43-052 516 WESTHAMPTON RD BP-2005-1217
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:43-052 CITY OF NORTHAMPTON
_
Lot:-001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-2005-1217
Project# JS-2005-0615
Est. Cost: $7990.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Adam Quenneville 120982
Lot Size(sg.ft.): 40772.16 Owner: BURKE MATTHEW M
Zoning: SR ApBlicant. Adam Quenneville
AT: 516 WESTHAMPTON RD
Applicant Address: Phone: Insurance:
P 0 BOX 612 (413) 467-2426 O Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON:619105 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 6/9/05 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
516 WESTHAMPTON RD BP-2005-1217
GIS#: COMMONWEALTH OF MASSACHUSETTS
MU.Block:43-052 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-2005-1217
Project# JS-2005-0615
Est.Cost: $7990.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group Adam Quenneville 120982
Lot Size(sq.ft.): 40772.16 Owner: BURKE MATTHEW M
Zoning: S Applicant: Adam Quenneville
AT: 516 WESTHAMPTON RD
Applicant Address: Phone: Insurance:
P 0 BOX 612 (413)467-2426 ) Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON.619105 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 6/9/05 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
L —~ C."� f. Northampton
BU , � Department
�12 a i n Street
,! Ro m 100
��
.�tt+ �!"1t�on, MA 01060
wl j,'A rf -587-1240 Fax 413-587-1272
.i
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 11-SITE'-`i(NFOlktlYt/;TlfJN
1.1 Property Address:
1G�
Zoii �
W3,
_
ZZ
'EI 'r�St plStf'iCt � a�u s� B CE-1 i,`Q' "h
SECTION 2- PROPERT�f,01NESHIPlAUT4-ItORizfD AGENT
2 1,Owner of Record:
Name(Print) Current Mailing Address:
5,E -MY
Telephone
Signature
2.2 Authorized Aggrnt:
blot r
Name(Print) Current Maifing Address:
Signature Telephone
SECTION3 --ES,TIM'ATED`CONSTRLICTf<dN COSTS
Item Estimated Cost(Dollars) to be Official Use`Orrly
completed by permit applicant
1. Building (a) Building Permit Fee
17,99
2. Ele c.rical
(b) -Estimated Total Cost of
Construction.from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
15. Fire Protection
6. Total =(1 + 2 + 3 + 4 + 5) Check number
.This,Section For Official Use Only
Build'i:ng�Permit plumber: Date issued:.:
,
Signature:
Building Cornmissioner/Inspector of Buildings Date
Section 4.
ALL INFORMATION MUST BE COWLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF 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 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, des6ribe size, type and location:
1s r 4 R 5 15MG,
New House 0 Addition O Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: r n5rd�.rn� L�u�1hcu.�4 S�t�Cr�
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll D - Sheet❑
6a p r �.r�ron�r�o a isti�r�;�at` a ls° n���"��refi�ll 'tri�•
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. bimensions
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
�� y���h �► �, �� �RtZA4;1'�O,N ATO 13E'GOtV1f?�ETED„VYHEN�� � '
1, as Owner of the subject property
hereby authorize to act on
my behalf, in all matters relative to work authorized by this 'building permit application.
Signature of Owner Date
I, (-`C7 t U lcFxt,c.. 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.
fi C�F'21 .r..r
Print Name
-®S
Signature of Owner/Agent Date
S�GT�ON�,Gdl7,SyTF�41G�YO�J S�RVIC�$'
8.1 Licensed Construction Supervisor: (( Not Applicable ❑
Name of License Holder :--s ayq V1(-,2."v
License Number
Address Expiration Date
oz
Sign Telephone
Not Applicable ❑
Company Name J Registration Number
P (� i � ,�i'I„ 1 (�r� 3)as-/v 4
Address Expiration Date
Telephone_L- 7r� �If
CTIO �O II WIRE �ONi—§,-SATIOIU 1t�FSUF�ANCEaAFFIDAV. (M;G L t.;152, §2506))
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...... ❑
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 amcptable to the Building Official,that he/she shall be
responsible for all such work performed under the buildintj 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 fix 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
-fly Of Of �\jarti?cill pfoll
$ .. 6 fa�ranrtt(lnsrlta
t)I:PAaU'hMNr 4F EtUILDD3 G INSPECTIONS
212 Main Street ' Municipal Building
, y
Northampton, macs. 01060 "
w0mCmrs coMWENSA7701 T INSuRANO krrm,,�.Ntx
\vIth a przz-lcipa.1 place of busiracsslre; dence at
-f r (_ ^
ttcit,:
do hereby cer'tlly, llll:lti tllc pa.' 1S ;'.iid I)i il?ltic5 tlt pf:rJ11Sy, i.11<i::
I am -w ernpioyer providing the follovvint, •,;;Orrxr`s Co Inpctlsaboil Covera-�c for my
elll loyces wor�ansz on this job-.
an.mran=Company) (Peke-,.N,Umber} (Expiredon Daic)
{ j I am a sole proprietor, tir•enpral cont-mc.or or (c1 cle one) Pad ;izve nir(✓d
the conn-actors l?ste�l beiow ,vho h—,ve the iollvVin4 t;l r -7
orke, s cots pensa�ort
(Name of ConLmctor) (TLlsu;tincc Comm:ly Tolicy Nurnt*:r) (Ex T�:rnt on Date)
(Name of Contr<cto:) (Imsur;:ncc Co,7pazyfPohc}'Numb--r) -- (-:�rji;:tin;?Dale)
(Name Of{ OLit73Cior} (IIlS�t?S1C: {_O i;"t� !'i}(1i; N,lrllli=r) _ti; 0 hate:)
(Name of Contrictor) (Ins,:ranc. Cossmf[Poticy Numbs) Date)
( 1 t1ST] a: OIC proprlCLUi i!il'1 havc 110 :?IIC ','.'ilrhiii for I11E
12111 tl home ov"''nC: (iCirC"11115?^ ll t*n", v.;
Nuri::plc-.se t"+c aw a tlts.'.t?•i7e hc<;<a+��rta+i o cznpluy r .^ ;a t'.) .»�asxicc ez.:•-n G m rx: ,;.a t•+„ti:.^
riot trete th n tluoo uni's ir,tcf dt he E;;1>>:�Tr rc: s u oK;: .•;.�tpf R.r ra LtrexCc c e n t�rxtcrallY t�: ;:::v:a tti
ea pioyc�u.�'xz the�wri cr a cc x;::i^a�.'c (G ?So 1{t}).uy d:r:is n by a k x rra:1 for a t=-C ct par-:i::: _ :..acne Lin.
Icg11 rtatuc of an amploycr uoder tato Woricc%rt Corr=pa:"..,tipn ACL
7 uade^rzumd tfu.^.i cmy of this c ay bo f«wnniel to rt»tY_tiartzrn of Lv�ucr;J Anirar:a LiTicv of'tc rLa o foe tlm
oov x'bc vc it r_tioa and that f ilttrc to a Rsr:mtiwr,u uz d: c�.icr_23 A of?dGL t 32 cin tui Lo tttc intpositirzt o.r 3i: 3 pmak; s
tCrCtaisting or n rux of up to S I_00_00 ml..&W i.^.:c,risxn:: of;;p to r..- civil{x:tatua in dx form cf n Stc;r`,'.'cn )rdz --rA a
f sa~oC T l0i}.tk}t day i �_isizt m:.
Fur cic{:uumsal U. only l
P=Init Nuizitrx
Lot
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C ELKS
I �� QUENNEVIL• LE G� �
7` 9-
OO IF I N G The Premium Choice°
78 West State Street, Granby, MA 01039 / We Are Licensed
0-NEW-ROOF • 1-800-4-SIDING 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##57592D
Member of the Building&Trade Association Member of the Better Business Bureau P.P.C.38710
Proposal Submitted To: Date Phone#'s
__MA-W pi, Zveke S 3 G H:SFS7- 2? _ Cell:
Street Job Locatio
,2
City, State,Zip Code Special ements
Proposal to furnish �d install the following (° /f1Shl ESQ
❑ Re-Roof X1;Offyta ❑ Gutter S�c°p PI"zsh f'ti f
Complete Roof Preparation f k�-iti ISoc.f
K Home exterior to be protected by tarps and plywood _:7-1_Ct7YO� z�
0:
Shrubs, landscaping, trees to be protected from damage s tQ y5'o o,SCI
Entire existing roofing material to be removed to existing decking, including flashing, etc.
Site to be cleaned everyday with roll magnet debris removed at pr . ct comp Jy
,eP tict
t�>ec
Deteriorated existing decking replaced at ds c, per PC-1 o 0,t,I r:I-V\AtJc-40A�
8 inch metal drip edge installed at eaves and rakes ❑ 5 inch for re-roof only
New flashing will be installed where necessary(see Special Requirements)
We shall acquire all appropriate permits etc.for all roofing work
Complete Roofing System
ELK Leak Barrier installed at all eaves to protect from ice dams (and meet codes in the north)
ELK Leak Barrier installed in all valleys, around penetrations, and chimneys to protect critical areas
15 pd. reinforced underlayment installed over entire decking
Shingles:
[ ELK Prest4e0'Series J?�_30 year ❑ 40 year ❑ 50 year Color Pe 5�,,I er �ee
Nailable ridge vent will be installed
ELK ridge cap shingles
Warranty Options:
❑ We guarantee our workmanship for 5 full years
❑ ELK10-Year Umbrella Coverage Limited Warranty upgrade.
ELK15-Year Umbrella Coverage Limited Warranty upgrade. 7t�",
t / / (j,CG M]—
lk L. ', T0 UL �O�l, too
� � Ctl � / an with abovef:
ti. G ARA N /O/S`IO , Q G 3�yo' , tJP 7QC3O. o
Total Sale Price$ �7?90 • o c Down Payment$ Upon Completion $ S' Q E
ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are satisfactory and are hereby accepted.
You are authorized to do work as specified.Payment will be 1/3 down upon signing,and balance due upon completion.
Unpaid balances shall accru with interest at 18%per annum. Purchas s)will pay for all costs,expenses and reason-
able attorney's fees incurred b Adam Ouennev le Roofing and S/iiding, c.to recover any sums due under this contract.
Date:_ — Signature: ` ` !`� /_ ` Phone# SiF7
c �r 1
---
Date), U _ _ Salesperson's Signature:_-
Estimates ar onore or 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 and Sidings will not be responsible for debris or dust in the attic or
storage areas.