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36-047 RCI R LLP 51B Holyoke Street P.O.Box 309 Easthampton, MA 01027 Estimate Date Phone(413)527-4775 5/11/2005 Fax (413)527-8469 Name/Address Job Location Ralph Carpenter 20 Winchester Terrace 20 Winchester Terrace Florence, MA Florence, MA 01062 586-3933 Terms Rep Estimate valid for 60 days Mike Job Description Total REVISED ESTIMATE 4,900.00 Remove existing roofs. Furnish& install aluminum drip edge,pipe flashings and chimney flashings. Furnish& install ice&water barrier along eaves and valleys. Furnish and install 15 lb.felt over existing deck. Furnish and install 30 year Tamko 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 Add$2.50 per sq. ft. for wood replacement if needed. Remove existing plywood on front portion of house only and replace with 1/2"CDX. ADD........$1,250.00 Cut hole in plywood and install bathroom exhaust vent cover. Confirm placement of vent with customer. WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total $4,900.00 TERMS OF PAYMENT 30%Upon delivery of materials 70%Upon completion Customer Signature xz Registration# 126235 Construction License#074334 e' Insured by Hackworth Insurance(413)527-9907 Date .r R•(llA1•fAT _ (� \ F E (rite of Tortlialli ptotl �ZastnrhntrUa' - — c✓ DEPARTMENT OP BUILD0\10 iNSPECT101.'S —; 212 Main Strcct ' Municipal Building Northampt.on, Maas. O)OGO WOR1Q?R'S CO'Pv2ENSA7ION LNSURA.NCE AFTMAVIT (l1ccn5a PMM3jaoc) 9 �>�th a principaJ place of business residence at: 5lQ HD� ���, nfdYl MA OIOX/ Uhone.) L3• .5�27_ `I`�5 do hereby certify, under dic pains and penalties of perjury, h?.I an employer providing die followine worker's coinocnsn don coverage for my etuployces worUng on'tilis job: r110JI-044 10 0.5 aas4ancc Conr:n.) (p0Uc:NU_mb_r) (EX0,irnor, Dzt )- ( ) I.ann a sole propr;clor, general contractor or homeowner (ci;c:e one) and have hired the contractors bsted below cvbo have the following workers compe,Ztztion policies: `Namc Oi Contmcwr) (1nsur311cc Colnpan)•fi'GUCi �tt1IIt!C) (Y?:aliJG4� Detc) (Name of COGG-.1 Or) 02_7w-ancz CompanyiPolim, Number) t ExDir,:aon Date) (Name of COnuaetor) (Inswaac; Compan)•/Policq' Nwnkr) (Eapu'2600 Datc) (Name of Contnaor) (Insulaacc Compaay/Pobcy NumbJ) ('Expiration Date). (&mach adiitiocal 6CCL irnoo=a.uy to caduds iaforta&�oa p<ztaiaias to aL oo@aCOn) O I am a sole proprietor and bave no one wor4dng for me. ( ) I am..a home owner performing all the work myself. NOT]::plese be awvc a14 M•biJo bomoo,4mm wbo cmploy prow Lo d.,=- ir,�C===jAo C rcpair work oo a d..c1L:b of not ta=rt'L--D erne Lira is ubich Lbc borowwocr raid=or oo tlac Qvuaac`a a�purtcnst tbe-,�-c ox oeeaid.7td Lo t c etaploy-)bade the wak=Az o=Pc=Liioa Acs(GL157-=1(5)�applimaon by a bomoowva ry.Gcr-c or permit rney-id—the legal eLaIIU of Ln"'Ployee under dso Wockoeg Compoo*A;oa Amt_ 1 uodaAAad Lh.a a copy of tlua mtemem=say be forword.sd to tbo Dcp>noa w of 1nd.azri,1 Aeodaosa'Moo or knob.===for tb. - wage vc iLeaioo a_•Ld Ow r_iltae t4 u=mc)cova,,g,:undo soet.ioa 23 A of I.tOL 132 can tc d to the imposidoo of aiminal pe Wes oomi.4sag of a hoc of up to S 1.300.00 and/or¢»pojaoaW=orup to ooc yor and civil pcaatio is a v.form ora Slop Work Crdcr Lod a rsm o(5100-00 a day Lp i=Lac For dcp..rtac— uae only Permit NumbCs ` Y Lot S' �or L=ZCjFC miucc -� J .>. �e S �0 °1157 [ON SERVICES � 'U . I 8.1 Licensed Construction Supervisor:f Not Applicable 2 ❑ Name of License Holder : �v�"� ---*`P.11 SI C. / /'7 33 J License Number 7 5 , � - o4 Address Expiration Date I775 Signature Telephon Not Applicable ❑ l a b 2 3,1 Company Name .�— Registration Number .q f) Ma;n A�IWI,ej - P.a o oX .�Oq 5 - 6 - 0(c Address Expiration Date . u Telephone 3 - y77Jr �S�Cx- 1�0 �0' ERS�COMPENSA;TI01�fNIRANGE 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....... No...... ❑ } 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 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 fo-r 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 (� "(X ft P6 I'D 6 J, ch. New House O Addition ❑ Replacement Windows Alterations) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ } Decks [ ) Siding[ ) Other [ ) Brief Description of Proposed Work: a:uA yle j 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 Ga" 1= :.e o. orliYro"nto exrstingtihous�=ng. compl`efe"t�e`fal.lowrn 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. 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 ETEDYIIHEN SSE TJOC } ION�BE�COMPL E 0RgCTOFAPPt. E rORRGrJLDI GPI=RM1�'� F. x ; I, Ra C�aV y1p V,+�p r + /C as Owner of the subject property hereby authorize (ManX Del l Sle, b7 R. - T Tl 00 i 17Q to act on my behalf, in all matters relative to work authorized by this building permit ap icp ation. a f.+an6A ?•+,05 Signature of Owner Date I, nxk_ 'De-lisle, as Qu�bori zed aae-a - as Owner/Authorized Agent hereby declare that the statements and information on the fo going application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name 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 % (LA 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: ifs of Northampton �,Pding Department i Main Street C ~, oom 100 r� 2p0 - Nor ham ton, MA 01060 e phone-4J. 87.1 40 Fax 413-587-1272 4PPL'PE��?Ib VnTdCONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE fNF013MATIoN ;tea . , 1.1 Property Address: Th �sectrp. is -. AW 20 WI1 &Esley IP1(yaL'P A r AEI`St •District CBDistrtct ' SECTION 2-'PROPERTY OVYNERSHtP/AU.THO, IZED AGENT ..: 2.1 Owner of Record: �alnh Cam en-ter , lnl p �fipr �►r. I Fjaremce., Name(( rint) Curre ding A d� :3 ai-tap PA Telephone bb Signature 2.2 Authorized Agent: TebsIf, - . C'. Z oofi no x s09 - Easlhamphon .NIA Name(Print} �� Current Mailing Address: Signature Telephone _ SECTfON 3 - {y, E � ESTIMAIED COR OT OTS= Item Estimated Cost(Dollars)to be Official Use Only - completed by ermit applicant ow 1. Building Roo1 n X900 OO (a) Building Permit" Fee �1 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) , O Check Number This Section For Official Use Only. Building Permit Number: Date:'Issued Signature: Building Co.rmissioner%Inspector of Buildings Da"te" r 20 WINCHESTER TERR BP-2006-0138 GIS#: COMMONWEALTH OF MASSACHUSETTS MU:Block: 36-047 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0138 Project# JS-2006-0212 Est.Cost: $4900.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 074334 Lot Size(sq. ft.): 10018.80 Owner: CARPENTER RALPH E&ANN U Zoning.URA Applicant: RCI ROOFING AT. 20 WINCHESTER TERR Applicant Address: Phone: Insurance: P O BOX 309 (413) 527-4775 Workers Compensation EASTHAMPTON MAO 1027-0309 ISSUED ON:815105 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 8/5/05 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo