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17A-001 (6) 220 SPRING GROVE AVE BP-2019-1138 GIs 4: COMMONWEALTH OF MASSACHUSETTS Map.Block: 17A-001 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: REPLACEMENT WINDOWS/DOORS BUILDING PERMIT Permit BP-2019-1138 Proiect4 JS-2019-001848 Est.Cost: $22656.00 Fee: $148.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor. License: Use Groom KAREN CARTER 70008 Lot Size(sp.ft.): 13503.60 Owner: FRITZ NICOLE Zoning: RI000)/URA(100)(WSP(100)/ Applicant. KAREN CARTER AT. 220 SPRING GROVE AVE ApplicantAddress: Phone: Insurance: 223 MAIN ST (413) 221-7419 LEEDSMA01053 ISSUED ON:4/76/2019 0:00.00 TO PERFORM THE FOLLOWING WORK REPLACEMENT WINDOW WELL & EGRESS WINDOW, PATIO DOOR, WINDOWS, DOORS IN BASEMENT 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: FeeTvpe: Date Paid: Amount: Building 4/16/2019 0:00:00 $148.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File 4 BP-2019-1138 APPLICANT/CONTACT PERSON KAREN CARTER ADDRESSIPHONE 223 MAIN ST LEEDS (413)221-7419 PROPERTY LOCATION 220 SPRING GROVE AVE MAP 17A PARCHL OOI 001 ZONE RI(100)/URA(]00)/WSP(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST -11CLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid t t Building Permit Filled out Fee Paid Tjpeof Construction REPLACEMENT WINDOW WELL&EGRESS WINDOW PATIO DOOR WINDOWS, DOORS IN BASEMENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 70008 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 19tionDelay 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. File 4 BP-2019-1138 APPLICANT/CONTACT PERSON KAREN CARTER ADDRESSIPHONE 223 MAIN ST LEEDS (413)221-7419 PROPERTY LOCATION 220 SPRING GROVE AVE MAP17APARCEL001 001 ZONE RI(100)/JRA(100)/WSP(100 THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tvoeof ConsnmcC " REPLACEMENT WINDOW WELL&EGRESS WINDOW,PATIO DOOR,WINDOWS, DOORS IN BASEMENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 70008 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO TION PRESENTED: _LZApproved_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 Demolition Delay )Fz S" attire 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. Department use only -- City of Northa - ermit: Building Depa tmeiR EC E I V, P Cu dveway Permit 212 Main S1 feet Be r/Se tic Availability '1 Room 1 Wat rtW 1Availability Northampton, M 01 60APA 1 6 201 Two Sets f Structural Plans �\ -- phone 413-587-1240 F x 41 -587-1272 PI its Islas near.OF C+llll owr INSPF S APPLICATION TO CONSTRUCT,ALTER,REPAI , A ONE OR TWO FAMILY DWELLING SECTION t -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map 17,f Lot Of Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 220 spRiu( GRUA� Name(Print) Curre ailin tltlress Llrr .vI ,� b( o G � Telephone Signature 2.2 Authorized Anent: I Nb Pring Current Mailing Address: Signature -- Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building —) j, 5 (a) Building Permit Fee 2. Electrical WW (b)Estimated Total Cost of J� JVV Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total =(1 +2+3+4+5) 1 1 Check Number This Section For Officlal Use Only Building Permit Numb r: Date Issued: //,, / /+ Signature: l' -2o/7 Building Commissioner/InspeGor of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Sectional. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Foisting Proposed Required by Zoning This column to be filled in by Building Depadmera Lqt Sizc Frontage Setbacks Front Side L: R: U R: Rear Building Height Bldg.Square Footage Open Space Footage % (lul area minus bldg&paved parking) #of Parkin S aces Pill: (volume&Iaeataa) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW O YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds' NO O DONT 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 O DON'T 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 O , Date Issued: C. Do any signs exist on the property? YES © NO O 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 © NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing or Doors D Accessory Bldg. ❑ Demolltlon ❑ New Signs [0] Decks [p Siding[0] Other[E j Brief Description of Proposed p/y-7! tadOL O � Work: P54Sf�: til W T t/1/f 1•N1D W Wt(,(, ]iQf QES( �1/1 N'(\n W 3 W= f2L�Pt.hLedroom M/eNO� N D Adding �Tcmi� Alteration of existing bedroom_Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6s. If New house and or addition to gleUna housina. complete the following: a- Use of building : One Family Two Family Other b. Number o r s in each family unit: Number of Bathrooms c. Is there a garage a hed? J. Proposed Square footage ew construction. Dimensions e. Number Of stories? I Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of wnstruction L 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 Privatewell City water Supply_ SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR B�U�I�LDpING PERMIT I, �Q�'T IL r� as Owner of the subject pro erty hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Data I, fr �UCr'751 as Owner/Authorized Agent hereliy declare that the statements and information on th egoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains an nalties of perjury. 1< ( Plint Name C Iz 1 Signature of Owner/Agent Da e SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder Z O 0 License umber 2—z3 A^ lil- Add r Expiration Date 1-(M Signature Telephone �- 9 Realatered Home Improvement Contractor: Not Applicable 0 Com Name Registration Number I IdS Zdl Address y, • / �` (� l l Expiration to Telephone l'/ ��2 '7 �(� SECTION 16 WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be wmpleted and submitted vnth this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... ❑ No...... ❑ City of Northampton f . Massachusetts DNPARTMNNT OF BUILDING INSPECTIONS M 212 Hain Street *Municipal Building �Jti cs ��.. Northampton, MB 01060 ShK. PpP� Debris 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. The debris from construction work being performed at: 270 sw ► Otu" (Please print house number and street name) Is to be disposed of at: �/�U��l ��'�WCLI til?r—� ; Iyc1�� � ►-�,V7d+� , 1/� R (Please print name arld location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Signature of Permit Applicant or Owner Da e If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department of Industrial Accidents b I Congress Street,Suite 100 > Boston,MA 02114-2017 www.m=s.gov/dia Rorkers'Compensation Insurance Affidavit:Builders/Contractors/Eimtricians/Plombers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lezibly Name Business/Orgattiutionnndividuap: Q_-t w;_�_ Address: ��� 14& �) S'( City/State/Zip: OAO( S Phone#: L-t -5 9 11 Am au an employer?Cheek the appropriate box: Type of project(required): L[�r1maemployerwith �2cmploycrs(full andlor pan time)* 7. ❑ New eunsWelion 1Mam a sole pr.pmeter or partnership and have no employees working for me in g. Ea-Rem—odeling any capacity.INo workers'comp.insurance mi tured.l l Ql am ahomcowner doing all work myself.INo workrsomp ec .msumsrverequired.I' 9. ❑Demolition 4.n I am a homeowner and will m hiring comments to conduct all work on my Property. twill ID Building addition ensure that all conimmors either have workers'comyemnon insurance«are sole II.E]Electrical repairs or additions pmprlelors with an employees. 12.E]Plumbing repairs or additions 5.r7 I mea general contractor and I have hired the sub<onnamors listed on the attached sheet. 13.[]Roof repairs These,ime aracmrs M1aveemployees and have oval..'compinsurance) &M We as a common..and as officers have ewickol mrirnght of exemption per MGI,c 14.❑Other 152,$I(4),and we have no employees. No workers'wrap insuanm rcquired.l 'Any applicant that checks has#I must also fill out the seed..below,lowing their workers'compensation policy infomation- t Homeowners who submit this off davit indicating they are doing all work and then hire outside conladne,must submit a new atfdhvit indicating such, rCootroemrs that check this has masturbation!an additional sheet showing the name of the ria-contractors and state whether or not those entities have employees_ If the sub-comeastors have employees,they most provide their workersromp Policy number. 1 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.#: (n l'I U ry) ^-0 G-?`fJ.,,.,I'l' ^��� --3-/�Expimlion Date' yy ,,�t� t Job Site Address: 2/2i } �PaL.) A1��iRljtt(, /'"`7ali City/SlatefZip: `^-tel MA- 0 � Ob�?� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1500.(10 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties jury that the information provided above is true and correct. signature: IZ Phone Official use only. Do nal write in tofs area,to be completed by city or town official. City or Town: Permit/Licease# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton Massachusetts .? l OSPARTNSNT OF BUILDING INSPECTIONS 212 Main Street a Municipal Building Northampton, MA 01060 fYh. aoPo AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation ("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has •contracted with as corporation or LLC,that Sadly must be registered. Type of W ork: 1�'t h�"" -""' dA l'2.I r Fst.Cosfr �1) -9 I v Address of Work:_/�/� f>R' Date of Permit Application: Cl l k L 1 hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under$1,000.00 _Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: 1 hebuilding permit as the agent caner. Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature lPhon ••� DATE: April 10,2019 EST N NF41010 e MA 01053 Nicole Fritz ain Street 220 Spring Grove Avenue 413-221-7419 Florence, MA 01062 LIC. 70008 HIC# 124718arbetkar@crocker.comartercar arbetka!r@cro7cker.com Included SCOPE OF WORK Allowances I Total 1 General Construction and Management Costs 100 erriit fed $2,484.36 2 Sound deadening/Drywall: Install resilient strips on LR side of Hall wall, accoustic sealant as feasible, Roxul sound dampening baits in wall $100 (mise. cavities; Installation and finishing of drywall. Mat.) $1,890.00 3 Basement Egress: Excavation (Subcontractor); Cutout in foundation wall(Subcontractor): Mini-split removal and replacement/moddications; $1000 Installation of Egress Well Una and Cover, Egress Window; Associated (Excavation, Interior Wall Modifications and Finish Work Mini-split work) $9,074.00 4 Install 3 Interior Doors in Basement Including modificatios to existing Rough Openings and Wall Covenngs as needed. (1 Door provided by owner) $1,324.35 5 Breezeway: New Patio door Replacement window @ existing street side window 1 $2,884.00 Total Job Cost for Above Work: $17,656.71 PAYMENTSCHEDULE 50% Due Upon Accepatance of this proposal $8,828.36 50% (+/- allowance adjustments) Due Upon Substantial Completion of Work $8,828.36 CONSTRUCTION AGREEMENT(Sign to accept proposal) This is an agreement between Kar Carter, Licensed Construction Supervisor (Contractor7�z��T..__ (Date: ), sole pro/I1 p�rietor of Karen Carter Carpentry and Nicole Fritz ' (Date' i a F-r-= )and/or Jennifer Sowards i, % (Date: `f)(Homeowner(s)of pmperty at 220 spring Gperve Avenue;Florence, MA 01062 for the scope of work as outlined above. Contractor agrees to provide materials, keep worksite neat and clean for duration of and upon completion of work, provide dust protection for interior work and complete work in a timely and worker like fashion.The time frame of the work is expected to take approximately 740 work days to complete with the understanding that interrupt ns due to bad weather could prolong the duration of the work. ALLOWANCE AMOUNTS It is understood that any above allowance amounts are as is costs be adjusted in the final payment to reflect actual costs for that work. UNFORSEEN CONDITIONS If there are conditions not visible on initial site visit that impact work progress, Contractor shall stop work, notify Homeowner(s) of the condition, and discuss the nature, scope and added cost to complete the work effectively. Homeowner(s) shall approve scope and cost changes prior to Contractor continuing work. CONSUMER RESOLUTION DISPUTES and COMPLAINTS The Contractor is registered with the Commonwealth of Massachusetts and any inquiries concerning this registration should be directed to: Director, Home Improvement Contractor Registration, One Ashburton Place, and Room 1301. Boston, MA. 02108, telephone (617)727-8598.Claims or disputes relating to this agreement or any provision of it shall be resolved before a single arbiter approved by the Secretary of the Executive Office of Consumer Affairs and Business o 01 7J( Oridd'7N0J �j1y ,- �- 1*,;. 02 Z 7 osr -/+ - �.�ti�- k_o QrO di'1�S¢� 1.Srn wH c�2t 0 ISALI sa-r�MesJzt�b� �—'�� ,�,I��q cvlM Q�SOd � MOQry1M SS�'A`fj',d �•N-ALt3��M'O� Q 71�Y1� 1J�S �`L'LLAd Q?��" Z y o c �a Ov e 1 —:LO Mhotob'+— y N6 S-ro �6�OP. ssa Hen ,�. G7. LtYO$� _ nK� \ 36" IZ.O w,c 1-0(f:�— — � k' AQ- tow A(b% I Cf9 G6R 3bNe'u cow c- i Cel VOL