32C-207 (3) RC.I.-- oofmg, LLP
51B Holyoke Street
P.O. Box 309
Easthampton, MA 01027 Estimate Date
Phone(413)527-4775 3/22/2005
Fax(413)527-8469
Name/Address Job Location
Jon Scagel 81 Williams Street
22 Claire Avenue Northampton, MA
Florence, MA 01062 586-1838
Cell#: (413) 207-1245
Terms Rep
Estimate valid for 60 days Mike
Job Description Total
Remove existing roofs. ' d
Furnish&install 1/2"plywood over existing decking. 4N,boa
Furnish& install aluminum drip edge,pipe flashings and chimney flashings.
Furnish& install new lead counter flashings.
Furnish& install ice&water barrier along eaves and valleys.
Furnish and install 15 lb. felt.
Furnish and install 30 year Tamko Heritage Series shingle.
Furnish and install ridge vent.
All roofing related debris to be removed by R.C.I. Roofing.
All work will be performed according to manufacturers'specifications.
5 year R.-C.I. workmanship warranty included.
30 year Tamko material warranty included.
All related permits will be obtained by R.C.I. Roofing.
SPECIAL ITEMS NEEDED
WE LOOK FORWARD TO DOING BUSINESS WITH YOU.
Total y `f oo �Gee:-ee-
FC-IL
TERMS OF PAYMENT
30%Upon delivery of materials
70%Upon completion Customer Signature
Registration# 126235
Construction License#074334 Date 3/ O!�
Insured by Hackworth Insurance(413)527-9907
Cc)L-o r2: f 3 bq Ck �✓A L ti v 7-
�U /'Y lIX-IC /s��ov.rr
0 0
Cr 7 f�) Of C7�;f 1 j ci l l 1 p toll _ -------
E 'M&.31RchntcIts
i --
DEPARTMENT OP DU(LZ)r)\C rNSf ecrtor.s —
212 Main Strcct Municipal Dudding
Northampton, Mass. 01060
`VORICER'S CONCENSA77ON C` SUZ.ANCE AIT,9)AVl`I'
(L1 ccnscrJpermi ttcc) 9
pnncipa! place of business/residence at:
MA OIOa1 (phone.') / -4795
( city/state/zip)
do hereby certify, under Chc pains and penalties of perJury, hal
(� I arm an employer providing the following; worker's coinocnsZ�Jon covervsc for Illy
etuployecs working on'tlus job:
L.LgL_Adfial V �_3�s-��iqia -o44 10 05 _
ncc CoMp=v) (Pclic: Nt_a�cr) C'=; irruon Dal:)
O I•aln z sole proprietor, general coorractor or homeow-oer (cuc;e one) amd hzve hired
the contractors listed below wbo have the fOUO%V Mg worker's comoensadon policies:
(NaMc of Co-n.mcwr) (tnSLrancc Coinpwriy �oUCi NtuIIl!'Cr) 17_x:mwuOn D11c)
- (Namc of Cootraaor) (Lnsurznc_– Comoaa.•fpoijn, Numr cr) (i�virtion Duc)
(Na me of Conrraeior) Gnsurancz CompanyfpoUcy Nwmber) (Expir000 Datc)
(Name of Conaacior) (Lasuran Comrzuy/Policy NumlyJ) (Expiration Datz) .
(snucb sd li�oc�.l U'cot if OCC_.:V cn c�e'udc iaror=�. oo pcna'JinZ to.11
( ) I am a sole proprietor and bave no one worldog for me.
( ) I am..a home owner performing all Lbe work myself.
NOTE:pl=p be Lwzm LtW wt.-jo boaxouocrn%%J>o aaploy p,w Lo r•.=.-.,.,.,, cc.—.:e�ao cr rrpaa work on a d.•cJL&of
act mote th_a L`.roe=?'j is u'aich the bomoowvcr r=id=x oo the Vouod3 zppurten=thecoo c.•c ooc C=--Wy OLc- _c�i�o be
curployc�unCc tyc uq � yy�AG(GL152=1(5))�apptia6crn by a bomeowoa far r Geyw oc permit rr y«idmr_c tlr
"-Pj MxtL'of ea's?loy.r uodar die wacUe,C.oa4>. Li A,
I undc-t d&A a copy of tbi.mWtcmaa may bo forwvrded to tbo Dcp,ctmoo,of l.&"'icl Accdcoay OT'.of 4aur,•r.oe for tb.
O°v°"gc rc=iOO°nd th t Ld=to scaK%covcrxgr tinder sociioa 25 A of MOL 151=rod to the im wsi600 of aimiasl penahia
oomiring of a riot of up to S 1 500.00 andrx imPrb-0a of up to co-y=Lad civil patahio in tx f6cm of.Stop Wort Order acid a
Gm 0(5 100.00 a dry Lea me
For dcp.rta..=•.aJ u,c only
t omit Number
Si�aturr of LiccnsccJPcrmiucc —D3Ee 1.L�p __ Lot
StCTjON 8 „COISTROCTIO,N:SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : /S e, T76 6 33 q
License Number
o - 0 7 5 - 13 - 04
Address Expiration Date
�l775
Signature Telephone
Ree s e:e rn mn ouernentContractor _ , Not Applicable ❑
R. C • z. R�f� na 126 235
Company Name Registration Number
_q () .Mai n AVe_nL P_ - P-6. ox _3 O 5 - L_
Address Expiration Date
Telephone 13 --y77jr
SE rT 010WO.. IfERSC�OMRENSATION INSURANCE AFFIDAVIT(M G:L: c 152, § 25 C(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.
Fs Affidavit Attached Yes....... 11VIr No...... ❑
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)fami!ies
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 building 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
kYv.l°�
SEC410 S R PT 0 0 OPO fDVYO:RK� check°alla {ica {es :
New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ) Decks [ j Siding[ ] Other [ ]
Brief Description of Proposed Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0- Sheet 0
6a.. °fN whoueafi OUR
ditron to" eXsting hous`ingc plefefhefollowing
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. Mascheck Energy Compliance form attached?
h. Type of construction
i. Is construction within.100 ft. of wetlands? Yes No. Is construction within 100 yr. floodpiain 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
S_ECtTe�O, '' jerk '.
C!IE NO IZTIONt TOMI COMPLETED WHEN
OW�VEF� � O CO RECTOR APPLIES FOI �BU{LDING PERMIT
I' as Owner of the subject property
hereby authorize M - Ro o Ft na to ac;. on
my behalf, in all matters relative to work authorized by this building permit application.
aiian6J 3- 30 05
Signature of Owner Date
I, 1. 1 QS QU ri 1°d agmt as Owner/Authorized Agent
hereby declare that the statements and information on the fdYkgoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
Print Name
3' 3d- 05
Signature of Owner/Agent Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
J -
C,ity_of Northampton �_ .•
8- ilding Department
_. ,' '212 Main Street ,.
Room 100 a
t,!AR 3 ? 20Q5 Northampton, MA 01060 •e
phone 413-5871-1240 Fax 413-587.1272 cs to
- -APPLICATION jTO'CONS-T-RUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE . 'RMAT:ION
r
1.1 Property Address:
Zo a Over tr ct
elm toy)
nElrrt StwD�strri t.-
SECTIONI2 - PROPERTY OWNERSHI:PfAUT J. EDiPAGENT
2.1 Owner of Record:
jf)n Songe ei
Name(Print) �— Current Mailin Address:
attct_n�� X38
Telephone
Signature
2.2 Authorized Agent:
Print -1;S1 . R. C'. z, Roofl nom_ PO. L�x309 - (fasAampton NA
Name
(Print) Current Mailin g Address: Q)Qa/1
q►3) 5a7- +jg5
Signature Telephone
SECTtOH 3 - ESTIMATED COISTRlJET10N°COSTS^ .
Item Estimated Cost(Dollars)to be icial,-Use' 410hll y
completed by ermit applicant
1. Building 7 'Roo -i n � 1l 100.00 (a) Building Permit Fee
►l _
2. Electrical (b) '::;timated Total Cost of
Construction from 6`
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3 + 4 + 5) y 14 oo co Check Number
This Section:For.Official Use Onl
BUlldln Permit:Number: Date l"ssued;
..g`
Signature:
Build,ing Commissioner%Inspector'of Buildings Date
81 WILLIAMS ST BP-2005-0920
GIs#: COMMONWEALTH OF MASSACHUSETTS
MapBlock: 32C-207 CITY OF NORTHAMPTON
Lot:-001
Permit: Buiidinci
Category: BUILDING PERMIT
Permit# BP-2005-0920
Project# ]S-2005-1285
Est.Cost: $4400.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: RCI ROOFING 074334
Lot Size(sq. ft.): 1916.64 Owner: SCAGEL JONATHAN A
Zoning.URC Applicant: RCI ROOFING
AT: 81 WILLIAMS ST
Applicant Address: Phone: Insurance:
P O BOX 309 (413) 527-4775 Workers
Compensation
EASTHAMPTON MAO 1027-0309 ISSUED ON:3131105 0:00:00
TO PERFORM THE FOLLOWING WORK.STRIP, PLY & 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 3/31/05 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo