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24D-124 (5)
CONTRACTOR: Rainbow Home Improvement 126 Ryan Road, Florence MA 2668 - (413) 341 3838 CLIENT: TUB AND 5HOWER SURROUND Justin and Rachel kemp / TO BE REMOVED 21 Hooker Ave TOILET Northampton, MA W u, EX5ITING ALL AND PLUMBING TO BE REMOVED TO BE REMOVED SCOPE OF WORK: 10 11 Existing flooring to be removed down to sub floor. Existing i�DD- bathtub 51NK AND VANITY and end walls to be removed. Existing wall hung sink TO BE REMOVED to be removed. Existing vanity over sink and over toilet storage cabinet to be removed. Existing radiator to be b'-3" RADIATOR removed and retained for reuse. TO BE REMOVED AND RETAINED Existing plumbing layout will be modified to relocate vanity/ FOR REUSE sink to location near existing entry door, and facilitate install of new claw foot tub with wall mounted tub filler and shower 2ND F LOO R BATH _ EX 15T I I`�I 1 G faucet. Rain head shower fixture to be centered over tub. Existing radiator plumbing will be modified to allow for install of existing radiator centered under exsiting window. Existing electrical will be reconfigured to allow for vanity light and GFGI outlet near new sink/vanity and near toilet location. New NEW WAIN5COTTING WITH TOP CAP 5" recessed can light will be installed over existing toilet TO HEIGHT OF 42" ABOVE FLOOR location. New 1 cone 100 GFM bath exhaust fan will be SURFACE 5'-1 1/2" installed in central room location. Access to existing over- NEW VANITY AND TOP BY CLIENT stair storage space will be modified to allow for access from NEW WALL MOUNT FAUCET bathroom. r2668 NEW CABINET DOORS AND STORAGE NEW VANITY LIGHT All floors in bathroom will be tiled with slate over electric 2'_b11 NEW GFGI OUTLET radiant heat system. Baseboard around bathroom perimeter NEW TOILET ° 5t°f will be 3" slate tile. Bathroom vanity to be custom fabricated 5°a` NEW 5" REGE55ED LIGHT by client. New sink will have wall mounted faucet. New claw _ NEW GLAWFOOT TUB foot tub will be approximately 30 x 55 and 24 deep. Floor NEW 5" REGE55ED LIGHT 1'-b" mounted bath/shower fixture will be installed to function with R - NEW TUB FILLER AND claw foot tub. Ceiling mounted shower ring will be installed cn �, ® RAINHEAD 5HOWER above new tub to facilitate shower curtain use. Modified walls RE-INSTALLED RADIATOR `� NEW CEILING MOUNT will be sanded to a smooth finish. Client will prime and paint 4' 5HOWER RING all walls. CENTERED UNDER WINDOW NEW EXHAUST FAN b'-3" NEW SLATE TILE FLOOR WITH (no light) \ UNDER TILE ELECTRIC HEATING 5Y5TEM AND WALL CONTROL 2ND FLOOR BATH - PROP05ED Home Owner's who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund.Where the contractor deems himself to be insecure he may require as a prerequisite to continuing said work that the balance of funds due under the contract,which are in possession of the owner,shall be placed in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal. DO NOT SIGN THIS ONTRACT IF THERE ARE ANY BLANK SPACES. 1 . Owner: Owner Contractor: "The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in MGL c 142A. Owner: Contractor/ _- Contract RHI Construction Inc(Rainbow Home Improvement)Proposes to hereby furnish t Jmaterial&labor complete in accordance with the specifications,and for the sum total outlined in estimate number s i�b.Payments to be made as follows: 1/3 of full total upon acceptance, 1/3 of full total upon the start of project and the balance upon completion.All material is guaranteed to be as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.All agreements are contingent upon strikes,accidents or delays beyond our control.Owner is to carry fire,home owners other necessary insurance.RHI Construction Inc(Rainbow Home Improvement)will maintain proper liability insurance and workmen's compensation insurance as necessary.Acceptance of Proposal will commence with the home owners signature.Prices,specifications and conditions are satisfactory and are hereby accepted upon signature.RHI Construction Inc(Rainbow Home Improvement)is authorized to do the work as specified and to be paid as specified.RHI Construction Inc(Rainbow Home Improvement)EIN#27-1544579, 128 Ryan Road Florence,MA 01062.A Massachusetts registered Home Improvement Company#137097.Represented by Thomas Malone,Construction Supervisor#55236 and Peter Cabaniol Construction Supervisor#99861 are entering into an contract agreeing upon the stated construction,reconstruction outlined in the estimate attached here in# on this date by the rightful home owners `J'"L�`� 4— -V�`�p " '`— V6 GI?i,The work is scheduled to begin on The work is to be substantially completed by All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to; Registration Divison,Program Coordinator One Ashburton Place Room 1301 Boston,Ma 02108 Tel: (617)727-8598 The homeowners have three day cancellation rights under MGL c 93 s 48; MGL c 140D s 10 or MGL c 255D s 14 as may be applicable. All warranties on the owner's rights under the provisions of 780 CMR R6 and MGL c 142A.Home owner will reveal whether any lien or security interest is on the residence as a consequence of this contract Permit Notice:Any and all necessary construction-related permits that it shall be the obligation of the contractor to obtain such permits as the owner's agent. Electrical Plumbing_ 10 Building i o�j�\� 128 Ryan Road Estimate RIWIN110mill Florence, MA 01062 Date Estimate# 2/18/2014 1368 Name/Address Justin and Rachel Kemp 21 Hooker Ave Northampton,MA 01060 Terms Project On receipt Kemp Bathroom Description Floor-mounted tank type toilet re-install existing I Ea Recessed fixture 5 in.recessed light housing,insulated 2 Ea Modern vanity light fixture single light OWNER SUPPLIED fixture 1 Ea 15 amp, 125 volt electrical receptacles Ground fault circuit interrupter receptacle I Ea Under tile floor heating mat I Ea Wall thermostat for under tile heat Single pole 1 LS Move existing heat radiator centered under window I Ea Project material,labor,subcontract Material,per job Labor,per job Subcontract,per job *Project Subtotal *Project Total Total $10,875.06 We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total.Payments to be made as follows:half of full total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion.All material is guaranteed to be as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance. Acceptance of Proposal will commence with the home owners signature.Prices,specifications and conditions are satisfactory and are hereby accepted upon signature.Rainbow Home Improvement is authorized to do the work as specified and to 'd pecified. Phone# E-mail Signature (413)341-3838 PETER @RAINHOME.NET Page 3 ; -"'� 128 Ryan Road Estimate Florence, MA 01062 '— M J v A Date Estimate# � 2/18/2014 1368 Name/Address Justin and Rachel Kemp 21 Hooker Ave Northampton,MA 01060 Terms Project On receipt Kemp Bathroom Description 2 Ea Removal of sub flooring necessary to rough in new plumbing 8 SF Solid plank paneling,unfinished Cape Cod,beaded,up to 42 in.on walls 90 SF Installation of slate We in thin set mortar,floors 85 SF Installation of slate tile in thin set mortar baseboard trim tile 20 LF Vertical discharge bath fan 100 CFM, 1.0 sone(including ductwork)OWNER SUPPLIED Fan, I Ea Dump fees Mixed loads,per load 2 Ea Building permit fees 2 LS Subfloor sheathing 85 SF Detaching membrane,Ditra,polyethylene laminate.Laid on a level slab 85 SF Detaching membrane,Ditra,polyethylene laminate.Add for adhesive cemented seams 85 SF Remove existing radiator 1 Ea Plumber rough-in for sink water supply/drain pluming 1 Ea Sink and faucet fixture(OWNER SUPPLIED FINISH AND ROUGH ASPECTS OF FIXTURE AND SINK) 1 Ea Plumber rough-in Bathtub and shower drain/supply 1 Ea Bathtub Claw foot tub w/rim mount faucet/ceiling mount shower curtain ring(OWNER SUPPLIED FINISH AND ROUGH ASPECTS OF FIXTURE AND TUB) 1 Ea Total We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total.Payments to be made as follows:half of full total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion.All material is guaranteed to be as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance. Acceptance of Proposal will commence with the home owners signature.Prices,specifications and conditions are s tisfactory and are hereby accepted upon signature.Rainbow Home Improvement is authorized to do the work as specified and to be paid pecified. Phone# E-mail Signature (413)341-3838 PETER@RAINHOME.NET Page 2 g,R•—MODE —� 128 Ryan Road Estimate RaDIUM Florence, MA 01062 .Z ��,c� U ( Date Estimate# �A 2/18/2014 1368 i✓ Name/Address Justin and Rachel Kemp 21 Hooker Ave Northampton,MA 01060 Terms Project On receipt Kemp Bathroom Description Estimate includes work to renovate existing 2nd floor bathroom at 21 Hooker Ave in Northampton.Work to be completed as follows. Demo.Existing flooring to be removed down to existing sub floor.Sub floor will be removed as needed to facilitate new plumbing layout.Existing bathtub and end walls to be removed with new solid wall to he sheet rocked over and corners above wainscoting to be compound feather finished. Existing wall hung sink to be removed.Existing vanity over sink and over toilet storage cabinet to be removed.Existing radiator to be removed an retained for reuse.Estimate includes disposal fee for removed items. Rough-in and Framing.Existing plumbing layout will be modified to relocate vanity/sink to location near existing entry door,and facilitate install of new claw foot tub with rim mounted faucet adjacent to new vanity location.Existing radiator plumbing will be modified to relocate existing radiator centered under existing window.Existing electrical will be reconfigured to allow for vanity light and GFCI outlet near new sinklvanity and near toilet location.New 5 inch recessed can light will be installed over existing toilet location.New 1 sone 100 CFM bath exhaust fan(no light) will be installed in central room location. Access to existing over-stair storage space will be modified to allow for access from bathroom. Fixtures and Finishes.All floors in bathroom will be tiled with slate over electric radiant heat system. Baseboard around bathroom perimeter will be 3 inch slate tile.Bathroom vanity to be custom fabricated by client.New sink will have wall mounted faucet.New claw foot tub will be approximately 30 x 60 and 24 deep.Floor mounted bath/shower fixture will be installed to function with claw foot tub.Ceiling mounted shower ring will be installed above new tub to facilitate shower curtain use. Modified walls will be sanded to a smooth finish.Client will prime and paint all walls as per conversation with client.All materials supplied by client negate trades warrantee all material warrantee registration is the sole responsibility of the home owner.All supplied material must meet all UL and Plumbing ratings to appease building code requirements. Estimate only covers plumbing and electrical work inside of the room to be renovated.Additional costs may be incurred if upgrading existing plumbing or electrical services are necessary.This estimate does not include painting. Removal of ceramic tile flooring 10 SY Removal of stud walls 2 in.x 4 in. 55 SF Remove existing vanity sink 1 Ea Remove existing toilet 1 Ea Remove existing Tub/Shower Total We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total.Payments to be made as follows:half of full total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion.All material is guaranteed to be as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance. Acceptance of Proposal will commence with the home owners signature.Prices,specifications and conditions are satisfactory and are hereby accepted upon signature.Rainbow Home Improvement is authorized to do the work as specified and to be paid as specified. Phone# E-mail Signature — (413)341-3838 PETER @RAINHOME.NET Page 1 CERTIFICATE OF LIABILITY INSURANCE DATE Y1 rTHISCERITIFICATE IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE PRODUCER,AND THE-CERTIFICATE HOLDER. NT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder M lieu of such endorsemen s. PRODUCER CONTACT NAME: KING&CUSHMAN INC PHONE FAX P.O SOX 447 (A/C,No,Ext): (AIC,Noy E-MAIL NORTHAMPTON,MA 01061 ADDRESS: 26LPY INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A. TRAVELERS INDEMNITY COMPANY OF AMERICA RHI CONSTRUCTION INC INSURER B: INSURER C: INSURER D: 128 RYAN RD INSURER E. FLORENCE,MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TO FY THATTHE POLICES OF NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANYREQUIREMENT,TEEM11 OR CONDITION OF MNYCONTRACT OR OTHER DOCUMENT WITH RESPECT TO WENCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN B SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LUTS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS NSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF NSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MNWkyYYY) LIMITS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY AMAGETO RENTED $ CLAW MADE M OCCUR REMISES(Ea ocetxrence) rERSONAL EXP(Any one person) $ &ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ERAI AGGREGATE $ POLICY �PROJECT�LOG DUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SALE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per Person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAR M OCCUR EACH OCCURRENCE $ EXCESS LIAB rl CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ ± $ A WORKER'S coMPErosATlaa AND WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-494OP941-13 1112412013 11/24/2014 LIMITS ANY PROPERITOWPARTNERIEXECUTIVE NIA E.L.EACH ACCIDENT $ 100,000 OFFICERIMGWER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERAS(ONSI LOCAT IONSIVEHICLES IRESTRICT)OWSPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CHRTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION ..... ,........ JUSTIN AND RACHEL KEMP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED 21 HOOKER ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTAy VE NORTHAMPTON,MA 01060 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1986-2010 ACORD CORPORATION. All rights reserved. '`'`°R°® CERTIFICATE OF LIABILITY INSURANCE 7/28/201 YY, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT House OIISe King Sr Cushman Inc. PHONE . (413)584-5610 F'a'x (413)584-9322 176 King Street &M AIL INSURERS AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA:Peerless Insurance INSURED INSURER B, Rhi Construction Inc INSURERC: 128 Ryan Rd INSURER D: INSURER E: Florence MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1472800491 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I TR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A CLAIMS-MADE FO OCCUR CCP8196830 0/3/2013 0/3/2014 MED EXP(Any one person) $ PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIESPER: PRODUCTS-COMPIOPAGG $ 2,000,000 X POLICY PRO LOC. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS SCHEDULED O AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS APer accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORJPARTNERiEXECUTIVE I I E.L.EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEO S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space is required) CERTIFICATE HOLDER CANCELLATION .SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Justin & Rachel Kemp ACCORDANCE WITH THE POLICY PROVISIONS. 21 Hooker St. Northampton, MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2010105) ©1988. AC CORPORA I . r g served. INS025(2o1o05).Ot The ACORD name and Ivan are renkf-rPd marks of ACARn SECTION 8-CONSTRUCTION SERVICES " 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: P'�1J�. (�i LIZ F 6 License Number 1911962- ) -I V) - 201 b Address Expiration Date �)3 3�(-( - 3�� (4 Signature Telephone e. 9.Registered Home lmproveh^ierit Contractor: Not Applicable ❑ 16 ? 5 -1 1� Company Name Registration Number Address /, Expiration Date 12� AAA I�-,Gt �Q�GVI(,� Telephone(41Z MIM-30 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...... ❑ 11. - HoMe.Qwite Ez n 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House Addition ❑ Replacement Windows Alteration(s) Roofing Or Doors 0 Accessory Bldg. ❑ Demolition New Signs [p] DBcks [M Siding[p] Other[p] Brief Description of Propose r�C Work: 4MOVAI Q G 4 J*yl 211,11) Plow �' tti-�'11V►G �00��� IIn44 tAI V tnep) vi n ifs- hit-,es t�tgtn•1-tk� I Alteration of existing bedroom Yes_ No Adding new bedroom Yes o'No Attached Narrative Renovating unfinished bas 'Yes Yes _,_No Plans Attached Roll -Sheet 6a.-If New house'atad or addition to existina°housinn 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. Masscheck 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 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 COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT t I, in y-H &.0 ti 4 d Kemp as Owner of the subject property �j u hereby authorize ( DM M �1 ON / F-rl I " 2/I 111 P VQyeMe*+ to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date O'UTN{- 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. —rD M p<LD Z Print Name, nature 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: _w ..' L:= R:._ . Rear Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location) _,__a. A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued:! IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW �.J YES 0 IF YES: enter Book Page: Document# B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q 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 0 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 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required, Depat#msta#,sfse only ity of Northampton -Status afPermit., ullding Department 1Purb,CuI1Dfiveway Permit — 2014 212 Main Street £ewrl�SeptiirAvailabtdy Room 100 WateiM 4,AvaROilif�r _ —•� No hampton, MA 01060 Two:Sets of Sw' d i ' Plans Electric, Plumbing&GW Ins ect'o Northampton, itiz,p � 587-1240 Fax 413-587-1272 F?fot%Site Plans Cfther Spec"+fyr APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Prooertv Address: This section to be completed by office 2 1jV p 1<eV Map Lot Unit IY O V+k G M P +V N I Ml� Zone' Overlay District 0 P (go EIm St:District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: '1 In 6�LI*N 5i IF-.A-G4fE1� V�t°iM'P 21 �-I-v v k e fit-• 1V v✓'I'1�+A,vvv�p-bN Name(Print) Current Mailing Address: r'69 �> 307 q410 Telephone Signature 2.2 Authorized Anent: 111 A 1 V bv1& A0 M (M�l�vcM eiv1-F- 1 Z 2�t aM Z r� . �I aGe , o LIJ z Name(P nt) Current Mailing Address: �L /31 3291 — 33fj Signature Teleph ne SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building -7, -7 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of U Construction from 6 3. Plumbing O Building Permit Fee i 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-2015-0137 APPLICANT/CONTACT PERSON THOMAS MALONE ADDRESS/PHONE 128 RYAN RD FLORENCE (413)885-9038 PROPERTY LOCATION 21 HOOKER AVE MAP 24D PARCEL 124 001 ZONE URC(100) THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out i Fee Paid Typeof Construction: RENOVATE 2ND FLR BATH New Construction Non Structural interior renovations Addition to Existin Accesso Structure Building Plans Included: Owner/Statement or License 055236 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: __t/A` pproved 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 Storm Water Management m 'ti elay Sign ure 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. 21 HOOKER AVE BP-2015-0137 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24D- 124 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-2015-0137 Project# JS-2015-000243 Est. Cost: $11095.00 Fee: $66.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THOMAS MALONE 055236 Lot Size(sq. ft.): 5096.52 Owner: KEMP JUSTIN Zoning. URC(100) Applicant. THOMAS MALONE AT. 21 HOOKER AVE A_ pplicant Address: Phone: Insurance: 128 RYAN RD (413) 885-9038 WC FLORENCEMA01062 ISSUED ON.81412014 0:00:00 TO PERFORM THE FOLLOWING WORK.•RENOVATE 2ND F L R BATH 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 8/4/2014 0:00:00 $66.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner