17D-044 a professional manner according to local building codes and standard
practices. Due to the nature of a remodeling project hidden and unforeseen
costs may arise, if additional work is needed to complete this project you
will be contacted and an estimated will be provided before the work is
performed.
Our workers are fully covered by workers compensation & liability
insurance. Contractor is to obtain all necessary permits for this project.
Acceptance of Proposal—I/we accept the prices, specifications and
conditions stated. I/we understand that upon signing, this proposal becomes
a binding contract. Any alteration or deviation from above specifications
involving extra cost will be executed only upon written orders. You are
authorized to do the work as specified.
Payment will • - made as sutlined above.
yfrti.n '/v o/ Date 11141115
Please contact me with any questions you may have
Walter Marek
W.Marek Construction
09/02/13
W. Marek Inc.
General Contractors
73 Southampton Rd.
Westhampton, MA.
(413) 977 9539 - (413) 527-7667
CS #055201
HIC # 159488
Proposal
Brian & Lesley Baldi
62 Straw Ave
Florence,MA 01062
The following is an estimate for the installation of replacement windows
and structural repairs to house and garage
Remove existing vinyl windows, install 11 new Paradigm Brand vinyl
replacement Window -Tapestry line including welded frames & sash, Low E
argon insulated glazing(u-valve of.30), brushed nickel locks and half
screen
Replace 4 basement support columns
Add 4x4 post to basement stairs
Add 2x6 roof supports to garage ceiling and remove roof storage
We Propose hereby to furnish materials and labor for the project as
specified for the sum of:
Six Thousand Three Hundred and Sixty Dollars
$ 6,360.00
Payments to be made as follows :
$ 2,360.00 at signing of proposal
$ 2,000.00 after installation of wimdows
$ 2,000.00 at completion of work as per this agreement
City of Northampton
w{
Massachusetts
;14
. \
�Y; �< �i` DEPARTMENT OF BUILDING INSPECTIONS r Pt
212 Main Street • Municipal Building
„.a ✓ Northampton, MA 01060 sPkV ,y71t'
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
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 any 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
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
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
p Boston, MA 02111
t ►' www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information / , Please Print Legibly
Name (Business/Organization/Individual): IN I r (e' C.�
Address: 73 &Wra,p✓
City/State/Zip: `I"O- Phone #: `3 9771 X153 5
Are you an employer? Che the appropriate box:
I am a general contractor and I Type of project(required):
4.
1. r:` I am a employer with ❑ g
employees (full and/or part-time).* have hired the sub-contractors 6. New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.t
required.] 5. ❑ We are:a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repai}s
insurance required.] t c. 152, §1(4), and we have no
yemployees. [No workers' 13.g[,Other rf ,�
�;�'.. U
comp. insurance required.] v
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
tHo meowners 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. EVCArs'e •
Insurance Company Name:
Policy#or Self-ins. Lic. #: Expiration Date: i J/i3
Job Site Address: 6 - 5 17 City/State/Zip: 11-111340+\ I4 T
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 certify under the pains and pe lties of perjury that the information provided a'ov' is true and correct.
Sil ature: '� Date:
Q Ib 13
Phone#: Ln � l 95-3T
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 £
Name of License Holder: G_)Gt, igareil( "' CS-s c of
License Nu ber
3 Cowl G y65 13 H
Address .el._____,
Expiratio Date
(73 �a.? a�3
Si ature Telephone
_" " ` Not Applicable £
GO i Mar g- —LrIC 4;9:Registered Home Improvement Contractor :. . ;_ �... ;;:... .. . .:. .. _� ..�.,.. PP
Company Name �� Regi�t�n Number
r■ `fx
Address �, (mil Ex irati n D to
., .i»�l/.JiaA P Telephone U� `-!t ! -iy
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. =Mame 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-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 indows Alteration(s) Q Roofing El
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [I:=J Siding [O] Other[O]
Brief Description of Proposed vat) Wl 2"j, itpk ICI'� �I ji/uv r c f
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
IfNe hOS noradd f on to exstig= iot s�ncrnete tefolloinia < W Ue d: n q; o w :
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
01 eAt) 4 rv-I itt-C7 in CO-4'P ,,, eff.,71- 1,0 ,w , 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
(ca-" /14a,' 1 L ,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 and r the pains and pr enalties of perjury.
(A I til;il f/ /la _//J��
Print Name
C1/1 13
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
i Building Department
Lot Size 1 I ? _..t
FrontageI.__ ..._____._._.____1 ___._______._____ _ 1 .._._..__.___._________I
Setbacks Front , J I 1 =
Side L:`1 R:f 1 Li I R:1 ' 1
Rear
Building Height 1---
Bldg.Square Footage [,_----1 I-1 ' 1-1 r____1 -
Open Space Footage ��
(Lot area minus bldg&paved [___ .I t� _J [_.,_,._,�I L-..._.._.,.1 II
parking)
#of Parking Spaces = r--- H1
Fill: 11 _..__....._.___..�.,._.__,�.....�:...__.�..:M..,
(volume&Location) l
i!
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:;
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW Q YES 0
IF YES: enter Book 1 Page and/or Document#Pagel ___________
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued: 1 1
C. Do any signs exist on the property? YES Q NO 0
•
IF YES, describe size, type and location: f
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO 0
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 Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
i i} fDe pafrtent Use DRIB}( C S*�t4 '7 `t
r r R 4,.-,, 1 F:'t!J°+0;: tQG'. I.r.�F?', sx.h d� salt l si I tiitRi+, I1
r City of Northampton fatus,ofPer n(t - it x 4 r l>x�,�, I w i t r r a.
•,, 1€ u X11����`' ,}rrd �,�u ><� I'S t i i'�F'� >•
_ Building Department Perrrttt�° y �I�F m
4
212 Main Street £ �`(t k l9 ` y 5�9t Y1'f y`n cv Room 100 Vlfater/tl�le t vatlrab:Iitj� t�a k$ �'^� v k 1� F y
t Northampton, MA 01060 Two bets ot5tr ictPral Ptar►s��; i " i 'f� ' f
'if'/' [ phone 413-587-1240 Fax 413-587-1272 PIo/Site Plans = �'x',�y E°# =N�r r+r;,9U 're fi� dam.
�rj G Other apee�f'L I fyr'S�i r. "I'ip r �i' :.:.'.
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
•
SECTION 1 -SITE INFORMATION
• leted by offce Thts section o be omp1.1 Property Address:
6� J�Gtiiti.J 47-t, ,�Map h.
S J
�/� Zone Overlay District
FtJf*CPC V
d
gElit St Ristnct CB District
SECTION 2•-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Recor C1 rlQitt
i4ve Ftrc,,,,,,c, ilig•
Name(Print) Current Mailing Adds:
9 l 4 36s�
Telephone
Signature
2.2 Authorized Agent: n to
)3 Svcil'utlif4 -,Name(Print) Current Mailing Address:
"0, alt 3 q?7 c15-35
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS.
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
j.(1 (a)Building Permit Fee
1. Building 6 2
2. Electrical (b)Eott of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection ,y�
6. Total=(1 +2+3+4+5) 6/3 Check Number p? (y��'{
This Section For Official Use Only .
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
•
•
File#BP-2014-0304
APPLICANT/CONTACT PERSON WALTER MAREK III
ADDRESS/PHONE 73 SOUTHAMPTON RD WESTHAMPTON (413)527-7667()
PROPERTY LOCATION 62 STRAW AVE
MAP 17D PARCEL 044 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �h S
Fee Paid W
Typeof Construction:_INSTALL REPLACEMENT WINDOWS&REPLACE LALLY COLUMNS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 055201
3 sets of Plans/Plot Plan
THE FOLL ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
I FO ATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Peanut With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
�elay
:-��
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
62 STRAW AVE BP-2014-0304
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17D-044 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-2014-0304
Project# JS-2014-000515
Est. Cost: $6360.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WALTER MAREK III 055201
Lot Size(sq. ft.): 5183.64 Owner: SIROIS DANIEL&JARA MALIKIN-SIROIS
Zoning:URB(100)/ Applicant: WALTER MAREK III
AT: 62 STRAW AVE
Applicant Address: Phone: Insurance:
73 SOUTHAMPTON RD (413) 527-7667 () Workers
Compensation
W ESTHAM PTO N MA01027 ISSUED ON:9/16/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT WINDOWS &
REPLACE LALLY COLUMNS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Numbing 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 9/16/2013 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner