17A-173 (4) We propose to furnish the material and labor necessary for the completion of the above stated ork for the sum of:
Twenty Seven Thousand Four Hundred & Sixty Seven Dollars. $27 7 0.00
P meat as follows: et J: 611 ,14
,000 upon oomplaiitstr Start of Demolition.
$ 0,000 upon completion of the rough inspections.
S5,000 upon completion of the painting.
$4,710 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 execut . only upon written
orders in the form of a change order, and will become an extra charge over and abov the estimate. All
agreements contingent upon strikes, accidents or delays beyond our control.
Owner to carry fire tornado and other necessary unsurance.
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Note: This proposal may be withdrawn by Harlow Builders if n accepted by within 60 days.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 1i Signature '1 ''
Signature
Harlow Builders Shaw Kit
112 "gypsum board applied to the new framed doorway and areas that need to be patched,
Fastened with 1 1/4" screws, taped, coated (3) applications and sanded to a paint ready surfa
Interior Painting:
Walls, ceilings, doors and trim to be painted with (2) coats of finish paint. (Color by Owner)
Kitchen Cabinets; (Material allowance of $7,910)
nib Cabinetry, Shaker door panel, Maple wood with painted white finish. ( s'1 „)
Soft close hardware. Drawer extensions and (2) double trash unity.
Quoted by Deerfield Cabinets 3128/12 (Dave Satk»wski (219 - 3507)
Cabinet knobs and pulls:
Knobs and Pulls (supplied by owner) and installed by Harlow Builders.
Kitchen Countertops: (Material and Labor Allowance of $4,595) r Cot t 1 J J.
Cambria Custom Quartz countertop (Castel! color) standard edge treatment, no backsplash a , d polished cut out
for under mounted sink. Template, delivered and installed.
Tile Backsplash: (Labor allowance of $400)
Install ceramic tile from the top of the countertop to the bottom or the upper cabinets. (Tile rial by Owner)
Interior trim:
All door, window and base trim to match existing.
Casing to be primed and fingered jointed pine with an edge molding.
Window sill to be lx primed and fingered jointed pine.
All baseboards to be primed and fingered jointed pine with a base molding.
Flooring: (Labor allowance for tile floor work is $650)
Install 1/2” !TLC underlayment to kitchen subfloor.
Install owner supplied tile to the kitchen floor are». (Tile material by Owner)
Radiator Cover:
We will build a wood with vented metal screen cover to place over the kitchen steam heat radi or.
We will paint the cover white. (Cover to match the one in the dining room.)
Appliances Installed:
We will install a stove, refrigerator and dishwasher to the kitchen area.
Install a new microwave/hood to the wall and cabinet and re- circulate the vent into the room th ugh the filters.
Harlow Builders Shaw Kit
F
PROPOSAL
Harlow Builders
336 Coles Meadow Rd.
Northampton, Ma (1060
(413) 586-0465
Submitted to: Marc 29, 2012
Beverly Shaw & Tom Bassett (413) :4-5399
40 Howes St. C- ,E 5 -1836
Florence, Ma. 01062 Page 1 of 3
The scope of this project is to renovate the existing kitchen 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 Deerfield Kitchens Dated 3/28/12
Demolition:
Remove existing kitchen appliances. Remove existing kitchen cabinets and countertops.
Remove existing soffits. Remove partial doorway Ito widen) leading into the dinning room.
Remove vinyl flooring and underlayment down to the sub floor. Remove existing tile back sp h.
Framing:
Frame existing doorway leading into the dinning room, to widen, }using comparable material,
Windows:
Paradigm new construction vinyl windows with full screen, Low E; glass and argon gas.
Double locks and no grills. (1) NC 8300 2 lite slide window. RO 55 x 41 %
Siding:
Patch in the siding around the new window using the existing siding material.
Wood trim will be covered in aluminum coil stock material.
Any caulking that needs to be done will be done with silicone caulking.
Electrical: (Allowance of $1,500)
Includes: Permit for electrical work. Disconnect and relocate wiring for new construction.
Material and labor for switches, receptacles, ceiling fixtures and microwave.
(4) 6" recessed lights / #24w -wh trims and 65 watt bulbs.
(4) pendant lights.
(2) Receptacles in the fixed island.
(Owner to supply decorative fixtures.)
Plumbing: (Allowance of S500)
Includes: Permit for Plumbing work. Disconnect existing sink, garbage disposal and dishwashe
Reconnect new sink and faucet, existing garbage disposal and dishwasher. install water to ice I, ker.
H
Move steam radiator in kitchen area.
Insulation:
We will install fiberglass insulation around window unit.
Harlow Builders Shaw Kite
• ''
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 owns constmetion supervisor, to be aware that
by doing so you become responsible for compliance with state building codes and
regulations. The inspection process requires that building department be called to
inspect work at various stages, which include foundation /footings (before backfill),
sonotube boles (before pour), a rough buildinginsnection (before work is
concealed), insulation insnection (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 occunancv
until the work can be insoected.
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
jermits 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 nle:
Date
Address of work
location
The Commonwealth of Massachusetts
Department of Industrial Accidents
_ Office of Investigations "
SIMP=. 600 Washington Street
Boston, MA 02111
www mass.govidia
-Workers' Compensation Insurance Affidavit Builders / Contractors /Electricians/Plumbers
Applicant Information • Please Print Legibly
Name ( Business /Organization/lndividual):f��`w l,: ��> P S
• Address: 7S`3 c, ClkOk• .
City /State/Zip: '' \0 Phone. #: C3(1,`
Are you an employer? Check the appropriate box:... ., , Type of project (required): /
1 I am a Io ..er .. 4.. 0 ram a general contractor and I
. y with � 6. New consnvction
— - lo ees full and/or art tune * _ — Dave lured - the - sub- contraetms —
2._0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
• sfiipi and have no employees — These sub- contractors -have- - - 8. ❑ Demolition •
wor for me in a ca aci employees and have workers'
Y P ty $ • 9. 0 Butld;,+g addition
[No workers' comp insurance comp. Insurance.
Electrical repairs - �. 5. 10. � We are a corporation and its ❑ � eP airs or additions
ffi
ocers have exercised their 11 Plumbing or additions
3. ❑ I am a homeowner doing all work r ❑ mg repasrs
myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs
c. 152, and we have no .
• insurance required] t 12 _ � 1 4 § � )�
employees. [No workers' 13.[] Other
comp. insurance required }. ,
`Any applicant that checks box #1 must also fill out the section belowshowing their workers' compensation policy information. • •
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contracts must submit a new affidavit indicating such
:Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have .
employees. If the sub - contractors have employees, they must provide their workers' comp. policy number. ' •
lam an employer that is providing workers' compensation insurance for my eniployeex Below Ls the policy and job site
information. ,
Insurance Company Name: 5� d C L k1 C 14 \I 4 C 1\5 u,k C: V�1 •
Policy # or Self-ins. Lic. #: C - S o) a Expiration Date: - u I a / J p�
Job Site Address : "\ CC 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.
Ida hereby certify under the • and penalties of , 'jury i at the information provided above Is true and correct
Signature: —.o// ��i / /'�.a/ / Date: •
( c ,
Phone # \'Y l�) �� �, • •
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 ffi •
Contact Person: Phone #: 1
SECTION 8 - CONSTRUCTION SERVICES ,
k
8.1 Licensed Construction Supervisor: Not Applicabl2 ❑
Name of License Holder : :1, *f 1 S T two
License Number
-- b ( -.0 Js V , c.)w c \‘‘‘• (k *, k\4 --)( ( ( 2
Address Expiration Date di_
-e ' 1' ./ •ge P Vif '
Signs ure Telephone
: ®,t s ® ,Jon' )im '� a. , _... Not Applicable ❑
Company Name Registration umber
- 3-3c (-1Qs \-%.,q.zi, W " fk OA , i Qi 9 ‘ Z
Address Expiration Da e
.f Telephone S`1(C — ‘Wr4c ---
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M O 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 th building permit.
Signed Affidavit Attached Yes No ❑
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
SECTION 5- DESCRIPTION OF PROPOSED WORK (check: all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [lam] Decks [C] Siding [0] Other [0]
Brief Description of Proposed
Work: R 2.4YDV c l e l . x ; St l � C.Ce i� / CRt•p 1 -st ,
Alteration of existing bedroom Yes I No Adding new bedrddm Yes d No
Attached Narrative Renovating unfinished basement v' Yes No
Plans Attached Roll - Sheet
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: 7 Number of Bathrooms
c. Is there a garage attached? y �S
d. Proposed Square footage of new construction. Dimensions
e. Number of stones?
f . Method of heating? S ' n Fireplaces or Woodstoves t\ 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. Wilh.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
, 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 , mpt, \� aC' \tLt t (b9, �S 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 / J I
Signature of • ner /Agent Date
■
4 ` �.
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information "P 1
Existing Proposed Required by Zorfing a V
This column to be• filled in by
` Building Department
1i
' Lot Size 1 i
Frontage \, I l
774 i
Setbacks Front r 1
Side L: R: 1 L:
ni R:l s 1 ( ...._,.....
Rear 1 1 1 1/
Building Height _____R [ I '
i �O
Bldg. Square Footage i 1 =% 1 1 1 1 / =
..pen. ace Footage ` %. - - - --
P g
(Lot area minus bldg & paved E = ,.
parking)
/
# of Parlung Spaces
Fill:
(volume & Location) — 1
A. Has a Special Permit /Variance /Finding ever been issu :d for /on the site?
NO 0 DONT KNOW 0 Y 11 ' 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry o Deeds?
NO 0 DONT KNOW 0 Yi {S 0
IF YES: enter Book 1 Page I and /or Document # 1 I
B. Does the site contain a brook, body of wat: or wetlands? NO', Q DONT KNOW 0 YES 0
IF YES, has a permit been or need to b obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , pate Issued: I
C. Do any signs exist on the property? YES 0 NO 0\
i
IF YES, describe size, type and ocation: 1 i '
D. Are there any proposed chan• -s to or additions of signs intended for the property ? YES 0 NO 0
IF YES, describe size, ty6e 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 0 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
o..
O �� City of Northampton
�., Building Department ' a
��� ��►a 212 Main Street �: g,�� - �� ,� • t do s o at Room 100 ���f� �� ,
Np Northampton, MA 01060 f ' kP I
phone 413 -587 -1240 Fax 413- 587 -1272 i; , , -. ; . ° � e
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 SITE INFORMATION I
�
This section to be completed by office
1.1 Property Address:
l p t ,,, sL'ot Unit
1 n�� �.
w � � � � � '" �t vm`��� s �s ,�� � r � �' � �� �� � � .� ,dam „� -� � ,
\ C -� �, t `�( /� j\ `O ' Zo ne z E , erlayDistrict.'
E
-„Iw m Sc P trl ', . . B Distr
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
Tyr, QaS s 8' R. e v e CN■f t--)p \-\,,,...,3 e.S J\ , � OcAANC.,, K1 ,
Name (Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent `,
S � °- App , C �.rlgW Q,.,,(y4 S - C Q,0( tS Mc�.w W 4vvk�
Name (Print) Current Mailing Address:
Signa ure Telephone
SECTION 3 ESTIMATED CONSTRUCTION COSTS;:
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building . b O (a) Building Perrit Fee
0
2. Electrical i S 0 (b) Estimated Total Cost of
_ Construction from {6)
3. Plumbing O Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
] O� O Ch eck N umber
6. Total= (t +2 +3 +4 +5) � 'f. /
! 17'iy-121
This Section For Official Use Only
. ate
Building Permit Number: Is
Signature: �/
Building Commiesienerllnspectorof Buildings Date
40 HOWES ST BP- 2012 -0871
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A - 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: INSULATION BUILDING PERMIT
Permit # BP- 2012 -0871
Project # JS- 2012- 001414
Est. Cost: $24000.00
Fee: $144.00 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:4/5/2012 0:00:00
TO PERFORM THE FOLLOWING WORK: RENO KITCHEN (CABINETS &
COUNTERTOPS),ENLARGE DOORWAY
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 4/5/2012 0:00:00 $144.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner