29-186 9. COOPERATION. That the OWNER(S)shall cooperate with the CONTRACTOR to facilitate the
performance of the work. The CONTRACTOR shall keep the premises clean and orderly during the course of
the work and remove all debris upon completion of the work. Materials and equipment that have been removed
or replaced as part of the work shall belong to the CONTRACTOR.
10. The CONTRACTOR shall indemnify and save harmless the OWNERS)from any and all liability for any
injury or damages to persons or property resulting from the prosecution of work under this CONTRACT.
The undersigned shall have no claim against the Department of Housing and Urban Development, the
city of Northampton or any person acting on behalf of them,for any action taken pursuant hereto to the
completion of this contract. However, nothing herein shall be deemed to affect such rights of the
aforementioned to lay claim against any CONTRACTOR for breach of contract of for actions otherwise
connected with such rehabilitation work.
11. DISPUTES. The PROGRAMshall, within a reasonable time, make decisions on all claims of the OWNER
and CONTRACTOR and on all other matters relating to the execution and progress of the work or the
interpretation of the Contract Documents. The Program retains the right to interpret contract documents and
disputes arising therefrom. All decisions rendered by the PROGRAM hereby shall be final and binding on the
OWNERS)and the CONTRACTOR(S).
12. WORKMANSHIP. The work hereunder by the CONTRACTOR shall be executed as directed by the
proposed work items and materials and performance standards in the most sound, workmanlike manner. All
materials shall be new unless otherwise expressly.set forth in the work specifications.
13. COMPENSATION. That for the consideration named herein, the CONTRACTOR proposes to furnish all
the materials and do all the work described in, and in accordance with, this Contract for the sum of$Six
Thousand Four Hundred and Seventy-five 00/100 dollars
Upon completion of this agreement, the PROGRAM will provide a Loan not in excess of
$6.475.00 to be applied as final payment for the completed rehabilitation work. The balance of
$00.00 shall be paid by the OWNER(S)to the CONTRACTOR.
14. EFFECTIVE DATE OF AGREEMENT. This AGREEMENT shall not become a Contract binding upon the
parties connected until these parties have properly signed this-AGREEMENT and the CONTRACTOR for the
respective deferred payment loan has received authorization to proceed.
15. All contract prices are final. They are firm quotes, not estimates. No changes will be allowed on the work
as bid unless authorized by the PROGRAM.
16. ALL CONTRACTORS agree to abide by the Material and Performance Standards.
10
Owner's Signature Date
"�A ?- - vc
C07 ctorIS-Sig e Date
Director—Council on A Date
r —
a
NORTHAMPTON COUNCIL ON AGING
HOME REPAIR AGREEMENT
By and Between
Helen and Wayne Torrey (Owners)
And
Dave Johnson (Contractor)
Whereas the OWNER(S)desire to engage the CONTRACTOR to perform certain repair work on the OWNER'S
premises, the CONTRACTOR, OWNER, and PROGRAM,for the consideration hereinafter named, agree as
follows:
1. LABOR AND MATERIALS. The CONTRACTOR agrees to protect, defend, and indemnify the OWNER from
any claims for unpaid work, labor, or materials with respect to the Contractor's performance.
2. PERMITS AND CODES. The CONTRACTOR agrees to secure, and pay for all necessary permits and
licenses required for Contractor's performance with applicable local codes and requirements, whether or not
covered by the specifications and drawings for the work.
3. EQUAL OPPORTUNITY. The CONTRACTOR agrees to provide equal opportunity to all persons, without
discrimination as to race, color, creed, religion, national origin, sex, sexual preference, marital status, age and
status with regard to public assistance or disability.
4. UNACCEPTABLE RISK. The CONTRACTOR represents that at the time of execution hereof, it is not listed
on the Disbarred and Suspendable Contractors list of the U.S. Department of Housing and Urban Development.
5. LIST OF IMPROVEMENTS. The CONTRACTOR acknowledges that he has reviewed the list of the
Proposed Work Items (attached herein)and that such list is accurate and consistent as to scope of work,
Contractor's proposal and the work, which the Contractor will undertake.
6. SUBCONTRACTORS. The CONTRACTOR agrees that all the warranties contained herein shall apply to
all work performed under the Contract including that performed by subcontractors.
7. METHOD OF PAYMENT. The CONTRACTOR may make application for payment as soon as work has
been completed. Final payment shall include the releases of any liens by subcontractors, laborers, and/or
material suppliers. Upon approval of the completed rehabilitation by the OWNER and the PROGRAM, the
contract shall be paid in full, except for an amount equal to 10%of which will be held for 30 days after
completion of the work unless waived by the PROGRAM.
Acceptance offinal payment by the CONTRACTOR shall constitute warranty by the said contractor
that any and all mechanic's liens arising from this contract have been released.
That all amounts due and payable by the OWNER to the CONTRACTOR for the work performed shall
be payable within a reasonable period of time after the work is satisfactorily completed, inspected and
approved by the OWNER and the PROGRAM.
As a condition to receiving final payment hereunder the CONTRACTOR shall deliver to the OWNER a
warranty covering all work performed hereunder to the effect that such work shall be free from defects arising
from the workmanship of the CONTRACTOR or any subcontractor and as to the specified quality of materials
used therein,for a one-year period commencing upon completion of this contract.
8. Changes. It is agreed by the parties hereto that, after the Contract signing, no changes can be made to
the work listed in the Cost Estimate or in any addendum unless approved by an amendment to the contract and
endorsed by the OWNER, CONTRACTOR, and the PROGRAM. Any agreement or amendment not signed as
heretofore indicated shall be considered null and void.
¢St1AMp�, ,
O O
ti$ Lzt-g of Xazt4ttuiptan
DEPARTMENT OF BUILDING INSPECTIONS /=
INSPECTOR 212 Main Street • Municipal Building
Northwnpton, MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as has/her construction supe:-,- sor. 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
� A��yEU,rl� t7I �t11:f1�c1111�JiIIll _�—�=
u o DEPARTMEVT OP BUILDr,G INSPECTIONS
212 Alain Strcct ATunicipal Building
Northampton, Mass. OIOGO
«rOR ' R'S COKPENSATION C`ISURANCF AFFMAVI-l'
is
(ii ccns--dpermj acc)
vrith z pr"Mcipal place of business/residence at:
y f/ tQ V lam ! l� ACC7�. Lf f r !dt w.n b in.r� (phone:') c3L&g -73W
f (sa�tici ty/ a t r�zj p)
do hereby certify, under the.pami and penalties of penury:; lhai
t -
( ) I
am an employer providing the followine workces coinoensat;on coverage 'or in
elnptovices worong on ties job:
(Lanlran= COM _C,)' --- -
(Pcucr Nu r) (r:"plf�lior, D2j-}
O I am a sole proprietor, general contraaor or hotneowver (cl cie one) and Lave hired
the coasactors Este+ below who have the following workers comoerl_sa ion policies:
(i+�t11C Of Coninaor) Onsurziicc Coinpa+i)-i ob-i i,!umh,-:) (Expii-auon bate)
I
f '
(N me of Cootrcror) (Lnsa=cc aMD'aaYlPOLIei NU06cr) (Lx-Diration Date)
(Name of Connacto;) (Lasuranc:CompanyROL-q- N Lmtj) (Expirdoo Date)
-
(Name of Coatraaor) (Insurance Company/Policy Nutnb r) (Ex pu-a6oa Datr).
(n¢ac�=ddit:ocal rbtc,irnccci.�-tc a�crucL inform��oa pataisias to.11 000 -�o:s) ,
({� I am a sole proprietor and have no one wort ng for me.
( ) I am.a home owner performing all Lhe work myself.
NOTE:plese be ncrxrc t*_c NtJG hcmeovvcrs wbo en�t%Pe soup eo S� -. ��e�oo c rcp jr Boric oo,d,,cU Z of
ooe mocc the Lb:--ors in u'y kbc botnoo-ocr raid=a oa the 1��:ppurtearl thee=nZ ooe C e=2p oecid=cd to he
citploycs un -the kui ds�w Act(GLI 5Z=1(5)},rpplioDoo try a bomcoovc for n Gczr.cc pcsma rLy c%4&z=the
1 ctaau oC
m e..�loyx wader dae Woc'fccle
I +nda sL ad t>'d a copy of a l"mt cm may be fell a,i ad to Lb-(}.p�� of lodusricl AxcdccdY OT,—or G=--o-for tbo
co�vc if c=ioa&ad th1 L-L=to Lcouc eorcrngt tmd-soetioa 25A of?,(GL 152 ran I=d to tba i=poaitioa of cimiwl Pcn-% -
cows=Z or a[ice OruP to SI-MW=Idfoc b=4a-i3.cc i oCup to ooe yur Lod c%il p o tum is to rocm of a Stag Work Ord-and a
fire 0(:;1 WOO r d--y rgaia-�j m,-
For d,=,�--ody
Permit Number
Sit�,Z�n of Li cr7rtiucc L?3te -- -� g
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:�� Not Applicable ❑
Name of License Holder. 0 "s0A Q,!�-N-90 3
License Number
Pd wx 39J- /,Ui1�►a.,.1b�.. �1� 6 ---)-9- o
Address Expiration Date
X739
Signature Telephone
nf Co tractocw. s - �r r Not Applicable .0 9A Qed w6f IKme
Comp/a�ny Name nn Registration Number
bT fl CQ�tp loAl MUD Q)[� �1 V�Sa 7/`7/ O$
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(U,.G:L,c.1"52,-§;-25C(0
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...... IJ
RE
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 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
SECTION S DESCRIPTION OF PROPOSED WORK(check aft applicable)
New House ❑ Addition Q Replacement Windows Alteration(s) Roofing
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs (pj Decks (0 Siding(0] Other(p]
Brief Description of Proposed
Work: 2914 GQ &� �/1 1 T'f JK+i'w k r Ct.iy1 Ob,Q
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a_ff 'ew�oas a�t2>�.c alrvtOxfn+giausE corpcee= aufct:
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 C;nnservation 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,At.ITHI0RIZATIOK TO BE COMP LET ED=WHEt
OWNERS AGENT76k CONTRACTOR APEC IES F..OR`BUICDING.PERMIT;
I, as Owner of the subject
property
hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
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.
A V,
Print Name
Signature of Owner/Agent V 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
Lot Size
Frontage
Setbacks Front
Side L:+—.___ R:' LL__._._, R.t._�
Rear
Building Height
Bldg.Square Footage % --
Open Space Footage % 7-7
(Lot area minus bldg&paved
parking)
i
#ofParking Spaces
i 3 ---
Fill: i
volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DON'T KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DON'T KNOW Q YES 0
IF YES: enter Book Page' and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW Q 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 Q NO 0
F
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 Q
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 Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
City of Northampton
building Department
12 Main Street
Room 100 3ellt( t��
N6rthanhpton, MA 01060 be
phone 4121-587-1240 Fax 413-587-1272 i an
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1°-SITFEINF.ORMAT.ION:
d h, Wt
1.1 Property Address This sectrarto he com fete h t
� Z 1
Map Lot Ut
/ L� Zone. OverfaD�tctcf
or-evk r-e A �
�`FkC�.DistrRCt.
�E�S�Dtst[tct '
SECTION 2-PROPERTY'OWNERSHIP/AUTHORIZEDAGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address: c
Telephone
Signature
2.2 Authorized Agents r
4) 19 L,"~l A vi sc.A 3 ?y L-CllI huv1J /L1
Name(Print) Current Mailing Address:
a&K' 7: 6
Signature Telephone
SECTION�3:-ESTIMATED,GONSTRUCTION COSTS,
Item Estimated Cost(Dollars)to be Official Use Only
--
completed by ermit applicant
1. Building c (a)Building=Permit Fee
2. Electrical -(b)Estimated Totat Cost of ' f
yCXT Construction from: 6
3. Plumbing , Building Permit Fee,
4. Mechanical(HVAC)
5. Fire Protection A au
6. Total=(1 +2+3+4+5) ivroo Check Number
This Section For Official Use Only
Building Permit Number. Issued:
Signature:
Building Commissioner/inspector of Buildings Date
w"` .It
File#BP-2007-0283
APPLICANT/CONTACT PERSON David Johnson
ADDRESS/PHONE P O Box 390 WILLIAMSBURG (413)268-7389
PROPERTY LOCATION 126 DEERFIELD DR
MAP 29 PARCEL 186 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: REPLACE BATH FIXTURES,FLOOR&DOOR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 055903
3 sets of Plans/Plot Plan
THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF91MATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Co s on
�00 1,150fle,610
Signature of Bui ing Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
126 DEERFIELD DR BP-2007-0283
CIS #: COMMONWEALTH OF MASSACHUSETTS
Ma .Block:29- 186 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2007-0283
Project# JS-2007-000429
Est. Cost: $6400.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: David Johnson 055903
Lot Size(sq. ft.): 15028.20 Owner: TORREY WAYNE P&HELEN F
Zoning: URA Applicant: David_Johnson
AT: 126 DEERFIELD DP
Applicant Address: Phone: Insurance:
P O Box 390 (413) 268-73.89
WILLIAMSBURGMA01096 ISSUED ON.911512006 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE BATH FIXTURES, FLOOR & DOOR
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:
J
Final: 'f"",t,�"�� � Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: 0/�
THIS PERMIT MAY BE REVOKED BY THE C "Y OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
Feel e: Date Paid: Amount:
Building 9/15/2006 0:00:00 $50.001867
212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo