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32A-153 (13) Zl l LA L Z/1 5 It :r °° .Zlt 6M — cc o .o.s 'a o N L 11 N iD 2 "q N 0 LL L fi N ® I 00 c N 0 zo O Q m � 8 0 0 -92 .9.Z d LL .Ul 4,6 .Vt L. o � 0 O 0 El .lt.11 00 O xUt0s a o —p°� � •rte— «0.8 r, .9z .Z Q r O � N L it O o - N g m jai rn 00 C U N N fn Q tV N r N OO p O© 1 .8 z 6 U E O O p xUl b.4 v PHILIP LAWRENCE Builder 52 Warm Ave Northampton, Ma 01060 413 586 6857 phi llawrence @crocker.com ESTIMATE Tim Bacon,Shona Kerr For Property at 28 Strong Ave Northampton,MA 01060 Plumbing and Heating: Gas fired Hot Air w/AC,Electric Hot Water Heater,(1)laundry hookup-Rough 2 baths, 1 kitchen, 1 bar-Finish 1 bath and kitchen Gas piping as required. 18,000 Electrical: 200 amp service,wiring and outlets to code,no fixtures 7,000 Insulation:Blown in cellulose for heat and sound 3,500 Drywall: 1/2 inch and 518 inch where required,taped and finished,sanded 8,000 Sprinkler system: engineered drawings(fixed cost) 800 to code suspended from floor joists and rafters 2,500 Roof penetrations(4) 1,500 Interior partition framing: 1 bedroom,2 baths,hallway/entry,miscellaneous 6,000 Flooring: 1/2 ULCX underlayment throughout;Ynaterial'aid-installation 3,000 Interior stairwells(2): plywood treads and risers,pine skirt boards,prepped for carpet,handrails 2,000 interior doors(3): 1 bath, 1 bedroom, 1 hall entry,installed 1,500 Kitchen allowance: rudimentary cabinets and countertop 2,200 Supervision 4N Total 60,000 Note: No fixtures,no appliances,no paint,no trim,no closet doors,no permit ESTIMATE of � � E qta5 opt tSlncrlla' w c� DEPARTMENT OP BUILDrNC INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 W O RICER'S C O NIT E N S A`IT O N M S URA_N CF A F M A)'IT (li ccusxlpern�i flee) vrith a prblicipal place of business/residencc at: N83 PHfR-K E ,C LL RiD_ FLOC ce_ V — (��ty/stalcrzi p> do hereby certify, under the pains and penalties of perjury:, ?hal ( ) I am an employer providing die following Workers colnnensZDon coverage for illy etuplovecs working on this job. (Iasw- = Coc=Y) (Peti(7:Numocr) - :piratioa Dale) " ( ) I am a sole proprietor, general contractor or homeovrver (ciicie one) aDd have hired the coauactors listed below who hzve the 'MoVving workers como°nsnon policies: (i+amc Of CO".':'.1Ci0-) (Ins nncc Colnoanyi-Poiic; ru171LC:) (Y_X)lidliQ Da1c) (Name of Contractor) -- 0=w-a_ncc Comoan`•1Potic), Nulaccr) (.\pu.i)on Date) (Name of Connaelor) (Insurane:- Compan)'(PoLicy Number) ('Exp ration Date) (Name of Contractor) Jnsufan� Comcaay/PoUcy Number) Txpif-,,6on Daic) . (nQac�.Ai:;oca1 r'_xci if nco jr\ w in_Ndr�nrocm,Eoc pertaiains to.L co=rnco:. ) I am a sole proprietor and have no one worii-og for me. ( ) I am.a home owner performing all the work myself. NOTE:plG.sc be ewe tfie w1 ]c boa,,"­ocn.bo cu loy pcson.i w do m,ix rcpau-ork on.d.IJL=&or aot mote thn t5v=rc in%bath the bornoo xue raider a oo the Qou zppurtcnun thcdn C=)azuv oc<= crcd to be catploy­ric lbc.. :oc�oa Aa(GL152=1(5)�apparition by a bomcow=far c lic=x or pcltnit r=y c«dcoc c LL-c lcgil rt%2"of an e=Ployx uodrr dw Workoes cocopomar.ioa AaL I uodari..nd dW a copy of d�j mt�may be foc_ded to tbo Dcp,rtmcat or In i ui id Acadonly Offioo rac tfm covrmtsc V+crircmioa aM t1111(.nitre to tenure),overage undo soction 25A of hiOL 152 Can Icad to the Lm ositioa of cnmiaA pc—w- oocsis of a rive of up to S 1-500.00 Krkvoc inter orup w or y�w end o%il pcoaltia in dx form of a Stop Work Ord=and fit»of S 100.00 a day rEainA rbc Foe dcp.rtrr��u.e only Permit Number /✓ '? Lot y 1.-a �. fie- 1 . SlGnacun,of Liccnscc.fPccmiucc , _ _ -- mow O�'tNAM pTO $ � yLlassacllusetfs 5f s DEPARTMENT OF BUILDING INSPECTIONS , INSPECTOR 212 Main Street • Municipal Building Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as 'r:is/her construction sup:_: ,-:sor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing& gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location Signature of Owne gent Date ` SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: CP�1'4�� of i Q pQ 11 C C 0,r�, ID "I ��p License Number R i<Address Expiration Date Signature Telephone 9 Registered 4,6rk�Irnurovei�ient Contractor": ' Not Applicable ❑ Pe (- .nee NJ Company Name - k` 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...... ❑ 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 fob 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all aoolicable) New House ❑ Addition ❑ Replacement Alteration(s) ❑ Roofing ❑ Windows Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other Brief Descripti f Prop sed / �k� Work: .��L� �� Y�v�-,� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative o Renovating unfinished basement Yes No Plans Attached Roll o-Sheetr 6a::T illl]�fIi114> h 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? i 'e� �� Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction �- a i. Is construction within 100 ft. of wetlands? Yes 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 Wing 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, Z, �li r7-2,1 ,as Owner of the subject property 7! r� hereby authorize �1 i �/ �� C to act on my behal ers relative to work authorized by this building permit application. Zoo Signature of Owner Date I, L C1 zzt— C' zy aV&441WAuthorized 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 then ppainns and penalties of ppedury. Print Name 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 % S.S� 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 DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DONT 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: e City of Northampton uilding Department " V E 212 Main Street °p # Room 100 Un ;1587-1240 hampton, MA 01060 AUG " 5 2Kon Fax 413-587-1272 r Jjij'�ONST UCT,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: r Z8 � /� �-- Map' Lot bit f�1 �/� Zone Overlay,District Elm st.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: yr /tea co S40'00!1 iQVe Name(Print) Current Mailing Addres . 0%,rfi4-7G --i eo7"0ki l/UI /v6 O Signature Telephone L//-3- 330 2.2 Authorized Agent: ` f4l 2e-, . 5 2 Name(Pri Current Mailing Address: ©(�� - q(-2� Signatu a Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 5177D (a)Building Permit fee 2. Electrical _ (b)Estimated Total Cost of Construction from 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 2- 5. Fire Protection 7, 6. Total = (1 + 2+ 3+4+ 5) Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2005-0156 APPLICANT/CONTACT PERSON George Peppard ADDRESS/PHONE 483 Park Hill Rd NORTHAMPTON (413)587-9750 PROPERTY LOCATION 28 STRONG AVE MAP 32A PARCEL 153 004 ZONE CB 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: BUILD OUT FOR RESIDENTIAL CONDO New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IPjF9J61ATION PRESENTED: 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: § Finding Special Permit Variance* 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 Commissi o0zo-vW 0001, /-/C9/Zv Signature of Building 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. 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Class: Contractor: License: Use Group: George Peppard Lot Size(sq.ft.): Owner: BACON TIM Zonms: CB ±p,alwaty: George &ppard AT. 28 STRONG AVE Applicant Address: Phone: Insurance: 483 Park Hill Rd (413) 587-9750 FLORENCEMA01062 ISSUED ON.•9115104 0:00.00 TO PERFORM THE FOLLOWING WORK.-BUILD OUT FOR RESIDENTIAL CONDO POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: / '7� � G�, � Meter: V •�' Footings: Rough: Rough: Vfk- Souse# Foundation: 4 /Aprrveway Final: Final� ,D Final: Rough Frame:O i< CadaR Gas: Fire Department Fireplace/Chimney: Roug Oil: Insulation: r`5 K Final:�'—O'*'09w Smoke: ,X `. /SfCyj� Final:6H 5--3-o THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATIO F ANY OF ITS RULES AND REGULATIONS. Certificate of Occu ang // Si nature: Fee'Type' Receipt No: Date Paid: Check No: Amount: Building 9/15/04 0:00:00 21-53 $300.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo