25A-129 (2) / New Horizons
Builders and Remodelers
PO Box 413
92 South Chesterfield Road
Goshen,NIA 01032
All warranties on the owner's rights under the provisions of 780 CMR R6 and MGL c 142A
Permit Notice:
a. any and all necessary construction-related permits;
b. that it shall be the obligation of the contractor to obtain such permits as the owner's agent.
c. that owner's who secure their own construction-related permits or deal with unregistered
contractors shall be excluded from access to the Guarantee Fund.
Arbitration: If the contractor determines that in the event of a dispute, the contractor wishes the
dispute to be settled by state-approved arbitration, this fact must be signified on the contract and
both the contractor and owner shall sign this clause separately.
"The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a
dispute concerning this contract, the contractor may submit such dispute to a private arbitration service which has
been approved by the Office of ConsumerAffairs and Business Re
ulation and the consumer shall be required to
submit to such arbitration as provided in MGL c 142A.
Homeowner Signature: Date
Contractor Signature: v'^ `�' Date
NOTICE:The signatures o the parties above apply only to the agreement of the parties to alternative dispute
resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section
is not signed separately by the parties."
Page 5 of 5
�- New Horizons
If Builders and Remodelers
PO Box 413
92 South Chesterfield Road
Goshen, MA 01032
DO NOT SIGN THIS CONTRACT IF YOU DO NOT UNDERSTAND THE TERMS,
SCOPE OF WORK OR ANYTHING ELSE WRITTEN IN THIS CONTRACT
meowner' Signature
/U1/C)LO
Date
Con actor s Signature
Date
You may cancel this agreement if it has been signed by a party thereto at a place other than
an address of the seller,which may be his main office or branch thereof,provided you notify
the seller in writing at his main office or branch by ordinary mail posted,by telegram sent or
by delivery,not later than midnight of the third business day following the signing of the
agreement. No work shall begin until both parties sign the contract and the owner has a
copy of the contract.
This CONTRACT satisfies all basic requirements of the state's Home Improvement
Contractor Law(MGL c. 142A),but does not preclude parties from adding language to
protect their specific interests. Seek legal advice if necessary. Before agreeing to any home
improvement work on your residence you should obtain a free copy "A Consumer Guide to
Home Improvement Contractor Law" by calling the Office of Consumer Affairs and
Business Regulation's Information Hotline at 617-973-8787.
The homeowner has a three-day cancellation rights under MGL c 93 s 48;MGL c 140D s 10 or
MGL c 255D s 14 as may be applicable.
Page 4 of 5
t New Horizons
`
rl Builders and Remodelers
PO Box 413
92 South Chesterfield Road
Goshen, MA 01032
The following schedule will be adhered to unless circumstances beyond the contractors control arise:
Work Scheduled To Begin: October 10,2006
Expected Date of Completion: October 13, 2006.
Please note construction projects can be delayed due to supplies,weather and unexpected
problems. However, the Contractor intends to work in a continuous manner until project
completion.
TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE
The Contractor agrees to perform the work, furnish the material and labor specified above for the
SUM of: $ 1,316.00 (Price does not include change orders or unforeseen problems)
THIS IS A TIME AND MATERIALS CONTRACT.
Payments will be made according to the following SCHEDULE:
$0.00 upon signing contract
$300.00 by 10/10/2006 or upon initial start date
$1,016.00 or as invoiced upon completion of work.
In order to meet the completion schedule, the following material/equipment must be special
ordered before the contracted work begins:
At this time no materials/supplies are anticipated to be backordered.
Page 3 of 5
New Horizons
I � Builders and Remodelers
PO Box 413
92 South Chesterfield Road
Goshen, MA 01032
SCOPE OF WORK
Remove existing door above porch and install exterior finish. Finish material will be pre-primed
clapboards then painted. Paint to be supplied by homeowner. Paint area above gable.
MATERIALS FOR THE PROJECT
See Attached Estimate dated October 1,2006.
UNEXPECTED and UNFORESEEN PROBLEMS
If the Contractor observes problems such as rot,bug infestation or other unknown or unforeseen
problems, the Contractor will inform Homeowner immediately. Additional disposal of rotted wood
or other waste materials and replacement/repair of those areas not specified in this estimate will be
added to the final invoice.
Homeowner initials and date
Contractor initials and date Ia 1(��dfD
CHANGE ORDERS
CHANGE ORDERS AT THE REQUEST OF THE HOMEOWNER DILL BE A DIRECT
BILLING ONALLMATF.RIALS. HOMEOWINERAGREES TO PAY PRIOR TO THE
PURCHASE OF THOSE MATERIALS. LABOR DILL BE A DIRECT COST AT AN
HOURLY RATE OF x'25.00 PER HOUR.
SERVICES PROVIDED BY HOMEOWNER
The Homeowner is to provide electricity and water(outside faucet) at no additional expense
to the Contractor.
Page 2 of 5
New Horizons
Builders and Remodelers
PO Box 413
92 South Chesterfield Road
Goshen, MA 01032
PROJECT: Door Closure
Homeowner Information
Name
loan Finn
Street Address
69 Day Ave.
City/Town State Zip Code
Northami2ton,MA 01060
Daytime Phone Evening Phone
413-584-8950
Contractor Information
Company Name
New Horizons—Builders and Remodelers
Contractor/Owner Name:
Toseph Dunn
Business Street Address
PO Box 413 92 South Chesterfield Road
City/Town State Zip Code
Goshen, MA 01032
Business Phone
413-297-3334 or 268-3383
Federal Employer ID : 20-0003810
Contractor No. 088718 HIC # 144334
Page 1 of 5
Board of Building Regulati{�ns and Standards
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement Contractor Registration
Reqistration: 144334
Type: DBA
Expiration: 9/24/2008
NEW HORIZONS ENVIROMENTAL PERMIT
JOSEPH DUNN
PO BOX 413
GOSHEN, MA 01032
Update Address and return card.Mark reason for change.
Address Renewal Employment Lost(and
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
r Board of Building Regulations and Standards
- b Registration: 144334
Expiration: 9/24/2008 One Ashburton Place Rm 1301
' ter..,' Boston,Ma.02108
Type: DBA
NEW HORIZONS ENVIROMENTAL PERMITTING+L
JOSEPH DUNN
92 SOUTH CHESTERFIELD RD ��
GOSHEN, MA 01032 Deputy Administrator Not valid without signature
BOARD OF WILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Ntxnber: CS 088718
611ydwillt4s: 07/2811965
Explrm:07/28/2008 Tr.no: 88718
PAntrielled: 00
JOSEPH G DUNN
PO BOX 864
GOSHEN, AAA 01032
Commissioner /
O¢'StlP.MA�O .
Grzfl! of War#4amptan z
835 RChliB[tt3 -
s
DEPARTMENT OF BUILDIN G INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building
North,unpton, MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as 1-11s/her construction super-,.' sor. 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
¢-fttnlf pT
R E UT tTf �tt1 f Ijii111�JfD11 _ _-
gf '51X3 achnsclle' _
DEPARTMENT OP BUILDD\10 INSPECTION'S
212 Alain Strcet Municipal Buildinc
Northampton, Mass. 01060
N-YOMC R'S CONMENS!+ TION •CgSLrR�hCF' A r TM VIT
(li ccnsxJperm�tfcc)
v.9ih a prb,-lcipal place of business/residence at:
{)hone-=)
(sar t/ci ty/suLC/a P)
do hereby cerdi , under thc.pa_itLs -nd penalties ofperjury, ihzl
( ) I ;1n an employer providing die followine v,orkcr's comncnMnon cove 2gc for Ind•
emp!ovees woflong on Lins job:
(Lasw-an=Comp am) (Policy NU-mi cr) - ( :pirarioc Du-)
( ) I am a sole proprietor, general contractor or homeowner(circle one) amd have hired
the contractors listed below rvbo hive the fobo%ving worker's cot oen_sanion policies:
(-Namc 0. Coa=aor) (In umric:c Cor pan)-fPoUCi ��tt1II1=<I) (I•`-J�iJ ^ D IlC}
(Namc of Contractor) Ojis-Iancz Compaay/Po(]CZ Date)
(Nzme of Coanacldr) Ozsurancc Compan)-/PcL-q-ivamb�r) (Expir000 Dalc)
(Name of Contractor) CL=ranc-- Comczay/PoLcy Number) (Expim6on Dair).
(atlar�:d�iCOCa1�cC,tf acc�a�to incluck=iaform oc pctn.ia to'U oca=--mo:. ) 6
ii
I am a sole proprietor and bave no one work-j-Dg for me.
( ) I am.a home owner performing all the wofk myself.
NOTE:plc be cw-im Eb--v-lr}c bo=on",=_bo ccuplaY pcsws to do ma cam-c,00 c rgair work ao x d..cll_z of
ant most th_o t'.1o^_tit-in ulyeb the bocDOOV VC rcido or.the pmtta_,z77.rtc*+.*+tbe-ro c.-r vx w=d=d to be
employe uor e the .aS ssb o=p=-,:m An(GL1 5L=1(5)�:W U=L000 bf a bomwwvc for:6c=.or pcmn e=y-iM—the
Ic pI cU,---of= =pl*yec under drn Woricolc Comyom.atioa Act_
I uadeixind tb-A°DYy-[Lb:-=acme=m..y bo foe-+.erd..d to tba Dcpnrcmr_x¢orin&rrju A &xdy oT,-orlra--f-tb<
oov-n se rt if==ion end drat L-that w scout hovRy6C tmdc=ciion 25A of MOL 151 c=!ad to the=P.�joo of c=insl pcM&1,=
coaiL'a g of a fiat of up to 51.50o.00 andloc b33;ruocmcII of up to occ y,rid c%il pmaYio io bbc focm of.Stop Work;Ord-nod a
rim of 5100.00 a d_y apinA me
For u.c Doty
PcrmJt Nttmbcr
In h lvfnP° Lot
Si 4't of Lia-nsczfPcmniucc —�� -_ j
SECTION 8 CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
/
Name of License Holder: c�(�l'17�'\ �-1. v`I� `9* bl/I
T
License Number
Address Expiration Date
,n `'I13 L�, -.33b
Signal re Telephone
Not Applicable ❑
AhJ An Z&N Su c, l qq 3541
Company Name Registration Number LA
Address Expiration Date
Telephone 2-L pj
SECTION 10-WORKERS'COMPENSATION- AFFIDAVIT'(M.G L.c.1'52,:§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 a€Homeowner:-Person-(s}-who-awn-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 ❑ Mr ent Windows Alterations) E] Roofing ❑
J-60
Accessory Bldg. ❑ Demolition New Signs [O] Decks [❑ Siding[0] Other[C]
Brief Des nption of Pro,PQsed
Work: If d ue Old d0,Qr A CJ(3 e U a (.r ppJ l S'r) KC
Alteration of existing bedroom Yes—7x—No Adding new bedroom Yes x No
Attached Narrative Renovating unfinished basement —Yes
Plans Attached Roll -Sheet
sari N�evu o�asan ` rJtion eisuiu >Idcorrt ei o n� g:
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 i"E�COMPLETED W,MEN -,
OWNERS,,AGENTDR CONTRACTOR--PLIES-FOR BOIL"DING:.PERMIT.
as Owner of the subject
property
hereby authorize
to acct on my behalf,in all matters relative to work authorized by this building permit application.
"tu" ner Date
I, wo as Owner Minowledge
ftp)Pherehy declare that 7M6 statements and information on the foregoing application are true and accurate,to the best of
ifftd belief.
Signed under the pains and penalties of perjury.
Print Name
v
Signature of Owner ge Date
. � . fo .
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
Frontage
Setbacks Front
Side L:
Rear
Building Height
Bldg.Square Footage
Open Space Footage %
(Lot area minus bidg&paved
#of Parking Spaces
(volume&Location)
,
'
'
A. Has a Special Perm it/Vahanca/Findi ng ever been issued for/on the site?
�� Ah
NO �~� DONTKNOVV \1 " ��YES �.�
IF YES, date issued:!
IF YES: Was the permit recorded ot the Registry u[Deeds?
NO �� DON7KNOVV YES�_�
IF YES: enter Book Page and/or Dncument#
�� ��
B. Does the site contain a brook, body of water orxvet|ands? NO DO07KN8VV �_� YES \��
'—�
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs umbeobtained �~� Obtained �~\ Date
\~� �_� ' ' '
��
C. Do any signs exist on the propor�? Y[3 �~� 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
' ~
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,gradingexcavation,or filling)over 1 acre nrioit part nfu common plan
that will disturb over 1 acre? YES NO ��>
�� s=
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
• 1 r
Y ^a
'"' Northampton ' ` '
"o �, BUIiCXIrf , Department
�`� 21ain Street
Room\100 a
10 Northan pton,\MA 01060
� phone 41 , ,$7` 1244 Fax 413-587-1272
AIPPLICAN'TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION,1 -SITE-INFORMATION
1.1 Property Address: Th�ssecfion to be complefea affice
aA
" a , ot� tYnr
OYerlayQtstctcf p
SECTION"2-PROPERTY OWNERSHIPIAUTHORIZED,AGENT
2.1 Owner of Record:
Name(Print) Current Mailing ddress:
2 - - ,{✓}yqy Telephone
Si nature
2.2 Authorized Agent:
1)�^V% �
Name(PT t) Current Mailing Address:
IU-338 3
Signatu re Telephone
SECTIW3 ESTIMATERZONSTRUCTIOWCOSTS
Item Estimated Cost(Dollars)to be Official Use Only
om leted by ermit applicant
1. Building � o (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
This Section For OffciaLUse Only
Building Permit Number.. Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2007-0401
APPLICANT/CONTACT PERSON JOSEPH DUNN
ADDRESS/PHONE PO BOX 413 GOSHEN (413)268-3383
PROPERTY LOCATION 69 DAY AVE
MAP 25A PARCEL 129 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
T_ypeof Construction: REMOVE DOOR&CLOSE UP W/SIDING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 088718
3 sets of Plans/Plot Plan
THE F OWING 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 Stree mmission
Signature of Buil mg O icial 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.
69 DAY AVE BP-2007-0401
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25A- 129 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-2007-0401
Project# JS-2007-000589
Est. Cost: $1500.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOSEPH DUNN 088718
Lot Size(sq. ft.): 18992.16 Owner: FINN JOAN B&KIM F GOGGINS&
Zoning: URB Applicant: JOSEPH DUNN
AT: 69 DAY AVE
Applicant Address: Phone: Insurance:
PO BOX 413 (413) 268-3383
GOSHENMA01032 ISSUED ON.1011112006 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMOVE DOOR & CLOSE UP W/SIDING
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 10/11/2006 0:00:00 $25.001409
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
69 DAY AVE BP-2007-0401
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25A- 129 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-2007-0401
Proiect# JS-2007-000589
Est. Cost: $1500.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOSEPH DUNN 088718
Lot Jli. -�f.;; ":'�`?Q? !B Owncr_FINt4 JOAN B&KIM F GOGGINS&
r, �.
Zoning:URB Applicant: JOSEPH DUNN
AT. 69 DAY AVE
Applicant Address: Phone: Insurance:
PO BOX 413 (413)268-3383
GOSHENMA01032 ISSUED ON.1011112006 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMOVE DOOR & CLOSE UP W/SIDING
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: Douse# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
lcuug►: Insulation:
Final: Smoke: Final: (Jt%-
THIS PERMIT MAY BE REVOKED BY THE TY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULA ONS.
Certificate of Occu anc Si nature:
FeeType: Date Paid: Amount:
Building 10/11/2006 0:00:00 $25.001409
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo