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38A-137 (4) 107 MOSER ST BP-2018-1200 GIs a: COMMONWEALTH OF MASSACHUSETTS MV.Block:38A- 137 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-2018-1200 Project# JS-2018-002147 Est.Cost:$14500.00 Fee:$94.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: KUELMCQUAID 051394 Lot Siu(sp.IT): 0.00 Owner: CHERNLY SUNNY Zoninw Applicant. KUEL MCQUAID AT. 107 MOSER ST Applicant Address: Phone: Insurance: 131 FERRY ST (413) 537-5063 n EASTHAMPTONMA01027 ISSUED ON.511812018 0:00.00 TO PERFORM THE FOLLOWING WORILTURN EXISTING BREEZEWAY INTO FINISHED SPACE - 3 SEASON ROOM 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 ft 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 Sismature: FeeTvpe: Date Paid: Amount: Building 5/18/20180:00:00 $94.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck-Building Commissioner L File#BP-2018-1200 6: APPLICANT/CONTACT PERSON RULE MCQUAID ADDRESS/PHONE 131 FERRY ST EASTHAMPTON (413)537-5063 Q j PROPERTY LOCATION 107 MOSER ST �l MAP 38A PARCEL 137 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST LOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tweof Construction: TURN EXISTING BREEZ TO FINISHED SPACE-3 SEASON ROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 051394 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION 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 Stomt Water Management Demolition Delay la�y d, " ri 1 7 lQ 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 infomration. Department use only City of Northampton Status of Permit I / -. ' �*• Building Department Curb Cut/Driveway Permit 212 Main Street Sawa7Septic Availability Room 100 WaterNdell Availability Northampton, MA 01060 Two Sets of Structural Plarre phone 413-587-1240 Fax 413-587-1272 PlotlSite Plans other qp fy 94 APPLICATION TO CONSTRUCT,ALTER REQ ISF A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION Btu S I An his action to be completed by office 1.1 Property Address: Q..pp poi H05" 1 i. 03Al ` Lot 1 -37 Unit E KIAMP71 Ai MA 6 10 6 0 Zone Overlay District Elm St.District Ca District SECTION 2.PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: UNN CKC-- 161 MoSER S1. ANWHA111176N , W Name(Printl ^ Current Mailing Address. plf La C Signature Telephone DD 6 D b 2.2 Authorized Agent: ./ /<V if- I"1L Qu41d X31 Y"=sc� Sl �es'�� o„u,t '>w,� /✓�� Name) np" � Current Mailing Agile ns. XPQ/ 1� 6ze' Y/3 s37- So�3 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Oficial Use Only completed by permit applicant 1. Building ,I (a) Building Pennit Fee 2. Electrical (b)Estimated Total Cast of c' U Construction from 6 3. Plumbing _. Building Permit Fee n 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number 2077 This Section For Official Use Only Date Building Permit Number: Issued. Signature: Building Commissioneninspector of Buildings Date McQ,p:�. 11yQ.kl7gr5S .[. �W� EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed, Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Tbis column to be filled in by Badding DepaMmnl Lot Size ._ Frontage Setbacks Front Side L R: L:T_.. Rear _ Building Height Bldg.Square Footage % Open Space Footage (Lot arta minus bldg&paved __....inulanno 0 ofl'arking Spaces I - -- Fill: (volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW ® YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW ® YES O IF YES: enter Book Pagel. and/or Document# ///^^^��� B. Does the site contain a brook, body of water or wetlands? NO tt / DON'T KNOW 0 YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained ® , Date Issued: C. Do any signs exist on the property? YES O NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading,excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION b DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement W' dows Alterations) Roofing ❑ Or Doors V Accessory Bldg. ❑ Demolition ❑ New Signs [01 Decks [E-3 Siding [0] Other[0] Brief Description of Proposed../ o y ` p ( v 1 a S� q Work'. It/6tn . wcr '?-1CST4`F. b4'¢eZeWa.a "q A-6 Pp .S'lr!N Alteration of existing bedroom_Yes 1/ No Adding new bedroom Yes ✓ No G-3 5c O e rl Attached Narrative Renovating unfinished basement _Yes �No Plans Attached Roll -Sheet Sa.If New house and or addition to existing housinig complete the following: a. Use of building. One Fani 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 farm attached? In, Type of construction L 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 COMPLETEDWHEN OWNERS AGE.NrT,,rOR CONTRACTOR APPLIES FOR BUILDING PERMIT I, SU�Ny C ffERNLy as Owner of the subject property )� ,1,1 hereby authorize Y ✓ e to act on m half, in all matters relative to work authorized by this building permit application. C// I Signature of Omer V In Date I, /'1 'e—If as OwnerlAuthorized 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. Print Name s Ta �nt Signature of OwnenAgent Dale SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction/Supervisor: Not Applicable El // ( Name of License Holder ` U' e Me G C, UQi✓� ✓ - L)5 )361—T License Number lei mA 2-,) Address p 1027 Expiraf n Dale Signature Telephone 0,,�� 413 - S37-SoG3 9.Registered Home Improvem/ent Contractor: Not Applicable ❑ �vL � /�c QU0.uaC 10G700 Company Name _ Registration Number 1 � ) 1/3-63-?01027 X124 (2©(8 Atltlress Expi tion D to Telephone 566; SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§2506)) 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...... ❑ City of Northampton Massachusetts i 1 DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street a Municipal Building iv Y. CD Northampton, !Ll 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration,renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: Est. Cost: Address of Work: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): —Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton Massachusetts I DEPARTMENT OF BUILDING INSPECTIONS '� x 212 Main Street a Municipal Building Jsn Northe ton, MA 01060 Massachusetts Residential Building Code Section 110.R5.1.2 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. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. 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. City of Northampton 55 Massachusetts I DEPARTMENT OF BUILDING INSPECTIONS 212 Main �m Street ipal Building Narrhpicn, M 01060 y R'ry'y711� Debris 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. The debris from construction work being performed at: ) 0-7 Mosos Vo :-�katm qrq (Please print house number and street name) Is to be disposed of at: W\�e V <er- �t (Pleas rint name a�d location of facility) Or will be disposed of in a dumpster onsite rented or leased from: ////�(Company Name mee and/Addddresss,)) Signature of Permit Applicant or Owner Date If,for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department of7ndustrial Accidents I Congress Street, 700 Boston,MA 02174-204-20 17 wwwmass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le¢ilily J/ q Business/Organization Name: �`\ V 2. Address: �1= City/State/zip: G, [:..54114 o„S s 6 Phone#: 4/3- S3 7 - So 6 Are you an employer?Check the appropriate box: Business Type(required): 1.❑ I am a employer with employees(full and/ 5. ❑Retail —/8r port-time).' 6. ❑RcctaurantBar/Eating Establishment 2. 4/ I am a sole proprietor or partnership and have no 7, ❑Office and/or Sales(incl real estate,auto,etc.) employees working for me in any capacity. [No workers' comp. insurance required] 8. ❑Non-profit 3.ElWe are a corporation and its officers have exercised 9. ❑ Entertainment their right ofexemption per a 152,k1(4),and we have 10.❑Manufacturing no employees.[No workers' comp. insurance required]*' 11.11Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees. [No workers'comp.insurance req.] 12.0 Other "Any applicant that checks box#1 most alw fill oat the section below showing thew v e6wmcompensecon policy information. —Ifthe cnrpnmte officers haveemptei therm lves,butthe em-pomdum has other employee ,a workers'companscionpolieyisrequredandsuchan m,,m,etum should cheek box pL I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: Insurer's Address: City/State/Zip: Policy#or Self-ins.Lic.# Expiration Date: 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 a f 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 ofthe DIA for insurance coverage verification. I do hereby certify,under the pains andpenaldes Jofperjury that the information provided above is true and correct Signature: /.��1� Qj,/i// D t � Phone#: LN3-- S37— S063 Official use only. Do not write in this area,to be completed by city or fawn official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www. ss.gowdia h1 of o 5 11�US� �pC7 � ��uy2 Ilpuse` /Vey /1/e ✓ D l7 00 it Order#224908 Quotation Page 1 rFrom —� Factorywill Ship To r Older Information R.K. Miles, Inc. (WH) R.K. Miles, Inc. (WH) Date 3/19/2018 PO Box 1125 21 West Street Ord Type Retail 618 Depot Street Route 5 South Manchester Center, VT 05255 West Hatfield, MA 01088 Route T2 Phn: 802 362-1952 PO# Fax: 802362-6436 Customer -- Comment MCQUAID-KUEL-03-19-2018 Products Manufactured by Phn: Paradigm tMndow Solutions Portland, ME 04103 Line Qty Description Color Width Height Unit Cast Net 7 3 NC 8300 Double Hung-Premium Deal White TTT 35 112 691/2 296.72 890.16 RO 38 76 Tempered L.E WArgon Top 76,21 228.6: ® LowE w/Argon Bottom 7621 22e6 No Grid T No Grid Top No Grid Bottom Double Lock Extension Jamb 4 Sltlea 57.85 173.5; Wall Wall Depth-4.S625 Fibegrass Full Screen Line Item Total 506.99 1,520.97, 2 1 NC 8300 Picture Window --- White TTT 11 1/2 69112 17224 172.24 RO 12 76 Tempered LmE w/Argon 135.89 135.8£ No Grid Primed Extension Jamb 4 Ekes 44,63 44.6 Wall Depth=4.5625 - — Line Item Total 352.76 352.7E 0 1 NC 8300 Patio Door (Slider) White TTT 71112 82 1,168.10 1,158.1[ Cox\ RO 72 82112 Tampered LewElArgon Left ff Tempered LowE/Argon Right ® No Gritl Left No Grid Right Standard Roller(Zinc Placed Steep Patio Door Buck While Handle KEYED 34.81 34.87 XScreen(Fiberglass Wire) Line Item Total 1,202.91 7,20291 -----•a-_.. ...�� Order Totals --- Total 3.076.64 Sales Tax @ 6.25% �1 2.2£ Grand Total 3,268.9; Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,parmership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit most be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 www.mass.gov/dia Form R-r, d 02-23-I5 5/17/2018 City of Northampton Mail-107 Moser St. Cum Of Louis Hasbrouck<Ihasbrouck@northamptonma.gov> NmOKunpillon 107 Moser St. Louis Hasbrouck<Ihasbrouck@northamptonma gov> Thu, May 17,2018 at 1:46 PM Draft To: mcquaid.kuel@gmail.com Kuel, Is the breezeway going to be heated?Will the current exterior on the house door stay? How big is the current exterior door? If it's heated space, we'll need a lot more info. Let me know. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax hftps://mail.google.com/mail/ca/u/0/?ui-2&ik-ee5flga57e&jsver-FPvd7ux ULs.en.&cbl=gmail_fe_180508.13_p9&view=pt&msg=1636f35918e7dMa&dsgt=l&siml