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17A-173 (2) t • Roofing 51B Holyoke Street P.O. Box 309 Estimate Date Easthampton, MA 01027 Phone (413) 527 -4775 4/29/2009 Fax (413) 527 -8469 Name / Address Job Location Beverly Shaw Garage Roof Only 40 Howes Street 40 Howes Street Florence, MA 01062 Florence, MA 584 -5399 Terms Rep Estimate valid for 20 days Rich Job Description Total Remove existing roof on driveway side addition only. 3,430.00 Furnish & install aluminum drip edge, pipe fleshings, chimney flashings and step flashings. Furnish & install CertainTeed Winterguard ice & water barrier along eaves, valleys and entire low- sloped portion. • Furnish and install synthetic underlayment over existing deck. Furnish and install 30 year CertainTeed Woodscape Series shingle. Furnish and install CertainTeed approved ridge vent. Replace gutter approximately 14' of gutter along driveway side of addition. Replace elbow on existing downspout. Furnish and install leaf guards on house and addition gutters. All exterior roofing related debris to be removed by R.C.I. Roofing. All work will be performed according to manufacturers' specifications. 5 -year RCI Roofing workmanship warranty included. 30 year CertainTeed material warranty included. All related permits will be obtained by R.C.I. Roofing. SPECIAL ITEMS NEEDED Add $2.50 per sq. ft. for wood decking replacement if needed. N TALL L 6..D Co v N rrgrl S �► N �) (IN11 5 W,A 9 .J 0.16 a i p L o'PC) THE OWNER HAS THE RIGHT TO CANCEL THE CONTRACT WITHIN (3) THREE BUSINESS DAYS OF DATE OF SIGNING. Total • TERMS OF PAYMENT 5 %:Deposit Balance upon completion Customer Signature Registration # 126235 Construction License # 074334 Date (e v Insured by Reynolds, Barnes & Hebb, Inc. 413 - 447 -7376 Page 1 ' QN -2O P O '` r ( t of p. ` ISZ�[ Mil �IItt to .. 'p��1':_ � ,lassssdtnsctts' R � in '� "" DEPARTMENT OP BUILDI]ZG INSPECTIONS -, 1; . N 212 Main Street ' Municipal Building fi Northampton, Mass. 01060 Z ' go WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, .. . - • I I • • 0,4 ( icensee/permittee) with a principal place of business/residence at: . .. _ al, - ' e di ii, •_„ •,.4 • .. O 1 (hone# - ??5 J city/state/zip) do `iereby certify, under the pains and penalties of perjury, that: (I am an employer providing the following worker's compensation coverage for my employees working on this job: 1J0..\= onee.\ %AA 'F', •'�. :i..ns . co. oG Q'.4rsco , pith W C 3 i.sri vg 10-S-01 (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Data) • (Name of Contractor) ' ' (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) • (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (r u.uh additional shoot if neoesury to iochudo informal= pertaining to all 0000votocs) ( ) I am a sole proprietor and have no one working for me. () I am a home owner performing all the work myself. . ' • • NOTE: *tut bee aware that vrbilo h om m pas= oowo who employ p to do tmnt or, ooastractibo'at mar gods es tirnWeg t nc: roam than three units in which the bon seewoar resides of on the pounds sppwttette t thereto see not aeoesany eomidae! to be csaloycs under the wocicet't coovecoatioo Act (GLI52,34(3)), appliatioo by a boareowoec far a bogies or pewit mty **wad* the :cgi1 rtaaia of an employee uadorthe Woekcs'i Coaopcoattion Amt. • • I waderstaad thzt. a 000py of thin asateaseas may be forlwudd to the Dcpastmsot of lmdttsttiel Mideetttt Omer disown Otto C" Ygeogka xnd that ftiltt;e to MX comp Wee W. MX IS3 tISA tea t+o dot Impanels dallied loft a outsistin of& fine of up to S1,S00.00nuke imprisonment of tip to one rat end eivlipemtftiaindm hem ofa Stop vetoer ids , fire of 5100.00 a day &Oast toe. • ttrettly •,,.. , ' tordepetseseW r . , ......000.2.........d< PtIrait N �i1 3 ;11 t , S . �uatm e of Date .„,......--.-• � a..�.r.��rrr ! ,, a . Lccesecf i■ • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : M -11 h "Del is k . . 1/ License Number • t O �a • as I iii . • 4. 5 -03 -10 Address Expiration Date (4 3)52 ? -4r/75 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ fi. C. T. Ro f i J 1262.55 Company Name Registration Number 5 5 -Q6- r0 • Aaoreaa Expiration Date SO Lill aYllplOY1 Ma , O1o13 Telephon,01 ? ??5 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 ❑ H. - 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 buildin¢ 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, voq 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 a,t.a(?le(1 . • yY ItA- lb SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing 1:36 1 Or Doors D • • Accessory Bldg. ❑ Demolition ❑ , New Signs ED] . Decks ,[Q . Siding [CO Other la' - • Brief Description of Proposed }- Work: 2.tarh.P1i 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 existing housing, complete the following: I a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms _ ;.. J . 1 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 I, Qe--\,) ev 5\ICt , as Owner of the subject property hereby authorize t aY .Ue i S , P !1T f ] • e I . Rco to act on my behalf, in all matters r ative to work authorized by this uilding permit application. 9 . A,taxhed - -3 - 01 Signature of Owner Date . I , IA. 1 11- I • • • • 0 .1 , as Owner /Authorized . Agent hereby declare that the statements and information on the foregoing . t 'lication are true and accurate, to the best of my knowledge and belief. ' Signed under the pains and penalties of perjury. : Mark II mo, Print Name Signature of Owner /Agent Date • v. 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 I i I F .-------- ..._.. _. ._,._.._ _ ,_.. Frontage 1 1 1 I ....W - - - -w_ _._-_-1 Setbacks Front Side L:l ' R:I.. I L.IL I R:11,_ I [ _ 1 ---- 1 Rear [. 1 Building Height ; 1 L____1 1. -1 Bldg. Square Footage i i i % Open Space Footage (Lot area minus bldg &paved . i i ..... _ . ■ ! I _ parking) # of Parking Spaces �I 1 - Fill: 1 , 1 (volume & Location) ._ ,_.. __._ , A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued:L __ I . IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW 0 YES O IF YES: enter Book I 1 Pagel J and /or Document # C --___ B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained © , Date Issued: C. Do any signs exist on the property? YES © NO O IF YES, describe size, type and location: [ 0 1 D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO O IF YES, describe size, type and location: I 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 O NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. VAT's* _;. 11 • City of Northampton Sta Building Department CurbC '.� a +� • 212 Main Street Se`INe!rt,f1 ti ts V ;\ 'r • Room 100 vfe, r i�iF ra Northampton, MA 01060. � phone 413- 587 -1240 Fax 413 - 587 -1272 Pio 4, iA' APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION This section to be completed by office 1.1 Property Address: ` t 0 t k w z Y . ma -, •• Lot Unit Zone Overlay District . • Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record; e J 14 Lo C' 6 c i _ill C Name (Print) Cum t ht-lope Address: \S� � c at } a e)ie� Tele hone / 1 J Signature - 2.2 Authorized Agent: Ma Yik 1)P. le - ,.C.L R oof, .. Si Name (Print) J Current Mailing ddress: Q l 0`13. ('13)527 - 4775 .. Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building QOQF) 4 3 c t so 00 (a) Building Permit Fee 2. Electrical i v (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Are Protection 6. Total = (1 + 2 + 3 + 4 + 5) $ 3 -j , (� , OLD Check Number /gilt' j'6 This Section For Official Use Only Date Building Permit Number. Issued: • Signature: Building Commissioner /Inspector of Buildings Date • • l a Y •( li ` BP- 2010 -0151 GIS # COMMONWEALTH OF MASSACHUSETTS k. l7A - 173 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- 2010 -0151 Project # JS- 2010 - 000181 Est. Cost: $3430.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RCI ROOFING 74334 Lot Size(sq. ft.): 14984.64 Owner: BASSETT THOMAS A & BEVERLY A S Zoning: URB(100)/ Applicant: RCI ROOFING AT: 40 HOWES ST Applicant Address: Phone: Insurance: 6 LINE ST (413) 527 -4775 Workers Compensation SOUTHAMPTONMA01073 ISSUED ON:8/7/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF ADDITION 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 8/7/2009 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo . k c., t......-A T _,_,,„ , •\ \ ,),:-.. ' `7I lV I t /t- • ---0<th ) . . )1 - ' // - 1111 11 "0.011111.11 11 M. 1.10111111.1111111.11.111111111v 1 (2/ lee" _—_------ .-- 1,0 JA e \ • (an b \c\ \4173r) /I — \ IP 1 N ), , \ 7 A1 .,......Axo%.5 ...,-7 li vii. • 'IV- t:4 ,,,,,,,,,,,,,,„:" ‘\ "7- :: 7 :-------"::' 321.r \-). .rq • \ `,- `-----„,,,, -',,,lite itelltig tc-.,-,(Ii>\8 \( +kil .. /-- .,--, • ,_. SYk\-.4s5''A i )( 7"7-7 . , jx bss c..r)-51 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS THE MA. SACIIUSET TS STATE BUILDING CODE c ding/roof area of the addition combined. 780 CMR TABLE 6101.3 If any individual fenestration component PRESCRIPTIVE ENVELOPE COMPONENT e ceeds the maximum U- factor listed in CRITERIA ADDITIONS TO EXISTING 7 0 CMR Table 6101.3, then the LOW -RISE RESIDENTIAL BUILDINGS a- weighted average U- factor for all [MAXIMUM MINIMUM Ceilings , f- estration components must be less than or f Slab Basement ual to the listed value. The R -value !Fenestration ex and exposed Wall Floor Wall I Perimeter; re uirements for opaque envelope floors a 9 ue thermal envelo U- factor p I R- ValuetR- Value; R -Value R -Value I c mponents indicate insulation products R-Value and Depth (.vity and/or insulating sheathing), and 0.39 R37 R13 ! R-19 R-10 R -10, s all be equal to or exceed the applicable f 4 feet li. ted values found in 780 CMR Table For SI: I foot — 304.8 mm. 6 01.3. If such addition is separated from a. R -30 ceiling insulation may be used in place of R -37 t main house by a wall or doors and is if the insulation achieves the full R -value over the conditioned, then a readily accessible manu entire ceiling area (i.e., not compressed over exterior al or automatic means shall be provided to walls, and including any access openings). p< 'ally restrict or shut off the heating 6101.3.2.3 Historic Buildings. Historic a dlor cooling input to the addition space. buildings, as defined in 780 CMR 9309 of T tat portion of a wall that separates the 780 CMR 51.00 through 99.00, are exempt a dition from the existing building/dwelling from the requirements of 780 CMR 61.00. u. it, if an existing exterior wall, shall be 6101.3.2.4 Change in Occupancy. A change a owed to remain, and neither that portion in the occupancy or change in use of an o 'said wall nor any fenestration within said existing building or structure shall be irtion of wall common to the addition need permitted, subject to the applicable provisions c Imply with the thermal envelope of 780 CMR 93.00. requirements of 780 CMR 61.00. Exception: Sunroom Additions/ 780 CMR 6102 MATERIALS, SYSTEMS Consumer Notification: Sunrooms, as AND EQUIPMENT defined in 780 CMR 52.00, shall be 6102.1 General. Materials, equipment and systems exempt from the compliance requirements shall be identified in a manner that will allow a set forth in 780 CMR 6101.3.2.2 and determination of their compliance with the 6101 .2, provided that the actual property applicable provisions of 780 C MR 61.00. owner (not the owner's agent or representative) of the structure onto which 6102.2 Materials, Equipment and Systems the sunroom addition is being made, installation. All insulation materials, caulking and provides a signed copy of the sunroom weatherstripping, fenestration assemblies, "CONSUMER INFORMATION FORM" mechanical equipment and systems components, and (found in 780 CMR 120.P) to the Building water - heating equipment and system components Department. This signed "CONSUMER shall be installed in accordance with the INFORMATION FORM" shall be manufacturer's installation instructions. submitted to the building official as a 6102.3 Maintenance Information. Required requirement of building permit issuance, regular maintenance actions shall be clearly stated and shall remain as part of the construction and incorporated on a readily accessible label on the documents. If such sunroom additions are equipment or made otherwise available for separated from the main house by a wall permanent reference. Such label shall include the and are conditioned spaces, then a readily title or publication number, the operation and accessible manual or automatic means maintenance manual for that particular model and shall be provided to partially restrict or type of product. Maintenance instructions shall be shut off the heating and/or cooling input to furnished for equipment that requires preventive the sunroom addition space. That portion maintenance for efficient operation. of a wall that separates the sunroom addition from the existing 6102.4 Insulation Installation. Root %ceiling, floor, building/dwelling unit, if an existing wall cavity and duct distribution system insulation exterior wall, shall be allowed to remain, shall be installed in a manner that permits inspection and neither that portion of said wall on any of the manufacturer's R -value identification mark. fenestration within said portion and 6102.4.1 Protection of Exposed Foundation common to the sunroom addition, need Insulation. Insulation applied to the exterior of comply with the thermal envelope foundation walls and around the perimeter of slab - requirements of 780 CMR 61.00. on -grade floors shall have a rigid, opaque and weather - resistant protective covering to prevent 776 780 CMR - Seventh Edition 12/28/07 (1/1/08) ti r We propose to furnish the material and labor necessary for the completion of the above stated work for the sum of: Ninety Thousand Six Hundred & Six Dollars. $90,606.00 Payment as follows: $20,000 upon completion of the foundation/backfill, $20,000 upon completion of the water -tight shell (Roofing, Windows & Doors) $20,000 upon completion of the exterior (Siding & Deck) $15,000 upon completion of the rough inspections, $15,606 upon completion of the project. (Certificate of occupancy) All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviations from the above specifications involving extra cost will be executed only upon written orders in the form of a change order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire tornado and other necessary insurance. Our workers are covered with workman's compensation insurance. Certificate of liability insurance will be sent to the above address upon signing. Note: This proposal may be withdrawn by Harlow Builders if not accepted by within 60 days. Respectfully Submitted by of Harlow Builders. ACCEPTANCE OF PROPOSAL I accept the above stated prices, specifications and conditions. You are hereby authorized to do the work as specified. Payment will be made as outlined. Date firth 227/) ' Signature i dz Signature " Harlow Builders Page 4 of 9 Howes St. . •• • ■ I r Heating: Includes: 32' of Kompak Radiation for new room. Digital thermostat Heat only, Move steam radiator in dinning room, Install one flat plate heat exchanger to the side of the existing boiler in the basement. Install two circulators to boiler and flat plate. New copper and pex piping to be used. Insulation: (Allowance of $1,300) Basement ceiling area will have 6" fiberglass insulation (R-19) installed. Exterior walls will have 6" fiberglass insulation (R -19) installed with a poly vapor barrier. Attic insulation to be R-38, fiberglass insulation installed. We will install fiberglass insulation around window and door units. We will install proper vents in ceiling areas where needed for proper ventilation. Sheetrock: 1/2 "gypsum board applied to the new walls and ceiling, fastened with 1 1 /4" screws, taped, coated (3) applications and sanded to a paint ready surface. A' " moisture resistant board will be used in the bathroom. Interior Painting: All new walls and ceilings to be painted (1) coat primer, (2) coats finish. All interior doors and trim to be painted with (2) coats finish. Interior Doors: Interior doors hung on 4 9/16" flat jambs. 311).„— 2668 solid core, molded, six panel, pre -hung doors. (Bathroom) Door Hardware: All interior doors to have brass finish hinges, knobs and stops. (1) Privacy knobs, (1) Wall Stop. (Bathroom) Interior trim: All door, window and base trim to match existing. Casing to be primed and fingered jointed pine with an edge molding. All window sills to be lx primed and fingered jointed pine. All baseboards to be primed and fingered jointed pine with a base molding. (2) closets to have (4)'/." plywood shelves with edging installed on lx cleats. Crawl space opening to be trimmed out. A plywood door installed / magnet catches and knobs. Bathroom Accessories: (Material Allowance of $100) Includes Installation of (1) towel bar, (1) TP holder, (1) wall mirror. Bathroom Venting: We will install 4" flexible aluminum duct, to the bath fan and vent to the outside of the house. Flooring: Install 3/8" ULC underlayment to the tile floor area. (Bathroom) Install Ceramic tile to the bathroom area. Install 2'/4" red oak strip flooring, to the new addition area. Patch dinning room floor as needed. Sand and apply 3 coats of urethane. Portable Toilet: Will be brought to site for the workers to use, (allowance of $480) Harlow Builders Page 3 of Howes St. ih. t t r EXTERIOR Roofing: We will install a white aluminum drip edge around perimeter of roof. Apply one row of ice and water barrier to the eaves. Apply 15 lb. felt over remaining roof surface. A 30 year architectural shingles applied over entire roof surface, shingle to match existing. Install a continuous ridge vent (roll vent). All roof & pipe flashings as needed to complete. Windows: (Material Allowance of $2,0001 Paradigm new construction vinyl windows with 1/2 screen, Low E glass and argon gas. Includes 6 -9/16" painted pine interior jambs. (2) PDH3457, (2) PDH3457 -2, (1) PDH3440 Exterior Doors: (Material Allowance of 53,4251 (1) Paradigm new construction 60x 68 insulated slider door. (1) Paradigm new construction 120x 68 insulated double slider door. Siding: Tyvek house wrap on all new exterior walls _New vinyl siding, on all new exterior walls. Wood trim soffit and facia will be covered in aluminum coil stock and vinyl soffit material. Any caulking that needs to be done will be done with silicone caulking. We will install vinyl light blocks behind light fixtures where needed. We will nail all siding at least 16" O.C... (Vinyl siding and trim to match existing) Gutters: We will install new heavy duty white seamless aluminum gutters and downspouts to the addition area. There will be approximately 81' of gutter with 3 drops and 27' of downspout. INTERIOR Electrical: Using existing electrical service and main circuit breaker panel in basement. Install all switches and outlets as per code. (1) CATV outlets.(1) GFI outlet, (1) Bath Fan/light combination with vented ductwork, Crawl space lights, Exterior double floodlight, All electrical as per plans. All necessary permit, material and labor to complete electrical. (Owner to supply decorative fixtures.) (Decorative fixture allowance of $500) Telephone and cable utility company fees are not included. Plumbing: Includes: waste, vent and water piping to (1) toilets, (1) Lavatory sinks, (1) Shower unit, ABS waste piping to start in basement and piped to fixtures with traps and vent through roof. Copper water piping to start in basement and piped to fixtures with stops and supply tubes. Fixtures and faucets listed below, Plumbing permit and all labor to complete work listed above. Fixtures & Faucets included: (all in white with chrome trim) (1) Aker 36x36x78.5 Will NEO -RND front shower. (1) Delta shower valve / Leland trim. (1) Delta #56713 Hand shower w/bar (1) Gerber Picturesque 12" white 17" high toilet wlseat. (1) Retrospect wall mount 8" lavatory with chrome legs. (1) Delta #3575 mpu Leland Hi -ARC faucet. (1) Delta H778 Leland Lever handles. Harlow Builders Page 2 of 9 Howes St. 416 q PROPOSAL Harlow Builders 336 Coles Meadow Rd. Northampton, Ma 01060 (413) 586 -0465 Submitted to: Beverly Shaw & Tom Bassett 40 Howes St. Florence, Ma. 01062 (413) 584 -5399 Page 1 of 4 April 5, 2010 The scope of this project is to build a 437 sq.ft. One story addition, a 192 sq.ft. deck and to add a full bathroom to the existing dinning room area. We hereby submit specifications and estimates for the work to be performed. All materials and labor to complete. All permits obtained by Harlow Builders. All debris caused by construction removed by Harlow Builders. See attached drawings for details on framing and placement of fixtures. Drawings by Integrity Dated 3/9/2010 Demolition: Remove partial exterior siding, windows, wall Finishes, sheathing and framing. Remove partial interior wall and ceiling finishes. Remove partial oak flooring. Basement window to be enlarged, for the crawl space access opening. All necessary Demolition as per plans for a complete job. Site Work: Remove existing concrete sidewalk and steps. Remove and dispose of existing shrubs. Grub and strip existing pacasandra and place in new location. Excavate for a new crawl space foundation as per drawings. Backfill the foundation to grade. Spread stone inside foundation area for under concrete slab. Import loam for lawn area around new foundation. Grade, rake, seed and fertilize new lawn area. Does not include patio stone work. (Watering of lawn is owner's resnonsibility) Concrete: 3,000 psi poured concrete used in foundation material. Included are anchor bolts and 3 standard vinyl slider basement windows. 76' of 16"x 8" Footing. 76' of 8"x 6' foundation walls. 437 s.f. of 3" concrete slab. Framing: Sill seal applied to top of concrete wall, 2 "x 6" pressure treated sill, bolted to top of concrete wall. Floor system to be 11 7/8" Pre engineered I joist and rim board framed at 16" O.C. Sub - flooring to be 3/4" tongue and grove advantech panels. (Glued & nailed) 2 "x 6" studs 16 "O.C. used for the exterior wall framing. 2 "x 10" kds and LVL material used for window and door header material. Exterior wall sheathing to be 'h" cdx 4 ply wall sheathing. (fastened with ring shank nails) 2 "x 4" studs 16 "O.C. used for the interior wall framing. Stick framed roof using 2x kds material. Roof pitch and overhangs to match existing. Roof sheathing to be 1/2" cdx plywood. All necessary framing as per plans for a complete job. Harlow Builders Page 1 of 9 Howes St. 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 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 • • 1 - • • • - si • • s • • - - - s I . t the buildin• de • artment 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 - - - - - -- --- perrTMit� in- permits-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. Address of work location 9 r c\ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations t t _ 600 Washington Street Boston, MA 02111 • www.massgov /dia -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization /Individual): �j cc.,���;� Address: *3 C \A\ -r\ k.\ \ ■ City /State/Zip: 4 4n ) S' Phone. #: `�(a� 74 S b Are you an employer? Check the appropriate box: Type of project (required): / 1. ❑ I am a employer with 4. 0 I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub- contractors 2. El I am a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling ship and have no employees These sub - contractors have. 8. ❑ Demolition for me in any capacity. employees and have workers' working Y P tY• 9. 0 Building addition [No workers' comp. insurance comp. msrtrance insurance required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3. I am a homeowner- doingall-work — — cersl y_t ,er d_their___ --I-LEI-Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no . employees. [No workers' 13.0 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 afdavit: 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: s +fit\ 1 Cj, e.k, \ 1� C ' Policy # or Self -ins. Lic. #: ��C-� '�' 3 `� G ' [ y j'vC Expiration Date: - :73(4) Job Site Address: `t City /State/Zip:W' , 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 frnf` of up to $250.00 a day against the violator. to 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 pen ' s of r erjury that the information provided above is trueandcorrect. — • Iw Si,..lure: 7/ Phone #: - O f f i c i a l use o n l y . D o nol wince in this area, to be completed by city or town officlaL City or Town: Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector __ __ 6.Other r , Contact Person: Phone #: r 1 R , SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : C;\1J � O ; v `'� c -S � License Num er Address Expiration Date Signature Telephone 1. Registered.LHotn tnprove ent _ m k � S Not Applicable ❑ ��� =� ���;e�s � r \ass Company Name Registration Number i Address Expiration Date C k .74"-C3 - elephone SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) J 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 ❑ The_curr-ent_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 o ampton • r • inanc -s, a e : n • r. • • ` - General- draws- Annotated. Homeowner Signature SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors Cl Accessory Bldg. ❑ De1]lolition El Ne . �� - Decks Siding [0] Other [D] E / � 1'p1 "ii "� •7 Brief Description of Proposed ry a dn Work: � �� ' Work: �v.�� � i Ur'1 Oh� C\ Alteration of existing bedroom Yes No Adding new bedroom Yes I No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet \ c��rs�E��u�ri� 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? Y ■ d. Proposed Square footage of new construction. `T �3 7 �� Dimensions X rt X )`D e. Number of stories? tip , f. Method of heating? S 0 ‘.< 4 'N Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? f\ h. Type of construction `� I A C«'t"\Q i. Is construction within 100 ft of wetlands? Yes r No. Is construction within 100 yr. floodplain Yes ( j. Depth of basement or cellar floor below finished grade GA ("\ k. Will building conform to the Building and Zoning regulations? (Yes No . I. Septic Tank City Sewer `l Private well City water Supply V SECTION la - 'OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT l , 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 \ C\v� �L-- � � � �C' 'L.� ck. 1 4z-c) , 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. Print Name Signature f ner /Agent Date , w Section 4. ZONING Alt 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 I / 5J ' , S � ` :E , " `ei'P.M.,.,� _I _- ._ m~. _....._..___ :_.- Frontage f �S '3 e' I _. ' __ _ ._ Setbacks Front , , r q Side L:1 R:? a? L:' ` R:t L 3 Rear 1 ; ^ a - Building Height ( Bldg. Square Footage l i % [( Open Space Footage % (Lot area minus bldg & paved j int 3 _ j IFI L.__ I parking) # of Parking Spaces 1.= Fill: _______ m .. (volume & Location) i It I 1 - _____— A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO Q DONT KNOW 0 YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES IF YES: enter Book I P ag e and /or Document # { _ B. Does the site contain a brook, body of water or wetlands? NO 3 DONT KNOW Q YES 0 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 0 NO IF YES, describe size, type and location: i D: a ffie I any proposed"c anges to or a itio o sign intended for tFiie 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 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. City of Northampton 4 , 4 Building Department a 212 Main Street m R $ 9 1 Room 100 p Northampton, MA 01060 R 7 phone 413- 587 -1240 Fax 413- 587 -1272 L', a = R A}'S '001 4,14 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 Map Lot Unit Zone Overlay District Eitrmst District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner Record: t Name (Print) Current Mailing Address: 1 Telephone Signature 2.2 Authorized Agent: a(.: l�a.J Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building . / / (a) Building Permit Fee j 2. Electrical L °� (b) C Estimated nstruction Total om Cost ) 3. Plumbing .. S' c— Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection _ 6. Total= (1 +2 +3 +4 +5) � J Check Number � n This Section ForOffcial Use Only i * 1"' " '. '(*) Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildin• Date — 4 C \riliPA// I 4 File # BP- 2010 -0869 APPLICANT /CONTACT PERSON HARLOW BUILDERS ADDRESS/PHONE 336 COLES MEADOW RD NORTHAMPTON (413) 586 -0465 PROPERTY LOCATION 40 HOWES ST MAP 17A PARCEL 173 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid 4f3e OS Tvpeof Construction: CONSTRUCT 437 SQ FT FAMILY RM ADDITION, DECK,ADD FULL BATH IN EXISTING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 052460 3 sets of Plans / Plot Plan t THE ' 4 LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON �t ` INF !i • ATION 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 Commission _ Permit DPW Storm Water Management Demolition Delay c/a--- f 4/13)16 Signature of Building 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. 2 BP- 2010 -0869 G #. COMMONWEALTH OF MASSACHUSETTS 3 • 1 A -In 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- 2010 -0869 Project # JS- 2010- 001290 Est. Cost: $90606.00 Fee: $543.60 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HARLOW BUILDERS 052460 Lot Size(sq. ft.): 14984.64 Owner: BASSETT THOMAS A & BEVERLY A S Zoning: URB(100)/ Applicant: HARLOW BUILDERS AT: 40 HOWES ST Applicant Address: Phone: Insurance: 336 COLES MEADOW RD (413) 586 -0465 Workers Compensation NORTHAMPTONMA01060 ISSUED ON:4/13/2010 0:00:00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT 437 SQ FT FAMILY RM ADDITION, DECK,ADD FULL BATH IN EXISTING 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 4/13/2010 0:00:00 $543.60 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo NO 5NVU.