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Prepared for the exclusive use of WRIGHT BUILDERS, INC. stall, subcontractors, and suppliers. ti All other uses prohibited. r i • . k 1 , ) , f l5 ` c' t, 41 -1� -r 1 � 14l I a-it . (-* M , c.. f / _ _ '� / , ~— - .-_ - -- ///1. • ■ C ) - . 7 r . .� „- • :( 1 , ' _ :1.� 0 4( k. I . ,,,, , ... ._,,.. 0 - -�� 'gt.r}„..KF.. .,. - , : i. tom. , ,, w�',•' ��..,.,...,.,.,............ ,...;,,_.......- ......,........ .,. ''...:='s.:.._...�.,.r� ._- _.-. l w,._' . .. c....., _\ ---..- t_' ii 76 l it �� �'- ..., f • i I co 4 ! 1 11 k:- . • I < C"P C. • s • b ro o o A p {< . . • If ° WRIGHTBUILDERS Z n y � �* t N C 0 R P 0 R A T E D 'c: V C 1 '. 48 BATES STREET z y q NORTHAMPTON, MASSACHUSETTS 01060 't `a ^° > fD 413 - 586 -8287 FAX 413 -587 -9276 O T. , . ©Wright Builders, Inc. • 0 lA Prepared for the exclusive use of WRIGHT BUILDERS, INC. staff, subcontractors, and suppliers. All other uses prohibited, • r ' SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction S Supervisor: Not Applicable 0 er Name of License Holder : W 1 1 V H ki � pl / `�' 51 •w License Number '&g pi-~( 5r, Nb A-v flt FMK iofi0/7o11 Address , Expiration Date �f��. 007 Signature Telephone 9. Registered Home Improvement Contr ctor: Not Applicable ❑ (N Pl &It(Lae 10 t (3 Co Com an Name Registration Number d I s r., N 6( 4 e�Ni /‘• CpJ 24 I Zc)I Address Expiration Date r /V 5 �.�° L�-� Telephone Cgs - bigl SECTION 10 'WORKERS' COMPENSATIO NSURANCE 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 • SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding [0] Other [0] Brief Work: Description of Proposed y,i9.• '' ` D., , 4 n , %4 0 . I N,rP fr e, -`( 0 Sri Alteration of existing bedroom Yes No Adding new bedroom Yes •K N s P - g t Attached Narrative Renovating unfinished basement Yes ) No °w Plans Attached Roll - Sheet c Fr , O 6a. If New house and or addition to existing housing, complete the following: Or) •r 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. Di -nsions 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 = wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of baseme • cellar floor below finished grade k. Will build - • conform to the Building and Zoning regulations? Yes No . I. •tic 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, �c1'p N r'C 111 AI VV i n , , as Owner of the subject property hereby author' 1 p, , , twin to act on my •7., IfIIr II matters relative to work authorized by this building permit applicat' n. iiP Gt 2•� �2 v 1 V Signature o 0 n -r Date Ito 't , , as Owne i• uthorized Agent ereby declare that the statements and informal •n on the foregoing application are true and accurate, to the best of my now e•ge nd belief. Signed under the pains and penalties of perjury. f _• i • Print Name d7/2 Signature of Owned' gent Date AIu- NON W e p-r- �o W fi�ti r� 2 i s-n' - PorPp,° fit- tie -us•-� 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 fill • n by Building Depart - Lot Size Frontage Setbacks Front Side L: R: L: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking S es Fill plume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO ► ®1 DONT KNOW Q 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 0 NO igt IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO �Qj IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading ex .vation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Department use only 'City of Northampton Status of Permit: 2-- � � Building Department Curb CutlDrfveway Permit 212 Main Street Sewer /SepticAvaifability SEP 2 7 2010 Room 100 water/Weu Availability Nort ampton, MA 01060 Two Sets of Structural Plans phone 413 -5 7 -1240 Fax 413- 587 -1272 PlotiSite 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 3 ) 5-r, A Map Lot Unit _ Z4 �g l ` f t / " A,t k Zone Overlay District ,Y ` Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: gefrr.ori r OA 1 Name (Print) y / f �, �. ' Current Mailing Address: s , 2. a _ • Telephone J Ao Signature 2.2 Aut . rized A. ent: L/ Lf AA-clef r. /!6ti-1nrf Pty N Name (Print) / Current Mailing Address: Signature Telephone SECTION 3 ESTIMATED CONSTRUCTION COSTS Item Estimated Cos (Dollars) to be Official Use Only completed by permit applicant 1. Building 8r, 2 o ( (a) Building Permit Fee J lJ 2. Electrical 1'1 r V() ,l (b) Estimated Total Cost of V Construction from (6) 3. Plumbing J, ClU Building Permit Fee 4. Mechanical (HVAC) J 5. Fire Protection '1 /, v � " �,)Q N'p ea 6. Total = (1 + 2 + 3 + 4 + 5) �L 14 f ( � : Check Number 3,'6.? � "`tKKf This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File "# BP- 2011 -083 APPLICANT /CONTACT PERSON WRIGHT BUILDERS ADDRESS/PHONE 48 Bates St NORTHAMPTON (413) 586 -8287 (116) PROPERTY LOCATION BEACON ST MAP "23APARCEL 196 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid ft !' 4 Typeof Construction: REMODEL KITCHEN & BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9RMATION PRESENTED: ir 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 Demolition Delay 7/3C1 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. C"` - BP- 2011 -0283 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block:IIK=196 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2011 -0283 Project # JS- 2011- 000473 Est. Cost: $49000.00 Fee: $294.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WRIGHT BUILDERS Lot Size(sq. ft.): 27660.60 Owner: WRIGHT JONATHAN A & MARGARET E KELSEY Zoning: URB(100)/ Applicant: WRIGHT BUILDERS AT: 43 BEACON ST Applicant Address: Phone: Insurance: 48 Bates St (413) 586 -8287 (116) Workers Compensation NORTHAMPTONMA01060 ISSUED ON: TO PERFORM THE FOLLOWING WORK: REMODEL KITCHEN & 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 Occupancy Signature: FeeType: Date Paid: Amount: Building 9/30/2010 0:00:00 $294.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner