17C-052 (3) -- Joe and Martha Lellman
48 Strawberry Hill
Florence, MA. April 28, 2002
CR&C will remodel the first floor bath at the
Lellman's Strawberry Hill home.The existing full bath will be
torn out, as will the finishes inside the adjacent linen closet
and master bedroom closet. Inside this expanded space, a
new-full master bath and new half bath will be installed.
CR&C will also remodel the basement, already
somewhat: "finished", in the following manner. A wall with
Cook two doors will be built dividing the basement approximately
in half, leaving the stairs on one side and the boiler on the
RESTORATION& other. Within the stair side, a wall with one door will be built
CONSTRUCTION
around an existing 3/4 bath, and a plywood wall around a
13 GROVE STREET storage space will be removed. Finishes will be added, (tile
HAYDENVILLE, MA. 01039 and paint in bath, carpet and paint in remainder of stair side)
413-268-3265 to complete a playroom/ activity space.
These tasks will be completed on a time and material,
cost plus basis at an estimated value of$25,000.
Benton Cook
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m DEPARTMENT OF BUILDFNG 114SPECTIOIIS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSA INSURANCE AFFIDAVIT
(licensee/ ttee}
P�
with a principal place of business/residence at:
t 11(03 r�
V I (Phone#) 3 6' 3-4 6-
( city/sta&zip)
do hereby certify, under the pains and penalties of pegury, that:
( ) I am an employer providing the following workers compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am sole ropriet , general contractor or homeowner (circle one) and have hired
the contractors sted below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expimtioa Date)
f.
(Name of Contractor) (Insurance Compauy/Poticy Number) (Expiration Date)
(Name of Contractor) (Insuurance Compauy/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(anach additioml lb—t if neccazary to include infocimIIon patsining to all oo,&ecfors)
( I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware(hat whilo homcowucn who employ pczzom to do m iatca cc c=str=on or repair work on a dwelling of
not mete than tboc units in wtvch the homeowner ride oc on the grounds appurtenant thereto arc not gracrally oomidcrcd to be
employes 11 the worica's oompexr4ca Ad(GL152,m 1(5)),applica6on by a homeowner for a Gecase cc permit may evidence the
legzl status of an employer under the Workces Compensation Ad_
I undrntand that a copy of this ctatemcat may be foawnrded to tbo Dcpar�of Dial Aocidm&Ofboo of]nzurwoo for tho
coverer va-&catioa aad that failtue to aearre coverago under secdoa 25A of MOIL 152 can lead to the imposition of criminal penalties
oomisiiug of a fine of up to S 1,500.00 andloe impr6onmrni of up to one year and civil pcaalt cs in the form of a Stop Work Ord--and a
firm of x 1110.1111 a day against
p«.�,tmmtal uro only
Permit Number
g �d Mai Lot#
Si of Li ermi 2
SECTIQN 8 CONSTRUCTION.SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: KI �/f c-�, 0
License Number
Address Expir ion Date
i nature Telephone
Not Applicable ❑
Company Name e is rati n dumber
1 16 r'
Ad/dress Expira io Da
/� - Telephone
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...... ❑
NMI
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� ��DS C rP TIt OF PROPOSED WOR 3ch c gall a licable'3
, x r : .,v a._ n ,3b
;.,:, ,'^vNe i rrAl,,t7.2..A„v�l�k�:.9''A^zs, .:.�3 rip. _:. : . 3}+,Y31,�Ila�:�x;7•, �1:.,
New House ❑ Addition ❑ Replacement Windows Alteration(s) Ev Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: d
4 LQ
Alteration of existing droom__V Ps No Adding new bedroom Yes k No
Attached Narrative IV Renovatin nfinishe_d basement as NPlans Attached Roll ❑ Sheet �
l` �e, ddit on oez'r`s"fi h: I-ncom `lea flto,, .
a. Use of building : One Family d7 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. Mascheck 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
OWN>rRS AGENT OR CONTRgCTOR.APPLIES�F.OR;BUILbING'PERMI,T
...
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 thai the statements and information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains a d penalties of erjury.
Print N I fQ
gnature of Owner/Agent Da
i Y
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF 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 DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
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
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:
D. Are there any proposed changes to or additions of signs intended for the property ?YES —
No
IF YES, describe size, type and location:
City of Northampton
�- $gilding Department
[[{ "' T""X12 Main Street
�' 1\_-- - `"^1 Room 100
N,orthampton, MA 01060
MAY — h � 413417-1240 Fax 413.587-1272 o,
�r.
.APPLICATION I..O C614STR CT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: .
Zone Ouer ayfistr c#
Elm St. District.
SECTION 2 -'PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
vv
Name(Print) Current Mailing Address:
Telephone /►�� Q�
Signature `tS
2.2 Authorized Agent:
t� vim.
Name(P ' Current Mailing Address:
'f e3
gn ure Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed by ermit applicant
1. Building aCj OZ) (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) Check Number
Gq1 This Section For Official Use Only"
Building Permit Number: � t Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date,
File#BP-2002-0957
APPLICANT/CONTACT PERSON BENTON D COOK
ADDRESS/PHONE 13 GROVE ST (413)268-3265
PROPERTY LOCATION 48 STRAWBERRY HILL
MAP 17C PARCEL 052 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tvpeof Construction: REMODEL BATH&CLOSETS TO 1 1/2 BATH&PARTITION WALLS IN
BASEMENT
New Construction
Non Structural interior renovations
_ Addition to Existina
Accessory Structure
Building Plans Included:
Owner/Statement or License 049209
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION 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 Stree ssion
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.
BP-2002-0957
.. .
G1S#: COMMONWEALTH OF MASSACHUSETTS
� x CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2002-0957
Project# JS-2002-1550
Est.Cost: $25000.00
Fee: $100.00 PERMISSION IS HEREB Y GRANTED TO:
Const. Class: Contractor: License:
Use Groin: BENTON D COOK 049209
Lot Size(sq.ft.): 22346.28 Owner: LELLMAN JOSEPH E&MARTHA R
Zoning.URA Applicant: B E N TO N D COOK
AT. 48 STRAWBERRY HILL
Applicant Address: Phone: Insurance:
13 GROVE ST (413) 268-3265
HAYDENVILLEMA01039 ISSUED ON.517102 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMODEL BATH & CLOSETS TO 1 1/2 BATH
& PARTITION WALLS IN BASEMENT
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 5/7/02 0:00:00 2275 $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo