18D-035 (39) 48 DAMON RD BP-2017-0347
GIS#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block: 18D-035 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-2017-0347
Project# JS-2017-000569
Est. Cost:$13000.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grouo: RCI ROOFING 774334
Lot Size(sq. ft.): 23783.76 Owner: KERRYMAN PARTNERSHIP
Zoning:GB(100)/ Applicant: RCI ROOFING
AT: 48 DAMON RD
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527-4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:9/14/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:RE - 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 It 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:
FeeTvpe: Date Paid: Amount:
Building 9/14/2016 0:00:00 $100.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0347
APPLICANT/CONTACT PERSON RCI ROOFING
ADDRESS/PHONE 6 LINE ST SOUTHAMPTON (413)527-4775
PROPERTY LOCATION 48 DAMON RD
MAP 18D PARCEL 035 001 ZONE GB(I00)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED O T
Fee Paid cr l 0,7(.279
Building Penni;Filled Out
Fee Paid
TypeofConstruction: RE-ROOF
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 774334
3 sets of Plans`Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
pproved 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 Delay
ret410,1V-...//td/ 2—/7"—/e./ .
Sig . of Bui di-1( .icizl 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,
RECEIVFD
Version].7 Gammercinl Bui!dine Permit Ma- 15 20(10
Department use.only
City of Northampton Status of Permit:
Building Department Curb CuvDriveway Permit
>'+arnwang urr oea 212 Main Street Sewer/Septic.Avaitability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Sae Plans
Other Specify
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN AONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Atltlress. This section to be completed by office
Zffr: -tttto...,n111,,,£d- Map Lot Unit
NetifiaYnten), Ih/3 C"'& ' Zone Overlay District
/ Elm SL District Ca District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owneyuf Record:
Steac&A:t(ant Boa
/10F64244vane(Prim) Ktrrymrvn Fazino-slr p Curies(Magma AOdress
Signature Set attached Telephone (4/i3) 6-24 - AZ97 _
2.2 Authorized Agent:
Xlt C. C. ROOF-rnc) E.tp Cc 1-..>n C ]fir- .kr\ utvcl-C rt rna eto13 !,
Name IPrinll Current Mailing Address:
( i3) 6-221- w`�-t5
Signature relephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
' completed bypermit applicant
1. Sodding •... Building ,,.
" {Ijppr a nc C, iJPermit Fee
... �_ lar rco. `"...
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3- Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6 Total= (I . 2 +3 r n + 5) /.3 eru. Check Number Ad r � �
This Section For Official Vse Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/inspector of Buildings Date 1
Versinul.7 Cunnee :HHl Buldmag Permit NLiv ❑.2u11U
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs C Demolition Repairs 0 Additions ❑ Accessory Building
Exterior Alteration ❑ Existing Ground Sign❑ New Signs 0 Roofing Er Change of Use❑ Other ❑
Brier Description Enter a briefdeseription here `` ` \
Of Proposed Work: Qyt rooF C_.. C\-\i>i
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ a
A-4 ❑ A-5 ❑
B Business ❑ eit__2n-- -�----.
E Educational ❑ --28
F Factory 0 F-I ❑ F-2 ❑ G
H Hod Hazard ❑ _3A -".._—....
I Institu0onal ❑ I-1 ❑ 1-2 0 p 6
M Mercantile ❑ ��
R Residential C R-I ❑ R-2 ❑, d �„
5 Storage ❑ S-I ❑ S 2 0
U Utility ❑ Specify:
M Mixed Use
Specify: --
S Special Use E Specify.
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group' Proposed Use Gr0up:
Existing Hazard Index 750 CMR 34)'. Proposed Hazard Index 780 CMP 34).
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor Isf)
2ri0
4u.
Total Area (sQ Total Proposed New Construction ref)
Total Height (II)
Total Height ft
7. Water Supply (M.(3.L. c. 40, 4 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public 0 Private ❑ Zone Iadisposal_systezuL
Version 1.7 Commercial 13tildiug ['crmil Nley 15. 212ll1
SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11)
I
Independent Structural Engineering Structural Peer Review Required Yes 0 No O
SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT ORACONTRACTOR APPLIES FOR BUILDING,,UPERMIT
I, Shut, l..[/hbla e Y2r/inerSkt as Owner of the subject property
hereby authorize )ke / 7s0O4//9 /Li° lo
act on my behalf, in all matters relative to work authorized by this building permit application.
>e e_ ci..O--\ tick .:, Q .29 -/6
Signore:a of Owner — Dare
MCS-C \)CV',S\C. - 91e- -_ Koo-C,n� L.L.P as ownennuLrtoazeo_
/yglereby declare that he statements and information on the foregoing application are True and accurate, to the hest of my knowledge
and belief.
Signed under the pains and p [ties of perjury.
Mad behsky
Print Nance --- --6P-s.2 9-9- / ,'
Sonarwe of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: irnstr S Vire_\\"At - Y.,C'S_ eooc, <\c LSP —1 c_k 23(..
License Number
33 -C1.-S\- CAA)e_ ESS\\.wmp\c(-1 I (A4. pyoal 5. 3 _
._
Address Expirallpn Date
__L, Q413)52.1 d 4ck-15
Signature r elepbone
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 Ie provide this affidavit will resort
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes v No 0
The Commonwealth of Massachusetts
Department of Industrial Accidents
=j Office of Investigations
= 600 Washington Street
ji t U Boston,M.4 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plunabers
kpplicant Information Please Print Legibly
dame (Business/Organization/lndividual):_J ooc n.q L1P
kddress: Ce 12,re. 5
L'ity/State/Zip:5Qo_s-l-.as,\\-0 n Mo. ato1?, - Phone #: {y03i Sa`t 'tl11S •
.reou an employer? Check theappropriate box:
YType of project (required):
Eli am a employer with a,() 4. [ 1 am a general contractor and 7
6. ❑ New construction
employees(full and/or pan-time).` have hired the sub-contractors
ElI am a sole proprietor or partner- listed on the attached sheet. r 7. r] Remodeling
ship and have no employees - These sub-contractors have S. ❑ Demolition
working for me in any capacity. _ workers' comp. insurance. 9. Q Building addition
[No workers' comp. insurance 5. _ We area corporation and its
required.] officers have exercised their 10_1 Electrical repairs or additions
❑ I am a homeowner doing all work right of exemption per MGL 11.0 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.Q Other
comp. insurance required.]
ny applicant that checks box Ml must also fill out the section below showing their workers'compensation policy infom,alion:
omeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
mtractom that check this box must attached an additional sheet showing the name of the subcontractors and their worker'comp policy information-
m an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
rormailon.
turance Company Name: c1 0-c' Testi,
hey#or Self-ins. Lic. #: l.3 e ()Let3`'l.4 r Expiration Date: ICJ - 5 - /,(p
b Site Address: Lig 1)/1 reicfl ki' City/State/Zip:_A424/7:2/2/24/94)/7, /Y1f1 Of 6 0
lath a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
litre to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
to 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
vestigations of the DIA for insurance coverage verification.
to hereby certify under the pains and penalties ofperjuryy that the information provided above is true and correct:
¢nature: /"'�—
Date: 2 "02 '//0 _
tone#: 41t�s) 527-41 '(
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): •
1. Board of Health 2.Building Department 3.City/Town Clerk 4,Electrical Inspector 5, Plumbing Inspector
6, Other
Contact Person: Phone #:
'SCA, 0 zom.csm ^ ,, Massachusetts Department of Public Safety —
®/ Board of Building Regulations and Standards
r%/„`FG;, License. CS-074334
nn(d��� u %,c Construction Supervisor
77s - 0ff a of ConsumerAffairs&Busi Reg latian p
IP HOME IMPROVEMENT CONTRACTOR
Registration:. 126235 Type: MARK T DELISLE
�' F
59 BRIGGS STREET f
// Expiration =51612016 Partnership il,;,,;�✓19-
EASTHAMPTON MA 01027
R.C.I.ROOFING
MARK DELISLE .,
n
6LINE ST Co' slon 0510Exp1912018
SOUTHAMPTON,MA 01073 Undersecretary
.-ntre n i*} lett a �a CoY1 oN;A T il o� 1S,I ro�ws�rTs.
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HOME MPR Vk-USI'7cirD1,��CONTN.A,CTOR ."< Q�EDARgOF
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cueD 0624E40 /1 aj01/G61.� Jyi� '17/30/2014 59 8R I GOS S'I` Ii 'Al
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EXPIRES
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v niu r! I her 1
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• e9ASPl1A`MPTON a M17A 01027-1 1),9 1%'
I G . ' G5, z8 16 ,, 1 218n±
=+ 'r&OOMMONW ALTH OF MASSAOHLUSETTS
101VISION OEPHOFESSIONALLLIGENSEIi1E :`'
Bor,�R a8,
SHEET METAL WORKERS- i
ISSUC,STISE FOLLOWING LICENSE•AS A ;
R.C.I. Roofing Estimate Date
6 Line St.
Southampton, Ma.01073 I U20/2015
Phone(413)527-4775
Fax(413)527-8469
Name/Address Job Location
Steve Cahillane 48 Damon Rd.
Kerryman Partnership Northampton, MA
P.O. Box 60266
Florence, MA 01062
Terms Rep
Estimate valid for 30 days Chris
Description Total
Remove existing roofs. 13,800.00
Furnish & install aluminum drip edge, pipe flashings, chimney flashings(if needed)and step
fleshings.
Furnish& install CertainTeed Winterguard ice&water barrier,6 feet along eaves and 3 feet in
valleys.
Furnish and install synthetic underlayment over existing deck.
Furnish and install Lifetime CertainTeed Landmark Series shingle.
Furnish and install CertainTeed approved ridge vent.
All exterior roofing related debris to be removed by R.C.I. Roofing.
All work will be performed according to manufacturers'specifications.
Lifetime CertainTeed material warranty included.
All related permits will be obtained by R.C.I. Roofing.
Add$2.50 per sq. ft. for wood decking replacement if needed.
Add$500.00 for rubber valley.
6Yi/ -p,-7i 0,i 7 )46/1
),)d 7, ( 95, 0,0 ��oSrD
WE LOOK FORWARD TO DOING BUSINESS WITH YOU. F/3,000,a
Total $13.see700
TERMS OF PAYMENT
5%Deposit Cu ¢ yfS y tore: 412 Air
Balance upon completion ,
Registration k 126235 are, Q L qq
Construction License ft 074334 O t 3 " �6
Insured by Banes&Fickert Ins. Shingle Color Selection:
(413)527-2700
RC Roofin
6 Line Street,Southampton,MA 01073
Phone:413-527-4775 Fax:413-527-8469
Website: www.rciroofing.com
Sept. 9, 2016
To whom it may concern,
I request that you grant a modification to waive the requirement for control construction for the
project at 48 Damon Rd. in Northampton 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 consideration. "Mass Amendments,section 107.1 allows for an exclusion from control
construction for this project".
Respectfully,
Mark Delisle
RCI Roofing, LLP
6 Line St.
Southampton, MA 01073
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
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: .2/9 xon d
The debris will be transported by: CJ+fr1 !e-LC- D IS��5A
The debris will be received by: Q P lei-2 (4-0(uck
Building permit number:
Name of Permit Applicant tLOT (7.6u1j (,,r\ (_,L.P
Date - ?-/.{, Signature of Permit Applicant