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Laurent Gaulin 399 Cherry Street
Home Improvement Contractor Holyoke, MA 01040
Registration#101667
Contractor Supervisor License 005270 (413) 534-3744
I (we) Mary Lyons Address 183 Chestnut St Flornece MA
Date 4119104 Phone 586-1733
hereinafter called the"Owner(s)",do hereby agree to purchase the following materials from BEN GAULIN INC.hereinafter called"Contractor"
and authorize Contractor to furnish all labor necessary to install,place and construct this material in the improvements described in the
specifications herein and authorize the contractor to proceed under the terms and conditions as specified.
Complete demo of front porch. '
Rebuild front porch approximately 22'X6'with a pressure treated deck and fir plywood t&g floor.
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Cover complete exterior with Mastic siding and aluminum trim. t
Buid new front stairs with pressure treated lumber and Choice decking. =�
Includes steel front side cites, lattice and fasteners. $7,289.00 I
Budget for dumst $5611.00.
Build one side porch as above, apporximately 8'X6'.
Use existing storm door and window.
Install one entry door purchased by owner, finish inside and out except paint or stain.
Both porches do not include: interior finishes, electrical, wall board. $3,300.00
Strip existing rear addition roof and reroof with Potyglass Elastoflex self adhesive roll roofing over Elastoflex base
sheet. Use 112 plywood for new underlayr>:'lent. Includes all drip and rake edge. $1,100.00
Remove two existing windows in upstairs bedroom and install larger Harvey Vinyl Classic double hung replacement
windows with Low E glass and half screens. Finish exterior only. $400.00
CONTRACT AGREEMENT
Ben Gaulin Inc.will provide workmen's compensation and liability certificates of insurance upon request.
It is expressly understood and agreed that this contract constitutes the entire agreement between the parties.Any revisions,modifications,or
changes must be made in writing.
The owner,expressly agrees that if any balance due under this Agreement as set forth above is unpaid as herein before set forth within the time
provided for payment,then the Seller Contractor shall be entitled to collect interest at the rate of one and one half(1.5%)percent interest per
month for the period of each such sum remains unpaid.
Contractor will not begin the work or order the materials before the third day following the signing of the Agreement,unless specified here in
writing.Contractor will begin the work on or about 4/19104.Barring delay caused by circumstances beyond Contractor's control,the work will
be complete by 4130104.The owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are
not avoidable by the Contractor shall not be considered as violations of this Agreement.
The Contractor warrants the work furnished hereunder shall be free from defects in materials and workmanship for a period of two years
following completion and shall comply with the requirements of this Agreement.
Ail home improvement moors and aubcontractois must be registered with the comrnorwAro of Massachusetts under Provisions of Chapter 142A of the general laws.Inquiries
about regmtrabon and status show be made to the Drector,Home Improvement Contractor Registration,One Ashburton Place,Roorn 1301,Bad=,MA 02108(617)727-a%a.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
Said specifications in contract to cost $12,089.00
DEPOSIT $6,000.00 ON COMPLETION $6,000.00
Owner may cancel this transaction at any time priorlp midnight of the third business day after the date of this trans n.Cancellation must be done in writing.
Authorized Signature R Signed
Ben Gaulin Inc. Signed
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DEPARTMENT OF BUILDING INSPECTIONS /=
INSPECTOR 212 Main Street • Municipal Building
Northampton,MA 01060
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HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as } is/her construction sups:,;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
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J DEPART1fETT OF iUILDMG INSPECTIONS
212 Main Street ' Municipal huilcling
I,,Torthainpton, Mass. 01060 '
Wor,EER'S COMTENISAI N INSURANCE AS M.AVIT
Y
(IIc--ns-r-11)ittCC) -
vnth a principal plan, of businesslre:;idenc
()/O'/P i o n eJr L/1 -s,3Y - 7yy
CIO hereby ceruf�', t:ita-.r the p,:ms at}d pcnaitics of pcF-)uty,
I am an employer providing the `or my
cmploveeS wo6drig un dils fob:
Al G: (A!C2. gS_77�_--- r Z 0/--C�y
(1 r=al Compam') etc,N,amfxr) (rte pir.:aon Date)
( j I ant a sole proprietor, genera consac or or homeo;voer (circle one) and "gave hired
the contractors listed below %-O'c) the `olio ,. g v�01-keys compen�='ion �eiici s:
(Name of Contmotor) (T-us:---ncC CCI^. -:-}'i:PGISCj Number) lT iC' bate
(Name of Connector) _ 0SLSUrm1C Conn=:ItilPo!ic; Number) (I J .atio Date)
(Name of Coatmicior) (InsurlIlc
- (Naive of Contrictcr) — (Ias�raz}c Com? +.y�olier Numi^i_r) - fE;:ri::tip Dare)
nil
I tlSTl tl sOIC hl L)prlt I`Ji iii:'1 have no oIl'
I ;:ill a hon?e cw",!1C'r
In a zrc ti/s:,l:ilc 1x<r�a t:r a c:rpl ;;r. __ ._�:�anc�ar.: cn cr;:".u 1<<,:i; cl!ir.
not mccc Ih--a throe unis ir,%%i at rca:,o n a;
cII,.to u_z':rs tlx,twri;a'.cc;x•-�:_i-a Fr. Gt.I52.��t 511• ic;; v n hot:lroll,xr icr z I:ccu cc p_r :i;:: ...'tin`c tip.
legal et uua of as aMvloyor un ier tvc W c kr,'t Coe;or ation?.cL
I
I undcztxnd thst a cv- y of tl"ctatci.st cuy bo fawwcl!to[1»lYtrut�x:oFIr u'r�J An-i1.cl:f Ci�cw of for Ux �I
cove agc vcrificiioc and tent f--J=to 25A of MOL.152 Can lid to tl-intpasiiia ;r� 1 p:,�:,,
comistmg a[&rtrr_of up to S l-M-0uJ of up to rr, }- :.j Civil pC=ltia in do Ic;nn of S!c l` 'c i=0`Z:---J s
Grp of S 1013.00 1 day igzin:A m:. .
_ For dq:ut::3 `j u,o o"'y 4
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S�GTION8 CONSTRUCTION;SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : LA[ljewr it G-40t.I`-v WSZ�d
License Number
:glZ��
Address Expiration Date
V0 g MA Q10 Q y 13 spy 3ay�
Signature Telephone
Reg sfere ome =maKO�rern'enY Contracto Not Applicable 0
6W 6AuGIV /o�dS7
Company Name Registration Number
3 � CAW 6- 21- oy
Address Expiration Date
jklVOk�- 1A- 010 (�D Telephone Vtl .3`L3 'ILI
SECTION IO 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"homeoNvner"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��D�S fi14FFROPOSED iNORK checkiall a ppilc able
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ) Othe
Brief Description of Proposed Work: Rudd env 8' k t.' ejo
Alteration of existing bedroom Yes�No Adding new bedroom Yes No
Attached Narrative D Renovating unfinished basement Yes _e?!;� No
Plans Attached Roll D- Sheet
a f: e—W O-US #odd'iteonsi dWisting using cam= 6 e hb-'aaLo m:.
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?_ 0 ``�� pp
d. Proposed Square footage of new construction. yb 44c `(-r. Dimensions 6 xD
e_ Number of stories?
f. Method of heating? Norio Fireplaces or Woodstoves NoNC Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?
h. Type of construction woes
i. Is construction within 100 ft. of wetlands? Yes —A— No. Is construction within 100 yr. floodpiain Yes X No
j. Depth of basement or cellar floor below finished grade 1V0
k. Will building conform to the Building and Zoning regulations? _Yes No
1. Septic Tank City Sewer Private well City water Supply
SECI�UlaOWNERi7�3jORIZATION TO BE COMPLETED WHEN
OWNETS�G�E1�T OR�ONfRACTOR APPLi:ES FOR BUl[bi G"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
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
i
Signature of Owner/Age-n Date i91
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 lodx--)
Frontage
Ab i
Setbacks Front
r t
Side L: R: yO L: J§ R:�
Rear
Building Height .110
Bldg.Square Footage %
Open Space Footage %
(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 .X DONT KNOW YES
IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT 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. rere any proposed changes to or additions of signs intended for the property?YES_
No
IF YES, describe size, type and location:
City of Northampton _
Building Department
212 Main Street
Room 100
Northampton, MA 01060
M
phone 413-587-1240 Fax 413-587-1272 '
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVAT�OIkDEMOLISf, A� N ORTj W FAMILY DWELLING
--V-
;SECTION 1-SITE INFORMATION ;
1.1 Pro erty Address: f '� feted by office
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FlOvaeirlay D�stnct
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SECTION'2-PROPERTY-OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Curren eili g Address:
Telephone •�/C
Signature ti 1-3 /
2.2 Authorized Agent:
Name(Print Current Mailing Address:
LIQ s,y 37z/Li
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS'
Item Estimated Cost(Dollars)to be Official Use:.Only
completed by ermit applicant
1. Building 12, =(a)Building Permit Fee
2. Electrical 7� (b)Estimated Total"Cost of
Construction from 6
3. Plumbing Suild;ng`Permit Fee
4. Mechanical (HVAC)
5. Fire Protection _
6. Total = (1 + 2+ 3+4 + 5) s CheckNumber d
This`Section'For;Official UseOrd
Building Permit Number: 1r Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2004-1008
APPLICANT/CONTACT PERSON Ben Gaulin
ADDRESS/PHONE 399 CHERRY ST HOLYOKE (413)534-3296
PROPERTY LOCATION 183 CHESTNUT ST
MAP 17C PARCEL 060 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinfz Permit Filled out
Fee Paid
T_ypeof Construction: CONSTRUCT 6 X 8 ENCLOSED SIDE PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included• -
Owner/Statement or License 005270
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFeqATION 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 ommission
Signature of Building Official 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.
183 CHESTNUT ST BP-2004-1008
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map-Block: 17C-060 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildiinci DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:ADDITION BUILDING PERMIT
Permit# BP-2004-1008
Project# JS-2004-1386
Est.Cost: $12000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Ben Gaulin 005270
Lot Size(sq. ft.): 30796.92 Owner: LYONS MARY F&CHRISTINA SOSA
Zoning:URA Applicant: Ben Gaulin
AT. 183 CHESTNUT ST
Applicant Address: Phone: Insurance:
399 CHERRY ST (413) 534-3296 Workers
Compensation
HOLYOKEMA01040 ISSUED ON:4123104 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 6 X 8 ENCLOSED SIDE PORCH
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• Receipt No: Date Paid: Check No: Amount:
Building 4/23/04 0:00:00 16605 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo