49-050 691 PARK HILL RD BP- 2009 -0876
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 49 - 050 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2009 -0876
Project # JS- 2009 - 001284
Est. Cost: $1678.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WRIGHT BUILDERS 101536
Lot Size(sq. ft.): 78408.00 Owner: HOLLEY CYNTHIA L & ALEXANDER D ADAMS
Zoning: SR(100) / /WSP 1I Applicant: WRIGHT BUILDERS
AT: 691 PARK HILL RD
Applicant Address: Phone: Insurance:
48 Bates St (413) 586 -8287 Workers Compensation
NORTHAMPTON MA01060 ISSUED ON:4/28/2009 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL NEW STANDING SEAM METAL 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:
FeeType: Date Paid: Amount:
Building 4/28/2009 0:00:00 $35.0031868
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/DrEveway Permit
' 212 Main Street Sewer/Septic Availability
Room 100 WaterNVell Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
This section to be completed by office
1.1 Property Address:
1 e.,:'
/ 1 l i''' ti 1 1 1 , . c Map
Lot Unit
1 ,, , ., ,-
1ii i 1(. 1 i'l fi , ',.,..
Zone Overlay District
Eirn St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
. r ! . ' .". ,-;..
„/...‘ ,/ , ', , i "-'' , , , ,"/ ° '''
- - =
Nayne (rint)
i Current Mailing Address:
-
t 'IL ..„4:''''-- Telephone
Siglhoiture
2.2 Authorized Agent:
, ‘‘.
i C i li:•:' j CV:: ; ' - ‘, 1 , ` ' i ..) : -
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Name (Print) - i , 1 Current Mailing Address
,..e „,
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7 ,
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signature- Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS 1 44 j - O r kt j.4 " - * ft - e - 41' '''' ' ,,,,..
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
/1
1. Building , .... h.t1/41C.,,,„ 1 i 1 3.--- (a) Building Permit Fee
2. Electrical t 9 5 ' -r- (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) (0 7 r - '''''' Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings ' Date
.,
o p t
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 :. L.. R..
Rear
Building Height
Bldg. Square Footage��
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking SRaees
oiume & 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:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book Page', and /or Document tt
B. Does the site contain a brook, body of water or wetlands? NO iti DON'T 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 (3 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
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, ex ►:vation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO i t
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ( I Addition I I Replacement Windows Alteration(s) I Roofing r7
1
Or Doors El 1
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [Q Siding [D] Other [D]
Brief Description of Proposed r t� ,,`
Work: S ? .-
Alteration of existing bedroom Yes No Adding new bedroom Yes No fl. r
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet /
sa.) house and or addition to existing housing, complete the following: t
! "ai`°r
a. Use of building : One Family Two Family Other
1 -1'1N01-r sit
b. Number of rooms in each family unit: Number of Bathrooms 4 . , ' 6.'"
C. Is there a garage attached? "
d. Proposed Square footage of new construction. Dimensions e
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
] ;
1 , ,, yo r m e, ) ,, i o , as Owner of the subject
property} t
hereby authorize L".- t i -: IA. t , 3 t. , ` - ., _ 1 ) e ) , , -, r fr ,a r 1
to act on my behalf, in all mhtters relative to work authorized bytfhis building permit application.
I C ,Z7 ,-3
Signature of Owner Date
��,, c' � y � � �, � , f,_� ' �`
I, C , „L t ,t z u, I II , as Owner/Authorized , ”
(Agent hereby declare that the statements and inf rmation on the foregoing application are true and accurate, to the best of my knowledge
'and belief.
Signed under the pains and penalties of perjury.
Print NameO t f J( if
Signatur•'of'Owner /Agent , Date
SECTION 8 CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder Li, s 4 t ( id I ii. i 4`lg x � t ,e , a !t L ft r / t -- t %'" _.' ' ,✓ ".?
License Number
Address t ° Expiration Date
J LL
Signature Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
Comparui Name Registration Number
�`3 $t�E' � `> C L't,t ; ¢o�rUcft'�; a ' / t >tr , �C.;� t r c '
Address Expiration Date
Telephone `f/
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 V No ❑
I1. 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 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
WRIGHLABUILDERS
I N C OR P OR ,4 T ED
48 BATES STREET
NORTHAMPTON, MASSACHUSETTS 01060
April 10, 2009
Ms. Cindy Holley
366 West Rd.
Ashfield, MA
RE: Repairs to 69 Park Hill Rd. — Florence, MA
Dear Cindy:
Thank you for your confidence in Wright Builders and for the opportunity to work together and
be of assistance.
The Scope of the Project: The scope of the work is as outlined below:
Demo existing wood flooring and baseboards throughout the entire house. Repairs include
patching drywall, caulking, cleaning glass at gas fireplace, and miscellaneous carpentry and
electrical work. Install new wood baseboards throughout house, new wire closet shelving with
hanger bar in the master bedroom. Included also is installing new standing seam metal roof
including ice belt above Living Room bay window. Paint all interior, including walls, ceilings,
trims and doors. Wash exterior vinyl siding and composite decking, and paint front porch
columns with 2 coats paint and wood trim at front door.
Wallpaper removal and final cleaning is by owner. New wood flooring is under separate
contract and billed directly to owner.
NOTE: before work to start, owner to remove all contents in house and Project Manager
4 . will inform owner when wallpaper removal by owner will need to be completed.
Costs: Costs for the project are as shown on the attached estimate summary and Wright Builders,
Inc. makes substantial efforts to secure and hold pricing on all aspects of the work. Volatile items
such as, but not limited to, wire, copper piping, plastic products, oil based products and lumber
are beyond the control of Wright Builders, Inc. and the customer agrees to pay for incremental
- ost changes that exceed those unit costs contained within the quoted package, by change order,
' such conditions arise.
Options for material or costs savings, if applicable, are included in a separate
,ry page. They may be selected at time of original contract, and will then he
a
ONE 413 -586 - 8287 _ FAX 413- 587 -9276 ELECTRONIC MAIL: info @y7right - builders. corn