38B-315 City of Northampton
T-03/8" Building Department
Plan Review
212 Main Street
Nort hampton, MA 01060
Recessed Medicne Cabinet
Dm..nt.d Vanity To
Cabinet built into wall recess
22 1/2"wide
48"tall
"co
Tiled shower 40x48
3"curb
Glass door
O
Project Name
Lerner Freeman Bath
Client Name and Address
Lerner Freeman Bath
Sheet Number A_1 Sheet Title Proposed Plan
T-0 3/8"
10 Closet
Demo:
remove fiberglass shower
remove vanity
remove closer walls and door
OD
Toilet to remain
Project Name
Lerner Freeman Bath
Client Name and Address
Lerner Freeman Bath
Sheet Number Existing Plan Sheet Title E-1
18 Interior walls
Repair walls and ceiling around removed closet.
Replace sheetrock removed behind vanity
Install Wedi shower system for new tiled shower(39"x48"by 84"high)
Tile shower floor(tile supplied by owner)
Tile shower walls 7"high (tile supplied by owner)
Install threshold at shower door (threshold supplied by owner)
Large format tile vertical layout
20 Interior doors and trim
Repair base trim at closet
Base trim may be tide extra
Build and install built-in wall cabinet with drawers ($600.00 Allowance for cabinet)
21 Specialties
Install 2 vanity wall mounted mirrors(Allowance$125.00 each)
Install two towel rods(supplied by owner)
Install glass shower door (Allowance$1,800.00 installed)
22 Vanity Cabinet and top
Build an open paint grade wooden base with shelf for granite top,detail as shown in
drawing (Cost$690.)
84"vanity top/with sinks (supplied and installed by others)
23 Flooring
Install new tile(tile floor by owner)
24 Painting
Painting by owner
25 Cleanup
General cleanup
Dump run
35 Build and install a cabinet(half in the wall)in the hall under the skylight. This is an extra and is
not included in the cost of the bathroom. Estimated cost$1,500.
35 Replace cherry handrail with simple cherry rail and square balusters. Estimated cost$1,050.
Thanks,
Jeffrey Bott
Jeffery Bott Contracting
jeffbott&aol.com.
Jeffrey Bott Contracting
32 Pine Street
Florence, MA 01062
413-530-6920
8/1/2015
Hi Harris and Cathy,
Please review this Scope of work and cost estimate and let me know if I can have work started on the
vanity base. I will be ready to start demo on August 18 if you would like.
Let me know,all changes could be done on a cost plus 15%basis.
Scope of the Work
1 Planning and design
2 Permitting
Building permit
3 Site preparation
Demo
Remove and discard:
Fiberglass shower stall and drywall to a height of 7' in shower stall area
Vanity top,base and mirror
Closet door and walls
Ceiling fan and light
Open wall for recessed cabinet 22"wide by 36"high
Open wall for vanity plumbing changes
Remove toilet and save to reinstall.
Remove existing floor tile
15 Plumbing
Reposition shower drain for new shower pan.
Install new shower valve (Allowance$250.00 supplied by plumber)
Install 2 new wall mounted vanity faucets(faucets by owner)
Install drains for two sinks,and hook up when counter and sinks are installed
Reinstall old toilet
16 Electrical
Install 2 new vanity lights,new location(Allowance for fixtures$250.00)
Install new quiet bath fan,same location,same switch,reuse duct
Install new recessed light
City of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building 3y,+
Northampton, MA 01060
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her
construction supervisor. 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
1, 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
r'
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
_ 600 Washington Street
# Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le,ibly
Name (Business/Organization/Individual): Z _
Address:
City/State/Zip: Phone #:
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. F1 I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2: I am a sole proprietor or partner- listed on the attached sheet. 7.$4 Remodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp.insurance.1
required.] 5. ❑ 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.❑ 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.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: A `.-
Policy#or Self-ins. Lic. #:06L 5005-00 aOD q6 7.015A Expiration Date: Z9 16
- Job Site Address: -5S I-OleT 5T &Z -City/State/Zip: 117$ ®1y6 0
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
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Si ature: AI& Date:
Phone#: 4/3 53<3 6 9 2 8
- --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 -CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0 y
Name of License Holder:--. G j p C
License Number
Address Expiration Date
Y' '53 C3 6)2v
Signature Telephone
J.`tegisteed HoiieJmprovem to
ent`Contracr : _ u .x . Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone 530 d
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...... ❑
.dome caner Egempiion
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 Jkat the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of omeowner:Person(s)who own a parcel of land on which he/she resides or i ds to reside;on which there
is,or is intende a one or two family dwelling,attached or detached structures ace ory to such use and/or farm
structures.A person who c cts more than one home in a two-year period s not be considered a homeowner.
Such"homeowner"shall submit to the ing Official,on a form acceptable e Building Official,that he/she shall be
responsible for all such work per formed un a building permit.
As acting Construction Supervisor your presence on t ' b site wi e 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(Worker ' ompe on) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death)of the M achusetts General Annotated,you may be liable for person(s)
you hire to perform work for you under this permit
The undersigned"homeowner"certifies and a mes responsibility for compliance with th to Building Code,City of
Northampton Ordinances,State and Local ring Laws and State of Massachusetts General Laws otated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) w
New House ❑ Addition ❑ Replacement Windows Alteration(s) ® Roofing E]
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks Siding[0] Other[0]
Brief Description of Proposed ttL.�
Work: WIJo� ASt �e2 �dtT 5 40
Alteration of existing bedroom Yes No Adding new bedroom Yes _ No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
fia.If New mouse and or=addition.#o ezisting housing,3complete thb following:
a. Use of buildin : One Family Two Family Other
b. Number of rooms each family unit: Number of Bathrooms
c. Is there a garage attac ed?
d. Proposed Square footage new constructi Dimensions
e. Number of stories?
f. Method of heating? V Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 . of wetlands? \grade
No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or Ilar floor below finished
k. Will building confor to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
'SECTION 73 OWNERAUTHORIZATION,,TO BE COMPLETED,WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT -;' ,
as Owner of the subject
property (�
hereb a ho ' eQ -l- �G✓Io ��
to act n b alf, in all matteirs7 relative ti work authorized by this building permit application.
Signature o r Date
as Owner/Authorized
Agent hereby declare that the tatements 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. _-
F'
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 Requi d by' oning
i
This
lumn to be filled in by
B,u
u*i ding 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/ riance/Finding ever been issued for/on the site?
T
No N' KNOW 0 YES 0
V
IF YES, date issu
IF YES: Was the p r it recorded at the Registry of Deeds?
NO 0 it recorded
0 YES 0
IF YES: en er Book Page' and/or Doc ment#
B. Does the site contain a brook, body of water or wetlands? 00 DON'T KNO 0 ES
IF YES, has a permit been or need to be o ained fro the Conservation Commis ion?
Needs to be obtained 0 Obtain 0 Date Issued:
C. Do any signs exist on the property? YES NO 0
IF YES, describe size, type and Locati n:
D. Are there any proposed changes or additions of signs intended fo e property? YES 0 NO 0
IF YES, describe size, typ and location:
E. Will the construction activ' disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 re? YES 0 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
City of Northampton Status of Permit � �� � 2
MZ
i Building Department Cu bsCutlDrlue}n+ay Permtt
212 Main Street SewerlSepticgvallabdlty V
Room 100 1NaterllNeA Ayailabihtyt
ric Plumbing b i t ons x, rr
a .
Northampton, MA,0tUUo Northampton, MA 01060 Two�e#s�afStr- turaLPlan �� °,
a
phone 413-587-1240 Fax 413-587-1272 Ploe 'lans
Other': peci#y
F_ APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION I:--SITE INFORMATION
This secfion to be completed by offACe
1.1 Property Address:
S F D9T ST O O Map Lot Unit
�-� 6 v
e> �,k�f�tlY1 P l Q .zone ' ' Overlay District
Elm St.-District�' CB L)istnct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.rg 1 Owner of Record:
Current Mailing Address:Telephone
2.2 Authorized Agent:
1 �� a 3 7, F'►�"�� .S`t 'F-l�o t2 e v\L D 06L
Name(Print) Current Mailing Address:
o3� C� H2O
Signatur Telephone
SECTION 3_ESTIMATED CONSTRUCTION COSTS.
Item Estimated Cost(Dollars)to be i Official Use Only .
completed b permit applicant
1. Building (a)Building`'Permit Fee
2. Electrical �� (b)Estimateti Total host of
.'_Construction from 6
3. Plumbing V DO Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+-4+5) 5 ��� Check Number
This Section For Official Onl
Date
Building Permit Number. . Issued: .
Sigriature_
Building Commissionerllnspectorof Buildings; Date
File#BP-2016-0172
APPLICANT/CONTACT PERSON JEFFREY BOTT
ADDRESS/PHONE 32 Pine Street FLORENCE01062 (413)530-6920 Q
PROPERTY LOCATION 55 FORT ST
MAP 38B PARCEL 315 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: REMODEL MASTER BATH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 053157
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
proved 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
4:ature of Bui ding 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.
55 FORT ST BP-2016-0172
GIs#: COMMONWEALTH OF MASSACHUSETTS
MaR:Block: 38B-315 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-2016-0172
Project# JS-2016-000295
Est. Cost: $15000.00
Fee: $98.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JEFFREY BOTT 053157
Lot Size(sq. ft.): 14549.04 Owner: FREEMAN HARRIS AND LERNER CATHY
Zoning: URB(100)/ Applicant: JEFFREY BOTT
AT. 55 FORT ST
Applicant Address: Phone: Insurance:
32 Pine Street (413) 530-6920 O Workers Compensation
FLORENCEMA01062 ISSUED ON.811312015 0:00:00
TO PERFORM THE FOLLOWING WORK.REMODEL MASTER BATH
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 8/13/2015 0:00:00 $98.00
212 Main Street, Phone(413) 587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner