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Board of Building Regulations and Standards
T = ti HOME IMPROVEMENT CONTRACTOR
a
t ,® Registration: 150718
�°� Expiration: 4124/2008
Type: DBA
SUNDERLAND ROOF SPECIALISTS
MICHAEL KILLEEN.
27 A HEMENWAY RD g----.4•
LEVERETT,MA 41054 Deputy Administrator
OWNER/CONTRACTOR
AGREEMENT
AGREEMENT,made this 7 day of August,2006 A.D.,by and between Brian Thayer,hereinafter called the Owner,and Mike Killeen,
hereinafter called the Contractor.
For the consideration hereinafter named,the said Owner covenants and agrees with said Contractor,as follows:
FIRST. The Contractor agrees to furnish all material and perform all work necessary to complete the re roof of 23 Smith St
Northhampton MA 01060
for the above named structure,according to the plans and specifications(details thereof to be furnished as needed)of ,Architect,
and to the full satisfaction of said Architect or Owner.
SECOND. The Contractor agrees to promptly begin said work as soon as notified by said Architect or Owner,and to complete the
work as follows:
Rip and dispose of existing roof.Install 1/2"cdx plywood over existing decking.Install drip edge around the perimiter of the roof.Install
ice and watershield on all eaves and chimneys.Underlay the remaining decking with 151b felt.Install Certianteed 30 year Woodscape
shingles(color to be choosen by homeowner).Vent ridge and cap over.All flashing to be replaced with new.All materials and disposal to
be paid for by Sunderland Roof Speciailists.
THIRD. The Contractor shall take out and pay for Workers' Compensation and Public Liability Insurance,also Property Damage
and all other necessary insurance,as required by the Owner,Architect,or by the State in which this work is performed.
FOURTH. The Contractor shall pay all Sales Taxes,Old Age Benefit and Unemployment Compensation Taxes upon the material
and labor furnished under this contract,as required by the United States Government and the State in which this work is performed.
FIFTH. No extra work or changes under this contract will be recognized or paid for,unless agreed to in writing before the work is
done or the changes made.
SIXTH. This contract shall not be assigned by the Contractor without first obtaining permission in writing from the Architect or
Owner.All Sub-contracts shall be subject to the approval of the Architect or Owner.
IN CONSIDERATION WHEREOF, the said Owner agrees that he will pay to the said Contractor$8,525.00 for said materials and
work,said amount to be paid as follows:
$4,000.00 deposit
balance due upon completion of j ob
The Contractor and the Owner for themselves,their successors,executors,administrators,and assigns hereby agree to the full
performance of the covenants of this agreement.
Witnesses: I I /
-7(4 Owner
Contractor
®E-Z CONTRACTORS FORMS FORM NO.OCAP
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'�—— DEPARTMENT OF BUILDING INSPECTIONS =,?E.- /=
INSPECTOR 212 Main Street • Municipal Building >,
Northampton, MA 01060
e
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction super Hsor. The stale 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
•
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(r_L7i17 of N otilia?lllptoll __
4 Q.v�1�"�...' 3laaancflncrtta' �+
,• o- DEPARTMENT OP IIUf11?1hG INSPECTIONS
212 Alain Street Municipal Building _
Northampton, Macs. 01060 r'
WOP G?R'S COMPENSATION NSURANCE AVVLDAVIT
.Y.C.d./VA
(li crasXJpc,-mi tree)
with a principal place of business/residencc at:
(phone )
(so t/city/stairi p)
do hereby certify, under the pains and penalties of perjury; that
•
( ) I am an employer providing the followine worker's compensation coverage for my
employees worming on this job:
(I.osui-gin=Coop-m•) (Policy Nu_ r) (I.•piraon Date)
( ) I am a sole proprietor, general contractor or homeowner (c cie one) and have hired
the conuactors listed below who have the following worker's cor pen_anon policies:
(Marne of Con,..c or) (Insurance Corno ny PoUCi NumL'c') (Expunuon Date)
Ma me.of Contractor) (Insurance ComoanyPotic Number) (LXDir,son Date)
•
(Name of Connaetor) (Lnsuraoea.Compare}•/Folic)• Numbu) • (Expir-tioo Date)
(Name of Contractor) (Insurance Comeatry/Poticy Number) (Expiation Date) -
(.aarh additiec2J Mort ifneo=t.v cc induce perm'^'x to.1J ccor-..o:o)
I am a sole proprietor and have no one world.ng for me.
( ) I am-a home owner performing all the work myself
NOTE:plcx be cw2rC iti,.while boo:c ntven wto eamploy pc-sum to LIP -• -• cci-zrze.,00 a tens work on.do,..tlinz of
ant CDOrt than r rr tm11 in which the bomoo+wa raider or oa the avuodi zppsrtersrl thcoo err ax ocorid_-rcd to be
eth,ploycs tt"r-the w a fir•,,— .,:ca Act(GLI52..m1(5)).r-pptiatioo by a bomeoa-ocr fcr c lic:�.or perms 2=y esidcaee t1:c
Iced cta3u of ca crrtIoyor ceder ttao Workola Compom..tioa Ac[.
I uedezuad did>Dopy of(hi,¢�tomem oyy b.for-xardod to tbo Di morn of l ••ericl N.udratl'Office of lazurwoo for IS.
covC1 if cnioo tmol that L-iltaa to secure bovctn.Se=d or tcetioa 25A of MIL 152 our Ian to the iapasaioa of criminal pcosl•ia
=maim;of a floc of up to 51}00.00 and/or inmpriroanoczo of up to ooc year e.,od eivi1 pmrtio io 6c form of Stop work Order read a
rirb o(S100.00 t thy tptina tnc
For 6ca.rtm7"'-JJ u.c only
Permit Number
,
V • AL( /1. . map:: Lot
Stg:o.a.- of Li.- . 'crmiucc D3te • .
•
1.
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
9 a 4 sterea fot iedr roVei ertttontion� . � , "�: `----asNot Applicable ❑
Company Name Registration N mber
Address Expira on Date
:■/( f tae--‘,,N_ Telephon ( 7 -1
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 ❑
, ,
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 CI Replacement Windows Alteration(s) Roofing 17<.'
❑ Or Doors El
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding[0] Other[0]
Brief Description of Proposed ,
Work: • t "+► 0 Q .... ' I- IA.9 7 . • - mil _it he
•
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa M t ew hoase an tadditlarn ko:existIncr fiousIn: mu e ^t W.:.o Wlfaq:
•
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? 1\--27
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 PERMIT
1, ,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
I, lkLU(AA \_U_'' ,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.
Print N
ippriaitliwii
Signature f Owner/Agent Date
f
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:s L:___ R:= _
Rear ? `
Building Height
Bldg. Square Footage
Open Space Footage % ,______I
(Lot area minus bldg&paved I
parking)
#of Parking Spaces
Fill: `'
(volume&Location) '`
A. Has a Spec' Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES 0
IF YES, date issued: 1
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0� 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 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 Q , Date Issued: 's
C. Do any signs exist on the property? YES 0 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
1
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,ex Lion,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.
( __-_, De® ieeratrserl A
II W EI I Northampton ��Department `'. t p' ain Street � ®° �
,'�I! AUG — 8 2006 .00m 100 w � z §; �
N orthampton, MA 01060 -�E -k7; . -
phone 413-587-1240 Fax 413-587-1272 - m :„'„ < .
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1--SITE INFORMATION
1.1 Property Address:
This-sectlei to be 4I/fP: te,;hyaffice
3 �— `5 "' ' f ° mot
Zones �6 veEJ y)3tstnct
Elm t strict. �' _--- :_�' �t�.B,.DIStnCt.
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
1Jl ,c _ 9-3 �,.c4-1-
Name(Print) V Cu in`<ail g Addr :� c _ ^ 'q
Tel one i mil
Signature
2.2 Authorized Agent:
c c-t,ems_ L � ,�� C� � (.6 4-6 v,k k t �A Q`G
Name(Print) ,� Current Mailing Address:
Sig ture Telephone
—
SECTION.;
BP-2007-0148
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2007-0148
Project# JS-2007-000219
Est. Cost: $8525.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SUNDERLAND ROOF SPECIALISTS 150718
Lot Size(sq. ft.): 8842.68 Owner: BROWN JUSTIN M&BRAD THAYER
Zoning: SI Applicant: SUNDERLAND ROOF SPECIALISTS
AT: 23 SMITH ST
Applicant Address: Phone: Insurance:
P 0 BOX 88 (413) 374-2027
HADLEYMA01035-0088 ISSUED ON:8/8/2006 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP, PLY & 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 8/8/2006 0:00:00 $25.001288
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo