32A-020 1
Pricing Summary
100 — Administration & Project Management: Permit process, construction drawings, detail
review, client meetings. (Includes permit fee) $ 245.00
200 — Demolition & Waste Disposal: Remove and dispose of siding, trim & windows; provide
general construction debris disposal. $1,875.00
300 — Carpentry: Wall furring, window installation, window extension jamb and casing, corner
board installation, PVC trim board at grade, door casing back band, miscellaneous trim and wood
clapboard siding installation. $5,075.00
400 — Window Units: Provide new solid white vinyl sliding window units with regular low E glass,
with white hardware (sash locks), white screen frames with charcoal mesh screening. Perimeter air
sealing at windows. Interior and exterior caulking is included. DCCSI will require the client to
provide access to the interior of each window as needed during the installation process. Approximate
duration of interior impact is two hours per window.
$1,350.00
Based on total cost of construction of $8,545 a deposit of $3,000 is required before permit is applied
for, windows are ordered and work begins. A second payment of $3,500 is required once siding is
removed, furring is complete and new windows are installed. A final payment of $2,045 is due when
siding and trim are complete (completion of project including final building inspection).
Respectfully submitted,
Dave Chicoine
Signature indicates acceptance of terms as outlined.
Christine Mark
Thank you for your business!
2
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Dave Chicoine Construction Services, Inc. �e4aJ-f` .
ie
16 Edgehill Place '"- '` 14—; A
Amherst, MA 01002 °'�
413/246-7536
Christine Mark
89 Market Street
Northampton, MA 01060
First Floor Storefront Siding and Window Replacement
Proposal/ Estimate
October 24, 2011
Dave Chicoine Construction Services, Inc. ( DCCSI) proposed to provide a carpentry service to
complete the following:
• Replace four front wall windows (right side wall window remains)
• Remove siding at front and right wall only (no removal of siding on left side)
• Furr the front wall as needed with pressure treated furring to build out window recesses
• Install new PVC trim at base of wall
• Concrete abutment at the left front corner will remain exposed
• Provide and install four new vinyl sliding windows, white interior and exterior including screens
and hardware (regular low E glass)
• Replace exterior window trim with PVC 5/4" x 4 ", interior trim remains (extension jambs and
casings)
• Windows will be installed from the exterior with minimal impact on interior working
environment (caulking only)
• Install new pre - primed 1/2" x 6" wood clapboards
Furring installation assumes siding removal only, no sheathing or framing repairs or replacement is
included in this proposal /estimate. Additions or changes to the scope of work as well as repairs
required as a result of hidden conditions i.e., water and /or insect damage will be performed upon
acceptance and pre - payment of a written change order. Painting is not included. Waste disposal and
building permit are included. Permit process includes a basic elevation drawing to satisfy the building
department requirements.
DCCSI requires off street parking for a construction trailer to be stored onsite for the duration of the
project. Posting of a jobsite sign is required. DCCSI requires basement access to electric panel and
bathroom access as needed. This proposal is as comprehensive as possible. Any work not outline
herein is not included. DCCSI carries necessary licenses and insurance. Certificates are available
upon request.
Please see attached pricing summary for all related construction costs as well as payment schedule.
1
Dave Chicoine Construction Services, Inc.
16 Edgehill Place
Amherst, MA 01002
413 /246 -7536
November 14, 2011
To: Louis Hasbrook
Building Commissioner
City of Northampton
MA 01060
Request For Waiver Of Controlled Construction
Pursuant To 780 CMR 116
Property Under Consideration
89 Market St. Northampton
Dave Chicoine Construction Services Inc. (DCCSI) requests the waiver be granted based
on information being provided within this letter as well as with the attached proposed
construction drawings and the building permit application. DCCSI has indicated that the
location of work being limited to the single first floor street side wall and six foot long
single story side wall section. The nature of work also being limited to cosmetic
enhancements as well as energy upgrades (new siding and four new windows). DCCSI
appreciates your assistance with this process.
Sincerely,
Dave Chicoine
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office oflnvestigations
600 Washington Street
Boston, MA 02111
www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual - ", - e- t' -�•' f C,�Ie7, -T .Pry+ .!J '. - V;cE t � �C
Address: .7 If A i f/ ?/.9 c e
City /State /Zip: /0a4.-,/f , 1,4 ®om i,' a- Phone #: Z -'1( f' 7
Are you an employer? Check the appropriate box: Type of project (required):
1. ❑ I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part- time).* have hired the sub - contractors 6. ❑ N construction
listed on the attached sheet. 7. 21eodeling
2. ❑ I am a sole proprietor or. partner-
ship and have no employees These sub- contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'.
g Y P h' 9. ❑ Building addition
[No workers' comp. insurance C+ .' . , insurance.#
required.]
5. ro e are a corporation and its 10.0 Electrical repairs or additions
i
h
d i
have officers ave exercse their 11.
3. ❑ I am a homeowner doing all work ❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. ❑ Roof repairs
insurance required.] t c. 152, § 1(4), and we have no
employees. [No workers' 13. Other
comp. insurance required.]
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
'Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: City /State /Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby cert der the pains and penalties of perjury that the information provided above is true and correct
Siznature: Date: /7Z V//
.� //
Phone #: 91/7 �"/ � �✓'� 6
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 #:
Version1.7 Commercial Building Permit May 15, 2000
SECTION 10 STRUCTURAL PEER REVIEW (780 CMR 110.11) '
Independent Structural Engineering Structural Peer Review Required . Yes 0 No
SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED::. WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, .- . __. v f� w.... _.. _ .. ._. as Owner of the subject property
.
hereby authorize ..... __. f.�.. A . .� _. La). B.C.mm.�.,..v_� __ ________ to
ac on ;-�.'n al atters r ti e to work authorized by this building permit application.
Signature of 0 r Date
— _.__ , as Owner uthr' d
Agen hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
elief.
Signed under the . ,d_„genalties • •eriur,
Print Nan d--<394A-1.•
(- ca.,✓! e %/�� //
Signature of Owner /Agent Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Su ervisor: Not Applicable ❑
Name of License Holder . ?. _ . `�� . G !' i r �� �� 2 ` r
License Number
Address _ Expiration Date
cXr -�.✓ e--4//e- _ .... " ✓ 7
Si ure Telephone
SECTION 13 - 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 0 No
Versionl.7 Commercial Building Permit May 15, 2000
SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF EIJLOSED SPACE)
9.1 Registered Architect:
' Not Applicable ❑
Name (Registrant): -- —
Registration Number
Address ._,._..__..... ___... ___
....
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number •
Signature Telephone Expiration Date
— _ 9 E
Name Area of Responsibility
Address ._..___. Registration Number �....
I t
Signature Telephone Expiration Date
Name Area of Responsibility
i
. I , __.___, ..._. _____
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
.___..__.._ �_ ____.__
3
Signature Telephone Expiration Date
9.3 General Contractor
_. ._ .,_...____ _.__.__.W...._.__. , _,..._._. ._.. .._._..�._,___ _... _._._` Not Applicable ❑
Company Name:
Responsible In Charge of Construction _
Address__
Signature Telephone
•
Version1.7 Commercial Building Permit May 15, 2000
8. NORTHAMPTON- ZONING ,
. Existing Proposed Required by Zoning ,
This column to lie filled in by
Building Department
Lot Size .,.. — ,
1 x I . " ____,_ .
Frontage ____ ._ ,. ..., ___
Setbacks Front t
Side L:—__: R: i L:1 1 R: _ ,
z r
Rear ......_......J ;
Building Height
Bldg. Square Footage _.. % "° i 1,
Open Space Footage %
- (Lot area minus bldg & paved
i
parking)
# of Parking Spaces .j
Fill: ,
(volume &Location) µMM_____ — —
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO Q DONT KNOW (.� YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book ' Page and /or Document #� _..
B. Does the site contain a brook, body of water or wetlands? NO GY DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , Date Issued:
C. Do any signs exist on the property? YES C.) NO
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 ler
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.
Versionl.7 Commercial Building Permit May 15, 2000•
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE '
Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑
Exterior Alteration Existing Ground Sign ❑ New Signs ❑ Roofing 0 Change of Use ❑ Other ❑
Brief Description ;Enter a brief description here. .T-' 7 ° ./°7/L L c'L J." 4l7 ---
Of Proposed Work , % !' f ` f GL'.� ,,.• 9 �j C�/1 ael AA /'/
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) I CONSTRUCTION TYPE
A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑
A-4 ❑ A -5 ❑ 1 1B ❑
B Business id 1 2A ❑
E Educational ❑ 2B - r ❑
F Factory ❑ F -1 0 F -2 ❑ 2C ❑
H High Hazard ❑ — 3A ❑
Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑
M Mercantile , ❑,/, 4 ❑
R Residential L�J R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑
■ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑
U Utility ❑ Specify:
Specify: r" — .. .._ . _ __— --
M Mixed Use
P fy
S Special Use ❑ Specify:
1 _
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE
Existing Use Group: _ _��� _ Proposed Use Group: .. . _
Existing Hazard Index 780 CMR 34):',. ..., Proposed Hazard Index 780 CMR 34) -..._..._.. _. ._.., _,
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION ' OFFICE USE ONLY
Floor Area per Floor (sf)
4
_._ --- . 1 st i
1 , 2 G!� -_-.
n d
2nd i L del 2 i
3rd a._1 7 O7J =. _._.,q..._. 33rd 3 -
4
4th _ _ _______...___. .......__.._.�..�...._..
Total Area (sf) f 0 i Total Proposed New Construction s
Total Height (ft) � .. ." ..._ __.�_ _ .
Total Height ft
7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood_Zone information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone "_______ Outside Flood Zone❑ Municipal ❑ On site disposal system❑
__ Versionl.7 Commercial Buildin• Permit Ma 15, 2000 t
— , D - b d 2DG N Ri t- u $er`0"" R ' ° . ` ;� `.s^ . g i,
City of Northampton
NOV + Bu Department . ' .' ' � ;
52111
212 Main Street �,
Room 100 ' . l ., ,, t*,-;, * * . �
D73
,� .
e N of HAMPTON n A 010 6oNS Northampton, MA 01060 r
$�� � - :
tea
NoA AAA 01080 � i x' �" � "' e � � � a� �
ne 413- 587 -1240 Fax 413- 587 -1272 Jiofi ns '4M ")4,44' .'��r`�
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address:
This section to be completed by office
Map Lot Unit
9 4 /114,-44 ' '4 S---71:r Zone Overlay District
' " Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
Name (Print) Current Mailing Address: _
r _._._q1 ) i. S 73 ..i_____ ___. _.._
Signature at �/' , _ /C. Telephone
2.2 Authorized Agent
Name (Print) Current Mailing Address: ,fszi d
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building 0„r79,5' �j ) (a) Building Permit Fee
2. Electrical i (b). Estimated Total Cost of
Construction from (6) :__.._.M.. ._._.__..__ ___ __ .._..
3. Plumbing a Building Permit Fee
4. Mechanical (HVAC) . _______
5. Fire Protection i ""
6. Total = (1 + 2 + 3 + 4 + 5) Check Number 9L0 46 "µm
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner /Inspector: of Buildings Date
File # BP- 2012 -0485
APPLICANT /CONTACT PERSON DAVID CHICOINE
ADDRESS /PHONE 16 EDGE HILL PLACE AMHERST (413) 246 -7536
PROPERTY LOCATION 89 MARKET ST
MAP 32A PARCEL 020 001 ZONE URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Paid
Tvpeof Construction: REPLACE SIDING & 4 WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 061582
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
V 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
(2
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.
89 MARKET ST BP- 2012 -0485
GIs #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32A - 020 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: replacement windows /siding BUILDING PERMIT
Permit # BP- 2012 -0485
Project # JS- 2012- 000816
Est. Cost: $8595.00
Fee: $60.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: DAVID CHICOINE 061582
Lot Size(sq. ft): 6316.20 Owner: MARK JASON N & CHRISTINE E HENRIQUES
Zoning: URC(100)/ Applicant: DAVID CHICOINE
AT: 89 MARKET ST
Applicant Address: Phone: Insurance:
16 EDGE HILL PLACE (413) 246 -7536
AM H ERSTMA01002 ISSUED ON:11/28/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: REPLACE SIDING & 4 WINDOWS
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 11/28/2011 0:00:00 $60.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner