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17A-298 (2) � � �i .�, _ I �� �e .y rt y, 4 �„t�� 1 7 ' ��' �' y��t _ d� k. My�?i fre. �i �� �,� � .. �, ., �� � - \ � � ., _ _ �. . ?s '�: <- � `,^ ,� .� 36 r �-- " on Q d+i -4.0 �+a�h -Iw, h��Jr\fi ;r, K, r he►� �nnv„. rJ�ac.K tJr `C'J-�C- e-)c�eribr G !' Gk ►'+(� w;nc ow 5Xd' sFYCCkroc,�. h„„1k �v i�e�c�=5 w��h Cad � `J e / you+ hoe7KS C'--I ove base bc,,A h\,—c C v�d��- —De,n ch — — -- - — J { . t i0 QZecon��gUrc aline\v �10 o� ®�• a C.Montgomery ! " Jess ;: JCM Home Improvement 46 Oak Street Florence,MA 01062 T; tab" e� f - V D O v r� Ar ` Jesse C.IN Iontgomery "JCM Horr 8 Improvement 46 Oak St eet Florence, 1AA 01062 G �s= PROPOSAL iii T T i ,�Ir a°I �uW r"HI vw i��14�-�I IC,dui ry WI I 'Ffv.tll r,! yl W"x i I U'AIE I PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT r j.-,. ,Vis•,I ry -� N'' �I�,I xn,lr.In4.ii�'+. 41r°�11ja ?I��11I�rR'k � i"W':.IIN.�InI a�I" �hl:�.u�r�di _ s�w , Ik�II6-.w.�:S:'r�I.N�u 9C'��,k'��Ik�la i I r_.•r. ���.. ,„ f fir �r ON FNIN I rr.l i - Fh rhtll�4. II I- Is, "u PHONE NO ARCHITECT f i 7'{IN�"Eh. 9k y IV Iy , x T , - INN r I '`4 -I r '- 4✓lu w•rl:,u 1iV_1141vf�.lpWI ..:x"•G' �..":"� l�r d =a�.� ur+�';t I.,, . FFMI .rllr III 1 , , 1 r a ,I i:ur v x.l ,� ?, ,V r P = p �p ;II i:r rgall y6 I _:.. SGr„{ l�.::III G ; VI_�.i„ I it ary„,I.. r' r r.�, ;:f:` I r_ - �d rl lVa'�IV��rydl�r L_lly Vii rl. . u „i`.�, , e, '?O�Wl.}III�I11g��ti�pp I�I �'�'„"'. 4a W a V�II.+ul�V 1 ik �V ,1 x' r v 1;H�... 17 '°.I W �r 51 i4�"ryl I III ` '`lil � •sl P.r�r�^.��I= � f r r r aVP '. r rl dxv III Ilvl VIII VI[F IV 11 II h,, INI NI.,.I JVI WIVI?A is .n ° .f "W` I yV� u1,I LTV v I' ,I II >I ^'' u ryi II wti lur r�l'.. I. , i lr NW r 1 "C ,a, 4 Al I IF II fin, u r WI`-`IVI j i ilf II °'p r r r k 1 r I , I 1 r 4� WJ I.,'.,.1 u I ` �Lnr•- I I r i FIR IF All.'material is t i to as fied, and the aboae work to be performed in ac cordance with the dill d spol cations su ed�`above wo[f�and completed in a substantial workmanlike manner for the surh of A ', >,!=e,I Dollars _ IC1 } with.payments to be made as follows. �.� � � ,; ��' �� �' � :4 �`�'" )v rr e cry Respectfully submitted X'11 Any alteration or deviation from above specifications involving extra costs 4 , Will be executed only upon written order, and will become an extra charge Per + , [ over and above the estimate. All ag nts contingent upon strikes, ac- 1 cidents,or del wed our cx�ntrol. n�. ,C' ' _ Note—This proposal may be withdrawn 9r l by us if not accepted within —2—days. I - f -.„x _l.r'f lu..:r i v s4 I i .�,I�a I•�m,H,�, Ira I-., -� I,I•.,I r.lu.,.I lu II �.rnllVl W V Ih ,:,�-1WI d rVV _ - d y �r. w d Jw •'. :i'k. I ,f�,,,,�I� m r'--, I I"°1I6I1 ;• ::- ;I „k ..JI I If Il,,:.�r I ,� ,a"'I_• ,...I P„ICI—"�_. ,. :..J WL_ ,_.l��IV a {_ � I IV�uF •4r Ir�,r � I r sM _ _ y� ant3 ate'herppy a � ''"�44p r � L1r IF Signature a i Date r Signature L ° li GAEINUSA 381850 PROPOSAL MADE IN USA ' i 0 �� y L U i v'.:liL k ._ �Ai _ PTO ,�O s � 6 �assafflttsrtttr' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT Ij c ) with a principal place of business/residence at: �o ©e V, 5, 14('EhC C 01 Q(,7�1(Phone4) j ; (sheeUci ty/statr/a p) 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: (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/Poky Number) (Expiration Date) r. (Name of Contractor) (Insurance Comparry/Poky Number) (Expiration Date) (Name of Contractor) (Insurance anipan}/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy plumber) (Expiration Date) (attach additioml I cct ifnoo=Lixy to inr}' iafocrosrion pertaining to ell ooa4adoc3> M/1 am a sole proprietor and have no one worldng for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware thai whilo homcot5vers who czaploy periow to do nxii trap lion or repair work on a dwctling of not ntofo than three units in which the homoowner resides or oa the grounds appurtenant thereto ntc oo(garcnlly coandacd to be employen undo the worker's compensation Act(GL152,sa 1(5)),application by a homeowner for a Game a permed may cvidcnoc the lepI ctatun of an employer under the Workcj't Compensation Act. I uadesst=d th:t a oopy of this ztat�may be forwarded to the Dcpam ..i of Dial Aocidw&Oflioo of In'- oo for the covmge vmfieaiioo and that fniltze to secure coverage under sccuon 25A of MOL 152 can lad to the imposition of aimiml penalties oomistiag of a fine of UP to S 1,500.00 and/of of tip to om year and civil pcmtlia in the form of a Stop W orb Ocdc and a firm of 5100.00 a day against mn Foc d ttso cady permit Number hiap-4 Lot# Si tccnsee/permittee e CON;STRUCTION SEtVICES 8 1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : P55� +- l���-f � �� 072 y 1 0 License Number (D c�rcex e 1:)-Lc 1 105 7ddes Expirati n Datfi Signa r Telephone e:.:m ;. vemen .° Not Applicable ❑ .:�,. �e5�e McsR-� cm��4t L ELI :7 V Company Name Registration Number t-1 G, CQ I< 6�. 10 h el /0—? Add((ress /�/ rr�� //aa ��pp prt Expirat'on D e A. 10T�'1C� + � � ��'?.0 Telephone -// `,U.S' ��(J �( .twcrl,/I oa, / SECTION 10- ORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G..L. c. 152, § 25C(6)) W Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affil_ will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... ❑ No...... ❑ MOW n The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)famihi 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 �EC7tON D SCR P 10 RROPOSED ►VORacrt�ckal a Ica�bte New House ❑ Addition ❑ Replacement Windows Alteration(s)� Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: vx L� yv c�,Ye M'J cknd>0m e" y Alteration of existing bedroom Yes No Adding new bedroom Yes v No Attached Narrative❑ Renovating unfinished basement Yes v No Plans Attached Roll ❑• Sheet❑ 6a If.Ne _ tto�se "d' ddi#ion # eXi iffit,�.1JMJ ...com° l'e the fo�Ilawin a: 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? e S d. Proposed Square footage of new construction. 10 A• Dimensions mu4io El e. Number of stories? pp���6t ii f. Method of heating? r - wcNeV_ 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 v 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 an Zoning regulations? Yes No .. p I. Septic Tank City Sewer Private well City water Supply V SECTION 7a OWNER AUTHORIZATION ,..TO BE:COMPLETED WHEN OWNERSAGENT3ORCONTR OR�AppLIES-'FOR;B(11LD1NO PERMIT l 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 e MT d",ee- as Owner/Authorized Agent hereby declare that the stateme'htlkt and in mation 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 Signature Owner 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 ver 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 v DON'T KNOW 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: orthampton I Department Lj ain Street FEB 1 _ i i! om 100 No am ton, MA 01060 a l— ----pt n 13' 7-1 40 Fax 413-587-1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 3.-SITE INFORMATION This section to be�compl�ted bye ffice�� 1.1 Property Address: r Map Lot �eC�v�E (A. o l (p Zone Ouer�lay D�stra r �d �3k Elm St. District' CB District SECTION'2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: 0oref.e /N Name(P int) Current Mailing Address: 913 - 58,6--- 4 fe)- Signa re Telephone SE lON 3 - STIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars) to be Official Use Only completed by ermit applicant 1. Building ' #&?o (a) Building Permit Fee — 4 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing i ov 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: SI Date Issued: "- Signature: • Building,Cgmmissiooer/Inspectojr�,of BuiJdings Date ILLCREST DR BP-2002-0714 GIS#: COMMONWEALTH OF MASSACHUSETTS Map-Block: 17A-298 CITY OF NORTHAMPTON Lot: -001 Permit: Buildin£� Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2002-0714 Project# JS-2002-1167 Est. Cost: $6000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JESSE MONTGOMERY 077410 Lot Size(sq. ft.): 20342.52 Owner: BACH NEIL D&JOAN E zoning:UxA Applicant: Jesse Montgomery_ AT: 148 HILLCREST DR Applicant Address: Phone: Insurance: 46 Oak Street 413 585-8482 FLORENCEMA01062 ISSUED ON:2119102 0:00:00 TO PERFORM THE FOLLOWING WORK.-ENCLOSE PORCH TO MUDROOM 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 2/19/02 0:00:00 1223 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo ow 148 HILLCREST DR BP-2002-0714 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-298 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2002-0714 Project# JS-2002-1167 Est. Cost: $6000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JESSE MONTGOMERY 077410 Lot Size(sg. ft.): 20342.52 Owner: BACH NEIL D &JOAN E Zoning:URA Applicant: Jesse Montgomery AT. 148 H I LLCREST DR Applicant Address: Phone: Insurance: 46 Oak Street (413) 585-8482 () FLORENCEMA01062 ISSUED ON:2119102 0:00:00 TO PERFORM THE FOLLOWING WORK.-ENCLOSE PORCH TO MUDROOM POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: 1�,�/ Footings: Rough. Rough:a//���JZ%�I House# Foundation: Driveway Final: / %G'•4 Final: Final: �Z� �;-j. �1 Rough Frame: Q Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: v Final: Smoke: .FmtgL THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLAT N OF ANY OF ITS RULES AND REGULATIONS. SS•� Certificate of Occupancy tore: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 2/19/02 0:00:00 1223 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo