38-078 195 GROVE ST BP-2005-1076
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38-078 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2005-1076
Project# IS-2005-1464
Est.Cost: $30000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: FIVE STAR REMODELING 085319
Lot Size(sq.ft.): 11412.72 Owner: WU RICHARD
Zoning.URB Applicant: FIVE STAR REMODELING
AT: 145 CROVJ'--�_ ST
Applicant Address: Phone: Insurance:
P O BOX 778 _ __. _. (413) 527-6355 O WC
EASTHAMPTONMA01027 ISSUT'D 0N.5/9105 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 12 X 14 S'UNROOM
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:
Rou;h: Rough:�O`�Ul D House# Foundation:
Driveway Final:
Final: Final: t� jI10
/ �- Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: (9
THIS PERMIT MAY BE :REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATI OF
ANY OF ITS RULES AND REGULATIONS�Cl y,, - s/
Certificate of Occu an _ Signature:
FeeType: Date Paid: An►ount:
Building 5/9/05 0:00:00 $50.00 + City of Northampton
w BUILDING INSPECTION LABEL
l jVl501—A-r1e)V .J- 9 U9RICANV- CLIPS'
212 Main Street,Phone(413)58, A P P R 40 V E n
Building Commissionei
Inspector
Date (o
k
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195 GROVE ST BP-2005-1076
GIS#: COMMONWEALTH OF MASSACHUSETTS
MO.Block:38-078 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2005-1076
Project# JS-2005-1464
Est, Cost: $30000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: FIVE STAR REMODELING 085319
Lot Size(sq.ft.): 11412.72 owner: WU RICHARD
Zoning:URB Applicant: FIVE STAR REMODELING
AT. 195 GROVE ST
Applicant Address: Phone: Insurance:
P 0 BOX 778 (413) 527-6355 WC
EASTHAMPTONMA01027 ISSUED ON.519105 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 12 X 14 SUNROOM
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 Si nature:
FeeType: Date Paid: Amount:
Building 5/9/05 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2005-1076
APPLICANT/CONTACT PERSON FIVE STAR REMODELING
ADDRESS/PHONE P O BOX 778 EASTHAMPTON (413)527-6355 Q
PROPERTY LOCATION 195 GROVE ST
MAP 38 PARCEL 078 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid -�:2/107 VPC;/L11
T_ypeof Construction: CONSTRUCT 12 X 14 SUNROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 085319
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF 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 Street Co ion
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.
_ ..._,. City,of Nortoampton
'Btjilding Department
212 Main Street
Room 100
Northampton; MA 01060
phone 413-587=1240 Fax 413-587-1272 `
APPLICATION TO' ONSTRUC-T,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE.iNFORMATION
1.1 Property Address: AR
This section to be completed by office
410/���/1.����iyerla�CDlrtct
SL u u l; lSfl�Ct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 gener off Record: I /
f/' 61171 1 1� �l e l� l�filr JY3`i
Name(Print) Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
Ave, rlctfiez14 %s A
Name(Print Curfent Mauling Address:/
Signature Telephone
SECTION 3-'E TIMATED CONSTRUCTION"COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. BuildingrC?
(a).Building,-Permit Fee
2. Electrical Xb)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) Q. Check Number
This Section For Offidial Use Only
Building Permit Number Date
Issued:
Signature: ,
i
Building Commissioner/Inspector of Buildings Date
,
`
Section 4. ZONING All Informat-i6n 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
Frontage
Setbacks Front
Rear
Building Height
Bldg.Square Footage
Open Space Footage %
(Lot area minus bIdg&paved
#of Parking Spaces
'
(volume I&Location)
A. Has | ���mb����od���
�
u��
�� ^~��� DONT KNOW it YES
IF YES, date issued:,"
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES
IF YES: enter Book and/or Dncument#
D. Does the site contain abrook, body ofwater orwetlands? NO DONT KNOW �_� YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
~
Needs tobembtaioedx�� 0�ta�ned �~� Oat� �s�u�d'
�~� v_� ' �
. Dnany signs exist onthe property? YES 0 NO 0
IF YED, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES NO
|FYES, describe size, type and location:
E Will the construction activity disturb grading e cavation,orfilling)over 1 acre oris itpart ufecommon plan
that will disturb over 1 acre? YES NO 0�N�
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION5-DDE�SCRIPTION OF PROPOSES?WORK(check'all applicable)
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [CI] Decks [Q Siding[Cl] Other[ICj
Brief Description of Pro osed ] j
Work: p p ����F/` �' V an
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement -Yes No
Plans Attached Roll -Sheet
rt .��` "
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. !n Dimensions 1 a A r 4l
e. Number of stories? //,
f. Method of heating? AU ,o Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction wocr,/ �
L Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes v)CNo
j. Depth of basement or cellar floor below finished grade _a 1 �✓�E'�
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank City Sewer Private well City water Supply _
SECTION Ta-OWNER.AUTHORIZATION--TOBE.COMPLETED=WHEN
OWNERS AGENT,OR'CONTRACTPR ADPL IES Ft3Ft BCIILDING"PERMIT
I, /Gita✓i'� W !/ as Owner of the subject
property
hereby authorize %US 1wr
to act on my behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, as Owner/Authorized
Agerft here y 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 pain d penalties of perjury. '
Prin Name
Signature of caner! g Date
SECTION 8-CONSTRUCTION SERVICES t
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: 9 Ss'/y
� / / • License Number
Address / ExpiratiodDate
414 >�
Signature1 - Telephone 117
rmre ` o f " Not Applicable ❑9se� WON;
� rd -
Company Name Registration Number
r---------
,, ,
Address Expiratio Dam
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFiDAY1T(M:O.L.:c.1'62,§,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-vear 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
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o DEPARTMENU OP BUILDD\,G INSPPCTIOI S
212 Main Strcet ' I\funicipal Building
Northampton, Mass. 01060
I
«'O"RUCER•S CONITENSATION MSURANCE A=— AV17'
�f
(li cons-zJpc,-m�cirx)
\Vith a principal place of businessfresidence at: -- —
�
- (Scr=t/cirJls=lzip)
do hereby certify, under the.pp-ins and penalties of pefJury, hal
( I am an employer providing the followint iworke>'s cosnocasaoon coverage for Iny
etvplovees wocldng on tins job:
i
(IJ=an= Comr.: ) (Police: Nu_b-cr) :pi �tior, Date)
i
O I am a sole proprieror, general cooaaaor or homeowner (c cie one) and have hired
the coouaCors listed below r-rho hive the folloWimp workers comoensaaon policies:
i
(N+amc Oi coninCiOr) (In urant: COrnplrlpll obc) !',ILL lLtr)
(Name of Cont;acior) (lnsuanec CoMI)an-VIPOUM Nurac_r) (ExDuz6on Date)
I
(Name of Connaao,-) (Lasuranee Company/Polio' mup u) (Expimaon Date)
(Dame of Contractor) (Lasurmcc Company/Policy Numb r) (Etipiradon Date).
(ac ch:.d4—;ocsJ rhcC—if ncc -,Y to cx!ucti�iaforn..�oa pcln.iainb to.11 ooa�-tom) .
O I am a sole proprietor and have no oae working for me.
( ) I am-a home owner performing all the wort- myself.
I�
I NOTE:please be awwt it—Kt , bc,,=,,,,K'bp c=plcy Pcn-a 2 Lo do•-•;• -,•m= c--zcjoo c rrpaa—or ca r d—Ulin-E of
aoe more tin Lb"L'-1'r1x is Kbeb Lbc bomoowner rcydm or oa the proun6 zp7jrLc==tbcCo e-e oot CC=--Uy«r1:d.-rci Lo be
cirploye�Ltn�e the Kms:—,r..._T ca Act(GUI 52-=I(S)1=-pplir6on by a bommaaa fc a lig=er pc-mit racy-16—Lc
lcpl rt=�••of ea eraloyx undcT tbo WorScolr C.ompomatioa AcC
1 mad ti-a-opy of thi.mt®ma oaay b<foa-xnrded to the Dcputmcoa Acedcaa'Off oo or[murwce for Lb,
—vazsc vcif eaioa and U%--L Ciliac to soxrc tov=-Zc Linder y-ecioa 23 A of hIGL 152 c 3n tad to the i=p=tioa of eimin"pea+Jrics
000sising of a fiat or up to S 1300.00 or isa{siyc,�of up to ooc yc-.end ei%-U pmxYia in d5 room of.Slop Wort Order and a
fim of S 100.00 a day a me
i
.. Fix �u.c Drily
permlt NLunbcs _
j- �.s,P. t,ol
1 Sim of Li crmiucc DBEe --
�'Ct1A]NPl•
,..Crzty of Worthalliptan L z
� � �Glassacf�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 suer.visor. "lie state defines"Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be,a one or tWb fami� -
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
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-T-Locimis Way, P.O. Box.778 413-527-635,1
Easthampton, MA 41027 IL 1-800-767-635,1
R,E M 0 D E L I N G
This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A).Any person planning home improvements should first obtain
a copy of"A Consumer Guide to the Home Improvement Contractor Law"before agreeing to any work on your residence.The guide will inform you of your rights and respon-
sibilities as well as provide you with important information about what to do if a dispute arises.You may obtain a free copy by calling the Executive Office of Consumer
Affairs'Consumer Information Hotline at 617-727-7780
Homeowner Information Contractor Information
Name Company Name
Five Star Remodeling
Street Add-ress(do nor use a Post Office Box address) Contractor/Salesperson/Owner Name
Kevin Perrier
City,Town State Zip Code Business Address(must include a street address)
1 Loomis Way, P.O.Box 778
Daytime Phone Evening Phone City/Town State Zip Code
Easthampton Mass. 01027
Mailing Address(it different from above) Business Phone Federal Employer ID or S.S.Number
1-413-527-6355 75-3034389
0w requires that.11 home Home improvement Contractor Reg.Number Expiration Date
have �orrtradors
ve a valid repstralion 12-3-05
number.
134511
The Contractor agrees to do the following work for the Homeowner:
(Describe in detail the work to be completed,specifying the type,brand,and grade of materials to be used.)
,j Check this box if additional pages are used for this section
Required Permits-The following permits are required and will be secured by the contractor as Proposed Start and Completion Schedule-The following schedule will be adhered to unless circumstances beyond
rhe homeowner's agent Owners who secure their own permits will be excluded from the the contractor's control arise.These dates are approximate start and finish dates.
Guaranty Fund provisions of MGL chapter 142A.
Date when contractor will begin contracted work
Date when contracted work will be substantially completed
Total Contract Price and Payment Schedule
The contractor agrees to perform the work,furnished the material and labor specified above for the total sum'of:
Payments will be made according to the following schedule:
upon signing contract(not to exceed 1/3 of the total contract price gr the cost of special order items,whichever is greater").
by or upon completion of
by or upon completion of
upon completion of the contract-(Law forbids demanding final payment until contract is completed to both party's satisfaction).
The following material/equipment must be special to be paid for ------
ordered before the contracted work begins in order to
meet the completion schedule": to be paid for
Homeowner is responsible for all collection and reasonable attorney fees if payment is not received at time of completion.
Express Warranty-Is an express warranty being provided by the contractoo. J No ayes (all terms of the warranty must be attached to the contract)
Sub contractors - The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the
contractor.The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement.
Contract Acceptance- Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document,the contract shall not imply that any lien or
other security interest has been placed on the residence.Review the following cautions and notices carefully before signing this contract.
• Don't be pressured into signing the contract.Take time to read and fully understand it.Ask questions if something is unclear.
• Make sure the contractor has a valid Home improvement Contractor Registration.The law requires all home improvement contractors and sub contractors to be registered with
the Director of Home improvement Contractor Registration.You may inquire about contractor registration by writing to the director at One Ashburton Place,Room 1301,Boston,
MA 02108 or by calling 617-727-8598 or 617-727-3200.
• Does the contractor have Insurance?While it is not required by law,it is a good idea and an additional protection.
• Know your rights and responsibilities.Read the important information on the reverse side of this form and get a copy of the Consumer Guide
You
u may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office
o branch
ciffir
r=bhc office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement.See the attached
ricit'..of .nc.
tation form for an explanation of this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!!
Two identical copies of he contract must be signed.The white copy goes to the homeowner.The yellow copy should be kept by the contractor.
Homeowner's Sfqnalum nstp,