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11A-007 1 10 3 qj , ., > Ar LA fki Cb CN i � � y i t i __Deaab� dD X040 s j _.. .. l7o U f, 9 ro } c avJ k a f , 44 c-4-, 0 v C , w� i i h W jcm home improvement jcm home improvement Estimate p.o.box 329 leeds,MA 01062 + _ (413)585-8482 01/02/2014 1079 jcmhome @comcast.net nemmm 01/02/2015 35 Chestnut ave. Leeds,Ma.01053 Activity Quil"00 �iate' Amount •REMODEL HOUSE,DETAILED BELOW •Install new kitchen cabinets,counter tops and floor. 5,000.00 •Update electric panel,hard wire smokes and wire 2nd floor bath and bedroom 5,000.00 •Refinish floors. 2,500.00 •Replace windows and entry doors. 4,000.00 •New kitchen and second floor bath plumbing. 1,250.00 •Add bedroom and full bath to 2nd floor 7,500.00 •Add insulation to attic 2,000.00 Total $27,250.00 31 J SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction'S"u[peervisor: /�,, Not Applicable Aipplicable ❑ Name of License Holder: , SS ( - `� � @ 0 � -7 L-A (d License Number // ,S- Address Expiration bate 1-1(3 S „� Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number C�Q 0,K- - t- 1/7 //4-/ Address �r ( () � Expir tion Date "C6 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...... ❑ 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) Roofing ''❑ Or Doors ;E Accessory Bldg. ❑ Demolition ❑ New Signs [a Decks [[:3 Siding[O] Other[a Brief Description of P oposed Work: LAodo le It, /_ Af_ y Alteration of existing bedroom Yes .�N0 Adding new bedroom v Yes No Attached Narrative Renovating unfinished basement Yes i/ 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, ��SS C !ch-N OMC as Owner of the subject property hereby authorize to act on my be_z ill ative to work authori d by this uilding per it application. ..A' Sign Dat I 1 �MD ✓t'I as Owner/Authorized Agent hereby declare that the state ents 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. -3 S C � C r/Y" F�►�� Print Name r , 2 ly S' u nt Date Section 4. ZONING At(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 Parkin S aces Fill: volume&Location A. Has a Special Permit/Variance/Findin ver 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 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 0 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 Cr IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, ex ion, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only D City of Northampton Status of Permit: • 2 2014 A Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability _._._�. _. Room 100 watermen Availability EbCtnc, PLimtirG ,uAs Insortham ton, MA 01060 Two Sets of Structural Plans Nortr,arr:ntcn, A4A 010 p phone 3-587-1240 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 1.1 Property Address: n This section to be completed by office 3S C. h e s`�n� !"W Map Lot Unit L_-<f acts M4 (9 10-S-3 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) - Current Mailing Address: n P !" Telephone Signa 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 ermit applicant 1. Building , 1500 (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 SOD 6. Total=0 +2+3+4+5) 7 �?,.5r0 Check Number ' This Section For Official Use Only Building ermit Number: Date g Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-0766 APPLICANT/CONTACT PERSON JESSE MONTGOMERY ADDRESS/PHONE 40 OAK ST FLORENCE (413)585-8482 PROPERTY LOCATION 35 CHESTNUT AVE MAP I IA PARCEL 007 001 ZONE URA(101)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 1444 e Fee Paid ` Typeof Construction: REMODEL KITCHEN ADD 2ND FLR BEDROOM/FULL BATKINSULATE ATTIC& INSTALL REPLACEMENT WINDOWS/DOORS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 077410 3 sets of Plans/Plot Plan THE LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON I 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 D i . n Delay id, Si re o Bu ldin f cial 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. 35 CHESTNUT AVE BP-2014-0766 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 11A-007 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2014-0766 Project# JS-2014-001317 Est. Cost: $27250.00 Fee: $163.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JESSE MONTGOMERY 077410 Lot Size(sq. ft.): 11325.60 Owner: MONTGOMERY JESSE Zoning:URA(10I)/ Applicant. JESSE MONTGOMERY AT: 35 CHESTNUT AVE Applicant Address: Phone: Insurance: 40 OAK ST (413) 585-8482 FLORENCEMA01062 ISSUED ON.11612014 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMODEL KITCHEN, ADD 2ND FLR BEDROOM/FULL BATH,INSULATE ATTIC & INSTALL REPLACEMENT WINDOWS/DOORS 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 1/6/20140:00:00 $163.50 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner