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23D-151 (13) 149 HINCKLEY ST BP-2005-1078 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D- 151 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2005-1078 Project# JS-2005-1466 Est. Cost: $59485.00 Fee: $62.70 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THOMAS BACIS 070061 Lot Size(sq. ft.): 18513.00 Owner: DAVIS DEBBIE Zoning_URB Applicant: THOMAS BACIS AT: 1`,� HI CI,:i-i_S' ST Applicant Address: Phone: Insurance: 67 DIVISION ST (413) 529-0801 EASTHAM PTON MA01027 ISSUED ON:5/16/05 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 11 X 19 2ND FLR DINING ROOM ADDITION 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: g am' 'i Driveway Final: Final: ' 9 -;2 5-(9,C '"'Final:® `t ,' Rough Frame: S�� 0 9, . .:9/ /�/�`v c- Fireplace/Chimney: eei Gas: Fire Department �a P r, � Rougn:� . ' .►i i;:;I:I:.ticr,: ©4- Z9/ c- P I Final:/��''f�J 0 � / Smoke: Final: „ed ok to 3/- 45--� THIS PERMIT MAY BE REVOKED BY THE CI Y OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu anc C7V Si nature: FeeType: Date Paid: Amount: Building 5/16/05 0:00:00 $62.70 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo es/7 tftv -Nye rs _58/Pep/ ',if 5 (.1./�/ 7cc/s s,W (IT ?zzgl✓ ,11' 'd 19k9 a49 (�f File#BP-2005-1078 APPLICANT/CONTACT PERSON THOMAS BACIS ADDRESS/PHONE 67 DIVISION ST EASTHAMPTON (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 dOr ` new Fee Paid G�/ Typeof Construction: CONSTRUCT 11 X 19 2ND FLR DINING ROOM ADDITION 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 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 C 'ssion _c A, ' Ir—' -S --12/1.C2C--- 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. Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 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 ti q 1-fin c�k -- --: EMap Lot Unit } Zone Overlay District I MAY - 4 2005, i J Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ebb ie \tea✓t'f ( bI I-It'n CV-levy S 7 Name(Print) Current Mailing Address: Sg� - 0 767 Telephone Signature 2.2 Authorized Agent: 1� 7h rfrta5 � � �CvGt S G 7 QJ1 ✓IS/ cl 5 -7 Name(Print) Current Mailing Address: --/4 6 6 CL r7D S'd- 9 - a gar) Signature Telephone SECTION 3 ESTIMATED CONSTRUCTION COSTS Item - Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building S' 1, 91 S (a)Building Permit Fee 2. Electrical - , Goo (b)Estimated Total Cost f Construction from(6) 3. Plumbing Ga S r S O ° Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) S{y, t f r Check Number .0, tti i ln 0 This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings 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 _ i I ' Frontage I S)- / I t i I 1 Setbacks Front I I 7 i i , Side L: R: L:' R:1 Rear - i2 0 Building Height AP pgY i Bldg. Square Footage 3 / i I % ( I ( i i , ' , O Open Space Footage 141 S`S'"- % (Lot area minus bldg&paved I r i I i I ! parking) C---/ i #of Parking Spaces Fill: ' I II 1 i I (volume&Location) I A. Has a Special Permit/Variance/Findi ever been issued for/on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: I IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES 0 IF YES: enter Book Page and/or and/or Document#• l B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained Q Obtained 0 , 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 0 NO ri'1 IF YES, describe size, type and location: i ! 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 ® , NO i(i) IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition Replacement Windows Alteration(s) n Roofing n Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [E] Siding[0] Other[O] Brief Description of Proposed J �,`c)� n Work: C 6nS lr✓ � n f—(ae r� � ] � (y S'Pto Cld�i 1'!//7f Alteration of existing bedroom Yes V No Adding new bedroom Yes Nq Attached Narra Renovating unfinished basement Yes �/ No Plans Attache Ro�-Sheet Y{' r sa [fNew=houserand=o add tia a existit c. .Fiousm F.cor4tplete#het tovang: 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? Aa d. Proposed Square footage of new construction. � Dimensions (1)( ! 1 e. Number of stories? f. Method of heating? . (ea ✓14 Fireplaces or Woodstoves 'Yes Number of each ( U g. Energy Conservation Compliance.1 ✓ Ye'S Masscheck Energy Compliance form attached? �Pf h. Type of construction l)vCz>) (4 r3- i. Is construction within 100 ft.of wetlands? Yes V No. Is construction within 100 yr. floodplain - Yes No i j. Depth of basement or cellar floor below finished grade -1 Soh a 7 2 e•S k. Will building conform to the Building and Zoning regulations? V 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 to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date Gel-- a S Ct, , ,as Own:r/Authorized hereby declare that the statements and information on the foregoing application are true and accurate,to the best o • edge and belief. Signed under the pains and penalties of perjury. dr^45' /14 . aac, 'f Print Name --�� S — 3- o c- Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES f 8.1 Licensed Construction Sup�ervisor: Not Applicable El Name of License Holder: / /L i' ) +'I. v r�006. ( License Number 7 DIVi`S."dvt S7, "1-6 — 07 Address Expiration Date ate. 5 d-4/1 a 80! Signature Telephone 9:Registece"'i tiome ripiavernent Contraeto Not Applicable 0 4. fella A emool 9 • 1 ?-6 t/6 Company Name Registration Number _ y o ( ��/ 1 Si'c 57,, Li — Z7-- as Address Expiration Date C4 574 4 m (J 7ay.I /11a O'0" 7 Telephone O$ 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 0 • 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-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 r • R1,kAtr , (riff of ort(jaii :ptonn _Jip _ _— V{emsr- rE i;asa.rfintrlle' =i DEPARTMENT OP BUILDING INSPECTIONS 212 Main Street Municipal Building "a • Northampton, Mass. 01060 r WORKER'S COMTENSATION INSURANCE AFFIDAVIT I, _ 6 KY)4 S _ cr`I (1iccns./permifiat) with a principal place of businessfresidence at: o' 7 b /VI s;e S7 `'1 , (phone ) (sar_..t/ci ty/state./zi p) do hereby certify, under the.pains and penalties of perjury, that un an employer P providing the followine'workcr's conocnsanon coverage f0r ly( employees wording on this job: • L.l erry v7e-ut (,vc5 -- ?IS - 337 ? ? °' 3 g``7 —aS'— (Insu—_nc Co tc ny) (Policy Nu_ r) (Expiration Dai) ( ) I am a sole proprietor, general contractor or homeowner (`i cie one) and have hired the cone actors listed below who have the following worker's compensation po iciest (Name of Con-!ractor) (lnsvranc a Cairoanyi oUei NtilnliC:) (aplyduon Date) (Name of Cootnaor) (Insurance Comp,-Lay/Policy Nunc^r) (Eipiradon Date) • • (Name of Conrctor) (Insurance Company/Policy Numb:I) (Expiraoo Date) • Maine of Contractor) (Lasuranc Comcauy/Policy Numbr) (Expiration Date). j (easel ad.� oaa1 t_scc.ifncco_.ry to cscrv. pc-.iaia.s to.11 n+----cos) ( ) I am a sale proprietor and have no one working for me. ( ) I am..a home owner performing all the work myself. NOTE:plt—sc bc cwsrc Ls '4nic hocaccrwincra wbo crap lo-y petoas to ds r-. rgair worit on.d.•r11—^a of not most th.a ` oo trai,j is which the bomoowoc ra+do of oa ttu aoun6,ppurtc0 tbeeo s-r oor c=r.Uv co rd.-r'4 w be eitployc-,uode the..ui d:<, pr •.lion Acz(GI2152 1(5)).:application by a bomooa-oa for tice.or pcmit trey cvidmcc the Icgs1 ctaau of as er;tloy.r under dro Woricoet Compa¢zavoa Act t?ode+zaad tba..a copy of thin mr.®mi WAY bo foc-x.nud.d to Lt.(}cp.,tc000t of Ind Aced stY Off oo of 4o+r.00e for Lb. oovc-tsc vciLartioci and the Liana to sot u c bovRyb-c tnsdc soaion 23 A of MOL 152 an lad to the i_ztpolitico of=immat pa"itio ooau ag of a rsac of up to.11. 00.00 and/or csr{sisocomcci.of up to ooc yru Loci civil pe"..1'uo is tb<focal of...Stop Wort Ord=.ad■ arc o(5100_00 a day.piast me Far uic only e _. PeTnvt Numbcr lv��:-- Lot.g �. Date � R Signature otLia nurJPcrrsuttcc __ - PAM e Z 4 , (iLit- of Niartliampton . *7444,4 ti• 7: =7:41iNN -- ''r "Y DEPARTMENT OF BUILDING INSPECTIONS WI _, /i INSPECTOR 212 Main Street • Municipal Building —S '.. 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 supc: , ispr. 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 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 r • ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE.RESIDENTIAL NEW CONSTRUCTION AND ADDITIONS 780 cMR Appendix _14-effective 3/1/98) Applicant Name: OY'7 S ✓!rI, �GG 3 Site Address. Applicant Address: G S 7• City/Town: ,A/d✓76i'Yr h /7i ' /14 &, E 4�7h4 n� 0z >1 _ Use Group: also""v./ /A a. 0 t oa l Date of Application,,: S- 3 - QC- Anrlirrwr{t of,r.,.: — �.._!:_ tior S;g-- � ,' 2-►2a-�; r+1.sV���-L�Iv�i � I�OiIiT: Coritialarvae Path(check ant,x ❑ Prescriptive Package ('_united to 2- or 2- family wood frame buildings heated with fossil fuels only) Pachate (A through KK from Table J5.2. lb): Heating Degree Days (ADD")from Table J5.2 la: (For items d. through i., fill in all values that apply from Table J5.2) a. Gross Walt Area 7 sq. ft • t. Wall rR--Valve R b. Glazing.Meat q sq. ft g. Fioo- R•Vaiue P. Cq c. Glazing%(100 z b+a) qt, h. Basement wall L� �. �7azinv Ll-,ral�w ll. • 30 Sieb Perimeter P. e. Co+ling R-value Ft- e o i. Heating AFu� ❑ Compo ae-r-i Performance: "Manual Trade CrfP (Limited to wood or metal framed buildings only) Ctima-t Zoete(-from Figure J6.2.2) 0 Zone 12 0 Zone 13 ❑ Zone 14 Attach rrade-Off Sittkshert from Appendix J,[and HVAC Trade-Off',%ariaheet. if applicable) ❑ FAAScheck Software Attach Compliance P.epact and Inspecrion Checklist printouts. ✓ Systems AnaiytiS OR Q Renewable Energy Sources Attach Mass Registered tt-hituct or Engine^r Analysis • __ --------_. - - 7 • • ALTERNATIVE FOR ADDITIONS ONLY: a: Gross Wall + Ctiiino Area 517 sq. ft. b. Glazing Area' CP- Solt. c. Glazing a) 2" % Glazing q. ng�,(.IO+Jx'b,- O ADDITION with Glazing%(c.)up to 4-0%may use 780 CMR Table J1 1.2.3.1 glow: MAXIMUM U-value Minimum R-Values Fenestration Ceiling Wall Roof Basement Wall Slab Perimeter, Dept , 0:39 R-37 IR-13 R1.9 y R-10 • I R•10,d tt. ❑ -SUNP.00trl- addition (greater than 40%glazing•to.wail and ceiling gross area) Attach 'Consumer Information Form"from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved ❑ Denied ❑ Date of App:o:•alJDenial: Qiva Sv (S)vi Deriai: (pr6vide additional details as needed on back side) . I_C$amat lstsa..may--bc-eet erAcogh-Opening or Liai t- -vas. New England Remodeling General Contractors Inc. Proposal No.: 909 Thomas M. Bacis Date: 03/25/05 67 Division Street Easthampton, MA 01027 Terms: 1/3 down (413)529-0801 ft�+' MAY - 4 2005 1/3 mid- way Remainder upon completion TO: Debbie Davis 149 Hinckley Street MA Lic. #: 070061 Northampton, Ma 01060 - MA Reg. #: 126116 587-0368 0-7" 5- Job Description Price Construct a 11'X19' second story addition. Description. 8 integrity double hung windows, oak flooring, sheet rock, insulation, vinyl siding, shingle roof, and all information on spec sheet. $1,300.00 cabinet allowance. Original quote. $42, 300.00 Changes. Remove and install vinyl siding to lower portion of addition. Add additional supports in wall to ensure proper support of addition. Enlarge tile entry area. Install gas lines for gas fireplace. $4,460.00 Sheetrock kitchen ceiling. Bathroom remodel. All work as described in spec sheet. d Original quote. 1°1 r1 4 ��>�l ti � $11,500.00 Changes. ,� Wood floor, pocket door, electric heat. $1,225.00 Items Not included in this proposal. Hanging light fixtures, bath faucets, sink, vanity, toilet, towel bars. TOTAL DUE: $59,485.00 - A 1 1/2% monthly service charge shall be applied to any balance over 30 days. - Above prices good for 14 days. - Any additional work or changes will be priced at the rate of $58.00/hr. plus material. - Our contract may be withdrawn if not signed by both parties by the stated date. - Required deposit must be given upon signing to ensure price guarantee. Customer Signature: Date: WY/OS— Contractor Signature: Date: $ / ... 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