11-012 RN>FNG !F- BP- 2010 -0644
GIs #: COMMONWEALTH OF MASSACHUSETTS
_' '- k'. -- t2' 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- 2010 -0644
Protect # JS- 2010 - 000940
Est. Cost: $12300.00
Fee: $73.80 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: STEVEN ZUCCHINO 021356
Lot Size(sq. ft.): 30012.84 Owner: WEISENTHAL IRVING S & AMANDA L
Zoning: SR(100) / /WP/WSP Applicant: STEVEN ZUCCHINO
AT. 110 MORNINGSIDE DR
Applicant Address: Phone: Insurance:
70 Gleason Road (413) 584 -3878
NORTHAMPTON MAO 1060 ISSUED ON. 11612010 0:00:00
TO PERFORM THE FOLLOWING WORK. REMOVE NON - BEARING KITCHEN
WALL,INSTALL NEW FLOOR & COUNTERTOPS
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 1/6/2010 0:00:00 $73.80
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
File # BP- 2010 -0644
APPLICANT /CONTACT PERSON STEVEN ZUCCHINO
ADDRESS /PHONE 70 Gleason Road NORTHAMPTON (413) 584 -3878
PROPERTY LOCATION 110 MORNINGSIDE DR
MAP 11 PARCEL 012 001 ZONE SRO 00) / /WP /WSP
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: REMOVE NON - BEARING KITCHEN WALLJNSTALL NEW FLOOR &
COUNTERTOPS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 021356
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO MATION PRESENTED:
J_ pproved 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 Commission Permit DPW Storm Water Management
Demolition Delay
,;e, 10
Signa re of Building O ficial 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.
M
N rye
City of Northampton
Building Department ra��afiewajje��t n
212 Main Street Se �Septi��iaila) ill � ,`� r , r k
DEC Room 100
Northampton, MA 01060�� g
phone 41,3 -587 -1240 Fax 413 - 587 -1272 2ItPCan� 3�
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Propert Address
This section to be completed by office
y
j�
I t o flatrkir .ek %ove Map Lot Unit
VV Zone Overlay District
Elm St. District C13 District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of
I P JAI --- — t5�e — w dqt / '1111,41 #A 1 1 F E - r-*V ,
N e (Print) Curren Mailing A
- —
Telephone
ignature
2.2 Authorized Agent: `` LL
SLIP y ZVct [ 11 0 7 c 0 PktSih f //�� j-f r hkkfGimptg, , MA
Name ) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED. CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
1. Building I �0 (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) , i ,check.Number
This Section For Offirial USe Onl
Date
Bui mg Permit Number: l 0 U Issued:
Signature:
Building Commissioner /Inspectorof Buildings Date
r .
s A
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 _ _ __ ... _._ ..._ _.r_.- _ .....
Setbacks Front
Side L: _` R :'---,- , L ' __ R: '.- ...___r,
Rear
Building Height
Bldg. Square Footage mm
Open Space Footage
(Lot area minus bldg & paved µ
p arkin g)
# of Parking Spaces
Fill:
(volume & Location) --
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DONT K NOW 0 YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book g Page; and /or Document #'
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 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:
tfiere any proposed "changes to or ad 6 l ns of signs inten3ed fob lil6 property ? YES 0 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
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
c ,
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [p Siding [17 Other [D]
Brief De of Pro osed t t
Work: J1en re_ rio►� ur W "(1' �,f", hJ. fi � �h�'.�, cre %, Lhglc(( n ews Od a:^ K►wt CJ. ftferl f .
Alteration of existing bedroom Yes �_ No Adding new bedroom Yes No 1
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a_ If:Nevu hoca se ar d�"& addifibirfAd fi'ousi cnfiiml efhe.fod6ww _ifig:
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. 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 '" �f �.4-�" �A-4 0,q ( ti, s 0; 1 - r t as Owner of the subject
property
hereb authorize
to d n my behalf, in all matters r lativ work authorized by this building permit application.
6' C G
S ature of Owner _ __ _ Date
I, 1\eV'eV\' 7-U C-41 i h 0 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.
,l v tl'en 2vf C. k i hR
Print Nam
Signat e o Owner /Ag Dat
, 4
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor Not Applicable ❑
Name of License Holder 5+91/4 20 -A l lku C Z_2 J 3 5 6
�• / / t /. /� License Number
�r� la �i S �Y► � 0 �,�� IV J r t n ^ `��d�1 / A _� 3 011
Address Expiration Date
Sign ure Telephone
9.`:Registereii Home fmprovementontracfor t. Not Applicable ❑
Company Name Regis ration Number
5
70C1 I1 D 61111.zoi o
Address Expir tion Date
,J (�P�Sv1 ���'�� } �►1rnM,< I`� 1 �A Telephone '1/3`D '
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....... J10 No...... ❑
S
T_he_curr_ent_exemptionfor "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 rime, 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
n _ aTTlptAil 1 1t1aI1GC5.' 1 o s General - La-ws Annotated.
Homeowner Signature
The Commonwealth of Massachusetts
Department oflndustrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.massgov/dia
- Workers' Compensation Insurance Affidavit: Builders/ Contrac tors/Electricians/PIumb.ers
App licant Information Please Print Legiblv
Name ( Business /Organization/lndividual): %_ve ve ►'( •0
Address: - 70
Ci /State /Zi IV0► V L ^ M �
tY P= �!h 1 Phone. #:
Are you an employer? Check the appropriate box: Type of project (required):
4.. m a genera contractor an
1. El I am a employer with � I a l t t d I 6. ❑New construction
employees (full and/or part- time).* have hired the sub- contractors
2.IY,I am a sole proprietor or partner- listed on the attached sheet 7. Remodeling
ship and have no employees These sub - contractors have g. Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insuran _ comp- _insurance_ 9. Budding addition
required:] 5. F We are a corporation and its 10.0 Electrical repairs or additions
3. Q I am-a- homeowner d,6ing all- work - --- --- _-- l-LEIP- lumbing repairs or additions
myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insuran required] t c. 152, §1(4), and we have no
employees. [No workers' 13.[D Other
comp. insuran requited j
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub-contrsctors have employees, they must provide their workers' comp. policy number.
I am an employer that isproviding worker' compensation insurance for my employees Below is the policy and job site
I
Insurance Company Name:
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: City /State/Zip:
Attach a copy of the workers' compensation policy, declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Secti6n - 25A of MGL 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. lie advised that a copy- of this statement may be forwarded to the Office of
Investieations of the IRA for insurance' coverage verification
I do hereby _ce under the pa . •and penalties ofperjury that the information provided abovE is true_andcvrrect____ ._
Ifs Si tore: ate
Phone #: 4 YI
Official use only: Do not write rn this_area, to be compleledby city or town official
City or Town: Permit/License
Issuing Authority (circle one):
-1 Board of RPalth 2. Building Department City/Town Clerk 4. Electrical I nspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction supervisor. 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-ofNorthampton wants 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
-regulation The in. ne rtion process re that the building department be calle 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
- -- — -- - - - - -p its in cQnjunctionto- the- building-pernlitissued, -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.
_� te _T_
Address of work
location
' 10/6/09 Steven Zucchino
70 Gleason Road
Northampton, MA 01060
413 - 584 -3878
steve.zucci @comcast.net
Lic. # 21356
HIC# 100199
Iry and Amanda Weisenthal
110 Morningside Drive
Northampton, MA 01060
Estimate for kitchen renovation as discussed -
Remove existing wall between kitchen area and adjacent room. Reconfigure cabinets as
discussed including relocating dishwasher and adding one new 24" microwave base cabinet.
Remove existing oak flooring in adjacent room and kitchen down to subfloor. Install prefinished
2 %" oak flooring to closely match flooring in adjacent rooms. Install granite counter tops with
under mount sink. Install subway the backsplash above counters and stainless steel or laminate
backsplash above stove.
Repair existing cabinets as needed. Install pendulum lighting above peninsula. Dispose of all
construction related debris. All materials and labor included except those materials listed under
allotted cost. Except for the painting, labor to install the items listed as allotted costs is included
In the contract cost.
Allotted cost: Contract cost:
Painting- $2000.00 Labor- 5000.00
Sink and faucet- 600.00 Materials- 850.00
24" base cabinet- 500.00 Electrical- 600.00
Electrical fixture- 200.00 Plumbing- 500.00
Counters- 5500.00 Prefinished floor- 4800.00
Wine rack- 300.00 Debris removal- 400.00
Total 9100.00 Permitting- 150.00
Total cost- $12,300.00
Payment schedule -
15t Work begins $4000.00
2 nd Existing wall and finish floor removed $4000.00
3` Job complete except for painting $4000.00
4 th Final inspection $300.00
$12,300.00
Iry and Amanda Weisenthal S ven Zucchino