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17A-141 PROPOSAL` :, � ��'� � (111:i1iUC1i(1V1 1 r � I�� North 14 1.,1 58 -5077 Date; September 11, 2003 NAME Mr. & Mrs. Keefe RE: Siding(residence) ADDRESS 211 Chestnut Street CITY Florence, Ma. 01062 We hereby propose to: Remove existing siding and dispose of properly. Wrap trim with white aluminum, cover house with fanfold insulation, and finally to cover entire house with Carvedwood double 4" Pebblestone Clay vinyl siding. As discussed on site with owners. For the sum of_Six thousand four hundred sixty Dollars ($6,460.00) With payment made as follows: $3,460.00 to start, Balance immediately upon completion. Respectfully submitted Note-this proposal may be withdrawn by us if not accept within days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are autho . d to do the work as specified. Payments will be made as outlined above. 7 Z Z�z Signature l!'? t � ; ature i Date bat 4Tt�MP�. o oy $� Grzty of &Nart4aiwptan z Z $ � �lassacl�useffs - DEPARTMENT OF BUILDING INSPECTIONS /= INSPECTOR 212 Main Street • Municipal Building Northampton,MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supc . :or. 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), s_onotube 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 these inspections can result in failure to obtain a certificate of occupancy 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 6 ��3�[SS AC}11ISCIIa �' - dir of ~1 I)EPfu2TMENT 7 Of' £UILDII�G INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE /IFFEDANI.T — Qsz v,,�t v,itl) a principal place of bbusirnesslres dence (s:TCevcit;ic'-t:; r!p) do hereDy CCri1I}%_ UnC'c1_ L11C,' t) !ilS 2ii7 1)C it ltl' s C}1 pC:rjIlry, (Rat: (� I am au employer providirig t11C iollov.,M2 '.:ort;Crt cornnnsHUOt] c0vc:-2',C iror my e pl0 Ces working on this job: (Ins.Jl C-z rtpam') (Po�_;c.NtL fiber) --- (F>.�.iration Date) j I am a sole proprietor, general Contr.C`or c r tlon1c0:N-ner (Circle one) and ha'l-e hind the contractors listed beiovv the foll rg v orke`s compen� (NE-me of Cwamctor) (?ns�-rte Come:.:,-,:?oiic; Number) doin Datc) (Na-mc Of CoatPCiOr) Date) (Name of Coatractor) ,1 ------ .x; rndo_ Dat'c T1S I1C COD :? .i/1)Ol;C: t,T,,, �l (Name of Con nctcr) —- (Ins rallc� Cotn� .}.rt'olicy Numy�*) (I::ni-::ior. Date) i O I tun it pole proprie.vl a_il;i have no 011e .�.;;rt.�il ; for in-- I a1I1 a hom, Ov'!?1C� �.r?C.'1111Ii ?II i'i iiY� li- r NOTE,:pfc u tr nwzrc tl:Z�-,L•J'C l:crca r-..,-Leo=-,PI,+,.. � n:::.. _r ncc cz.._n r"Cl ar::Pair not LncYC then throo uni+ij in t:l.di he f,r.>±::iZ. rr <x x;'` ._..:z z •1i ct r1 LhcRC c c o t�crrzl!Y c:r. :c t esployca u.�ei the tvca:a's c�z >eti-n i L (G.!Sw !(Si;,a :'Cie:;by a hotnco«vncr for r l cc c ct p:r tir c t r ]cgzl ctatuc of nn oa-nployx ur)c' the Wcv�c�: oa w nation!.ct tr I uz>dczt,<nd Lhi>cmy oI thy, et>t­-s1 cuy bo fcx„'nrded to t1»IY_Sinrt-xrri:of Industrial�ri�lat:e'Ci icw of 1::1.+r�.a for tlx oovm gc VCri ciioa aid tI_W C it uc tc t- c cnr M u:3: caiK 25.A of?.tG1.152 Can Ic^d to the r t zitiD t o;c ._1 petal:u romisting of a rtrx of up to S 1.5WOO n:'' r i^:itri r^ti:1 of up to Cr.:}: ..:.i civil ixnzttia in de fc nn of a S!r, ';.'c t:Orin a P oCS109.00 a day ig�.ina rn,. . -- For d4%uuTZ<�YsJ urc qtly i Pczrnit Numfr.:r r Lure of i.ic= JI' - SCT�ON 8 GONSTRl7CTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder :�— � E ©t �� License Number Addr ss Expiration Date Signature Telephone 1VffReg s ere am . mo;ouementGontracto Not Applicable [I Company Name Registration Number Address Expiration Date Telephone SECTION 30WO'RKE=RS' COMPENSATION INSURANCE,AFFIDAVIT(M:Ga.-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...... ❑ 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 acecptable 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 i i l i SECT ON l S. Afi110 ' ROPOSEDgWORK checka`II a I�catile New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding Other [ ] Brief Description of Proposed Workn�c9 ��' u�t � lrl Alteration of existing bedroom Yes V No Adding new bedroom Yes ✓ No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll D• Sheet 0 a e o gad r�adi£tion to ex:isinghousng�, c "npl.etetieLhow�ng: 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. 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 Nc 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 T TO.BE COMPLETED WHEN OYYNEFtA �ONyTRAC gPPLIES FOR BUILDING ERMITI. I, as Owner of the subject property hereby authorize to ac; oi my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, C—zs a�..Qbtaec/.Authorzed 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 under the pains and penalties of perjury. Pr t N Signature of Owner/Agenf Date 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 V YES IF YES, date issued: IF YES: Was the permit recorded at the Regis ry 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 y IF-YES, describe size, type and location: City of Northampton Department �12 Main Street Room 100 Nortampton, MA 01060 .�' ph&441,3 5$7-1240 Fax 413-587-1272 APPLICATION TO CdksTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION r- ,7 This secfiD. to h compTetedFby ffic 1.1 Property Address: EImStDistrict` .. . CBs ricf SECTION 2- PROPERTY OWNER SHIPrAUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: am rint) Current Mailing Address: !Rjr �1-)A Signa Telephone SECTION-3 ESTIMATED CONSTRUCTION COSTS- Item Estimated Cost(Dollars)to be Official Use'Only'. completed by ermit applicant 1. Building a OBuilding Permit Fee 2. Elec"rical (b) =.Stimated Total Cost of Construction from .6` 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) JQ Check Number his Section For Official Use Onl Building Permit-Number: Date Issued: Signature:' _ Building Commissioner/inspector of Buildings Date t 26 dlk I BP-2004-0390 GIs#: COMMONWEALTH OF MASSACHUSETTS h t° A-tl CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2004-0390 Project# IS-2004-0570 Est. Cost: $6460.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groin: CDT CONSTRUCTION 130152 Lot Size(sq.ft.): 23478.84 Owner: KEEF RICHARD&PHYLLIS Zoning:URA Applicant: CDT CONSTRUCTION AT: 211 CHESTNUT ST Applicant Address: Phone: Insurance: 158 NORTH MAPLE ST (413) 585-8677 Workers Compensation FLORENCEMA01062 ISSUED ON.1018103 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMOVE SHAKES & INSTALL VINYL SIDING 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• Receipt No: Date Paid: Check No: Amount: Building 10/8/03 0:00:00 5505 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo