29-228 Proposal
Date: 7/15/12
Proposal Submitted to: . Proposal Submitted by:
. .
Joanna Wellman . , Parsons Prot, LLC
. ..
168 Acrebrook Drive
eneral Contractor - Jeff Parsons
„ .
.. ...,
Florence, MA 01062 150 Woods Road
(413) 320-2682 (Cell) Florence, MA 01062
(413) 584-5649 (Home) (413) 563-1624 (Cell)
PARSONS (413) 584-3652 (Home)
PROJECT
Design • Remodel • Build
I hereby propose to furnish the materials and perform the labor necessary for the completion of the following:
- Permit: The homeowner is required to obtain the appropriate permit from the City of Northampton.
- Preparation: The homeowner is required to remove any and all materials around the perimeter of the house.
Chimney Repair: Both chimneys are required to be repaired due to year of weather damage. Both chimneys are going to be
repaired with extra mortar, or replacement depending on the condition. The flashing is going to be replaced to prevent any
_
further leakage in this area New concrete caps are going to be added. Any chimney material is going to be rernoved by the
contractor. These tasks are going to be completed by a qualified mason.
Demolition: The existing shingles on the sunroom only are going to be removed along with the felt paper and drip edge back
_
to the original sheathing. All materials are to be removed by the contractor.
Plywood: All plywood sheathing on the exposed sunroom is going to be inspected by the contractor. Any damaged plywood
- sheathing is going to be replaced by the contractor. If any sheathing is to be replaced, the homeowner is to be notified of the
additional costs for the materials and labor.
Protection: New 15 pound asphalt felt paper and drip edge around the entire perimeter of the sunroom roof. A layer of water
and ice is to be added to all edges of the sunroom roof.
Shingles: Shingles are going to be added to the house structure, sunroom and garage, The sunroom is going to have a single
layer while the remaining house and garage is adding a second layer of shingles. The homeowner has been supplied with a
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sample tablet of IKO Cambridge style of architectural shingles. The homeowner is required to determine the color of
sh ingles.
Sheetrock Demolition: The one wall in the sunroom with water damage is going to have all the sheetrock removed and along
with any damaged insulation. All materials to be rernoved by the contractor.
- Sheet Rock: Tape all joints. Apply necessary layers of joint compound on both the walls and ceiling. Sand smooth.
- Paint: Primer paint alt fresh joint compound. Finish paint completely the wall(s). All paint is purchased by the homeowner.
Al material is guaranteed to be as specified, and the above work to be performed in accordance with the specifications submitted
for above work and completed in a substantial workmanlike manner for the sum of $11,925 with the payment to be made as
follows:
Payments to be made as follows: $6,000 Prior to starting.
$5,925 Upon completion
Contractor's signature: ..-. ,.. .-./...e ..._ r Date: 7,/,,
,..
Any alteration or deviat w the above specifications involving extra costs will be executed only upon written order, and will
become an extra charge over and above the proposal.
ACCEPTANCE OF .PROPOSAL
The above process, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as
specified. Payments are to be made as outlined .bove to Parsons Project, LLC.
_
Owner's signature: Mr " Date:
- ,. , " - :1 i I -
/ 7 /. /2.
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City of Northampton
Massachusetts fr
is
F
e DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building '� ` , ;";"'
Northampton, MA 01060
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her
construction supervisor. 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
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
The Commonwealth of Massachusetts
"" •— Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers
Applicant Information Please Print Legibly
Name ( Business /Organization/Individual): S ea y _ • •
Address: ji–d uo Os d
City /State /Zip: – , , _ _ • _, _ Phone #: _ -/6 I �2
Are you an employer? Check the appropriate box: Type of project (required):
1.17 I am a employer with 4. ❑ I am a general contractor and I
6. New construction
sanployees (full and/or part- time).* have hired the sub - contractors
2. I am a sole proprietor or partner- listed on the attached sheet. 7. (i Remodeling
ship and have no employees These sub - contractors have 8. (1 Demolition
working for me in any capacity. employees and have workers'
9. [1 Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. n We are a corporation and its 10.1j Electrical repairs or additions
3. n I am a homeowner doing all work officers have exercised their 11.F1 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.[ Other
comp. insurance required.]
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached 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.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: City /State /Zip:
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 c. 152 can lead to the imposition of criminal penalties of a
fine 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 up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Si. ature: !«� i� . Date: c, /,
Z
Phone #: y /3 .,. S -
1 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):
1 Ro o f h 2. R, Tlvpart 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 A le ❑
Name of License Holder : 1 l�l t r( �S O / ppl S l i5 �/ ? G1 ? 7 5
License Number
Address Expiration Date
5' �u - 352
Signature Telephone
9:;11egistered Home Irriprovement Contractor _ ' _ Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
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 ❑
1 1.._ Home O - Exe
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 Replacement Windows Alteration(s) Roofing ✓
l ( n Or Doors CI
Accessory Bldg. 1 1 Demolition ❑ New Signs [I]] Decks [[] Siding [O] Other [O]
Brief Work Description of Proposed V) W r a 1 S . - 1 " - r i ' f y1 -. s
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a. If :New house a nd:or addition to exi housing, ccomplete 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 .
I. 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
V V\Gt. Y�
`.1 OA y ., ,� C W e , as Owner of the subject
property
hereby authorize �� (5 fro ( � C
to act on my behalf, in all matters relative t work authorized by this building permit application.
�vyt�✓�".t, alit) An -- 2 1 �`
Signature Owner Date
To v y cUPVE?)` VY\t , 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 unde •e pains and penalties of perjury
— a a � V\ Weil tM
Print Name / " Ale.,i,„,,,,..i
Si of Owner /A t Date
„of
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
Lot Size �� _ .
Frontage ------- _ _ _ _—____._._.___._ ---------
Setbacks Front
Side L:— R: L: .�.,..
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 0 DON'T KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES
IF YES: enter Book Page; I and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
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 0 NO 0
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 0
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
\ City of Northampton Status of Permit A
\ x. e k tY M f{ k
' t Building Department Curb Ct1
u Driveway P er mt , f
. �i7
212 Main Street • Sewer(Sep tic.AvailabiIity' �.,:.
' Room 100 WaterlWell A vailability
L
Northampton, MA 01060 Two Sets of Structural Pl
U pig - k . r i � . -d. ? a ' kr ». "' '
o�
�" phone 413- 587 -1240 Fax 413- 587 -1272 Plot/S e P ',: .� 2«
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATIO
This section to be completed by office -,
1.1 Property Address:
1 Cf re- 0, jar . Map Lot u nif
Lc /' VV �� Zo Overlay District
F\6(e �,c;� , 61 0� Elm St. District 2,
GB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
fro �In na VVt- 1\ yn CX v1 l !off ACS V; -. )o(rnce
Name (Pri Current Mailing Address: 5 -,,., 1 (a q G1
i IP iii , , V /1,,t'V Telephone `y5 � 1
Signature / J
•
2.2 Authorized Agent: �/� p �y ' I
P( f iS 1 Ya c// 15 o VVoo Pd, ) Fl r �
Name (Print) V Current Mail - Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building i (a) Building Permit Fee
`
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Buil Permit Fee
4. Mechanical (HVAC)
5. Fire Protection d '
6. Total = (1 + 2 + 3 + 4 + 5) P 1 I 9 0-5 Check Number ( °
This Section For Official Use Only -
Date
Building Permit Number: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
168 ACREBROOK DR BP- 2013 -0136
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29 - 228 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- 2013 -0136
Project # JS- 2013- 000219
Est. Cost: $11925.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JEFFREY PARSONS 98275
Lot Size(sq. ft.): 10018.80 Owner: WELLMAN JOANNA S & JOANNE M GANGI
Zoning: Applicant: WELLMAN JOANNA S & JOANNE M GANGI
AT: 168 ACREBROOK DR
Applicant Address: Phone: Insurance:
168 ACREBROOK DR
FLORENCEMA01062 ISSUED ON:8/6/2012 0:00:00
TO PERFORM THE FOLLOWING WORK: STRI P & 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 8/6/2012 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner