23D-151 (12) 149 HINCKLEY ST BP-2002-0657
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23D- 151 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2002-0657
Project# JS-2002-1028
Est. Cost: $22574.00
Fee: $73.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THOMAS BACIS 070061
Lot Size(sq. ft.): 18513.00 Owner: GIBBS PATRICIA CANDEE&
Zoning:URB Applicant: THOMAS BACIS
AT: 149 H I NCKLEY ST
Applicant Address: Phone: Insurance:
114 LINE ST (413) 529-0801
EASTHAM PTON MA01027 ISSUED ON:1/18/02 0:00:00
TO PERFORM THE FOLLOWING WORK:REMODEL KITCHEN
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: � 'j , Rough:\ J2 8(� .4,y House# Foundation:
-"/` / Driveway Final:
Final WI ek�,,,,t� Final:,21/1/6.2
Rough Frame: a rt ) - 3 /-op
Gas: E"0"C Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final Final:
Final`T eta?) Smoke: OK Zz�z
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS. ,
Certificate of Occupancy.
/-z Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 1/18/02 0:00:00 1631 $73.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2002-0657
APPLICANT/CONTACT PERSON THOMAS BACIS
ADDRESS/PHONE 114 LINE ST (413)529-0801
PROPERTY LOCATION 149 HINCKLEY ST
MAP 23D PARCEL 151 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 2 �j _ _
Fee Paid 0, f /
Typeof Construction: REMODEL KITCHEN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 070061
3 sets of Plans/Plot Plan
THE FO 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 Commission
—4
Signature of Buil g Offic 1 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.
t •
ri- Department use only i Northampton Statu s of Permit:BUII g Department Curb Cut/Driveway PermitN 1 7 2002 i Main Street S we.r/septic AvailabilityR om 100 Water/Weil Availability_ °" _i?JI'. '��!NSFF ham ton, MA 01060 Two Sets of Structural Plans"A°ph ��a - 240 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
This section to be completed by office
1.1 Property Address:
' 1 gi o K le S Map Lot Unit
y-/1/Of it)arrPIon Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
ebbie 'Dcti,.°s 14 r 14inkler 37
Name(Print) CurreIltYM,si;li^g0?6
Telephone
Signature
2.2 Authorized/ Agent:
7nbma5 / n 4 . 1 c,rS I 1 Y(.-iv1<' 5--7' .
Name(Print) Current Mailing Address:
�A l'h. , G< e/1 S^d- q - p O 1
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed by permit applicant
1. Building 1 y 3aC( (a) Building Permit Fee
2. Electrical 4 Cr (b) Estimated Total Cost of
0 Construction from (6)
3. Plumbing L{ 000 Building Permit Fee
1
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) 2 2-f S 7`( Check Number /b / 3 -
This Section For Official Use Only
Building Permit Number: 3)D `7 '7 Date Issued:
Signature:
Building Commissioner/Inspector of Buildings 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 YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry 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 A
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
IF YES, describe size, type and location:
SECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition 0 Replacement Windows Alterations)g Roofing 0
Or Doors 0
Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
t
Brief Description of Proposed Work: i 7G keh Q ehtOJe I
Alteration of existing bedroom Yes *6 No Adding new bedroom Yes 4 No
Attached Narrative❑ Renovating unfinished basement Yes X, No
Plans Attached Roll ❑ - Sheet❑
E I AN"e�iv h"o`use 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. 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
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
rvV `•-aketG( G� S , as Owner of the subject proper
hereby authorize to act
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, (7601^-‘a S ,/', • Retc S , 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 penalties of perjury.
�11(,,A.4 f .M • 60-c
Print Name
Signature of Owner/Agent Date
•
SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Construction Su ervisor: Not Applicable 1:1
Name of License Holder : d rn g 5- -A` • G G 1^r 0 7 0 v6 r
License Number
1 (41 L;Inc •S7 - 3- 6r6)
Address Expiration Date
'- .44,,,e, rk , 6,,e< 5;-q- 0 go ,
Signature Telephone
R gfsferedT-i"ome lmprove ne'ii6.1iIiikeriRoe . Not Applicable 0
mac/ 14- L'el,'land re, e-'rad8I Al f � ' 116
Company Name Registration Number
1(6( I tx-c 5T- &I S'7110r►-•gr40n ./''Ict , 4 ` Z 2 '0Z
Address ' / S.
Expiration Date
Telephon[ c 5) J 2-f-6 0I
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 affid<
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes No 0
.-- ome1 ®wrier xemp in
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)familic
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 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(
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
.,.O s f 8 LLx of Na iliampton 1
8 ti- ti_ �B A.,..gns,tts
70.
DEPARTMENT OF BUILDING INSPECTIONS
tsttt212 Main Street ' Municipal Building
Northampton, Mass. 01060 ter'
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, '---7/4.014,t45 /1'1- ' I ,� Gr'I
(licenseelpermittee)
with a
principal place of business/residence at:
1 ( 6/Vic 5 --7, s-zh �r�n /14k n a(phone#6a) ) S2c-0�c1
(street/city/state/zip)
do hereby certify, under the pains and penalties of perjury, that:
(\() I am an employer providing the following worker's compensation coverage for my
employees working on this job: 01
G
ti e/-.7-y /v1,..-76..4( i 1 -- ?l S- 3)--7 •633--per
- (Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
a(
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional +r.sed ifnrr.-cr.ry to include information pertaining to all contractors)
( ) I a a sole proprietor and have no one w
m orldng for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while homeowners who employ persons to do Ina rtrt.s,.rxr cvastrualon or repair work on a dwelling of
not more than throe units in which the homeowner resides or on the grounds appurtenant thereto arc not gt lly tonsidcrcd to be
employers under the worket'a oompeasatim Act(GL152,ss 1(5)),application by a homeowvcr for a license or permit may evidence the
legal status of an employer under the Worker's Compensation Act
I understand that a copy of this rt.t..mrt may be focaavded to the Department of Industrial Aaidemta'Of5oo of Insurance for the
coverage verification and that failure to seatre coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties
ootuisting of a fine of up to S 1,500.00 andlor imprison of up to one year and civil penalties in the form of a Stop Work Order and a
firm of 5100.013 a day against tnc.
For dgrxtmesdal stern nary
// ' Permit Number
�'�z- Ma0 Lot#
Signature of Lir1-r, fPr.rrn;tter Date
L
/ 1824" / CD
174"
/ y 424" y 4s' / 424" / /
u ,0
H
A l�
\ k —III, \ v Z
\4: 2Z --. u C U
P N
N -(Z) 1 1 'S g . r,g o (��
4_ O2 a uU
ASS \ \ ` �j
LL
-1,
3T'
jLLN
f 724" ' r' 5
N CO A
. N
_ !I.,01 i L — . At
\ , - Z ►wu_a�
r Tea cts
O g I
o O
O0
O
`� - POT—� If
NI,
i--' (5)Paz ours DivA N
pY� `j
4, 24 y
g COMBO.WD U062480R -_.-.
/ 424 / 24" / 424" __ 3"
i/
1974" /
All dimensions size designations given are This is an original design and must not be Davis,D... .kit Designed: 8/29/01
subject to verification on job site and released or copied unless applicable fee has Fp 1 Printed: 8/29/01
adjustment to fit job conditions. been paid or job order placed. Drawing#: 1
Scale: 0 5/16"= 1'
Y-
New England Remodeling
General Contractors
Proposal No.: 592
Thomas M. Bacis Terms: 1/3 down
114 Line Street 1/3 midway
Easthampton, MA 01027 Remainder upon completion
(413)529-0801
MA Lic. #: 070061
MA Reg. #: 126116
TO: Debbie Davis Date: 10/02/01
149 Hinkley St.
Northampton, MA 01060
(413)587-0368
Job Description P►i e
Cabinets $3,016.78
Counter tops, including moveable table top. $582.25
Electric work to consist of:
All necessary wiring for a kitchen and laundry area to be done to ma. state code.
New sub panel in basement.
3 under cabinet lights and 3 recessed lights controlled by 2 dimmer switches.
Install ceiling fan box, fan provided by customer.
Move electrical work for rear door placement. 4 o t►+ efea, hwe,of �,. .(/'3k�+�KI-' ' $3,845.00
All plumbing work according to ma state code. ^`kei``0fit'cl' fe.//k ��1;
wf un
Move heat unit and install new piping) et44607 , 4e.C.o ) %Loa '
A $350.00 allowance for sink and faucet. /e* ' on no.-#G. 11 5i4444. 44g16- tIgki r $4,000.00
Acquire building permit. col/nev�44%r 1 V f����� / $200.00
Disposal fees. �� $600.00
Move rear door. h„,14141 dl5A.u.ir5 " $1,200.00
Install cabinets.drtrc. $1,680.00
Miscellaneous labor +�
atripiKlywn
Miscellaneous material./ 1-4%G. $1,500.00
Tile entry arec. tile maieliJl IJ not II IOIUUCU.
Install hard wood floor with 3 coats of urethane. -f'►^ #a'( Ili V `\. $2,000.00
All painting and finishing to be done by the customer.
TOTAL: $22,574.03
- A 1 1/2% monthly service charge shall be applied to any balance over 30 days.
- Above prices good for 30 days.
- Any additional work or changes will be priced at the rate of $45.00/hr. plus material.
�� �Signature: � � Date: bo l/y/p/