32C-090 (7) BP-20030521
GIS ft: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit ft BP-2003-0521
Project# JS-20030867
Est. Cost: $3600.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Groun: RCI ROOFING 126235
Lot Size(sq. ft.): 13764.96 Owner: AOUADRO FAMILY TRUST
zonins:URC Applicant: RCI ROOFING
AT: 33 WILSON AVE
Applicant Address: Phone: Insurance:
P 0 BOX 309 (413) 527-4775 Workers
Compensation
EASTHAMPTONMA01027-0309 ISSUED ON:11/21/02 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 Occuoancv Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 11/21/02 0:00:00 647 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
FR'
i
11
City of Northbnpton t r
tr
NOVEtt2ilelirttpepartnent
212 Main Street
3po71x100
Northa jptiirr,:MA 0L060
- -----
phonn e 413.5871240 Fax 413-5$7-1272 i.:1 :
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECJ10U.1•BliE f° x*1 tru 4.,‘ ,,
1.1 Property Armrest: 11i 3iX...a 4in0 (%,a•_' yG '1"-)
3 :3 (,p) tv San C1,4 6 • r i � ' r ;
rrs
s t �. . - i ' fi+fir
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SECTION 2• PROP,BIL fe( ,YJLE_SSttf,P1AUTH,,,,,, AQ NT
•
2,1 Owner of Record: l -, ff
solm
Name(Print) --.� Current Mailing Address:
.517G--137
UOQ 10 n
Telephone
Signature
2,2 Authorized Arent
I
tt\ cK �C., ,•r , R t} ?)6X_. 309 F frn Etre .o i
Name(Print) Curredt Mailing Address: ; '
ilf3 ) 44-11.5Signature Te phone
• - .
-y a s
Item Estimated Cost(Dollars)to be ' `QJiipiat Use Oply
}, Jcompleted by permit applicant • .
1. Building W 2 b, 1 00 • °C) (a)Building Perm43,*e;
2. Electrical `7 . (b)Estimated Total:postof •
Constructionf romc(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
{ 5. Fire Protection
6. Total =(t +2+3+4+ 5) Check.Number
This Section For.Official UsefOnly
Building Permit Nvrri¢rer:, Date Issued F- -
* 4'�.dam *Y grkt• '> VCAp '�t r ' i,C `I `€ s C ' ' £,
Signature � ''?,r�
Bulidtniecabinsiss1PJ18t(l3P£GlojoJ ))ding& DA[We'1.- . . y`.."
Section 4.:
ALL INFORMATION MUST BE COMPLETED, or PERT CAN BE
'DENIED DUE'ro LACK OF INFORMATION 7R
Existing Proposed This 3a by —.is--
•
i---... - Building Deymentr
Lot Size
Frontage
Setbacks Enna.
.fir,--.
$1d4 - L: R: L:_&_
Building Height -.
Bldg.Square Footage V.
Open Space Footage
(lot arta minus bids&wed
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 DONT KNOW YES
-i r
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 3. _-_ _.
IF YES, has a permit been or need to be obtained from the Conservatiop,Dommission?
Needs to be obtained Obtained , Date Issued:
pit
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
---IF YES, desdribe size, type and location:
..
e f' h
�i �5et7L;') el < z.
New House 0 Addition 0 Replacement Windows Alterations)❑ Rooting pi(
Or Doors 0
Accessory Bldg. 0 Demolition❑ - New Signs ( ] Decks ( ] Siding[ ]- Other[ ]
Brief Description of Proposed Work:(cc( ¶\ A \r'. ar A et?(at.t,
Alteration of existing bedroom_Yes No Adding new bedroom Yes _No
Attached Narrative O Renovating unfinished basement Yes No
Plans Attached Roll 0•Sheet 0
'v1. . •
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. 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
sEEC1�7Je Z ^Stf�`;t/Yst+d°arJ
7 ' OW t����® ' � aCOLS _"bF ED-WHEN
c;mR\\ ti i/inr .° Mlx��;4011) PceT *.a;
L. C_61 rS l)LC\\�A�2 R , as Owner of the subject property
hereby authorize c \ns*c E vc.A i. -, CT ROOF' ✓\a to act on
my behalf, in all matters relative to work authorized by this building,permit application. J ,.
/0 -3o - o
Signature of Owner I 11 Date
MifekS 0��k• g—. ' 'Q\ Q. L RT1r'cv , as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing a;tation are true and accurate, to the-best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
m0.cK -): �� C Z- \oo kbeN
Print Name J
Signature of Owner/Agent Date
•
n i 1 I eed Gonstructionn Supervisor:" Not Applicable 0
Nme
aoILieemaeHoldet: \ r IQC U� � 0 1ya-k 3 4
License Number
L-if0 'Mn on E . Qi4. . F'.‘\itr tv c .. `5' 3.• 0y
Address Expiration Date
Signator Telephone
=1i;Yx Ltca(a rcd:nfr .1 i01111,rrTait :wt-tix»arz- Not Applicable 0
u _ / zr, 2. 35
„ Registration Number r ).
Address - Expiration Date
X10 YYlai n L ai F_ L
i n Telephone - t4
i`SS _OOP Ci"?%I!21' A,I1,P5!{TIr, 'I`ygl YKSAW V'".I:4cn S5252§.. 1"BS
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 0
IF IL,;'�lf;(;oATsl(v(0}i551u wi`i.;',{01rjd"i'"u:1i
The current exemption for"homeowners"was extended to include Owner-occupied Dwellines 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'ddvised 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
•
p. �T
NoriEjautptsm 5;
t'041:0461 awra.gu.ue• t
si,wos� L_
c� -1 DEPARTMENT' OP EUI DNO INSPECTIONS -
212 Main Street ` Municipal Buildingn•
Northampton, Maw. 01060
WORKER'S COMPENSATION INSURANCE AM:DAVIT
.1
dirimtn,/permittm)
with a principal place of bMine 1residtnrp at:
I LI 6_11\ �. _ t`.. plot.,,hone#) 4/3-S274171S_
(annWelty(state/z p)
do hereby certify, under the pains and penalties of perjury, that:
�am an employer providing the following worker's compensation coverage for my
employees working on this job:
G:+int:tnkski.n, 1,)C1.--315.31112.4•011 10 . 5-02
Compauy) (Policy Number) (Expiration Dara)
( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Losutaa=Compaq/Policy Number) (Expiration Dare)
(Name of Contractor) ([nsaance Company/Poticy Nomlvr) (Expiration Dale)
(Name of Contractor) (Insurance CompaaytPoliry Numhn) (Expiraeon Bate)
Math addiGWd aaaa Ir W' ray ta mcrhide infanndi a madaWm la 4J=04.400)
( ) I ama sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:planabaa*atcdug*tile bamowamswbo=ploy;atom to da,..inikunot,cot ai o ormak work en adw<alaa of
as mar gap Wm aka la which da tnmaowmr xaido c m the lama&mayart uttbam aaa.amr+ny eoa idad to be
=Oven=It Me wakes roepmuilat Am(OLId2mi(5)).apptialiooby•homnwo=ler atiauoe or mak may aided=the
Upham eta.apteyw uadntba Wakal.Coc poatiaa Aac
I wdvaaod glut aeayy ordua wtmotemy bfaros-dad to tba Dpamw[atlaaamid Mama'Omo.af os a.edlo'W.
cwaaaavaitaaaaa sadist failure to acute ammo tads,'naiad 23Aatlia.133 w Maio rMimpe»tiaa oraimiadp.oataa
aviation(arm{adman 11,3WAa endearimptisoatueat atop too=yaraateed pemrda iota Canada ampv?Gtc tsada
Laaratea.n0 a day aping ma.
ler dpaNNMalwao°°r3'
�.., Permit Number •
Map#
Signature ofLiocase/crmiueo Vete . . A..
R.C.I ROOFING
40 MAINE AVE.
P.O. BOX 309 �(
EASTHAMPTON, MA 01027-0309O, tY CCESTIMATE)
PHONE (413)527. 4775
FAX(413)527-8469 I1�I{ 1
1 V • Date: OCTOBER 3, 2002
Estimate To:
CHRIS AQUADRO n ui Estimated By: MARK BELISLE
33 ifILLI 9TON AVE. Start Date:
NORTHAMPTON, MA. 01060 Job Location: 33 Ri LtIGTBR AVE.
NORTHAMPTON, MA. 01060
Job Phone: 913 586-7373
JOB DESCRIPTION
REMOVE EXTSTTEC. ROOFS
FURNISH & INSTALL ALUMINUM DRIPFDGE AND ALL OTHER RELATED FLASHTNGS
FURNISH & INSTALL ICE & WATER BARRTER ALONG EAVES AND VALLEYS
FURNTSH & TES TALL 151b FELT OVER EXISTING DECK
FDRNTSH & INSTALT 30 YEAR TAMKO SFUNGI;F
FURNISH & TVSTALR RRRJE VENT.
ALL ROOFING RELATED DERRTS TO RF REMOVED Ry RCI ROOFING
ALT, WORK WILT, PRRFORMFD ACCORD TNR TO MANUFACTURERS .SPEC TF MATIONS
5 YEAR R C T. WORKMANSHTP WARRANTY TNCLITDED
30 YEAR TAMKO MATER TAL WARRANTY ANGLIFIED
ALT RFT.ATFD PFRMTTS NATAL RE ORTATNFJ) RY R C. T. ROOFING.
SPECIAL ITEMS NEEDED
ARV $2.00 PER SQ. FT. FOR BROKEN PLYWOOD REPLACEMENT.
Addtional infcimation • ani ?to this Job Estimate
TERMS OF PAYMENT
30%PRIOR TO START Total Estimated
TO%UPON COMPLETION Job Cost $3,600.00
REGISTRATION 8128235
FEDERAL 1.0.804 3418839 Authorized
CONSTRUCTION LICENSE 8074334 Signatu
INSURED BY HACI(WORTH INSURANCE(413)527-99O7 •��/ A.
If
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DUPLICATE-CLIENT COPY / I