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17C-253 (15) � - r i �1 -.Mlda�`! � / Of ON- 000 0 .Iv � �r .� 000 ,F Interior Work: Patch in 1/2"gypsum board above and next to new doorway. To be fastened with 1"1/2 screws, taped,coated (3) applications and sanded to a paint ready surface. Re-install interior trim work if salvageable. If not, will install 1 x6 primed and finger jointed pine flat casings. Fire Escape: Fabricate and install steel fire escape and bottom landing on driveway side of home. We will dig (4) pier holes 4' deep as per code. Insert (4) 10" sonatubes into holes . Fill tubes full of concrete. We will place anchors into concrete piers. 3" pipe supports anchored to piers. 10" stringer channel 1 1/2" grate used for treads. This proposal does not include any painting, flooring or repairs to flooring. We propose to furnish the material and labor necessary for the completion of the above stated work for the sum of: Nine Thousand Six Hundred and Fifty Dollars $9,650.00 Payment as follows: 50%) upon start , $4,825.00 50`%, upon completion of proposal , $4,825.00 All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviations from the above specifications involving extra cost will be executed only upon written orders in the form of a change order and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. A certificate of workman's comp. insurance, liability insurance, license and registration will be presented upon signing. Respectfully Submitted by---2� �' of[Iarlow Builders. ACCEPTANCE OF PROPOSAL I accept the above stated prices, specifications and conditions. You are hereby authorized to do the work as specified. Payment will be made as outlined. Date �Ti' Signature Harlow Builders Page 2 of 2 FLRNCRH.DOC 1 PROPOSAL Harlow Builders 350 Coles Meadow Rd. Northampton , Ma 01060 (413) 586-0465 Submitted to : May 1, 2000 Florence Rest home Florence , Ma 01061 Page 1 of 2 The scope of this project is to build a steel fire escape replacing the old wooden one. We hereby submit specifrc.ations and estimates for the work to be performed . All materials and labor to complete . All permits obtained by Harlow Builders . All debris caused by construction removed by Harlow Builders . See attached drawings for details on framing . Demolition : Remove existing wood fire escape on driveway side of building. Remove existing steps and railings from interior bedroom. Remove existing 2nd floor steel door unit and associated trim work.We will attempt to salvage interior door casings for re-installation. Remove existing side entrance landing 1st. floor . Exterior Repairs: Reframe doorway rough opening flush with existing 2nd floor flooring and approx. 12" towards the right. New doorway rough opening to be centered on new steel fire escape. Install new 310 x 6/8 single bore flat steel door unit with a flat threshold in new opening. Reinstall doorknob from old door. Fill in areas left exposed by moving new doorway. Includes siding clapboards and exterior trim where needed to complete siding repairs. Patch in new roofing next to top landing of fire escape with charcoal one tab shingles to match existing. Includes new step flashing next to house. Repairs/replacement of clapboard siding where needed to complete roofing patch. Clean out gutters and down spouts next to new fire escape-.. Repair or replace skirt board and clapboard siding where 1st floor entrance landing was attached to house. Harlow Builders Page 1 of 2 FI,RNCRH.DOC p' N j' LA. . �. O' C i Alt mom" fj a IFI �. ¢�LiAMp�, y� w a e �lisaAC}InSrtra DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (licenserlpermittec} with a principal place of business/residence at: (phone#) (stre city/slafdzip) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees woricing on this job: (Insurance Cody) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Numbcr) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Imurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach addition l sheet if necessary to incaude jdbrm oa pertaining to ail coatrn ) ( ) I am a sole proprietor and have no one wort ing for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that wbilo homeowners who employ person:to do mai*A &ace,suction or repair work on a dwcUiag of not more than throe units is which the homeowner reidca or oa the grounds appurtenant thereto arc not generally oomakred to be employva under the worke's compensation Act(GL152,ss 1(5)),application by a hotneow ner for a license or permit may evidence the legal stet-of an employer under the Wort %Componsdion Ad. I understand that a copy of this rbacmeat may be f0gvmrded to the Departmr of Indu-rial Ac6den&Offioe of Insurance for the coveage verificstion and that failure to secure covcmF under section 25A of MGL 152 can kid to the imposition of crimiad penalties oomisting of a fine of up to S1,50o.00 andlor imprisomncat of up to one year and civil penzMc3 in the form of a Stop Work Order and a firm of 3100.00 a day against me. For 6T-taocdxl use only permit Number Map# Lot# s,. ignature ofLicensee/pe SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: c \�' cam✓\��^� J�� 7 y 0 License Number Address Expiration Date Signature Telephone Not Applicable ❑ Company Name Registratiorf Nu ber Address Expiration Date 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...... ❑ 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 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 SECTI S- DE$9811PTIQN OF E!RQPP.§ he!;k all he!; applicabl e New House ❑ Addition ❑ Replacement Windows Alteration(s)10 Roofing 111. Or Doors IC Accessory Bldg. ❑ Demolition® New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: Ex ell r c Alteration of existing bedroom Yes Y/ No Adding new bedroom Yes Y No Attached Narrative❑ Renovating unfinished basement Yes __%[No Plans Attached Roll ❑ - Sheet❑ flog Wj��am Od'Abef,611 'A 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. 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 . I. Septic Tank City Sewer Private well City water Supply SECTION 7a •OWNER AUTHORIZATION -TO RE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING 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 Signature o Owne/Agent Date (� A { 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 SC3 N`��e�� 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 alpecial Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO U DON'T 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. Are there any proposed changes to or additions of signs intended for the property ?YES_ No IF YES, describe size, type and location: of Northampton ` 2 i Piyldlng Department 212 Main Street �G IN`'✓ T1(�h� :,. ,',60 Room 100 Northampton, MA 01060 phone 413-587.1240 Fax 413-587.1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-"SITE INFORMATION 1.1 Property Address: This ito b Elm L Dta SECTION 2-PROPERTY.OWN ERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: 0- Q_Jc_ O CA'' Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: G�c� Name(Print) Current Mailing Address: Signature Telephone SECTION'3- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (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 A 0C 6. Total =(1 + 2 + 3 +4 +5) Check Number This Section For-Official Use Only'' Building Permit dumber: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date ,a File#BP-2001-0394 APPLICANT/CONTACT PERSON Harlow Builders ADDRESS/PHONE 336 COLES MEADOW RD (413)586-0465 PROPERTY LOCATION 29 NORTH MAIN ST MAP 17C PARCEL 253 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 Typeof Construction: REPLACE EXISTING WOOD FIRE ESCAPE WITH STEEL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 052460 3 sets of Plans/Plot Plan THE LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD .ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § —w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § —w/ZONING BOARD OF APPEALS 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 Co sion Permit from CB Architecture Committee 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. 29 NORTH MAIN ST BP-2001-0394 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C-253 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2001-0394 Project# JS-2001-0649 Est. Cost: $9650.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Harlow Builders 052460 Lot Size(sq. ft.): 18948.60 Owner: HEROCHIK MAE Zoning:URB Applicant. Harlow Builders AT. 29 NORTH MAIN ST Applicant Address: Phone: Insurance: 336 COLES MEADOW RD (413) 586-0465 Workers Compensation NORTHAMPTONMA01060 ISSUED ON:10 116100 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE EXISTING WOOD FIRE ESCAPE WITH STEEL POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 10/16/00 0:00:00 4427 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo e o � r - `— � " _• -fir �w. §� � x ,r "'r�� ;� • �: � ; :. v. r ;gam 5 } r � �3 AV 29 NORTH MAIN ST BP-2001-0394 GIs#: COMMONWEALTH OF MASSACHUSETTS MR.-Block: 17C-253 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category'Non structural interior renovations BUILDING PERMIT Permit# BP-2001-0394 Proiect# JS-2001-0649 Est.Cost:$9650.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: Harlow Builders 052460 Lot Size(sq.ft.): 18948.60 Owner: HEROCHIK MAE Zoning: URB A licant. Harlow Builders AT. 29 NORTH MAIN ST Applicant Address: Phone: Insurance: 336 COLES MEADOW RD (413)586-0465 Workers Compensation NORTHAMPTONMA01060 ISSUED ON.•10116100 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE EXISTING WOOD FIRE ESCAPE WITH STEEL POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: �� "�? 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 VIOLATIONPF ANY OF ITS RULES AND REGULATIONS. ! Certificate of Occu anc si nature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building t 10/16/00 0:00:00 4427 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo