31D-218 RC Roofing
LLP
6 Line St.
Southampton, Ma. 01073
P.O. Box 309 Proposal Date
Easthampton, MA 01027
6/11/2009
Phone (413) 527 -4775
Fax (413) 527 -8469
Name / Address Job Location
Joan Gross
25 Dewey Ct. 25 Dewey Ct.
Northampton, Ma. 01060 Northampton, Ma. 01060
(413) 586 -2661
Terms Rep
Estimate valid for 30 days Rich
Job Description Total
Remove existing roofs. 10,500.00
Furnish & install aluminum drip edge, pipe flashings, chimney flashings and
step flashings.
Furnish & install new lead counter flashings.
Furnish & install CertainTeed Winterguard ice & water barrier along eaves and
valleys.
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 roofing related debris to be removed by R.C.I. Roofing.
All work will be performed according to manufacturers' specifications.
5 -year RCI Roofing workmanship warranty included.
30 year CertainTeed material warranty included.
All related permits will be obtained by R.C.I. Roofing.
SPECIAL ITEMS NEEDED
Add $2.50 per sq. ft. for wood decking replacement if needed.
e. • 4 . a . .•••• ••• - -- • -
Add $225.00 for Certainteed Surestart Plus extended warranty included if
WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total
TERMS OF PAYMENT
50% Deposit upon delivery of materials.
Balance upon completion
Registration # 126235 Customer Signature
Construction License # 074334
Insured by Reynolds, Barnes & Hebb, Inc. Date 7 O q
413 - 447 -7376 l
Page 1
�c, _ ..% (i xtR of Northampton 1 •
�i�ti;i;: � R a Alassac}�nsells' A
'� DEPARTMENT OP BUILDING INSPECTIONS , 1 f •
212 Main Street 'Municipal Building r,
Northampton, Mass. 01060 t, ` � "'
WORYCER'S COMPENSATION INSURANCE AFFIDAVIT
•
I, • I I • • 0 ,1
(license /permittee)
with a principal place of business/residence at:
_ • , • ... 4_,,, . b., • . , O leil (phone# - 115
., city/stair/7m
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:
.)..0....\ V►.A.o.4 c'. re.
ins . co . oC 4 7,ic4s0 q Q N vt) c 3 haft OS to-S-09
• (Insurance Company) (Policy Number) (Expiration Date) •
() 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 Data)
•
(Name of Contractor (Insurance Company/Policy Number) (Expiration Date)
•
•
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) •
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(e.c.a.ch additional shod if neo:airy to include iafoctnatioa pertaining to 411 000 ttutocs)
( ) I am a sole proprietor and have no one w orking for me.
() I am a home owner performing all the work myself,
•
. NOTE: pkase be mare thd.Niltilo homoovnxs who employ pets ons to do mslota ooe, oombuetkts a repairwvetc a shddlisi at •
ant room than theca vans in winds the bomoowar resides oc on the grounds eppuutteaud thereto an Dot rowdy mated* bs
cploycs under the waiters compectutim Act (GLUS?,ssl (S)), applicatico by a bontacta Die for a Ixepst a permitmty e;ridcm a dN
:cogl reams of as osaployer un the Wodums Campeoastion Act.
I uodesuad that a copy courts statetaeot ussy ba facwuded to the Depumoot ofloduesisl Aosi4 V" COW elemental"
oover,so veci5eatioo sad that Ally to sown wasps uodee seance 33A CAL l3 on lead *Wu to tbWu ardI d . i
oaasis2i;tg of t fine of up to SI,S40.00 sxt/a of up to one year sad dvs7 ppenalties io>be Arm ota Mop i _ t
firs of s 100.00 kris) against a=
• Fadapatmtdatus• 1 � , ,
• t P ...is ' ,.
l:, v iguaLmce; of Lia:usetJPtrmittce Date I vlip' I ..-..••••• r
r w
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all am :ikable)
I New House El Addition Replacement Windows Alteration(s) Roofing 136
Or Doors 0 . •
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks ,[[] Siding [DI other [C7[
Brief Description of Proposed a�t�Ch.P��
Work:
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 followinst:
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 , C A. \`` l � , as Owner of the subject
property kc.I. hereby authorize t�.,Mar J J011 Si t Q ROO 1 1 n
to act on my behalf, in all matters r ative to work authorized by thuilding permit application.
• e•
Sign tUre.of Owner Date •
I, 11- - - 0 • - • . L .1 , as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing . . • lication are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
•
14A is
Print Name
•
Sigriature of Owner /Agent Date
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition E.] Replacement Windows Alteration(s) El Roofing ryi
Or Doors CI . •
Accessory Bldg. ❑ Demolition ❑ . New Signs [CD] , Decks . , Siding ID) Other [Dr
Brief
Descript on of Proposed � �
Wr }a�ht1J
Work: L
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?
1 h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
I. 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, , as Owner of the subject
property kc,.I. r
hereby authorize JlY ) �e S 1 P O r i R to act on my behalf, in all matters r ative to work authorized by thuding permit application. .
Att 10he rt • .-:" - - oc
Sigi*iikof Owner Date
I, la. 1 t- - - ere ' • - ' .1 , as Owner /Authorized
. Agent hereby declare that the statements and information on the foregoing . t • lication are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
a Y Print Na I,�l
` me
Signature of Owner /Agent Date
,
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size I ._.. .._ ____..._... _
Frontage 1 `
Setbacks Front i
Side L:I i R: I L.i.. I R:LIJ _ _
Rear € I.. ! .
Building Height i _I . . 1 I. - 1
B;dg. Square Footage i ; i
Open Space Footage
(Lot area minus bldg & paved s 's I I I I
parking)
# of Parking Spaces 1 i ._..___j
Fill: .._......,_
(volume & Lpcation) _ ..... . ..... . . .. . . . .... ., , _ .,, ._ _.._. __ .__,._._.. _.. ...._.._.,,_
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES 0 •
.
IF 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 [ ^
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued: f I
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO O
IF YES, describe size, type and location:
E. Will 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
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
4
City of Northampton Statoeol �� �� , `'
� � ' � � n � , r sty' �'
Building Department
212 Main Street SeweriSO I�
,� , �
Room 100 VVaferlYlt����:� �'
Northampton, MA 01060
phone 413- 587 -1240 Fax 413- 587 -1272
Other Specie
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address:
This section to be completed by office
7` c2Q_ �.. . Map Lot Unit
Aj Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record;
Name (Print) Current Mailin9 Addr ss: .)
Telephone
Signature -
2.2 Authorized Agent: r
m - o e le, ` �•CL I QOfi n _" *U. as S,..V
Name (Print} Current Mailing ddress: 1 0`1.3
(' -4115
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building
ROOFI J E `� Ci(� (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection y(4f�
at 0
�
6. Total = (1 +2 +3 +4 +5) / C) . 6 c� Check Number /
This Section For Official Use Only
Date
Building Permit Number. Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
•
5 - , Y BP- 2010 -0150
GIS #: COMMONWEALTH OF MASSACHUSETTS
k: 31D - 218 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -0150
Project # JS- 2010- 000180
Est. Cost: $10500.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RCI ROOFING 74334
Lot Size(sq. ft.): 6751.80 Owner: GROSS JOAN H
Zoning: URC(100)/ Applicant: RCI ROOFING
AT: 25 DEWEY CT
Applicant Address: Phone: Insurance:
6 LINE ST (413) 527 -4775 Workers Compensation
SOUTHAMPTONMA01073 ISSUED ON :8/7/2009 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 8/7/2009 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo