25C-244 Philip A. Morin Contractor Page No. of Pages
REMODELING AND DESIGN PROPOSAL
54 Wilson Street • Ludlow, MA 01056
Tel(413) 589-0957 • MA Reg. #119336 All home improvement contractors and subcontractors engaged
in home improvement contracting,unless specifically exempt from
registration by Provisions of Chapter 142A of the general laws,
Submitted To: WW, vh e–t— must be registered with the Commonwealth of Massachusetts.
Inquiries about registration and status should be made to the
Director, Home Improvement Contract Registration, One
Ashburton Place, Room 1301, Boston, MA 02108 (617) 727-
��. G Ali 8598.Owners who secure their own construction related permits
or deal with unregistered contractors will be excluded from the
Guaranty Fund Provision of MGL c. 142A.
PHONE DATE REGISTRATION NO.
JOB NAME/ JOB LOCATION
>We hereby submit specifications and estimates for work to be performed and aterials to be used:
Lei 'J
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Construction related permits:
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WORK SCHEDULE
Contractor will not begin the work or order the materials before the third day fol owing the signing of this Agreement,unless specified here in writing.Contractor will begin the work on
or about (date).Barring delay caused by circumstar ices beyond Contractor's control,the work will be completed by (date).The Owner
hereby acknowledges and agrees that the scheduling dates are approximate a d that such delays that are not avoidable by the Contractor shall not be considered as violations of this
Agreement.
WARRANTY
The Contractor warrants that the work f urnished hereunder shall be f ree from defe tsin materials and workmanship for a period of following completion and shall comply
with the requirements of this Agreement.In the event any defect in workmanship or materials,ordamagecausedbytheContractor,hissubcontractors,employeesoragents,isdiscovered
within one year after completion of any job,including cleanup,the Contractor sh all,at his own expense,forthwith remedy,repair,correct,replace,or cause to be remedied,repaired,or
replaced,such damage or such defect in materials or workmanship.The foreg ing warranties shall survive any inspection performed in connection with the agreed-upon work.
We Propose hereby to furnish material and labor—complete in accordance with above specifications, for the sum of:
1C ` i d L%,u � C
.� t '0 b dollars
Payment to be made as follows-
�%($ ) upon signing Contract; Name of Contractor/Designated Registrant
V�%($ ) upon completion of "" Street Address
%($ ) upon completion of city/state
shall be made forthwith upon
'
%($ completion of work under this contra t. Phone Federal to No.
Notice: No agreement for home improvement contracting work shall require a Nameof an
down payment(advance deposit)of more than one-third of the total contract price
>or the total amount of all deposits or payments which the contractor must make,in A razed Signature
advance,to order and/or otherwise obtain delivery of special order materials and
equipment,whichever amount Is greater. Note:This proposal may be withdrawn by us if not accepted within days.
Acceptance of Proposal-I have read both sides of this docum nt and all attached documents and accept the prices,specifications and conditions stated.
I understand that upon signing,this proposal becomes a binding cci ct.You are authorized to do the work as specified.Payment will be made as outlined above.
You, the Buyer, may cancel this transaction at any t me prior to midnight of the third business day after the date of this
transaction. Cancellation must be done in writing.
DO N_ OT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
Signature x__� Date ""'Z—QLS Signature Date
IMPORTANT INFORMATION ON BACK➢
p.2
Sep 15 OS 0113lp
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,.
'a Cart of Part tlull Ivitola
91 as1ork Ord a(fa'
DEPARTMENT OP bUlLDrr(C INSPPCTrONS +
z
212 Main 'Street Muaicip") Duildin�
Nori.hampton, Mass. 010GO
NVORKER'S COaNTENSA170N GgStMANCE AFFMA. -
I . Ulf
(1,ccasc c/perav(tnc)
�I-q b a principal place of businessfresidence Pi _
L,4, 1401V
I (srrootici ry/sumr>;p)
do hereby certify, under We pauu zzid penalties of Perjury. :hat
( ) I am an cmployer providing the follow ng�vvorkcr's comoeasr;on cover3�'e`or )s)y
i cmpiovees Nvorsdng on this job.
i
,1 (lnsvrnC Comp gyp) (PotiCf�):ucaoccl (Fapirr;on Dart)
1
( ) I am a sole proprietor, geoual'coatnctor or homeowner(circ;e one)aid hive hitea
the coarra tqm fisted below who have the foilowiag worker's compenstoon policies:
(tvamc o'Cosc-�aor) ()nsvranc:Coinpanyjr ri4c; Nmmcct) (ir�puutron oatc)
(Name of Coocaaor) (LArUmaa CoMPUv/?0U v Numb:r) (L•xnin�00 Date)
(N=t of Coar ae1C:) Qnstuaa=Cow wy/PoUcy Nutrbw) (Cvpira000 Dale)
(N=c of Contractor) a 4suraaae CntrmpaoylPot cy Numbet) (Eapindoo Datc),
cw.es add�eml dea.iree -Y ibd ;dam..ieo P*-Ai.ise u,U meson)
PA i ass a WC pfoprietor LA6 have no one woridmS for me.
T aai.a home ouroex perforrnmg a#! the-work myscif
NOTE:View W*—a 0-.ale aaaa�wecn rto eagioy PMUN is As wAiw....w ec==+ 90 a rawk writ am,dwea ing of
ad—thra dzee aa4b 16-lit'!a Z.6oft.--v r reiba or o0 11e vmade gpurtca 46ere.ex CUw%Jly oeptdwW r br
eorpl®yaa+ueEv�!.wlceh camposay,aa Flo(CiIJ)3 2.a 1(S)1 ePPlicaaov by.QemW war fai.liea;x a pe'mi(isaT w,dmx rkc
Iapi a4.ea.erect.aaieyerarwl.'du weat,l�CamV+a+Kws Aw.
i wda:tid da.eePy aJ Vi.aaatio.a�ae.y w te/+.vd.d�.1L.pePera,�a er 4A�+J Aao�y C1de+e!'- ----r«t►.
oow'r.yoi cmum nand Ow ULIMM to aeaw taveee je�Bc aaCiiev 2S A d Aldl 131 ae lal a td i9pmO0a eFaiaiotJ Oma1Da
ewe,iaaaae e(. UP 4I I}00.00 anCyCr 6W4& W.0 or.P 4 9M yW ash Ciril peatre a U fV"era sW Wart Ordo and a
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SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
�Re""`ster`ecTHorrieln Fcvemerr Eontractoit F11 Not Applicable ❑
��L
"�`• i � Ci .^� � �`mil � � �v
Company Namb
/ 4rat n Num er ----
Address Date
Telephone -'0{. I
SECTION 10=WORKERS'COMPENSATION INSURANCE.AFEIDAHkT'`(M.C.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...... ❑
x-411 i
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 Aiuiatated,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
r
SECTION 5-DESCRIPTION OF.PROPOSED WORK(check-all-applicable)
New House ❑ Addition Replacement Windows Alterations) ❑ Roofing ❑
Or Doors C]
Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [p Siding[0] Other[O]
BriefDescri nsoRroposed
Work: I ✓►
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa Llev LKarrse a�ickdd io . aext S Ift oriiethLLo
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.
1. Septic Tank City Sewer Private well City water Supply
SECTION 7a-':OWNER AUTHORIZATION-'TO BE COMPLETED WHEN
OWNERS AGENTAR CONTRAGTOR'APPLIES'FOR'BUI'LDING PERMIT
I. 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, 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
v 't
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' L R::_-
Rear
Building Height
Bldg.Square Footage I % F—i I'
Open Space Footage %
(Lot area minus bldg&c paved
' ---
arkin
— r
#of Parking Spaces
Fill:
volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW 0 YES 0
IF YES, date issued::
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW 0 YES 0
IF YES: enter Book Page: and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Date Issued:
C. Do any signs exist on the property? YES 0 NO Q
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES NO Q
IF YES, describe size, type and location:
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 , NO Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
ii�c of�Vortf��mpton cts ems . �4
u I g Department
fife spt
�rtain Street
b0m 100 re1C �ct1i1 x
r_ 5 20ort�' ' ion; MA 01060 ets."E� 5 ra Plar"ts
phone 413-5�7-1240 Fax 413-587-1272 PIo Sit Ian ��
tttereetfy
APPLICATION To'CCtNORUT. TER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1 This sectron to be completed byroffce
1 Property Address:
Untt
Zone Overlay Distrct
Distnc4
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner ofRecord:
Name(Print) Current Mailing Addre
Telephone Y6 — ("6
Signature ,�J
2.2 Authorized Agent:
r // y
Name(Pri Current Mailing Address:
Si ature Telephone
SECTION 3-ESTIMATED=CONSTRUCTION COSTS
Item - Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building <�0 (a)Building Permit fee
S� I ,
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 Offtcial`Use Only
Date
Building Permit Number Issued:
Signature: -
Building Commissioner/Inspector of Buildings- Date
}
249 BRIDGE ST BP-2006-0299
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C-244 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0299
Project# JS-2006-0440
Est.Cost: $5540.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: PHILIP A MORIN 119336
Lot Size(sg. ft.): 5096.52 Owner: DEITNER WANDA A
Zoning URB Applicant. PHILIP A MORIN
AT. 249 BRIDGE ST
Applicant Address: Phone: Insurance:
54 WILSON ST (413) 589-0957
LUDLOWMA01056 ISSUED ON:911912005 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL VINYL 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 9/19/2005 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo