32A-014 17 WALNUT ST BP -2010 -0084
GIs #: COMM ONWEALTH OF MASSACHUSETTS
Map:Block: 32A - 014 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit # BP- 2010 -0084
Project # JS- 2010 - 000091
Est. Cost: $2500.00
Fee: $55.00 PERMISSION IS HEREBP GRANTED TO:
Const. Class: Contractor: License:
Use Group: KAREN CARTER
Lot Size(sq,_ft.): 6229.08 Owner: MILNE MARGARET T
Zoning: URC(100)1 Applicant: KAREN CARTER
AT: 17 WALNUT ST
Applicant Address: Phone: Insurance:
223 Main Street (413) 221 -7419 ()
LeedsMA01053 ISSUED ON:7/23/2009 0:00:00
TO PERFORM THE FOLLOWING WORK: Repair Porch
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: 1 /, L g
Rough: Rough: House # Foundation: �7 p
Driveway Final: sue' -0 /
Final: Final:
Rough Frame: Cl/ C6 07/ o9 4(/6
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: ,
8/4
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATIONN OF
ANY OF ITS RULES AND REGUL ION ;?
Certificate of Occupancy` � Signature: C,/
FeeType: Date Paid: Amount:
Building 7/23/2009 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
Attachment One:
CONDITIONS
Arbitration
The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dis ute
concerning this contract, the Contractor may submit such a dispute to a private arbitration service which has been
approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the Consumer shall
be required to submit to such arbitration as provided in MGL c. 142A.
Karen E. Carter
Contractor
1 3
Owner -03pitoer
(NOTE: The signature of the Parties above apply oMy to the agreement of Parties to alternative dispute
settlement initiated by the Contractor. The Owner may initiate alternative dispute resolution even where this
section is not separately signed by the Parties.)
Changes in the work
During the progress of construction the Owner may order extra work without invalidating this agreement. Any extra work
must be first authorized by the Owner. The estimated amount for such extra work shall be determined by the contractor
and agreed upon by all parties in advance, if possible. Any extra work will be done on a time and materials basis at an
hourly rate of forty -five dollars ($45.00) an hour.
Requirements of public bodies
Any changes, alteration, additions to, or deletions of any drawings or specifications which may be required by any public
body, utility, or inspector shall constitute a change in the work and shall be paid for in the same manner as any other
change in the work.
Existing out -of -plumb and out -of -level conditions
Unless otherwise agreed, the contractor is not responsible for correcting existing out -of plumb and out -of -level conditions
in existing structure.
Matching existing finishes
The Contractor calls the attention of the Owner to the limitations of matching finish surfaces. Although the contractor
make every effort to match existing textures, colors and planes, exact duplication is not promised.
Termites and Rot
The Contractor shall not be obligated to perform any work or correct damage caused by termites or rot, unless otherwise
specified herein.
r
• No work shall commence prior to the signing of the Construction Agreement and transmittal to the Owner of a copy c°
such Agreement.
• The owner agrees that the foregoing terms, specifications and conditions are satisfactory and are hereby agreed
Authorization is given to do the work as specified and payment will be made as outlined above. The owner, upon
signing this Agreement represents and warrants that she /he is the owner of the aforesaid premises and that she, :h
has read and agreed with this contract.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES,
I/ 2' 2 7 I sm
Contractor Date
Owner Date
Scope of work and specifications are based on, but not limited to, architectural plans and dr awiri s_
discussions between client and contractor, product manufacturer's information, subcontractor i
•
Karen Carter Carpentry
MA CS LIC. #070008
HIC #124718
223 Main Street
Leeds, Massachusetts 01053
(413) 586 -8733
CONSTRUCTION AGREEMENT
This agreement is between Karen Carter, a State Licensed Construction Supervisor and Horne Improvement Registrant.
herein referred to as "Contractor "; and Teddy Milne herein referred to as "Owner ".
IN CONSIDERATION of the promises as stated below, it is mutually agreed as follows:
• Contractor promises to furnish the necessary labor and materials, including tools, required to complete work in
timely and quality manner at 15 Walnut St. Northampton, MA 01060 for owner as follows:
1. First and foremost it is mutually understood by both parties that the porch is in dire need of repair, that the Owner
is in need of spending as little as necessary and that the Contractor needs is in need of making a living.
2. With that in mind Contractor agrees to perform minimum necessary repairs to porch Structure at 17 Walnut St. !II
is understood that new concrete footings are needed and shall be poured as required by code in order to are .st
the sinking of the structure.
3. it is also mutually understood that the full extent of the porch damage is unknown as it is covered by the existi:.n
exterior siding and interior porch ceilings and that the Contractor will open up the exterior and interior finishes a j
needed in order to fully assess the structural integrity of the porch. As such it is also mutually understood that the
costs are unknown. It is mutually understood that some assessment work has been performed thus far.
4. In light of item #3 above, Owner agrees to pay Contractor an amount not to exceed a total of $2500.00 and a
minimum of no less than $1250.00 under this contract.
5. Contractor agrees to keep Owner up to date regarding what is revealed as to the assessment of the structural
integrity of the porch as it is revealed. It is further understood that there is a possibility that more work shall be
required and that any necessary work beyond the cost and scope of repairs costing $2500.00 shall not be
performed nor covered under this contract.
Owner promises to pay to Contractor in consideration for performance of the work as outlined above as follows:
1. PAYMENT ONE $500.00 down payment (received)
2. PAYMENT TWO $300.00 due upon commencement of work
3. FINAL PAYMENT min $450.00; max $1700.00 due upon completion of work as outlined in this
contract and based upon actual hours on the job and materials purchased and used for the
repair.
• Performance: the work will be performed by Contractor persuant to this Agreement and shall be substantially
commenced on or before: July 27, 2009, and shall be substantially completed on or before:July 31,2009 with the
understanding that weather may adversely affect and delay the proposed timeline.
• Requirements: all home improvement contractors and subcontractors shall be registered with the Massachusetts
residential contractor's guaranty fund. (The residential contractor's guaranty fund is a State fund out of which an
owner aggrieved by a registrant(s) may be paid part of all of their damages under rules and regulations promulgated
by the secretary of the Massachusetts Office of Consumer Affairs and Business Regulations.)
• Any inquiries about a contractor or any subcontractors relating to a registration should be directed to:
Director
Home Improvement Contractor Program
One Ashburton Place, Rm 1301
Boston, MA 02108
(617) 727 -8598
• Permits: Necessary building and sub -trade permits will be secured and in place as required; contractor shall secure
permits as the agent of the owner. Owners who secure their own construction related permits or deal with
unregistered contractors will be excluded from the guaranty fund provisions of MGL c. 142A.
• Cancellation: Under Massachusetts General Laws (MGL), the owner has a legal right to cancel this contract if so
desired, without penalty or obligation within a period of 3 business days after signing and to reclaim any deposit made
at signing.
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
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
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.
Date
Address of work
location
. s
* The Commonwealth of lifassachusetts
° Department of Industrial Accidents
{ — 13= `r
R., - Office of Investigations
` 4. 600 Washing ton Street
Boston, MA 02111
`: , >' www.nzass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers
Applicant Information Please Print Legibly
Name (Busints5lOigauicatiurv' 'Indivi dual) : 1� [ e-
Address: 2 2 3 ,A ;■ a • \\
City /State /Zip: L e10c ( MA- 0/643 Phone #: / 3 - 2 2 / _ -- r a
Are you an employer? Check the appropriate box: Type of project (required):
1.0 I am a employer with 4. 0 I am a general contractor and I
yees (full and/or part- time).* have hired the sub - contractors 6. ❑New construction
2. /Q I am a sole proprietor or partner-
listed on the attached sheet. 7. ❑ Remodel ug
ship and have no employees These sub - contractors have 8. 0 Demolition
working for me m any capacity. employees and have workers'
9. Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their 11.0 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 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 Hp to $250 00 a day against the violator. Be advised that a copy of this statement may be fonvarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby ccer under the pains and penalties of perjury that the information provided above is true and correct.
Signature: \-�� Date: -('C4) ` /
Phone #: /j/ 2- 1 r - 1 I)
Official use only. Do not write in this area, to he 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. EIectrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:
Not Applicable ❑
F <
Name of License Holder : A`T� "'
License Number
02- M k Sf. LuzPs /AA. 7soOE
Address Expiration Date
Signature Telephone //
e�
t 3 -2_2-1 --
9. Registered Home Improvement Contractor - . - Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
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 ❑
11. 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 1083.5.1.
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 nat resulting in Death) of the Massachusetts General Laws Annotated, you may be liable fui peisuu(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 n I Replacement Windows I Alteration(s) Roofing 7
Or Doors El
Accessory Bldg. ❑ Demolition n New Signs [t] Decks [[] Siding [O] Other [p]
Brief De cription of Proposed PC N (eut{e-p MG wtt►c1 j ®t
Work: Duce NSW CFO t37I IJG-S Cr kl/t t..( Suee v p 57k U U 1 c1 J kO - R-94 -4 5—g1C$o N. t
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
sa. If New house and or to::existing haus ng, complete. the following:
a. Use of building : One Family Two Family Other
b. Number of room s`i1each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimension
e. Number of stories?
f. Method of heating? Fi -. aces or Woodstoves Number of each
g. Energy Conservation Compliance. check Energy Compliance form attached?
h. Type of construction ~'\
i. Is construction within 100 ft. of wetlands? Yes No. Is construction 'thin 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
, 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
4 °lit as Owner Authorized
Age hereby declare that the statem is and informa • = • e foregoing application are true and accurate, to the best of my knowledge
an. belief.
gae the pains and penalties of perjury.
Print Name
- 7 / 2 3 2,d,D
Signature of Owner /Agent � Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed RL,quitul by Lotting
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L....._.._. R.;,.._ _..' L.' _
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 er been issued for /on the site?
NO 0 DONT KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO (:) 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 Cr DONT KNOW 0 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 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
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 Q NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
r Departni t U orkty
City of Northampton S tatus ` r44Permit �
Building Department C ur b CutlD P
ew er1Septio A varlabiiht y
212 Main Street S
Room 100 W ater /W e1I.Av a iIabih t y ` r
Northampton, MA 01060 Two.Sets ofStructuraiPlans
phone 413- 587 -1240 Fax 413- 587 -1272 PloUUSit P lans
Y
Other`Spe crry ,;
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
`1 VVCLI Aift St . Map Lot Unit
Zone Overlay District
Elm St District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
1 dd 14 (IQ_ 15 h/At it) v S`T.
Name (Print) 1 Current Mailing Address:
�i 3- $ 4 s = - Pci
Telephone
Signature
2.2 Authorized Agent:
KftR , e, ' &1 i ? ,2,13 14m1.1 5? . 1_,. =�1)5, h A
Name (Print) Current Mailing Address:
413 221 .. 7419
Signature Teleph e
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building - - D (a) Building Permit Fee
2 Electrical _ V . (b) Estimated Total Cost of
_ Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) '-- 'S . " -- 61) Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature: _ ova ^^- 4if,--,—(-).-0 0 7/03/02
3/0/
Building Commissioner /Inspector of Buildings Date