23B-065 a . . Roofing '
Est • rive Da_
Lit
!Woe (_11 3) 527 ,Th �.—
His !•t
Name / Address Job Location
Laryssa Bach insky Cynthia Bachinsky
Berkshire Terrace 9 Berkshire "Terrace.
Florence, Ma, O 062 Florence, Ma. 01002
Terms Rep
-
Estimate valid for 30 days I );ivc
Description Total
Ruinov, existing, rook. 7.2(' 00
install aluminum drip edge, pipe llashings, chimney llashings and step !lashings.
ash , instal, new lead counter llashings
d' Install Certaini'Peed Winterguard ice & water harrier along eaves and valleys.
het .1; on i ir;stall avntlactic underlayment over existing deck.
Fr i.�tsl, .o,d ;:r,call 3t. year CcrtainTeed Woodscape Series shingle.
Ful tu_'t1 rn,l ins!, +;1 Ccr:ain hccd approved ridge vent.
,111 rxtci "r root ituc'elated debris to he removed by IL.C.I. Roulin, .
A.; work *II :H,' pe nn'ied according to manufacturers' specification
,(1 )car Cri:ain'(,ed ial warranty included.
111 !dated p, wilt h; nht wined by R.C.I. Roofing.
Add $2.50 per s;i ft. fr wood decking replacement if needed.
Add: $010.00 for Ccrtaintecd Landmark Woodscape 50 year premium shingle.
A Cert linieed Surestart Plus extended warranty will he included with a fee of ($200.00)
absorbed he RCA Rooting if signed within 7 days. This extended warranty means that 20 of the
30 y ar w: rrante is covered for lahor and material. The last 10 years of the 30 year ('ertaintccd
wail—am) ) 'ufu he :.'wered for material only.
Price For Metal Roof: $10,000.00
L_—
vv a )oK I oRW.'.RD To DOING BUSINESS WITH YOU.
Total $7.200.00
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SECTION S - CONSTRUCTION SERVICES
! I censec .onstruct Su pervisor; Not Applicable ❑
License Number
• . • .. .• . . 5 - 0 3
Expiration Date
cia:^nor
Register Home Improvement Contractor: Not Applicable 0
-- ,._ 1.26235
ompanlNarne Registration Number
*:> , - - Expiration 5-016- t � r�
e Iepn o
��1:T1. aQY la= _ o _L
.C�.I._ __.- -- - - - - -r n 613)_�?2'�.• 7
SECTION i WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
c sat« nsurance affidavit must he completed and submitted with this application. Failure to provide this affidavit will result
tir ,ssunn^e of the building permit
i
fiachcd yes No C3
i 1. - Horne Owner Exemption
sent exemption for "homeowners was extended to include Owner- occupied Dwslllnei of one (1) or two(2) families
to tiIO■ such homeowner to engage an individual for hire who does not possess a license, provided that the or acty,
,r. ;upervisor. (TMR 780, Sixth Edition Section 108.3.5.1.
f)clnnition of Hotoeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there
H, l ntcnded to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
;:c. A Gerson who constructs more than one home in a two -year period shalt not -b4 Considered a h4jiasorracr•
•'i -,ui cu,vcue: ' shall submit to the Building Official, on a form acceptable to the Building Official, that hekhhe Shall be
- _irnnsibtc for all such work performed under the buildinz permit.
.u::init Construction Supervisor your presence on the job site will he required from time to time, during and upon
of the ,vvrk• t« r which this permit is issued.
he ,advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
:;'o■ccs t,1r injuries not resulting in Death) of the Massachusetts General laws Annotated, ygti may be liabk for person(s)
,alarm work for you under this permit.
,.r„ersicnch+ "homeowner certifies and assumes responsibility for compliance with the State Building Code, City of
un; tare Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
mcowncr Signature att�Cbld
�[�r| ' ilE��DDT|�N OF PROPOSED WORK
(check .�� |/�nJ'»� |
�unr./Wn�[rn�r4u��yyV�o/(@�AOD||0\ h|
' ' � -�r`~~'`
Ho ,--
Nc �
w u�o Addition Replacement Windows Alteration(s) --' Rooting -��
^
Or Doors
Accessory �'�9 n New [O] Decks (� S�|
� � ` / . Signs L� Siding Other (0)• •
^cf • x p'opoacu
' `
'
No ^uumy new bedroom Yes ____wo
noovvnong unfinished basement _ Yes No
, iu�s�oaca, ao/ Sreu
_
sa
If Newlhpuse and or addition to existing housing, complete the ymUuwinQ�
One Family _ Two Family Other . _ _ �
each family unit Number of Bathrooms
is there o /o,agc attached? _ ''' '
propose,: Square footage of new construction Dimensions
mvmnc' `m /'*f
Fireplaces or Woodstoves Number of each
`,c',.o.n�Cnmpxnocc __ Masscheck Energy Compliance form attached?
�
100 ft, o/ wetlands? ___ Yes __mn Is construction thin 100 yr. 0oudp|an Yes No
.,emcmo' cellar 000,below finished grade
_______
conform 0 he Building and Zoning regulations? _ Yeo No
Se;;;c�o^` Cx y��w�, _ Private Q�y* �ou�Suppy_ __
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--` —~
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SECTION 7a OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1
\
________ .*x Owner o( the muupat
"ueu/ c'
.� ac� c' �.�ax in aU matters r ative to work authorized by this uilding permit application. |
Dale
�
. as Owner/Authorized
:c,rfr, ^�,�onme foregoing a c�|icahon are true and accurate, |n the best ofmykncw4e*ge
oaonf
Signed under : pains and penalties o(perjuni
L ^ \
`
'
7 |
I \ � 70�!Kr i �|� io 8u�! �� �00J(�iC0 P�{0|| '80 �� Denied Due To Incomplete Information
-- ^` ' ` | � ` ^ ~'�
'—� T �-- -
Proposed | Required Zoning
ihis column to t riii in by
' omm.nu ovpanmen/
,_ ,
| \
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_ !'
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!/
..,)1,!;i0.:
-- [I� |
- ------ ----- —
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) ��� L�____ K��� � L�� K/ i �
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Rear | i
: )J >| gh ! �
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'y ` `"^ " "^"
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�� ��/ �
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c x / ____ ,
A Has a Special Permit/Variance/Finding ever been issued for/on the site?
�� 0 ��
NO \.~� DON KNOW \�� YES \~/
J: YES, date issued:
IF YES: was the permit recorded at the Registry of Deeds?
'NU /—� DON'T KNOW /�\ YES /'�
�� \�/ \_�
IF YES n
ctc' Book Page • and/or Document D
H .�,, s me ``�ccona`n a brook, body water wetlands? �� �� and�/ NO \�� DO�T KNOW \~/ YES ��/
IF YES, xasu permit been or need to be obtained from the Conservation Commioahon/
Needs to be obtained /—� Obtained /—� Date Issued: i — - --- - |
■
\`~/ \`^/ ' � |
{ Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and location:
i� Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO y~~\
! - --- - -- --'--- ----
IF Y[I, describe size, type and location: (
i_. . _- _� —_-_----------------- /
� vux me construction activity disturb nng, grading vawon, or filling) over 1 acre or `okpart of a common plan
*^i 'u disturb over I acre? YES ( ) NO ( )
�� ��
I
. ' ' '1i4, 111:11""ta., 70'.."*S
4 ,, if # 4 ' 0 ' 0 I:. a
+1.4 . "..,, )1,;Iii
City of Northampton ,
Statutot 0 Alp.:
'E EA ED „
":1•' • S -1,04. 4. ? tr ,i ' k P , ' i
Building Department Curb'C'
.,
— 212 Main Street . li:41, l': Pr
WWl . ,
. sewor :. , .,,,,, , , . , , . f •
*'1 ,',V . 1 ,4 4 1 t i .1 ,:r ' p . : 1 ; * . 1 , ■ , • '..I
.
Room 100 Water/W:1' * i.,:.,...t.i 1 : . 1•• . ' — .
: • , : -4,1••„,..) ' - , •• . — - • " • •
NAP u4sPEclie Northampton, MA 01060 T.' • • .5 ' : • • . • ..
'-'-' ) ... , „,,.• ,, i. ,.• ...•• • ":, • . •,-1 • -"• • •••1• -
;phone 413-587-1240 Fax 413-587-1272 viovwle lictiik/. at, "...,..,
, , , ,A..,' ,, 'T " 011 `,6' 3 ° " ' ' \ . / .' '
Other Sp C ed:fi Atettc ,, . ' ''.. '•4 • ;,
', r ' , 4 , 04.1.,:•t.' . , ,, ••,, t.' ,,. 1,... 6%..,. t ,
APP,,,:,,AT;ON TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
_ I
1
SEC HON 1 - - .-,ITE INFORMATION
• Proper :ldress
--
This section to be completed by office
1
CA C6 ex \INS\r \ t i•-e— '--- \ C. Map • Lot Unit,
C ko .re-siNC):— Zone °volley District
Elm St. District CB District
SECTION :. - . OWNERSHIP/AUTHORIZED AGENT
Owner of Record:
C_:,s, V\ -■', , c■.„ .. _ Ce: ,\,-,'■ ,r..._ \z.,+. CI R-.e._c--.7\i, c-c___ Ave ct- _ -C\ tyce_ALL bV%2
n.-It) Current Mailing Address:
att,a2h _ c, 1 0 0 ,13) 5 3 1( 3 4
Telep —
Signature
I..'.2 Authorize Agent:
- _ • . • . ii • 14 • •
'`..,117)e ( 25
...."" Current Mailing .ddress: 01 0-13
(i13) 52'1- 4115
.■.;n.aLure Telephone
1
SECTION 3 . ESTIMATED CONSTRUCTION COSTS i 1
Estimated Cost (Dollars) to be Off■dal Use Only
completed by permit applicant
,
(a) Building Permit Fee 1
' BuildIng ),,_\ 0. F. 1 sac 4 , aoc,,c
, ....
2
Electrical _, (b) Estimated Total Cost of
_ _ Construction from (6) i
3 l- Building Permit Fe.
-----]
-.-------.-
4. Mechanicz .HVAC)
5.'Fire Protection
-- 1
.,_
.3. Total ... CI _
3+4+5) 4 + 5) 1 la 00 , Check Number /
2
This Section For Official Use Only
Date
5ailciing PCITT : Nlirilt)e,; _ ----------- Issued: I
,
Signature:
' Date
•
9 BERKSHIRE TER BP- 2011 -0919
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23B - 065 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: roofing BUILDING PERMIT
Permit # BP- 2011 -0919
Project # JS- 2011- 001499
Est. Cost: $7200.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): 13939.20 Owner: BACHINSKY LARYSA C & CYNTHIA B KOLESAR
Zoning: URB(100)/ Applicant: RCI ROOFING
AT: 9 BERKSHIRE TER
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 -4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON:5/9/2011 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 5/9/2011 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner