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036-250 i.. .I. Roofing Es Date 6 fine St. Southampton, Ma. 01073 4/20/2011 Phone (41 3) 527 -4775 Fax (413) 527-8469 Name / Address Job Location Suzan Edwards 22 Maple Ridge Rd. 22 Maple Ridge Rd. Florence, Ma. 01062 Florence, Ma. 01062 (41.3) Terms Rep Estimate valid for 30 days Dave Description Total Remove existing roofs. 12,900.00 Furnish & install aluminum drip edge, pipe (lashings, chimney (lashings and step (lashings. Furnish & install new lead counter (lashings. Furnish & install CertainTeed Winterguard ice & water barrier along eaves. Furnish and install synthetic underlayment over existing deck. Furnish and install 30 year CertainTeed Woodscape Series shingle. Furnish and install CertainTeed approved ridge vent. All exterior rooting related debris to be removed by R.C.I. Rooting. All work will be performed according to manufacturers' specifications. 30 year CertainTeed material warranty included. All related permits will be obtained by R.C.I. Rooting. Add 52.50 per sq. 0. for wood decking replacement if needed. Add: SI,400.00 for Ccrtainteed Landmark Woodscape 50 year premium shingle. A Certainteed Surestart Plus extended warranty will he included with a fee of (5560.00) absorbed by RCI Rooting if signed within 7 days. This extended warranty means that 20 of the 30 year warranty is covered for labor and material. The last 10 years of the 30 year Certainteed warranty would he covered for material only. WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Tota I 512.900.00 TERMS OF PAYMENT 5% Deposit Balance upon completion Customer Signature ( ht Registration # 126235 Insured by tunas & Fickert ins Construction License It y i kcrt Ins. 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Construction Supervisor: Not Applicable ❑ • 1mc :" rn •.2 }10Ider ____._ ____Kaile. ts. ed 1.. _ _ __________ _____ ________________ . ri t_q 1 -1 334 License Number ° " "` Expiration Date Telephone Registerna Home Improvement Contractor: Not Applicable O ___ _.e __ ZRoo f i - -- 1.26235 Company Name J Registration Number ! --> - o- - ccre.1,,,, Expiration Date ktitanF al 1 Telephon 0131527' 47 ?5 SECTION ti WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) '^ /,i,r leers _::: ',. ensa ton insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result th aen,a ;_he issuance of the building permit �o :ne° Aff cl., Attached Yes. _ No . 0 { i 1 1 . - Horne Owner Exemption ,,,Ori exemption for "homeowners" was extended to include Owner - occupied t)welilnes of one (1) or two(2) families to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner tell _upervisor. (MR 780, Sixth Edition Section 108.3.5.1. ■)chnition of Homeowner: Person (s) who own a parcel of and on which he/she resides or intends to reside, on which there R. .,r is intended to he, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm :,!urea. A t,crson who constructs more than one home in a two-year period shalt not be considered a_homeovrocr. :-,omeowncr" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be rc ponsihle for all such work performed under the building permit. ,,r:;iou Construction Supervisor your presence on the job site will be required from time to time, during and upon ,'H.piction of the ‘v-ork. for which this permit is issued. , o be advised that with reference to Chapter 152 (W'orkers' Compensation) and Chapter 153 (Liability of Employers to Ho ecs for injuries not resulting in Heath) of the Massachusetts General Laws ,Annotated, you may bo habit for peraon(s) ;,) perform work for you under this permit. „r.!cr "homeowner' certifies and assumes responsibility for compliance with the `hate Building Code, City of ,is;on Ordinances, State and Local Coning Laws and State of Massachusetts General Laws Annotated. r{,.meowner Signature . ta t rr: -•, t. rl'' q' � . ,; it • . r -- - ---- SECTON 5• DESCRIPTION OF PROPOSED WORK (check all applicable) / _ _ � � New House ! Addition | | Replacement �|�mdoo(o} --\ Roofing �—^ �- Or Doors [] � |«] �l ! Accc`xnnf *:q ..... - j Demolition L__I New Signs ([]] Decks [[] • Siding [DJ Dthmr|[IF ' - _-_- �'/u 5csc.n `/ :/p'o,Ciscv '/:'�---- — rlez-1 _ ____ `.*^„w. .„ ,.;^x� ,unworn Yes No Adding new uou/oom _ _ Yes No e:acxcO :z, Renovating unfinished basement Yes No r/am,Axacr~,i ■o: Sheet - �^ If New :: and or addition Vo existing housing, complete the hoUowing Use o/uv'mmg One Family Two Family Other . -. � x./�no='c • rooms m each family unit � Number of Bathrooms ~` -1 c Is t:wc n ;arage attached? ''� � ' � . ' o Propose,: Square footage of new construction Dimensions _ c mombc stories"' me;:-.0e ' - ,m!,» ,- ,` Fireplaces u,vv000xm*,o Number of each ; i::c/s/ ,: :*.`^:o^Comp/.n"c~ Masscheck Energy Compliance form ahached? ' :, : / c e zc�avvo.nn to , vnx .=m/� 100 ft, of wetlands"? Yes No Is construction thin 100 yr floodplain Yes No Detr sement or cellar floor below Unshed grade � V.111 burdin ocnfmm to the Building and Zoning regulations? Yes No Septic ro:�_______ City Sewer __. Private well City water Supply __ SECTION 7^ OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGewT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ________ .� __ . om er of the wwuhax ! properly :a/coy a"no". ,:. �' ' � � uc o7, r1'.' :' - ax .n a,/ matters relative to work authorized by this 'pudding permit application. \ | - > '' u /_// z- _ ___ \ - as »� p\i����. �� -I th . mm i � - - ----- � \\ ��c � m, m�/�n:ms vng in|onnahon on m� /o,ngoi"g x��|icahon ava {mn ond ao�ru�m. (o �m best of my km/Madge onobeoc/ Signed u^uero'e pains and penalties of perjury. ' �� � K -- Print w^�o ~-� ,,■ _ ^~~--- ) / | signature of Date �\ � � ) —/� / -- --- -- ■ C. - .'ion ' GNIING AU Information must Be Completed, Permit Can Be Denied Due To Incomplete Information ______ f ,x i st i ng Proposed Required by Zoning This column to be (fled in by Building Department ■ - -- 1 f _ . . ---- --- __.—.. III , i i I.: R: l_:' it:. I !tear � l i1H1 <iii,, tleignt 1g. �ilu Footage ootagc in� : L . i m ■,mace FO0litge — % , I ,r ea nu >w bldg t p;t■cd �I , ' u )4 Snacc:s I }r.� ,, ,ii,,nl Has a Special Permit/Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES O F YES, date issued:: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and /or Document p ::oes the site contain a brook, body of water or wetlands? NO 0 DONT KNOW O YES 0 IF YES, ‘,,Is a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: F Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: ar there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 IF YES, describe size, type and location: \Vii the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO 0 •-- — c+ ,,,,, \nintor kAananement Permit from the DPW is required. 4 4 _ . '., Arirro Ir..- c, 0. , . . , - 1 ,, i. , ,.( Vri it 1 ,.' • ' . • NED City of Northampton ..,,,,:,.,.‘ i ,.,• , . r A A, . Building Department t,;tirbt; 14,,i ; .,:;:.• ',. , , . ,... , AN .. 1 101\ 212 Main Street ' ' -' ', e: — ' , Vvi'°: • . . ..■ ._ Room 100 Wit. .'l '1.-vv.:0' ‘, ,.,--' : ' ''` •'. •■ , , .' • . 01 •..,.! . rthampton 1 , MA 01060 • . phone 413-587-1240 Fax 413-587-1272 0 ,.1•,.'.- Othetipagi ‘, , " : 7'' I: ,•1 . '''''' '' ,''. : , : 2 : ',n . ' ' . • r t '..-'4,t'-%:..:.."....!,?41....= _________ __ - , APPL.CATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION ------------ --------- Property ,Ariress This section to be completed by office 1 1 .' 22. t-' 4 C C IA . t)N. ' M a p . Lot Unit , ck.0e rn-a_ . o'x'0 (04 Zone Overlay District Elm St. District CB District `. 2 - lROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: , _ 3 _AA (:).... _ cA■J.Do-A..% 2Z vxNatt-ii■AAo , S - ' ,A)cAr , il Name ', Curre I Mail' Address: j Oita) (11 5 11/4.1g, attaCht-c., Telephone . . SIgnature - 2.2 Authorized nt: 1 • . - .c.i..._.?‘..cafirkl___ . ._ . . a . - • ... sal • 14 • • Name (Pnr"W --- Current Malting • ddress: - 1 ( 13) 52 - 4 T15 , Igrmwre Telephone .... SECTION 3- ESTIMATED CONSTRUCTION COTS Estimated Cost (Dollars) to be Official Use Only completed by permit applicant , Building ).,.. 0. (a) Building Permit Fee I — . 2. Electrical - (b) Estimated Total Cost of Construction from (6) J 3. Plumbing Building Permit F•e , 4. Mechanica: ,:HVAC) 1 5.-Fire'Protection _ 41,-N Total = (1 - 2 + 3 -t• 4' + 5) t . 1 a • 60, 00 . Check Number • Li , 1 1 , _ This Section For Official Use Only _____I Date Building Pem Numbe Issued: --- -- — ---- -- — -1 Signattire. __ .____ , Building Commts,sloner/Inspector of Buildings Date 22 MAPLE RIDGE RD ' BP- 2011 -1017 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 250 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 -1017 Project # JS- 2011- 001648 Est. Cost: $12900.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 74334 Lot Size(sq. ft.): 31276.08 Owner: EDWARDS SUZAN & CHESLEY DUNCAN Zoning: SR(100) //WSP II Applicant: RCI ROOFING AT: 22 MAPLE RIDGE RD Applicant Address: Phone: Insurance: 6 LINE ST (413) 527 -4775 Workers Compensation SOUTHAM PTON MA01073 ISSUED ON: 6/7/2011 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 6/7/2011 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner