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23A-055 (2) �r HOME IMPROVEMENT Commissioner Hasbrouck April 2, 2015 Subject: Request for Waiver I request that you grant a modification to waive the requirement for control construction for the (Ted Boyer- Fitzgerald Properties) at (29 Maple Street) in Florence/Northampton because the work is of a minor nature, will not affect health, accessibility, life and fire safety, or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work.All work will be completed within the prescriptive requirements of 780 CMR.Thank you for your consideration. "Mass Amendments, sections 107.1 allows for an exclusion from control construction for this project" Respectfully, Keith Devin Production Manager Vista Home Improvement 2003 Riverdale Street West Springfield, MA 01089 2003 Riverdale Street,West Springfield MA 01089-Phone. • (413)382-0249 Fax: (413)382-0241 { - Roofing Propozat - CT.REG.No.0621848 �Vi ta Page No. of Pages MA REG.No.162058 HOME IMPROVEMENT 2003 RIVERDALE STREET +I� . WEST SPRINGFIELD,MA 01089 Toll Free:1-888-597-2323•Local:413.382-0249 FAX:413-382-0241 Proposal Submitted To Homeowner Work To Be Performed At Name `—\ S r"Nam,, q Street �� d° "� rt,,,� /� p\j Street % t'.'v City C[D(CI JL C State)!!!'Zip_! tt o `° a City .:6rrA ' State Date � � Telephone tJ 3 r Date ' Telephone I }Vista Home Improvement agrees to do the fallowing: i R Acquire all permits for roofing work 41--, y(.r1 4Materlal Location ❑Shingle Over.�Tear Off ) Main House ❑Garage ❑Shed Ur Supply Dumpster-Location ML °" I ❑Inspect Decking for damage ❑Replace Decking @ per sheet ` _ ti N a1r..�+�t C' Install all ew DecId Type C-' �p9YSTfd`aI t� �,ry c., yRo�ofing MFG tJXu` olor ��d` Style c° 4"�White!Brown drip edge aF-8 ❑F-5 JCII Deck Underlayment ❑#15 Felt XRhinoLiner ❑ Ice and water Barrier IS(3' ❑6' ❑Full Flash all valleys,penetrations,eaves and chimneys Supply and Install pipe boot flashing dSupply and install ridge vent ❑Generic ❑Cobra Exhaust ( ^^ Cur ❑/Supply and Install vent kit ❑Supply and Install soffit vents- Qty. ❑R&R Gutters Total Job Clean-Up teat,Supply and install 12 in.lead on chimney WARRANTY i ❑Standard ❑System Plus ❑Golden Pledge Attention Homeowners:Please cover all personal belongings in the attic,garage,or storage areas due to the possibility of roofing debris or dust coming throught the cracks of the wood.Vista Home Improvement will not be responsible for debris or dust In the areas mentioned.Also Vista Is not responsible for gaps from siding on home and roof line due to multi layer strips. ❑Rolled/Robber Roofing Type " Color Location Othsr' � t7tu�r' t —rfr�+�r aH fr",51�cm}J, nil / . o—, a G ry1r� C �1w I r+ S LCt-►� w 4 tY�Cr LA.J �.,.�.'„�►'rynr7.tN!. O+�icti ♦,!S'�l t S ,1 t�.:, ..- i a I ' I All material Is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard-practices.Any alteration or deviation from the above specifications must be made in writing on an Add-on/Modification of Contract form and may become an extra charge over and above the amount stated herein.This agreement Is contingent upon delays beyond our control,Owners to carry fire,tornado and other necessary Insurance.Our workers are fully covered by Workmen's Compensation Insurance.Homeowner agrees to pay for all work as set forth below.If the homeowner defaults,homeowner agrees to pay all costs of collection,including reasonable attorneys fees,in addition to other damages incurred by contractor.An 18%per monthservice charge will be assessed for all payments not made within 10 days of due date per the schedule below: y' Vye propose hereby to furnl9h material all labor complete in accordance with the above specifications,for the suv n i WOO sk"a / ti dti �/ w i W J. Said amount shall be paid as follows: f� l 4J nti<�Ca, ? /. �` Note:This proposal may be withdrawn by us if not accepted within days. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF/THE THIRD BUSINESS DAY AFTER THE DAY OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FOR AN EXPLANATION OF THIS RIGHT.(SATURDAY IS A LEGAL BUSINESS DAY IN CONNECTICUT.)THIS SALE IS SUBJECT TO THE PROVISIONS OF THE HOME SOLICITATION SALES ACT AND THE HOME IMPROVEMENT ACT.THIS INSTRUMENT IS NOT NE Signature of Contractor or authorized representative: j *([/We)have read the terms stated herein they,have been exglalned{o(me/us),and(IIWg)find them to be satisfactory and hereby accept them. ' Signature of Homeowner(s). X Fl` 1 ( 1,.,"'1 I X 1 The Commonwealth of Massachusetts Department of Industrial Accidents (_ Office of Investigations 600 Washington Street Boston, MA 02111 S•` www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ig bly Name (Business/Organization/Individual): 1'r-A0 Address: (gcJo \k 10-er( tc City/State/Zip: t o. b� Phone #: L4 Are you an employer? Check the appropriate box: Type of project(required): 1.� I am a employer with 4. El am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. + Remodeling �• ❑ ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 131 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �C�- �Y150 !21 VA CC Policy#or Self-ins. Lic. #: \5 Expiration Date:' Job Site Address: �� ��" \7' 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 Investigations 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: 1 Date: L4 l Phone#• Qaq 7 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 6. Other Contact Person: Phone M SECTION 8-CONSTRUCTION SERVICES 7 8.1 Licensed Construction'Supervisor:\\ I Not Applicable ❑ Name of License Holder: \�1 D12, t n o�9 3 ` Q License Number Addre Expirati n D e Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Ad s Expidation 01ate Telephone SECTION 10-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...... ❑ 11. - Home Owner Exemption 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 buildine 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 Alteration(s) ❑ Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding[pj Other[O] Brief Description of Proposed V � S�\Y N k ` (a5 (11 Work: Pl qu 'Vie JOCAf y1 1c&V1 t) c ea� <_J Ci,Yni v 9 Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existina housing, complete the following: 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-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT \ � e as Owner of the subject property ,� ) hereby authorize !2\i—\C'� �<&O(Z—A to act on my behalf, in all matters relative to work authorized by this building permit application. ��, C-'gn A_�_f'k ­3 3(-) 1 �- Signature of Owner Date Cam)-- y \S�c�'� - � y� e 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 penalti s of perjury. Prin me _ I 15 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 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 0 DON'T KNOW � YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 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 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? 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 ® NO 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 IF YES,then a Northampton Storm Water Managemen Permit from the DPW is required. (� Department use only r; *rlt' of Northampton Status of Permit: ing Department Curb Cut/Driveway Permit APR _ 2015 �. 2 � 1 Main Street Sewer/Septic Availability ions oom 100 Water/Well Availability Electric,Piump" GAS tnr h pton, MA 01060 Two Sets of Structural Plans MA 01 Ncrthamp n, -587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: 1�. �r� i c(plf_ JA ` e:1f-A- Map - Lot Unit b,1 A Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Div f -u ,gi- a Name(Print), Current Mai ddr ss: W 0\ c.,_u Telephone Signature 2.2 Authorized Agent: vl.' � ��� ��yey'c to Name(Print) Current Mailing Address: Signat �- Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building j , (a)Building Permit Fee 2. Electrical �y D (b)Estimated Total Cost of Construction from 6 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 File#BP-2015-0921 APPLICANT/CONTACT PERSON VISTA HOME IMPROVEMENT ADDRESS/PHONE 2003 RIVERDALE ST WEST SPRINGFIELD01089(413)382-0249 PROPERTY LOCATION 29 MAPLE ST MAP 23A PARCEL 055 001 ZONE URB(100Z THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid 9 16 it its q Building Permit Filled out Fee Paid Typeof Construction: STRIP&SHINGLE ROOF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building_Plans Included: Owner/Statement or License 099931 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INITPORIUTION PRESENTED: —44111proved 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 Permit DPW Storm Water Management Demoli ' n Delay 7 Sig re o 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. 29 MAPLE ST BP-2015-0921 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23A-055 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:ROOF BUILDING PERMIT Permit# BP-2015-0921 Project# JS-2015-001783 Est. Cost: $68732.00 Fee: $412.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VISTA HOME IMPROVEMENT 099931 Lot Size(sq. ft.): 32190.84 Owner: FITZGERALD REALTY CORPORATION Zoning. URB(100)/ Applicant. VISTA HOME IMPROVEMENT AT. 29 MAPLE ST Applicant Address: Phone: Insurance: 2003 RIVERDALE ST (413) 382-0249 WC WEST SPRINGFIELDMA01089 ISSUED ON.•41312015 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF 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 Occupant Signature: FeeTyue: Date Paid: Amount: Building 4/3/2015 0:00:00 $412.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner