32C-205 (7) 1 . ( ILLIAMSBURG HOME IMPROVEMENT Lic.4034841
L� Q V LS P.O. Box 535 + Williamsburg,MA 01096
(413)268-3553
hiAgreWnt�s` nt�Q $ int e day of ,1.' �' , 20 , between
f�
("Owl� er") and Williamsburg Homc Improvement("Contractor"), and concerns property located at
The Owner and the Contractor agree as follows:
All material is guaranteed to be as specified. All work is to be completed in a workmanlike manner according to standard
practices. All agreements are contingent upon strikes, accidents, or delays beyond our control. Owner will carry necessary insurance.
ARTICLE 1 —THE WORK
✓it/P ,� ( �11 �1 UC/0I
A/✓G L�U 1 f—S 4�d.� X'-t C—v.v 1 r'� �� ,.� 2X SiJ , I
ZL A C 1-4 C T— r- L �y A-4 VI/C- 1 � - f I r Lc_1U u G
iK-O0 ✓✓c� llC I 3 / Sri 7,bC)07Q-5- E-11 , ''C 1. 1� C '_lam' 1`11:1 ?e!::� e,-� 13
IV 1 Al,:;)v C r^tn/ 1 5 F-J W c7R 1<
Owner may order changes in the work(additions,deletions, or modification s7V�it the contract sum and the contract time being adjusted
accordingly. All changes shall be authorized by written Change Order, describing with specificity the nature of the Work to be
undertaken,and shall be signed by Owner.
ARTICLE 2—COMMENCEMENT AND ESTIMATED DATE OF COMPLETION The work shall be commenced after delivery
of a fully executed copy of this Contract to Owner, and after payment by Owner of the First Payment. It is estimated that substantial
completion will be achieved on or a A/n1/-I`i f, /, subject to change orders, weather, and availability anelivery of materials.
7., I 1Z__ ;=1,i l s N E v ,J--
ARTICLE 3 — CONTRACT PRICE and PROG SS PAYMENTS The Owner shall pay to Contractor,"subject to additions or
deductions by written Change Orders,the Contract Sum of$ 1 0 C% No work shall begin prior to execution of the contract.
The Owner agrees to and shall make progress payments to the Contractor on account of the Contract Sum as follows:
UPON SIGNING OF THE CONTRACT $ f o D o !r" TA iZ _r
$ Lf i�L a t� J� C-�: F c: ./✓
$ .fir) 0 0 T=1 A/ 1 5 c) r<,
$ C>n0
Final payment, constituting the entire unpaid balance of the ntract Price plus any Change Orders and costs of materials shall be paid
to Contractor upon substantial completion of work. If payments are not made in accordance with above schedule, Contractor may
stop work until payments are made.
ARTICLE 4 — PERMITS, ETC. Owner shall pay for all necessary approvals, building permits, governmental fees, licenses and
inspections,assessments and charges required for the construction,use, or occupancy, and Contractor agrees to obtain such permits, etc.,
as Owner's agent. Owners who secure their own construction-related permits or who deal with unregistered contractors will be
excluded from the guaranty fund provisions of M.G.L. c. 142A.
ARTICLE 5—TERMINATION OF CONTRACT If Owner fails to pay within twenty days of the date set in this contract, Contractor
may terminate the Contract, and Owner shall pay for all Work done and for all materials, including reasonable profit and damages. If
Contractor persistently fails to perform any material provision of the Contract, Owner may cancel the Contract after five days' written
notice to Contractor. However, Owner shall provide Contractor with reasonable time in which to commence the corrective work.
ARTICLE 6—MISCELLANEOUS
6.1 Owner has the right to cancel this contract within three days after signing under M.G.L. c.93§48; M.G.L. c.140D§10; or M.G.L.
c.255D§14, as may be applicable.
6.2 All warranties and owner's rights are set forth in provisions of 780 CMR R6 and M.G.L. c.142A.
6.3 There is no lien or security interest on the residence as a consequence of this Contract.
6.4 The Contract shall be governed by the law of the Commonwealth of Massachusetts.
ARTICLE 7 — DISPUTE RESOLUTION THE CONTRACTOR AND OWNER HEREBY MUTUALLY AGREE THAT IN THE
EVENT THAT THE CONTACTOR HAS A DISPUTE CONCERNING THIS CONTRACT, THE CONTRACTOR MAY SUBMIT
SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE
EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED
TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN MA ACHUSETTS GENE L LAWS.
-� '� •�
CONTRACTOR OWNER
NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the
Contractor. The owner may initiate alternative dispute resolution even where this section is not signed by both parties. All home
improvement contractors and subcontractors shall be registered, and any inquiries about a contractor or subcontractor relating to
registration should be directed to: Director, Home Improvement Contractor Registration; One Ashburton Place, Room 1301; Boston,
MA 02108; (617) 727-8598.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
OWNER DATE ! CONTRACTO DATE
U
t
r
�j
4Trr.
CL
+� (4 a f
mow
I'S
T,5
V-11
4�1
CIQ
. - --
> 33
•�0 a
B . fl �X� IOI� �Lrz�I��11T�t��It
�taSEACIIttSCl1E'0
m DEPARTMENT OF BUILDITIG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORICER'S COMPENSA`zTON INSURANCE AFFIDAVIT
No R AAIA,N a/q- C_-E-S /-, C(
(Ii ce nser�permi tiee)
with a principal place of business/residence at:
01696
UA (phone#)
(6t1=Ucity/Aate/2iP)
do hereby certify, under the pains and penalties of perjury, that.
( ) I am an employer providing the following workers compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors Listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
f
(Name of Contractor) (Insurance Company/Policy Number) (Expiratioa Date)
(Name of Contractor) (Insurance Companyipolicy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additiOnA shoct if naccxsuy to inchsdc infocrostioa patmining to aii o.. ad ors)
�I am a sole proprietor and have no one worming for me.
( ) I am a home owner performing all the work myself.
NOTE:please be as uti that while homeowners who employ pusom to do mjLiof�coa3tvaioa or repair work on a dwmlling of
not moce than thr oo units in which the homoowncr reside oc on the growls apptutenant thamto arc not generally mosidacd to be
cmployrss under the%vm*-t`s.compcnu4oa Act(GL152,"1(5)�application by a homcowna for a boos--or permit may cvidcnoc the
legal dates of an employer under the Wort t C.ompanution Art
I uadcrsiaad that a copy of this crag may be forwarded to tho Dcpuu3co2 of Indzutria.I AOcid'.&offiw of ln—for the
cova-ago verification End brat failure to scene coverago under soctioa 25A of MGL 152 can lead to the imposition of criminsl penalties
oonsbting of a fine of up to S 1,500.00 anNor imprisoamari of tip to ow year and civt7 penattics in the focm of a Stop W ode ordc and a
find of 5100.00 a day ag&ir&ma
gor dq=tnal—oaiy
C) Lot
Permit Number
Map=t
Signature of Licrosecipermittee Datfe
E7ONCONSTRUC7lON SERVICES
8 1 Licensed Construction Supervisor:
,� Not Applicable ❑
Name of License Holder: lvo , to _`� -Jg L E 11 kl�
License Number
ib -P�' d 3 y
Address Expiration Date
Signature Telephone ��
re o'm m r v' men' n r"actor. Not Applicable ❑
Ul/(' 1r Q,a•s 6 Ur9 tlo f r IYhP f` y p Aare
Company Name Registration N mber
lR) P6 n 5 '2> a �3
Address M Expiration ate
Ly, I(c-,c,,6VI!D / 't�l Telephone .Z 0
,SECTION 10—WORKERS' COMPENSATION 1NSURANCE,AFFI DAVIT(M.G.L, c. 152, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidE
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)familic
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(
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
-
SEC ION DESGR F?110 fOF PROPOSED Uu �a�ll
5&N
New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. �K Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ]
Brief Description of Proposed Work: 22- A("G Si—
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑- Sheet❑
f�Newhouse a"�"id�or��d`tl�tfonto ��c'rstingousi"nfr:compsle`te�ttli`� followin"ir:
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. Mascheck 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
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
OaNNERS/AGEt4TIOR,CONTRACTOR APPLIES FOR BUILbING PERMIT
arr ,
as Owner of the subject proper
hereby authorize to ac
my behalf, in all matters relative to work authorized by this building permit application.
Sature Owner Date
, 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 Name
Signature of Owner/Agent Date
.I
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
' � Building Department
Lot Size V, `� i�COD
Frontage 7 ��
Setbacks Front,c6 1
Side ij L: R: L: R:—!�/--
Rear l
�fi
Building Height
Bldg. Square Footage % a Qa 6
Open Space Footage % �/ a
(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 DON'T KNOW 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 Obtained Date Issued:
C. Do any signs exist on the property? YES NO
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:
I r
of Northampton
?,. ding Department
2 Main Street x
1 NOV 19 2001 Room 100
orth mpton, MA 01060
no 7F111�s�l.l'LDIN�l 3 58 1240 Fax 413-587-1272 al?otlSite{P an
.,gin u� iP10N,MA 01060
C3 er�p '.
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
This section to becompletedby office
1.1 Property Addres�s:
� 4
57
Zone¢ Drla �s#roc# ,
t rsr� r
4
Elm SC'District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailin Add re s'
�� MP ti
Telephone S—Q .7 5 ��
Signature Oo
2.2 Authorized Agent: F0 6)0 K S 3 'r.—
/Vo 2N1AA/ �`i4 K� k/I I ( ^ s d y rg i✓tay O /a a to
Name(Print) Current Mailing Address:
ignature Telephone
SECTION 3 - ES7IMATED:CONSTRUCTION,COSTS
Item Estimated Cost(Dollars)to be Official Use;Only
completed by ermit applicant
1. Building a u (a) Building Permit Fee
/tf OVU —
2. Electrical (b) Estimated Total Cost of
A/o �t/ -� Construction from(6)'
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) ^/-0/V
5. Fire Protection
6. Total =(1 + 2 + 3 +4 + 5) Check Number
This Section.For Official Use Only
Btilding Fermat Number Date Issued:
ti.
3-
Signature
Building Gorimtslader,: lnspector ofBu�ldings Dote.
File#BP-2002-0529
APPLICANT/CONTACT PERSON NORMAN ZALESKY
ADDRESS/PHONE 37 CHESTERFIELD RD (413)268-3553
PROPERTY LOCATION 5 KARY ST 1
MAP 32C PARCEL 205 001 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building-Permit Filled out
Fee Paid aAr
Typeof Construction: CONSTRUCT 22 X 22 DET GARAGE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure '
Buildina Plans Included:
Owner/Statement or License 034841
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INVYRMATION PRESENTED:
Approved Denied
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan OR Special Permit and Site Plan
Major Project: Site Plan OR Special Permit and 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 Comm n
C
Signature of Building Official at
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.
BP-2002-0529
GIS#: COMMONWEALTH OF MASSACHUSETTS
° CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: ADDITION BUILDING PERMIT
Permit# BP-2002-0529
Project# JS-2002-0808
Est. Cost: $14000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: NORMAN ZALESKY 034841
Lot Size(sq. ft.): 5619.24 Owner: PULASKI ROBERT B
Zoning: URC Applicant. NORMAN ZALESKY
AT. 5 KARY ST
Applicant Address: Phone: Insurance:
P O BOX 53 (413) 268-3553
WILLIAMSBURGMA01096-0535 ISSUED ON.12131010:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 22 X 22 DET GARAGE
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 12/3/010:00:00 617 $50.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo