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35-115 (6) } Bortf`B $ ofn an a"r8s"" HOME IMPROVEMENT CONTRACTOR Registration: 150539 Expiration: 4/6/2008 Type: Individual WELCOME HOME BUILDING&DESIGN ILIE TRAISTA 264 HARVEY RD WORTHINGTON, MA 01098 Deputy Administrator -p ✓lie vovrunza�rturea,��-o�. �cic�z��.6eCla -_.. BOARD OF BUILDNG REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 092029 Birthdate: 07/10/1959 Expires:07110/2009 Tr.no: 92029 Restricted: 1 G JULIAN TRAISTA PO BOX 106 WORTHINGTON, MA 01098 Commissioner '7 �S /oT Welcome Home green Buildings JULIAN TRAISTA Po Box 106, Worthington,Ma, Tel/fax:9-13-238 5336 CONSTRUCTION CONTRACT This co ntr t,dated cd /10 is by and between the following Owner: Property address p City f 7 71�€�1/� State Zip TeL - W. / aqd -& i Contractor: Street c2Z4 711-lxwe � _City 0 ./�✓��il/� State ip j��W`Te1:ca3,�'"5�.3 O 1. GENERAL This contract is for the following work and materials to be performed by the contractor on the property address above. The project is generally described as follows:- Jf.0EL _ /C/��"Cy'7E�t/ Change orders and modifications shall be in writing and shall become part of this contract. 2. PRICE j The total price for the work agreed upon is $ <20 C,7 Timely payment by owner of all sums due under thi co rac i pf the essence to this contract. The parties agree to the following schedule of payments:-1. Initial payment: S(� 2.Progress payments Stage of work date ex ect am o t 4 a. .�ylil�t/D/1� / b.2�jij ----- — C. B.Contractor may cease operations if any progr s p ment is not made by Owner as required herein,and proceed to collect any balance due with any legal remedy. 3. STARTING AND Cp L T ON PROVISIONS e ork will be in on (�� and will be completed,absent unusual circumstances on 4. PEAMITS AWAPPLICABLE CODES;COMPLIANCES WITH LOCAL LAW A.All ork to be done under this contract will be in accordance with the building codes presently in force in the City of A. Contractor shall obtain all necessary permits and pay all required permit and plan fees from the down payment. B. Contractor shall at all times comply with the laws of this state regarding mechanic's liens. 5. SPECIFIC REQUIREMENTS FOR MATERIALS AND WORKMANSHIP A. This contract will be completed by Contractor in a good and workmanlike manner,using good quality materials. The parties agree upon the following materials specifications and work description,together with any plans or l specifications incorporated herein: -windows A Wall construction roof detail Cabinets fixtures Others as applicable B. If applicable the contract price includes the following allowances: Kitchen cabinets bathroom tub,toilet,vanity Others as applicable 6. SIGNATURE 3 Attached hereto are General Conditions governing the rights and obligations of the parties to this contract. The parties are further subject to the laws of this state governing contracts and mechanic's liens IN WITNESS WHEREOF,we have hereunto set out hands and seal this day of Owner / Co r ctor w0�/ IY �-�` Lem I a Crzty laf Yazthailtptou z $ d �11rlasaRChusetfe - r « DEPARTMENT OF BUILDING INSPECTIONS /= INSPECTOR 212 Main Street • Municipal Building Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction sup,". ,e ::or. 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 hour) a rough buildinzr 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 V The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston,MA 02111 s�•°�� www.mass.gov/dia -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): C7ul-1 071 %'Vt Address: City/State/Zip: ©�/ -�� 7�h�l Phone.#: �i�t��d' ` i3 -,93J``� ��� Lit'Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. [] I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2 0 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers 9. ❑Building addition [No workers'comp.insurance comp. insurance.$ required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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 comp. insurance required.] "Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners 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 far my employees. Below is the policy and job site information. Insurance Company Name: �L7f7< ��'V � .mil Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: i4 rV o _� City/State/Zip: 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 Investizations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 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 el 6. Other Contact Person: Phone#: f SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number L?2 Address Expiration Date Signature Telephone 9,R isfereii Homelm'° ementM:Coritractoru y *; 5 Not Applicable ❑ Company Name Registration Number Address Expiration Date ' Telephone� � J / 2a Q SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M G.L.c.152,§25"C(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.:�=H�me��� nerx��gemutii�-n 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.E 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 shalt 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 I Alteration(s) [�2/ Roofing ❑ Or Doors 171 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks Siding[0] Other[0] Brief Descr of Proposed Work:,crW— -O ),.)// 7�Giflr6 , y��/�/'�i�,O �©pN7� /� �l�f/ 77�O�jh�� Alteration of existing bedroom Yes_ l No Adding new bedroom Yes _1// No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet ,. „.- ,� �..�,v-- sa:1f New House and.Ota itio/n to-ezistina houstncl..completethe fa'[ouvI ,C a.}y Use of building:One Family I Two Family Other b. Number of rooms in each family unit: cX Number of Bathrooms r c. Is there a garage attached? /Vo d. Proposed Square footage of new construction. Dimensions r 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 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 c�Cj( fJ�T/ as Owner Agent reby declare that the statements'and information on the foregoing application are true and accurate,to the best of elief. Sign nd he pains d penalties of perjury. kz ` 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 Rear Building Height Bldg.Square Footage Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces (volume&Location) A. Has aSpaciu| Perm it/Vahanoe/Findi ng ever been issued for/on the site? �� NO �+�� VV� DON7KNO ��/ YES �� IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? �� NO �� DONTKNOVV YES IF YES:� enter Book Page, and/or Document#' i B. Does the site contain o brook, body of water urwetlands? NO �_��� DON7KNOVV \^� YES / IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained �-� Obtained ^�� Date Issued: v~� \~� ' ' �� C. Do any signs exist nn the pnopo�y? 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 y—\ NO 0 IF YES, describe size, type and location: ' E Will the construction activity distudb(clearing,grading n.nr filling)over 1 acre nrisit part ofo common plan that will disturb over 1acre? YES ���) NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. .ti r 4 Department use only City of Northampton Status of!?t Building Department ` CurCx�Cut� V6w--fit. 212 Main Street s" "ie e Se abti Room 100 aii Northampton, MA 01060 106ISSe, sr y x phone 413-587=1240 Fax 413-587-1272 l?lott �te ?kans F Other Specfir� APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION Th's°section to be completed by office 1.1 Property Address: x Map° "Lot .Unit Zone Overlay District f�t—�l/l.t� Elitist District. � ., .: casn�stnct „ SECTION 2-PROPERTY OWNERS /AUTHORIZED AGENT 2.1 Owner of Record:` Name(Print_)) Current Mailing Address: 6' ll�l�–C� Telephone ��t� O Signature 2.2 Authorized Agent: (L-JC11-171Y 7-,PC7�j/"� 10A Name(Print) Current//Mailing Address: Signature Telephone SECTION 3-ESTIMATED"CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building ©�Q (a)Building Permit Fee e5- /pU 0 2. Electrical ��� (b)Estimated Total Cost of 2 r 0 0 D Construction_from.6 1 3. Plumbing Building Permit Fee< 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number. Date .Issued: Signature: Building Commissioner/Inspector of Buildings Date lg ( � oc)o yb I I File#BP-2007-0920 APPLICANT/CONTACT PERSON JULIAN TRAISTA ADDRESS/PHONE P O BOX 106 WORTHINGTON (413)238-5310 PROPERTY LOCATION 14 DREWSEN DR MAP 35 PARCEL 115 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiniz Permit Filled out Fee Paid Typeof Construction: REMODEL LAUNDRY ROOM/BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 092029 3 sets of Plans/Plot Plan THE FO)KLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: 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 Co on Signature of uildmg Officia 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. BP-2007-0920 GIs#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2007-0920 Project# JS-2007-001500 Est. Cost: $21000.00 Fee: $90.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JULIAN TRAISTA 092029 Lot Size(sq.ft.): 8102.16 Owner: WARE ROSEMARY Zoning: SR Applicant: JULIAN TRAISTA AT. 14 DREWSEN DR Applicant Address: Phone: Insurance: P O BOX 106 (413) 238-5310 WORTH INGTONMA01098 ISSUED ON.414/20070:00:00 TO PERFORM THE FOLLOWING WORK.-REMODEL LAUNDRY ROOM/BATHROOM 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 4/4/2007 0:00:00 $90.001715 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo