31D-091 (12) 66 WEST sr BP-2006-0350
GIS it: COMMONWEALTH OF MASSACHUSETTS
Man:Block:31D-091 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit tt BP-2006-0350
Project JS-2006-0513
Est.Cost: $9150.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const Class: Contractor: License:
Use Group: RCI ROOFING 126235
Lot Size(sq. ft.): 7884.36 Owner: WEBER WILLIAM R
Zoning: URC Applicant: RCI ROOFING
AT: 66 WEST ST
Applicant Address: Phone: Insurance:
P 0 BOX 309 (413) 527-4775 Workers
Compensation
EASTHAMPTONMA01027-0309 ISSUED ON:9/2972005 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 9/29/2005 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
----� :
•
City of Northampton
Building Department
212 Main Street • •
's, "�. .�
Room 100 yPua ''ht-�I r
Northampton, MA 01060
phone 413.587.1240 Fax 413-5871272 ¢ .ptr�__
o
APPLICATION TO CONSTRUCT, ALTER, REPAIR, REt bVATE:OR DEMOLISHA ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION --
1.1 Property Address.
Z i &�tx �-
I010 West Street -- `hh� �a:itt'; tet'``'
;one x w '4"-. rl�yrisr, � ��t'1. �`�r {
Elm St. District -CB Mulct
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
\AJiII Weer aqs State. 5-i] N'kn
Name(Print)
(Print) Curren_ I,iRgtl� 8.2
d4 S arTelephone //��''
Signature
2.2 Authorized Aeent:
P.o. Bni aq - Eas hampton, Ma
Name(Print) Current Mailing Address: 01021
(413) 52.7- 4795
Sigfiatur Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed by permit applicant
1. Building Rooftn' 4 9150 00 (a)Building Permit Fee
2- Electrical r I (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
15 Fire Protection g
6. Total =(1 + 2 + 3 + 4 + 5) 41 41150.0-0 Check Number
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date,
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENTED 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)
N 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 X
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
!F 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:
SECTION 5- DESCRIPTION<OF''PROPOSED':WORK(check,all applicable) -
New House ❑ Addition ❑ Replacement Windows Alteration(s) 0 Roofing IV
Or Doors 0
Accessory Bldg. 0 Demolition❑ New Signs [ I Decks [ ] Siding[ ] Other[ ]
Brief Description of Proposed Work: art l I a(r`RPA
Alteration of existing bedroom Ye No 7 ,,Adding new bedroom Yes No
Attached Narrative D . 'Renovating unfinished basement Yes No
Plans Attached Roll 0 • Sheet❑
1 Sa.IfIN e'W`3fiou'se aTidfl37iatlBttiori'fo eY[stin-g Hb'Gsfn$.-complk"_MbI7lf6t18Wifl_:
a. Use of building : One Family Two Family Other
b Number of rcoms in each family unit: Number of Bathrooms
c Is there a garage attached?
d. Proposed Sgiare footage of new construction. Dimensions
!!!I e. Number of stories?
1. 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
SECTION 7a -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES.FOR BUILDING PERMIT
I, Will Y V JMark , as Owner of the subject property
hereby authorize ark Delick oc R.C.I RonR1nn to act on
my behalf, in al matters relative to work authorized by this building permit applicatio J
ata ached 9/28,05
Signature of Owner Date
Mark lDelisle as atitlouIPA agent_ , as Owner/Authorized Agent
hereby declare that the statements and informal non the foregoinglapplication are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
V______eilsk
Print � 9/as/os
Signature of Owner/Agent Date
SECTIONS -CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Ma /„ -IIsl e. 974334
License Number
516 Hal ole Street - `F'asthamptonf Na. 0102.7 5 - 03 - Ob
Address Expiration Date
04 13) Sari- >♦775
Signature Telephone
kyffReP c e e 7flb�ne11R3rarn entre seimaiNot Applicable 0
RC. I. Roofln 12.112.35Com,any Name 9 Registration Number
51 B Nolynl`,- Street - P.O. Rex 309 5- oh - 06
Address Expiration Date
Easthampton Ma. oIoa7 TelephonP•113) 527-1-1775
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 it the denial of the issuance of the building permit.
Signed Affidavit Attached Yes ❑ No 0
IFIL.-+�o NI, Imo. Oe 6Lj e ili0,ii1OI.
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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 a V.aeher�
eo¢S pro'. Gag of Northampton
DEPARTMENT OR BUILDING INSPECTIONS•
. 212 Main Street Municipal Building
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE ATTWAVTT
lfria l�lDtl►sle of R e.L Roo{inq
(liccnsa/permiuec)
with a principal place of business/residence at:
5I1fiaja.keSt./Fastham to 14a oina'7 (phoneOki1►3) 5a7-H775
cout/city/stafr)rip)
do hereby certify, under the pains and penalties of perjury, that:
(VCI am an employer providing the following worker's compensation coverage for my
employees working on this job:
ki bejut Mutual ViCaa1S-31712.4 0yH iO 0
ce Company) (Policy Number) (Expira ba Date)
O I and a sole proprietor, general contactor or homeowner(circle one) and have hired
the et:_tractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
•
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Daze)
("Name of Contractor) (Insurance Cornpauy(POECy NnmMr) (Expiration Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(atu;f._Iicvil trees ifremnry to inchxk infvtmsti0o Dain°ab ell m.*edi)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NMET:please bc aware th.:whilo homemwna who®ploy pay=tom Dmialetance,maromim or/opal/work one dwoiling of
seteen atm itte onto in tit the hemeowocr rteida or w the ground+apP,nemal thereto ere rot g illy wmimn to be
mployc,uMr the worimee canpaismica Act(GL152•nI(5)),application by•bomaowm fax.Name et porton may evident the
kcal ctarau of an employer under the Woh es Coeopeamtiou M.
I tatassaad nut a copy of this catment may be fomented to Me Dgamoc t ofrnS.mid Accident?Offline of Imoence for the
coat-Icevtrifiaum cod that failtue to smut covmgo coda section 25A of MOL 132 an Ina b 06 itapo+mto of aims'rabCa
wmixag aft fine orup to Sl}oo,00 mdaimpbemmlofup ID ow year mdcivil pendtia Bee tam ole Stop YMOrttod a
fine c(`.100.00 a dsyyy tgaiimtme
Permit Number
Map® Lot#
4.i
Signature of Liccvsce/Permittee Late
RC.'. Ro Roofing, LLP
51B Holyoke Street
East ampto9
Estimate
Easthampton, tr#A OiG'27 Data
Phone(413)527-4773 5/27/2005
Fax(413)527-8469
Name/Address Job Location
Will Weber 66 West Street/Route 66
273 State Street Northampton, MA
Northampton MA 01060 584-1852
Terms Rap
Estimate valid for 60 days Mike
Job Description Total
Remove existing roofs. 9,150.00
Furnish&install aluminum drip edge,pipe flashing and chimney flashing.
Furnish&install new lead counter flashings.
Furnish&install ice&water barrier along eaves and valleys.
Furnish& install 15 lb. felt over existing deck.
Furnish& install 30 year Tamko Heritage Series shingle.
Furnish& install Cor-A-Vent ridge vent.
Furnish& install Versico rubber 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.I.workmanship warranty included.
30 year Tamko material warranty included.
All related permits will he obtained by R.C.I.Roofing.
SPECIAL. ITEMS NEEDED
Add S2.50 per square foot for wood replacement if needed.
NOTE: Chimney should be repaired before roof is done_
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total $9,150.00
TERMS coF mYMoNT
30%Upon delivery of materials
70%Upon completion Customer Signature
Registration N 126235
Construction License 074334 Date 26444 zg}
it
Insured by Hackwarlh Insurance(413)527-9907