25C-235 (13) 183 BRIDGE ST BP-2020-0094
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C-235 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Door Replacement BUILDING P E RM I T
Permit# I BP-2020-0094
Project# JS-2020-000157
Est.Cost:$8550.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: KEITH GUYER 095143
Lot Size(sq. ft.): 19079.28 Owner: RANSON GARY
Zoning: SC(67)/URC(33)/ Applicant. KEITH GUYER
AT. 183 BRIDGE ST
Applicant Address: Phone: Insurance:
60 RIVER ST (413) 768-0607
BERNARDSTONMA01337 ISSUED ON.7/29/2019 0:00:00
TO PERFORM THE FOLLOWING WORK.-DECK REMOVAL & EXTERIOR DOOR
RELOCATION
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 SiVnatnre:
FeeType: Date Paid: Amount:
Building 7/29/2019 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2020-0094 f R— S S (� �APPLICANT/CONTACT PERSON KEITH GUYER Pp?
ADDRESS/PHONE 60 RIVER ST BERNARDSTON (413)768-0607 Cjl
PROPERTY LOCATION 183 BRIDGE ST
MAP 25C PARCEL 235 001 ZONE SC(67)/URC(33)/
C�
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:_DECK REMOVAL&EXTERIOR DOOR RELOCATION
New Construction
Non Structural interior renovations
Addition to Existing
Accesso!y Structure
Building Plans Included:
Owner/Statement or License 095143
3 sets of Plans/Plot Plan
TH�.FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
JNjI'ORMATION PRESENTED:
_K_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 Permit DPW Storm Water Management
Demolition Delay
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.
epartment use only
City of Northam tStatu of Permit:
Building epa I urb ut/Driveway Permit
A 212 M in Sheet ewe/Septic Availability
Roo 10P JUL 2 4 2019 ate ell Availability
Northampt ,n, MAS 01060 wo ets of Structural Plans
phone 413-587-1240 F 1413-58 - lot/Ste Plans
i DEPT OF BUILDING INSPECT101 4Otherecl
NORTHAMPTON,MA 01060 p
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
6n ( f -75� Map ,;, sc Lot a 46– Unit
JZone Overlay District
a Q JJ t Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
G k-f U � t$'�
Name(Print) Current Mailing Address:
S2- Cay0-C ac.._Cfi� Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
obo
Signature G Tele�ph ne
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Oficial Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
2. Electrical c (b) Estimated Total Cost of
Qo Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total =(1 +2+3 +4+5) Sd Check 5wKber Creif!`
7' wto
This Section For Official Use Only
Building Permit Number: Date
Issued.-
Signature:
ssued:Signature:
Building Commissioner/Inspector of Buildings Date
L' tII °3r � @ C ��i c ; �!�•
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
R
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoping
This column to be/fled in by
Building Depar7lent
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 b n issued for/on the site?
NO 0 DON'T KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Re stry of Deeds?
NO 0 DON'T KNOW YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body f water or wetlands? NO 0 DON'T KNOW 0 YES
IF YES, has a permit been or n ed to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the operty? YES 0 NO 0
IF YES, describe size, ype and location:
D. Are there any prop ed changes to or additions of signs intended for the property ? YES 0 NO 0
IF YES, descri a size, type and location:
E. Will the cons uction activity disturb(clearing, grading, excavation, or filling)over 1 acre or is it part of a common plan
that will di urb over 1 acre? YES 0 NO 0
IF Y ,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition Replacement Windows Alteration(s) Roofing ❑
Or Doors I]
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding [0] Other[0]
Brief Description of r
Work: 'P 10 r 1 h u r-,
Alteration of existing bedroom Yes No Adding new bedroom Yes 0<1No
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 > t w
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
I, ska— Ccr-K!-rn cf- as Owner of the subject
property
hereby authorize Q �I Cl-
to
/to act on my behalf, in all matters relative to wok authorized by this building permit application.
Signature of Owner �te
I, ILe as Owner/Authorized
Agent hereby declare that the btatements 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.
(�1
--
1
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: �, ,'� Gy►/�/ l — oc\j
License Number
� b f�
Address Expiration Dke
Signature Telephone,/
9. Registered Home Improvement Contractor: Not Applicable ❑
kCk, k Q- W,1,-- 111 \ eS `1
Company Name pQ �1 pp Q-r� Registration Number
CQ 9.,y'2/ J� U�r (�rsrJ �.ln �AA 005 /l j 1 zc 1 aU
Adddrre-ss- Expiration ate
Telephone d 1 d b a �
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...... ❑
F
City of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes.Prior to
performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC").
M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion,
improvement removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be
done by registered contractors.
Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered
Type of Work: �.Me1 �Q�, , Est. Cost:
Address of Work: a '3 �j n c` S� a� �'1� pin 41 N '•�
Date of Permit Application: a `2 lS
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law(explain):
Job under$1,000.00
Owner obtaining own permit(explain):
Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
Date I Contractor N me HIC Registration No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
i
Date Owner Name and Signature
City of Northampton
Massachusetts
r t X'A
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building �y �*�
Northampton, MA 01060 S jlt�
Massachusetts Residential Building Code
Section 110.R5.1.2
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.
Section 110.R5.1.3.1
Any homeowner performing work for which a building permit is required shall be exempt from
the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s)
for hire to do such work, then such homeowner shall act as supervisor.
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.
City of Northampton
Massachusetts -
[IV
DEPARTMENT OF BUILDING INSPECTIONS
ry �
212 Main Street •Municipal Building
Northampton, MA 01060
D bNPosa1NAWdaV4;;
In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the 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.
The debris from construction work being performed at:
(Please print house nurJber and street name)
Is to be disposed of at:
q 0A 4L-1,
(Ple se print nametand loc ion of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
r-k�k Gt,�' �
Signature of Permit Apodant or Owner Date
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street,Suite 100
< Boston,MA 02114-2017
www mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
_Applicant Information Please Print Le2ibh
Name(Business/Organization/Individual): Q�
c
Address: 60 (L I ie.- :54
City/State/Zip: r\ Phone -1 l
Are you an employer?Check the appropriate box: Tvpe of project(required):
1.0 I am a employer with employees(full and/or part-time).* 7. ❑New construction
In I am a sole proprietor or partnership and have no employees working for me in
8. N Remodeling
any capacity.[No workers'comp.insurance required.]
9. Demolition
3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.]t
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. [will 10 ❑Building addition
ensure that all contractors either have workers'compensation insurance or are sole I L❑Electrical repairs or additions
proprietors with no employees.
12.E]Plumbing repairs or additions
5.F1 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[:]Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
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 r—O-e CQ—
Policy#or Self-ins.Lic.#: (i5 C21S — (� Expiration Date: 14 �'2d
Job Site Address: �$3 � Sk City/State/Zip: t i c -t�A,— M/L 6 M I
Attach a copy of the workers' compt4sation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify__un'd'er the pains and penalties of perjury that the information provided above is true and correct
Simature: Date: :7
Phone#: q X1)-14b 06 cr Z
Oficial 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#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.mass.gov/dia
KEITH GUYER
.
IT'S ALL IN THE DETAILS
Keith Guyer Custom Carpentry
60 River St Bernardston MA, 01337
413-271':-0693
Home Improvement reg #171657
Construction Supervisor License CS-095143
Customer Contract
TII,IS AGREEMENT made,on July.19, 2019 by and between Keith Guyer, hereinafter
galled,the Contractor, and Gary Ranson, hereinafter called the Owner.
WITNESSETH, that the Contractor and the Owner for the considerations named agree
as follows
Article 1. Scope of the Work
The Contractor shall perform all of the work shown on the Drawings and/or described in
the Specifications entitled Exhibit A, as annexed hereto as it pertains to work to be
performed on property at 183 Bridge st Northampton, MA.
Article 2. Time of Completion
The work to be performed under this Contract shall be commenced on or before July 23,
2019 and shall be substantially completed on or before July 30, 2019 The following
constitutes substantial completion of work pursuant to this proposal and contract: All
prescribed tasks listed on Exhibit A shall be completed with the exception of any work
that is agreed upon to be in conflict with further work to be performed. Any time
restrictions placed on the performance of this work for issues dealing with material
availability and delivery will not be at the fault of the contractor.
Article 3. The Contract Price
The Owner shall pay the Contractor for the labor to be performed under the Contract the
sum of$8,050.00, subject to additions and deductions pursuant to authorized change
orders.
Article 4. Progress Payments
Payments of the Contract Price shall be paid in the manner following:
Deposit check $2683.33
Phase one completion $ "&6 3$x,66
Completion of work payment $500.00
Page 1 of 4
Article 5. General Provisions
Any alteration or deviation from the above specifications, including but not limited to any
such alteration or deviation involving additional material and/or labor costs, will be
executed only upon a written order for same, signed by Owner and Contractor, and if
there is any charge for such alteration or deviation, the additional charge will be added to
the contract price of this contract. If payment is not made when due, Contractor may
suspend work on the job until such time as all payments due have been made. A failure
to make payment for a period in excess of 60 days from the due date of the payment
shall be deemed a material breach of this contract.
In addition, the following general provisions apply:
i. All work shall be completed in a workman-like manner and in compliance with all
building codes and other applicable laws.
2. To the.extent required by l'aw all work shall be performed by individuals duly
licensed and authorized by law to perform said work.
3. Contractor shall furnish Owner appropriate releases or waivers of lien for all work
performed or materials provided at the time the next periodic payment shall be
due.
4. All change orders shall be in writing and signed both by Owner and Contractor,
and shall be incorporated in, and become a part of the contract.
5. Contractor shall at its own expense obtain all permits necessary for the work to
be performed.
6. All disputes hereunder shall be resolved by binding arbitration in accordance with
rules of the American Arbitration Association.
7. Contractor shall not be liable for any delay due to circumstances beyond its
control including strikes, casualty or general unavailability of materials.
8. Contractor warrants all work for a period of 6 months following completion.
Article 6. Insurance
The Contractor shall file Certificates of Insurance, naming the owner/person hiring the
contractor is additional insured, in duplicate, acceptable to all parties within 48 hours
prior to commencement of work, which shall contain a provision on coverage under the
policies shall not be cancelled or allowed to expire or permit material changes until at
least 30 days written notice has been given to additional insured.
Article 7. Contract Acceptance
Upon signing, this document becomes a binding contract under law. Unless otherwise
noted within this document, this contract shall not imply that any lien or other security
interest has been placed on the residence. Review the following cautions and notices
carefully before signing this contract.
1. Don't be pressured into signing the contract. Take time to read and fully
understand it. Ask questions if something is unclear.
2. Make sure the contractor has valid Home Improvement
Contractor Registration. The law requires most home
Page 2 of 4
improvement contractors and subcontractors to be registered
with the Director of Home Improvement Contractor Registration.
You may inquire about contractor registrations by writing to the
Director at 10 Park Plaza, Room 5170, Boston, MA 02116 or by
calling 617-973-8787 or 888-283-3757.
3. Does the contractor have insurance? Ask the contractor for his
insurance company information so that you can confirm
coverage, or ask to see a copy of a "Proof of insurance"
document
4. Know you rights and responsibilities. Read the Important
Information on the following pages and get a copy of the
Consumer Guide to the Home Improvement Contractor Law.
Two identic pies of the contract must be com feted and signed. One copy for the
homeown r a d one copy for the c ract
Owners ignature
Contractor u,,V�,-
Signature:
Street Address: 160 River St
City/State/Zip: I Bernardston MA 01337
Telephone No.: 413-270-0693 /413-768-0607
Contractor's State License No.: Cs 095143 HIC 171657
Contractor Arbitration
The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action
(as an alternative to court action)if they have a dispute with a contractor. The same right is DDA
automatically afforded to the contractor, however. The contractor would have to resolve any dispute he/she
has with a homeowner in court unless both parties agree to the optional clause provide below. This clause
would give the same fight to arbitration as is afforded to the homeowner by the Home Improvement
Contractor Law.
The con actor and a ho eowner hereby mutually agree in advance that in the event the contractor has a dispute
Cance g this co ac th contractor may submit the dispute to a private arbitration firm which has been approved by
the ec etary x ti e Office of Consumer Affairs and Business Regulation and the consumer shall be required
t t c itration as provided in Massachusetts General Law,chapter 142A.
meowne s Signature Contractor's SignatuW
Page 3 of 4
NOTICE:The signature of the parties above apply only to the agreement of the parties to alterative dispute resolution
initiated by the contractor. The homeowners may initiate alternative dispute resolution even where this section is not
separately signed by the parties.
Homeowner Rights
A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer
protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners
may be excluded from certain rights if the contractor they choose in not properly registered as prescribed by law.
Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of
the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a
timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor
guarantees or provides and express warranty for workmanship or materials. In addition to guarantees or warranties
provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for
a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be
added to the teras of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have
questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below).
Execution of Contract
The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced
documents have been attached. Parties are also advised not to sign the document until all blank sections have been
filled in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to
be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing
and agreed to by both parties. Contracted work may not begin until both parties have received and fully executed copy
of the contract,and the three day rescission period has expired.
Accelerated Payments
A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the
homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems him/herself
to be financially insecure,the contractor may require that the balance of funds not yet due to be placed in a joint escrow
account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the
signature of both parties.
Additional Information
If you have general questions of need additional information about the Home Improvement Contractor Law or other
consumer rights,or if you wish to obtain a free copy of"A Massachusetts Consumer Guide to Home Improvement"
contact:
Consumer Information Hotline
Office of Consumer Affairs and Business Regulations
10 Park Plaza,Room 5170,Boston,MA 02116
617-973-8787,888-283-3757 or visit the OCABR website at hJJWL1www mass,gnv/o.cater/
If you want to verify the registration of a contractor or if you have questions or need additional information specifically
about the contractor registration component of the Home Improvement Contractor Law,contact:
Director of Home Improvement Contractor Registrations
Office of Consumer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
617-973-8787,888-283-3757 or visit the HIC website at httpJ/www.mass goy/_ocahr/
Go online to view the status of the Home Improvement Contractor's Registration:
hhM://dbstate-ma.us/hom .improvem .n/l icenseelist asp
For assistance with informal mediation of disputes of to register formal complaints against a business,call:
Consumer Complaint Section
Office of the Attorney General
617-727-8400
AND/OR
Better Business Bureau
508-652-4800,508-755-2548 or 413-734-3114
Page 4 of 4
From: ` �}
l�rs be n A r R Pr--
To:
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, 1 request that you
grant a modification to waive the requirement for construction control of the project at
because the work i of a minor nature,will not of ect structural elements, health, accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,
p pe
i
S
I
i
i
D p�
son
13 10
KEITH GUYER 60 River St Improvement
MA,01337
Home Improvemeament reg#171657
Construction Supervisor License CS-095143
CUSTOM
413.768.0607 It's All In The Details
t
Mrs
Z. '
77
rn -ntUC�
M 2 °
n
-�o y 77
ski ? j
.i � ► �� eco -��.�
q —i--T
Loll,-
Aj iLvIi
2,X�a
KEITH GUYER 60 River St Improvement
MA,01337
Home Improvement reg#171657
Construction Supervisor License CS-095143
CUSTOM
413.768.0607 It's All In The Details
i
err ,,
e
4t 71
d{
I
CRS. U,� „