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23D-033
ziN D V , DISCOVER Q U E N N E V 1 L L E www.1800newroof.net ROOFING 'V SIDING II WINDOWS We Are Licensed 160 Old Lyman Road • South Hadley, MA 01075 1.800.NEW ROOF • 413.536.5955 Fully 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 #575920 Member of the Building & Trade Association P. P.C. 38710 Proposal Submitted To: Date Itr Phone #'s C: 4 13 6v7 11 941. AETHe -Am sv .Ek'-mAhve1� — H: W: Street Email: S /n, /'fon/ Si City, State, Zip Code Special Requirements: F/r)Rerk/ce, - - - MA © t U Ira L Recover K, Strip .. ! ,a.yG;2s Complete Roof System • We shall acquire all appropriate permits for all work g1 Home exterior and landscaping to be protected X Strip existing roofing to existing decking and dispose of. Do not Do. A4 •R� © Deteriorated existing decking will be replaced at $3.47 per sq.ft. after full inspection. Xi Install Ice & Water Barrier at all eaves, valleys, chimneys, pipes and skylights ❑C Install (15Ib. felt / Synthetic) underlayment over remaining decking area ❑ Install Metal drip edge at eaves and rakes (8" / 5 ") (white /brown /copper) K Install manufacturer's starter shingle on all eaves and rake edges BBB j Install new pipe boot flashing (standard /copper) / vents ` 1 X Install Snow Country or Cobra rolled vent ridge vent Winner of the 2010 Install proper soffit ventilation TORCH AWARD Shingles: ( 6 nails per shingle) J 1 ( T+ 'r NC _ Shingles L11 25 year ❑ 30 year [1 50 year Color WA iC Ridge cap shingles Warranty Options: 1 , We guarantee our workmanship for 10 full years (see our warranty coverage) ❑ GAF System Plus warranty ❑ GAF Golden Pledge warranty Chimney Options: X❑ Lead Counter Flashing ❑ Water Seal & Tuckpoint ❑ Rubberized Crown ❑ Metal Chimney Cap We propose hereby to furnish materials and labor - complete in accordance with above specifications for the sum of: Total Due ($ 6 S 81 ) ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are a eAre Down Payment ($ Z. 000 ) satisfactory and are hereby accepted. You are authorized to do work as specified. Payment will be 1/3 down at start of job, and b nce upon completion. Balance Due Upon Completion ($S 8 / r7 _ ) Date: ii/ // Signature: ..' '' ✓ ��'`�i Date: II 1/- 11 Estimator: (Print Name) `j /tree t) LA--( (Sign Name) Estimates are honored for 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 will not be responsible for debris or dust in the attic or storage areas. The Commonwealth of Massachusetts Department of Indus Accidents t• ; - - i . Office of Investigations �.' 6D0 Washington Street ewer r ' �= � ' 02111 ' = -= = ' geWdia s � n Insurance Affidavit But? deal /Cont ractors/ldeciricians/Phmnbers Workers' Campeasatza lican station Please PA ad i.egigi liv Name : A ( m Q, M ..,t ; 11t I�D44n) t- S f AI 01 a .lYi4 � 0 1J� Address: Li a n f , city i .: '= 4 ' a d ` MA- o ho1e #: 1 3 - . 6 -61 s Are yon an. eQ Inyer? Check the approp • , = box Type of prate (ralais•ed): I. rig I am a employer with KT 4. ❑ I am a general contractor and I 6. ❑ 2zw oons�nd employees (bull andlar pa time ).` have hind the sub -contractors listed on the armed sheet - I_ ❑ Remodeling 2. ❑ lam a mkptoptu� i or I ax Thew sub-contractors have li. ❑ lwili nn slip and have no =4km:es . • working fins m me in y capacity. �P viable 9. ❑ Bing additian P- inquired) workers' P- 5.0 We are a corporation trod nts IOQJ Electcacal repairs or additions 3 ❑ Is �� Eck officers haws ex cis c . their 1 L❑ P6umbmg repairs or additions of myself [No workers' comp_ nett f 11(4 haven 1 Ober employees. [No ,oakexs' insurance requirixI.] • romp insurance incined.] •Any appfiaat that chocks bar N1 men also tilt oat the sse6oa below :bowing if>zir warless compensthM policy iaLiraadieo. t g a m e t r w o e t t v i t a l sabot' t b k & M o v i e indenting day are � a l l work rad dca hire a n d & anal actraw mi t sablaits.now affidavit imalicatias sack tcoaenaooas Theo check h i s boa m a s t a t o s b a d an a d e i rt i o a a l s t o a t thawing t h e masa oftba suhcasdnernte and staavtlazikar ar rot d se =skits lava amployee s. Ifdasalmardrastres hoc candopes, *ay anatlaovide their wadcas mac. policy saratox rain as employer that irproviang workers' compensation iirsrrrancefor my u slow is the poffcy anti site 'T- asman= Company }Tame: A i M mti Thal InSit • Policy # orSel i n s . L i o . i k Aux '1i 11kL 10 1 EXpitaii011 Pat= q - ti' 6 t I Job Site Adchtss :_6 1 Tv 5 rk , F=10 ( (1 , istEderap: MA- t to 9- Attach a copy of the Workers' compensation policy dorbralion page (showing the policy ammbear =Rd expiration date). Failure to wares coverage aste Wired ander Sect m i 25A ofMGL c. In can lad to the impositbn ofcrimind penalties of a fine up to S1,SOO.00 and/or one -year imps n#, as well as civil premier in the form ofaSTOP WORK OBOE&and a fine ofup to 5250.00 a day against tbo violator_ Be advised that a copy alibis statement may be forwarded to the Office of [ate aft= DIA 1 do hereby cent y air the pains aardpenezfies fpujmr that the information provided arbor is time and correct Z ( -I■ Dal= 11 '1— f I j PhrtW}€: q t 'S- c t4_ -64 SS Official arc oae5s Ile ,goer sv.:8r m dear" arras b ba cold by caty Or tONM official City or Town: , PerudfiLicense # Issaiug Authority (circle one)} 1- Board of Health Z Bnildtug Department 3. City/Town Clerk 4. Sly Inspector 5. Plumbing Inspector: 6. Othcr 1 Contact Person:. Phone tit SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Aft uY. / (.LP. ti 1); PLe 70 U •a t License Number I taO n I d 0. v. (2,t. Ca - YR& s e - a (- dal Address Expiration Date Sign Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Adam Quenneville Roofing& SW's":, Inc, 0-0 ge Company Name 160 Uhl Lyman Road Registration Number South Hadley MA 01075 3 a s o Address Expiration Date Telephone 4 f /3 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 in the denial of the issuance of the building permit. Signed Affidavit Attached Yes j< No ❑ 11. - Home Owner Exemption 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 acceptable to the Building Official. that he/she shall be responsible for all such work performed under the buildine 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 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) i t Roofing ItJ. Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [L7 Siding [0] Other [0] Brief Description of Propo =. Work: - 4 - °,r 4.4.4 /L 4 ` GL / a Alteration of existing bedroom Yes No Adding new bedroom Yes No `� Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: 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. Masscheck 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, /}--e T / 1`-e C i & � /1 e — � a `1 L r , as Owner of the subject property hereby authorize Adam Inc, Roofing & Siding, In to act on my behalf, in all matters relative to work authorized by this building permit application. /tit. hit C- - ' e_d? O_ /OS-s� f l - /7" r � Signature of Owner Date I, Adorn Qum& Roofing & Siding, Inc, 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. f "CIGLat, 4 tidu tf i l� Print Name /1 - 17 — /I Signatu /Agent Date > i RECE /ED Department use only C i l, of Northampton St atus of Permit: Bu Iding Department Curb Cut/Driveway Permit NOV 1 2011 12 Main Street Sewer /Septic Availability Room 100 Water/Well Availability DEPT, Cr r..: ' �, ort ampton, MA 01060 Two Sets of Structural Plans "''" - ;7 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPUCATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOUSH A ONE OR TWO FAMILY DWELUNG SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 56 r'Y) // tor? c t Map Lot Unit F/6 r4 11 C fl U4 G / "). Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: K z - -e --t1 a h 1 r- P5 s ;' 1 ton T. F/6 /1t Name (Print) Current Mailing Address: / 1� 44 /7/4/ fro a 1- a (t Telep one Signature 2.2 Authorized Agent: / AcI i vy Ola d i t L ((D o 5l + Lt- may ? • LL l 71k Name (Print) Current Mailing Add s: CGS LIP"?' s36 - SIc Sign Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (� / 0, 06 (a) Budding Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection _ 6. Total= (1 +2 +3 +4 +5) G C , Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date ____ 55 MILTON ST BP- 2012 -0521 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D - 033 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 PERVIIT Permit # BP- 2012 -0521 Project # JS- 2012- 000871 Est. Cost: $6587.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq. ft.): 8145.72 Owner: ENZER - MAHLER AETHENA Zoning: URB(100)/ Applicant: ADAM QUENNEVILLE AT: 55 MILTON ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536 -5955 0 Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:11/29/2011 0 :00:00 TO PERFORM THE FOLLOWING WORK: STRIP ONE LAYER & 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 11/29/20110:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner