30C-015 359 FLORENCE RD BP-2016-1273
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map•Block: 30A-015 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: replacement windows/siding BUILDING PERMIT
Permit# BP-2016-1273
Project# JS-2016-002184
Est.Cost: $16199.00
Fee: $106.00 PERMISSION J$HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RENAISSANCE BUILDERS 013302
Lot Size(sq. ft.): 16639.92 Owner: MIZULA FELIX&KATHRYN M
Zoning: URA(100)/WSP(100)/ Applicant: RENAISSANCE BUILDERS
AT.- 359 FLORENCE RD
Applicant Address: Phone: Insurance:
P O Box 272 (413) 863-8316 Workers Compensation
TURNERS FALLSMA01376 ISSUED ON.•4/29/2016 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL REPLACEMENT WINDOWS/DOORS &
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 4/29/2016 0:00:00 $106.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
7jAPR
Department use only
ity of Northampton Status of Permit:
uilding Department Curb Cut/Driveway Permit
1 212 Main Street Sewer/Septic Availability
2Q16Room 100 WaterMell AvailabilitN hampton, MA 01060 Two Sets of Structural Plans
phones-413 587-1240 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
1.1
Property Address: This section to be completed by office
C' \macs Map Lot Unit
c z' \'l c>..x r t I , �`-1 r1 --c 1 G(C,C1 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Addres C)IG Ci
g,�� -c5�"U
C ee_ k3 (�'. _ -A Telephone
Signature
2.2 Authorized Agent:
Name 1P nt) ',Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building `(�,(� C)V (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
6. Total= 0 +2+3+4+5) , o Check Number Lo
This Section For§fficial Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
Section 4. ZONING All Information Must Be Completed'I. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size .3 c' Ghr« rlc_v(--
Frontage �.)c) C.U «,c
Setbacks Front
Side L: R: L: R:
Rear
Building Height r y (\ )0
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 KNOWyy
YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry,of Deeds?
NO () DON'T 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 C) YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtaine
Id Q , Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions 0f signs intended for the property? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing, grading ''ex avation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
---"'
P"
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition F7Replacement Windows Alteration( Rog
Or Doors 14
Accessory Bldg. ❑ Demolition ❑ New Signs [Q] Decks [0 Siding[X] Other[CQ
Brief D scription of Proposed �, r
Work: l acs . �' i i vl� i i0d i Ie C �ti)ft �rw
r'1 600 5 1 iad() , Or tx�"ifZdcif_� fl.fIO.Cef !l
Alteration(if existing bedroom Yes No Adding now bedroom Yes No
Attached Narrative Renovating Unfinished basement Yes No
Plans Attached Roll -Sheet
6a. If New house and or addition to existing 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 ND. 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 PE RiMIT
I, C ) I X ( 1 + -' 1< " as Owner of the subject
property
hereby authorize r y)al ol ICS r C`S
to act on my behalf, in all matters relative to work authorized by this bt ilding permit application.
Signature of Owner Date
I �t ?i�ifYr) � ,r r..t-r)LL)o JC� �fli r)cL; SSu.r1C, )_, l4jrr'� 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 O er/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder: !SL1. 0LLr--) 0 13-3 Or
License Number
0 C%J
-311 of3,59 7/17
Address Expiration Date'
1113 a 10 �6
Signature Telephone
9. Registered Home Improvement Contractor: Not Applicable 0
Company Name Registration Number
3
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....... X No...... 0
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..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 horrit 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 builging 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 respotisibility 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
The Conozo7twealth of Massachusetts
Department of hidustrial Accidents
Of Iq of Investigations
600 ,Washington Street
Boston,jVL4 02111
WIVW.Mass-0,0v1dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
A imlicant Tmformation Please Print Legibly
A
Name (Business/Organiz,-Tion/Individual):
C,> --�
Address: I , 1--' � 2� 2.7 Z_
City/State/Zip:TU If �fV_ 5 F-(:24,I A !LM3 hone IT 3
=
Are you an employer?Check the appropriate box: ' Type of project(required):
I.X I am a employer with 1 -7 4. F1 I am';a general contractor and 1 6. ❑New construction
ffmPioyees(fuU and/or part-time). have:hired the sub-contractors
2,7 I am a sole proprietor or partner- listed on the attached sheet- 7. Remodeling
ship and have no employees These sub-contraztors have 8. 7 Demolition
working g for me in any capacity. employees and have workers'
I�iasurance.T Building addition
comp
[No workers' comp. insurance
required] 5, 7 We are a corporation and its 10.[]Electrical repairs or additions
3.7 1 am a homeowner doing all work offic4rs have exercised their 11.7 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MOL 12.7 Roof repairs
insurance required.]t c..152, §1(4),and we have no 13.7 Other
Mpicryees.[No workers'
comp,,insurance required.]
*Any applicant that cheeks box#I ram also W out the section Mov showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing aU�k and then hire outside comra=s must submit anew affidavit indicating such,
ZComractors that check this box-musts:rtachazi an additional sheet sbDw*the name of the sub-conz=ors and stare whether or not those entitits have
employees. If the sub-contractors have employees,they must provide their wasters'comp.policy number.
r am an employer that is providing workers'compensatiot insurance for i7ty employees. Below is the policy and job site
information.
Insurance Company Name:
Cc
Policy#or Self-ins.Lic.#: UM-L �00 400 FV973 2,01'ZLExpiration Dai% )t)j3i azlitp
Job Site Address,, _P1 0 V,e Oce city/state/zip:�16 rf hCU-1 •01 c)6)ci
Attach a copy of the workers' compensation policy decl4ration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to-the imposition of criminal penalties of a
fine up to$1,500,00 and/or one-yew 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 cert" der the pains andpenaXes ofperjuo e information provided above is true and correct.
Signature: Date: zl(r,
Pboneik (4 1
Official use only. Do not write in this area, to be completed by city or town officiaZ
City or Town: Perm it/IjcerserLr`
Issuing Authority (circle one):
I. Board of He2 ltb 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
5. Other
Contact Person: Phone
AFFIDAVIT FOR DISPOSAL OF DEMOLITION DEBRIS
Supplement to Permit Application
As a result of the provisions of MGL c. 40„ s54, I acknowledge that as a condition of the
issuance of a Building Permit, all debris resulting from the construction activity governed
by this Building Permit shall be disposed of in a properly licensed solid waste disposal
facility, as defined by MGL c. 111, s 150A.
1 certify that debris resulting from this demolition will be disposed of as listed below:
9
Job Site Location. 22A � I.Ct,,.
Name of Permit Applicant: Renaissance Builders
Disposal Facility: F & G Recycling
Address of Facility: 15 Mullen Rd., Enfield; Ct 06082
IF SAID FACILITY IS OTHER THAN WHAT I HAVE LISTED, I CERTIFY THAT
I WILL NOTIFY THE BUILDING OFFICIAL OF THE CORRECT LOCATION OF
THE SOLID WASTE DISPOSAL FACILITY WITHIN TWO MONTHS OF THE
DATE OF THIS APPLICATION.
014
Signature of Applicant Date
l
Mizula Proposal Page 4
ACCEPTANCE OF PROPOSAL:
Agreement between:
Felix Mizula, 359 Florence Road, Northampton, MA 01062
And
Renaissance Builders, PO Box 272, Turners Falls, MA 01376
The prices, specifications, and conditions are satisfactory and are hereby
accepted. Please send a contract for the following work, as specified in the
Proposal dated April 6, 2016:
Exterior Renovations $ 26,462.00
Alternate # 1 $ 16,199.00
Alternate # 2 $ 4,166.00
Please make the following changes or clarifications:
t
Payment will be made as outlined below:'
Deposit on signed acceptance of Proposal: $ 500.00
A payment schedule for the balancewill be included with the contract.
I authorize you to apply for a building permit, if required, F m,/y behalf.
Customer Signa re Date
Please print legal name for Contract Documents
Customer Signature Date
Please print legal name for Contract Documents
All individuals listed as Owners of Record for a property are required to sign Contract Agreements.
Please note any corrections to your name or address. Also, please give us your phone
number(s) and the best times to reach you so we can keep you posted regarding our
schedule. You may also provide an email address if that is a good way to contact you.
Note: Please return only this signed acceptance sheet along with deposit.
Retain the Proposal for your records.
Renaissance Builders, PO Box 272,Turners Falls, MA 01376 License#013302, Registration#106490
4/6/2016
Renaissance
Builders
PO Box 272, Turners Falls,MA 01376
Phone(413)863-8316; Fax(413)863-9712
www.renbuild.net
April 6, 2016
Felix Mizula
359 Florence Road
Northampton, MA 01062
Work list for exterior renovations to home at above address.
Scope to include the following:
Remove and dispose existing siding.
Install new vinyl siding.
Remove and replace gutters and down spouts.
Scrape and paint all exterior trim, doors and windows.
Options for window replacement.
1000 GENERAL CONDITIONS
1300 Project Management
A. Provide shop drawings, samples, color choices, and/or selection charts as
needed for Owner's approval.
B. Coordinate operations under different sections that are dependent on
each other for proper installation and operation.
C. Notify Owner as necessary when scheduled work will impact occupied
portions of the premises.
1310 Supervision
A. Provide supervision at all phases of construction performed or
subcontracted by Renaissance Builders.
1400 Warranty
A. All work performed or subcontracted by Renaissance Builders to be
guaranteed for one year.
1520 Temporary Facilities
A. Provide portable toilet for workers.
1530 Temporary Protection
A. Provide protection against the spread of lead dust to surrounding work
areas.
1730 Cleanup & Trash Disposal
A. Clean up all debris and leave the job site broom clean at completion of all
work.
B. Legally dispose of all debris.
C. All work to be performed per the EPA Safe Lead-Based Paint Regulations.
1950 Owner Responsibilities
A. Cost of electricity and water during construction.
B. All other phases not specifically outlined in this Proposal.
Mizula Work List Page 2
I
2000 SITE WORK
2220 Demolition, Exterior
A. Remove and legally dispose of existing siding on entire exterior of house.
B. Siding that is on the interior of storage shed to be left in place.
C. Remove and dispose of all existing gutters and down spouts.
2226 Hazardous Materials
A. Test all exterior wood elements scheduled to be removed for lead paint.
B. Perform all demolition of painted wood materials per EPA Lead Safe
practices.
C. Perform all clean up after demolition per EPA Lead Safe Practices.
7000 THERMAL & MOISTURE PROTE!gTION
7200 Insulation, Vapor Barrier
A. Install 1" polyisocyan u rate foam insulation (R-7) over all exterior
sheathing.
B. Tape all seams with air sealing tape.
7460 Siding
A. Siding to be CertainTeed Monogram double 4" vinyl with trim accessories.
Siding to be .046 in thickness and have a manufacturer's lifetime
guarantee against fading.
B. All siding and trim accessories to be nailed with electro-plated 13/" nails.
7700 Gutters
A. Install seamless aluminum gutter, with outlets on all eaves of garage and
house.
9000 FINISHES
9910 Paint, Exterior
A. Scrape, wet sand and prime all existing wood trim, window and door
casings and doors on exterior. Primer to be Mad Dog exterior primer.
B. All previously painted surfaces to eeceive two coats of finish paint.
C. All paint to be best quality Benjamin Moore, Sherwin Williams or
equivalent.
Alternate # 1 - Window Replacement
A. Remove and dispose of all windows in house and garage with the
exception of Jalousie window in breezeway and two awning windows in
rear of garage.
B. Install new Integrity fiberglass windows sized to fit existing unit sizes.
C. All windows to be prefinished wood in white on the interior.
D. Install transition trim on interior to bridge gap between new windows and
existing trim.
E. Paint and finish all new interior trim to match window color.
F. All new windows to match existing,window styles.
G. All new windows to have no grills or muntins.
H. Install PVC sill and brick mold casing on exterior of windows.
Renaissance Builders, PO Box 272,Turners Falls, MA 01376 License#013302, Registration#106490
4/26/2016
Mizula Work List Page 3
Alternate # 2 - Breezeway Windows and Doors
A. Remove and dispose of Jalousie window and doors in breezeway.
B. Install Harvey rolling all vinyl windows in existing openings.
C. Install Harvey solid core storm doors.
D. Install Therma Tru or equal fiberglass door to replace existing back entry
door to garage.
End of work list.
Renaissance Builders, PO Box 272,Turners Falls, MA', 01376 License#013302, Registration#106490
4/26/2016