23A-233 I
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i
OB U I LDE R. Sc
S-COPt O WORK
APRIL 03,2014
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CUSTOMER NAME: Jeff Fowler& Natasha Yakovlev
ADDRESS: 147 Nonotuck Street, Florence, MA 01062
ESTIMATED PROJECT RUN TIMf': 3 - 4 Drays
ADMINISTRATION
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Keiter Builders, Inc. will manjage the following aspects of the project:
i tial Hers:
Building permit applicaiJon, fee,, and inspections
c Standing all necessary i!1spections -«b«
Materials ordering and delivery
o Site set-up and break-driwn
o Certificate of Occuipanciv.
WINDOWS (Please see attached hjitegrity quote #AJP774# for window specifications)
(Please see attached Rjeeb quote#50526 for door specifications)
This proposal includes the following:
• installation of(7) new construction Integrity window units. This includes the following:
o Removal /disposal of 6 isting storm windows, if present
* Removal /disposal of c�i isting interior window trim, exterior trim, sashes, and window frames
o Rough opening preparation including pan flashing
o Cut back existing siding!material to accommodate new nailing fins and exterior casing
o All weather sealing ineltliding low expansion foam and caulking
o New exterior casing using PVC 51'4 or equivalent
o New interior casing, stool, and apron using flat stock clear pine
• Installation of(I) new construction exterior door. This includes the following:
• Removal /disposal of exjisting exterior doer, frame, sill, interior trim, and exterior trim
• Rough opening preparation including pan flashing
• Installation of new exterior door to all manufacturer specifications
All weather scaling inclt.Iding low expansion foam and caulking
* New exterior casing usinie PVC 5/4 or equivalent
o New drip cap at head piece location
o New kick plate
u New interior casing, stood, and apron using flat stock clear pine
• Please note that the following arc not included in this contract: Any painting, nail hole filling, stain, polyurethane, or
other finishcs.
PRICE FOR WINDOWS & DOOF! (Including Tax): $3,788.26
PRICE FOR PERMIT, MISCELL`!kNEOUS MATERIALS, AND LAB OR: $5,800.00
TOTAL PRICE FOR LABOR AND MATERIAL $91W$-26
By signing this Agreement, you al-.knomdedge that you have received a complete and original signed copy of the
entire Agreement and attached b1hibits. Keiter Builders. Inc. may not start tivork until after this Agreement has
been signed.
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DO NOT SIGN THIS CO TRI4CT IF THERE ARE ANY BLANK SPACES THIS IS A LEGALLY
BINDING AGREEMENT. IF 7 HERE ARE ANY PROVISIONS WHICH YOU DO NOT UNDERSTAND,
YOU SHOULD COA"SUL T WI T)II ANA TTORNEY BEFORE SIGNING.
KEITER BUILDERS, INC. OWNER
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b S ott eiter, President Date Date
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Date
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6
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of conservation commissions, are';required to be obtained before Keiter Builders, Inc. can obtain their permits, it
is Your obligation to satisf} such ii,equi rements and you shall meet those requirements at your cost.
STARTING.AND_GNDI�VG
Keiter Builders, Inc. will apply f!br the permits within 1_5 day(s) of`signing this Agreement or your sati
any conditions required to be met;prior to the permits being used, whichever date is later. Keiter Builders, Inc,
will start work within ( days) ci'f
completed obtaining the necessary permits and expects to have the work substantially
within 4 day (s} of starling.
If Keiter Builders, Inc. is delayed':at any time, in the progress of completing the work, due to acts of God
civil commotion, accident, government regulations or policies, any act or neglect of yours, or by any separate
contractor, or by change orders, c r by labor disputes, fire, delay in transportation, unavailability of materials,
adverse weather conditions, unavcjidable casualties, difficulty in obtaining fuel, electricity, services or supplies
from the sources from which they', are normally obtained, or other causes reasonably beyond my control, then
Keiter Builders, Inc. may reasonatly extend the date for substantial completion. If the work is not substantially
complete by the ending date, as e; tended, Keiter Builders, Inc. will not be liable to you for any incidental or
consequential damages you nay iir!,c:ur clue ti, such delay.
If' you are supplying any materials or equipment to be used in the work, you shall have such materials and
equipment delivered to the work site not less than 5 days before they are needed for the work. If they re not
delivered on a timely basis, Keiter !3uilders, Inc. will not be able to schedule work dependent upon the and the
date of substantial completion will be extended due to such delay.
TOTAL- AND_PAYMENT SCHEDULE:
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The total price for performing:
the work and supplying the materials under this Agreement is
Nine Thousand Fiv- 1-1 ndred_ ar
Eighty f;ieht _Dollars and__TVVent} -six Ce,�7ts (! 9,5$$.26) DOLLARS.
Payments against work completed and materials delivered will be made within 2 days from when Keiter
Builders, Inc. notifies you that the,i,, have reached different completion stages. Payments will be made in the
amounts as set forth in the attached''payment schedule.
60% of window cost due with signed contract
40% of window cost + 1/3 labor & misc. material due prior to initiating ($2,272.96)
p >; work
Final payment dine at Substantial (Completion, 03,44$.63)
($3,$66.67)
All sums not paid before substantial completion of the work will be due and payable upon subs
completion. po substantial
Payments due and unpaid under thi:!;; Agreement shall bear interest from the date payment is due at the annual
rate of Eighteen (Iii°io) percent or at the maximum legal rate whichever is Less. In the event that Keiter
Builders, Inc. incurs costs or expen,;es in collecting any payments due and unpaid under this Agreement, you
shall pay such costs and expenses inl(Auding reasonable attorney's fees.
If you fail to make any payments �)-hen they are due, then Keiter Builders. Inc. may immediate) -
Keiter Builders, Inc. may choose to not start ��ork a� y stop work.
gain until you are current with the payments and Keiter
Builders, Inc. feels secure in obtaining the remaining payments. If there is any stoppage in work due, to your
failure to pay on time, or to make Ki�iter Builders, Inc. feel insecure that the remaini
such delay shall automatically extend the date of`substantial completion. g payments will be made,
/'V e--D U(Y .
CONSTRUCTION AGREEMENT
Keiter Builders, Inc., of Northampton. MA whose f=ederal Tax Identification Number is 27-2518846,
Contractor's Registration Numb'�tr 175168 (Exp. 04-29-2015), and License 4102=157 (Exp. 06-20-2014), is
g ' g ��ou Jeff Fowler & Natasha_Yako��lev of 147 Nonotuck St... Florence, MA.
entering into this Agreement ��itil
ALL RESIDENTIAL. CONTIjIACTORS AND SUBCONTRACTORS ARE REQUIRED TO BE
REGISTERED WITH THE ibIASSACHUSETTS BOARD OF BUILDING REGULATIONS AND
STANDARDS, UNLESS SPI"CIFICALLY EXEMPT FROM REGISTRATION. INQUIRIES
CONCERNING REGISTRATION SHOULD BE DIRECTED TO: DIRECTOR, HOME
IMPROVEMENT CONTRAC-,1708 REGISTRATION, ONE ASHBURT'ON PLACE, ROOM 1301,
BOSTON, MA 02018 (617) 727=18598.
SCOPE OF WORK:
Keiter Builders, Inc. will perforrrii the work set forth in the attached Scope of Work on your home, or the
property located at 147..Nonotuck Street,_Florence,.MA. If you would like to change any work to be performed
or materials used, we will have to i?nake such changes through a Change Work Order, which may also change
the total price and extend the date 'ror completion. Change Orders will he handled on a time and material basis.
Keiter Builders, Inc. reserves the right to make minor changes in any plans and to substitute materials of equal
or better quality.
Should Keiter Builders, Inc. encouiitter any unknown conditions below the surface of the ground, or concealed
or unknown conditions in any exisiting structure, you will agree to make an equitable adjustment with Keiter
Builders, Inc. under a Change W'Ork Order, which shall increase the total price and extend the date for
substantial completion of the work.
PERMITS:
To perform this work, Keiter Builders, Inc., or subcontractors hired by Keiter Builders. Inc., will obtain, on
your behalf, the following permits (iii;required):
--x___ Building Permit E:lectrical Permit _ Smoke Certificate.
Plumbing Permit Demolition Permit Certificate of Occupancy
IT IS THE OBLIGATION OF KE!ITER BUILDERS, INC. TO OBTAIN THESE PERMITS AS YOUR
AGENT. IN THE EVENT THAT 'KEITER BUILDERS, INC. DOES NOT OBTAIN THESE PERMITS,
AND YOU OBTAIN THEM, OR %IF KEITER BUILDERS, INC. IS NOT REGISTERED WITH THE
BOARD OF BUILDING REGULATIONS, YOU' WILL NOT BE ENTITLED TO OBTAIN ANY
BENEFITS FROM THE GUARANTEE FUND ESTABLISHED UNDER MASSACHUSETTS
GENERAL LAWS CHAPTER 1411.
Keiter Builders, Inc. obligation to ob,ain permits is limited to those permits directly related to performing the
work Keiter Builders, Inc. agrees to do. To the extent that other permits or governmental or regulatory agency
approvals, such as, but not limited to, 'gone changes, variances, special permits, site plan approvals, or approvals
CITY OF NORTHAMPTON it
Constructi®n Debris Affidavit
In accordance with the provisions of MG.L. c. 40_§ 54, all debris resulting•from any work
-: - waver-ed=by-a-B-uilding-Permt-shalt be disposed-of•in a,propedy licensed.disposal facility,
as defined by M.G.L: c..111' § 150A. .
Address of Work: 7 no ck
.e-debris_v4l.be-transported by:_ -ext V - - g
The debris.will be.rbcdJVed.at:.
--- - -' Signature of Permit-A PO cant
bate '0 '
Buiiding Permit Number:
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The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
1 Congress Street, Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le ibl
.7 44 -e. -e�t� wr/eLe✓� /�r
5t A
City/SWe/Zip:GO�i"�a.vt�t o-b 0�0►00 Phone �f!v�
Aire>ybwan4employer?f Che&4heiapprepriatebox: Ty01406i6t reb
1. 1 am an employer with$ 4. ❑ I am a general contractor and I 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors 7_ ❑ Remodeling
listed on the attached sheet.
2. ❑ I am a sole proprietor or partner- These sub-contractors have 8. ❑ Demolition
ship and have no employees employees and have workers' 9. ❑ Building addition
working for me in any capacity. comp. insurance.$
[No workers' comp. insurance 10.❑ Electrical repairs or additions
required.] 5. ❑ We are a corporation and its
officers have exercised their 11.❑ Plumbing repairs or additions
3. ❑ I am a homeownerSeattle8 doing right of exemption per MGL c. 12.❑ Roof repairs
all work myself. [No workers' 152, §1(4),and we have no
comp. insurance required.] t employees. [No workers' 13.P Other W f lid-6W
comp. insurance required.] (t p 1A_c-e-
v►rt t v�
*Any applicant that checks box#I 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. " p� � ��� C�
Insurance Gompiiy lame �[Q 1/ �(-Q r S /
Policy#or Self=ins.Lic:# I C 2 4,5 to 5-7 Expiration Dater
1611 Stfe)kddre ist All Locations City/Siate/Zip:
/,f7 Aj6n o4u e_= A4 Ar- 6 16 fo Z
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 c rtifjv.undee the pains and penalties of perjury that the information provided above is true and
correct.
Signature. Date:
Phone#:
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. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other:
Contact Person: Phone#:
ZAWorkers Comp Aff-Highlited.doc
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: // Not Applicable ❑
Name of License Holder: S C OT-I- C�S -- 2
License Number
5� A- &/26 106 14
Addr'ss pp Q Expiration ate
Sp �P" p
lure Telephone
9,Registereg Horne Improvement Contractor: Not Applicable ❑
R.e-1'1-e r u r' .c / 75 I ( S
Cornpanv Name Registration Number
'514 �-�� � �/ /z9
Tress Expiration Date
MA— Telephone5$6 "-F(ab
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...... ❑
11. 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 1083.5.1.
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 al2 lio cable)
New House ❑ Addition ❑ Replacemendows Alteration(s) ❑ Roofing El Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding[O] Other[Q
Brief Description of Proposed
Work:_/ote-em e4g I o 7 tn7i nd Hsu In a-yi "-I-ert'ar do-D r
Alteration of existing bedroom Yes No Adding new bedroom Yes )e No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a. if New house and o dffion to existirici housin-g. o ' let a ow' ,.
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
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 applic tion are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print N me
at re of OwneprAgent 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 t
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 0 DON'T KNOW YES 0
IF YES, date issued:'
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW YES 0
IF YES: enter Book r 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 0 , Date Issued:
C. Do any signs exist on the property? YES I 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:
E. Will the construction activity disturb(clearing,grading,91cavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Depailmetlt use ofily-
��.1_' City of Northampton tatusof,Perrn '
Building Department Curb C-6t/Driv rey Pdi it
2014 212 Main Street Sewer/S60,tic Avallabili''
Room 100 1Na#er/I+Ua1IAvaliabAi#y
Plumbing&Gas Itor
e orthampton, MA 01060 1 Sets of°StruAral 014'.0
New
P
Northampton,MA 01 nspec ne 3-587-1240 Fax 413-587-1272 fmt/lahe Pl
Other i? , i -
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
q7 /VM 0 411 Map Lot Unit
r-e Pi Lt M A- o i e fo 2 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent: .
co44-K-P-r el�erc� l\ P->'-�°V S c 51 �t���i.��o� l-I� I�lo►'7 �a�tp'{�'�
N a 1 (Print) Current Mailing Address:
a
52(o -$(O66
i ature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applic ant
1. Building G , 2to (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) Check Number Q
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature:
Building Commissionerllnspector of Buildings Date
147 NONOTUCK ST BP-2014-1074
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23A-233 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: window replaced BUILDING PERMIT
Permit# BP-2014-1074
Project# JS-2014-001845
Est. Cost: $9588.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SCOTT KEITER 102457
Lot Size(sq. ft.): 22433.40 Owner: FOWLER JEFFREY P&NATASHA R YAKOVLEV
Zoning. URB(100)/ Applicant: SCOTT KEITER
AT. 147 NONOTUCK ST
Applicant Address: Phone: Insurance:
5 1 A HATFIELD ST (413) 320-9035 WC
NORTHAMPTON MA01060 ISSUED ON:411712014 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 7 REPLACEMENT WINDOWS & ENTRY
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:
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 4/17/2014 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner