32C-163 (29) 23 RANDOLPH PL BP-2004-0695
GIS COMMONWEALTH OF MASSACHUSETTS
4jjock: 32C- 163 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit 14 BP-2004-0695
Project ft 3S-2004-0999
Est. Cost: S611750.00
Fee. $310.00 PERMISSION IS HEREBY GRANTED TO:
Const Class: Contractor: License:
Use Group: J.D. RIVET & CO. Inc. 050230
LotSizetsg fttj_ Owner: RANDOLPHRANDOLPH PLACE CONDOMINIUM ASSOC
Zoning:URClWF Applicant: J.D. RIVET&CO. Inc.
AT: 23 RANDOLPH PL,
Applicant Address: Phone: Insurance:
P 0 BOX 51068 (413) 543-5660 Workers
Compensation
INDIAN ORCHARDMA01151 ISSUED ON:12/I7/03 0:00:00
TO PERFORM THE FOLLOWING WORK: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: Servicer Meter
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Cas: 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:
FeeTIme: Receipt No: Date Paid: Check No: Amount:
Building 12/17/030:00:00 14860 $310.00
212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
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SONVCNVIS aNV SNOLLYLI IONI¢IiCIS4O aEVOBZLVIS 100 OIL
780 CMR: STAIM BOARD OF BUILDING REGULATIONS AND STANDARDS
THE b3ASSACHUSE 115 STATE BUILDING CODE
SECTION 4-WORKERS'COMPENSATION INSURANCE AFFIDAVIT pLG.L ca152 g 25C(61):
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this
affidavit tern result in the dental of Ire Issuance of the buI1dtng permit
Sigh Affidavit Attached Va No s
SECTION=S PROFESSIONAL DESIGN AND:CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT.
TO CONS/RutTION CONTROL PURSUANT TO 780 CMR IIS(CONTAINING MORE TRAM 35000 CF.OP ENCLOSED
SPACEAne, ec
7.1 Registered Architect
Not AppUcable o
Name(Ferranti
Registration Number
Address
Expiration Date
Signature Telephone
5.2 Registered Professional Engluee fed:
Nam _._ Area of Responsibility
Address ... Rt sbannn Number
Stgnarm Telephone Expiration Date
Name . At®of Rt ponsibWry
Address
Number
SIIwmture �— Telephone Eapintbn Gate
Name AxmofResponsibility
Andress Fegamtbn Number
lSWNtva Telephone Expiration Dais
Name Area of Responsibility
Mdms Registration Number
on
Signature TekPtwne Exptnvan bete
5.3 General Contractor
U -VlVe. d-lS
li T t(- _ Not APpilcfileCom
S4 �fceU(
Aesponathk In Charge of 'as then
i � . a _ A s.:.! F�f '
�,✓ 13 S�f3 2/1
S�gm ...... Telephone LL
674 780 CMR-Sixth Edition 2/7197 (Effective 2128197)
SECTION 8. DESCRIPTION OF PROPOSED WORE.(check all applicable]'.' I
New Construction ❑ EMsUng Building C Repalr(s) e Mteadon(s) e I Addition e
Accessory Bldg. o Demolition o Other a Specify.
Bad Desedption of Proposed Work
( 4j W C 1—SI- C.Ei mCdici-c, :
SCE ATTaa+ED SSE o f w Oki C ON Ce,JJCAcT.
SECTION 7-USE GRCUPAND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly C A-1 e A-2 a A-3 e LA -a
A-4 a A-5 C 1B - o
B Business a 2A o
E Educational O 28 c
F Factory C F-1 o F-2 c 2C c
H High Hazard C - 3A C
I Institutional C I-1 0 1-2 a 1-3 G 3B o
M Mercantile 0 4 e
R Residential c R-1 ❑ R-2 C R-3 a SA c
s Storage a S-1 a S-2 0 5B e
U Utility a Spccify.
M bitted Use C _Specify.
S Special Use I C Specify, - ..
CONFUSE 2EUSSEC"ONg. NCBUUfING( NDERGEIING'RENOVATIONS.ADD6TTONs AND ORECHaNGEIN USE.
Edstlag Use Group: Proposed Use Group:
i
Existing Hazard Index 780 CMR 341: Proposed Hazard Ind=780 CMR 34):
.SECTION 8 BUIDINCEIEIG ITTANIMATIES
BUDDING AREA .• Existing(If applicable Proposed
Number of Flooa or stories include
basement levels
Floor Arm par Floor(SI)
Total Area Mil - -
TotalHeightlRl
SECTION a-STRUCIORAL PEEaRrassr ciao CMR110 all `t.
Independent Structural Engineering Structural Peer Review Required Yes a No e
SECTION 10a.—OWNER AUTHORIZATION—TO BE COMPLETED WHEY
)OWYERs'AGENT OR CONTRACTOR APPLIES FOR BUQ:DING;PERMIf.
, as Owner of the subject papc.-ty
hereby authorize to act on
my behalf. In all matters relative to work authorized by this bullding permit application.
Signature of Owrr. late
• Tao CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
THE MASSACHUSETTS STATE BUILDING CODE
SECTION 10b-OWNER/AUTHORIZED AGENT DECLARATION
Pa i ' u tLiz4M'PsH:CQ- Pup MXunz: G- uRasownerAnthod=edAgent
Denby declare'that the statements and Wotmatfon on ilio foregoing application ate true and accurate-to the best of my ^-='
imowiedgrand beget
Signed under the pains and penalties of perjury.
tr
/ alPNC N 1��"''
e "-f_. : (21 �.L j 1 Oi J
Signature of Omer/Agent Date
( L5 em
SECTION LL-ESTIMATED CONS 'COTTON Los to
Item .. Estimated COSI IDollar,)W be Ofi1Cal Use Only
completed by pernllt applicant _
1. Building G/
I4-75-o — (a) h Pct43t Fee.
2. Electrical
@I Faftviated?ofal'CostoE
Gbushvctlautn(S)
.Planking DPDd3vgSitlitPes (.4xMt)
4. Mechanical(HVAC)
5. FL Protection
&Total a(1+2+2 +4+5) Check NSWYer ' '
I.
676 - 780 CMR-Sixth Editor. 2/7/97 (Effective 2/28/97)
e -_— The Commonwealth of Massachusetts
':r__ -gi Department of Industrial Accidents
w -- k Office allnresllgauuns
600 Washington Street
. `- , Boston,Mass. 03111 .
" ', .
Workers' Compensation Insurance Affidavit
7r1c,ti7ricta 41 v":nc_ _--4-..- ';-b:m..e_ n;sot. f,3.liCbc _.7._.4,:-..r1- P..L.d:--' : rrs '-14—^x 3 ., vv''am
F
name
location
city ohone.
El I am a homeowner performing all work myself.
El I am a sole proprietor and have no one working in any capacity
`ul'lI am an employer p
rovid
ing
}workers' compensation for my employees working on this job.
rie
�c'nmnanvt-�+' �il.Lf�,�''jn tici _
addre,v ( o3C P/r1(l`T�lr„-�'. ;ut AI/W J Z `� ` '\
cN. ((��� ` �//u4& t' G j f7 II V'7 ohone N- /3 -�f# f'3Cit
msarance co. (37r1T nohev# (6,c/clod/clod
a..:.am;,etw..vte-,.Z' .,eaa
o I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation polices:
caoanvname:
m
address:
city:- ohone#- '
insurance co. oolicv# - _
companvname:- - - -
address.
city: Phone N_
insurance co.
'Altadiciaamomifierc <:-." _ r.. ?rf`:a ak1;7al'J<".'.;..+. e .. z e.,-
wu�'-derS ..,. MG u.'t <le
Failure to secure coverage as required under 5«don 25A of MGL 152 can Indio the imposition of criminal penalties of a fine up to 51500.00 and/ort
copy +ne years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 3100.00 a day against me. I understand that a
y
of this statement may be forwarded to the Office of Investigations of the DIA for coverage yeti Ii cation.
Ida hereby certjv er th s and penalties ofperjury that the information provided above is true and ea.
dir
Sienature .��. Date ,y/Ii 6 10 1/,rl/_
Primn / , , Phone"- I13 - 'Ky3-c"" 6
II
1.. r- . - ' . ...
so official use only do nor write in this area to be completed by city or mown o cial
is city or town: - - - - permihhiccnse li 1Suitding Department
-
n ❑check if immediate response is required
tact person: phone:: 1
•
J.D. Rivet & Co., Inc.
ROOFING•SHEETMETAL
April 16, 2003 1635 PAGE BOULEVARD R/
SPRINGFIELD.MAP.O.
INDIAN
ORCH8ARD,
[[
TEL
53AR6,MA 01151 { 1 ;��{ l`
TAL 413))53 4
660
Hampshire Properties FAX gala)543-3373 I� E
P.O. Box 686 •
Northampton, MA 01061
Attn: Pat Taylor
Re: Replacement of flat roof at 23 Randolph Place,Northampton,MA—
approximately 16,300 sq. ft.
1. Furnish and install 1/8" tapered panel polyisocyanurate insulation over the
existing roof pitched to exterior gutters. _ ,,.=" ^+ i^ s W%�P-'ti" w't�`1�"¢
2. Furnish and install Firestone 60-mil TP fully adhere roofing system complete
with all associated flashings.
3. Furnish and install new pressure treated wood nailers with height to match
thickness of the new insulation.
4. Furnish and install new(6") .032"painted aluminum K-Style machine gutter
complete with appropriate attachments—approximately 710 lin. ft.total.
Note: Existing rainleaders to remain.
5. Clean jobsite of all roofing debris.
.. F •'sh owner with a 15 year Fire e fie labor and material warranty.
PRICE =$ 1,750.00 (Sixty One i ousand Seven Hundred Fifty Dollars)
D •s L. Trask
' vet Roofing Company
Acceptance of Proposal—The above prices,specifications and conditions are satisfactory and are hereby
accepted. You are authorized to do the work as specified. Payment terms are net 30 days unless otherwise
agreed in writing.All material is guaranteed to be as specified. Any alteration or deviation from above
specifications involving extra costs will be executed only upon written orders,and will become an extra
charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond
our control. Owner to carry fire and other necessary insurance. Owner responsible for all building
permit fees. All accounts not paid within 30 days are subject to a late charge of 1 Yz%per month on the
unpaid balance. In the event that legal action is instituted to collect any sums due under this agreement,the
undersigned agre
�es
to pay all costs inc -d including reasonable attorney's fees.
igpp
Sture 6,/. _ i
STO
(late: 7/177° idri
mss/ / ' d"
� firestone
�,9ekucctii y 20 MASTER 03
C'-ux emit-amen
CONTRACTOR
�: BUILDING PRODUCTS
j- Ince /960