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•
KIM GRASSFIELD
INSPIRED DEsIGN, EXPERT CARPENTRY & BUILDING SERVICES
i'..14NriY STREET. Hai:1'0Kr.., MA 01040 (413:.■ 26b b432
www. kimgrassfield . corn
Formal Proposal
May 21, 2010
Submitted to: Submitted by:
Kysa Nygreen Kim Grassfield
3 Graves Ave. 17 Canby Street
Northampton, MA 01060 Holyoke, MA 01040
Business: 413-265-5432
PROJECT OVERVIEW
Build new walk-in closet for master bedroom and reconfigure walls to provide new closet in proposed
children's bedroom and entrance to new master bedroom. Make necessary amendments to wiring, moving
lights, receptacles, and switches, and adding a light and switch for the walk -in closet.
DETAILED DESCRIPTION
Remove existing hall wall in rear bedroom and frame new entry doorway for new master bedroom. Remove
a length of wall at rear wall of front bedroom to create an opening for a bifold closet door. Remove and
salvage existing closet door in rear bedroom. Frame to enclose this opening to create a front bedroom
closet. Build new walk-in closet wails as defined by client. Frame opening for front bedroom closet door.
Frame an opening to tho walk coot to ncoll S:".-i!\1 closet door. Remove existing electric: recepticals
and switches a.s :;r1:10! to : ronlovod ores nstall new
lighL and swltch far the '.7,th 112" sh r,lainaged wall areas
with plast o a. t€.. coJc.d - repo lristoll a 1 pine
bifold door J.3..coeoThly at the bedroom entrance
and waNs and
iiocr,ivais ,.()Od,
GENERAL CONDITIONS
The contracto: shall all d000e-czy s2nd orill tasks required the work
described aloove. All spacifications
provided by :L !: insurance
=NA;
be
Revcri CFR 7,45 .f".ii E
Project Specifications
Closets
PROJECT PREPARATION
On-site survey and discussion of plans.
• Obtain necessary permits.
4
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
q� � �/,, _ t
Name of License Holder : /(1\/1 � F{�ti' /l � � % -t�^�� co /7
License Number
I`7 CAN.F;)Y` ' 'Th .c- C , t-1 L` O E , 1-1 A. 0LO' 1 � (8 `It>
Address Expiration to
2-65 643E-
Signature Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
KIM 6 to -O 16(6266)
Company Name Registration Number
17 CA --(oL��%�K i ls- CS IC>i o p l � � ( if
Address 7 ltd Expiration [Ate
Telephone "tf 'G * f
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 )3(
11. - Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one ( 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 ❑ Replacement Windows Alteration(s) Roofing ❑
Or Doors E
Accessory Bldg. n Demolition ❑ New Signs [O] Decks [E Siding [El] Other [O]
Brief Descriptio. of Pro.os- • �11
Work: .l l ai _ la ►1 4 ai t✓ .. . i ; I 0
Alteration of existing bedroom _ C Yes No Adding new bedroom Yes x No
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll - Sheet
6a. If New house and or addition to existing housing, complete the following:
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
I, K�
Y 1 `1 Y4I1 , as Owner of the subject
property
hereby authorize K t" liPt419F(LD to a on my beh If, in all matters rve to work authorized by this building permit application.
Signatu of Owner Date
M 6 , as Owner /Authorized
Agent hereby declare that 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
Print Name
•
Signature of Owner /Agent 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
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage
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 0 DON'T KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 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 0 YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Q , Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location:
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:
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 O NO ID
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
��Q 212 Main Street Sewer /Septic Availability
01\\( 2 $ 2.010 Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
'phone,''413 - 58 1 7 - 1240 Fax 413 - 587 -1272 Plot /Site Plans
Other Specify
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: A /�
3
4 RkW6 Y 'GPI 1 Map 3(/ Lot 61 / Uni O3
I �d Zone eeFA6eRaeistrict
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
KOA 1 Y* f-t tAQ65 > 'J
Name (Print) Curren Mir}B AddrQSS: e + , j 0166D
Telephone "����•/� Mft
Signature
2.2 Authorized Agent:
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building 3 I o o (a) Building Permit Fee
2. Electrical ,��((�,,.� 44 (b) Estimated Total Cost of
+ fC -CJ Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) ` t om ./ Check Number J -909
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
t f
File # BP- 2010 -1077
APPLICANT /CONTACT PERSON KIM GRASSFIELD
ADDRESS/PHONE 17 CANBY ST HOLYOKE (413) 265 -5432
PROPERTY LOCATION 3 GRAVES AVE
MAP 32A PARCEL 091 003 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out i�
Fee Paid 0 21 0
Typeof Construction: REMOVE NON BEARING WALL, BUILD CLOSETS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 59364
3 sets of Plans / Plot Plan (`l .D m a.s t) 5 M c tce D rc AND D (NF CARZON M-O N 0X I
�}F'r 6c-To (L Muse BE IN.; IN gt5b PZO i
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF RMATION 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 Commission _ Permit DPW Storm Water Management
Demolition Delay
c,„7:A", I
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.
i t
3 GRAVES AVE BP- 2010 -1077
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map :Block: 32A - 091 CITY OF NORTHAMPTON
Lot: -003 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -1077
Project # JS- 2010- 001581
Est. Cost: $3600.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: KIM GRASSFIELD 59364
Lot Size(sq. ft.): Owner: NYGREEN KYSA
Zoning: URC Applicant: KIM GRASSFIELD
AT: 3 GRAVES AVE
Applicant Address: Phone: Insurance:
17 CANBY ST (413) 265 -5432
HOLYOKEMA01040 ISSUED ON :6/1 /2010 0 :00 :00
TO PERFORM THE FOLLOWING WORK :REMOVE NON BEARING WALL, BUILD
CLOSETS -HARD WIRED SMOKE DET & 1 CO DET INSTALLED IN BEDRMS
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 6/1/2010 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
3 GRAVES AVE , BP- 2010 -1077
GIS #: COMMONWEALTH OF MASSACHUSETTS
:Block: 2A t' CITY OF NORTHAMPTON
Lot: -003 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -1077
Project # JS- 2010- 001581
Est. Cost: $3600.00
Fee: $80.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: KIM GRASSFIELD 59364
Lot Size(sq. ft.): Owner: NYGREEN KYSA
Zoning: URC Applicant: KIM GRASSFIELD
AT: 3 GRAVES AVE
Applicant Address: Phone: Insurance:
17 CANBY ST (413) 265 - 5432
HOLYOKEMA01040 ISSUED ON:6/1/2010 0:00:00
TO PERFORM THE FOLLOWING WORK: REMOVE NON BEARING WALL, BUILD
CLOSETS -HARD WIRED SMOKE DET & 1 CO DET INSTALLED IN BEDRMS
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:
—to - 7 8 Z tou'En-
Final: Final: .
' 6 / 4 2 Rough Frame: sr( (it p
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: O K
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND RE TWOS.,
Certificate of Occupanc , • Signature:
FeeType: Date Paid: Amount:
Building 6/1/2010 0:00:00 $80.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner