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31A-272 (3) QUENNEVILLE ROOFING W SIDING W WINDOWS 160 Old Lyman Road•South Hadley,MA 01075 BB 1.800.NEW ROOF 413.536.5955 T. Email:info*1800newroof.net Website:www.1800newroof.net Winner of the MA Construction Supervisors Lic.#070626 MA Registration#120982 8010 Member of the Home Builder's Association of Western Mass. CT Registration#575920 TORCH AWARD Member of the Building 8 Trade Association Proposal Submitted To: Date Phone#'s C: yap 2S'G1! PC-Ice, ,wkmce c °I II I H: W: Street Email: 23 �c 0.25 G(r, City,State,Zio Code fVoc�1�G�- fio�, r�� O1ouc� Proposal to furnish and install the following Iie,L) k Mt( r r_,L conc- C Ce.f dt 4�a.c4)L Ncw <<P e BSc �w►,�x� J 1VCt,J t&Ao4( CN (U t(C ( )or .c,nS��e wc.ccan�� Ctvili �ongtt�Q71t 1 Ask us about affordable bank financing We propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of:Total Due($ e) O O u-G d ) ACCEPTANCE OF PROPOSAL: The above prices,specifications and conditions are 4 ci ctk Down Payment($ —1.00.°) ) satisfactory and are hereby accepted.You are authorized to do work as specified. I 3'10 g Payment will be 1/3 down at start of Job,and balance due upon completion. Balance Due Upon Completion($ 13 0 O-ou ) Date: f�(b/_Signature: l Date: It I 1 Estimator:(Print Name) o (Sign Name) Estimates'arJ 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 Quenneville Roofing will not be responsible for debris or dust In the attic or storage areas. Q V E N N E V I L L E www.11800newroof.net ROOFING 'W SIDING W WINDOWS We Are Licensed 160 Old Lyman Road•South Hadley, MA 01075 1.800.NEW ROOF 413.536.5955 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 Westem Mass. CT Registration#575920 Member of the Building 8 Trade Association P.P.C.38710 Proposal Submitted To: Date Phone#'s C: Ha-1— 3%Y H: W: Street Email: City,State,DO Code Special Requirements: `( Nor,tio.- Taw, MrJ c)IOUG �41 ICC Gnu wb�cr bACCicC` rJ S Clone 4u 0CJoS<(_ 1`1T" as poss,llc ❑ Recover EN Strip Q]LayersQer �,� c P I eC c 3' d(' Cla��oal Complete Roof System St�,r +° Wtoo Zcaa,d W&'rc� VQ wwlt f'easr ku w- tZtox <yaco_}e, f a slcr') 00 We shall acquire all appropriate permits for all work N, vaoF or Celar I S� FI. � 4 Home exterior and landscaping to be protected Strip existing roofing to existing decking and dispose of. Do not Do. �' °`e� ('r°K;G 4.e sl°P Deteriorated existing decking will be replaced at$3.47 per sq.ft.after full inspection. N Install Ice&Water all eaves,valleys,chimneys,pipes and skylights X] Install(151b.fell Synthetic) derlayment over reTAuaing decking area ® Install Metal drip edge at eaves and rakes(8"/6')*Lite brown/copper) ® Install manufacturer's starter shin I on all eaves and rake edges BBB X Install new pipe boot flashin standard opper)/vents X In all =Country Cobra rolled vent ridge vent Winner of the 2010 ❑ Install proper soffit ventilation TORCH AWARD Shingles: ( 6 nails per shingle) G Shingles ❑ 25 year �30 year ❑ 50 year Color Pe W i tr G rc b� Ridge cap shingles Warranty Options: fQ We guarantee our workmanship for 10 full years(see our warranty coverage) F„11 Ir ".5 ',—c, ❑ GAF System Plus warranty ❑ GAF Golden Pledge warranty Chimney Options: Lead Counter Flashing ❑ Water Seal&Tuckpoint ❑ Rubberized Crown ❑ Metal Chimney Cap We propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of:Total Due($ 9&0 oo ) ACCEPTANCE OF PROPOSAL: The above prices,specifications and conditions are I c�N Down Payment($ 3 3 O 0 ud ) satisfactory and are hereby accepted.You are authorized to do work as specified. 3� p ( ) Payment will be 113 down at start of job,and balance due upon completion. Balance Due Upon Com letion $ 5 GU .20 u Dater— Signature: Date: a Estimator:(Print Name) �� h Sc_�k gL (Sign Name) t.ci Estimate ar 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 Quenneville Roofing will not be responsible for debris or dust In the attic or storage areas. The Commonwealth of Massachusetts lreparontnt of Industrid Accidents O,rice of Iavestigat+ions _ s �. .. 600 Washuigton Street Boston,MA 02111 www.ma$&gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers tyl2licant Leformatioa #ease Print.Leaibly Fume(Business lorganiistioc✓tndividual): Adam Quennevilte Rooft&Siding Inc Add=: 160 Old Lyman Rd - —- -- City/State/Zip: Phone#• Ate you an employer?Check the-appropriate box: Type of project(required):. 1. I am a employer with t 5 4. ['] I�am a general contractor and I 6. C]New construction employees(full and/or part-time).'*.. have hired the sub-contractors 2® 1 am a sole proprietor or partner- listed on the attached sheet 7..❑Lemodeling. ship and have no employees 't�rese sub-contractors have 8. C3'Demolition working for me in any capacity. employees and have workers' 9 ❑Buildio addition [No workers'camp.insinmee 'comp.insurance.: required.] 5. ❑ We are a corporation and its 10;[] Electrical repairs or additions 3. ] I am a homeowner doing all work officers have exercised-their 11:❑Plumbing repairs or additions myself.[No workers'=M. , right of exemption per MGL 12[5 Roof repairs inscnanoe required.]t. ,, c. 152,§1(41 and we have no employees.[No workers' i 3.[]meter comp.insurance required.] -Anj applicant that checks box#I'must also fill out the section below showing their workers'compensation policy iiotmmaion t l•Itgnwwncts who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew afftdavit indicating such. %Contractors that check this box must attached an additional sbect showing the name of the and state whether or not those entities have !ym If the sub•contracoots have employees,they must provide their workers'caatp,policy number. =P.lJ kyer aw it prvvmt lvomks' _ i1 Cf9T�dm�fOyers. Blew it tie p*&7 adj9b Sft lnmfrance Company Nsat - A!M Mettiial lnsrtraace Policy#or Self-ins.Lic.#: AWC4007012861-2016A Expiration Date:_,.4/29/16r- Job-Site Address: Atck a copy of the workers'.compensation,po[iFy declaration page(showing the policy�ttipnber and expiration date): FaiGrrrt;to secure coverage as required under Section 25A of MGL c. 152 can lead to the impositiorrof criminal penalties of a full tip to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a:STOPiWORK ORDER and a fine': , of to 5250.00 a day against the violator. Be advised that a copy of this statement rilay be forwarded tot>aeOffice of -IRv stigations of the DIA for insurance coverage verification. 1 d6i hereby cer fy undet:iQ paLw andperm dries o&nYt&.F td Ae Wormadvas provided 4"IS a and Correct y - Aidaf use only. Do not w,rlteo d&are%to be co4Ued by city or town afflew Pty or Town: Permit/License# 0suing Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector.5.-Plumbing inspector t Other �ontact Person: `� Phone#• r 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 8/21/2017 Address Expiration Date 413-536-5955 Signature Telephone 9. 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....... V 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 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 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 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing rXJ Or Doors ID Accessory Bldg. ❑ Demolition ❑ New Signs [O) Decks [❑ Siding [❑] Other[p] Brief Description of Proposed Work: Remove existing roof material and install new asphalt shingle system.Remove existing roof material from garage and install new EPDM Rubber flat roof system. Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the followina: 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. 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 I, Peter Whittredge 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 - 1(5-1 I� Signature of Owner Date I, Adam Quenneville Roofing & Siding Inc. 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. Signed under the pains and penalties of perjury. Adam Quenneville 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 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 Q DONT KNOW © YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO 0 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 Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. i Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability `'. CEP 18 �OtS Room 100 Water/Well Availability orthampton, MA 01060 Two Sets of Structural Plans iq6%,4 3-587-1240 Fax 413-587-1272 Plot/Site Plans E�ectr1O ^„ joy rrF,oloso 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 Map Lot Unit 23 Dryads Green Northampton, MA 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Peter Whittredge 23 Dryads Green Northampton, MA 01060 Name(Print) Current Mailing Address: 413-427-2568 See Contract Telephone Signature 2.2 Authorized Agent: 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 $ 11,800.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) 11 800.00 Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date 23 DRYADS GREEN ST BP-2016-0386 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31 A-272 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-2016-0386 Project# JS-2016-000624 Est. Cost: $11800.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq. ft.): 33541.20 Owner: WHITTREDGE PETER Zoning. URA(100) Applicant. ADAM QUENNEVILLE AT: 23 DRYADS GREEN ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 Workers Compensation SOUTH HADLEYMA01075 ISSUED ON.912112015 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF & REPLACE FLAT 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 9/21/2015 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner