29-002 (2) OCT-16-2003 08 :55 AM AMERICANMODULARHOMES
••A � 1 4 3 4101
P. 01
Amerksn WdWw Hone %ire.
133 French King Woway
0111,MA
Phone sad Fax: 413.883.4101
FAX DATE: .
TO: Bt*d ft Depart 11 i
FROM: LXMW
PAGES: 1
RE: Refund for payment of Joe Kochapaki's building permit
CC:
We are requesting that the funds we sent in to secure a building permit for Joe
Kochapski be returned to us. He was planning on building on Florence Rd. but
was not approved. The amount is$1, 122.60. Please contact us with any
questions.
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Received and Recorded
Register
APPROVAL Z2
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d - DFPARTMLNT Of BUILDING INSPE&107,'S
N 212 Afain SlrcCl * MunrcrPnl Du,Idinn
1'.'SP[CTO.?
Northnmplon, i\1nss. 01000 _
Square Footage Amount
3asemer t @ $.15 �P__ (�
1st r lo-ac @ $.50 f;
2no Floor @ $.30
1/2 Floocs, ALLic, Garage $.15 w
v i (3 G
Deck, Porches $_15
TOTAL
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Aug 08 03 07: 32a p. l
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August 8, 2003
To Whom It May Concern:
This letter is to serve as confirmation that Barrows Construction, 12 Williams St.,
Brattleboro, VT 05301, Federal ID #: 35-2166051 is certified to set any and all Excel
Homes, Inc. modular homes throughout the United States.
Sincerely,
'��Q.ZSYY1
Careen Basom
Administrative Manager
EXCEL HOMES, INC.
R.R. A2,BOX 683 • LIVERPOOL,PA 17046
PHONE: 717.444-3396 •800-346-6767•FAX: 717-444-2021
ENTAIL: cbasom @excelhomes.com
`l
OR-
Mitt Romney �� `a r%L70�7�7r� Joseph S.L.alli
Governor /y y y p Commissioner
Kerry Healey �XX )/2-1U2 Thomas Gatzunis
Ueutenant Governor Chairman
Edward A.Flynn � Thomas L Rogers
�, � ! }
Secretary �-',.,.,, i�' � `('� U �i � Administrator--•"
F
May 1, 2003 CN j
Excel Homes, Inc.
RR #2 Box 683
Liverpool, PA. 17045
RE: RECERTIFICATION IN THE MASSACHUSETTS MANUFACTURED
BUILDINGS PROGRAM— MC# 129
To Whom It May Concern:
This letter is to confirm your certification in the Massachusetts Manufactured Buildings
Program as a producer of Manufactured Buildings for the period of May 1, 2003 through
April 30, 2004.
This approval is contingent upon compliance with all previously listed conditions of your
approval, and compliance with the provisions of the current Massachusetts State Building Code,
Electrical Code, and Fuel/Gas Code.
Yours truly,
X
STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
`IIibmas t Roo rs
Administrator
cc: MA Board of Examiners of Plumbers and Gas titters
MA Board of Examiners of Electricians
This correspondence has been issuedfrom the Board of Buil zng(Regulations andStandards
Taunton(District Office: 1380 Bay St.,(P.O. Box871,Taunton, "02780
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-:7- The Comtnon wealth of Massachusetts
;";4 Department of Industrial Accidents
gff/C.- 711W7VSffff2&8flS
600 Washington Street
Boston, .Suss. 02111
XT-) Workers' Compensation Insurance Affidavit
al—C,
loc2cion 7
SEP 1
Ci
❑ 1 am a homeowner performing alllxcr�myself.
7 1 am a sole proprietor and have no ortworking in any capaciry DEFT Cif KILP"'G INN-PECTICINS
U-<-am an employer Providing worl<tn*:ompensation for my employees y(orking on this job.
comparly name- -14(nt&,(=, d-1 t—10j)
3 d d r ess-
.: hC6L
ciry: /v 6--3 -7 6 phone
insur2ricm—co.
1 am a sole proprietor,general contactor,or homeowner(circle one) and have hired the e conz=n listed below who have
the following workers' compensz.ca_offices:
cornj2anx name:
address:
citv:
n s a ra cc,to".
nolikx# ........
corni2ary name-,
..........
addres3: . .....
city: Rhone 4:
insurance co.
Failure to secure coverage as required under-Sk—caon 25A of NIGL 152 can 1c2d to the imposition of criminal pensides a[a ace up to 51580.00 aadlor
one ve2r3'imprisonment as well as civil pen2ldesio the form of a STOP WORK ORDER and a fine ofSI00.00 a dzy q3Li=me. I understand that a
copy or this statement may be forwarded to the c OfTice of Investigations of the DLA for coverage verific2don.
fdo hereby c i u er the pains and pen per' that the information provided above is n-je and
jury
Siznarurc Date
Print name Phone I
OfrICiai Use OnlVdo not write in this 2rn to be completed by city or tow-n official
Department
j
city or town: permit/license "Banding Deparrusenc
I—Lic-ensing Board
r-7 check if immediate response is required Sdecrtnen's 0Mcc
i=H=1th Department
contact person:ntact person: phooc Otter
—,-ca ;,95 PIA)
FROM Orchard Electric IRc. FRX NO. 4135862492 Sep. 15 2003 02:55PM P5
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red4andRec Od.
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PPROVAV
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Ed Wd2S:Eo 2002 ST 'daS E6VE98S2TV "ON XU-d oui olx�OM13 Pue4ouo W06-d
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SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name af License Holder:
License Number
Address Expiration Date
----"_- -
-- --- --------------- ------------------------
Signature Telephone
9.Aeaistered Home Improvement Contractor: Not Applicable ❑
--------- -------------- — -- -- --------------------------
CompanvName 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 affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... No...... ❑
11. - 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 inj uries 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 4.
ALL INFOAlATION MUST BE COMPLETED,or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION
�ta>� Proposed ��by
�nr.wawsu+a�eu«i>a ar
! [mac elan Acre r 4r-r r ao 00o
.2P_R�,,(4 L•Wes„_.It:X_6 �O
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1 ftePfelsk S00` R#Pfb x Soo
o
' cox hidai� � C�s�
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l
+ A. Ha=NIT Yarioncefflndirig ever boom!zs ed fo0vn the site?'
NO KNOW—r. YI:S
i
IF YES,date Nwed
If M.- Was the par tt nxmr+ded at the Registry of oft-ds?
! NO DORT KNOW
i
IF YES: ants look ` Pap and/or D*4Qmqt.#
1
S. Does the 0%=tain a brook,body of mater or rvetlarsds? NO �DGN'T KNOW ,.
IF YES, has a permit been or reed to be obtadtoed tram the Commvi on Comff*09nl
NMI*to be abtwined-Obtained obtained Data issupo
j C. Do any signs exist an the pr6perty3
YES No
IF YES,denuibe stte,type and lacat:tait: t; "o -r C>�r A x-L C Lo_c T v + C
D. Are�d�anY PmP�'d charws to or additions of sigm Intended for the prr periry?YE5,
No
–i/
if YES,describe size,type and twatlon:
I
i
i
i
" ' �rt�ryd a.RRar..onrrt�nr..�[��ty}��eik rq n r i
NOW How" Addtgeel ❑ Rrp#eaan�r►t YYfndaas Alraratlaafs� f� A�nq CI
pr Dots Q
Araeaeoetr ipdp. [] DereoiitJoni7 New r1s 1 Dodo i 1 S"l 1 Q"Hl
afw Dowption of pwimw /`r. La+,T& !►�kc CEO la'?XWG rtt�li
Wodt'
AIINr>iWn of*4dng bWMW_". Yeas_..... .No AWN new bedroom _Ye4 _ _No
AUwJMd rarretiw psnovatang unfinidwd bab&Mat _ Yoe .. .....-._.W
Pl&%AftkdW Rost -SMKiI
a. U�Je at bWiding:Ons faatatiy .__ TMAD pnily—f -Jr__......_../�
b. tv<low or morels IA aeah"ly wbi'_.. Ihtumloer Of Satniooh+9�_J.•
G. L tltl)Iie 8 serr atmorrbd? �.
/.v X wo
�a
d, t�rripased 9�rg tbotage�Harr tAxtaMrcoan.--��.:�L_.ht�,.Graenaiwre__a'z$�k!/� -1-l" �acs se�4�—•a
6RYf�6� /s7'}f�l�
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r. tvlathadOfherttrrg7_-�iRs �srsrt..�..i"y+�►el'IsCplraoit5rWo0dnWvtle "�*"'�.leum!'lrtoi' aRtd't,,,,,,��
I
s. Er►tr�tlnnaM'retirrr,Cloerrp0errrsa. ._�`��__. Nlasoheak >r+rar+q'y CornF,liertoe tam et�ekaet7_,,..„�„°��...,�_- 1
i ie WBbti+Efibn w oln too t►,of wed?__. yes — `'':Ko. is aarftucfioa+VANM 100 yf, d%ciplein _-Yes_"o
Flo
' j. Cfet+�ft ortSeaserrrti'rt(xsdNarllatx beiOw!ln�tt¢d gwoe_ ��'w_• ..^_,.,,,..._._
k. Will bulid *W tOnrt ho fie aM Zdning mgufadaw?
� 9utlanQ �,-"'"Gres_... No.
L -%OWC Tar*-, 'Coif►%WXW_.. i:! Mtivate rMaC__ _. Ctty vrater t'`uppiy C
'.li3Crit5N?e•OWNER AUrMAZATION-TO 82 COMPLUM WHEN
>WNUtD MISKr OR CONTRACM APPUBS Mit 88fi VMd weRUrr
t+wrriny authaioe --~��� _�,___��,t ..r�s-,.••_�._....._....
to ad my in 11 retsthM to vvori ugthoriza:d by this building 9"1 appke6on.
ne
OWN
L�Dflor rapt the stafem_enr1�and ie�kurfl 0;m on MG bregoir*appNatian are iruo and exurale,to+A*b t�e
SW%d wider the PAM wid PWWdog of per)try,
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City of Northamptolt
err Budding Dt;"MmOnt
212 Main Street
r "r
Room 100
Norf'lampton, MA 01t?BO
phone 413,687-1240 Fax 413.597-1272
APPt-lGATIGK To CgMMUCT.AMP,REVAIA.RIu9VATE OR DEMOLISH A ONE OR TM FAMILY DWELLING
isCO 0H i-OrM tNMORMATM
S.1 cmwtw Addnras: hla by aft
/�•`° ��d dr.e�..c� 1� 1hiMl�, �gT bytNni,.—, _
Idq+4t '._ _ q1 _
3ECMM -P2 ROPRM-fOWMFR> NKAUMHdRK90ASMIT
Ll ftnw of ftod 1=CV C,
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rrIMPto►MAlting/Id0►C33: r
2.2 Amot
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crroN s.i=al�te► j�"lTRUCTION C99io
Item fie mated Cbm fW14nj to be MW Use only
i*p10 !jp2licant,
,y QgU3
1. Bustling � 4 C7f?C`? tat bulkding PafFdt fire
2. Elrctrlaq! fOlrD (b}fflo A4 Taut C"t or
COmwUdfat from(6'
S. Phsrs►fng �� auk**Psrmk FM
r
A. lavwhmnicW IHVAC) '
S.F1re pra omm
6. Toni-,,,(l +2+3+4*6) Check Nmnbor 12Ld (27
This MoMm For OtActtl use On
as
Niue k
9t1ik11'Ifl i'i0MT10�1[r�flhr!SPP12E7r of"wing* I
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SEP 17 2003
� C �
File#BP-2004-0289
APPLICANT/CONTACT PERSON AMERICAN MODULAR HOMES INC
ADDRESS/PHONE 133 FRENCH KING HIGHWAY (413) 863-4101
QN 2.10 FLORENIt -
MAP 29 PARCEL 002 OOI�bN�� ;AICSI ,
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT 2 FAMILY MODULAR W/ATT GARAGES
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 069937
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION P SENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: § 41 i,,L(a
�,v� 19
Finding Special Permit Variance* oR
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission
Signature of BuiIdmg Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.