24D-183 ADDITIONAL WORK.•
UFC will perform any desired additional work upon mutual agreement with Customer; either by
change order for an agreed price or billing for time and materials at $55/hr.
PRICE:
Note: replacement window prices are subject to change until ordered. The prices given have
been quoted from supplier and will probably remain good.
Brosco windows (9) 1920
Marvin windows (2) 980
Labor 2400
Permit 55
Debris disposal 40
Materials /supplies 100
Job overhead 240
Total $5735 r�
- plus - `1" .a6 -0 f KfT l -' � s
Insulate wall/window cavities if needed $ 650
PAYMENT: 3a
Customer shall provide UFC a deposit in the amount of $2.900 as surety for material purchases
and other direct expenses; further $1300 at 50% completion defined as completed installation of
at least 6 windows. Remainder due on completion. Any additional charges payable upon weekly
invoicing.
SCHEDULE:
Work to begin at earliest agreeable time. Work to be completed in a timely manner. Customer
agrees to provide access and allow construction work to proceed on all weekdays beginning at
8:00 AM and ending by 6:00 PM. Other arrangements may be made by mutual agreement.
Notice to homeowner: Massachusetts state law provides that all home improvement contractors and subcontractors shall be registered with the
Commonwealth of Massachusetts Board of Building Regulations and [ ny inquiries about a contractor or subcontractor relating to a
registration should be directed to:
MA Board of Building Regulations and Standards
Registration Division, Program Co ordinator
One Ashburton Place Room 1301
Boston, MA 02108
Tel: (617)727 -3200 ext. 25239
DO NOT SIGN THIS CONTRACT IF HERE ARE ANY BLANK SPACES
n
Owner: � i-,--1
Contractor:
l
�
_ •
opa UNDERDOWN
FINE CARPENTRY
33 Phillips St.
Greenfield, MA 01301
(413) 367 -2122
PETER C. UNDERDOWN
MA CONSTRUCTION SUPERVISOR LIC. #96600
MA HOME IMPROVEMENT CONTRACTOR REG. #149771
CONTRACT FOR HOME IMPROVEMENT WORK
10/22/09
CUSTOMER & LOCATION:
Mark Karpel/Denise Gelinas; residence at 125 Prospect St., Northampton MA
SCOPE WORK PROPOSED:
1. Install 3 windows -- assorted sizes, using Brosco double -hung wood replacement
rl.) sash kits Orrand Marvin Tilt -Pac replacement sash kits (2). Windows to include Argon -filled
double -pane insulating Lo -E glass, painted wood interior and exterior, full screens and standard
white hardware.
Units to be installed per manufacturer's requirements and completely sealed and insulated.
Interior and exterior wood surfaces to be primed and painted with two coats finish paint.
Interior trim is to be removed from 2 test windows in order to inspect for proper insulation
between window frames and wall studs: if found to be lacking all windows are to have interior
trim removed and insulation installed, at additional cost (see price quotes below). All interior
trim will be replaced and touch -up painted.
2. Repair 2 casement windows in kitchen such as to restore proper functioning of
opening- /closing and latching mechanism.
Services provided shall include:
Project planning, coordination of design, purchasing of building materials.
Procurement of all required permits and approvals.
Protection of existing structures during work, all reasonable protection of landscaping and
maintenance of premises in a clean, weatherproof and habitable condition.
Execution - oTwork according to agreed p1ans, MA State Building Code, and manufacturers'
specifications.
Removal of old windows and all other project - related debris.
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
regulations The inspection process requires 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
— — pests -in conjunctiontto the_building permit.Issued,_ 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
1 , 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
4
y
The Commonwealth of Massachusetts
Department of Industrial Accidents
= :1.= Office of Investigations •
1= v 600 Washington Street
a
jo
Boston, MA 02111
www.mass.gov/dia
-Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name ( Business /Organization/Individual) ,. it r.�_'D 0 .... . ,.. _,Q 'cure!
Address: 33 Q tLL1 QS j
City /State/Zip: Cl-IZ tcalN) Mk 0 13 0 1 Phone. #: (.0 i3) 3 6 7 - 2 12 z
Are you an employer? Check the appropriate box: Type of project (required): ' I,.
1. ❑ I , a employer with 4. 0 I am a general contractor and I 6. ew construction
employees (full and/or part- time).* have hired the sub- contractors
2. 74 I am a sole proprietor or partner- listed on the attached sheet 7. Remode}ing
ship and have no p1oyees These sub - contractors have 8. [] Demolition
for mein any capacity. employees and have workers'
working
Y P t9• 9. Q Building addition
[No workers' comp. insurance - comp. insurance.t.
required:] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.0 I am-a -hameo&ws e ioiag-allwork _ hers vekxercise.c11heir -- -1-1.0 Ph mbingrepairs 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 requited.}
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy mfoni
t Homeowners who submit this aidavit indicating they are doing all work and then hire outside contractors mast submit a new affidavit indicating such_
1 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.
Iam 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 crimin 1 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: lie advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification
I do he rebycertii4 un • the , a ns :i d,, en ;•s ofp :jury that the information provided.abov_e is.true_andcorrect__ _
Signature: H r Date: 1( Oct d,
Phone #: (q CO ' 367 — 1
O fficial use only: Do�tvt write in this — area; to comp eted by city or town official.
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Buildi a Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector _ __
6. Other
Contact Person: Phone #:
t ,
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : C r■J9 (44220 CnA,wa -I 66 cro
License Nu ber
' 33 Q k LL lP5 5 T • 6a0e ct U( 12 Z'7 /(o
Addre Expiration ate
-( • QA- Si ature Telephone
(4(3) 367 - 2A22,
9.` RegisteredHomeAi t,provemeritcdiAractor- „;. ,",,", <. . ;,,,, . ; : ::z ,, Not Applicable ❑
U E / �AA
VcrK4N1 1 C�.SaNing4
Company Name Registration Number
3 3 r(-( ( P5 Sr. c ut M A 01301 (-49 771
Address Expiration Date
Telephor yl��U3}767'2122 01_/d7 1
—
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 buildpg permit.
Signed Affidavit Attached Yes No ❑
T_he_current_exemption for "homeowners” was extended to include Owner 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 tit - . mad�"nces; Sfate - and ,ocal' .
,. - 6 .- a s- General- La- rysAnnotated.
Homeowner Signature
J
•
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement W doves Alteration(s) ❑ Roofing n
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[l Siding [0] Other [o]
Brief Description of Proposed
Work: [%JST M. 12 «�)1T t (41) ® WS ("sisd, N ONLY `')
/
Alteration of existing bedroom Yes �/ No Adding new bedroom Yes /No v
Attached Narrative Renovating unfinished basement Yes ✓ _ No
Plans Attached Roll - Sheet
6a. !Mew :;[rarusesand..Or.addition a 65aMinti housing; complete the'fol[ inq:
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 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
1, IA e<12 K Q tn._ , as Owner of the subject
property n 0 l
hereby authorize Pc '& �J •''( - 1ZD O`er
to act on my behalf, in all matters relative to work authorized by this building permit application.
616, 6N M vvcs ce)t r cr
Signature of Owner D
p( -' C
C. U KI'Q Qaw 0 , 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.
il r` C. UNDsznitvotdii
Print Na
11.1, -, .. (- 1.4....ILL-7 4 --- /I09/
Sign ure of Owner /Agent ate
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
Frontage
Setbacks Front
Side
Rear „ ._._ ..
Building Height
Bldg. Square Footage %
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location) — — — A. Has a Special Permit /Variance /Finding ver been issued for /on the site?
NO 0 DONT KNOW YES
IF YES, date issued::
IF YES: Was the permit recorded at the Regi try of Deeds?
NO 0 DONT KNOW YES 0
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW e
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 Q NO 12(
IF YES, describe size, type and location:
re tFere any p roposed"chang es to or a i ions o signs in iiii d7or tTie property ? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, ex vation, 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
Building Department lauew
212 Main Street se 0 : c°t �ai e
Room 100 �fi
Northampton, MA 01060 T
phone 413 -587 -1240 Fax 413- 587 -1272
APPLICATION TO Ci�NSTRUCT, 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
125 co s Poor SVV, Map Lot Unit
Zone Overlay District
Eimt St District CB District
SECTION 2 -PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
Ar4b( -- — f+o — - -- ( - -` . _ _ Nava P1Zw ( O 1 0
/ame
(Print) 'Si G . otJ f'i (j4e Current Mailin Address: C C s 7
Telephone
Signature
2.2 Authorized Agent:
OCIES t SVc'2`DCr1 -re`I '3 3 Pc-t- tu_tes Sr. G e NFlr fu - o1_ /
Name (P ' ) Current Mailing Address:
( '36 —2t 22 —
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building 7 67 3 5 (a Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
i
6. Total= (1 +2 +3 +4 +5) ,. 3_5 Check Number a, .!i 3
•
This Section For ®, rcial se Only
Date
Building Permit Number: Issued:
Signature:
Buliding Commissioner/inspector of-Buitdings= Date
41. I ff BP- 2010 -0527
GIS #: COMMONWEALTH OF MASSACHUSETTS
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 -0527
Project # JS- 2010 - 000741
Est. Cost: $6735.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: PETER UNDERDOWN 96600
Lot Size(sq. ft.): 13764.96 Owner: KARPEL MARK & DENISE J GELINAS
Zoning: URC(100)/ Applicant: PETER UNDERDOWN
AT: 125 PROSPECT ST
Applicant Address: Phone: Insurance:
33 PHILLIPS ST (413) 367 -2122 0
GREENFIELDMA01301 ISSUED ON :11/13/2009 0 :00 :00
TO PERFORM THE FOLLOWING WORK :INSTALL REPLACEMENT 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 11/13/2009 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo