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17C-060 (3) Laurent Gaulin 399 Cherry Street Home Improvement Contractor Holyoke, MA 01040 Registration#101657 Contractor Supervisor License#005270 NU (413) 534-3744 NI, I (we) Mary Lyons Address 183 Chestnut St. Florence MA Date 2117103 Phone 586-1733 -221-3/10 UP 041V 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. Remove all furring strips around first floor and insulate all walls, upper and Iower, with 3/8 Ammofo(amacker board _ � � 7'`") f Reside all walls with Mastic Barkwood vinyl siding. Do not cover inside front porch. Colo. Cover all trim around windows, doors and fascia with aluminum coil and all soffit with vented vinyl soffit. Includes all dryer vents, light blocks and faucet blocks as needed. Also includes matching gable vents. Jack up front porch and pour four concrete piers four feet in ground to resupport existing porch. Finish exterior with above vinyl siding. Remove existing porch windows and install six Harvey Gliding aluminum storm windows with full screens. Supply and install eight Harvey Vinyl Classic double insulated replacement windows with 7/8 Low E glass and half screens. Insulate all around with fiberglass and rubber caulking. Clean and remove all debris. 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. `3111 Contractor will not begin the work or order the materials before the thirdf day following the signing of the Agreement,unless specified here in writing.Contractor will begin the work on or about 3/15104.Barring delay caused by circumstances beyond Contractor's control,the work will be complete by 4/15/04.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. All home improvement contractors and subcontractors must be registered with the Commcx wealth of Massachusetts under provisions of chapter 142A of the general laws.Inquiries about registration and status should be made to the Director,Home Improvement Contractor Registration,One Ashburton Place,Room 1301,Boston,MA 02108(617)727-85% DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Said specifications in contract to cost $14,500.00 after porch&windows $5,500.00 DEPOSIT $2,000.00.,%A eu ,.� -.N COMPLETION $7,000.00 Owner may cancel this transaction at any time pngr to midnight of the third business day after the date of this transa 'on.Cancellation must be done in writing. Authorized Signature '�'� Signed Ben Ga lin Inc. Signed 4�HA1�tP�. G1 y of Wort4a p toll z 9 8 �Glassac!lusctts - � DEPARTMENT OF BUILDING INSPECTIONS -cs INSPECTOR 212 Main Street 0 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 has/her construction supc­,,ii:;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 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 O O` f �� ` { (1-lftT 1� i17�" �Jci1li�JfL111 _ - g 55 Fdjlit c ti s ' � III ~> DLPIU2TMENFT OF EUILDD) G INSPECTIONS 212 Main Street ' Municipal Duilcling j Northampton, MASS. 01060 WORKER'S COMTENSATION I- SURANC,E AA l + AVIT v"It11 a principal place of businessJre?; d�I}ce CA�•4�-- �''�---- 1��Xd�'. --A*A'- 016Y6.— do hereby cerify, un�J:.r dic p ns and pcnq iti::s ofperju?y O I am an empioycr providing the v"orl_cr`s cornpe.'mbon coverage for 1ny employees worming on this job: (Ins`d=cz;Conpam') c:icr Numbcr} (ra:,rraen Date) j I ?GI a sole proprietor, general c:)nc or or homeo wner ;ci de one) and l:a.'e hired the contTactors 1.stet beiov «::o tht oii v orite�s co pens ion el c:es: (Name of C'mincior) (LnSun3.,lc:. CC.IIID 0hC-J 1`usnt--i) Datc)- (Name of Contractor) _ (L-LS-Jmp.ce lo:,.Date) (Name of Contractor) (Insl rice Com;antiiPolic. i�umrr_r) ^=.x;, r nog Date} - (Name of Conti ctcr) _ (Insz raace Com i�a,y Polio Number*) l L I iLT1 is Olt prUprlt Ji ii;:'"1 118VC 1 10 oIic '.''0 ii`; for (, 1ii1 i? l:Ot.1?e 0�'r'I1C" i�Ci TC:'1?11Ii X11 iCi J._.., iii` lf- N07T.:plc�nsc be n\+-a:c itt3!\tiiilc kx-rc�Ynr,=\.bo rnpl ;x.^ ;n:. •1: nc4 ar.:r m rr::;n t\c,,;:,c _..«cl!i not U\--cc tlLn three unity in-\;loan;hc l r,.-..;.zF r=:c;:j cr a; �:ployc3 u.7.:cr t}r_\vccL:ct'a cc:x:-=s='i�r,r�.c:(GL.!52s�!(Sl?•z+:�'.x::icn t?v s F,or\cv\\•nor`:or=l:cc_;c c.paa:i::: ..'cr,�c�.� legal cta!us of nn csgloyx under tLn Wcviccri iat�;wrYation Act.. Iii I ua\dcztsad ths!a copy of this ciatc:s ruy bo fo w v J J to cba IY_txi L�r, of Ir dzu cl AA i"'! Off, O of for ifk covtr-&&c vaTiicfioo and that f:lurc to! c m\tr�uz�:zc-.iM 25.A,of?.iGL,152 can Ica1 to the intposiiio:! c ututg of a fur_of up to S I-500.00=tt1'cr r.:prt xn ;N of::p to or.:}, r.r.j civil pc=ltics in dK;imn of"s!r,+ fim of N.N i day ivr.inrt m:. _ rc�6,p.=X fsj u.°Wly { Ycrrnit Numlx ------- --- 1�}t Jit;niturc t�f I•icz;n�;ctJI crnt,;tr.: r ':' - r S�CT3ON 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Lmytpr Q 6Au 9b�,P-.70 License Number J" GAk4cY s7- /ybki $�23'/0-f-- Address Expiration Date z�c Signature Telephone k9Regis" eredtiotta�e littp ouementContrac#o r Not Applicable ❑ Company Name Registration Number 3 9S G.(en,xv 57' 60-/Y. Ar M 4/2 4A `1 Address Expif Date Telephones SECTION 10 WORKERS' COMPENSATION INSURANCErAFFIDAVIT(M G:L.,c..!152, §;25CM _ .:Q ,... 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"homeo�vner" shall submit to the Building Official,on a form acecptable 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 `e �ECT, . gg cecIO � DWORK kl Rapplica ble New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing ❑ Or Doors f� Accessory Bldg. ❑ Demolition❑ New Signs [ } Decks [ } SidiingX Other[ Brief Description of Proposed Work: ✓�r'f�� S.M`.nc. -e W�t/e0 _f w Low6 91Adt /N1'✓ o,' &g � pytc4/y> U I./ Alteration of existing bedroom Yes No Adding new bedroom ` Yes X _ No Attached Narrative 0 Renovating unfinished basement Yes _ No Plans Attached Roll 0 • Sheet 0 _�a "':f. 7ewi uo sando a. ditionto�eXisting_housi<ngc mo pie"te"tliefollowrn : 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? /" o 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 No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . f. Septic Tank City Sewer Private well City water Supply SECT)©Tt 7a�C:NER A17TyORIZATION TO $E COMPLETED WHEN OWNERS G�EMVM0.RIC0NTRACTOR APPLIES FOR BUIL DI NG 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,-- y "Z- G 4t4 c-•`,t/ 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. &A4 Print Name Signature oft—wn-779ge �� 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 Frontage Setbacks Front $ ` .56►sN E Side L: R: L: R: Rear Building Height 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 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 DONT KNOW L� 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 v� 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: City of Northampton Building Department 212 Main Street Room 100 r :� Northampton, MA 01060 ri phone 413-587-1240 Fax 413-587-1272 g APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWQa FAA IV 1)W',, ELLING 3 i LC,,,-r SECTION 1 SITE INFORMATION 1.1 Progerty Address: r Zh- 'ie tiol e�c plet °b o.. x Earn y���t bR C A-/C, ZoneX Overlay D�stnct Elm St.D�str�ct� , �• .�` � C8 D�stnct�a � ... SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing ng A�d�sJ Telephone Signature 2.2 Authorized Agent: /-3 7 o�y6k'oT oiDYD Name(Print) Current Mailing Address: `-/'/'/X S3 v j 196 Signaturg Telephone SECTION 3-:ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use..Only completed by ermit applicant 1. Building 0) 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 I This Sectilonfor Official U"se-Onl Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2004-0935 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 Building Permit Filled out Fee Paid Typeof Construction: INSTALL VINYL SIDING REPLACEMENT WINDOWS&NEW`IERS FOR 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 FOL 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 Street Commission Signatu a of Buil g Offici 1 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-2004-0935 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C-060 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-2004-0935 Project# )S-2004-1386 Est.Cost: $14500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Ben Gaulin 005270 Lot Size(sy.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.411104 0.00:00 TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING, REPLACEMENT WINDOWS & NEW P IERS FOR 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 4/1/04 0:00:00 16606 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo