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32C-206 (7) Reg.rr`128487 WILLIAMSBURG ROME I.1\'I1"ROVENVIENT Lic.,,-034841 P.O. Box 535 + Williamsburg, MA 01096 (413) 268-3553 This Agreement is entered into on the2.3 day of 5 6PE 20 001 , between ("Owner") and Williamsburg Home Improvement (`Contractor"), and concerns property located at I K4� r,, -)1' T' (' Al/ The Owner and the Contractor agree as follows: All material is guaranteed to be as specified. All work is to be completed in a workmanlike manner according to standard practices. All agreements are contingent upon strikes, accidents, or delays beyond our control. Owner will carry necessary insurance. ARTICLE 1 -THE WORK E Nt o E 1 L, / I-y i tJ t N /V � S 1 W 1'�/' \ �'i �C�•p L�C� 1,�' � '1 l��✓ `7 �!'�� / L.:% �L1� r�' LS/ iv,�k-T` t✓ Il r%t, ✓,1 '�� : T—/-� LV I I✓Z> 4 t./6 i A s c) L�/ S u✓N t r�� ' 4-S<1 2 c �=�' f� F' i,i i't'y 0 4.S/ ; v Owner may order changes in the work(additions, deletions, or modifications) with the contract sum and the contract time being adjusted accordingly. All changes shall be authorized by written Change Order, describing with specificity the nature of the Work to be undertaken, and shall be signed by Owner. ARTICLE 2-COMMENCEMENT AND ESTLMATED DATE OF COMPLETION The work shall be commenced after delivery of a fully executed copy of this Contract to Owner, and after payment by Owner of the First Payment. It is estimated that substantial completion will be achieved on or about j`.�-'� I ;'subject to change orders, weather, and availability and delivery of materials. 1 ARTICLE 3 - CONTRACT PRICE and PROGRESS PAYMENTS Tire Owner shall pay to Contractor, subject to additions or deductions by written Change Orders, the Contract Sum of S 3 �_ Z l No work shall begin prior to execution of the contract. The Owner agrees to and shall make progress payments to the Contractor on account of the Contract Sum as follows: UPON SIGNING OF THE CONTRACT S U E S S Final payment, constituting the entire unpaid balance of the Contract Price plus any Cliangc Orders and costs of materials shall be paid to Contractor upon substantial completion of work. If payments are not made in accordance with above schedule, Contractor may stop work until payments are made. ARTICLE 4 - PERMITS, ETC. Owner shall pay for all necessary approvals, building permits, governmental fees, licenses and inspections, assessments and charges required for the construction,use, or occupancy, and Contractor agrees to obtain such permits, etc., O��t 1 P '�aSEa[{�nBttlE DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building 'a Northampton, Mass. 01060 WORKEWS COMPENSATION INSURANCE AFFIDAVIT I, _UJ 1 2 A C - (Iicenseelpermittee) with a principal place of business/residence av (phone#) Q(,2j: (stzeet/city/statrlap) do hereby certify, under the pains and penalties of perjury, that: O I am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Dale) ( ) 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 Number) (Expiration Date) r. (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (anach additional sheet ifnoccssary to mcladc information pertaining to all ooat"d ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be avrarc that while homeowners who employ persons to do maintcaance,oorrstructioa or repair work on a dwelling of not more than throe units is which the homeowner resides of on the grounds appurtenant therete are not generally oo=dcred to be employem under the wod=Az compassation Act(GL 152,ss 1(5)),application by a homeowner for a license a permit may evidcaoe the legal status of an employer under the Worker's Compensation Act I understand that a copy of this xWemmi may be forwarded to the Depertm of Iadsutrial Acddratd Offioc of Iasur.noe for the coverage verification and that failure to scatre oovaage under section 25A of MGL 152 can lead to the ikon of criminal peaelti'm oomisting of a fine of up to$1,500.00 arWor imprisotnnarl of up to one year and civil pemlties in the form of a Stop W ode Order and a firto of 510-0.00 a day against mc. gPeTmit trn a use only G�., � _ Ntunber GU --Lot# Signature of LicenserlPermittee 2 MW SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: /y d�/� C' License Number Address Expiration Date Signature Telephone f 2 , �� _ Not Applicable ❑ 14 g2 Company Name C r Iaj,-5 &Q O� Registration Number tA� 1` f� '1°l�' y - 2- , C, f Address Expiration Date PO PON 3 (Ne (C:9-'5GW'1 Telephone 2611F -11 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 SECTIRN ION QE RROPOSED WORK01heck all iapplicable) New House ❑ Addition ❑ Replace ent Windows Alteration(s) ❑ Roofing [I Or Doors Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding�Q' Other [ ] Brief Description of Proposed Work:��CSI /1!/�0 V S V (AZI L /� ®f/V Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative ii Renovating unfinished basement Yes No Plans Attached Roll ❑- Sheet❑ 01#16zth UN WE 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 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 I, M Gp�' A/V C_ t S Y as Owner/Authorized Agent hereby declare that the statements and information on the foregoink application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. M c) rk M4v-1J A 5 � 1 Print Name , n-::� 5� CSC ( _�<J 2oo0 Signature of Owner/Agent c./ Date 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 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 a Special 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 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: City of Northampton Building Department 212 Main Street Room 100 = Northampton, MA 01060 5_ 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 This sere dmpf dt� h>fi �E 1.1 Property Address: 3 A A 5 ( Map 9 A 14 Elrn SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Telephone S"T q, 1 Signature G / 2.2 Authorized Agent: Name(Print) Current Mailing Address: 1/1 a e ,« �-- J ( r: 3 2-) Signature Telephone SECTION 3 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 07 00 0 U (a)Building Permit Fee 2. Electrical (b) Estimated Total Cast of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2 + 3 +4 + 5) Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building,Commissionerlinspeetor of Buildings Date. r I KARY ST BP-2001-0436 CIS#: COMMONWEALTH OF MASSACHUSETTS Map.Block: 32C-206 CITY OF NORTHAMPTON Lot:-001 Permit: Buildin Category:replacement windows/siding BUILDING PERMIT Permit# BP-2001-0436 Project# JS-2001-0746 Est.Cost: $9000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NORMAN ZALESKY 128482 Lot Size(sq.ft.): 3702.60 Owner: PULASKI FRANCIS S&SOPHIE A Zoning:URC Applicant. NORMAN ZALESKY AT: 1 KARY ST Applicant Address: Phone: Insurance: 37 CHESTERFIELD RD (413) 268-3553 WILLIAMSBURGMA01096-0535 ISSUED ON:10130100 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS & VINYL SIDING 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 10/30/00 0:00:00 353 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 128481 WILLIAMSBURG HOME IMPROVEMENT' Lic.9034541 P.O. Box 535 + Williamsburg, MA 01096 (413) 265-35 5, its Agreement is entered into on the2.3 day of `J�_�:( 20 CMG' . between Owner") and Williamsburg Home Improvement("Contractor"), and concerns property located at he Owner and the Contractor agree as follows: All material is guaranteed to be as specified. All work is to be comple[cd in a workmanlike manner according to standard ractices. All agreements are contingent upon strikes, accidents, or delays beyond our control. Owner will carry necessary insurance. iRTICLE I—THE WORK R (A-1 U +,t/ 4A S h� �n� 1� S�G��M �,2," t �l,' L'C� ��,t -� I;✓ •> ��`�_l -.t! L� /�.0�=—�I i , i-_ r✓ l %L� ✓,�/ 4/�) rrJ �,/ I Vl,> L/4 i �l c) L ,1(i