Loading...
36-271 (4) /A7 Lr visa Q � ,A Q V E N N E V I L L E www.iaoonewroof.net ROOFING 'V SIDING I WINDOWS We Are Licensed 160 Old Lyman Road•South Hadley, MA 01075 1.800.NEW'ROOF • 413.536.5955 Fuuyfnsurea Email:info@ t800newroof.net Website:www.1800newroof.net Factory Trained MA Construction Supervisors Lic.#070626 MA Registration#120982 Factory Certified Installers Member of the Home Builder's Association of Western Mass. CT Registration#575920 Member of the Building&Trade Association P.P.C.38710 Proposal Submitted To: "Date [^ Phone#'s C: F3 L ,C' Street Q Email: City, State,Zip Code F Special Requirements: l7r Pn c /x'1 ,4 Rl:�-lvl aC, 5 KX 11 y ti s ❑ Recover O(Strip 1 Layers 01., t4 ~✓M W K 7'�kl 0 0 k4 4NIC ilii Complete Roof System I:fU [ We shall acquire all appropriate permits for all work 7-,/ (;) `j`f � �y l LA/O9 Home exterior and landscaping to be protected 1,n G f v - Strip existing roofing to existing decking and dispose of. Do not Do. � [ . Deteriorated existing decking will be replaced at$3,47 per sq.ft.after full inspection. LN Install Ice&Water Barrier at all eaves,valleys,chimneys,pipes and skylights Install(15tb:4etil-SynthbtiC)underlayment over remaining decking area Install Metal drip edge at eaves and rake (8" 5")(whit brown opper) Install manufacturer's starter shingle on all eaves and rake edges $$B Install new ipe boot flas hing�/copper)/vents . Instal Snow Count r Cobra rolled vent ridge vent Winner of the 2010 ❑ Install proper soffit ventilation TORCH AWARD Shingle: ( 6 nails per shingle) Shingles ❑ 25 year [:130 year �K 50 year Color Ridge cap shingles Warranty Options: XWe guarantee our workmanship for 10 full years(see our warranty coverage) ❑ GAF System Plus warranty [ ) GAF Golden Pledge warranty IV Q w fa N© 1~17 f e,(1 W or t't-A"ft1 �,q� o r a o M4�e#,41 earfa A f' Chimney Options: iWead Counter Flashing [Water Seal&Tuckpoint ❑ Rubberized Crown ❑ Metal Chimney Cap We propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of:Total Due($� -?72rrr./ ) ACCEPTANCE OF PROPOSAL: The above prices,specif tiona and conditions are Down Payment($ G, ` ' ) satisfactory and are hereby accepted.You are authoriz" to do work as specified. I l��`/ Payment will be 1l3 down at start of job,and balanc Pon completion. Balance Due Upon Completion($ 1 i ✓'� ) Date: 3 CCSignature: 1 Date: 3"I —/JEstimator:(Print Name) ` 1 rm (Sign Name) Estimates are honored for sixty(60)days from above date ATTENTION HOMEOWNERS:Please cover all personal belongings in the attic,garage or storage areas due to the possibility of roofing debris or dust coming in through cracks of the wood.Adam Quenneville Roofing will not be responsible for debris or dust In the attic or storage areas. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual) Adam Quenneville Roofing&Siding Inc. Address: 160 Old Lyman Road City/State/Zip: South Hadley MA 01075 Phone#: 413-536-5955 Are you an employer?Check the appropriate box: Type of project(required): 1. >X' I am an employer with 15 4. LJ 1 am a general contractor and 1 6. U New construction employees(full and/or part time).* have hired the sub-contractors 7. ; ; Remodeling 2. i_� I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. I Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. $ required] 5.( 1 We are a corporation and its 10. L 1 Electrical repairs or additions 3. ! 1 am a homeowner doing all work officers have exercised their 11. J Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4),and we have no 12.6ZRoof repairs employees. [no workers' 13. ,, I Other comp. insurance required.] `Any applicant that checks box#1 must also rill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contactors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. _ am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIM Mutual Insurance _ Policy#or Self-ins. Lic.#: AWS40070128612014A _ Expiration Date: 4/29/2015 Job Site Address: a ��x s �D,i _ City/State/Zip:_ C;Or(^Lx_ W\A U 10��- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration (date). Failure to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date. 3 Print Name A&atv-- Phone g. 113 53 _fKY_ Official use only Do not write in this area to be completed by city or town official City or Town: Permit/license#: Issuing Authority(circle one): l.Board of Heath 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Adam Quenneville CS 070626 Name of License Holder: License Number 160 Old Lyman Rd South Hadley MA 01075 8/21/15 Address Expiration Date 413-536-5955 Sign— at� Telephone 9.Registered Home Improvement Contractor: „ Not Applicable ❑ Adam Quenneville Roofing 120982 Company Name Registration Number 160 Old Lyman Rd South Hadley MA 01075 3/25/16 Address A-� Expiration Date Telephone 413-536-5955 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§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...... ❑ ll. - Home Owner Exemption 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors i] Accessory Bldg. ❑ Demolition ❑ New Signs [ice] Decks [p Siding[[3]- Ot er[p] Brief Description of Proposed Work: Strip existing roofing and install new asphalt shingles,replace 4 skylights L Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. If New house and or addition to existina housing, comaiete 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? 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 . 1. 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 Kevin Epstein I, , as Owner of the subject property hereby authorize Adam Quenneville Roofing&Siding Inc. to act on my behalf, in all matters relative to work authorized by this building permit application. See Contract 3/ ignature of Owner Date Adam Quenneville 1, , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. avf Print ame 3 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 Setbacks Front Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved 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 ofDeeds? NO «r� DON7KNOVV ��� �~� ��, /ca IF YES: enter 8onk V Pag 1 and/or Document# B. Does the site contain a brook, body of water orwetlands? NO DONT KNOW �_� YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained _�x�� Obtained ��` Date --- � �_� ' C. Do any signs exi �� ��»�on the 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 0 NO e IF YES, describe size, type and location: x E. Will the construction activity disturb(clearing,gradingexcavation, or filling)over 1 acre orinb part oyo common plan that will disturb over 1 acre? YEO K � NO K�J �� IF YES,then a Northampton Storm Water Management Permit from the DPW is required. to ,�Ul7�patln•t�rs��se Dftly City of Northampton St tus f 0 it Building Department Curb utli3rlvu�ry F�eFrrtl1 212 Main Street Sew <7 T Room 100 ytiate�tlt f i€ � la f iC3 Northampton, MA 01060 Tvutf' cturlans hone 413-587-1240 Fax 413-587-1272 flpitr itanmd' 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 Map Lot Unit 168 Maple Ridge Rd Zone Overlay District Florence, MA 01062 Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Kevin Epstein 168 Maple Ridge Rd Florence MA 01062 Name(Print) Current Mailing Address: 413-883-6958 Telephone Signature 2.2 Authorized ent: �{f� +I �4tx�N n -i- c " �1c• ea So 61u7S ame(Print) Current Mailin ddress::: (a 3 lOr Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 20,925 (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=0 +2+3+4+5) 20,925 Check Number (- ( s � This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date 168 MAPLE RIDGE RD BP-2015-0902 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-271 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2015-0902 Project# JS-2015-001738 Est.Cost: $20925.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sa. ft.): 94089.60 Owner: EPSTEIN KEVIN G&DEBORAH L FEEN-EPSTEIN Zoning: Applicant: ADAM QUENNEVILLE AT. 168 MAPLE RIDGE RD Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:312512015 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF & REPLACE 4 SKYLIGHTS 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 3/25/2015 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner