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25C-241 (3) RC.I.--R ' fin O O g, LLP 51B Holyoke Street P.O. Box 309 Easthampton, MA 01027 Estimate Date Phone (413)527-4775 10/24/2005 Fax (413)527-8459 Name/Address�! Job Location Will Weber 235-237 Bridge Street X73 State Street Northampton, MA Northampton, MA 01060 584-1852 Terms Rep Estimate valid for 60 days Mike Job Description Total Remove existing roofs. 9,200.00 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 over existing deck. Furnish and install 30 year Tamko Heritage Series shingle. Furnish and insta!i Cor-A-Vent ridge vent. All roofing relateu debris (o 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. WE LOOK FORWARD TO DOING BUSINESS WITH YOU. Total $9,200.00 TERMS OF PAYMENT 30%Upon deliver} of materials 70%Upon completion Customer Signature Registration# 126235 1�ael Construction Licen.e#074334 Date Insured by Hackworth Insurance(413)527-9907 ��e 0 0 yu eZ4e.N Crxf Of Warfilttmptall 3 H �lassachnsttta' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSAITON rNSURANCE AFFIDAVIT (licensec/permi�ice) with a principal place of businessJresidence at: sorer/ ty/statr/ap) do h(_reby certify, under the pains and penalties of perjury, that: (1� = am an employer providing the following worker's compensation coverage for my employees working on this job: Amaly-an`Int'l Goo jr) 6816bI0 10/5 /Ob (lnsurancc Company) (Policy Number) (Expiration Date) 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 Date) ,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) (attaC:A3ditiocul tbcet if neccss to include infonnziioa perudniog to all cocradots) ( X am a sole proprietor and have no one work-ing for me. ( ` I am a home owner performing all the work myself. NOTE:please be aware that wkOa homeowum who ealpto y pessom to do maiatea=eer cotntructioa or repair worn on a dwelling of J not mere than throe units is winch the homoovvaa•resides oc oa the grounds>cpvidtaaat thereto are oa generally oomidered to be carp!oycn under tho worker's coaVcnss4csx Ad(GL1 52.=1(5)),application by a homeowner for a Geese or pennh may evidence tha lcg�i status of an employe under tho Wocicees Compeosstion Act ?undcnund that a copy of this eutemagd may ba forwardod to the Depaitmccd of In&xstrid Aoridexx&Offioe of Insunner ford* -vatic vaifi cation and that fai vm to more coveraga under saWoa 25A of MOL 152 an lard to the ion as of aialbal pea wfA 00-is4 ottt f=ot'up to S 1,300.00&Woe WVVb0 0Cd of tiq to rtes year trod dva p=Wts 6 the Poem of it Ito Wads Order led a fir-of S 100.00 a day lvitui the For dVut=W we OWY Pcrmit Number Map# Lot# ` y t, Signature of LiccnSwjpermittee SECTION 8-tCONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : . maY� S 1 / 4 334 License Number 51 A tot - 027 5 -03 - ob Address t Expiration Date (.q13) Signature Telephone lk`Z "i`g Fend a m n °ontractor Not Applicable ❑ R-0- 1. oof� a I It 235 Com anyName Registration Number ,5113 Stril?L°t - P.n. 3m 3o9 5- 0b - CIL Address J Expiration Date Telephon 'l5 SECTION 10-WORKERS'COMPENSATION INSURANCE 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 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� taehp SECTION 5-DESCRIPTIONiOF PROPOSED WORK(check=all'aaalicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet❑ 6a 'IfIN"iMIK60Se,J d 0WMditionAo existing h"o'rusinfr combte`fi"e thb fflt`I I`M 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? In. 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 OWNER&AGEN7 01 W ONTRACTOR APPLIES FOR BUILDING PERMIT ),4e 6dc as Owner of the subject property hereby authorize Nark 6 S P o 00 fiYld to act on my behalf, in all matters relative to work authorized by this building permit application. attw.11�d 3- -,)q- Db Signature of Owner Date I, Mares A S'L as eA as t as Owner/Authorized Agent hereby declare that the statements and information on the foregoin application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. =Name Print 3- a9-06 Signature of Owner/Agent Date Section 4. r 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: • City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413.587-1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ON T LY4WtL SECTION 1 - SITE INFORMATION 1.1 Property Address: " x This s c i ;235 237 ae; st. p Zone �Ovrlay, �� c r Elm St.'District CB`Drst?ct,- SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Will Aeber 273 "Std-r& St Kee Al `4n Name(Print) Curre icing A�t5- AttacheJ Telephone +t J a Signature 2.2 Authorized Agent: arh`)el i51e-.—9. e. ED. &x 9 - EaAt araotw- Ma Name(Print) Current Mailing Address: 13 5T - -4 TIS Sig ature Telephone SECTION 3 -"ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building Roof A -! zW-Vv MM (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 6. Total = (1 + 2 + 3 + 4 + 5) ClIZ00,00 Check Number This Section For Official Use Only Building Permit Number: Date Issued: 3. g re: Building Commissioner/Inspector of Buildings Date., fwwl BP-2006-1044 Al GIs#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Cate og ry: BUILDING PERMIT Permit# BP-2006-1044 Project# JS-2006-1546 Est. Cost: $9200.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 126235 Lot Size(sc.Al 7056.72 Owner: WEBER WILLIAM R Zoning: URB Applicant. RCI ROOFING AT. 235 BRIDGE ST Applicant Address: Phone: Insurance: P O BOX 309 (413)527-4775 Workers Compensation EASTHAMPTONMA01027-0309 ISSUED ON.41412006 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 4/4/2006 0:00:00 $25.008477 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo