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17A-254 ,, •m .. -� e .. � _- ,_ k> --— — PR �. Jesse C. Montgomery PROPOSAL NO. JCM Home Improvement 46 Oak Street SHEET NO. Florence,MA 01062 DATE I 1710:2 PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: NAME ADDRESS 1 �C4 ADDRESS DATE OF PLANS PHONE NO. r ARCHITECT We hereby propose to furbish the materials and perform the labor necessary for the completion of v Li 4 u '. f ' . Par" Prz;r 1(. -< i,rc, C{ G I sle / f v n't l Y'►' cx r� In rep t't' ,etc t' ��cn-f G 1-101) 1. .Qc 3 '7 "c e C r. r tt c All material is guaranteed to be as specified, and the above work to be performed in accordance w h e drawin nd s ecifi- cations submitted f r above work anq completed in a substantial workmanlike manner for the sum of ' '" '�o Q r? V it1 , ,ruck &CL l��-f' j -----1..... ___._ ..,. Dollars ($ � C, } with payments to be made as follows. Lam'' S� -5 `` - ° kit � f espectfully 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 over and above the9 esti te. All a eenjents contingent upon strikes, ac cidents,qr delays be and `r control. C i '^ P `+ r' ;, �' �. �-- I Note—This proposal may be withdrawn by us if not accepted within days. f µ CCEPTMCE OF PROPOSAL r The above prices, specifications and conditions ale satisfactory Arid are hereby+ accepted. You ar o ' ed to do the work as specified. Payments will be made as outlined above. Sighatur Date / Signatu NC 3818-50 PROPOSAL MADE IN USA it 0 Grxt�l x1f wart 1jalllpfoil 8 aB �asaxcE[asctta DEPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORICER'S COMTENSATION INSURANCE AAFFMAVTT � Jesse wi, c�e (li permittee) with a principal place of business/residence at: r (� Oo , k �7 �C�l�e✓)C e MA. 0)% (phone#} ( 3'' `'�` yt(J (stmet/city/staielzzp) 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 worming 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) (Inure c Company/Policy Numkr) (Expiration Date) (Name of Contractor) (Laurance Compam/Poticy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Numb--r) (Expiration Date) (a[Iath additicaal ihcc(if ntocniry to include Mfontution P,:.rt ring to all ooaf r3) i ( Ka-M a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that whilo homeo"ncra who employ pc za u to dD mat atcaau cc rust' or rcpnir woe oo a d�vdl ng of not prom than LLrco units in wfrich the honbowncr rtsidcs or oa the uouzxb appurtenant thuctD arc rxX gcrxtally oocoidcrcd to be eatployrrs under the woricrr's compeasatiea Act(GL152,n 1(5)),application by it homco-ner for a UccWC ex permit may cvidece the legil ctaau of an employor uoder the Woricola Compensation Act I und�d thst a copy of this ctatemmt mAy bo forv+nrded to the Dcpart.,d of Accidntf Offioo of Ir:n�for thf cove-agc vaifict oc and that failure to sown covcmp under s4xt on 25A of MGL 152 c n lmd to tha imposition of cri ninal penalties comisting of 1 fine of up to S 1,500.00 and/or irnpri3otrma of up to one}stir and civil paultia in d1c foan of a Stop Wor1C Ordcz and a fim of S 100.00 1 day against rnr- 7 ._... Fp(:-.:rrnit tttxrd�l u*c mly -- / Number I,ot 11 - Sig to i crinittcc D tie 1 , � J f 3 SECTION 8x-CbNS RUCTION SERVICES 8.1 Licensed Construction Supervisor: / Not Applicable Name of License Holder: V'•, ®7< Y` / License Number 3 Addres ExpiratioK Datuf Sign Telephone Not Applicable ❑ Company Name Registration Number tq Oak 5} ��ar� � - y ,Os Address p h Expira ion D e Telephone ��U VFL 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...... ❑ ITS mori'u, q- 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 SEf TiANiDSCRftIONOIF PROPOSEDIWORK cti�eckallLa` licablen D a .1 Wllar' New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks 1[ J Siding[ ] LOther [ ] Brief Description of Proposed Work: .4ls « �GCe�'►err' 4 N �,t,c,-.— arld loU h4 t( AJC w Vt;b_74_ Alteration of existing bedroom Yes 14 o Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0- Sheet 0 •• i" a"d o "�ddJti ff41 )(i"s'tin�h uo s'ing c e e th tlo�" ui : 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 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 MIT APPLIES FOR::BUILDING PER as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date �e e �A('/Y✓l as Owner/Authorized Agent s hereby declare that the statemen nd info ation on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. now CIY7 e Print Name Date Signatur wne t 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 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 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: _ __— r s . t City of Northampton Department 2 ain Street m 100 JUN 2 0 2J rthtl ton, MA 01060 phone 5 40 Fax 413-587-1272 it APPL2AIICI '1dCY0 NPPfRUC LTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION:1 - SITE INFORMATION ^5 z" t Il�s 5ecti 4 aar-al 1.1 Property Address: p(`�✓1� e �� �,. Zone k h - Ov rla lstric Elm Si.'District GCB Distr ct SECTION'2_- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record::" CQ CX- SST Name(Print) Curr nt � at M ng Add s , Signature Telephone 2.2 Authorized Agent: e S.5 •-n oti tf(p Oct k f Name(P int) Current Mailing Address: �` Sig ur '�c l 3� L �G. Telephone SECTION.3 TIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars) to be Official Use Only completed b y ermit applicant 1. Building f D0 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of 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 ' BP-2002.1141 Wo N 01 0GIS#: COMMONWEALTH OF MASSACHUSETTS fiiaiwak* CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2002.1141 Project# JS-2002-1837 Est.Cost: $3100.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Grogg.— JESSE MONTGOMERY 134274 Lot Size(sg. ft.): 12806.64 Owner: GOYDA MICHAEL F Zoning.URB Applicant: Jesse Montgomery AT. 135 OAK ST Applicant Address: Phone: Insurance: 46 Oak Street (413) 585-8482 0 FLORENCEMA01062 ISSUED ON.6121102 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF & INSTALL GARAGE REPLACEMENT DOOR 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 6/21/02 0:00:00 1384 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo cm L N Classic�Jir,,�l DH Ided UIIH National Fenestration 0016-01658656 0005 Y-03 30 712912002 Rating Council •Energy savings will depend on you specific climate,horse and lifestyle •For more informatfoy call 603622.4232 or visit NFRC's web site at wwwift.org pain 2 ,fbte o- �oeffi�,.en± ansmittanrw,; -----•---------- ------•---------- 3 . 2 . 4 Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product energy performance.NFRC ratings are determined for a fixed set of environmental conditions and specific product sizes. 135 OAK ST In J02-1141 GIS#: COMMON ,, .;ALTH OF MASSACT'l. t TTS Map-Block: 17A-254 CITY OF NORTHAMPTON Lot:-001 Permit: B u i l d)ng Category: BUILDING PERMIT Permit# BP-2002-1141 Project# JS-2002-1837 Est. Cost: $3100.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groin JESSE MONTGOMERY 134274 Lot Size(sq.ft.): 12806.64 Owner: GOYDA MICHAEL F Zoning:URB Applicant: Jesse Montgomery AT_ . 135 OAK, ST_ Applicant Address: ~ Phone: Insurance: 46 Oak Street (413) 585-8482 O FLORENCEMA01062 ISSUED ON:6121102 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF & INSTALL GARAGE REPLACEMENT DOOR 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 Deaartment Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final:Ok' rl err; THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate Of OCCU anc re; Fee Type: Receipt No: Z Date Paid: Check o: Amount: Building 6/21/02 0:00:00 1384 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo