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23A-186 (6)
8 PINE ST BP-2007-0513 GIS#: COMMONWEALTH OF MASSACHUSETTS Man:Block:23A- 186 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2007-0513 Project# JS-2007-000747 Est.Cost:$7980.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: WALT KOWAL 124626 Lot Size(sq. ft.): 39291.12 Owner: LEVINE HANNAH Zoning: URB Applicant: WALT KOWAL AT: 8 PINE ST Applicant Address: Phone: Insurance: 13 REDDEN RD (413) 782-2656 () Workers Compensation SPRINGFIELDMA01119 ISSUED ON:11/2/2006 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 11/2/2006 0:00:00 $25.00MO 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo } •I \s c OE • Department use only City of Northampton Status of Permit: ^, Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability 20O6 Northampton, MA 01060 Two Sets of Structural Plans • SE( \\01 • phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Ov Other Specify 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 v /%2-t 7 f` Map Lot Unit Zone Overlay District Elm St.District_ CB District — SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1,OOwner of Record: &O/)ct/) / f(J l f7 .7 r ✓7`' Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: 11/4(/t /l 'c.t'ct //17'e' Name(Print) Current Mailing Address: 7j /v:/ Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS !. 7 e) Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building roof �lri`� (a)Building Permit Fee 2. Electrical YY�� (b)Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+ 5) Check Number r ;: This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ( I Addition ❑ Replacement Windows Alteration(s) Roofing ri1/4 I Or Doors E Accessory Bldg. Demolition ❑ New Signs [O] Decks [0 Siding[D] Other[O] Brief Description of Proposed / Work: //'/0 , do ! �/7/'f 9 `' 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 and or addition to ezistinq housing `completethe fo1Iowinq: a. Use of building : One Family X 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? 6 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? X Yes No . I. Septic Tank City Sewer Private wet City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT , 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 1, Le/fl ! ' < ` V f' y/ , 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. Wzi /7 /tiCMG/ter,Print Name Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone 9.Registered Home Improvement Contraefo% ,; � Not Applicable ❑ 'c--' / Z '/6? Company Name Registration Number • / "Prc/) 2 (/'�"( 7^ c -2 Address Expiration Date iy Ae// Telephone J / v//0 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 0 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 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 • • • • 10 • os- F1 `� .,ti (rii� of {orfl)ailt}�;olt 1', •e Va14.1"/ f rlcssarilosrtle• . V�1 7 - _ DEPARTMENT OP BUILDING INSPECTIONS 212 Train Street. ' Municipal Building • Northampton, Mass. 01060 r'y WORKER'S COMC PENSATION [NSURA.NC E r1I'1.3)A V1T et4 • (licciis 'permittcc) with a principal place of business/residence at: • ,.ed1 'ii /er4 (phone#) r71'// os • (sUt/city/staiezip) do hereby certify, under the pains and penalties of perjury; ilia' • • ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: -o _p ansuran=Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (ci cie one) and have hired the contractors listed below wbo have the following worker's cotpensadon policies: (Name of Coat:maww) (Insurance Company/Policy Nu n±c ) (E';Jtrduon Date) • (Name of CooD Qor) (I11$urance Comnaa.'iPo!icy Num6r.r) (expirtion Date) • • (Name of Coaoaaor) (I.asuranca Company/Polio' Nambes) (Expiration Date) • (Name of Contractor) (insurance Comcany/Policy Number) (Expiration Daft). (•bath ifOM- •-,to aid&infor�OG yCru s ...I n) ( ) I am a sole proprietor and bave no one worh.ng for me. ( ) I am.a home owner performing all the work myself. • NOTE:pt e be torare the.M4.:Jc bo©eowocrr wbo aaploy pe-svaa to do-•M�in-r ear.--.•r�oo a/gnu work oz I d••ell_n of cot more th o th t tj is which the ba oov.- a raido or oe the croto0da zpp stews_tbceo 0° _ ,ally ocrridani to be ctptoycs uole the t ecStk ems•-••fie•-lion Act(GL1S2s l(5)),appliaaoo by•bomeoava fee lipic a p..,an may cridcocc the legal rasa of Dz gloy.r coder ciao Worked•Coom.tioo Act I uoderstand tha a Dopy of this mt®con may b.forward.d to tbo popersmoo of 1 •sni Aoodrad onion or for tb• c°"'Q-L,st vaif cioo Dad t1L a L-atae to&ooure boverace undo section 2Sn of Mat-152 an tad to the imposition of mimio:l pco... yet oc�r'-f c f-'of a floe of up to S 1300.00 sad/or anti up to one yr r Lod c si1 pr*•ttio is eSc form of a Stop Work Ordoe and• • ft=of S I a day Mayan tnc For dcp.rtmr-o-J vac oniy PermitAtl.mbG` QCMang__ Lot K Signature of LiomsccJPcrntiuce Dace ¢T11wM pl, c \ 1 �� "()-1t 01,z# of Nortlianipton . _ Q r � ."tf., 4 PAff ACtlf tttf -_t`s / $te `m-r DEPARTMENT OF BUILDING INSPECTIONS `IN /: INSPECTOR 212 Main Street • Municipal Building 'o = 5 Northampton, MA 01060 �~ r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction sups: ,• 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 backf ll)t 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 • • General Contracting & Property Services 13 Redden Road Springfield,Mass. 01119 (413) 782-2656 Cell phone 575-1105 IIIC Lic #124626 We hereby submit specifications and estimates for: Roof Customer Name: Asilammikilealwitf cx.-----Q &Avl ham. 8/16/06 Street: 8 Pine St ' Cg/g 96/ .-2.79/ City,State and Zip Code: Florence, MA Phone: 586-2345 (1, )5 6/0 -�-4- Re: • We will strip the roof of the house and dispose of the material. • We will apply Ice Guard 3 feet up. • We will apply 15 lb felt paper on the rest of the roof • We will install new drip edge. • We will install boot for the vent pipe to aid ventilation. • We will install the appropriate length of ridge vent. • We will apply Elk 30 Year architect shingle.. • We will apply for the permit. • We will apply 1/2"plywood on to the main house. • The flat roofs in the back of the house will receive a self adhesive membrane. • This roof has slate shingles underneath the asphalt shingle on the main house • We propose hereby to furnish material and labor complete in accordance to above specifications for the sum of $ 7,980.00 All material is guaranteed to be as specified. All work to be completed in a work man like manner according to standard practices. Any alteration or deviation from the above specifications involving extra costs will be done only upon a written change order. The costs will become an extra charge over and above the estimate. This is to include, but is not to limited to,hidden damages that are uncovered during the course of the job and additional work required by local building inspectors. All elements of this agreement are contingent upon delays beyond our control. The estimate does not include material price increases,or additional labor and materials which may be required should unforeseen problems arise after the work has started. You,the buyer,may cancel this transaction at anytime prior to midnight of the third business day after the date of this transaction. Cancellation must be done in writing. Acceptance of Proposal: The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made half down when material is delivered and the labor is started,quarter payment due when half way through and remaining balance due when job is completed. (Please do not hesitate to call me if you have any questions at the ve n be PeCt/71-e/2 /99y