17D-008 1 ��� UENNEV�LLE [10 ELK
The Premium Choice
78 West State Street, Granby, MA 01033 We Are Licensed
1-800-NEW-ROOF • 1-800-4-SIDING Insured
mail:info@ 1800newroof.net Website:www,1800newroof.net Factory Trained
'.1A Construction Supervisors tic.#070626 MA Registration#120982
.'!ember of the Home Builder's Association of Western Mass. CT Registration#575920 Factory Certified Installers
.'amber of the Building&Trade Association Member of the Better Business Bureau
posal Submitted To: Date /c' 7 4S Phone#s
� � t'L' `.r - _
_� - C Cell:
,;veet Job Location
�y,State, Zip Code Special Requirements
r�
Proposal to furnish and install the following ,/_
fie-Roof ,Tear-Off ❑ Gutter
Complete Roof Preparation
'? Home exterior to be protected by tarps and plywood'
Shrubs, landscaping, trees to be protected from damage tC:' !' 'C
Entire existing roofing material to be removed to existing decking, including flashing, etc.
Site to be cleaned everyday with roll magnet debris removed at project completion
Deteriorated existing decking replaced at a[ per sq. ft.
j 8 inch metal drip edge installed at eaves and rakes ❑ 5 inch for re-roof only
New flashing will be installed where necessary (see Special Requirements)
We shall acquire all appropriate permits etc.for all roofing work
Complete Roofing System
ELK Leak Barrier installed at all eaves to protect from ice dams (and meet codes in the north)
KI, ELK Leak Barrier installed in all valleys, around penetrations, and chimneys to protect critical areas
K,I 15 pd. reinforced underlayment installed over entire decking
Shingles:
' LLK Prestige,"Series X30 year ❑ 40 year ❑ 50 year Color____
Nailable ridge vent will be installed
[ ELK ridge cap shingles
Warranty Options: 3�
We guarantee our workmanship for, full years
[; ELK10-Year Umbrella Coverage Limited Warranty upgrade.
ELK15-Year Umbrella Coverage Limited Warranty upgrade. V-�I d ��'�
��
4 Propose hereby to furnish materials and labor-cl mplete ,accordance with abo specifications for the sum of:
T,i,it Sale Price S /1 00 0 Down Pay' ent$ 1pon Completion $ 1 s�ACCEPTANCE OF PROPOSAL:The above prices,specifications- satisfactory and are hereby accepted.
You are authorized to do work as specified.Payment will be 1/3 down upon signing,and balance due upon completion.
Unpaid balances shall accrue with interest at 18%per annum. Purchaser(s)will pay for all costs,expenses and reason-
able attorney's fees incurred by Adam Quenneville Roofing and Siding,Inc.to recover any sums due under this contract.
I
Signature. _�/ 1 Phone��� _ ��-1�` ..._LfG Sc2
'—• -i-_
n,+ days CSalespers�ij gnat \�5 � '�
Estimates are honore or s y 160) y from above date
Al TION HOMEOWNERS:Please cover all personal belongings in the attic,garage or storage areas due to the possibility of roofing debris
e coming in through cracks of the wood.Adam Quenneville Roofing and Sidings will not be responsible for debris or dust in the attic or
r;, areas.
Ate eomwwwwqa&, aYt-,,&4,wc�
Board of Building egulations
One Ashburton Place, Rm 130
Boston, Ma 02108-1618
t_icense: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 08/21/1971
Number: CS 070626 Expires: 08/21/2007 Restricted To: 00
ADAM A QUENNEVILLE
160 OLD LYMAN RD
S HADLEY, MA 01075 ----
Tr no 3761.0
_ .
Board of Building Regu a ions an , t�ars
r =I One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement Contractor Registration
Registration 120982
Type: DBA
Expiration 3/25/2006
ADAM QUENNEVILLE ROOFING
ADAM QUENNEVILLE
P.O. BOX 612 -- -- —-- —__
SO. HADLEY, MA 01075
i 1pdate Address and return card.Mark reason for cbsog
STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION
Be it Known
ADAM QUENNEVILLE
7&.,W-$UAeTE,,-ST
O -BY,� 010.33
- i
is certified by the Departrtte t o>r onswme"r P z�ection as a registered
-
HOME IMPROVEMENT CONTRACTOR �
Registon
_
ADAM QUENNEVILLE ROOFING `TRgrvSr, ,
Effective: 12/01/2004
Expiration: 11/30/2005
Jut U /-ZUUO 10 : J,D HM Kemiiiara Insurance 141 ScdUIU
r ACQM- CERTIFICATE OF LIABILITY INSURANCE _ CSR RL DATE 6/291105
" ADAId -1 06/29/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
itemillard Insurance Agcy, Inc HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
9 Lyman Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
!;youth Hadley XA 01075
Phone-.413-538-7862 Fax:413-538-7179 INSURERS AFFORDING COVERAGE NAIL
'vSURED INSURER&' w—i-1 elro Yetiuo Ioa. co
INSURER B: Arbella Protection Ins Co
Adam n
neville Roofing
X� INSURER('- Lnf teicual Znaoreoce C�anY
& Siding Inc - ---
p O BOX 612 INSURER D:
South Hadley MA 01075 _INSURER E.
:OVERAGES _
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD LNO:CATED.NOTWITHSTANDING
ANY REOUtREMENT,TERMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 14HICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS;EXCLUSIONS AND CONDITIONS OF SUCH
P(11 ICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAO CLAIMS.
tir: EC7 f�C1CirE7 PITIONT
:.TR INSRU TYPE OF INSURANCE POLICY NUMBE MAf
R DATE mnjyY I DATE Ml1UDDNy) 1 Ups
T GENERALLIABRITY EACH OCCURRENCE $1000000
A X COMMERCIAL GENERAL LIABILITY BIATDER#15168 06/23/05 06/23/06 PREMISES(Eac wenw) s50000
I CLAIMS MADE FX OCCUR MED EXP{Any one person) $50 00
PERSONAL SADVINJURY $1000000
GENERAL AGGREGATE $2000000
GFSTL AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOPAGG $2000000
Ir
POLICY F-1 je LOC I
I AUTOMOBILE LIABILfTY I COAd31NED SINGLE LIMIT S
a i ANY AUTO 54906400002 11/01104 11i01/05 (Eaaeddenq
i ALLOWNEOAUTOS UOOILYINJURY $250000
X SCHEDULED AUTOS (per person)
X HIREDAUTOS BODILY 6NJURY
X NO"WNEDAUfOS (Pcracodent) S500000
PROPERTY DAMAGE S 100000
(Per accident)
I GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
1 ANY AUTO OTHFH THAN EA ACC 5
AUTO ONLY- AGG S
EXCESSNMBRELLA UABILFTY EACH OCCURRENCE S
f4 OCCUR EI CLAIMS MADE AGGREGATE S
{ $
DEDUCTIBLE S
RETENTION $ -- -- S
WORKERS COMPENSAMON AND X TORY MRS ER
EMPLOYERS'LIABILITY '-'A'
C AWC7012861012005 04/29/05 04/29/06 E:L EACH ACCIDENT s100000
ANY PROFRIETORIPARTNER/EXECUTIVE
OFFICERNEMBEREXCLUDED7 E-L DISEASE-EAEMPLOYE $100000
if ye,des nd^_SPECIAL VISIONS below i E.L DISEASc-POLICY LIMIT S 50 0 0 0 0
I OTHER
1 1
I _ I
lKSCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENOOR5EMENT i SPECIAL PROVISIONS
CCRTIFICATE HOLDER CANCELLATION _
SHOULD ANY Ur THE ABOVE DESCRIUEO POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRDTEN
NOTICE TO THE CER T!FICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO ODUGATI LIABILITY OF AFY MXD UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVE
AurHOaIZFD +���yae,Y°""
L- --- — - Sto h > a9don
AGORD 25(2001108) 0 ACORD CORPORATION 1988
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�111A)-fp O +�
—
Iorillalli}3fnil
p
rfl L)EPARTMFNr OF BUfLDD�G INSPECTIONS
212 Mann Street ' Municipal BuiltiinG
Northampton, t1'Iacs. 0]060
WOI2TCCR'S CONMENI SATION INSURANCE AFFIDAM
�I I C-,P. r'C;?11,ttCC}
th a principal place o:busiress/r ';;dencc
,�r,-__ �_sy� -
-,'i
do hereby Ceriiry. she pen�!tle; ni
I am an e2aploycr providinS the ollo.=.'ir.c .c;rl_c>�5 �_;olnnc:lsallnn cr��cra.rc `o- any
calployces W06dring on Luis job.
Jnsi=an Company) D2tc)
( j I am a sole propnc.cr, r>encra conk or ��r h.octco���e; ;�l.c!e onei anc gave hired
the contractor lit o �l
$ $ P(' b�: O i s ill: i0 �: ='o CID i 'Den-a L, C, S.
(Name of Contactor) (�s ^cc el r Pr,1ic1 NuintK-.) -i�.t...or. Date -
(Name of Contnctoi) (Ims-u.--mcc Co`n7La.-i� o!Ic �uT,-) r� (Fv"G r;ii'ri1 DaiC)
(INSame of Contractor) - Irs �ncc C ' o!ic: N,llnt',1) 1.;a.ei
(Name of Conti-,Ictor) Jasunaicc Coir.7, i), P OLlcy NIiu ii=r). 1 :;r :ail. 7aCCj
( i <11I1 Z. SOIC l?rUpr7C:Ji haVe [?o
I i11
Ii ironic OA'!!1
*:O�rli:please tic nsvyc ltl'<t u',1�ic F,c<rco��ir-�a„p c.;.�!:ry;r=:�_�;,:;'.�;-�c";.:.incr, ti:.:::r.:�.:m .=:;-;;au�•,;•,.-:C��c I!���c.
not ux rc than d rno um,,in Ict:dt he!:c: .•.r rc: s a a; x 4.:-.�; L_r cr rS liu c c r:c tr:(Sri:!;c.:r......., tt
caP.plo}'CZ urx&-s 1}Y r(` L--c.:1.r,prr-v::-.
Icgil riatur of cn amp Ioyot uuder tL0'JJcvi;cK'c Co.-t-parn..tion�.c-L
I unarr:tand dl ,a co-try of thi. ctatct,c-y bo fl-H'—,I IJ to Itn Ir.l>orL,cn:of lndf ,: <%ilic.o of for lax
v—&c vairicztioe a.id aut G.ilure to r!Glr”eo r9%�un 1: c"ier:25A of:,G L,152 can 1cul to the i;rp,,s ti0,1 o", MILIL•:cs
OooiisImg of a firr_of up to S 1-500 C-0 r_q, of p to cc.-.)'_. ...I c-,VII,c:.tlLa to�c:ctnn cd a S:r.
fire-of S 100.OU .diy q:uml rn-_
YCT 17111 NIIt33tY.;.l" —_-
®�i�S��4JCTION SERVICES'
1 8.1 Licensed Construction Supervisor: Not Applicable Cl
Na
Name of License Holder : !-1a.Cty- ut�-k nVIet,t'lt ��
S O 'iOb )G
' License Number
Address Expiration Date
( ,gnature Telephone
I
�;,
Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone > $C157—
WL
SEC IOTI iET RKEQ 5tfiCOMPENSA"T10N 1NSU,RANMWFIDAVIT(M G'1. c. 152, §_25C(6))
` Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit
f will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... tg--- No...... ❑
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)fatni: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' Compensations and Chap ti 153 (Liability of Employer 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
r
S 1+1F� ;OSEDaWOR c cktal a I�cable:k �1�2� �
,r. P;°c•. _ ..W. .•,1�`'1'<1"s.;yM
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
grief Description of Proposed Work: � �a.� new Asps -, (1- S�ti�geS'
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
e ci' r 'c3'd'Wiso evrsri:1 =:h tao s ffnggmp�e heafollow ng
Use of building : One Family Two Family Other
Number of rooms in each family unit: Number of Bathrooms _
i c Is there a garage attached?
o. Proposed Square footage of new construction. Dimensions _
e Number of stories?
1 Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?
n. Type of construction
Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
l Depth of basement or cellar floor below finished grade
k Will building conform to the Building and Zoning regulations? — Yes -_ No .
Septic Tank City Sewer Private well City water Supply
5E NEW
?�RIjPk N TO BE COMP d'tD WHEN
0 G1O�t1PPLIES FOR BUl4f1f G PERMIT.',
;.
as Owner of the subject property
nereby authorize to acT on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
PA�O )ePli`L ti t � RI) as Owner/Authorized Agent
nereby declare that the statements and information on the foregoing application are true and accurate, to the best of my
i knowledge and belief.
Signed under th pains and penalties of perjury.
�/ u'� Qy(N VY� ►
Print Name
6�
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 bON'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:
I City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
phone 41\�-587.1240 Fax 413-5871272
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION-
7his'secttQjto be!=comp:I*etedzib ffice:
1.1 Property Address: ` { '
u >
fit.
A. itJ
a
/ M
ip
rK
ElmrSt�District_ - Cits DISr►ttr:.as'
j SECTION-2 - PROP,ER7Y-O)YNER$ff RlAUTHORIZED AGENT
12.1 Owner of Record:
I
Name(Pri t) Current Mailing Address
Telephone
Signature
Z2 Authorized Agent:
Name(Print) Current Mailing Address
f
Signature Telephone
5ECX10N 3 -ESTI'MATE'D CONSTRUCT(ON COSTS
:tern Estimated Cost(Dollars) to be Official Us,e Only
completed by ermit applicant
1. Building 000 (a) Building Permit Fee
Elec.rical (b) ctimated Total Cost of
_ Construction from 6
3. Plumbing i Building Permit Fee
4 Mechanical (HVAC)
5. Fire Protection
o. Total = (1 + 2 + 3 +4 + 5) Check Nurnber
This Section For Official Use OnlyV
Building•Permlt Number: Date issued:—_`_
Stgnature` _
Building Commission et/Inspector of Buildings Date
604 BRIDGE RD BP-2006-0507
GIs#: COMMONWEALTH OF MASSACHUSETTS
MM:Block: 17D-008 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0507
Project# JS-2006-0755
Est. Cost: $11000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Adam Quenneville 120982
Lot Size(sq.ft.): 29010.96 Owner: FYDENKEVEZ ANGELA&ANGELA M
Zoniniz:RR Applicant: Adam Quenneville
AT. 604 BRIDGE RD
Applicant Address: Phone: Insurance:
P O BOX 612 (413) 467-2426 O Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON:111712005 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 11/7/2005 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo