36-229 03/12/2012 14 :01 14133234111 N E WOODWORKING INC PAGE 02
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CON WL i j0N CON i RAC i
ganKrtagigal
This agreement made this 4 d ay of February, 2012 by Terry and Lisa Minnick of 44
Winterberry Lane, Northampton, MA 01060 , herein referred to as "Owner" and Michael A.
Si niscalchi d/b/a New England Woodworking of 18 Ledgewood Drive, Belchertown, MA 01007;
Phone: 413- 3234111; MA HIC Reg. #156346, MA Lie. #077811 herein referred to as
"Contractor".
Owner and Contractor in consideration of the mutual covenants hereinafter set forth agree
as follows:
SECTION ONE -
STRUCTURE AND SITE
Contractor shall furnish labor a*d materials:
House and Garage
Remove existing siding, all outside corneas, and apron around perimeter. Apply vapor wrap to
all exposed areas prior to the installation of the new siding.
Install 5/4" x 4" Arctic White (smooth) trim to outside corners, window trim and drip cap, and
exterior door trim. Install 5/4" x 6" Arctic White (smooth) trim for the perimeter apron and
apply aluminum white drip cap.
Install James Hardie Fiber-cement Siding in a 6-1/4" (5" exposed) in Select Cedarmill
(Woodgrain texture) in the color, Light Mist. Install 48" x 16" Hardi -shin ngle, half -round
notched panel w/7" exposure to accent areas of the house.
Scrap and paint trim, soffit and facia using Duramax flat white paint.
Remove old and install new French door units (3); insulate and apply trim where required.
*$250.00 each unit
Remove house side entry door and garage side entry door, and install new door units; insulate
and apply trim where required. *$125.00 each unit
Contract Total ( *less door unit installs) $32,600.00
Notes:
1) Price includes lift, dumpster, permit, labor and materials. All existing soffit, fascia, and
gutters to remain unless they show signs of wood rot at which time, homeowner will be
notified prior to replacement.
lnidaLs
5 Cliff Northampton
(i( Massachusetts
t„
4 <' DEPARTMENT OF BUILDING INSPECTIONS
� 212 Main Street • Municipal Building y� �,,,
Northampton, MA 01060 '311, f �
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
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HOME OWNER EXEMPTION ACKNOWLEDC EIVIENT •
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 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 Iequires that the building department be called to inspect work at various stages, which include
foundation /footings (before backfill), sonotube holes (before pour), a rough building inspection
(before work is concealed), insulation inspection (if required) and a final building inspection.
The building department requires these inspections before the work is concealed, failure to secure
these inspections can result in failure to obtain a certificate of occupancy until the work can be
inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be
responsible to make sure that the trades hired secure their proper permits in conjunction to the building
permit issued, and that they get their required inspections. Failure of the individual trades to secure
the permits and inspections as required can DELAY the project until such time as the proper permits
and inspections are made
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
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The Commonwealth of Massachusetts
_,� Department of Industrial Accidents
v. "`""" Office of Investigations
r �-` 4 600 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): j� at \i ` l( A.
Address: I g , i 6 , '.d t)r
City /State /Zip: ' J , '
-by()
, 1114 OI Fhone #: 41 5 5 -'OD147
Are you an employer? Check the appropriate box: Type of project (required):
1. El am a employer with 4. n I am a general contractor and I 6. ❑New construction
employees (full and/or part- time).* have hired the sub contractors
2. I am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling
These sub - contractors have
ship and have no employees 8. El Demolition
working for me in any capacity. employees and have workers'
g Y P h'- 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
d. ire
re u 5. n We are a corporation and its 10.0 Electrical repairs or additions
3. El required.] have their repairs or additions
am a homeowner doing all work ave exerc r 11. ❑ Plumbing P
myself. [No workers' comp. right of exemption per MGL 12.0 oof repairs
insurance required.] t c. 152, § 1(4), and we have no C • 4 `
employees. [No workers' 13. Other J o
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 certify under the pains and penalties of perjury that the information provided above is true and correct.
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Signature: V /Y� J ,Q Date: ! a'--
Phone #: L - 51S -UV)
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 #:
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. SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: . . Not Applicable ❑
Name of License Holder : t� rl • (` 01%11
1 1 f ISLIC61,1451Aon Mb q/al
License Vumbe
• evx08. I
Ader-ss , Expiration Dat
• ' ► , �I! ,t7� IYV�' 413 - 343 t l I
Signature , Telephone
9 eR • istered ;ti mo e,.Im a covelafbonir = , ' ` ,. ,h. e a i u,1 -If Not Applicable ❑
Company Name E:: dfr Registration Number
6/02 5/
Address Expiration Date
Telephone
SECTION 10-.WORKER COMPENSATION INSURANCE .AEFIDAVIT ( 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 ❑
® :Mei caner em o, - on
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
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SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)' , - « .
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New House E • ' . Addition 0 Replacement Windows' Alteration(s)' n' `' ' . Roofing n
Or Doors 0
Accessory Bldg. n . Demolition 1 New-Signs` [011 Decks [CM . , Siding [ClJ.." Other [Dl
Brief Description of Proposed _ / , /1 ( idin
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Work: ,�/,(t't�f
Alteration of existing bedroom Yes ' _ No 9 new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
"ei iiiiiiseran • 4 delifioi to''exiting li6iiiiraq; complete, he..fofiow1nq:
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 witl'100 ft. of wetlands? Yes No. Is construction within 100 yr. flpodplain Yes No
j. Depth of ba ent or cellar floor below finished grad .
k. Will b ding conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTI 7a ::OWNER AUTHORIZA TO BE COMPLETED WHEN a
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
I, LA i \ Vi l l ouRA
, 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.
.L alli
Pri • ame
' AAA..! NA . .a..•,1' 3 !d la
Signature of 11, er /Agent Date
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Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
b
Existing Proposed Required by•Zoning
This column to be filled in by
Building Department
Lot Size ; i
Frontage.
Setbacks Front 1 3
Side L: 1 R:v L: ; R: '
I
Rear
Building Height i
Bldg. Square Footage i i 1 I% I t {
Open Space Footage %
(Lot area minus bldg &paved F-----1 i l I
parking)
1 1 # of Parking Spaces v
Fill:_ _ _._ .w- .....___W
(volume & Location) _ 1 E
A. Has a Special Permit /Variance /Findin been issued for /on the site?
NQ DONT KNOW YES 0 _
IF YES, date Issued
I
IF YES: Was the permit recorded at Re a Ty of Deeds? ; : ;'
NO I DONT KNOW YES 0
IF YES: enter Book I Pager ; and /or Document #1
1
B. Does the site contain a brook, body of water or wetlands? NO ONT 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 0 NO
IF YES, describe size, type and location: 1
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO
IF YES, describe size, type and location
E. Will the construction activity disturb (clearing, grading, x ation, 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.
44 WINTERBERRY LN BP- 2012 -0787
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 36 - 229 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: vinyl siding BUILDING PERMIT
Permit # BP- 2012 -0787
Project # JS- 2012 - 001379
Est. Cost: $32600.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ELIZABETH VILLANI 77811
Lot Size(sq. ft.): 104544.00 Owner: MINNICK TERRY J & LISA L
Zoning: Applicant: ELIZABETH VILLANI
AT: 44 WINTERBERRY LN
Applicant Address: Phone: Insurance:
18 LEDGEWOOD DR (413) 575 -0067
BELCHERTOWNMAO1007 ISSUED ON:3/12/2012 0:00:00
TO PERFORM THE FOLLOWING WORK: REPLACE SIDING
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 3/12/2012 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner