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31A-317 (5) _ \'\‘ ;1 / 6 ^ . r-- - -------.....- ...----- ...--....................,..,- / `.2 1 �� __ /‘4\JN ___' ____'-' ___-' ___' ___- ____� _- .., • ''',1 . . to, 11!- if — 1 . ) S-(7 ..S.‘ Z" „,..„,-- • ,€ ---- _ . ,0,1 . - r-7•7 it a 0 i ‘15.. - 1-----F,4",' - ;• _ (2, ' , i t , ; ! , 1 cy..7.__. 54° _ 4 1 ' r Y N ' r,,, , „ (:,..,,re,'i•.:,f, . 4 4..........---------- ---- • ffr, . ,, r-1.41 ,..,.. _. 7%,Z . . ,..„- . . , I $, .. .6- 1--; r .. 0 . . ..,,. ,.... tyttl , N.......,_ ,.,. /(1/451/3 3 Will be executed only upon written orders in the form of a change order,and will become an extra charge • over and above the estimate. $40 per hour and 15% above material cost will be billed for the extras and credits. All agreements contingent upon strikes accidents or delays beyond our control. Owner to carry fire tornado and other necessary insurance. A certificate of workman's comp. insurance,liability insurance, license and registration will be presented upon signin . Respectfully Submitted by , (--'/of Harlow Builders. ACCEPTANCE OF PROPOSAL I accept the above stated prices,specifications and conditions. You are hereby authorized to do the work as specified. Payment will be made as outlined. Date ) f q --I Signature 2 PROPOSAL 4 Harlow Builders 336 Coles Meadow Rd. Northampton, Ma. 01060 (413)586-0465 /e/c. Submitted to: _6[ 1i2 a Ellen Kaufman (413)250-1465 126 Vernon St. Northampton, Ma.01060 Page 1 of 3 We hereby submit specifications and estimates for the construction of a 156 s.f. free standing deck. All materials and labor to complete. All permits obtained by Harlow Builders. All debris caused by construction removed by Harlow Builders. See Attached drawings: by Scott Harlow Dated: 10/25/13 Plumbing: We will move the existing exterior water faucet to the corner of the building. HVAC: We will drain the condensing unit of its Freon. We will cut the Freon lines to shorten the length and move the condensing unit in closer to the house. We need to have a least a ft. of the wall for circulation and repair. We will replace the Freon to the unit and start up the unit to check operation. Excavation: Remove existing rock steps. We will dig into ground surface,to place foundation blocks and beams as needed. We will backfill the blocks and the beam to grade.All excess fill will be spread out onto property. Foundation: We will place(12)8"x8"x16" solid concrete blocks as per plans to support the free standing deck. Deck Framing& Finish: Install(3) Beams the length of the deck. Beams will consist of(3)2x8 pt lumber fastened together. Pressure treated beams to sit on top of the concrete blocks. Install 2x6 pressure treated floor joist, 16" on center,on top of beams. Install 5/4"x6" Garupa decking to the floor joist using Camo 1-7/8" hidden fasteners. Bench: We will fasten 4x4 cedar posts to the deck framing. Frame out a bench made of 2x4 pt. • e • b I • . : I p. . • • : i i is. We will deck the bench seat with Garupa decking. We propose to furnish the material and labor necessary for the completion of the above stated work for the sum of: Seven Thousand Eight Hundred & Sixty Dollars $7,860.00 Payment as follows: $3,930.00 due upon start of project. $3,930.00 due upon completion of the proposal. All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviations from the above specifications involving extra cost, 1 City of Northampton ,o" , o S . 1#j' r, Massachusetts { = r�� ( -y,1 $ ` DEPARTMENT OF BUILDING INSPECTIONS ;'1` I I► (�, e,�, :e' - 212 Main Street • Municipal Building O Jb` „g✓ Northampton, MA 01060 �SIV II/O\ 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 • 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1= , 600 Washington Street *v rN _ E Boston, MA 02111 te N-' 'd Yi www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): Address: �-"S , CQ�eSa� City/State/Zip: �� ��, � .. ©�o�d Phone #: (mac Are you an employer? Check the appropriate box: Ts,ype of project(required): -11E1 I am a employer with a 4. ❑ I am a general contractor and I 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.Cl 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 repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other Qk C comp. insurance required.] *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. tContractors 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: SS be iO.V �''�P 1��/ "�c5 '�Y�S�C�S�e�Q: ��� _ Policy#or Self-ins. Lic. #: y Expiration Date: Job Site Address: - (a U City/State/Zip: \(\N■• � • 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 p ' s an penal ' s f pe ury th t the information provided abo e is true and correct. Signature: 4 Date: // /3 Phone#: I� ��h - c-)4 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 Supe-�rvviisor: Not Applicable £ Name of License Holder: 7 c \\ \-i ;[y,„D License Num er Rs) SZE-)_ k\\A\-\c--ky...4 11111C-- Address Expiration Date Ar o'1 Signature Telephone 9.:Registered HomeImprovementComractor ;' Not Applicable £ Company Name Registration Number . \\< P a i Address Expiration Da e _ ._,_ Telephone S`OG- 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 OwnerExemption 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 Windows Alteration(s) n Roofing ri Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [X] Siding[D] Other[D] Brief Description of Proposed Work: Lam— a .. Alteration of existing bedroom Yes I No Adding new bedroom, Yes ✓ No Attached Narrative Renovating unfinished basement Yes f No Plans Attached Roll -Sheet .6a. If New°house and.or'additionnto existincf ilousind;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? ‘)t._5 d. Proposed Square footage of new construction. 5"C. S V Dimensions ] _" S - - 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 \.r coo fl 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 , 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 S -4";"-\ \k k#\,•3 ,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. GO Print Name Signa ure 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 I Lot Size 1}} _... I j. -_---. I 1 Frontage I____. ____._..__,______._. _______.__.___.__-_. I I____________1 _..._1 Setbacks Front I_ I C ) Side L:t 1 R: LE—I R: - ) Rear C( a .. Building Height i Bldg.Square Footage i % I— Open Space Footage (Lot area minus bldg&paved [_] L. I t -, 71 parking) #of Parking Spaces t I Ia Fill: 1L____ (volume&Location) < -- --- A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW 0 YES 0 IF YES, date issued:1 IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES Q IF YES: enter Book ; Page and/or Document#I u---u B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW Q YES Q 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 C. Do any signs exist on the property? YES Q NO Q IF YES, describe size, type and location: l D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO Q IF YES, describe size, type and location: 1 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 O NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. er—V, t�D rirc e�nrayPerrrirfeht tfe�e onY y ' } i� 3 ) p I po fi ' r r t City of Northampton :wilding Department o�4s Nt ` � a n� d " kaP i- rt 1 o a ,n n r �n- tatusof Pem , � "w t drtr „i24 4 4 ` r1�i £°e Uty 4 l ni 5k 212 Main Street 1 E Y tnspeCt,on Room 100 Wa A ia � h ; Ptumb 1-A 0A°€'3 •_ham ton, MA 01060 Two Sets ot_°Structural Plans r"3 t �'tf a i ctric, h�rc,pic. p �- � t �� ; E1e tyort phone 413-587-1240 Fax 413-587-1272 PIoVSite Plans hf#hey E�d E 'r �' e It kn JI .x tr E 1 1 'k L y r'i,r ,FN hF iF- A4 - Otherz peclt'y ' Y� E, 4 � ailS Er M ��tii , , ;s 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 � Map Lot Unit � a Qc' c) () S� y Zone Overlay District _.Eim St D£stnct c8 District r-- . SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT • 2.1 Owner of Record: 6 kQ ''C. 4,-\ 1QG ��_ Stan S\' Name(Print) Current Mailing Address: Telephone (.11•- c�1 ns Co�(I 5' Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: 013) sCg�— ' 14 IA. 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) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number I�,Q?' This Section For Official Use Only . Date . Building Permit Number: Issued: • Signature: Building Commissioner/Inspector'of Buildings : Date • File#BP-2014-0582 OK ' APPLICANT/CONTACT PERSON HARLOW BUILDERS ADDRESS/PHONE 336 COLES MEADOW RD NORTHAMPTON (413)586-0465 c L ''" r PROPERTY LOCATION 126 VERNON ST MAP 31A PARCEL 317 001 ZONE URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building /1 7l 6 Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCT STRUCTURALY INDEPENDENT 156 SQ FT DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 052460 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INN F;OkMATION PRESENTED: V Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit 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 0- �,: ,nDela .� / // 77/3 Signature of Buil.mg 0 f 'al 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. 126 VERNON ST BP-2014-0582 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A-317 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING PERMIT Permit# BP-2014-0582 Project# JS-2014-000969 Est.Cost: $7000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HARLOW BUILDERS 052460 Lot Size(sq.ft.): 19602.00 Owner: KAUFMAN ELLEN Z Zoning:URA(100)/ Applicant: HARLOW BUILDERS AT: 126 VERNON ST Applicant Address: Phone: Insurance: 336 COLES MEADOW RD (413) 586-0465 Workers Compensation NORTHAMPTONMA01060 ISSUED ON:11/7/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT STRUCTURALY INDEPENDENT 156 SQ FT DECK 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 11/7/2013 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner