24C-016 (2) THOMAS L. CHAISSON
P.O. BOX # 1013
WENDELL,MA. 01379
HOME 1-978-544-8042
CELL 1-413-522-4939
4/15/2013
NAT ARAI •1 fr i L i J 1 oti6'i5
268 PROSPECT ST. e,a.
NORTHAMPTON,MA. .0 •t/#-- 06,c.3
ROOFING BID CONTRACT
1.TAREOFF ALLASPHALT SHINGLES,UNDERLAYMENT AND DRIP EDGE
FROM ENTIRE HOUSE INCLUDING FRONT PORCH AND LOWER ADDITION.
2.APPLY WATER&ICE SHIELD TO BOTTOM THREE FEET OF ROOF,IN VALL-
YS OF MAIN ROOF,TO THE ENTIRE PORCH ROOF AND ADDITION ROOF.
3.INSTALL NEW EIGHT INCH ALUMINUM DRIP EDGE.
4.REFLASH CHIMNEY AND INSTALL NEW VENT STACK BOOTS.
5.INSTALL THIRTY YEAR ARCHITECTURAL SHINGLES AND CAP AT PEAKS.
TOTAL COST OF THIS PROJECT IS $14,400 FOURTEEN THOUSAND FOURHUN-
DRED DOLLARS
TERMS OF PAYMENT ARE ONE THIRD OF THE TOTAL AMOUNT OF
CONTRACT AT BEGINNING OF JOB4ONE THIRD AFTER ROOF IS DRIED IN
AND THE REMAIDER AT COMPLETION.
CONTRACTOR TO CARRY LIABILITY INSURANCE.CONTRACTOR TO SUPPLY
ALL MATERIALS,LABOR AND EQUIPMENT TO DO JOB.CONTRACTOR TO
DISPOSE OF ALL DEBRIS ASSOCIATED WITH THIS PROJECT. CONTRACTOR
TO PULL BUILDING PERMIT.
THOMAS L. CHAISSON
GENERAL CONTRACTOR .....(4„:717441'
CSL#074671 HIC#131023 c-- 7' 7
' //3
CITY OF NORTHAMPTON
Construction ri Affidavit
in accordance with the provisions of MG.L. c. 40 § 54, all debris resulting from any work
covered_by a Building Permit shall be disposed of in a properly licensed disposal facility,
as defined by M.G.L. c..111 § 150A.
• Address of Work: Pr o.spe c1 .SL 4/0/ 1'-19-16.1. 411
— ---The--debris will be transported by: 4//en's cell 0 fib a is - Jtr1i-
The debris will be received at: A y4, .
Signature of Permit Applicant •
Date L/ /7.72 G
Building Permit Number:
•
•
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: /AG 044 j 01,4 I,SJ/h. 0-241 4 7 1
License Number
OJ /U S t
2 6 1 Z(
t ' H i1 la W iPGJ� PM vt ]�
Add gi____
Expiration Date
Signature Telephone
9. Registered Home Improvement Contractor: Not Applicabley ❑
Company Name 1 ' ! Registration Number
Address Expiration Date
Telephoned; ,S`ri-6 072
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 t'o family dwelling,attached or detached structures accessory to such use and/or farm
structures.A person who constr cts more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit t the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work pe formed 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 aid Loc. .Zoni• Laws a State of Massachusetts General Laws Annotated.
Homeowner Signature ! '' �r
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House n Addition ❑ Replacement Windows Alteration(s) ❑ Roofing El
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [EJ Siding[O] Other[0]
Brief Description of Proposed / /
Work: aT e_p/�°c,e... 7'�SAS/< c6 gP/ j(e..( •
Alteration of existing bedroom Yes No Adding new bedroom Yes _T______Z
Attached Narrative Renovating unfinished basement Yes 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 J a
-.
c. Is there a garage attached?J
d. Proposed Square footage of new construction. /2,6a Dimensions _IC k
e. Number of stories? 2-
f. Method of heating? ar Fireplaces or Woodstoves t7 G 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 )a
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply X
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
4171i V j! t/1 ,as Owner of the subject
property �,
hereby authorize / - 01 e---h/f/5-f G/J
to act on behalf in all at ers relaf to work authorized by this building permit application.
gna e of Owner Date g".. / ° /
I 0141 to CA‘; ' r, , 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.
G 7'1G0e.e,.J
C-4 ..4),JJU--,
Print Name / /
Signature of 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 2
Bldg. Square Footage .Z o %
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 ® DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW C YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW ® YES
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 ® NO (3
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES ® 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 ® NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
* .m - City of Northampton Status of Permit
_- Building Department Curb Cut/Driveway Permit
oIR 2 2.2013 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
GFgU1LD�NGIµAQCQ�NS rthampton, MA 01060 Two Sets of Structural Plans
fJNOAtNp70N p one 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address: 21 y p (v 4:, ' c Civ
Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
/ 523 /(e ►�A (JJ L c'°d J�✓'1 o1�
/t/4-l� c V
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent: "�
716+"1-4t.1 (% I.JJ e- P 6. 0 t�Y,: 1013 6/eJelI 1411 i 0 13 7i'
Name(Print) Current Mailing Address:
.. :=3"--U 1- f 2,_fvy--fO /2 CS ila.m -4-1,.2g4
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) 35
5. Fire Protection
/zi
6. Total =(1 +2+3+4+5) 1-746)(1 Check Number
This Section For Official Use Only
Date
Building Permit Nummt.: • Issued:
Signatur / >= �` AL e
Building Commissioner/Inspector of Buildings Date
268 PROSPECT ST BP-2013-0971
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24C-016 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:ROOF BUILDING PERMIT
Permit# BP-2013-0971
Project# JS-2013-001618
Est. Cost: $14400.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THOMAS CHAISSON 074671
Lot Size(sq. ft.): 11369.16 Owner: ARAI NATHANIEL Y&KATHERINE A FIRST
Zoning:URB(100)/ Applicant: THOMAS CHAISSON
AT: 268 PROSPECT ST
Applicant Address: Phone: Insurance:
P 0 BOX 1013 (413) 322-4939
WENDELLMA01379 ISSUED ON:4/23/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF
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 4/23/2013 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner