25C-067 (3) fi
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KOWAL
Const.
13 Redden Road
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Springfield,Mass. 01119
(413) 782-2656 Cell phone 575-1105
HIC Lic #124626-HIC#103802-Ma Cntr's Lic #014371
Roofing,Siding& Replacement Windows
.ESTIMATE. -------------------------------.._.._.-------------------_
Customer Name: Leff A1leti
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Street: P.O. Box 524
City,State and Zip Code: Leavett, Mass. 01054
Phone: 5489414 Work- 5455715-o--r 549-3700
---- ------------- -- -t-o-Re: 18-20 Day Ave. Northampn, Ma.
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1) We will strip the roof of the house and dispose of all the material.
2.) We will apply Ice and Water 3 feet up and in the valleys.
3.) We will apply 15 LB felt paper on the rest of the roof.
4.) We will install new drip edge.
5.) We will install a new boot for the vent pipe.
6.) We will install 40'of ridge vent.
7.) We will step flash around the chimney if needed.
8.) We will clean the gutters.
9.) We will apply three tab 25 year Certinteed Bird shingle.
10,) This cwt include front porch.
The homeowner will call electric light company to put rubber safe guard on electrical lines.
Labor and Material $8,850.00
All material is guaranteed to be as specified. All work to be completed in a work man like manner
according to standard practices.
Any alteration or deviation from the above specifications involving extra costs will be done only upon
a written change order. The costs will become an extra charge over and above the estimate. This is
to include,but is not to limited to,hidden damages that are uncovered during the course of the job and
additional work required by local building inspectors.
All elements of this agreement are contingent upon delays beyond our control. The estimate does not
include material price increases,or additional labor and materials which may be required should
unforeseen problems arise after the work has started.
You,the buyer,may cancel this transaction at anytime prior to midnight of the third business day
after the date of this transaction. Cancellation must be done in writing.
Acceptance of Proposal: The above prices,specifications and conditions are satisfactory and are
hereby accepted. You are authorized to do the work as specified. Payment will be made half
down when material is delivered and the labor is started,quarter payment due when half way through
and remaining balance due when job is completed.
(Please do not hesitate to call me ifyou have any questions at th�abov ber)
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8 B �aEEAC1InE[LLE
DEPARTMENT OP BUILDrNG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I,
(licensee/pern>ittec)
with a principal place of businessJresidence at:
_(phone#)
(stzret/city/statrizip)
do hereby certify, under the pains and penalties of perjury, that:
I am an employer providing the following worker's compensation coverage for my
niployees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) 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)
�,
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compaay/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach a6dr60=1 sheet ifnaccairy to include information pertm=nng to all oo&=tors)
( ) I am a sole proprietor and have no one worming for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that whila homeowners wbo employ persons to do mxmjc ja cc�o=z7;cum or repair work ou a dwcUing of
not nxve than throa units in which the hoamwncr resides o<oa the groins appurtcnnat thereto arc no(gmmily oomida-ed to be
employers under tha warica'z coaVc= 4ca Act(GL152,--s 1(5)),application by a homoowna for a Uccusc cc permit may cvidcaca tha
Icgil ctat,ra of an employor under the Workeet Compoma2iou Ad_
I under ai that a oopy of thu rut.cmmt may bo forwarded to tha Dcpartmcot of Industrial Acci&a&Of oo of Inwnnco for the
coverage verification aad that fad=to aecttre coventgo under zocUon 25A of MGL 152 can laad to the impo On of aitniasl peuakies
oomisting of a fine of up to S 1,500.00 and/oe imprisonmatf,of up to one year and civ�7 pemltia in the form of a Stop Wodc Ord--and a
fulo 0(5100.00&.&Y agninA ar-
Foe dqurtmeozal uao ooty
Pcrmit Number
Map# IAt#
Signature of Licensedpetmittee Date
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SEGTii0�18 CONSTRUC f10N 5ERYICES ;:
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
� Reg s e mom m rovemenn 7 ntr c#or Not Applicable ❑
Company Name Registration Number
Address 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 affidE
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)familic
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(
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 DESCRIP SON Of PROPOSED WORKffepeck0all applicable)
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New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: Cr*V'? 07J M
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑- Sheet❑
��1fi IVew�#house�ntl o ii�ition to�ezist�ng�ha"°`��sin�;.comple�e�he'"#o11aw9n`�:
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
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 OWNERAUTI♦ORIZATION TO,BE COMPLI=TED WHEN
OYNt�IERS"AGENT t?R�CONTRi�GTOR APPLIES=FOR�RUILDING PERMIT
as Owner of the subject proper
hereby authorize to ac`
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
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.
/"7 �
Print Name
Signature of Owner/Agent 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:
Y
n orthampton at
11 u I Department a t
1 Main Street 5ewe " e .►
om 100 a e e
NOV 13 z�o�,
or ton, MA 01060 fl Sets o. r
e 413- 87- 240 Fax 413-587-1272 �iot1 Ite a
DEPT OF B'lIWING INSPECTIONS Ot ie pew
APPLICATION TO CONSTRU , ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1'-SITE INFORMATION
= This:.section#ogbe�completed IZy=office�,�������
1.1 Property Address: � �
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m�f�� Zone 3 OverlayDstr�c
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Elm St. District stnct3 '
SECTION 2'- PROPERTY OWNERS HIP/AUTHORIZED'AGENT
2.1 Owner of Record:
cTr& &&o
Name(Print5 Current Mailing Address:
Telephone
Signature
2.2 Authorized
Agent: �J �r
f0 2n /t/NCO G �P��/ q
Name(Print) Current Mailing Address:
Signat re Telephone
•SECTION 3"--ESTIMATED CONSTRUCTION.COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building JOD p5p , (a) Building Permit Fee
j O A
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) Check Number
'This Secti4mFor Official,Use Onl
Bui(ding Permit Number: Date lssuecl;
Stnature:`
Builtlirag
D
ComrnissiopetAnspector of:B;uilding .at�;i
� ..
BP-2002-0506
GIS#: COMMONWEALTH OF MASSACHUSETTS
11u: kr 2Sr Atr ,:.: CITY OF NORTHAMPTON
Lot:-001
Permit: B u i l d bg
Category:roofing BUILDING PERMIT
Permit# BP-2002-0506
Project# JS-2002.0764
Est.Cost: $8850.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WALT KOWAL 124626
Lot Size(sq. ft.): 6229.08 Owner: ALLEN P GEOFFREY
Zoning: URB Applicant. WALT KOWAL
AT. 18-20 DAY AVE
Applicant Address: Phone: Insurance:
13 REDDEN RD (413) 575-1105
SPRI NGFFI ELDMA01119 ISSUED ON.11113/010:00:00
TO PERFORM THE FOLL O WING WORK:STRIP & SHINGLE ROOF
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 11/13/010:00:00 MO $25.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Building Commissioner-Anthony Patillo