23C-056 :
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of conservation commissions, are required to be obtained before Keiter Builders, Inc. can obtain their permits, it
is your obligation to satisfy such requirements and you shall meet those requirements at your cost.
STARTING AND ENDING DATES:
Keiter Builders, Inc. will apply for the permits within 30 day(s) of signing this Agreement or your satisfying
any conditions required to be met prior to the permits being used, whichever date is later. Keiter Builders, Inc.
will start work within 60 day(s) of obtaining the necessary permits and expects to have the work substantially
completed within 5 day (s) of starting.
If Keiter Builders, Inc. is delayed at any time, in the progress of completing the work, due to acts of God, war,
civil commotion, accident, government regulations or policies, any act or neglect of yours, or by any separate
contractor, or by change orders, or by labor disputes, fire, delay in transportation, unavailability of materials,
adverse weather conditions, unavoidable casualties, difficulty in obtaining fuel, electricity, services or supplies
from the sources from which they are normally obtained, or other causes reasonably beyond my control, then
Keiter Builders, Inc. may reasonably extend the date for substantial completion. If the work is not substantially
complete by the ending date, as extended, Keiter Builders, Inc. will not be liable to you for any incidental or
consequential damages you may incur due to such delay.
If you are supplying any materials or equipment to be used in the work, you shall have such materials and
equipment delivered to the work site not less than 5 days before they are needed for the work. If they are not
delivered on a timely basis, Keiter Builders, Inc. will not be able to schedule work dependent upon them and the
date of substantial completion will be extended due to such delay.
TOTAL PRICE AND PAYMENT SCHEDULE:
The total price for performing the work and supplying the materials under this Agreement is
Nine Thousand, Eight Hundred and Five Dollars and Zero Cents ($9,805.00) DOLLARS. Payments against
work completed and materials delivered will be made within 2 days from when Keiter Builders, Inc. notifies
you that they have reached different completion stages. Payments will be made in the amounts as set forth in
the attached payment schedule.
60% of window cost(incl. 5% mark-up)due with signed contract ($3,093.11)
40% of window cost+ 1/3 labor & misc. material due prior to initiating work ($3,612.08)
Final payment due at Substantial Completion. ($3,099.81)
All sums not paid before substantial completion of the work will be due and payable upon substantial
completion.
Payments due and unpaid under this Agreement shall bear interest from the date payment is due at the annual
rate of Eighteen (18%) percent or at the maximum legal rate whichever is less. In the event that Keiter
Builders, Inc. incurs costs or expenses in collecting any payments due and unpaid under this Agreement, you
shall pay such costs and expenses including reasonable attorney's fees.
If you fail to make any payments when they are due, then Keiter Builders, Inc. may immediately stop work.
Keiter Builders, Inc. may choose to not start work again until you are current with the payments and Keiter
Builders, Inc. feels secure in obtaining the remaining payments. If there is any stoppage in work due to your
failure to pay on time, or to make Keiter Builders, Inc. feel insecure that the remaining payments will be made,
such delay shall automatically extend the date of substantial completion.
2 •
CONSTRUCTION AGREEMENT
Keiter Builders, Inc., of Northampton, MA whose Federal Tax Identification Number is 27-2518846,
Contractor's Registration Number 175168 (Exp. 04-29-2015), and License #102457 (Exp. 06-20-2014), is
entering into this Agreement with you John & Wendy Sinton of 124 Willow Street, Florence, MA.
ALL RESIDENTIAL CONTRACTORS AND SUBCONTRACTORS ARE REQUIRED TO BE
REGISTERED WITH THE MASSACHUSETTS BOARD OF BUILDING REGULATIONS AND
STANDARDS, UNLESS SPECIFICALLY EXEMPT FROM REGISTRATION. INQUIRIES
CONCERNING REGISTRATION SHOULD BE DIRECTED TO: DIRECTOR, HOME
IMPROVEMENT CONTRACTOR REGISTRATION, ONE ASHBURTON PLACE, ROOM 1301,
BOSTON,MA 02018 (617) 727-8598.
SCOPE OF WORK:
Keiter Builders, Inc. will perform the work set forth in the attached Scope of Work on your home, or the
property located at 124 Willow Street, Florence, MA. If you would like to change any work to be performed or
materials used,we will have to make such changes through a Change Work Order, which may also change the
total price and extend the date for completion. Change Orders will be handled on a time and material basis.
Keiter Builders, Inc. reserves the right to make minor changes in any plans and to substitute materials of equal
or better quality.
Should Keiter Builders, Inc. encounter any unknown conditions below the surface of the ground, or concealed
or unknown conditions in any existing structure, you will agree to make an equitable adjustment with Keiter
Builders, Inc. under a Change Work Order, which shall increase the total price and extend the date for
substantial completion of the work.
PERMITS:
To perform this work, Keiter Builders, Inc., or subcontractors hired by Keiter Builders, Inc., will obtain, on
your behalf,the following permits (if required):
Building Permit Electrical Permit Smoke Certificate
Plumbing Permit Demolition Permit Certificate of Occupancy
IT IS THE OBLIGATION OF KEITER BUILDERS, INC. TO OBTAIN THESE PERMITS AS YOUR
AGENT. IN THE EVENT THAT KEITER BUILDERS, INC. DOES NOT OBTAIN THESE PERMITS,
AND YOU OBTAIN THEM, OR IF KEITER BUILDERS, INC. IS NOT REGISTERED WITH THE
BOARD OF BUILDING REGULATIONS, YOU WILL NOT BE ENTITLED TO OBTAIN ANY
BENEFITS FROM THE GUARANTEE FUND ESTABLISHED UNDER MASSACHUSETTS
GENERAL LAWS CHAPTER 142A.
Keiter Builders, Inc. obligation to obtain permits is limited to those permits directly related to performing the
work Keiter Builders, Inc. agrees to do. To the extent that other permits or governmental or regulatory agency
approvals, such as, but not limited to, zone changes, variances, special permits, site plan approvals, or approvals
mow
cos
Initial Here
BUILDERSN
SCOPE OF WORK
October 7, 2013
CUSTOMER NAME: Wendy&John Sinton
ADDRESS: 124 Willow Street, Florence, MA
ESTIMATED START DATE: Winter,2013
ESTIMATED PROJECT RUN TIME: 3—4 Days
ADMINISTRATION
• Keiter Builders,Inc.will manage the following aspects of the project:
o Building permit application
o Standing all necessary inspections
o Materials ordering and delivery
o Site set-up and break-down
o Certificate of Occupancy
WINDOWS (Please see attached r.k. Miles Quote#8ESP8GP for window specifications)
This contract includes the following:
• Permit application, fees, and inspections.
• Installation of(9) new construction Integrity windows. This includes the following:
o (3) Double Mulled Units
o (3) Single Units
o Demolition and debris removal
o Staging and Equipment
o Preparation of existing rough opening including new pan flashing
o Installation of new construction units to manufacturer specifications
o Installation of all weather sealants and low expansion foam insulation
o Installation of 3M flashing tape around window perimeter
o Cut back existing siding and re-nail to accommodate new 5/4" flat stock PVC Casing
o Installation of new 1 1/4" white aluminum drip cap
o Installation of new interior, pre-primed pine colonial 2 '/2" casing
• Please note that the following are not included in this contract: Any painting, nail hole filling, stain,
polyurethane, or other finishes. It is possible that new trim may not cover paint lines.
PRICE FOR WINDOWS (Including Tax): $5,155.00
PRICE FOR PERMIT, MISCELLANEOUS MATERIALS, AND LAB OR: $4,650.00
TOTAL PRICE FOR LABOR AND MATERIAL $9,805.00
The Commonwealth of Massachusetts
Department of Industrial Accidents
=,,,r...,,..=
•.-t Office of Investigations
—:� 1
xr ._ 600 Washington Street
'= '! Boston, MA 02111
`: , www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): /.Qi/-4e V 5 c i ii -e„/ ,
/ /V( L
Address: 5-1A- -[ - CPI V
City/State/Zip: WQv'-1-A.R, ltitIQ -- MA" °/Ph n°e #: `T03 .5i& -B/Ov
Are you an employer?Check the appropriate box: Type of project(required):
1.0 I am a employer with ,sj 4. ❑ I am a general contractor and I ❑
employees(full and/or part-time).* have hired the sub-contractors 6. New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.
# 9. ❑ Building addition
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 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.0 Roof repairs
insurance required.] t c. 152, §1(4), and we have no 13. Other✓e �GC C��
employees. [No workers'
comp. insurance required.] 1,-5 1 nd 614.)5
*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. ---i---, n
Insurance Company Name: /K Vhf'-e✓S 6/1.,°D-14 v- t,vl c-e-
Policy# or Self-ins. Lic.#::,,�C- (,(/5,2-A- 5 l0 5-7 a'-/ 3— Expiration Date: (7 . /I. �--D/`/
Job Site Address: /0214 l/V(ll6W Sf 4017-ek1C-P1 Mk— City/State/Zip: 0/Q &2
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 hereb/certi nder the pains and penalties of perjury that the information provided above •' true and correct.
Signatu / T (e� 6167�Ll► 1l��lJ/ W(�- Date: (O /17/3
Phone#: y/3. 57(0 - S b Uv
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#:
•
- CITY OF NORTHAMPTON •
• Construction Debris AffidaVit ,
In accordance with the provisions of MG.L, c. 40 § 54, all debris resulting.from any work
-= = - --cover-ed by-a-Building"Permit shalt be disposed of in a-properly licensed disposal facility,
as defined by M.G.L. c.•'f11" § 150A. / •
Address of Work: /o2 GO I(,6. ) �+- R.O.
Ire.
IreNce f
--The-debris._wtll-be-transported by: c(-r-e v-Zut(i /'S Go 6 •
The debris will be received at • I/GCti.'
` 4
- Signature of P it ficant i':A/ •
" bate /D // /3
- Building Permit Number:
•
•
• T
•
•
•
•
•
•,
• •
•
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: SC-01-1- K E 1T1✓2 CS 2`4 S
License Number
5 I A-- 14-et-i-4,e M kôI AAA— 0164,4 • 20 . 20(Lk
Add ss Expiration Date
LOS 4.06
S ature Telephone
9.Reaiistered tome Improvement Contractor: Not Applicable ❑
Ke /TER_ 3 u ILD�E2S, /1‘./C- . / 7.51 to g'
Company Name Registration Number
51 A- -1-kg tV Sf N6(-4-Aar/14/0fa-w M4— 6IO66 `1. Z1 - 2015
Address Expiration Date
Telephone/I?'53/ •3 Got
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 ❑
1:1. - 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 1083.5.1.
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
}
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacemendows Alteration(s) n Roofing n
Or Doors
Accessory Bldg. El Demolition ❑ New Signs [D] Decks [Q Siding[O] Other[O]
Brief Description of Proposed
Work: re-p/a_c-e,n of-- 9 w/ndaw�
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 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 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, , 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
l&0 TeoleV kot-a(G - -61 'e✓ '3" (lti-GV (146- , 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.
Sigfd er pai s and penalties of perjury.
riill'
Name '
(–On— 1 / /o p 13
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:
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 0
IF YES, date issued:
YES: Was the permit recorded at the Registry of Deeds?
NO 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 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 Q , 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 0 NO (53)
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.
�3rtment t ee )tly
I' (r 11:"''',j ity of Northampton Status of Prr It
lJ uilding Department Curb Cut/l �y Putt
�L6LU- , 212 Main Street Seer/ pti iIab1I
IS R oom 100
WsterlVUell AuatiabilitY
No hampton, MA 01060 two e#apf8truoturaP�ns
Electric, I'ium"!r G�' 41.'5 587-1240 Fax 413-587-1272 f�I ,rte F � 4
Northampton ti^KGi �
v
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 computed by office
/2,L W r/L61A -��-f Map Lot Unit
(e_iil C� /4f� oto/Oa Zane Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
Iio v tGc v to K.e r-/--e r a w (4-evs' �� ' 5/ A 4w-F-4.-e'ee( -t-
Na e(P t) Current Mailing Address: eft
A , f' /(-F -
'I'ature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building q 05-s J O (a)Building ermit Fee
2. Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) 9QO5. �o Check Number a47 € $.35--
This Section For Official Use Only
Building Permit Number: Date
g . . . Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
124 WILLOW ST BP-2014-0471
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23C-056 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: window replaced BUILDING PERMIT
Permit# BP-2014-0471
Project# JS-2014-000812
Est.Cost: $9805.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SCOTT KEITER 102457
Lot Size(sq. ft.): 30796.92 Owner: SINTON WENDY W&JOHN W
Zoning:URA(100)/WSP(100)/WP(29)/ Applicant: SCOTT KEITER
AT: 124 WILLOW ST
Applicant Address: Phone: Insurance:
51A HATFIELD ST (413) 320-9035 WC
NORTHAMPTON MAO 1060 ISSUED ON:10/18/2013 0:00:00
TO PERFORM THE FOLLOWING WORK: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 10/18/2013 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner