29-192 „,,. .,.. ropo P o
A s � p GC to,
FROM Philip Coderre Sheet No. f
Home Improvement
106 Hidden Ledge Drive pate
Conway,MA 01341
W413 - 3Gq -km ty'
Proposal Submitted To Work To Be Performed At
0
Name— _
Street Id City State
City rr C' • k A 0-,k— A-QA - 9tOOd
State
Telephone Number ”'
We hereby propose to furnish all the materials and perform all the labor necessary for the completion of
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F�-� ✓ of - ,
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no 16 . o,
All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings
and specifications submitted for above work on4 completed in a substantial workmanlike manner for the sum o,
r 300• r+ ".Dollars IS �C'QO:COI ).
a.350. t_ n 1% carri��ion
with payments to be made as follows a3r10
S (*1 &lor
Any alteration or deviation from above specifications Involving extra costs, will be executed only upon written orders, and will
become on extra charge over and above the estimate.All agreements contingent upon strikes, accidents or delays beyond ou+
control. Owner to carry fire, tornado and other necess Insurance upon /above work. Workmen's Compensation and Public
Liability Insurance on above work to be taken out by I {I1
) Respectfully submitted
Per
Note—This proposal may be withdrawn by us if not accepted within days
ACCEPTANCE. 0 PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work c
specified. Payment will be made as outlined above.
Accepted o Signal 4- `
Date � lt �
<x> Signature
' LITHO IN U. S.
Top4 FOPNI \A4n
14
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oy
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g^. e �Zc�sxchncrtla 1 _''
—0 i —
c� DEPARTMENT OP BUILDFNG INSPECTIoI.'S —
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S CO)ITENSATTON INSU RA-NCE AFFU M�TT
--
V.-It-b a r ncipal place of business./residence ac
(phone' ..
sv�ci ty/stalcf Zi p)
do hereby certify, under the pens and penalties of penury, that
( ) I am an employer providing die I011owins1 workeFs colnoc[IS�1iio, cove Zge Cor Inv
eluployces \vor ang on Oils job.
(Ins�ir-a Coax n�) (PoL c-, Nt=,Lb--r) --- (r=:p1r-,L on Date)
( ) I am a sole propnetor, general contractor or homeowver (ciucie one) and have hired
the contractors listed below who have the follo%vmg worker's c000en-,,,-don pokiest
(Nam-, of Copt:-,1Cwr) (Insuranc: CompanyfPG6c ?gy=m-:-) (i:xpuat;on Date)
,.
(Name of Contractor) -- (Lnsurance Comnanv/Poke), Nunerr) (Expir,iron Date)
(Name of Conn mo.) Gas ranc; CompaDy[PoUcy Numbu) (Expir-oboa Date)
(Name of Contractor) (Insurance Company/PoUc_y Numb,�r) (Expirlcion Date)
(mach addi;;ocil r'_x-c',if occ�s.r:to usc!u inforn-tioo P--L.rains to.11
am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:ply be ea-itc ttlzt quo boar�o+vcn wbo employ pcions w w rc,sau worm o-a.d—. U Z or
on(mo"th_r•,tt7vr ttat'u in which the twcmowocr rc ido«oo the PO,� app st<n tbcGn o-�,(C=�c2y OLc.6 rd to be
cnrploycz uodc Lhc—Z kr' , Len Act(GL1 appliatioo by .hoascoQua for:lip__oc pamrt r^.y tl:c
I19id rtnnu of an ea:,loyer under dso Workolr Compcaulion Ac(.
I uD4cr d dw x copy of th�j aIIlem—a ouy bo foe-x d.ed Lo tbo D p�nc of 1�i jd Ae d-aj Offioo of Ircur.000 for the
coven Se ventntioa and lhat Liha-e to caurc oovenq�c under sccdoa 25A of I.t4L 132 can Ic d to the=Pmitioa of cnmiald PC-- ies
ooaLLV ing of a rux of up to S I X00.00.rsdfc)r of UP to ooc year ead aril pm�P',a in tic focM of a Stop Work Order and e
fim of S 1 M.00.dray c pins mr-
For dcpL-un==�1 ur only
PcTU1711`t lltIl t)CS
I�111ll7L' ICCIISCCIPC[77111IcC�� —_.--DNCe -
P � .
E
'GT1aN$-'Co NSTRUCTION SERVICI s
Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Z6-1-2 z
License Number
Address Expiration-Efate
ignature Telephone
Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
E It 20 WORKERS'COMP'ENS"ATIt3N 1fiVSURANCE AFFIDAVIT(M.G.L.c.162, s�o
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.
ned 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
S `
New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[l/� Other( ]
Brief Description of Proposed Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet❑
is:1111 ii
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?
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
AMER APTHQRIZATION TQ B�GQMP]. 'TEp WHEN
WNE�S=AG �tT QR CO NTAC7'C3R AP ES.FAIit;BUlu))NG PERMIT
1, 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, 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.
ImQ*aned under the pains and penalties of perjury.
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:
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
phone 413.587-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
$ECTiON 1, .S]TE:INFORMATION
1.1 Property Address:
SECTION 2—PROPERT Y OWNERSIiIPIAUTHQRIZED AGENT
2.1 Owner of Record:
Arne(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent: r
Name rint) Current Mailing Address:
ignature Telephone
SOON ' ESJIMATED CONSTRU -TION COST$
Item Estimated Cost(Dollars)to be C}ffl ) Jse_Only
completed by ermit applicant
1. Building (a) Buiitfing Permit_Ee0
2. Electrical (b) Estimated Total CostTof `
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 +2 + 3 +4+ 5) Chek.hf;tamber - .
Tlais,Sec#iar►.IF,or Official We,'only
ullding hermit IVurnber: pate IsSUeCI;
Signature:
Byildi g Con rnisslo erllnsp 00 pr of Buildings ' Dst
135 DEERFIELD DR BP-2001-0152
GIs#: COMMONWEALTH OF MASSACHUSETTS
Ma :Block:29- 192 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:vinyl siding BUILDING PERMIT
Permit# BP-2001-0152
Project# JS-2001-0234
Est.Cost: $7070.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group PHILIP CODERRE 121421
Lot Sizes .ft. : 16814.16 Owner: CZERAPOWICZ JOHN S&MICHAEL E
Zoning:URA Applicant: PHILIP CODERRE
AT: 135 DEERFIELD DR
Applicant Address: Phone: Insurance:
106 HIDDEN LEDGE DR (413)369-4719
CO N W AYM A01341 ISSUED ON.-819100 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring DT.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 Tyne: Receipt No: Date Paid: Check No: Amount:
Building 8/9/00 0:00:00 1914 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo