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32C-041 (6) KEITER BUILDERS 35 Main Street-Florence•MA•01062•Phone:413-586-8600•Fax:413-280-0124•keiterbuilders.com August 27t',2015 Commissioner Hasbrouck 212 Main Street#100 Northampton, MA 01060 Subject: Request for Waiver I request that you grant a modification to waive the requirement for control construction for the Elisa Mai & George Alexander Project at 40 Pleasant Street, Apartment 42 in Northampton because the work is of a minor nature, will not affect health, accessibility, life and fire safety, or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work. All work will be completed within the prescriptive requirements of 780 CMR.Thank you for your consideration. "Mass Amendments, sections 107.1 allows for an exclusion from control construction for this project" Respectfully, Scott I. Keiter Keiter Builders, Inc. 35 Main Street Northampton,MA 01060 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: ya ® ,& a4'f ��- The debris will be transported by: Czx &t'41 ZS l Gi.G The debris will be received by: VA&M 6!..�' CL4 Building permit number: Name of Permit Applicant LC e4jr �wt l Date Signature of Permit Applicant A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DOnYYY) 7/lo/2ols THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Cynthia Henderson, CISR NAME: Webber & Grinnell PHONE P a Ext) (413)586-0111 - FAX Nom.(413)566-6481 EMAIL chenderson @webberandgrinnell.com 8 North King Street ADDRESS: --- -- ---- INSURER S AFFORDING COVERAGE NAIC# -_ Northampton MA 01060 INSURER Arbella_Insurance Group 17000 INSURED INSURER B Keiter Builders, Inc. INSURERC__-_ Attn: Scott Keiter INSURER D 35 Main Street INSURER E: -__- Florence MA 01062 INSURER F COVERAGES CERTIFICATE NUMBER:Master Exp 2016 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - -- -- INSRT ADDL SUBR _ I POLICY EFF POLICY EXP , LIMITS LTR TYPE OF INSURANCE POLICY NUMBER M/DD/YYYY MM/D /YYYY $ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000 000 DAMAGE TO RENTED 300,000 A � ' CLAIMS-MADE !!% OCCUR 8500064396 6/1/2015 6/1/2016 ��-PREMISES(Ea occurrence $ — 5,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _GENERAL AGGREGATE _ $ 2,000,000 %-ll� POLICY�_.. ] PRO L-1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 _(Ea accidenU__ —_- A AUTOS � R AUTOS I BODILY INJURY(Per person) $ ANY AUTO � NON-OWNED ALL OWNED SCHEDULED 1020039381 6/1/2015 6/1/2016 BODILY INJURY(Per accident) $ - PROPERTY DAMAGE $ Per accident_ _- ._..__. R ' HIRED AUTOS _X AUTOS — Medical a ments $ 5,000 $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ 1,000 000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 A -- --1 -�--1- - --. -- -- -- 1DED I B RETENTION$ 10 000 4600064399 6/1/2015 6/1/2016 $ WORKERS COMPENSATION R PER OTH- l 1 -_. STATUTE ER L _l - ONFDICERPMOMBER EXCBU D? YNN �' i E L EACH ACCIDENT $ 100,.000 ANY PROPRIETOR/PARTNER/EXECUTIVE � - ___- _ _�- ..__ A '.,(Mandatory in NH) N/A, 9127440615 6/11/2015 �i 6/11/2016 EL DISEASE-EA EMPLOYE $ __ 1 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 -7 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION (508)665-8449 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Tradesmen International, LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Ron ACCORDANCE WITH THE POLICY PROVISIONS. 10 Mercer Road Natick, MA 01760 AUTHORIZED REPRESENTATIVE �J C Henderson, CISR/CIN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS09.F ronianii The Commonwealth of Massachusetts Department of Industrial Accidents w Office of Investigations d 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): I Address:��j ►"� C.0 (vim i�� City/State/Zip: " Q Yk4 616 Phone #: 66Q) Are you employer? Check th appropriate box: Type of project(required): 1, am a employer with 4. ❑ [ 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. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working or me in an capacity. employees and have workers' g y p y� ' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.* required.] 5. F1 We are a corporation and its 10.❑ Electrical repairs or additions � 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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' 11❑ Other comp. insurance required.] *Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. ' I lomeowners 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 boa 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 emplovees. Below is the policy and job site information. Insurance Company Name:_bwv,�_ Policy # or Self-ins. Lic. #: °q l a 7 "� -1 �_l'� J Expiration Date: !!j // Job Site Address: �.5� /� City/State/Zip: ,/) 171i1 Ak+at06 d-- 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 i der the pains and penalties of perjury that the information provided above is true and correct. S ---� � _ �a Phone 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#: GEORGE-MAI (SCOPE OF WORK 07.08.15) July 8, 2015 Project Total $61,413.30 We appreciate your bu„sjness and look forward to working with you. Approved By. �' Date: ?' ' Date: t _ Contractor i, Y,�7 '�, _ Customer r� _ � 5 IJ Keiter Builders, Inc., License#: 102457 4 GEORGE-MAI (SCOPE OF WORK 07.08.15) July 8, 201: Description Cost MASTER BEDROOM Framing Misc. Floor Repairs Note Includes entryway wall Pocket Door install new pocket door at master bedroom closet location. Door and hardware allowance=$350 00. Includes specialty framing,jamb,trim,and misc.components Selective Demolition Window Installation of(3)Owner Supplied windows. (2)transom windows&(1)side window GENERAL Electrical Cutting&Patching Open and close all necessary locations for electrical work Electrical Per Plan: (20)fixtures,Panasonic Whisper ceiling fan,wiring for minisplit,dimmers,wiring,permit. Fixture package=$8,488.00 Flooring Flooring-Misc. Repairs General Carpentry Soffit&Built-In Includes framing,drywall,finish,installation of Owner Provided built-in shelving system,necessary plumbing to allow for new shelving system H VAC Carpentry for Minisplit Miscellaneous Carpentry. Includes possible re-configuration of closet shelving to accommodate new 1 3/4 ton head Ductless Minisplit Supply,and install new Fujitsu(2)ton ADU24RLXF2 multi condenser outdoor unit with(1)1 112 Ton ASU18RI-F indoor(ducted)unit and(1)3/4 ton ASU9RLF1 indor wall mount minisplit. 1 3/4 ton unit will be placed up high in closet and ducted into new soffit. Returns(2 grilles)and supply(2 grilles)will be symmetrically located in soffit. Locate exterior condenser above parking space. Add for(2)additional line sets and brown slim duct. a * ' �; � , � y Exclusion Priming,painting,nail hole filling,and other finishes are excluded f- ;3 Home Furnishings Owner to move all furnishings from walls. Select(large)items may be placed into center of room Owner to provide Washer/Dryer Keiter Builders, Inc., License#: 102457 3 GEORGE-MAI (SCOPE OF WORK 07.08.15) July 8, 201E Description Cost '*V I. ,syr-'�A� 't L �., ��F Y{� BATHROOM ENTRANCE Plumbing Connect and set new stackable washer and dehumidifier dryer Selective Demolition Tile-See"Bathroom Tile" BATHROOM Light&Fan(See Electrical) n .. M10111".�'.,, „ KITCHEN Soffit Extension Wall New wall separating pantry with textured,tempered glass (Owner to supply glass) AWN 1•a:n " � � ti w .- .u. ,da>wu. NOR Yea..,4. x .,a ,...:, Dry,,.. ..3r �N3�t !. .. '.a - a _` BEDROOM#1 Baseboard Trim Install new baseboard at new wall locations. Replicate existing baseboard height. Casings Match existing Doors He-use existing doors. Drywall Installation of new drywall,tape,and finish Finish Closet (1)shelf&(1)closet pole(wood) Framing Misc. Floor Repair Selective Demolition ar ,+s ' °.+ E' x 4'rs� ;7 K 's 3'l €� `I s + �' � ' € �'�`&ie{ M d P !-. } �� R 3�� � '" c�^� MASTER BEDROOM Baseboard Trim Install new baseboard at new wall locations Replicate existing baseboard height. ' Casings New casings to match existing. Closet Shelving , Not Included Door& Hardware Re-Use Owner-Supplied door(Existing Closet)for Master Bedroom. This will require re-mortising hinges and changing lockset to left hand in swing. Construct and install new door jamb,stops,casing,etc. Drywall Keiter Builders, Inc., License#: 102457 _ 2 GEORGE-MAI (SCOPE OF WORK 07.08.15) July 8, 2015 Scott Keiter Keiter Builders, Inc. 35 Main Street Florence, MA 01062 M�I .� xy Office 413.586.8600 Fax 413.280,0124 . BUILDER S scottkeiter @gmail.com www.KeiterBuilders.com License #: 102457 Project j Customer GEORGE-MAI(SCOPE OF WORK 07.08.15) Alexander George & Elisa Mai Mobile 646-484-8088 42 PLEASANT STREET 42 Pleasant Street alexander.george @gmail.com NORTHAMPTON, MA 01060 Northampton, MA 01060 SCOPE OF WORK Notes: BASED ON PLANS FROM KUHN RIDDLE ARCHITECTS, PAGES A1.2 & E1.2 DATED 03.07.14. SCOPE OF WORK IS GOVERNING DOCUMENT Description Cost ,e'b K ,,.:� - ,'�`.,�*�;. �° w,'E �, '{ ® '3� i s v k F D s s d bt `.� '.,. do I�, 'm.. E� " `,fts5 '"'?;, "e � ',��.Sf fir ,, t a k�,. ,, 1,50"N Blueprints&Reproduction General Administration Materials Running Mobilization Parking Permits Protection-Finishes Site Breakdown Waste Removal OR 41, k a? rI i A, BATHROOM ENTRANCE Doors for Washer/Dryer ALLOWANCE: $650. Add(1)solid wood bifold door,door kit,jamb,and casing ,aj y Dryer/Washer f Install Owner provided stackable washer and dryer. Non-Venting unit Drywall Framing Misc.Trim Includes Baseboard and Misc.moldings C Keiter Builders, Inc., License#: 102.457 cott Knit , President Date Date Date ADDENDA The following, have been attached to this Agreement: l. PAYMENT SCHEDULE 2. SCOPE OF WORK 3. COPY OF INSURANCE it. LIMITED WARRANTY 5. CHANGE ORDER (COPY AND EXPLANATION) n r V) ,f X', � fete 25% on the balance of the income is relieved from all other contractual duties, including all Punch List �-Contractor, including Contractor's Profit and Overhead at the rate o _. 'J, the Agreement. "I'hereafter, Contracto► rarity work. RMINAT L CONTRACT period of thirty (30) days under an order of any RIGHT TO 'TE our fault or he stopped or delayed either in whole or overnment and due to y If the work is stopped or delayed, either in►wsdicl►�i•►s substantial Part, of an act hall of g P court or other public authority having .I on time, or make Contractor ne ligence, or as a result of an act within Owner's control, or if the Fork s o ion or obligations under this g period of thirty (30) days due to Owner's failure to make a payment substantial part, for a p Agreement and recover 7 days written notice, terminate this Ag obligations, feel insecure, or if Owner should commit al►T�OW;material s�e'l�(7) any of Owner s r the work; for any liability, Agreement, then Contractor may, upon giving merit for all work performed; for any unpaid costs of and tees or gross from Owner pay Contractor may have incurred or might incur n and faith anticipated sg ►t s Ill damages,commitments, and/or claims that ' Agreement, as well as receiving payment for Contractor's attorney's and legal this g profits on the work not performed as of the date of the termination. NOTICE �d or if sent by certified mail, return receipt requested, to the address listed on the Notice will be deemed if delivered m hand front page of this Agreement. ARBITRATION ;OWNER HEREBY M[JTUALLY AGREE IN ADVANCE THAT IN THE CON'T'RACTOR AND THE HOMI ARBITRATION SERVICE WHICH HAS THE EVENT THE CONTRACTOR HAS A DISUPU"I'E CONCERNING THIS CONTRACT, D ARY OF THE EXECUTIVE OFFICE OF CONS SUBMITFTO SUCH CONTRACTOR MAY SUBMIT SUCH DISP[JTE TO A PRIVATE BEEN ASSROVIEU BY THE SECRETARY BUSINESS REGULATIONS AND THE GENERAL L LAWS, C I42A. REQUIRED S14ALL BE ARBITRATION AS PROVIDED IN MASS. Kl?ITF.R BUILDERS,INC. (CONTRACTOR) OWNER C)6- - Is _ Date By`> cott Ke►ter, President Date ------- Date NOTICE OVE APPLY ONLY TO THE AGREETHE"fOWNER MAY FINITIA] TILE SIGNATURES OF THE PARTIES AB WHERE THIS SECTION IS NOT SEPARA END TWO YDAI Al_,TERNA "i�IVE DISPUTE SETTLEMENT INITIATED 13Y THE �,ONTRAC'TO R. A ALTERNATIVE DISPUTE RESOLUTION EVEN THE PARTIES. THE RIGHT "i�0 INITIATE ALTERNATIVE DISPUTE RESOLUTION . AFTER THE DATE OF "THIS AGREEMENT. 10 owner---���—= Contractor__ -- - SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supe,,,rv`is�or: Not Applicable ❑ Name of License Holder: � l--C�l – — I ` License Number Addre Expiration Dale ign to Telephone 9 Registered Home Improvement Contractor': Not Applicable ❑ Company Name Registration Number Address Expiration al�te Telephone JU b 0 b 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 buildi 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 1083.5.1. 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 applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors ED Accessory Bldg. ❑ Demolition ❑ New Signs [01 Decks [C] Siding [o) Other[ol Brief Description of Proposed t Work: ��SCT �'✓y1 COS�.t,{ic �lnin�/J Alteration of existing bedroom ✓ Yes No Adding new bedroom Yes ✓I1lo 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? In. 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 �� as Owner of the subject property �,,/ hereby authorize t�f &Z(, to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date 1, h�l l 0,1��` �� I (.. 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 under the pains and penalti s of perjury. Sco�-�t- V ,I Print Name Si r of Ow Date Section 4. ZONING All 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 Frontaae Setbacks Front Side L:-- R:----- L: R:_ Rear Building Height Bldg.Square Footage `%� Open Space Footage °I, (Lot area minus bldg&paved parking) # of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Findin ver been issued for/on the site? NO Q DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Re ' try of Deeds? NO 0 DON'T KNOW YES O IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW &--'YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, exca Ion, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. �. � . . ._ s.,.. w° � Department use only Ir ity of Northampton Status of Permit: uilding Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Aims Room 100 Water/Well Availability !lilc, m Plumbing&Gas s hapton, MA 01060 Two Sets of Structural Plans Northam ton, 87-1240 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: This section to be completed by office p� Map Lot Unit � ��� �� Zone Overlay District Elm St.District CB District_ SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: a h b ' E I ' ��v ue �( Name(Print) Current Malin Addres : cam�6�t Mailing _ Telephone Signature 2.2 Authorized Agent: Name(P 5q) Current Mailing Address: iK�. yi3. szY� • �6cl) f uature Telephone TION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars)to be Official Use Only completed by ermit applicant 1. Building &S (a)�j / z (a) Building Permit Fee 2. Electrical W (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) ! �` O C110 5. Fire Protection 6. Total = (1 + 2+ 3+4+ 5) Check Number This Section For Official Use Only Building ermit Number: Date g Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0272 APPLICANT/CONTACT PERSON SCOTT KEITER ADDRESS/PHONE 51A HATFIELD ST NORTHAMPTON01060(413)586-8600 Q PROPERTY LOCATION 42 PLEASANT ST-#2 MAP 32C PARCEL 041 000 ZONE CB(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 -f p- Construction: MISCELLANEOUS CARPENTRY&COSMETIC FINISHES New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 102457 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON.THIS APPLICATION BASED ON INF�MATION 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 e o elay Si nature 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. 42 PLEASANT ST-#2 BP-2016-0272 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-041 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2016-0272 Project# JS-2016-000416 Est. Cost: $61413.00 Fee: $430.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SCOTT KEITER 102457 Lot Size(sq. ft.): Owner: GEORGE ALEXANDER C/O DEPT OF PHILOSOPHY Zoning: CB(100)/ Applicant: SCOTT KEITER AT: 42 PLEASANT ST - #2 Applicant Address: Phone: Insurance: 5 1 A HATFIELD ST (413)586-8600 O WC NORTHAMPTONMA01060 ISSUED ON.91812015 0:00:00 TO PERFORM THE FOLLOWING WORK.-MISCELLANEOUS CARPENTRY & COSMETIC FINISHES 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 9/8/2015 0:00:00 $430.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner