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25C-137 (2) ®1V pop Bar i z `h rpt�y�yy� Rim Ant'F I� J f I a aff + err �t d W' I M1 J i YE z i . rtl IE - j ti. `;TI L(- NEED S (o CAT 10 t� 6 F (To &t 0c) close . ali- � � S� GgoG5 � 1� a1 i o) lei J�� -vs j�F' llLtIIGIlGLIllf./F?2LC{l F)(v Q,A9(GC'dCGfF'GC4 Board of Building Regulations and Standards !- HOME IMPROVEMENT CONTRACTOR Registration: 100364 Expiration: 6116/2008 Type: Private Corporation THOMAS C.McCARTHY GENERAL CONTRACT Thomas McCarthy 3 BRODERICK ST �Z.i+« .►.. Easthampton,MA 01027 Deputy Administrator i L . U�� �oonir>cuyuuealll n�t,�.craurc.�xudF„f�a Hoard of Building Rtgnhtions and Standards ; Constmetior+gupervlsor Ucense License: CS 53221 S: BirtheM*: 5/23/1956 Exptrst 5/23/2009 Tr#1 12646 �;., Rostittt 90 THOMAS C MCCARTHIf �, �1 3 BRODERICK ST ''' 'i EASTHAMPTON,MA 01027 Commissioner CMQ CERTIFICATE OF LIABILITY INSURANCE o Boa i Pleootl�rR (413)S27-5526 FAX (413)527-S470 THIS CERTIFICATE IS ISSUED AS A MATTER OF BIFORMATION r4 nsk t Llamas Insurance Agseey, Inc. ONLY AND CONFERS NO MONTS WIN THE CE MW-ATE 8 s Lana HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLE!BELL YV. EastWimpton, NW 01027 Rabacca Kubosi ak INSURERS AFFORDING COVERAGE NAIC S ra I umtractors,Inc. +eim A General sue ty TRW- 3 Broderick St INSURER B. Easthampton, PA 01027 um : INeURER 0: e COVERAGE& TFIE POIJCIES OF INWRANCE LIS7W BELOW HAVE BEEN LSWW TO THE INSUM NAMFD ABOVE FOR THE PMJCY PERIM INDWW NOTMWANDM ANY REQU T.TERM OR COMMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AWFORDED BYSHE?OUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIGNS AND CONDRIONS OF SUCH POUCIES_AGGREGATE U WTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. L TYPI[OFSgIRtAN� POLICY NIXASM DlITE ) LOM "X,COMMERCIAL RCIAL GENERAL LIABILITY PREMISFE � s unq CLAWS MADE ©OCCUR WO pMaf011 e A , ,UUUI POLICY P LOC ISa+oLE LIMIT S ANY AUTO ALL OVA AUTOS DO WJ� 3 SCHEDULED AUTOS HIRED AV= 8WILYINJUtY NOovNEo AUTOS s PROPERTYDAMAGE $ ANYAUTO OTHER THAN AUTO ONLY: OCCUR a CLAM MADE . DEDUC KE RETENTION S COMPINNIPITION TO"Ovffll aeLOY�IeE'LIMN tTY A ANY PROPRIETORIPARTNvMD ECUTIYB NoyNOe MCCU�r -too SPECULPROYISIONS bNow 11IQIRAIM DATE TMIRROI,THE IiSIRN®INWNW WILL WWAVOR TO MAN. 10 DAYS WRTTTW NOTICE TO THE IWI TMATE NOLDW HAM TO THE LEPT, WT FAILURE TO MAIL SUCH NOTICE SHALL uIFOSS NOOELIGAT4N oR LIMKITY City of Easthampton OF ANY KIND UPON THE uNwlmt,ITS AGWITS OR ItEPIW WITAW4111L Easthampton Building Inspector r WWW.RUGGLUMBER.COM Email: TCMGCI @AOL.COM Jay Czelusniak 1.413.584.5703 7124/2007 60 Elizabeth Street Same Northampton,MA 01060 MA HIC#100364 Exp 5/16/08 MA Const.Supervisor#053221 Exp 5/23/09 Estimate for the following renovations to install a 9'deep x 6'6"full bath in basement. The estimate includes fixing existing framing and new framing as needed which includes installing framing for shower, 3'x 3', new pressure-treated framing for new replacement window and all necessary blocking as needed. The estimate includes rough plumbing, which includes installing drains, vents and water piping for one Sterling 4-piece 36" shower, Delta 1700 shower valve, Kohler Wellworth toilet, Delta 525 lav faucet, and one Gerber wall-hung lay. Connect to existing drains in floor and copper water lines. All fixtures to be in white. We will patch concrete floor with concrete after rough plumbing is done. Electrically, we will install a Nu-Tone fan, light, and heater in the ceiling, ducted to the exterior. We will also install the customer supplied vanity light, and one ground-fault receptacle near the sink. All switches and wiring included. We will insulate the entire room, sheetrock both inside and outside of the bathroom, including the ceiling. Taped, three coats, sand and sponge ready for primer& paint. We will primer& paint inside and outside of the of the bathroom, ceiling white and color of walls is customer's choice. We will supply and install, one solid-core birch pre-hung entrance door, one medicine cabinet and trim out window, door and baseboard in standard trim. Door and all trim to be primed and painted. We will supply and install one towel bar and one toilet paper dispenser. We will prepare, supply and install linoleum with a$30.00 psy allowance. The replacement window to be Mastic Earthwise vinyl white insulated glass Low-E with a full screen, slider type. REGULAR PRICE: $12,885.00 COURTESY DISCOUNTED PRICE: $11,900.00 All rubbish removal and daily clean up is included. Add for Northampton building permit, we will get. Eleven Thousand nine Hundred and xx/100 $ 11,900.00 20% Down for ordering : $2,380.00 30% Upon Start: $3,570.00 30% Upon Completion of rough plumbing&electrical: $3,570.00 20% Upon Completion: $2,380.00 45 Days The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street k1V Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeiblv Name(Business/Organization/Individual): 44 P Address: hone.#CitylStatelZip �l P 3 5� 'l Areyou an employer?Chect the appropriate box: Type of project(required): I I am a employer with ° _ 4. n I am a general contractor and I have hired the sub-contractors 6. C1 New construction employees(foil and/or part-time).* 2.0 1 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 for me in any capacity. employees and have workers' 9 Building addition [No workers' comp.insurance comp.insurance.; required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.0 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 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their worker;'compensation policy infornnation. t Home o%Aers 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 box must attached an additional sheet showing the name of the sub-conbwtors and state wbether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees Bekw is the policy and Job site information. / Insurance Company Name: �t . Policy#o Self-ins.Lic.#: `7�� Expiration Date: fL!t Job Site Address: City/State/Zip: 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 un_ er they s and a hies ojperjury that the information provided above is true and correct S• re r, (f Date: Stgnattrre: �!"' �� 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#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Su ervisor: ry Not Applicable ❑ Name of License Holder: (/�/ e5 5 // License Number AM 1 �; 3 1 A dre s _ Expiration Date 1 /�&-Signdfure Telephone 9-.Rediste�ed tlom"e lmproveinen . orractor`.-'-ss „r4 a q. Not Applicable ❑ Company Name //� Registrat on Nurfiber .. Auwei / r ' 4,4121200k. Adair ss �< _ Expiraffon Wite Telephone 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 buildin °ermit. Signed Affidavit Attached Yes....... No...... ❑ 11: ,IIome Omer 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 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 bome 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[] Siding[O] Other[�] Brief Description of Fropgsed Work: Alteration of existing bedro m Yes No Adding new-bedroom Yes o Attached Narrative Y�,S Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a_lfrNew-house and brad dfflon ta.:ezistlnd iousini ,complete fhe 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? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes o. s cons ruc wn wi 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-OWNERAUTHORIZATION,-TO BE COMPLETED?WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT (� as Owner of the subject property hereby authorize to act on my beh f,in all matt relative to work autho. ed b this building pe ap ication. Signature 10vpw Date `U� as Own uthonzed» - gen hereb declare t at th l statements and nformation on the foregoing application are true and accurate,to the best o edge _and belief. Signed under the p ins and penalties of perj 7 / "a Print Name Signature of Owner/Agent 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 Frontage Setbacks Front Side L:�-- R:1 R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved L parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO G DOWT YES IF YES, date issued: IF YES: Was the permit recorded at the'Registry of Deeds? NO 0 DONT KNOW YES 0 IF YES: enter Book Page' and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW )a YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: 0 0 1 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 NO 'V"9 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing grading ation,or filling)over 1 acre or is it part of a common plan I x that will disturb over 1 acre? YES 0 NO IF YES,then a Northampton Storm Water Managem grading, from the DPW is required. ` [x 1 Department use oraTy Otyf Northampton ipg Department a PSI , 2'1 Oain Street se c l a►a r� � �� " ` FRbom 100 r elyadabr ��- 'Cl4orthatllpton, MA 01060 hd Plan " phone 413-587-1240 Fax 413-587-1272t1 STtePlax�s* APPLICATIOKTO CC 4 r ;--ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION—I -SITE INFORMATION_ 1.1 Properiv Address: y . This section to be completed by`office = Map unit Aw6W46 Zone Overlay District Blrri St.District CB,District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owiier of Re rd: Na (P nt) Current Mailing A ress: Telephone ,,4///_?� Signature _ !/ 2.2 Authorized Agent: Name(Print Current Mailing Address T �t Si nature Telephone rte— SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building �/j i (a)Building Permit Fee 2. Electrical DO /IJ.' (b)Estimated Total Cost of 7 Construction from 6 3. Plumbing �/ •-� Building:Permit Fee 4. Mechanical(HVAC) (� 5. Fire Protection 6. Total=(1 +2+3+4+5) • Check Number This Section For Official Use Only Building Permit Number. Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2008-0145 APPLICANT/CONTACT PERSON Thomas C McCarthy ADDRESS/PHONE 3 BRODERICK ST EASTHAMPTON (413)527-5141 PROPERTY LOCATION 60 ELIZABETH ST MAP 25C PARCEL 137 001 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 Typeof Construction:_INSTALL FULL BATH IN BASEMENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 053221 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO$dCIATION 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 3167 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. BP-2008-0145 GIs#: COMMONWEALTH OF MASSACHUSETTS _ CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Perrnit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category. BUILDING PERMIT Permit# BP-2008-0145 Project# JS-2008-000221 Est. Cost: $11900.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Thomas C McCarthy 053221 Lot Size(sq. ft.): 4704.48 Owner: CZELUSNIAK JAY Zoning:URB Applicant: Thomas C McCarthy AT: 60 ELIZABETH ST Applicant Address: Phone: Insurance: 3 BRODERICK ST (413) 527-5141 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.811312007 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL FULL BATH IN BASEMENT 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 8/13/2007 0:00:00 $50.002526 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo s �� B 1/16S,5 6 Jo or 60 ELIZABETH ST BP-2008-0145 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25C- 137 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildbg DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Permit BUILDING PER Permit MIT P # BP-2008-0145 Project# JS-2008-000221 Est. Cost: $11900.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Gronp: Thomas C McCarthy 053221 Lot Size(sq. ft.): 4704.48 Owner: CZELUSNIAK JAY Zon nn: URB Applicant: Thomas C McCa_rthv AT. 60 ELIZABEi H ST Applicant Address: Phone: Insurance: 3 BRODERICK ST (413) 527-5141 Workers Compensation EASTHAMPTONMA01027 ISSUED ON.8/13/2007 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL FULL BATH IN BASEMENT 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.)1-6-0 7k Rough: Iris/� House# Fourdation: /�j Driveway Final: Final: Final: /C/� ` 0 sd,e A4�w ` Rough Frame: Gas: Fire Department Fireplace/Chimney: 111)ugh: 01+;: insu.stion: O/C/ Final: Smoke: Final: Pt\ O`"l 7'ir( n THIS PERMIT MAY BE REVOKED BY THEfflITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Si nature: FeeTvpe: Date Paid: Amount: Building 8/13/2007 0:00:00 $50.002526 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Conunissioner-Anthony Patillo