23D-191 Price for windows = $ 5200.00
Price for installation = $ 1200.00 6 qi o ,
• .
. �u I -., il.i
Total = $ 7600.00
For the doors I will remove and install new units.
Price for installation = $ 300.00 per door A i( a `'
Price for installation of storm door = $ 150.00 per door
Customer will choose door style.
Contractor Supervisors License number 082531
Home Improvement contractor Registration number 135204
I propose to supply materials and labor -in accordance with above specifications.
This proposal may be withdrawn 1011/
By us if not accepted within 30 days Authorized Signature _ A
Acceptance of proposal Signature
Stephen Camp Construction
46 East St.
Easthampton, Ma 01027
(413)527 -7124
27?
Submitted To Craig Porter Phone- 584 -' cell - 627 -9220
Address : 13 Winslow Ave. Date - 1/15/12
Florence, MA 01062
We hereby submit this estimate for- Assorted Jobs
For the roofs I will strip all old shingles and roof debris.
I will repair the rotted area as talked about.
Ice and water shield will be installed on the whole roof
I will install new drip edge and pipe flashings.
Shingles will be 30 year architectural style.
Color is customer's choice.
Materials = $ 2400.00
Labor = $ 1800.00
Trash removal = $ 300.00 Total = $ 4500.00
For the siding repair I will strip siding on the left side.
Any rotten framing will be replaced.
New T1 -11 siding will be installed on the whole wall.
I will install new white vinyl soffit and fascia boards where needed.
All fascia boards will be wrapped with white aluminum.
(Proper vents will be installed in the attic at this time.)
Materials = $ 1200.00
Labor = $ 2650.00
Total = $ 3850.00
Total of 13 windows / double hung Anderson windows
I will remove old windows and install new ones.
1 will caulk and insulate as needed.
The interior will have new trim installed.
City of Northampton
Massachusetts
r ;
ac i'. $ '' 3.
774 11 *
. h7
b � � ,, ,.. DEPARTMENT OF BUILDING INSPECTIONS
t • � 212 Main Street • Municipal Building
Northampton, MA 01060 11 IrD
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her
construction supervisor. 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
- The Commonwealth of Massachusetts
Y yy,�,, • - =r. Department of Industrial Accidents
Office of Investigations
-- r, 600 Washington Street w ,
'° MM. Boston, MA 02111
'40 www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers
Applicant Information Please Print Legibly
Name (Business /Organization/Individual): ALIIA4. .
Address: e % �;_j 74" f7Z-e f'
City/State/Zip: kiehl /iv" OW 2 ? Phone #: f2 7- 2/0 '
Are you an employer? Check the appropriate box: Type of project (required):
1. g I am a employer with 4. El I am a general contractor and I
n
* have hired the sub contractors 6. El] New construction
employees (full and/or part- time).
2. III I am a sole proprietor or partner- listed on the attached sheet. 7. Ji Remodeling
These sub- contractors have
ship and have no employees 8. Demolition
working for me in any capacity. employees and have workers' 9. 0 Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. ❑ Roof repairs
insurance required.] t c. 152, § 1(4), and we have no f
employees. [No workers' 13. Other�/r1J ���w.✓
comp. insurance required.]
*Any applicant that checks box #1 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.
Contractors 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: Ca, 0,,,,..4) 4 S , Cric,
Policy # or Self -ins. Lic. #: e 35 Expiration Date: 9
Job Site Address: / //4, - s /1,1 1,1 it 1 i " City /State /Zip: fl ra4) k J me 2 .
a /tV
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 un the f ins and penalties ofperjury that the information provided above is true and correct.
Signature: `'�' _ Date: /Z7 7i Z._-
Phone #: 5 7 /V
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. Pl Inspector
6. Other •
Contact Person: Phone #:
J
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: /� /� Not Applicable ❑
Name of License Holder : S I 4 9/ / a ,4 "yf C'2 53/
v License Number
Address I E xpiration Date
gnature L� Telephone
.""e:Cft ors. - OWI Tom. fi ^�°r °r�, *n, -ma ate `" >, 'ate.,' ¢ `
.9;r��tegastered�i come :Improvement�Contractor.� = ��� , ,���:�.� � �� �,.�.��.9 Not Applicable ❑
e4 i e fir e-1i62,./ /3r2 �1
Company Name Registration Number
7 j /4-4 , 3-/1-/7
Address . Expiration Date
Telephone $ 22 - 2 /z y
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M .G L c ;152, § ; !, . - -
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 e ffr i No ❑
°, a o M waer xi mp n
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
•
W
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) ,
•r
New House ❑ Addition ❑ Replacement indows Alteration(s) ❑ Roofing
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [[] Siding [D] Other [O]
Brief Description of Proposed //
Work: ,.5-1✓�i�J o�& Ke ah J 745k/I ,/2 me-kJ ,LDi✓1c
Alteration of existing bedroom Yes X No Adding new bedroom Yes A No
Attached Narrative Renovating unfinished basement Yes y No
Plans Attached Roll - Sheet
sa If n ew_housetand.or;addition.to ezistin housin
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 4 CONTRACTOR "APPLIES FOR BUILDING PERMIT
I, , as Owner of the subject
property ' / 4" hereby authorize �.t.✓ to act on my behalf, in all matte relative to work autho by this building permit application.
Signature of Owner Date
iyQ , :s Owner /' .: ' -d
Agent hereby Clare that the state nts and information on the foregoing application are true and accurate, to the .est of my knowledge
and belief.
Signed _. under the pains and penalties of perjury.
5+
Print Name
Signatur of Owner /Age l i� Da
l
J
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
b "
Existing Proposed Required by 'Zoning
This column to be filled in by
Building Department
bi
Lot Size I i 3 € 1
Frontage
Setbacks Front = J
Side L: € R: 1 L . 1 R
Rear I E ' ,
Building Height i a I
F
Bldg. Square Footage 1 i } 1% 1 € I
Open Space Footage %
(Lot area minus bldg & paved r i ? 1 t ,
parking)
# of Parking Spaces ` I
Fill:
(volume & Location) ,
.1
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES
IF YES, date issued:,
IF YES: Was the permit recorded at the Registry of Deeds?
NO 10 DONT KNOW 0 YES 0
IF YES: enter Book i Pagel and /or Document #
I I i
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , Date Issued:
C. Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and Location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0
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 0 NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
k
"" k -. c. �' t . *Pal ear use nl' " A �„.ua :�" ` : R .
City of Northampton Sta us o ermi .N
} •
,;a Building Department b C t/D a Pe x
' ti� 5 re p ` , , f}7 f$ ' 3
` ,���. � 212 Main Street Se e r ep t � s
��► 0� Room 100 , a � e s a tlabrl pi h , � , 4 ,E ;
\\\7 oo� Northampton, MA 01060 • a ,a — -
/o� � phone 413- 587 -1240 Fax 413- 587 -1272 e a t
� Q O � ��P Ov er'W - flr �? � �e ., $. ., ' _ -,.
t
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE bR TWO FAMILY DWELLING
SECTION 1 SITE INFORMATION
Th is section to be comple ted by o ffic e
1.1 Property Address 3 , , ,
e //_ � `. y c.'r a rA -! .,�. to �, * y d I '" ,M^k. y u'" y "� ' :+ k '� ,F. - .
„ � � 5 /t,., -/ , � Map t"^ an u " x y "�' ��F 'i... '^� a M1 a .. U nit e �. a .
,, 'a', S'" ,.,c E^,. iii. °s y. _. *-s s 4' a'a"m �� . ',:
O O Zo * Overl Distri
Elm S t. Distrrct : . "CB i
SECTION 2 - PROPERTY NE
OWRSHIP /AUTH ED GE
ORIZ ANT . ; .. '
2.1 Owner of Record:
C' ��1
Current Mailing /5 k,ns1e) ' i �
Name (Print) Address:
rev 2 22 �2 /— 2 2a
Telephone
Signature
2.2 Authorized Agent:
5—?e/444) (.17°'li
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3 CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building / /rte'- ( a) Building Permit Fee
2. Electrical ( b) Estimated . Tot
._' C from; {6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection 4).4'1 Chec Number .
6. Total - 1 + 2 + 3 + 4 + 5 / e ' k
� -- -.. This Section Fo Official Use Only
Date
Building Permit Numbe Issue
Signature.
Building Commissioner /Inspector of Buildings . Date
•
13 WINSLOW AVE BP- 2012 -0922
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23D - 191 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ROOFING /REPLACE WINDOWS BUILDING PERMIT
Permit # BP- 2012 -0922
Project # JS- 2012- 001607
Est. Cost: $15850.00
Fee: $70.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: STEPHEN CAMP 082531
Lot Size(sq. ft.): 13503.60 Owner: PORTER JOYCE L
Zoning: URB(100)/ Applicant: STEPHEN CAMP
AT: 13 WINSLOW AVE
Applicant Address: Phone: Insurance:
46 EAST ST (413) 527 -7124 0 WC
EASTHAM PTON MA01027 ISSUED ON:4/24/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF & INSTALL
REPLACEMENT WINDOWS
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 4/24/2012 0:00:00 $70.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner