36-016 (5) 35 FOREST GLEN DR BP-2016-1025
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 36-016 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-2016-1025
Project# JS-2016-001732
Est. Cost: $20000.00
Fee: $130.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: MARK BONDE 67758
Lot Size(sa ft.): 14157.00 Owner: MARTINEZ WILLIAM J&JENNIFER M
Zoning. Applicant: MARK BONDE
AT. 35 FOREST GLEN DR
Applicant Address: Phone: Insurance:
205 PARK ST (413) 535-9529 O WC
EASTHAMPTONMA01027 ISSUED ON:2/19/2016 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE KITCHEN CABINETS/COUNTER
TOPS, EGRESS DOOR & STAIRS
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 Siznature:
FeeType: Date Paid: Amount:
Building 2/19/2016 0:00:00 $130.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2016-1025
APPLICANT/CONTACT PERSON MARK BONDE
ADDRESS/PHONE 205 PARK ST EASTHAMPTON01027(413)535-9529()
PROPERTY LOCATION 35 FOREST GLEN DR
MAP 36 PARCEL 016 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid ��
T eof Construction: REPLACE KITCHEN CABINETS/COUNTER TOPS —"/�,Q/�,D
New Construction
Non Structural interior renovations
Addition to Existinz
Accessory Structure
Building Plans Included:
Owner/Statement or-License 67758
3 sets of PI lot Plan
THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
I ATION 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 Street Commission Permit DPW Storm Water Management
oli ' a or
01Signa a ding O fi ial Date(//J
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.
City of Northampton Department use only
x ) Status of Permit:
Building Department Curb Cut/Driveway Permit
FEB 1 7 2016 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
DEPT.QP F3U;LDIN;I,77CTUNS N rthampton MA 01060 Two Sets of Structural Plans
NORTHAMPTON,M -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
Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
i LA rZ' _ S QST' L/*
Name(Prin Curre t Addr
Telephone
1 f
2.2 Authorized Agent: ,
Name!::AQ
((F;rint)) Current Mailing Address:
/Y la L41--
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (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
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 aSpeci Permit/Variance/Finding ever been issued for/on the site?
NO 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 O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES O NO l:J
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YESO NO `
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? YEE O NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all agalicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolitiop ❑ New Signs D=J] Decks
[❑ Siding K3] Other
Brief Descriptio of Proposed
Work: - 7 c_ -JV--)
Alteration of existing bedroom Y- No Adding new bedroom Yes
Attached Narrative Renovating unfinished basement Yes o
Plans Attached Roll -Sheet
6a. If New house and or addition to existing housing COMPIete 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 0& h. E-z' as Owner of the subject
property
hereby authorize A eK �►�j�j�
to act on my b half mall matters relative t work nzed b tuildmg permit application.
ig e r Date
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.
"s�� �7
Print Name
-I .- 1b
Signature of r/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: MAcQk -r w9'Dt'c CS 06"1-7,5,5
License Number
Address Expiration Date
Signature Telephone
9.Registered Home Improvement Contractor: Not Applicable ❑
acs 1)�9!:, (--&-.)10 L)c wl6 N 1 (0-CA'ZZ-q
Company Name Registration Number
hME-113 HA
Address Expiration Date
Telephone 4I-3 7Z11-ZJ7(
—7 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 buildin2 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
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: 35 +na.r5-�-
The debris will be transported by: b
The debris will be received by:
Building permit number:
Name of Permit Applicants- w.►
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
r Office of Investigations
I Congress Street,Suite 100
Boston,MA 02114-2017
" www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual):_ Rt7 LLsr_ �'� 6 0
Address: ,2C)
City/State/Zip: 65(CoX7 Phone#: C•1`2 5Z.eA -ZA-Z
96
Are you an employer?Check the appropriate box: Type of project(required):
1.0-t m a employer with 2_- 4. ® I am a general contractor and I 6 ®New construction
employees(full and/or part-time).* have hired the sub-contractors
2.® I am a sole proprietor or partner- listed on the attached sheet. 7. ®'modeling
ship and have no employees These sub-contractors have g. ®Demolition
working for me in any capacity. employees and have workers'
insurance.:
9. ®Building addition
comp.[No workers' comp. insurance P•
required.] 5. ® We are a corporation and its 10.®Electrical repairs or additions
313 I am a homeowner doing all work officers have exercised their 11.®Plumbing repairs or additions
myself. [No workers' comp, right of exemption per MGL 12.[3 Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.1]Other
comp.insurance required.]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins. Lic.#: Ci C�? �' Expiration Date.-
Job Site Address: City/State/Zip: l jam, PQ Cr . (� 0Lob
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone 762
Oricial use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person• _ Phone#•
� o n Estimate
d �
Construction - Design
Name/Address
Bill&Jenn Martinez
36 Forest Glen
Florence, Ma 01062 413-529-2176
msb62@charter.net
Date Estimate No. Project 205 Park St.
12/03/15 308 Kitchen Easthampton, MA 01027
Description Cost Total
Building Permits 330.00 330.00 ►t�
Move appliances out of work area, return when complete. .
Demo: Remove cabinets, wall between kitchen and dining room , misc. 1,540.00 1,540.00
plumbing, misc electrical, window in dining room and section of wall,
remove floor.
Frame: Frame opening for door into backyard, including full glass 1,320.00 1,320.00
insulated exterior door, with brushed nickel hardware($583 allowance).
Cabinets: Cabinet cabinets; arts and crafts with rosewood stain: 6,788.75 6,788.75
$4993.75
Granit top: Cranberry tan/brown with pencil edging, and installation.
$1600
Sink: $195
Cabinets installation: install cabinets,fillerts knobs, crown molding 2,090.00 2,090.00
Plumbing: Connect dishwasher, 1,430.00 1,430.00
sink,
faucet,
waterline to refrigerator,
including all supplies and waste piping.
Electrical and Lighting: Add exterior light and switch at new door, 1,650.00 1,650.00
Bring electrical in kitchen area up to code,
including gfi circuits,
Add new circuits for appliances.
Disconnect and connect appliances.
Interior Walls:Repair walls after electrical, plumbing and wall removal. 330.00 330.00
Please Call After Review. Thank You! Total
Page 1
Estimate
Construction Design
Name/Address
Bill&Jenn Martinez
36 Forest Glen
Florence, Ma 01062 413-529-2176
msb62@charter.net
Date Estimate No. Project 205 Park St.
12/03/15 308 Kitchen Easthampton, MA 01027
Description Cost Total
Bcksplash: subway tile back splash. 638.00 638.00
Floor Coverings:Tile installed in dining and kitchen, $600 allowance on 1,980.00 1,980.00
tile.
Painting: prime and paint walls and ceiling and trim. �p�JL 1,100.00 1,100.00
Cleanup and Remove debris. 352.00 352.00
Please Call After Review. Thank You!
Total $19,768.75
Page 2
Valley Kitchens, Inc. Invoice
51 Al Holyoke Street
Easthampton, MA 01027 Date Invoice#
1/28/2016 1868
Bill To
Martunez,Bill&Jenn
35 Forest Glenn
Florence,MA 01062
P.O. No. Terms Project
Item Description Amount
Kabinart Arts/Craft Door Style,Full Overlay,Cherry with Rosewood Stain,Fillers,Crown, 4,700.00T
Toe Kick,Templated and Installed.Delivered.
Granite Countertop Cranberry Tan Brown,Pencil Edge,Templated and Installed.$1500(1/4 taxable) 375.00T
Intallation Of Above ,( 1,125.00
Alpha Sink U235 � 195.00T
C-11K�I
D0 S
L C, 0J
t
nv
Thank you for your business.
Subtotal $6,395.00
Sales Tax (6.25%) $329.38
Total $6,724.38
Payments/Credits $0.00
Phone# Fax# E-mail
Balance Due $6,724.38
(413)527-1500 (413)527-7177 todd@vkitche;ns.conn
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EXISTING
LIVING ROOM
CAR PORT 10X17 KITCHEN
INSTALL CABINETS
REMOVE WALL
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\\,--FLASH, CAULK AND INSULATE
INSTALL LANDING AND STAIRSJ INSTALL HEADER, JACKS & DOOR
EMOVE WINDOW
BONDE CONSTUCTION / 35 FOREST GLEN, FLORENCE MA 413 535-9529
LEDGER LOCK AND FLASHING \-LVL HEADER
INSTALL DOOR
P,T,DECKINCr-�
2 X 8 P.T. FRAME \3 _7��
GAL V, POST BASE
�s+ZaoE
INSTALL LANDING AND STAIR
6" SONO TUBE
BONDE CONSTUCTION / 35 FOREST GLEN, FLORENCE MA 413 535-9529
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TECHNOLOGIES This is an original design and must Designed: 10/29/2015
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iven are sub ect to verification on �A/ J not be released or copied unless Printed. 12/11/2015
job site and adjustment to it
job applicable fee has been paid or job
conditions. order placed.
- ---- - '
Marti nez35 -_ ==- -- -- — - All Drawing#: 1