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37-040 (2) City of Northampton . Massachusetts i DEPARTMENT OF BUILDING INSPECTIONS .212 Main Street • Municipal Building y �r Northampton, MA 01060 f ~' INSPECTOR ANTHONY PATILLO BUILDING COMMISSIONER F E G 1 8 2010 THIS FORM MAY BE FAXED TO: 413-587-1272 REQUEST FOR PERMISSION TO VIEW RECORDS OR HAVE COPIES OF DOCUMENTS MADE *PLEASE KEEP THESE DOCUMENTS IN CHRONOLOGICAL ORDER* DATE: fZ f /y MAP: 3 BLOCK: FILE ADDRESS: NAME: �j � ADDRESS: t T PHONE#: MASSACHUSETTS GENERAL LAWS GRANT US TEN (10) WORKING DAYS OF THE ABOVE LISTED DATE TO MEET THIS REQUEST. CITY OF NORTHAMPTON, MASSACUSETTS DEPARTMENT OF PUBLIC WORKS t 125 LOCUST STREET NORTHAMPTON, MA 01060 413-587-1570 FAX 413-587-1576 3 George Andrikidis, P.E. Director, City Engineer r J ASSIGNMENT OF HOUSE NUMBER(S) Street: Old Wilson Road -, - Assessors Map: ' House Number: Date: December 5,2002 Remarks: This number is assigned to the "cottage" located on this lot. (This structure has been previously incorrectly called 50-A Wilson Road.) Note: The Assesors ID for this lot was incorrect in previous correspondence dated December 2, 2002 and December S, 2002. Please make appropriate corrections to your files Ned Huntley Assistant City Engineer cc: Registrar of Voters Ann Marie Schauer Tax Collector Water Dept. Massachusetts Electric Sewer Dept. Verizon Telephone Streets Diviion AT&T Broadband Inspectors J✓ Bay State Gas Assessors Post Office Police Dept. Fire Department Applicant: Herb August 50 Old Wilson Road Northampton, MA 01062-9608 K:\House Numbers\Old Wilson Road 17 East Street 413-527-6355 Easthampton, MA 01027 'v e S /L 1-800-767-6355 ti Qom, REMODELING The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor.The same right is=automatically afforded to the contractor,however.The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below.This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in Massachusetts General Laws,chapter 12A. Home ner's signature` Contractor's Signature NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A) may not be waived in any way, even by agreement. However, homeowners°may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions or the Home Improvement Contract Law.The contractor is responsible for completing the work as described in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantabil- ity and fitness for a particular purpose.An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowners basic consumer rights.If you have questions about your consumer/homeowner rights, contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void, deleted, or not applicable. Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However, in instances where a contractor deems him/herself to be financially insecure, the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy-of"A Consumer Guide to Home improvement Contractor Law, contact Consumer Information Hotline Executive Office of Consumer Affairs One Ashburton Place,Room 1411,Boston, MA 02108 (617)727-7780 If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact Director of Home Improvement Contractor Registration Bureau of Building Regulations and Standards One Ashburton Place,Room 1301,Boston,MA 02108 (617)727-8598 or(617)727-3200 For assistance with informal mediation or disputes or to register formal complaints against a business,call Consumer Complaint Division Office of Attorney General (617)727-8400 PART 2OF2 17 East Street 413-527-6355 Easthampton, MA 01027 'v e S 1-800-767-6355 IkEM0DELING This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A).Any person planning home improvements should first obtain a copy of"A Consumer Guide to the Home Improvement Contractor Law"before agreeing to any work on your residence.The guide will inform you of your rights and respon- sibilities as well as provide you with important information about what to do if a dispute arises.You may obtain a free copy by calling the Executive Office of Consumer Affairs'Consumer Information Hotline at 617-727-7780 Homeowner Information Contractor Information Name Com any Na p me `.;',,� Five Star Remodeling Street Address(do oot use a Post Office Box address) i e` Contract r/Salesperson/Owner Name Kevin Perrier city I Town State, Zap Code Business Address(must include a street address) 17 East Street Daytime Phone Evening�Phone City/Town State Zip Code Easthampton Mass. 01027 Mailing Address(it different from above) 4 Business Phone Federal Employer ID or S.S.Number 1-413-527-6355 75-3034389 Law.agaves mat an tame Home Improvement Contractor Reg.Number Expiration Date improvement regist tion 134511 12-3-07 have a valid registration The Contractor agrees to do the following work for the Homeowner. r ` , (Describe in detail the work to be completed,specifying the type,brand,and grade of materials to be used.) E- c [J'Check this box if additional pages are used for this section Required Permits-The following permits are required and will be secured by the contractor as Proposed Start and Completion Schedule-The following schedule wig be adhered to unless circumstances beyond the homeowner's agent.Owners who secure their own permits will be excluded from the the contractor's control arise.These dates are approximate start and finish dates. Guaranty Fund provisions of MGL chapter 142A. Date when contractor will begin contracted work 'r r Date when contracted work will be substantially completed Total Contract Price and Payment Schedule The contractor agrees to perform the work,furnished the material and labor specified above for the total sum'of:$ Payments will be made according to the following schedule: 5 upon signing contract(not to exceed 1/3 of the total contract price 4L the cost of special order items,whichever is greater}. $ by l / or upon completion of $ by / / or upon completion of $ upon completion of the contract.(Law forbids demanding final payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ to be paid for s 1_ ordered before the contracted work begins in order to meet the-completion schedule: _ - $ e';, to be paid for, Homeowner is responsible for all collection and reasonable attorney fees if payment is not received at time of completion. Express Warranty-Is an express warranty being provided by the contractor?LI No Q°Yes (all terms of the warranty must be attached to the contract) Sub contractors - The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor.The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement. Contract Acceptance-Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence.Review the following cautions and notices carefully before signing this contract. Don't be pressured into signing the contract.Take time to read and fully understand it.Ask questions if something is unclear. Make sure the contractor has a valid Home Improvement Contractor Registration.The law requires all home improvement contractors and sub contractors to be registered with the Director of Home Improvement Contractor Registration.You may inquire about contractor registration by writing to the director at One Ashburton Place,Room 1301,Boston, MA 02108 or by calling 617-727-8598 or 617-727-3200. Does the contractor have Insurance?While it is not required by law,it is a good idea and an additional protection. Know your rights and responsibilities.Read the important information on the reverse side of this form and get a copy of the Consumer Guide You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement.See the attached notice of cancellation form for an explanation of this right DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of the contract must be signed.The white copy goes to the homeowner.The yellow copy should be kept by the contractor. Homeowner's Signature Date Contractor's Signature Date PART 1 OF 2 ti v e �J REMODELING CONSTRUCTION 17 East Street Easthampton, MA 01027 - Fax (413) 527-8255 (413) 527-6355 - 1-800-767-6355 Plumbing: Install one toilet high lift,one tub/shower with faucets,one vanity with top and faucet. Tie into existing sewer line, and existing water service. Box in existing service and insulate with access door in crawl space. New washer and dryer area to be included in the plumbing. Closet: One 5 ft. x 8 ft.walk-in off master bedroom,one 3 ft. x 4 ft. in hallway. Existing closet to become utility room. Doors: One 3068 flush steel door to utility room with lockset. One 3068 bi-fold closet door. One 3068 exterior full view with 15 lites, and interior shade. Three, 3068-6 panel molded doors, hall,bath, and to main house. Windows: White vinyl (Three )4 ft. x 4 ft. double casements with screens,(One)30310 Double Hung in the bedroom, (One)2430 in the bathroom, (Four) 28"x 50"vinyl replacement windows in main house. Flooring: Master bedroom to be carpet, (allowance$950.00)Hallway,hardwood, allowance ($275.00) Bathroom,Vinyl, allowance ($375.00)Closet, carpet, included with bedroom allowance. Drywall: One half inch drywall on walls and ceiling,three coats of mud,and finished sanded ready to receive paint. Interior Trim: All interior trim,base board, casings,closet shelving,to be primed white. Closet poles included.Note: vinyl cove base in bathroom. Add a pull down attic access set of stairs,not in original quote. Exterior Trim and Siding Siding to be ix8 reverse board and batten,with corner boards and facia boards to be 1x6 rough sawn pines to match the siding. Excavation: Excavate for foundation,and backfill. Excavate to locate sewer line,tie in, and back fill. New price to include removing old foundation. Not included in excavation,removal of any in ground oil tanks, or removal of any septic or leach systems, blasting if ledge should appear, (we would pin the foundation to the ledge) any or all unseen underground issues. )Oa 7 zo -o ' "We don't just get the job done, we do it right." u�. REMODELING CONSTRUCTION 17 East Street Easthampton, MA 01027 -, Fax (413) 527-8255 (413) 527-6355 - 1-800-767-6355 Concrete: Pour new eight inch wall aprox. Two ft. above grade and four ft. below grade with three basement sash for cross ventilation and a crawl space access hole. Roofing: Roofing to be ice and water at eaves,valleys,mating walls,and around all protrusions. Fifteen pound felt over entire roof, step flash chimneys and connection walls, 8 inch aluminum drip edge all around,and install thirty year architectural shingle. Items to be by"others": Interior and exterior painting,pointing of chimney,seeding, shrubs, driveway, and any unseen structural rot or issues not visible with existing building at tie-in point. Any items not to code in existing building. All items in new addition to Ma. State Building Code. Owner to supply bathroom fixtures, exhaust fan, ceiling lights, Mirror,paper holder, and any towel racks. Dumpster: Jobsite dumpster for construction materials only. All dump fees included. All above work to include: Materials,Labor,Permits,License,OSHA certified installers,Insurance,Electrical,Plumbing,Excavation,and Job-Site clean-up. Dates: First available date as of July 20,2007,would be the last week in Sept. to start excavation and demo. Thank you for giving Five Star Remodeling and Construction the opportunity to quote on the above project. Payments: 10%with contract. 25%at start of project,25%concrete in, and backfilled, 25%framed,weather tight,windows and doors in rough plumbing in,rough electrical in place,roofing on, siding on,and doors in place. Final upon completition. PRICE: $71,465.00 Sincerely, 'e�Q- ad,�uvta,� Peter A Shame,General Manager ;-PQ,..d 7 20 -o7 "We don't just get the job done, we do it right." "V e �` REMODELING CONSTRUCTION 17 East Street - Easthampton, MA 01027 - Fax (4I3) 527-8255 (413) 527-6355 - 1-800-767-6355 Mrs.Joyce 1.,.August,Trustee for Hurbert R.August Trust July 20, 2047 50 Old Wilson Road 40 Old Wilson Road(Jobsite) Northampton, Ma. 01062 RE: Demolition of existing 20 ft. by 11 ft. addition,and build a new 16 ft. by 26 ft. addition. SCOPE: Meeting with Mrs.August and Mr.Thurber on July 142007; the following changes were made/Remove the Patio Door to the rear and install three new 4 ft. x 4 ft. double casement windows with full screen. Change the bathroom window from an awning 18310 to a double hung 2430 white vinyl insulated with screen. Change the bedroom side window from a 3046 to a 30310 white insulated vinyl all the windows to be white vinyl with screens. Add a new Full View 15 lite door with a screen. The door to have a blind between the glasses. Excavate the existing foundation,and pour a new six foot foundation on a footing to allow for crawl space with a poured concrete floor. Demo room to the right of main entrance aprox 5'-3"x 8'-0". Insulate and drywall the outside walls and ceiling. Run water and drain lines in from the kitchen to enable a washer and dryer hook-up. Install electric to supply dryer off main box. Raise floor up aprox. 3 inches and use 2x4 pressure treated joist with three quarter inch advantek T&G sub floor.Owner to supply finish floor. Supply and install four Vinyl replacement windows with low E glass and screens on the main house. ABOVE CHANGES: The above changes and attached sketch, not to scale,will become part of the contract along with pages one,two,and three of this estimate. Engineering: Five Hundred dollar allowance for house design fee for permit reasons. Heating: Tie into existing heat system, use insulated flex lines from utility room to new addition. Electrical: Keep existing service is same location,install two smoke detectors, and one CO2 detector, install GFI outlet in bathroom, exhaust fan,wall switches, bathroom lights, light in closet, lights in master bedroom,wall switch in main bedroom,one outside flood in main bedroom,and outlets in main bedroom to code. Also to include the new room for the washer and dryer hook-ups. �QL• ir^ •O� C �, We don t just get the job done, we do it right" The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street IN Boston,MA 02111 wwv)v.rnass.gov/dia Workers'.Compensad-on [.ns-uraga_ce.�it�avi�,_�3u tors/Electricians/Plumbers_____ Applicant Information Please Print Le>rUy Name(Business/Organi7ationllr►dividuai): Five Star Remodeling Address: 17 East St City/State/Zip: Easthampton, MA.01027 Phone#: 413-527-6355 Are you an employer?Check the appropriate box: Type of project(required): 1.Q✓ I am a employer with 4. ❑I am a general contractor and 1 ti. Q New construction employees(full and/or part-time). have hided the sub-contmctoxs 2-E3 I am a sole proprietor or partner- listed on the attached sheet t` 7. Q Remodeling ship and have no employees These sub-contractors have 8. Demolition working for mein any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp_insurance 5. ❑ We are a corporation and its required-] officers have exercised their IO.❑Electrical repairs or additions 3_Q l am a homeowner doing all work ilea of exemption per MGL 11.0 PIun Bing repairs or additions nmyself. [No workers'comp. c. 152,§1(4),and we have no 12-E]Roof repairs insurance required.]t employees.[No workers' I3.❑Other comp.insurance require(L] _ 'Any applicant that cheers box Nl mast also fill out ttie se:ctioa below showing their workm'compensation policy inronnatioa t Homeowners who submit this affidavit indicating they=doing all work and then hire outside contractors must submit anew aFfrdarrit indicating such. lCon"ctors that check this box must attached an addifiooat sheet showing the name ofihe bgd)- ootaauors and their work%-s'comp-policy information I am tut employer th at is proving workers'compmsatiorr insurance for any employees. Below is the policy and job site informa&n. Insurance Company Name: Associated Employers Insurance Company Policy#or Self-ins.Lic-#: WCC500626401200 Expiration Date: 5-9-08 Job Site Address: 40 Old Wilson Road City/Statc0p:Northampton,MA 01060 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGT.c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one--year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certiify u the and penalties ofperjmy that the information provided above is true and aorrecL Signature: per: 09113/07 ppcuc#: 413-527-(V355 Officeal use only. Do not moire in this area,to he completed by any or town official City or Town: PermWUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Kevin Perrier 85319 License Number 17 East St Ea ham ton MA 01027 1/13/09 Address Expiration Date 413-527-6355 Signature Telephone 9 Registered Home Improvement Contractor: Not Applicable ❑ 134511 Company Name Registration Number Five Star Remodeling& Construction 12/3/07 Address Expiration Date 17 East St Easthampton MA 01027 Telephone 413-527-6355 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....... M 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 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 awlicable) New House ❑ Addition ❑✓ Replacement Windows Alteration(s) E] Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [a] Decks [Q Siding[0] Other[a] /V Fk"CA��)A6'-a J Brief Description of Proposed Work: Demo existing room, replacing with new Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet sa. If New house and or addition to existing housing complete the following: a. Use of building: One Family X Two Family Other b. Number of rooms in each family unit. 1 Number of Bathrooms c. Is there a garage attached? no d. Proposed Square footage of new construction. 416 sq ft Dimensions 16 x 26 e. Number of stories? 1 f. Method of heating? hot air existing Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Yes Masscheck Energy Compliance form attached? h. Type of construction conventional framing i. Is construction within 100 ft. of wetlands? Yes X No. Is construction within 100 yr. floodpiain Yes x No j. Depth of basement or cellar floor below finished grade 4 ft crawl space 3 inch concreate slab k. Will building conform to the Building and Zoning regulations? X Yes No. I. Septic Tank X City Sewer Private well City water Supply X SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I 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. ignature of Owner Date Kevin Perrier DBA Five Stare Remodeling & Construction 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. Kevin Perrier Print Name 09/13/07 Signature of 6w4q9-ge# Date 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 102 102 Setbacks Front 13 13 Side L: 16 R:50 L: 16 R:50 Rear 64 58 Building Height 14 14 Bldg.Square Footage 800 % 1216 Open Space Footage % (Lot area minus bldg&paved Zri/'` parking) #of Parking Spaces 5 5 Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO @ DONT KNOW Q YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW 0 YES 0 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 0 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. Will the construction activity disturb(clearing,grading, excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit: - Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability - Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans t 06ne 4131-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO C.dNSTRUCT,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. 40 Old Wilson Road Map Lot �L` Unit Northampton, MA 01062 Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Mrs. Joyce L. August Trustee for Hurbert R. August 50 Old Wilson Road, Northampton, MA 01062 Name(Print) Current Mailing Address: Telephone 413-586-5924 Signature 2.2 Authorized Anent: Five Star RemodeMa & Construction 17 East St Easthampton, MA 01027 Name(Print) Current Mailing Address: 413-527-6355 Signature Telephone SECTION -ES MATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building $71,465.00 (a) Building Permit Fee 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) $71,465.00 Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date Oct 12 07 11:07a Kevin Perrier 4136278255 p.2 ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL,NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix Applicant Name: 148li0 .*VVKe A dress: ' &D tM660 Applicant Address: 0 uAsT, Sr CityTown: HAf19/r7t7�J. ,14A. Om4d _F An Wh 0I03 Use Group: Date of Application: t'avu-r-'-) Applicant Phone: 413-sim- plicant Signature: Compliance Path (check one): ❑ Prescriptive Package(Limited to 1-or 2-family wood frame buildings heated with fossil:fuels only) Package(A through.KK from Table J5.2.1 b): Heating Degree Days(HDD.) from Table J5.2.1 a: (For items d.through i., fill in all values that apply from Table 35.2.1 b:) a. Gross Wall Area sq.ft f. Wall R-value R- b_ Glazing Area' sq.ft. g. Floor R-value R- e. Glazing% c 10 x b=a) °ln h., Basement wall R- d Glazing U-value U- i Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE ❑ Component Performance: "_Manual Trade-Off"(Limited to wood or metal framed buildings only) Climate Zone(from Figure J6-2.2) ❑ Zone 12 ❑ Zone 13 [Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet,if applicable] ❑ MAScheck Software Attach Compliance Report and Inspection Checklist printouts ❑ Home Energy Rating Sy0em Evaluation OCT ' ^r 6,07 Attach Home Energy Rating Certificate(HERS rating score must 83 or higher) °y- ... E] S stems Analysis OR 3' ❑ Renewable Energy rces Attach Mass Registered Architect or EngineerAnalysis ALTERNATIVE FOR ADDITIONS ONLY: a. Gross Wall-+-Ceiling Area,/6,65' q-fL b.Glazing Area'_ajk_sq.ft c. Glazing°lo(jolt x b aj .1 ❑ ADDITION with Glazing%(c.)up to 40%may use 780 CMR Table J1.1?.3.1 below: 141AXIMUM U-value TiTIM7MUM RA'alues Fenestration' Ceil' ' wall Floor Basement wail Slab.Perimeter,De th Q39, R-37 R-13 R-19 R-10 R-10.4 ft 1 Glazing Area may be either Rough Opening or Unit dimensions. z Based on NFRC listing_ Applies either to every unit,or to area-weiebted average of all mots. 3 R-30 ceiling insulation may he used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area (i.e:not compressed over exterior walls,and including any access openings.) ❑ "SUNROO?M"addition (greater than 40% glazing-to-wall and ceiling gross area) Attach"Consumer Information Form" from 780 CMR Appendix B. Official's Name: (official's Signature: Application Approved ❑ Denied ❑ Date of Approval/Denial: Reason(s)for Denial: (provide additional details as needed on backside) File#BP-2008-0360 APPLICANT/CONTACT PERSON FIVE STAR REMODELING ADDRESS/PHONE P O BOX 778 EASTHAMPTON (413)527-6355 () PROPERTY I W THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid T ypeof Construction: DEMO EXISTING ROW&REPLACE W/ 16 X 26(BEDRM/BATH)ADDITION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: _ Owner/Statement or License 085319 3 sets of Plans/Plot Plan THE F-LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION PRESENTED: L 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 Commis ' n 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. BP-2008-0360 GIs# COMMONWEALTH OF MASSACHUSETTS 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-2008-0360 Project# JS-2008-000519 Est. Cost: $71465.00 Fee: $225.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: FIVE STAR REMODELING 085319 Lot Size(sq. ft.): 11979.00 Owner: AUGUST JOYCE L TRUSTEE OF THE Zoning: SR Applicant: FIVE STAR REMODELING AT: 40 OLD WILSON RD Applicant Address: Phone: Insurance: P O BOX 778 (413) 527-6355 O WC EASTHAMPTONMA01027 ISSUED ON:1011812007 0:00:00 TO PERFORM THE FOLLOWING WORK.-DEMO EXISTING ROOM & REPLACE W/ 16 X 26(BEDRM/BATH) ADDITION 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: tt/ Fire lace/Chimney: Gas: Fire Department (} � P 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 si nature: FeeType• Date Paid: Amount: Building 10/18/2007 0:00:00 $225.005178 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo