28-049 (3) Y / / I�)`v
QUENNEVILLE MasterElite
OO F 1 N G & SIDING, 1 N C. GAFMC Residential Roofing Contractor
P.O. Box 612, South Hadley, MA 01075 We Are Licensed
1-800-NEW-ROOF 0 1-800-4-SIDING C Insured
Email:agrnewroofQwmconnect.com Website:www.180onewroof.net Factory Trained
MA Construction Supervisors Lic.#070626 MA Registration#120982
Member of the Home Builder's Association of Western Mass. Factory Certified Installers
Y
Proposal Submitted To: Date Phone#'s
W: j,) 0
Street f Job Name
City,State,Zip Code
Job Location
Proposal to furnish and ink li a following
D
❑ Re-Roof Tear- Gutter ❑ Repair
Complete Roof Preparation Pf
Home exterior to be protected by tarps and plywood eN Q i d %('c
Shrubs, landscaping, trees to be protected from damage
Entire existing roofing material to be removed to existing decking, including flashing, etc.
Site to be cleaned everyday with roll magnet debris removedt.projeCt 711ileti
�l Q " ��Deteriorated existing decking replaced at I o-t)C per �ssq..ft. near,
foot
Metal drip edge installed at eaves Metal drip edge installed at rake edges
, .New metal step flashing will be installed where necessary
New plumbing vent flashing will be installed and flashed Ask us about
Shingle valleys will be installed affordable
>zNew metal flashing will be installed around all chimneys financing
>We shall acquire all appropriate permits etc. for all roofing work options
Complete Roofing System
GAF Leak Barrier installed at all eaves to protect from ice dams (and meet codes in the north)
L'`GAF Leak Barrier installed in all valleys, around penetrations,and chimneys to protect critical areas
GAF Shingle-Mate°reinforced underlayment installed over entire decking(the best underlayment available)
Other shingle underlaymDes
GAF Ridge Vent will b e (-A P Shingles:
GAF Timberline°Series 40 year Lifetime Color v� 1 t` _rA t
GAF Hip and Ridge that warranty will be installed
Other Shingle Name Color
Warranty Options:
❑ We guarantee our workmanship for 5 full years
GAF Smart Choice TM Systems Plus Ltd. Warranty(doubles your up front coverage)
El GAF Golden PledgeTm Ltd.Warranty:America's strongest warranty-GAF backs our workmanship.
We Propose hereby to furnish materials and lab( 1complete in actor ante with above specif' ations}}ir the s m of L
2' ' _dollars($
C (
ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are satis cfory and a hereby accepted.
You are authorized to do work as e ' led.Payment ill be 1/3 down at start of job,and balance due upon completion.
Date: _ Signature: Phone#
- Y
Date Salesper on's Signature: - C �1 6GZ'4 J
C1' , c Estimate re h "ored for sixty(60)days from above date
X14.20 PN REMI'Lli'lRb INS FAii NO. 41,3 6010 P, 01
Y
c:
CERTIFICATE OF LIABILIT INSURANCm.-, 08/21/03
_'TR`iSf',MaR IFICATL is issun Ai A—WA—Tfr--'R'CJ-F-IN—F-0--k—MWTI( ---
ONLY AND CONFERS NO R10,HTS UPON THE CERTIFICATE
Remillarci Insuranoe h, C."
.1 J, HOLDEKTHIS CERTIFICATL DOES NOT AMC-ND,FXTEND OR
79 Lyman Street ALTER THE COVERACrE AFFORDED BY THE POLICIES BELOW
South Had:,ey W1, 01075
Phon�: 413t,38-7861 IN$URFRS AFrPRDING COVERAGIF
TNSURED
Nat-tona Yi l re Mar.�ne Ins. Co
I NSUREK.9 Ranover lrtsuranccA
Ad4l't 1r_LPjjuR 2 ATM Mutual Insiiranda Company
0 Box 612
COVERAGES
1HEP111_1cE80FiNSURAN7I=TFf';r71'17';�11ft BEEN issua)Yo rtic,NGuRFD NlAwo ABOVE FOR FNE FOUGYPFRIOD INDICATFE)NO'iwt'riSTANQNG
a y REQ U�RLMLN_f,7 E9 M OR GOW i ;ON(71 ANY C ON TKAO YOR D1-HER 00011MMN f N)I'H k&GPCC,-TO VAi QH-Till 3,,C FRTIFICATF MAY AE ISSUED c6',
POLICIES A6GHG ATE,_IMIT�5411 V4v MA rF 3tLPt Pauu En DIY PAD CLAIM&
Typa OF 1145WRAILICE DA-f LIMM&
T_12L_�_Yj__ __--7_4
CiEfl!'RAL LAUli 11-Y EACH 0('XjPkFI4CE
_.CA,WER�IAL,GENERAL LfA 1 0,9/:l 9/0/j FIRE (Any cno firdT $1,.0Q000
MED GXP(Any ono pcfwn) $
PERSONAL&APV INJUPY S 1000000
GRNERk1.A0/,,RiCW(U L$2000000
PRO,)UCTS-COW-10P AaG a20p00Q D
pe,_cy F7 R0_ ]r"
C;0VEINED 6INGUi LIMIT
li Ail"Au(o AYtZ 6,0,15 4 6 0 4 11/01/02 11/01/03
1 ALI.QVVN'{D ALJO,
BODILY 1IJJURY
F��AUTOU (0a,pwsv) 3 X50009
8001ILY INJURY
AL!
PROPERTY DAMAGE
P 4,1,00L)00
GARA59 LWDHfrY JAUTO ONLY•WLAA,�SIDENT
AN Y A J 7 0 I OTi-:ER T�IAN EA ACC
,AUTO CNVY AGG
ENCF
CLAIM$MADE ACI,:REGRTE.
_j
P%!!TENTI�)N
—VIC'
7A
WVF,KRRS fOMFkIN51.17UN AND 7U TORY
2 a c'.1 0 12 o 0:3 Ca/29102 1 ()4/29/04 E.L.EACHAGC104AT
DISEASF EA EIAKOYFE'S],Q(7000
011 H EK
=581; 0
T � PROVIS,ONS
CERTIC71('ATF.140l_DER Y4 ADrATIONAi.INSURFO:INSLJIOr',k IXTUR: OANCELLATiON
RIZ
AD TH�.ABOVE D9$CR[J6j:D PDUCIES BE CkXhf_;W)8EF;cR9'thf gXP1RATfc$
DATE THCREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL _j Q_DAYS WRITTEN
IMPOSE NU 013LIQATION QRLIASILIVY Of ANY KIND UPON THE IN317KER,ITS A$KNT$0R
2!_tRF.5EN,rATjVj;S,
A0 MRIZZED HE
kg
(7j'97)
D NCO RPORATION 1988
o4K>�pro
8 ti �z of Narf4amptan L
� � �Tassachusctfd -
cup "
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building '
Northampton,MA 01060
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as has/her construction sups,' :or. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends 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
home owner."
The building department for the City of Northampton wants any person(s) who seek to
use the home owner exemption, to act as their own construction supervisor, to be aware
that by doing so you become responsible for compliance with state building codes
and regulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation/footings (before backfill),
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work(electrical, plumbing&gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
I, understand the above.
(Home owner/resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date
Address of work
location
ti
Ci-zf�T o
B 6 fiizssacklnsrtls .
r m DEPARTMENT OF EUILDD) G INSPECTIONS
212 Alain Street ' Municipal builcling
Northampton, Mass. 01060
a principal place of busiressJrn",dcncc
---- - — ------- - _ (phone .';' - -- ----- --
do herelby ccr-Lify tlllf' ;r ?11e pn ii1S 3iiC pC;il li1CS (�i 7CrJUry, 111i!?
( ) I am an employer providing the foliowint .:orr_er's compensation coves' e for :ny
eluployces wor�dri`,� un this Job:
(lIlS'3 c:� : Company) �P O!!C:Nil_nibcr) ---- �-!~-?:"�'_.T;:i]^�D2tc)
l ) I a-ca a sole proprietor, gtnera± or homcovmc- (circle one) and hz`,-e. i utd
the contractors 11Sted, beio\v ;'l 0 i?, c th - .7Py '�IIOri;P�S GO%per1S?�Orl "011 '.CS:
(Name of Col-I[MCLG )
r)
1 t cc Col ;;, ctic T usnbcr
(Name of Conn.cto:) -- (711s�r,_nc Co~�_:,�'�Po!ic' Num, er) (I :ri.,:tin date)
(Ir'ame of Contractor) (In;r ace Co �yir'olic. Nlunh-r) .x; r i - Date)
- (Name of Contractor) -- (Insulanct Cotni.=y/'olicy Numbar)
(atLtdt:.dditicral s.>eet ii r.!rcv-::r k :!�.. :::fcs:-u::-;. - :..: - �.i;c:e:-.:�<::•)
( 1 i1S11 it soiC (?1 Ul)r1CtUi 211:1 hdVC I10 OI1^ ','.'Ur�tiiiif; toi n?G-
I ill a honle oWn--r
NOTE.:plc_ac be aw rc Lt>t.5i:ilc lxtrco.5,r^t5.�cnplc , n:.::rte^1 wZC�a.:_n r m cr:cpa r 5c•,;i;+-_..t c(li
not uxvc than Larne uni+tj in ui:i`-+t Lhe cx a;
eatploycs u-tixt t}x iwa: s x-_:e:i^n: (GL,!S2� !(5jl•a,:, ._ :ic:by a hnrtrottxs`or e L•ec::e a
legal etaiuz of=e=ployx under tarn Workers Co,•i,;wr_-ition!_cL .
1 undc_^to d that a copy of ttrzi Ltatc:6rt c:ay bo forwnrtio;l to t!»D-ji tax :of Ind tx ri l M6don:a'Ll 1—of for lix
eovernsc vaificiioc and that f_.ilum to:-ti L*c crot'-r_g^„urd;.CC-,io^25A of MGL.152 can toad to the imposition f c-- -ir_1
evausting of it fur_of uP to S 1.500-00 nmVor . x 6m,ea;, nu ea v u n
Lrr-
of S100A0 a day zrr-in:l m.
_ - --t
For dq:uunztal u.o ocily
Permit Nutnbx _------ --
,l
----- - ---- __...--_ _ ;.'fa;>' ------tilt • -------- �
• JtrnaWrr t�f i.ic�:r;cJI'crntittc�, _-_.r..,,.,_ i �
SCTON'� CONSTRUCTION SERVICES
8.1 Licensed ConstructionnSuepervis(orr: ` Not Applicable ❑
Name of License Holder : f fUCtVY1 I iUPpu3j]��I�. �S C1 7
License Number
Address Expiration Ilate
kf2/ 5 m )EUJ �3 CID F
Signature Telephone
R '111 e e e e'_ m � c Not Applicable ❑
I�eaa�n Q,
Company Name Registration Number
Address ' t Expiration Date
Telephoned
4.�CrtT M��OI�IV�OR�►C-ERS' COMPENSATION fNS,U,RANCE-=AFFIDAI/IT(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 acecptable to the Building Official,that he/she shall be
responsible for all such work performed under the buildine 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
i
SECT107 5 ffi 3� TTdb".NWF PROPASEDIWORK check ll0=a `IJtable r.
:'�`�:N: ".i -.`fs'',ii,, "# .�lxF.'C..+'; ..a7s. :; 1,�.,. >, :. 'k��:�:�:�*,�r.;'T.�` �`. 'H'+' "�,'";i�✓"�- '
n..
New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ )
Brief Description of Proposed Work: Rip o OFA P-ag U6
u
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative D Renovating unfinished basement Yes No
Plans Attached Roll D - Sheet D
o � itnoto.e o stingo> 'sing; . otn" e a hefol7awin :
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 Nc
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
3 _010
sHt�RIZPLETED WHEN TRACTOR APPLIES°FFOR BUILDING;PERMIT
i, as Owner of the subject property
hereby authorize to ac; or
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, Nam Ll ��1 as Owner/Authorized Agent
hereby declare that the statements and informati on the fo rooing 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 %
(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
�i uilding Department
212 Main Street
Room 100
Nor hampton, MA 01060
r� phon 13- 7-1240 Fax 413.587.1272
.y INSQC�i10��
r'
O CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
This sed It ` o b oix�p et" by fface �k:°
1.1 Property Address: r� r
M A
:yt�Cc manta r� � [� 5 �
.Elm�t�DrStr=ict .emu..._ ,CB;Dtsryrct
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED`AGENT
2.1 Owner of Record:
hc Co L+�
tt pluh . ILI
Name(Print) Current Mailing Address:
Telephone ')SS .' C7
Signature
2.2 Authorized Agent:
A(Yam 004J flail;to EMC'1 V\ j x Gil, &X� ! �cu 4 t�d[S7S
Name(Print) �j Current Mailing Address:
&L
Signature Telephone
SECTIONS ESTIMATED C NSTRU'tT
IOW,CO"STS 0
_.
Item Estimated Cost (Dollars) to be Official Use�Only
completed by ermit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) _:stimated Tota[Cott of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) r
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check Number 2 Z.
This Section':For Official Use Onl
Building PermitNumbe Q 2
,r: f �- �
.(¢g Date Issued: Q
Signature: _ d� --
Building Commissioner/Inspector of Buildings. Date
BP-2004-0268
GIS#: COMMONWEALTH OF MASSACHUSETTS
M ck:28-049 CITY OF NORTHAMPTON
Lot: -001
Permit: BUildinQ
Category BUILDING PERMIT
Permit# BP-2004-0268
Project# IS-2004-0390
Est. Cost: $0.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Adam Quenneville
Lot Size(sq. ft.): 16247.88 Owner: CALLAHAN DEIDRE
Zoning: SR Applicant: Adam Quenneville
AT. 94 CAHILLANE TERR
Applicant Address: Phone: Insurance:
P 0 BOX 612 (800) 639-7663-0
SOUTH HADLEYMA01075 ISSUED ON:919103 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP AND RESHINGLE MAIN 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• Receipt No: Date Paid: Check No: Amount:
Building 9/9/03 0:00:00 2728 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo