18C-117 (7) 9.
BUILDERS
SCOPE SCOPE OF WORK
October 4, 2012
CUSTOMER NAME: Paul Redstone
ADDRESS: 38 Allison Street
Northampton, MA 01060
PROJECT ADDRESS: 38 Allison Street
Northampton, MA 01060
ESTIMATED START DATE: Fall, 2012
ESTIMATED PROJECT RUN TIME: 3 Days
ADMINISTRATION
• Keiter Builders, Inc. will manage the following aspects of the project:
o Building permit application
o Standing all necessary inspections
o Materials ordering and delivery
o Site set -up and break -down
o General cleanup
WINDOWS
MATERIAL
o Please see the attached Quote # 3618 from Andersen for all window specifications
o All miscellaneous material, including interior stop molding, caulk, foam, etc. is included
DEMOLITION
o Remove, and dispose of (12) existing double -hung sash units and miscellaneous waste
o Remove, and dispose of (12) storm window units
o Prepare openings 10 accept new window units
INSTALLATION
o Install (12) new Andersen window inserts following all manufacturer installation guidelines
o Insulate and air seal all new units
o install new interior stop surrounding window unit
Please note that painting, priming, and other `finish' is not included in this contract
Please note that this proposal does not include the cost for a building permit. The permit fee will be added to this contract
price via change order.
TOTAL PRICE INCLUDING ALL LABOR AND MATERIAL $8,652.45
r
NOTICE:
THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES
TO ALTERNATIVE DISPUTE SETTLEMENT INITIATED BY THE CONTRACTOR. THE OWNER MAY
INITIATE AL'T'ERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT
SEPARATELY SIGNED BY THE PARTIES. THE RIGHT TO INITIATE ALTERNATIVE DISPUTE
RESOLUTION SHALL END TWO YEARS AFTER THE DATE OF THIS AGREEMENT.
MISCELLANEOUS:
This agreement is a Massachusetts contract, contains the entire agreement between us, any representations or
warranties not expressly contained in it are not a part of the Agreement, and it is binding upon our heirs,
executors, successors and assigns. This Agreement may be modified only by an instrument in writing signed by
both of us.
This agreement is subject to and is intended to comply with the provisions of Chapter 142A of the
Massachusetts General Laws and its corresponding regulations.
RIGHT TO CANCEL CONTRACT:
YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN SIGNED BY A PARTY THERETO BY
FORWARDING YOUR INTENT TO CANCEL IN WRITING BY ORDINARY MAIL POSTED, BY
TELEGRAM SENT OR BY DELIVERY, NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS
DAY FOLLOWING THE SIGNING OF THIS AGREEMENT.
By signing this Agreement, you acknowledge that you have received a complete and original signed copy of the
entire Agreement and attached Exhibits. Keiter Builders, Inc. may not start work until after this Agreement has
been signed.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. THIS IS A LEGALLY
BINDING AGREEMENT. IF THERE ARE ANY PROVISIONS WHICH YOU DO NOT UNDERSTAND,
YOU SHOULD CONSULT WITH AN ATTORNEY BEFORE SIGNING.
KEITER BUILDERS, INC. HOMEOWNER
/C-c9-/Z_ i
Scott Keiter, its president Date Date
Date
5
failure to pay on time, or to make Keiter Builders, Inc. feel insecure that the remaining payments will be made,
such delay shall automatically extend the date of substantial completion.
ANY DEPOSIT REQUIRED UNDER THIS AGREEMENT TO BE PAID IN ADVANCE OF THE
COMMENCEMENT OF WORK SHALL NOT EXCEED THE GREATER OF ONE -THIRD OF THE
TOTAL CONTRACT PRICE OR THE: ACTUAL COST OF ANY MATERIAL OR EQUIPMENT
WHICH HAS TO BE SPECIAL ORDERED OR CUSTOM MADE, WHICH MUST BE ORDERED IN
ADVANCE OF THE COMMENCEMENT OF THE WORK, IN ORDER TO ASSURE THE PROJECT
WILL PROCEED ON SCHEDULE. NO FINAL PAYMENT MAY BE DEMANDED UNTIL THE
AGREEMENT IS COMPLETED TO THE SATISFACTION OF BOTH OF US.
KEITER BUILDERS, INC. MAY NOT REQUIRE YOU TO PAY PART OR ALL OF THE BALANCE
NOT YET DUE UNDER THIS AGREEMENT BECAUSE KEITER BUILDERS, INC. DEEMS ITSELF
TO BE INSECURE. HOWEVER, IF KEITER BUILDERS, INC. DEEMS ITSELF TO BE INSECURE,
IT MAY REQUIRE A PREREQUISITE TO CONTINUING ANY WORK THAT THE BALANCE OF
FUNDS DUE UNDER THIS AGREEMENT, WHICH ARE IN YOUR POSSESSION, SHALL BE
PLACED IN A JOINT EXCROW ACCOUNT REQUIRING BOTH YOURS AND KEITER
BUILDERS, INC. SIGNATURE FOR ANY WITHDRAWAL.
SUBCONTRACTORS:
Keiter Builders, Inc. intends to hire the following subcontractors to assist in the work:
Name
These may not be all the subcontractors that may be hired, and Keiter Builders, Inc. may decide not to hire any
one or all of the above subcontractors, which decision shall be at Keiter Builders, Inc. sole discretion.
If you ask any subcontractor to make any changes or substitute materials without first obtaining Keiter Builders,
Inc. written agreement, these changes may adversely affect another part of the work that you are not aware of
any may create additional delays and costs. If you make such changes or substitutions, you will pay Keiter
Builders, Inc. the additional cost any subcontractor charges Keiter Builders, Inc. for such changes and
substitutions, and for any extra work and material related to your request, plus Fifty (50 %) percent.
INSURANCE:
Keiter Builders, Inc. shall purchase and maintain liability insurance for protection of all claims under workman
compensation acts and other employee benefit acts, claims for damages because of bodily injury, including
death, and from claims for damages, other than to the work itself, to the property which may arise out of or
result from my operations under this Agreement.
You shall purchase and maintain property insurance in a form acceptable to Keiter Builders, Inc. upon the entire
work and materials for the full cost of replacement as of the time of loss. The insurance shall insure against the
loss from perils of fire, extended coverage and shall include "all risk" insurance for physical loss of damage,
including without duplication of coverage, at least theft, vandalism, malicious mischief, transit, collapse, flood,
earthquake, testing and damage resulting from defective design, workmanship or material. You will increase
the limit of coverage, if necessary, to reflect the estimated replacement cost. You will be responsible for any
co - insurance penalties or deductibles. If the work covers an addition to or is adjacent to an existing building,
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You and Keiter Builders, Inc. agree to waive all rights against each other for damages caused by fire or other
perils to the extent covered by insurance.
RIGHT TO TERMINATE CONTRACT:
If the work is stopped or delayed, either in whole or substantial part, for a period of thirty (30) days under an
order of any court or other public authority having jurisdiction, or as a result of an act of government and due to
your fault or negligence, or as a result of an act within your control; or if the work shall be stopped or delayed
either in whole or substantial part, for a period of thirty (30) days due to your failure to make a payment on
time, or make Keiter Builders, Inc. feel insecure, or if you should commit a material breach of any of your
responsibilities or obligations under this Agreement, then Keiter Builders, Inc. may, upon giving you seven (7)
days written notice, terminate this Agreement and recover from you payment for all work performed; for any
unpaid costs of and fees for the work; for any liability, obligations, damages, commitments, and /or claims that
Keiter Builders, Inc. may have incurred or might incur in good faith in connections with this Agreement, as well
as receiving payment for Keiter Builders, Inc. attorney's and legal fees and all lost anticipated gross profits on
the work not performed as of the date of the termination.
NOTICE:
Notice will be deemed if delivered in hand or if sent by certified mail, return receipt requested, to the address
listed on the front page of this Agreement.
WARRANTIES:
Keiter Builders, Inc. will grant you, as part of the Total Price, a Limited Warranty, a copy of which is attached
to this Agreement. Keiter Builders, Inc. will use materials that are currently acceptable for their intended use in
performing work. You should be aware that it may be determined that some of these materials may cause
health problems. If there are any materials that you do not want used in the work, list them on the attached
Scope of Work form.
EXHIBITS:
The following Exhibits have been attached to this Agreement:
Scope of Work Limited Warranty
ARBITRATION:
THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN ADVANCE
THAT IN THE EVENT THE CONTRACTOR HAS A DISUPUTE CONCERNING THIS CONTRACT,
THE CONTRACTOR MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE
WHICH HAS BEEN APPROVIED 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 MASS. GENERAL LAWS,
C.142A.
4
of conservation commissions, are required to be obtained before Keiter Builders, Inc. can obtain their permits, it
is your obligation to satisfy such requirements and you shall meet those requirements at your cost.
STARTING AND ENDING DATES:
Keiter Builders, Inc. will apply for the permits within 180 day(s) of signing this Agreement or your satisfying
any conditions required to be met prior to the permits being used, whichever date is later. Keiter Builders, Inc.
will start work within 30 day(s) of obtaining the necessary permits and expects to have the work substantially
completed within 30 day (s) of starting.
If Keiter Builders, Inc. is delayed at any time, in the progress of completing the work, due to acts of God, war,
civil commotion, accident, government regulations or policies, any act or neglect of yours, or by any separate
contractor, or by change orders, or by labor disputes, fire, delay in transportation, unavailability of materials,
adverse weather conditions, unavoidable casualties, difficulty in obtaining fuel, electricity, services or supplies
from the sources from which they are normally obtained, or other causes reasonably beyond my control, then
Keiter Builders, Inc. may reasonably extend the date for substantial completion. If the work is not substantially
complete by the ending date, as extended, Keiter Builders, Inc. will not be liable to you for any incidental or
consequential damages you may incur due to such delay.
If you are supplying any materials or equipment to be used in the work, you shall have such materials and
equipment delivered to the work site not less than 5 days before they are needed for the work. If they are not
delivered on a timely basis, Keiter Builders, Inc. will not be able to schedule work dependent upon them and the
date of substantial completion will be extended due to such delay.
TOTAL PRICE AND PAYMENT SCHEDULE:
The total price for performing the work and supplying the materials under this Agreement is
Eight Thousand, Six Hundred and Fifty Two Dollars and Forty Five Cents ($8,652.45) DOLLARS. Payments
against work completed and materials delivered will be made within 2 days from when Keiter Builders, Inc.
notifies you that they have reached different completion stages. Payments will be made in the amounts as set
forth in the attached payment schedule.
60% of window cost due with signed contract ($3,391.47)
40% of window cost + 1/3 labor & misc. material due prior to initiating work ($3,360.98)
Final payment due at Substantial Completion. ($1,900.00)
All sums not paid before substantial completion of the work will be due and payable upon substantial
completion.
Payments due and unpaid under this Agreement shall bear interest from the date payment is due at the annual
rate of Eighteen (18 %) percent or at the maximum legal rate whichever is less. In the event that Keiter
Builders, Inc. incurs costs or expenses in collecting any payments due and unpaid under this Agreement, you
shall pay such costs and expenses including reasonable attorney's fees.
If you fail to make any payments when they are due, then Keiter Builders, Inc. may immediately stop work.
Keiter Builders, Inc. may choose to not start work again until you are current with the payments and Keiter
Builders, Inc. feels secure in obtaining the remaining payments. If there is any stoppage in work due to your
2
CONSTRUCTION AGREEMENT
Keiter Builders, Inc., of Northampton, MA whose Federal Tax Identification Number is 27- 2518846,
Contractor's Registration Number 163295 (Exp. 06 -01- 2013), and License #102457 (Exp. 06- 20- 2014), is
entering into this Agreement with you Paul Redstone of 38 Allison Street, Northampton, MA.
ALL RESIDENTIAL CONTRACTORS AND SUBCONTRACTORS ARE REQUIRED TO BE
REGISTERED WITH THE MASSACHUSETTS BOARD OF BUILDING REGULATIONS AND
STANDARDS, UNLESS SPECIFICALLY EXEMPT FROM REGISTRATION. INQUIRIES
CONCERNING REGISTRATION SHOULD BE DIRECTED TO: DIRECTOR, HOME
IMPROVEMENT CONTRACTOR REGISTRATION, ONE ASHBURTON PLACE, ROOM 1301,
BOSTON, MA 02018 (617) 727 -8598.
SCOPE OF WORK:
Keiter Builders, Inc. will perform the work set forth in the attached Scope of Work on your home, or the
property located at 38 Allison Street, Northampton, MA. If you would like to change any work to be performed
or materials used, we will have to make such changes through a Change Work Order, which may also change
the total price and extend the date for completion. Change Orders will be handled on a time and material basis.
Keiter Builders, Inc. reserves the right to make minor changes in any plans and to substitute materials of equal
or better quality.
Should Keiter Builders, Inc. encounter any unknown conditions below the surface of the ground, or concealed
or unknown conditions in any existing structure, you will agree to make an equitable adjustment with Keiter
Builders, Inc. under a Change Work Order, which shall increase the total price and extend the date for
substantial completion of the work.
PERMITS.
To perform this work, Keiter Builders, Inc., or subcontractors hired by Keiter Builders, Inc., will obtain, on
your behalf, the following permits (if required):
x Building Permit Electrical Permit Smoke Certificate
Plumbing Permit Demolition Permit Certificate of Occupancy
IT IS THE OBLIGATION OF KEITER BUILDERS, INC. TO OBTAIN THESE PERMITS AS YOUR
AGENT. IN THE EVENT THAT KEITER BUILDERS, INC. DOES NOT OBTAIN THESE PERMITS,
AND YOU OBTAIN THEM, OR IF KEITER BUILDERS, INC. IS NOT REGISTERED WITH THE
BOARD OF BUILDING REGULATIONS, YOU WILL NOT BE ENTITLED TO OBTAIN ANY
BENEFITS FROM THE GUARANTEE FUND ESTABLISHED UNDER MASSACHUSETTS
GENERAL LAWS CHAPTER 142A.
Keiter Builders, Inc. obligation to obtain permits is limited to those permits directly related to performing the
work Keiter Builders, Inc. agrees to do. To the extent that other permits or governmental or regulatory agency
approvals, such as, but not limited to, zone changes, variances, special permits, site plan approvals, or approvals
The Commonwealth of Massachusetts Print Form
Department of Industrial Accidents
4,' Office of Investigations
1 1 -,. Uj 1 Congress Street, Suite 100
r, Boston, MA 02114 -2017
er ,- #` www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business / Organization /individual): / r'&it. 6V t L 56.4. S , l J C.
Address: S A f-4 Esc. , ,ST
City /State /Zip: I1bov - t�tk.-&& 'zm/ 1 liAA Ot 01•0cPhone #: y 3 . ,x'6-6 - fa r o o v
Are you an employer? Check the appropriate box: Type of project (required):
1. ❑ I am a employer with 3 4. ❑ I am a general contractor and I
employees (full and/or part- time).* have hired the sub - contractors 6. El New construction
listed on the attached sheet. 7. ❑ Remodeling
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'
coo insurance.$ 9. ❑ Building addition
No workers' comp. insurance p
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3. ❑ 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. ❑Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. No workers' 13AZI Other LAN oci S
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: T t Jet i5
Policy # or Self -ins. Lic. #:2E - iSAA.S (r?578 2.12.- Expiration Date: ( l I - a 3
Job Site Address: 3 g ALA_ �SoN S' . City /State /Zip: Non- tN hN , t(.04 of de o
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 c .fy un r t pains and penalties of perjury that the information provided above is true and correct
Signature: 1'r2„S (4+ Date: If - / 3 - 1 Z-
Phone 1 //3 - 5 - ,T¢0 0
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 #:
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
c 1
Name of License Holder : oT` i We-,17 /0.2 LI C 7
License Number
S el gegr le-L- S 1 AJOrt- FDN AAA Oc o 6 ‘,0-
Addre ` / Expiration Date
� 4. i3 -586 moo
i nature Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
ke /Ter . vi ��� 5, ZI JC . (n 3 c ---
Company Name Registration Number
QA HAT .C - ( oc
Address Expiration Date
/ io'T++A T - °N ,f CI Telephone 1.1/3 •S£S(,• oo
—
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 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-vear 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
Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [EJ Siding [0] Other [6(
Brief Description of Proposed - i-- NseALT ',.-) i j 0`-1 S (z e c,AC T)
Work:
Alteration of existing bedroom Yes — No Adding new bedroom Yes p.__. ' No
Attached Narrative Renovating unfinished basement Yes a No
Plans Attached Roll - Sheet
6a. If New house and or addition to existing housing, complete the following:
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
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.
Q (. -SASE SC- -E 5 ' € . GO / .12 C 1
Signature of Owner Date
1 Sc. -I-i ke- -- , 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.
_, o lr , . =-c ti
Print e /
, I,G Sio6- 1 k ; 6frr L-Dert S 7C-r`.. c• 11 - /3 • I Z
I a ' u re o Owner /Agent Date
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 L: R: L: R:
Rear
Building Height
l31dg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking) _
#/ of Parking Spaces
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO O DON'T KNOW O YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DON'T KNOW 0 YES O
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW 0 YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO O
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? YEE O NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
City of Northampton Status of Permit:
'u _ _ __ _ Building Department Curb Cut/Driveway Permit
212 Main Street Sewer /Septic Availability
IBa 4 C }v i 4 2012 Room 100 Water/Well Availability
orthampton, MA 01060 Two Sets of Structural Plans
- DEPT. OF BUILDING If��P 4 3- 587 -1240 Fax 413 - 587 -1272 Piot/Site Plans
NORTHAMPTON, MA 01060 Other Specify
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
3`6 pru.■ Sory S i . Map Lot Unit
D 2 A N , tvLek o \ o Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
Rik/ 7Z316 315 1\c S t, /V vitT lt�} rc
Name (Print) Current Mailing Address:
'cE 5€ See itt'1TiPcC -1 C_o4 A r✓t Telephone
! 727 • fj 3 /
P
Signature
2.2 Authorized Agent:
ke" Dc.) \ CD S , zi., C• s� A 14,4 i - clef- s 6v&A.
Name Print) Current Mailing Address:
H(3- CVO •gb
nature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building $ � �S Z (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
6. Total = (1 + 2 + 3 + 4 + 5) �, to S Z• ' Check Number o 1a7 (1$-. r)
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
38 ALLISON ST BP- 2013 -0557
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18C - 117 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: windows replaced BUILDING PERMIT
Permit # BP- 2013 -0557
Project # JS- 2013- 000896
Est. Cost: $8652.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SCOTT KEITER 102457
Lot Size(sq. ft.): 9452.52 Owner: REDSTONE PAUL
Zoning: URB(100)/ Applicant: SCOTT KEITER
AT: 38 ALLISON ST
Applicant Address: Phone: Insurance:
51A HATFIELD ST (413) 320 -9035 WC
NORTHAMPTONMAO1060 ISSUED ON:11/14/2012 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 11/14/2012 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner