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41-016 • , , LL - - 20,10 nationaignd The ovver of actior H Reservoir Woods 40 Sylvan Rd Waltham, MA 02451 November 8, 2010 Eva Fierst 1253 Westhampton Rd Florence, MA 01062 ,. RE: Service Removal for Building Demolition. Attn: This letter is to confirm that, per your request; National Grid has removed the electrical service and meter at 1253 Westhampton Rd, Florence on October 25, 2010. If you have any questions or need further assistance, please feel free to contact me at (508) 357-4661. Sincerely, t „I/ . L 13ecky 1<efly nationalgrid Customer Order Fulfillment Central & Western MA M Office 508-357-4661 A Fax 315-460-9149 QRebQeca.Keily 'AUS,Elgt id coin • Northampton, MA Property Detail Page 1 of 1 . . C : :ity of - orthampton MA: Residential Property Record Card Nett. Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map -Block -Lot: 41 - 016 -001 Zoning: Assessment: Location: 1253 WESTHAMPTON RD Neigborhood: 2 Land: 184,800 #Living Units: 1 Deed Book: 2289 Building: 160,800 Class: R -101 Deed Page: 067 Total: 345,600 Dwelling Information Building Sketch Style: Conventional Year Built: 1943 Story Height: 2 Attic: None Descriptor /Area A.26d6 Basement: Full 25 672 sgft Total Rooms: 8 1F 8 BEEP TiSif� 209 sgft Bedrooms: 4 �1 C. C.1 Fr 21 252 sgrt Full Baths: 1 21 D:EFP Half Baths: 1 13 30 sgft Exterior Walls: Alum/Vinyl E -0oo Deck Unfinished Area: 0 4 8 11 2Fr /B Ground Floor Area: 672 6 E 8 32 32 5 Total Living Area: 1596 8 6 D 6 Finished Basement Living Area: 0 X 0 19 EFP 1s Basement Recreation Area: 0 X 0 © Woodbuming Fireplace Stacks /Openings: 0 / 0 11 21 Metal Fireplace Stacks /Openings: 0 / 0 Heat/Central A/C: Basic Heating System: Stream Fuel Type: Oil Quality Grade: C+ Physical Condition: Average Addition Information: Interior /Exterior: Same Condition/Desirability /Utility: AV Vacant/Dwell /Oby Status: Dwelling Lower I 1st Story 2nd Story 3rd Story Area Additional Features: (Basement lone Story Frame One Story Frame' 6721 Brick Trim: 0 X 0 'Enclosed Frame Porch 1 2091 Stone Trim: 0 X 0 'One Story Frame 2521 Remodeling Data: lEnclosed Frame Porch' l 30 1 Year Remodeled: 0 'Wood Deck 1 641 Kitchen Remodeled (Y/N): Bath Remodeled (Y/N): Land Data Outbuilding Info Square Foot Type Utilities Type 1SQ Feet1lValue Ino information' no information Type Qty Yeats Size 1 Size2 1Grd Cond Acreage Type 1 l RGl 1 1196511 1 11 672 11 C A l 1 Type 11Acres1 Value Street/Road 1 AP2 1 1 111993 1 1 960 1 C 1 A 1 Home Site 1 1.00 11101,7501 lno information lUndeveloped1110.001 51,000 1 Forest 140.0011 32,000 1 Sales Info Permit Info Date Type Price Validity Date Permit # Price Purpose 110/17/20081 426 11 0 'DEMO / FILL IN no information 1 0 1 GROUND POOL http: / /www.northamptonassessor.us/ noho /propertydetail.php ?map_no =41 - 016 -001 &page... 10/26/2010 Teagno Construction inc. 228 Triangle Street Amherst, MA 01002 Ph: 4135490803 Letter of Transmittal To: Louis Hasbrouck Transmittal #: 1 CITY OF NORTHAMPTON BLDG INSP Date: 10/26/2010 212 MAIN ST Job: 10 -038 Fierst Demo NORTHAMPTON, MA 01060 Ph: (413)587 -1239 Fax: (413) 587 -1272 Subject: 1253 Westhampton Rd Demo permit WE ARE SENDING YOU r Attached r Under separate cover via None the following items: r Shop drawings r Prints . " Plans r Samples ✓ Copy of letter r Change order , `° Specifications r Other Document Type Copies Date No. Description Other 1 10/26/10 Building permit and photos Other 1 10/26/10 $30.00 check #13190 THESE ARE TRANSMITTED as checked below: For approval E Approved as submitted r Resubmit copies for approval :`° For your use Approved as noted r Submit _ copies for distribution r As requested r Returned for corrections r Return corrected prints :"" For review and comment r Other ✓ FOR BIDS DUE s' PRINTS RETURNED AFTER LOAN TO US Remarks: Copy To: From: Gallinaro, Louis (TEAGNO CONSTRUCTION) Signature: a?* If enclosures are not as noted, kindly notify us at once. Page 1 of 1 CITY OF NORTHAMPTON Construction Debris Affidavit In accordance with the provisions of MG.L. c. 40 § 54, all debris resulting from any work covered by a Building Permit shall be disposed of in a properly licensed disposal facility, as defined by M.G.L. c. 111 § 150A. Address of Work: 1 -C g Lie s - U a oi-1 g ID • The debris will be transported by: 12,.E r4j 7 ' kt fifths �sn/ 1rw ' The debris will be received at Signature of of itApp ���" 1/7 Date t� / Building Permit Number: • r^ i ` .. ^� + , ma y, y 4 s' y ' ap ° ' ; � ^ E r k z x i s 6 s, Y " a' "! IL s,s, t ,,h .t 'I, ' A 3 c fk r , a � i . ,+' f �, �. 4 as "' ^ *,,' u { ►'∎ '�' •fir s , t a! v ' ^� s,�, rj a r �, „� .►. - 1 0 '� �}j '4 ''.:''''-'''',44- tom, t : 4" . - '' . i x II' ry • +� " ^ «t ''.t fi c• x c •. f x + , • r r w a� s' "; ��..� Cox .� � e .. ,.... . , ,. . x _ ,4..., _ _ __ _ . .;,..). , T .. ..r„r...•er.wnxr.- _r.+s�vrwn.., �.a,.rFc.rn+w.k _ _ ..... >.. . . • s • 6 . ,. ,w . . . - — • � } i R ( �g r 9 r - S y ' '-, ' ,,----- :4 4,, ,,, 04- ,.4.' ' ' RI ,,,_______ ''.; : ~ *;.0. '7, 7 -"' - ' 0 _ *Mt' a t. 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The Building Commissioner shall forward a copy of each complete building permit application that proposes total demolition for any regulated buildings and /or structures identified in the previous section to the Commission, or its designee, within seven clays after the filing of such application. No building permit for demolition shall be issued at that time. The Building Commissioner shall notify the applicant that the application activates the provisions in this chapter. A Permit for Demolition No building permit for demolition of a regulated building and /or structure shall be issued without following the provisions of this chapter, except for projects approved under the permit granting authority of any Local Historic District (adopted under Massachusetts General Laws Chapter 40C) or the Central Business Architecture District. Editor's Note: See Ch. 15o, Central Business Architecture. A. Submission requirements. In addition to the information required for the building permit application, a project proposing total demolition of a regulated building or structure shall include the following information: (1) Address of the building /structure to be demolished. /d S3 Gv es+4r• rnkl I `D • ' '' N0g_Tlrv/-wca-i-o a /1-e , 4- Owner's name. address and telephone number. Ae v 4 7 Z / ' R s 7 0 ?' MR S?'. F b 'tiet, r4 0/061 Description of the building. %wo S v Ry ex-hi-xgE Description of the proposed work. y 1 Reason for requesting a permit for demolition. ?rep f- si-h? go � Fu or .0 Ct?MJ t c I i "0 o a s e /Q F , ; y hoUs Brief description of the proposed reuse, reconstruction or replacement. 00/1Jirc, el' S 14 ,AP �P F!4r. i Ir J-O#t `Q Photographs of the building(s /structure(s). R. ATi � 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 of Northampton 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 regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation /footings (before backlit!), 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 occuvancv until the work can be inspected. If the homeowner hires other trades to perform. work (electrical, plumbing & gas) the homeowner will be responsible to rnake 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 . Np' 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 tome. Date Address of work location . .' . The Commonwealth o [Massachusetts Department of Industrial Acidents .......,—.., , Office of Investigations ,_......,=. 600 Washington Street ...• 7 -1 . -11:L.=- I Boston, Mei 02111 - - w.mass.gov/dia . . -b ..- -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information . Please Print Legibly --. Name (BusinesS/Organizationlindivirinal): ii.a. e„i+g cc 'r."0/v i - • Address: AP rrihtvyylyv ,i . City/State/Zip: /IX/ iiao j r , &At 4'e6A Phone.#: — -- 401 Are y,u an employer? Check the app(ropriate box: • Type of project (required): / • 1. ai am a employer with 4. 0 I am a general contractor and I _ , ,. . o. u New construction employees (full and/or part-time). have hired the sub-contractors liFfr-d on the:attached sheet. 7. 0 Remodeling 2_ 0 I ani a 'sole proprietor or Fanner- These sub-contractors have • shin and have no e,..7i-loyees -8. 0 Demolition working forme in any capacity. eoyees_-_andhave worke rs 9: - . usti da i i t i. -.,.........._.' aaamon _ comp..insTrrnmc .. [Na workers' comp. insurance 10.0 Electdcai repairs or adcritions requirertj We are a corporation and its 3. 0 I am a homeowner doing all work officers have 4xercised their . ..r 11.0 Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required:3 t • . ,c. 152, §1(4), and we have no errployeea [No workers' 13.0 Other co n31 iasurance =Pk -64 -1 . • : - • *My applicant that checks box #L must also fill out the section below showing theirworkers' compensation policy information. 1. Horneownesi who submit this afada:vit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state witether-or notthose entities have employees. lithe sub Italie empIoyeeS, they must provide their workers' comp polidy number. 1 am an employer that is providinp: workers' compensat....;nn insarance for my employee. Below is the policy an.d job information. . - . Insurance Company Name: 1 .7 '1 -. . _,, Policy* or Self-in.S. Lic. it: //v q , e-- go .i 0 6e2Ao Moio Expiration Date: . . ;oh Site Address: _Ad 6 itiefdefr XD . . City/StatiZrp._ -Of .._ '''A/ th 4Pe 7t /4' 0/vet, - Attach a copy of the workers' compensation policy declaration page•(shcrwing the policy number anct date). • Failure to secure coverage aS required under Sobtiiiiit5KOfMGL 152 can lead to the frUPOsiiiiiii Of Criiiiinal fieisaIiies of a fine up to 81,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK-OR.DER. and a frrIP of up to 8250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Offi of EtiTeiliiiikiiiiiif th eii. - . _ . , ... :„. ,... .--.:..-.-...• ,....,........,...... ..• „ _ .. ____ ______ __.... _ .16 her : riahr , -1 • the pains.andpenahies ofpedury that the information providitiiibovrisLtine_and iort_ec_ Signature .. „.... : --1-- 7 - 7es ■ a . ___ , , . , - - - • . Officittl use oily. Do not write in this area, to be completed by city Or town officiaL ' L • Phone 0: ,.. City or Tovvin • Permit/License ii Issuing Authority (circle one): .1. Board of Health 2. Building Department 3. City/Tovvn Clerk . 4. Electrical Inspector 5. Plumbing, Inspector 6. Other Contact Person: • Phone #: J • • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : DOA It L 0 , 1 , p 9 a. N"0 C C S 3 / 7/ 1 .J/ License Number of I r; duyle -�'. i J /��r�` D /O 0/00.1, 00/4/ ..� - / Ex iration s p Si• ^= ure 7 Telephone 9. 2egisted :.Ho�ieM(mprsivemert:onractor .,F, , BETIMEMMEZE Not Applicable ❑ l' ,v o ( 4049 s TQ. u c`t`,oa 1 AiC . /D 4P/0/ Company N e Registration N mber a AP i �i✓5 /,o Pt . 1 `J f , 1 wood Expi A•ss 0 / Telephone ( Expi tion ate 1W 'ice V S P- 7, -- 0 70 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M GL. 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 buildin permit. Signed Affidavit Attached Yes No ❑ c TM ✓ - i ' 'yam;,'° 4 �/" l 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 applicable) New House Addition LJ Replacement Windows Alteration(s) Roofing El Or Doors El Accessory Bldg. 0 Demolition New Signs [D] Decks [[] Siding [O] Other [p] Brief Description of Proppse Work: D 12r34-00 /13 11 R. L°- /'3 - I-t Ny 6-40 -ed- Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa 1f,ev+lhoIS a�d.or. accJ�tiolla ,. #o.xis #inp,ouslnponnle #a ti:fnaw�lla N �- 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 v l V ' F % l° e a t' , as Owner of the subject property 1 �,, here. authorize ::./� Al 1 ° ' [z id /0 lZ f > l ( t. -. on my h in all all matters relative to work authorized b fis building permit application. Signature of Owner Date Co.J TQ e4- c-TO '� I, 0 44 CD S. T e c /V o , as Owner /Authorized Agent hereby declare that the statements 6l id infon4iation on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. et) .o �. I -es1 ao P _ I I b."' Sig a i o - -.- irzic GtV 2 Date A S— /U E y 1- t�y � rg i IcQt-i 4-6 1 .t 1)0-..4,01 ' � o( 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 1 , ! r Frontage H Setbacks Front I j _� Side L:' 1 R:I 1 L:1 1 R:= 1 } 1 # 1 Rear Building Height Bldg. Square Footage % I i I F Open Space Footage % (Lot area minus bldg & paved I 1 7 ( I i parking) # of Parking Spaces I Fill: (volume & Location) 1 A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 1 6. 4 YES 0 IF YES, date issued:1 r; IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW ir YES 0 IF YES: enter Book I I Pagel 1 and /or Document #mm B. Does the site contain a brook, body of water or wetlands? NO 121 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained , Date Issued M C. Do any signs exist on the property? YES (k) NO IF YES, describe size, type and location: s D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO IF YES, describe size, type and location: I E. Will the construction activity disturb (clearing, grading, ex vation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. L a City of Northampton Status 'o f e f m r � 7 , .i , 4 w �' Building Department C rb ti � P ermit � ,4.-v. f r,a 212 Main Street S va i -, 4 0 44 1 i.. n Room 100 4 r ' 51`° Northampton, MA 01060 t, a - t o phone 413- 587 -1240 Fax 413- 587 -1272 ��� 1 APPLICATION TO CONSTRUCT, 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: LL ? )-/, ~ g ' , ? Lot , . Und -Zone{ ;` overlay District EIm St District CB Distnct SECTION 2 PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: E ,4 F i t? aC,s /D /2 r S % . F /ocee4)(F .t Y o ff?, N e rint) ( t--- Signature 2.2 Authorized Agent: _rilOdu 4.L0 3—. TPa9.vc) � 01EP T rt'� /e �- ff 4(4 PI i�� o /G% (-rint) Current Mailing Address: 11/ r y/3 - - ry �O Sig -cure Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building if 00- i (a) Building Permit Fee 2. Electrical / (b) Estimated Total Cost of Construction from (6) 3. Plumbing . Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) ,(. 0 Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date r File # BP- 2011 -0381 Q(/C `° 11-"1 APPLICANT /CONTACT PERSON TEAGNO CONSTRUCTION INC i 1 6 � � n d ADDRESS/PHONE 228 TRIANGLE ST AMHERST (413) 549 -0803 1 � PROPERTY LOCATION 1253 WESTHAMPTON RD t MAP 41 PARCEL 016 001 ZONE RR(100) //WP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 6 e 3 - Fee Paid / d/ y6 Typeof Construction: DEMOLISH SFH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 034716 3 sets of Plans / Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: 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 C ` t 2/4370 Signature of Building Of icial 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. t • BP-2011-0381 GIS #: COMMONWEALTH OF MASSACHUSETTS �xr 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- 2011 -0381 Project # JS- 2011- 000637 Est. Cost: $5000.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: TEAGNO CONSTRUCTION INC 034716 Lot Size(sq. ft.): 2221560.00 Owner: FIERST EVA Zoning: RR(100) / /WP Applicant: TEAGNO CONSTRUCTION INC AT: 1253 WESTHAMPTON RD Applicant Address: Phone: Insurance: 228 TRIANGLE ST (413) 549 -0803 Workers Compensation AMHERSTMA01002 ISSUED ON:12/6/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: DEMOLISH SFH 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 12/6/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner