17A-169 6u5TOM L-k SEK- �f-A -
,�_IRY 60" �JiOE x 7 ' Low& x 92" Neeµ
io'/z 35" 5«L 3'/
ICI w CDo Ij
LCIN
ol
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59'
(4 1110) orl
C/22A
it
PROPOSAL
PROPOSAL NO. II
SHEET N0.
I
i
DATE
6UA le E, t�t_A G/0,3 Z
PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT:
NAME ADDRESS
ILFtE2� E C")7 12 S ti+
ADDRESS
/ /-/OCuES DATE OF PLANS rlOPHONE NO.. ARCHITECT
i
We hereby propose to furnish the materials and perform the labor necessary for the completion of
/SPOSE —
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All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifi-
cations submitted for above work and completed in a substantial workmanlike manner for the sum of ,cfr,/-17
U v� '60 4 Dollars ($ `t�`�S7• U O )
with payments to be made as follows. - 7 C, -=,7,-4 e_T 26,41
_ c pC tai C-7&0
Respectfully submitted
Any alteration or deviation from above specifications involving extra costs
will be executed only upon written order, and will become an extra charge Per ,o,� z N GL 5&/Z y�
over and above the estimate. All agreements contingent upon strikes, ac-
cidents,or delays beyond our control. &, p� PE l t//-(
Note—This proposal may be withdrawn
by us if not accepted within days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work
as specified. Payments will be made as outlined above.
I
Signature djfl�&Vjo
Date IVA- - 53 y Signature
MADE IN s A 3818-50 PROPOSAL
MADE IN USA
�'St1AMP�.
O oy
Gz# of Xarthainptan Z
c
1�855ACh1i5[tt5 -
m DEPARTMENT OF BUILDING INSPECTIONS /=
INSPECTOR 212 Main Street • Municipal Building
Northampton, MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction sups:-, sor. 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
U'Itil of �,Na -fliampfml _ �-
� 6 rz�cssrtcllnsrtts
m DLPARI'k,ENT OF EUIL)MG INSPECTIONS
212 Main Street ' Municipal Builcling
Northampton, Klass. 01060
NVORICER'S COINITENSATION I- SURANCT. A MAVIT
1,
with a principal place of busMesslrCsIdcnce
(�tlonc - -
r
C10 her6by Cer-ujyj ImAt-1- ,h1 ,xn1i1S jInc pc it?.1t1CS of pf:r�lU�', i11iIl:
SII an employer pro"'IdIng the 1011ov"HIL v"ol"r_CI'5 c011npells?n01) GOV'Cr2 C nor Ind'
elllployc(-,s worlang on this job:
(LnstranG CQ>a ul) r c c.N,ualEr_r) ----- (E> .ir ten Datc)
! j I Lm a sole propne.er gtn°rai c-on=c`c; ,on e--O OCT- (Cl cle Oct) Pod 't:�rc hired
the contTac oTs listed beiov -s i0 i?0 tl1 10110 .ng wOrke,jS G'Jr?D°I1 u0i1
(Flame of ConLmct)r) (Tnss�,rancc Colr�-. Pc!ic; ?1wnMr) L _ :t.:.c-Qatcj
(Name of CODs'c or) -- ilzs� ance Con na �(Pe!ic NIr.Itrr) CI=?:v'`aiin Date)
(l"tame of Contractor) Late)
- (Name of COnt?)CIGt) --- (TUSumI1C2 COII) ;)i 1'OliCJ NflIII1✓ S) Daie)
(r.[Lidt a.d�!,;;cYal t_:cd:: -r-sir::n:�-:.}'.>'.�...:•r:fa::c<:f--._.... � _'ii ca .-�:r'_c:r')
(�) I illn c D1C proplictJi <ii:;l the-,,:, nu onc,
( 1 3111 2 home ov,f,lCr all
NO IT',:pic�sc In Aw:urc lti:::'.l�':1C 1K!i�:JttI Y_:1 tt�rJ C-")�1 h' >:—'^::14(:J:^1:::!:-13I1CC�Cti::=1'.:C-:CCI or:-j:1lr e�_
not Lmcc th_u ihroo uni',s in tt Lit LFK t;r.ti ..tz r rr:<;o x a;'` 4: ::>a •1t cr r1 Lhcc o c t rr-{(crsallY o:�;:;.::: :c 1
=?ployc3 ur�tfx tvcrf;f1 c —;Heim, r(GL!5�V1!(Sl,a,:, ._a;ic: by e hurt onnct`or r bccu cc
lesil a¢tus of=omploy under tb-o Wcgicc1 r CorL a_anon .cL
I utrdc.-zl.and th+:a co?y of th:s date:- --c•..y bo foru•nrc!e:7 to d-C-Ji L—I Lffi of[:::ura.'r-a for ilx
covcm,c vmflciion and tenet U-urc to sz c mgt nM ux--`r:c"icn 25A of?.1GL 152 can Ic_d to trrc impcsitioa
e,omisting of a ftrle of up to S 1-500.0vJ tn ,or ir.: ri:•^' :•1 of::?to cr, y erd e vil p-rulticz in tt fc,nn of n S!c `t'ni.Ch and
Lr--OISIDIN a diy a.-g.ina inc.
_ cc.rckT%uu:ra:sJ u,c oily i
ilIIltY-=f __II
---------__--
r ., ::
ri• . F
. 5[[;naturc of i.ic�:1�;c�JPr.rm.ac•. ___
Suan,-,NB CONSTRUCTION SERVICES
8 1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : GIZ14 PL-2/Z 2/ 3
License Number
43 �U.vG v/tw �A V�� G�,E112, ,vr/J. 010ka
Address � Expiration Date
/—4//3—9G7—5)00S
Signature Telephone
Reg s ere � rne�. MfA-.. anent on#ractor m Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
SECTION i01NORKERS' COMPENSATION a NSURANCEAFFIDAVIT(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...... ❑
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,attar ed or detached structures accessory to such use and/or farm
structures. A person who constructs more than one home i 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 frotn 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 _
SELTiO, DES. f3 P .OT OF�RROP6SED�WORK=ch�eck�afl�a licable
gTl
New House ❑ Addition ❑ Replacement Windows Alteration(s) ux Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition[D New Signs [ ] Decks [ ] Siding[ ] Other [ )
Brief Description of Proposed Work: I.V S i%p6 O F PA-tlT/Z V A&I A ,,4 �„�A V- AJ y L I'
.8LS0- 2EP.411e14A'- o,� Gh03/ti 4- /.v SHALL C11
Alteration of existing bedroom Yes ✓No Adding new bedroom Yes ✓ No
Attached Narrative D Renovating unfinished basement Yes No
Plans Attached Roll D- Sheet D
6a: T'e�h��u' se�'� o a�ii.ition��to eXisting��toLSing��omp:�:e: e��lfie�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. Mascheck 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 Nc
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
SECtNOW[ ERt�I TORIZATION 6:13E&
ONLPL'ETED WHEN
OWIJirftS`AOENTOR 0 TRACTOR'APPLIES FOR BUIL'D1NG PERMf`f
sA
as Owner of the subject property
hereby authorize to ac; or
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
l 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.
Print Name
Signature of Owner/Agent 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,ever been issued for/on the site?
NO DONT KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT 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:
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060 _
phone 413-587-1240 Fax 413-567-1272
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMA`nON-
* � ,� '7�issecho�tp be conrplete+�Iby office
1.1 Property Address: n
//06�E 5 S T Maw
k. 1 vii i ✓i, i X!verlalr Distract
F�c�.2E..cJGE', ��• �/d� Z zone � �?N
�m#5 .fl�stnct C8 i3isitrict
SECTION 2 PROP ERTY-OWNERSHIP/AUTHORIZEfl AGENT'
2.1 Owner of Record:
/V9/e-14 E4-1,L- 5e/Z�/'s /� - /,ldwe-.s s7 -
Name(Print) Current Mailing Address:
FAa4t E'4-je'e. 4io�
Telephone
Signature /— 4//3 — 'O
2.2 Authorized Agent:
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 9S 2•vo °(a) Building Permit Fee
2. Electrical (b)Estimated Total Cost of
/00c) . O p Construction from-.6
3. Plumbing ZC50 a O Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total = (1+2+ 3 +4+ 5) g9 S 7 d 0 Check Number`
This Section For Official Use OnT`
Building Permit Number: �� ?G Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2004-0768
APPLICANT/CONTACT PERSON CRAIG PERRAULT
ADDRESS/PHONE 13 LONGVIEW AVE WARE (413)967-0005
PROPERTY LOCATION 16 HOWES ST
MAP 17A PARCEL 169 001 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: CONVERT PANTRY TO 1/2 BATH&REPAIR&ENCLOS PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 075213
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INE V,RMATION PRESENTED:
R 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 Str Commission
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-2004-0768
16 HOWES ST
16 O COMMONWEALTH OF MASSACHUSETTS
MaBlock: 17A- 169 CITY OF NORTHAMPTON
Lot: -001
Permit Building
Cate
or : Non structural interior renovations BUILDING PERMIT
Permit# BP-2004-0768
Protect# IS-2004-1131
Est. Cost: $8957.00
Fee:Cost: $ PERMISSION IS HEREBY GRANTED TO:
Cons$. Class: Contractor: License:
Use Group: CRAIG PERRAULT 075213
Lot Size(sa ft.): 8537.76 Owner: SERRA MICHELLE
Zoning URB Applicant: CRAIG PERRAULT
A T. 16 i-i0' 'ES ST
Phone: Insurance:
Applicant Address:
13 LONGVIEW AVE (413) 967-0005
WAREMA01082 ISSUED ON.1/30/04 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONVERT PANTRY TO 1/2 BATH & REPAIR &
ENCLOS PORCH
POST THIS CARD SO IT IS VISIBLE FROM THE STREET Building Inspector
Inspector of Plumbing Inspector of Wiring D.P.W. g p
Underground: Service: Meter:
o� // I // Footings:
Rough: 'J �ough oG/.`LC�LD y - House# Foundation:
g _�2/ O� Driveway Final:
Final:s ^� 7�L� Final: 3 /!(l0 v r i`�
Y Rough Frame'/,�� 2 p t9 Z
Gas:
Fire Department Fireplace/Chimney:
Rough:
Oil: Insulation:
Final:
Smoke: Final: O/C 3-a 4! 0cy%Z,
THIS PERMIT MAY BE REVOKED BY THE CIT OF NORTHAMPTON UPON VIOLATIO F
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Si nature:
Feel e: Receipt No: Date Paid: Check No: Amount:
Building
1/30/04 0:00:00 MO $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo