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17C-050 (2) y to�. x 4 H-1 ry _ ! v S7v S �c"t ST►rv. co u.✓rte 't3/ f°� ACORO.. CERTIFICATE OF LIABILITY INSURANCE CSR SF DATE(MMIDDIYYYY) CONSR50 01/23/03 FR :JUCE THIS CERTIFICATE IS ISSUET.1 AS A MATTER OF INFORMATIO O LY A%D CONFERS NO RI.HTS UPON THE CERTIFICATE ARM Insurance Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 73 Market Street PO Box 4580 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Lrlring£ield NIL 01101-4580 1 Phone: 413-781-0416 Fax:413-735-8525 INSURERS AFFORDING COVERAGE ! NAIC# ;r:SJRED F. 1" .kr.. Central Insurance Companies I raUE E Safes Insurance Co 39454 Ink Black Inc. dba Cat E F3nd•.Znan Service sLPEEC — ---- — _--- - 137 Da. c.E. Rcaa-Stc. Cl uauPERD Northampton NIA 01060 --- -F -- — COVERAGES r HE POLICIES O�INSURANCE LISTED BELOA HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING NY REOUIRENIIENT TERM OR COND'TION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR AY PERTAI'I Tr. C-URANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES I :GRE F L''A'TS SnO.�':V rAtYHAVE LEE NF ED'JCEJ Bl'PAiJ CLAI.45 :5 L_- __ --. --._-------- -_---_ _._._---------------PO'1CY FFE�TIVE��7CYYY-LXPIRATION----- -- TF Ir.�RD TYPE OF INS RANCE POLICY NUMoER DATE(1dFJIOD,'YY) DATE(Mdd1DDIYY) - LIMITS Ei;CF Y E4--IOCCUIPENCE £ 1000000 A _X Cc_ RCiA_G ':EP _L'AS 'TY . BOF7930266 01/01/03 01/01/04 PRE'.ISES(Ea occorence) £ 100000 CLK'rfS V11 X OCCUR �M_D LXP(Any one Person) !£ 5000 PERSONAL a ADV INJURY S 1000000 j GENERAL AGGREGATE s2000000 GEtN'L AGGREGATE LMMTAPPLIES PER PRODUCTS-COMP/OPAGG j$2000000 X PC_bL;Y jcC: I L 0 AU70MOB'LE LIABILITY j I COf171NED SINGLE LIMIT B A':Y AUTO 1508342 07/29/02 07/29/03 (Ea =c'aenr) !S500000 A_L OVa ED AUTOS 60 -Y INJURY £ I }: ��nE;uLE. A',^�: j leer aersonj 1 i X I,RE AL OS E -Y INJURY !£ -- �. e- }s accjer.'1 r� r T� r-D AUTO: � � ; PR_��ERT'DAVA.GE £ (=e'eccoe-tj --- GARAGE LIABILITY I A'�-O ONLY-EA ACCIDENT S EA AC £----- — C'HEE THAN S— ---- -- _---- A_'TG ONLY AGG £ - EXCESSIUYBRE.LA LIABILITY E;7 OCCUPPENCE £ G-TE S S ' RETENTION £ S I WORKERS COMPENSATION AND I X TORY OMITS JU ER Ei.1PLCYER.:.'L;AC;LIT', A _ _ _ WC793026703 01/01/03 ! 01/01/04 EL EACH ACCIDENT £ 10_0000 A':i Pn`-PR!ETC�;PA.RTf-;EP'tXcCUTidE OFFrCER,VEM5EREXC.UDED% EL DISEASE-EA EMPLOYEE$ 100000 Is yc-. aes u - ---- ------- -------------- s -LSE.POLICYL,:'T S 500000 DESCRIPTION OF OPEPATIONS I LOC ATICNS I VEHICLES;EXC.U4IONS ADDEE EY ENDORSEMENT/SPECIAL PROVISIONS Carpentry-Interior CERTIFICATE HOLDER: _ _ CANCELLATION SEi VUAG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXP. A',:)N DATE THEREOF,THE ISSUING INSURER V,,-L ENDEAVOR TO MAIL 10 DAYS WR'-'E'. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF AN' KIND UPON THE INSURER,11 AGEN. -S OR REPRESENTATIVES A.; nOM=r EPRESENT<.'!VE _ IR*.' Insurance Aaencv . Inc. ACORD 25 (20:)1;05) C ACORD CORPORAliON 1 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction o�Supervisor: ,, I� Not Applicable El Name of License Holder: !� L�TKl�l� /7' 't•��/� d� Cj 0"23 4t License Number Address Expiration Date ignature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number 13Id b JM o AJ 120,0" 0aT)h9"4 P?D i J, i-W 4 Z 3/0 9 Address Expiration 15ate Telephone 4/3-s�4— XO 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 Owner 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 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 , SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [C] Siding [O] Other(�] Brief Description of Proposed Work: FdS e9m E7,;l -0 �Z Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house 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. 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 I, jt/ �, �_f as Owner of the subject property hereby authorize JZ1 C,1h n,> A-01-5772Z0114 /�n/�m /-f13�C.���f`yi1/ S 6V�-VY z.67 to act on m behalf, in all matters relative to work oriz by this building permit application. O ature of Owner D to as Owne'rAuthonzed Agent h6reby declare that the statements and information on the foregoing application are true and accurate,to the best of my now edge and belief. Signed under the pains and penalties of perjury. R 1;T12�OA1 Print Name 0(o 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: 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 O DON'T KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW Q YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O 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 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O 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 Q NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 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 :/✓CC >TP FCR-(2-"Y }.l(�(, Map Lot Unit FLc�(LC-�Z•E M /9' l ©/O 6 2. Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: eft/ 3,s',5� Name P' Current Maili Address, Telephone ature 2.2 Authorized Agent: /!?-t p , � -ziSSA44Ple'ory 4V E. toff Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building cJfS j (a)Building Permit Fee 2. Electrical ,!L' (b)Estimated Total Cost of �Y 00 Construction from 6 3. Plumbing 7 r?-° Building Permit Fee 4. Mechanical(HVAC) AJ 5. Fire Protection 6. Total =(1 +2+3+4+5) 36,5-, ls� Check Number 3'q O This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2006-0916 APPLICANT/CONTACT PERSON INHOME HANDYMAN SERVICES ADDRESS/PHONE 137A DAMON RD NORTHAMPTON (413)584-7700 PROPERTY LOCATION 35 STRAWBERRY HILL MAP 17C PARCEL 050 001 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out At Fee Paid Typeof Construction: REMODEL LAUNDRY ROOM&BATHROOM New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included: Owner/Statement or License 073454 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF94MATION 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 S t Commission / X00 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-2006-0916 6 IN-GIs#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0916 Project# JS-2006-1397 Est. Cost: $13366.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: INHOME HANDYMAN SERVICES 073454 Lot Size(sq.ft.): 19645.56 Owner: HINKS STEVEN L&MARY LEBEAU Zoning.URA Applicant: INHOME HANDYMAN SERVICES AT. 35 STRAWBERRY HILL Applicant Address: Phone: Insurance: 137A DAMON RD (413) 584-7700 Workers Compensation NORTHAM PTONMA01 060 ISSUED ON:311712006 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMODEL LAUNDRY ROOM & BATHROOM 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 OccuDancy Sian ture: FeeType• Date Paid: Amount: Building 3/17/2006 0:00:00 $50.001322 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo C,4 wl 0�/ o 86- Gas 6� �/od oo-a°es 35 STRAWBERRY HILL BP-2006-0916 CIS#: COMMONWEALTH OF MASSACHUSETTS Ma :Block: 17C-050 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0916 Project# JS-2006-1397 Est. Cost: $13366.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: INHOME HANDYMAN SERVICES 073454 Lot Size(sq. ft.): 19645.56 Owner: HINKS STEVEN L&MARY LEBEAU Zonrig:.URA Applicant: INHOME HANDYMAN SERVICES 4T. ?, STIRA\^/n,P ti 11 i Applicant Address_ Phone: insurance: 137A DAMON RD _ _ (413) 584-7700 Workers Compensation NORTHAMPTONMA01060 ISSUED 0N:311712006 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMODEL LAUNDRY ROOM & BATHROOM 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: /g��6� House# Foundation: fO V 6�t) Driveway Final: Final- -5 o fX4 Final, / / Rough Frame:t Ky '46�v Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: AL Final: Smoke: Final: OK to-1q.ag THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATILJN OF ANY OF ITS RULES AND REGULATIO Certificate of Occupanc Signature: FeeTyue: Date Paid: Amount: Building 3/17/2006 0:00:00 $50.001322 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo