Install proper soff it ventilation TORCH AWARD Shingles: (6 nails per shingle) � / �&A F Shingles El 25 year NT 30 year El 50 year Color 11*A1,_-,54"5 Sz e a A r- Ridge cap shingles Warranty Options: [Z We guarantee our workmanship for 10 full years(see our warranty coverage) ❑ GAF System Plus warranty ❑ GAF Golden Pledge warranty Chimney Options: f'a C If ❑ Lead Counter.Flashing ❑ Water Seal&Tuckpoint ❑ Rubberized Crown ❑ Metal Chimney Cap We propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of:Total Due($ c%OU ) ACCEPTANCE OF PROPOSAL: The above prices,specifications and conditions are Down Payment($ satisfactory and are hereby accepted.You are authorized to do work as specified. Payment will be 1/3 down at start of Job,and I c due u on c let Balance Due Upon Completion($ ) Date:-T-WI Signature• /� Date: S��a�rr Estimator:(Print Name) eg-V CAJe. (Sign Name) Estimates are honored for sixty(60)days from above date ATTENTION HOMEOWNERS:Please cover all personal belongings in the attic,garage or storage areas due to the possibility of roofing debris or dust coming In through cracks of the wood.Adam Cluenneville Roofing will not be responsible for debris or dust in the attic or storage areas. Ille Ce1>umm r of ManwAxsem er:trt of l>�ae1'>wsdsao!Aex7t�rtXs Of fs "0 W"hhWoat S~ Boston,MA 02111 wWMWdffa VW't ' Caulpenssfim Iwtwa Ai vih Btrutilde AMMOM WMIM36M Fk=O Flint I.» ►h Nam Adam Quenneville Roofing b Siding Inc. Addrfts: 160 Old Lyman Road C' • South Hadley AAA 01075 PiMXW#- 413-536-5955 Are you as emtp loyar?Cfsek tie apprespri a bone: Type of project( : I-0 1 am a employer wi11 15 4- ❑ I am a general corA aeaer and I 6. []New consavction (%U and/or pWt_iM*)•* baw bled die mat 2.❑ I sot s$tile peapr+MW OF Pwft r- hissed on die rtacbed sheet 7• ❑ ihip and bran so employees Them sob-eom/ractom love & []Demolition waddWS Par me on any cal?acitY• eajdayeft ow m 9. ( ]Boiidinp addition N wailm 'cry-inser<auce Comp' l 5. [] We are a e mparaaion and its 10-0 EledsitUd MpmrS at addWons 3.❑ t as a homeouraw domg all war officers hove exftrtood their 110 P�m�ie�npa�s or sddwanc ri¢a ofeteaosption per U / _ l r C. 152,f 1(4X and we bave no 12. Roesf' .(No wodoers' i 3.❑Other coop.;awranae red.! •Amy rs iirir Out drsts bet O moo do as ow du err-, beW dMir WM&M,otspstrama FAT it«o.e..rrr urie rsberdt dru etliirdt i�dicarbr;drry sic 8rded.n oat tmi dot tsR ueaidet ceaaMCtas eraet gimott a sMar etgdmtit i.dicatirye sedr :Conewon OW dirt Ads bee curt rrt dwA a uNki ad dtett drlrtlsK do nitre of doe ad►�and are who&*of met 000 Oddu trove raylrl ro. Kdte wb►earrseren Moe—qp' 2 ea,duy nut M I duty ra+mdtmis'osr*-poky msai+e. few w eta tafteyw Mart it prerirli w wwrkM,c;t=6rsar,�ewe r for aq'ewtpimyrrat Emlow is tJb►p rase►jalr sob► — ho""Aa . Insmanee Onapany Nom: AIM Mutual Insurance Policy#or Self-ins.lic.#: AWrC140070128612014A I-�>�DM,: 4/29115 Job Site Address: .S >4, Std �� CitylSate�Lip: Ana*a copy at the worken'coanpetrsados pobey dedwadim pap(showing tic'Polley number amd a *atisie date). FaiHrre to some eo ersge as requinW under Sextioen 25A of Mid.c 152 can kad to the in p n of criminal pewhies of a fine up to$1,500.04 and/or erne-yew unprtsoommA,as well as civil pftuMn in*w form of a STOP WORK ORM and a fine of up to S250.00 a day against the violaw. Be advisW dud a copy of obis may be focarrded to the Offirce of Iavetrggdees of dw DIA for inaraaoce coverage v+rx>ficatim I at hereby evro under tko us air!peaaahja of perjary that die Jeform!tien prrredmd above is erns and CWTv t I OM lr• 413-536-5955 tipw nos ee+*I.Y. Der xut r►iior in tAdr rv,re,to be cswpLrt+td by dry or itrrrn offlciai (qty or Town: PersiNLiceau# Inning Audw*y(drek mw): 1.Bew d efHealth 2.Bufftlbag Department 3.Gtytron Cleric 4.Electrical Inspector S.Plombing Inspector 4.Odrer Cornet Penns: P%ofte#• 6 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Adam Quenneville CS 070626 License Number 160 Old Lyman Rd South Hadley MA 01075 8/21/2015 Address � Expiration Date 413-536-5955 Signature Telephone 8.Realstered Home Improvement Contractor: Not Applicable ❑ Adam Quenneville Roofing 120982 Company Name Registration Number 160 Old Lyman Rd South Hadley MA 01075 3/25/2016 Address &-:::� Expiration Date Telephone 413-536-5955 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. Signed Affidavit Attached Yes....... ly 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 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_yerformed 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 for 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 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 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 O DONT KNOW ® YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW iD YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained O , 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: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all aoolicablel New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing r7 Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding[p] Other[ICI] Brief Description of Proposed Work; Remove existing roof material and install new asphalt shingle system. Alteration of existing bedroom Yes V No Adding new bedroom Yes V No Attached Narrative Renovating unfinished basement Yes V No Plans Attached Roll -Sheet 6a.If New house and or addition to existlna housino, complete the following: 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. 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 1, Robert Charette as Owner of the subject property hereby authorize Adam Quenneville Roofing & Siding Inc. to act on my behalf, in all matters relative to work authorized by this building permit application. See Contract S'a'7 11�_ Signature of Owner Date I, �t1h"A-1i�� t� rn '� Sic�n�r t as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Z d under the pains and penalties of perjury. Print Name Signature of Owner/Agent Date Department use only I _C�1 ' rthampton Status of Permit: � n Buildin j epartment Curb Cul/Drlveway Permit 12'' Street Sevier/Septic Availabii ��,� MRy 2 a 201' 0 100 Water/weli availability, pt�lsi MA 01060 Two Sets of Structural Plans a Fax 413-587-1272 Plot/Site Plans E1eGtt} ortha Other Specify_ APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 25 Stilson Ave Map Lot Unit Florence, MA 01062 Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Robert Charette 25 Stilson Ave Florence MA 01062 Name(Print) Current Mailing Address: 413-5862109 See Contract Telephone Signature 2.2 Authorized Anent: Adam Quenneville Roofing &Siding Inc. 160 Old Lyman Rd South Hadley MA 01075 Name(Print) Current Mailing Address: 413-536-5955 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee $4,800.00 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) $4,800.00 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/inspector of Buildings Date 25 STILSON AVE BP-2015-1186 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C- 102 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-2015-1186 Project# JS-2015-002225 Est. Cost: $4800.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq ft.): 8929.80 Owner: CHARETTE ROBERT L&SHIRLEY A Zoning: URB(100)/ Applicant. ADAM QUENNEVILLE AT. 25 STILSON AVE Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON.512812015 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 SilInature: FeeType: Date Paid: Amount: Building 5/28/2015 0:00:00 $35.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner