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32C-276 (22) New Office Space North Unit Common IF Stairwell (� :r New divider walls(Typical) This unit continues to Foyer- Living Space have two means North Unit North Unit of egress F L ' New Laundry North Unit Utility North [D] [ W /8"Drywall Unit 3"space between two framed walls to allow for horizontal plumbing [D] W Drywall New Laundry South Unit Utility South Unit This unit Li continues to have two means Living Room of egress Foyer South Unit South Unit Ellen Bernstein & Stephen Tennenbaum 82 Williams St. Northampton, MA. 1 st Level (Proposed Layout) Datel2/18/06 Scale-1/8"=F-0" Foyer- Nwth Unit Utility North Unit storage South [D] [W] Unit Utility South Unit Living Room Foyer South Unit South Unit Ellen Bernstein & Stephen Tennenbaum 82 Williams St. Northampton, MA. 1 st Level (Existing Layout) Date 12/18/06 Scale-1/8"=V-0" A R. Damon Construction Proposal 189 Eden Trail Leyden,MA 01337 Date Estimate# HICR # 136340 12/18/2006 95 CS # 056721 Name/Address Phone# Fax# Ellen Berstein&Stephen Tennenbaum 413-774-4187 413-774-4187 82 Williams St Northhampton,AAA. M060 (413)341-3013 (413)687-4218 _. Description Rate Total Proposal for miscellaneous renovations to two separate units owed by the above 11660.00 11,660.00 South unit: -Close off double doors between units with insulated,fire rated wall <� -Move laundry location to this new section of wall -Hard pipe laundry exhaust into existing system -Quote includes either the removal of closet door jambs(Non-load bearing)and raising negotiated l ��1�rL yl other o irons to be t c of soffit approximately 2"or the instilling of the upper corners to create a arch. Al( options -No additional lighting or outlets to be added beyond laundry needs �� y ✓ f{4�G t ' Vu `u j -Paint to be handled by others/owner and is not included in this quote " Ilk North unit: -Laundry to be added on opposite side of wall from south unit laundry(Utilities separate) -Foyer to be separated to create an office on north,laundry on south,and hall in center -A hollow core door and switched outlet to provided for the office and laundry -Trim to be clam shell type or equal No fixtures included in this quote -Paint to be bandied by eAhvistowner and is not included in this quote, -Removal of the non-functioning electric heater is included should it become necessary to provide space for the renovation v 7 Thank you for the opportunity to provide this bid to you. Total r, $11.660.00 r 25%required at signing of this contract,balance due upon substantial completion of the project. All material is guaranteed to be as specified. All work is to be completed in a workman like mannor according to standard practices. Any alteration or deviation from the above specification involving extra cost such as requests for additional services or unforseen repairs and/or code issues will be charged to the owner at time&materials plus overhead_ All agreements contingent upon strikes,accidents,or any other delay beyond our control. Owner to carry home-owners insurance. Authorized signature /'{��C % o s>7� -�TJlis proposal is good for 30 days. r Acceptance of this proposal-1 have reviewed and understand the above proposal for work and hereby accept the conditions. With my signature I authorize you to do the work as specified. Signature Date J 6A( a--A �Tv r- 5 De- � -tom THE HARTFORD Direct Assignment Operations Customer Service 1-800-453-9843 P.O.Box 4903 Fax Number 1-877-634-3710 Orlando,FL 32802 Claims Reporting 1-800-832-7839 August 28, 2006 Insurer: Hartford Underwriters Insurance Company DAMON,MITCH DBA M R DAMON CONSTRUCTION 189 EDEN TRAIL LEYDEN, MA 01337 — Policy No: 5521 C40706 Effective Date: 08/11/06 The Hartford has been assigned as the servicing carrier for your Assigned Risk Workers Compensation Insurance po icy. We have contracted with St.Paul Travelers to service your policy,and we welcome you as a customer. We have received your application and premium. Your policy will be issued shortly. In the meantime,should you find it necessary to file a claim,request a certificate or communicate with us,please note the following: For Claims Reporting: For Policy Services: For certificates of insurance: 1-800-832-7839 1-800453-9843 x 83025 Fax written request to: The Hartford (407)388-7848 Direct Assignment Division P.O.Box 4903 Orlando, FL 32802 The Claim Reporting system is a toll-free service that is available seven days a week,twenty-four hours a day. Usage of this system has been proven to provide significant benefits,with the immediate assignment of a Case Manager,automatic production of the First Report of Injury form,and earlier resolution of employee claims. Safety and Loss Prevention are critical concerns to any business. We have long been a pioneer in the field of accident prevention, having the experience,resources and capabilities to provide a complete range of safety services. Your policy will include more details regarding these services. Please keep this information available. Reference the above policy number on any correspondence and have it available when contacting us or submitting correspondence. It is our pleasure to work with you. If we can be of service,please call. Sincerely, DEBORAH DUPREY Account Manager Underwriter Orlando Service Center cc: BLACKMER INSURANCE AGENCY pggHAMP�O Lrz#p of Warthttlitpton z c 835$C{�1TSttt9 - 1 DEPARTMENT OF BUILDING INSPECTIONS /= INSPECTOR 212 Main Street • Municipal Building Northunpton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as },is/her construction sup:::, sor. 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 any 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 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 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 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. Date Address of work location The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston,MA 02111 M s�' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 't CA Address: tC fi r��. `i $ l City/State/Zip: Ln64 eA. 0133-7 Phone.#: '� �3 S 3 q t o I Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. [] I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. F-1 New construction 2.21 am a sole proprietor or partner- listed on the attached sheet. 7. g'kemodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' co insurance.$ 9. ❑Building addition [No workers' comp.insurance comp. required.] 5. F-1 We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.Q Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *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. TContractors 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-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: o fi r t Policy#or Self-ins.Lic.#: 'S 01 OG Expiration Date: 111110-) — Job Site Address: S,�• L,), City/State/Zip: No 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 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. Be advised that a copy of this statement may be forwarded to the Office of Investieations of the DIA for insurance coverage verification. I do hereby certify un er the ains and penalties of perjury that the information provided above is true and correct Si ature: / - ------�- Date: '7 Phone#: (0 1 -7 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# 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: ` ` '�'V O S 6 y' �-T 1 License Number t sc1 �d�:: \r-«;1 ' �,.e v�c3 c.. vvL i�+ o s`3'3 7 /y Lj-5-/oy Address, Expiration Date Signa re Telephone 9r12eaister'e .HomefmoiovementConaclto�.� kq Not Applicable ❑ Company Name Registration Number Address Expiration Date dLA^- V I Pt 01-3 Telephone q13 J-3 q 1017 SECTION 10 WORKERS'COMPENSATION INSURANCE AFFIbAVIT(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...... ❑ em' �� 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 Employemto 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) Q Roofing ❑ Or Doors 1:3 Accessory Bldg. ❑ Demolition ❑ New Signs [[--31 Decks [Q Siding[0] Other[E3] Brief Description of Proposed 1 g Work: Keotc c- 0-LOv.:..g Alteration of existing bedroom Yes ✓ No Adding new bedroom Yes ✓ No Attached Narrative Renovating unfinished basement Yes _/_No Plans Attached Roll -Sheet sa 1f1�erni troase�an�1°o��ddi"�tiorr4ta=exrstrng` ousrnct..camp{ee��ie�#oilowrna: �Y l P, 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 SECTION1a OWNER AUTHORIZATION-TO.BE COMPLETED WHEN OWNERS-AGENT OR`CONTRACTOR APPLIES 06k�BUILDING-PERMIT 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. Signature of Owner Date 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 underthe pains and penalties of perjury. 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 0 by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bIdg&paved #of Parking Spaces (volume&Location) A. Has a Special Perm it/Variance/Fi nd i ever been issued for/on the site? �� NO �~�� DON7KN8VV �� YES ��/ IF YES, date isauo& IF YES: Was the permit of Deeds? NO K � DON7KNOVV YES~� IF YES:� enter Book Page, and/or Document#I > L_____� B. Does the site contain a brook, body of water orwetlands? NO Q-- DON7KNOV 0 YES 0 IF YES, has permit been nr need tn be obtained from the Conservation Commission? Needs tobeobtained «�� 0b�a�nmd � v�� Dats |ssued' «~_� �_� ' � �� C. Du any signs exist on the prope�y? YES v�� NO IF YES, describe size, type and |uoodon: 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 VVUtheconstmctionoctivitydistudb(clearing,grading,excavation,cx filling)over 1 acre oris it part cfm common plan that will disturb over 1 acre? YES K � NO H�' �� |F YES,then o Northampton Storm Water Management,Permit from the DPW isrequired. r �,:�� ', Department use oniy � k � City of Northampton > Building Department �` �` �� a 212 Main Street Room 100 .E w,ax > ,�. Northampton, MA 01060 �aro� � aura ar � phone 413-587=1240 Fax 413-587-1272 l?la A7, r 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: uJ:�\ c. s Map Lot A7 Unit Zone Overlay Dtstnct r rt aaC is ' p Elm St District EB Drsct SECTION.2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: 14 t-1 341 30 r3 Telephone Signature 2.2 Authorized Agent: r ' >C-k k �q YyG ✓� la c` �C ...c t't>� \ �i t v� 1f�14 0t-31-7 Name(Pr t) Current Mailing Address: Signa re Telephone SECTION 3-`ESITiMATED'CONSTRUCTION COSTS- Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building <—, (a).Building Permit Fee 2. Electrical 6'00 (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) /6600 0 Check Number This Section For Official Use Only Date Building Permit Number Issued: Signature: Building Comm issioner/I nspector of Buildings Date File#BP-2007-0699 APPLICANT/CONTACT PERSON MITCHELL R DAMON —7 ADDRESS/PHONE 189 EDEN TRAIL LEYDEN as PROPERTY LOCATION 82 WILLIAMS ST UNIT 1B MAP 32C PARCEL 276 001 ZONE URC 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: REPLACE DOOR BETWEEN APARTMENTS W/LAUNDRY WALL FOR BOTH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 056721 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9F61ATION 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 Commis sio 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. 82 WILLIAMS ST UNIT I BP-2007-0699 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-276 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category:Non structural interior renovations BUILDING PERMIT Pernut# BP-2007-0699 Project# JS-2007-001051 Est.Cost: $11600.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MITCHELL R DAMON 056721 Lot Size(sq. ft.): Owner: BERNSTEIN ELLEN&STEVEN TEMENBAUM Zoning. URC Applicant: MITCHELL R DAMON T. � iA/II 1 ib.q!iQ q I IN,1 i 4R Applicant Address: Phone Insurance: 189 EDEN TRAIL (413)834-1017 0 WC LEYDENMA01337 ISSUED 0N:11512007 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE DOOR BETWEEN APARTMENTS W/LAUNDRY WALL FOR BOTH 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: i House# Foundation: 1,1b i�-` `a Driveway Final: Final: =0 1 , �inal: Rough Frame;D Gas: Fire Department Fireplace/Chimney: p ,,•.h• ��l• Insulation: Final: Smoke: Final:0 /—dZ V•G 7 THIS PERMIT MAY BE REVOKED BY THE OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULA Certificate of Occupancy Signature: _ FeeTvpe: Date Paid: Amount: Building 1/5/2007 0:00:00 $50.002071 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo