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24C-072 (2) _4 fE' (L9 IL, h/ SEP - ? 20 05 City of Northampton Office of Building Inspector 212 Main Street Northampton, MA 01060 September 7, 2005 RE: 54 Massasoit Street Northampton, MA Gentlemen: Please be advised that I have completed all my contractual obligations at the above residence of Cathleen Santosus and Jay Ferrara. Not included in the contract price, as only an offer to the owners, on an hourly basis, were certain door and finish work items. I and my crew offered to do this work today but a misunderstanding as to what we had offered resulted in a breakdown of our relationship and extreme hostility directed towards me and my crew. We have thus decided not to subject ourselves to this kind of treatment and we're not returning to work on any of their non- contract items. Kindly take all necessary steps to confirm, within your building inspector jurisdiction, that JCM Home Improvement and Jesse C. Montgomery are no longer the contractors of record at this address. Sincerely, ,,T sse C. • • :omery .„ \ 1 .0AMp 7O 330. k� ,, $ i ,. 01 ztp of N ort aiitpton 1 z _ -- ° /, $ am y l Ifiassaciyusetts __ - til DEPARTMENT OF BUILDITNG INSPECTIONS - -7- -- s = l• INSPECTOR 212 Main Street • Municipal Building 'r 5 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 fegulations. 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 i - , Div �ro2 _ -09. :(11.1..}1 l' a� s ++ `1e (Lii-i of Northampto 1 = � - -. E - gla3aic cl,nsctln • _ •jam I= r DEPARTMENT OP BUILDING INSPECTIOI.'.S , - - • 1 212 Main Street ' Municipal 13ailding Northampton, Mass. 01060 r` - ` WOR CEIZ'S CO ENSATIO. L`ISURAN Cr. AFFIDA.\!lT I, e5c ./cwirnC (li ccasccipermi ttcc) with a principal place of business/residence at: -- .. n/.- 5 1 rA.v.ice . ....... (S hona') .',c11 Y -L i q (str=ricity /staid p) do hereby certify, under the pains and penalties of perjury, that . ( ) I :rn an employer providing the follo.vine'workcl's comocnsaoon coverage for iny , employees worUng on this job: • ansur nc Coop :lay) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (ccie one) and have hired the conaactors listed below who have the foilo'ving worker's compen_sa6on policies: , (Nam:: of Contractor) (In , lane„ Cornoa"lyiPoLic Numbc) (`E4irataon Date) (Namc of Cot (.nsirznc. Como /Folic- `umc ^r) (k irtion Date) • , i - (Name of Connacto,) (insuranea Company/Policy Nus.hcr) (Expiration Date) (Name of Contractor) (Iesuranc Company/Policy Numbs) (Expiriion Date) . (aax3 4itioca.l rn.cctif nc-caary to i nba informiioa po-ta: n to .11 oc -ton) - ( I am a sole proprietor and have no one working for me. ( ) I aln_a home owner performing all the work myself. NOTE: ptese be aV•2r el.. ` 1Jc bcconowncra wbo employ pc-com to do r- - ;--, •,-,-, cis a,co c rc as Boric on . d.vd.lx r. of ant moc-o th:n tiro: =its in t.'�th the boc oco+vocr raid, or oa cbe Qouoc:s zppurten rs tbcc.o e-rr oat E- rk:.11v a cr ij od to he ccaploye, =Gar the v.'a- cc2pc—ztioo Act (61!152 -a I (5)). o-ppticicioa by a ho avow far c ties. or pcsmit may esz deooc t1:e Iepi name of an eqloyar wader tiro Wocicolz Co¢tpooaalioa Act 1 uada*s+ad that a copy of thin ortemeea may ba foeo wd..4 to tho Dcpanaaerd of la- *id Accdeasn' Off,oa of 4n+r.00a for tI covaxsc vcri f c aiaa and th_t f_ik - to sozuc roovcrase tmdcr sot t ioo 25A of MQ L 152 m Ied to tho innvositioa of a-imin_,1 pcailtic oocairoloz of a fine of up to Si }moo and/or Claprisocrsocli of up to aoc ynar t.od civil penalty= in dx form of . Stop Work Orden and a fires o(S 100.00 z dry tcilnsl roc � _ - - For dcpartm =- u.c only - /` permit Number _ Si c E01r ,otLi . ` - crrniuc / to 1 r . I_/ I`� ' SECTION 8 - CONSTRUCTION SERVICES ,1 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : T E 5 ( C41 L 4 Cy 07 - 01 �f ' / License Number L! (� C k 5 4- ( /14, /9/ Address ,4 Expiration ate Sign t r- Telephone 91.1RViggee as -,ve eli errtra ;a.. : -t w. ,Ven �, �71 Not Applicable ❑ ('sse 0 4 : . 7`+ Company Name Registrati Num er -- Address Expirat on Da Telephone 51Y-4/- 9 `1 • SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIkf"(M GL.c t52,;§ 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 ❑ { ,_ , g al Q19 g8 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 I ` SECTION 5- DESCRIPTION OF PROPOSED WORK (check all >applicable) New House ❑ Addition ® Replacement Windows Alteration(s) El Roofing IR Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [p Siding [I]] Other [1:51 Brief Description of Proposed 2 v9R , / r , S , l / w . a . 1 /5 ,•r,/4�� c�/ / f N -9 )/6 Work: y[= I t % 1� yf"� �"1 Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes ■ No Plans Attached Roll - Sheet 61k ff se n ® , ultra to ` T IStin, fffat _ o IT t tr o tetara: a. Use of building : One Family Two Family Other c . b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? 4 d. Proposed Square footage of new construction. C.: Dimensions /6 A- e. Number of stories? f. Method of heating? s- "cter? ( T. w1 Z 2 Fireplaces or Woodstoves i) Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction LA/ / I i. Is construction within 100 ft. of wetlands? Yes 7 No. Is Is construction within 100 yr. floodplain Yes VNo j. Depth of basement or cellar floor below finished grade C � k. Will building conform to the Building and Zoning regulations? ✓ / Yes No . I. Septic Tank City Sewer 7 Private well City water Supply SECTION 7a- OWNER: AUTKORIZATIQN TO BE COMPLETED :WHEN *OWNERS AGENT OR CONTRACTORAPPLIES FOR BUILDIN'GAPERMIT I, , 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 I, (,0�� , as Owner /Authorized Agent hereby declare that the state is an formation on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. '.k i'l ov['- V'" to Print Name _ ,4011/1v L Sign - = 4 • ,. , nt- _.._ Dat- '-- , S . ONI NG All Informattft 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 o ize I 1 i 3 I Frontage Setbacks Front , i 1 Side L R: ! L i -�? R : ; Rear ! I Building Height i Bldg. Square Footage i I i i% 1 I = i i t Open Space Footage % (Lot area minus bldg & paved 1 j i i d f parking) # of Parking Spaces Fill: ' (, 31 (volume •& Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 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! t and /or Document # I B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? ` Needs to be obtained Obtained Date Issued: I i C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: j D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO Q 1 IF YES, describe size, type and location: ` j 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 0 r NO 0 i IF YES, then a Northampton Storm Water Management Permit from the DPW is required. City of Northampton 4 Building Department , ^ 212 Main Street i _ I; ;. ',' , Room 100 Northampton; MA 01060 `® . r,, ,4phq 413 - 587 -1240 Fax 413 - 587 -1272 �s1 i _ , ,s Pec " „ ... �i � :' ,.,... - " APPLICATION TO CONBtRUC1 ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION f % � ( _ , f � ) 0 OR ( 4 , e L e l 1.1 Property Address r This section to4be complete ce `- ' ,A71Zc1Sotr Sr pia „Lod �, IJ tt f et/0C 1111)-10 P 7�r Al 4 ;26--6-4-:, 3, , ,, �, Overla DEStn Em`StwDi • »CaF7istnct r t $ SECTION 2 - PROPERTY "OWNERSHIP /AUTHORIZED AGENT , 2.1 Owner of Record: A c((LtCCL S l 455gSer Name (Print) Current Mai' g Address Telephone Signature 2.2 Authorized Anent: C 6A LIB 9. C . fO - 3 3y L NL= % rs X14. . Name (Print) -- _ Current Mailing Address: , = - L i/3 j 'y -9q // Sion re - _W.. -• = Telephone SEA .„ = E F! ED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by perm' applicant 1. Building --7 / •- 0 p - .( Buildi 7 ng Permit Fee 2. Electrical i f/ , (b) Estimated Total Cost of Construction from (6) 3. Plumbing /c9, COO Building Permit. Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 4/a t r' • 7 O Check Number This Section - For Official Use Only Date' Building Permit Number Issued: Signature: r- Building Commissioner /Inspector of Buildings Date File # BP- 2005 -0817 APPLICANT /CONTACT PERSON Jesse Montgomery ADDRESS /PHONE P 0 BOX 329 LEEDS (413) 585 -8482 () PROPERTY LOCATION 54 MASSASOIT ST MAP 24C PARCEL 072 001 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 Tvpeof Construction: CONSTRUCT 16 X 14 2ND FLR ADDITION (BEDRM) & REMODEL ENTIRE 2ND FLR, 4/14/05 REPLACE 1ST FLR WALLS W/2 X 6 New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 077410 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 C s f 'ssion _- D� - - yrs C ---- 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- 2005 -0817 GIS #: COMMONWEALTH OF MASSACHUSETTS �� CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2005 -0817 Project # 3S- 2005 -1136 Est. Cost: $100500.00 Fee: $377.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JESSE MONTGOMERY 077410 Lot Size(sq. ft.): 15855.84 Owner: FERRARA JAY Zoning: URB Applicant: Jesse Montgomery AT: 54 MASSASOIT ST Applicant Address: Phone: Insurance: P 0 BOX 329 (413) 585 -8482 0 LEEDSMA01053 ISSUED ON:3/11/05 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 16 X 14 2ND FLR ADDITION (BEDRM) & REMODEL ENTIRE 2ND FLR, 4/14/05 REPLACE 1ST FLR WALLS W/2 X 6 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 3/11/05 0:00:00 $377.50 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo Talc Sheet for: JCM- Ferrara.L10 , Al Page 1 of 2 KeyBuild Structure 03/02/05 Version 2.128d 11:22 AM Filename : JCM- Ferrara.L10 Member Type: Joist Description: Al Application: Floor Comments: Lateral Bracing: Continuous Building Code: UBC Deck Connection: Glued & Nailed Location: Live Load: 40 psf Slope: Dead Load: 15 psf Moisture Condition: Dry DOL: 100% Deflection Criteria: L/480 live, L/240 total Non - standard Loads (Uniform loads replace Standard Loads): Live Dead Type Begin End Start End Start End DOL Point(plf) 15' 7.38" 36. 80. 115% Point(plf) 0' 2.75" 36. 80. 115% Point(plf) 0' 2.75" 320. 222. 100% Point(plf) 15' 7.38" 320. 222. 100% v v 2'.00" 13'7.38" Exact Member Length: 15' 7.38" Reactions with all loads applied (lbs): 1649.# 1252.# Worst case (alternate load analysis) reactions at each support (lbs): Used for connector /min. bearing design. 1649.# 1322.# Worst case (alternate load analysis) reactions at each support (plf): Used as a line load on carrying member. 115% 41. 32. 100% 720. 593. Dead 477. 363. Total 1237. 992. ******************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Product: 9 1/2" NI -40x 16.0" O.C. spacing ******************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Allowable Stress Design Actual Allowable Capacity Location Loading Moment 1616.'# 2655.'# 60% Span one Odd Spans 100% Shear 618.# 1200.# 51% Span two Total load 100% Cant. Shear, Lt 977.# 1200.# 81% Span one Odd Spans 100% End Reaction 444.# 1200.# 36% Span one Total load 100% Int. Reaction 1648.# 2576.# 63% Span one Total load 115% LL Deflection .19" .34" L/855 Span two Even Spans 115% TL Deflection .18" .68" L/904 Span two Even Spans 115% LL Defl., Lt. -.07" .20" 2L/661 Span one Even Spans 115% TL Defl., Lt. .09" .20" 2L/556 Span one Odd Spans 115% , . , . , , ,„. ckyy.7100 0Z/552 4." -- 1 . --"r r CVI, 0 97 , 4 09 c February 24, 2005 ..••..••••q sy ve __i V v : 3CM I r i V0 . Cathleen Santosus & )ay Ferrara • P.O. Bo , to I 0 Otr''''' 0 ) r Lo 54 Massasoit Street • . 7 ' il..- /19Y / P i id Northampton, MA 01060 . •• • oo • ** .• 413-584-8766 5 v . r .„. : ey , r 6.7 We hereby propose to furnish the materials and perform the 1: Floor Remodel and Bedroom Addition. ...•---,i 0 (-- Items below are included in contract price: # 1. AD demolition & dump fees plus job site dean up daily. #2. All framing to create new space. #3. Ali wiring and fixture placement plus smokes and service, additional electrical work to basement and first floor to he charged extra $420,00 plus $50.00 for every new plug location. #4. Ail plumbing plus fixtures. Selection of fixtures can be chosen at Degrees of Comfort, staying within the allowance given by plumbing contractor. (All heating alterations plus new zone for addition.) #5. All insulation to be installed to meet code. #6. All drywall installed 1/2 inch, three coats, sanded, primed and ready for finish paint. #7. New roofing and gutters throughout the entire house. Roofing 30-year asphalt shingle over new 1/2 inch sub--strait. #8. Vinyl siding on new addition to match existing house siding. #9. Total of eight new windows installed. Windows to be vinyl type to closely match preexisting replacement windows. #10. *All floor coverings, hardwood in common areas and bedrooms. Ceramic the floor in bathroom. *Flooring materials cost allowance for hardwood $3. 00 per square foot. *Flooring materials cost allowance for ceramk tiles $4.00 per square foot. Ali material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for the above work and completed in a substantial workman like manner for the sum of $98,500.00, Homeowner to supply all interior4loors and moldings. 3CM to provide labor to install at a rate of $35,00 per hour. - ..,----- ' -- / Respectfully Yours: - ; rr o..- 7 '.e(i,"2.--- ) Date Ali alteration or dev4 tion,frOrn.Me above specifications involvin extra costs rill be executed only upon written orders, and_airti:ine an extra charge over and above th e estirnale The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do tt)p work as specified. / l Signature:( " - la&t, . p $' =�T.. /''' � i J&SEACl7IISttts , — ',! DEPARTMENT OF BUILDING INSPECTIONS =:F /_ INSPECTOR 212 Main Street • Municipal Building Q,y S`• Northampton, MA 01060 . e HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her construction sup .. 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 r 4 _ • r iv.}r nT f . _ . O Off -- ---_._ / R k (rill of { cn flla.]]tpto11 . -. ==, ' T-1: - DEPARTMENT OP BUILD I7 G INSPECTIONS _ 212 Main Street ' Municipal Building Northampton, Mass. 0] OGO M ` WORICEIZ'S COKPENSATION CNSUP.ANCE AFFIDAVIT -e5 _ 145CJYY1 C . (Ii pertrunix) with a principal place of business residence at: — L I& 04 K Sf= »( orolce / 0/c69 (phone) - 6 2 5 - ` VO' (stsrt/ci ty /szatc/a p) do hereby certify, under the pains and penalties of perjury, h21 - ( ) I am an employer providing the followinL!w'orkcr's colnocnsanon coverage for my • employees worinng on this job: ( ns u-:nc Coca nacv) (Pclic_. Nu. r) :piston Dais) i ( ) I am a sole proprietor, general contractor or homeowner (ciscie one) ?-no have hired the conn listed below who have the following worker's coDnenssadon policies: i (•amc of Contractor) (lnniranc Coinoart)•i?oUt ✓ i Nurn =c.) (ipi<-ancn Date) (Name of Contrctor) (tns Company/Policy Nusicrr) (Eiroir,:tion Date) (Name of Conlracto ;) (tnsluanea Company/ Policy Nusb:1) (Expiration Date) • . (Name of Contractor) (Losuran Company /Policy Numlxs) (Expiration Datc) . ( &ascii addY socoJ rhcct if occcs. ry to ioclod_ inform oo pctaia;as to .11 mc=--- .c.o:s) . , 0/(1 am a sole proprietor and have no one world.ng for me. { ( ) I arrl.a home owner performing all the work myself. NOTE: 0=-1c be awzrc it.,. se.JC becocowocri wbo cccplay pcwos to do • .coo r c —�c,00 r rruc ..-ori; oa . d••<11_i: of not mocc tb_o tisv: emir is w ch the bomoawocr raider or oo the ETou.ocis :,ppu i ca_ri thc-eo t-c not cc-I --lly a_r_rid to be onployca t"+r'- -- the 'sr c?a r atop -. • on An (G L't 51=1(5)). Itpptintioo by a bomwa -ne far c tic=c or pcmit tr. y n-ideocc the legal rt..= of en a:Goloyer under tbo WorSvolr C.ompoas .iioa Ant_ 1 yodar:aod tb..t x Dopy of thi. ca.tcmost m.y bo rocworded to tbo Dop.rtmmd of Indutri.J Acedcff f OfLoo of Ir=ur+ora for Liao coveri.sc vaif cmtioo nod that L -i]tac to saZUC tovcrase "r,M- soetioo 25A of hiQL 152 cc lcxd to the iscx*tioa of airmail pen'tltic, cowl-slag of a floc of Up to Si ..00.00 uta'or iatprboomazl or up to ooc ycr rod civil pm.ttic to t c form of a Slop Work Order and s fix= o(SlnOOO id:y ay'. • .• .. For dcp.rtr u.c only Pcrmt Number 1 r711111PP C962C G' 1.tap Lot u •- • •• I: •crnti ucc e -- - - ' - • .7- f 4 • SECTION 8 - CONSTRUCTION SERVICES r 8.1 Licensed Construction Supervisor: Not Applicable 0 11 /^, /, Name of License Holder : � 5C c j "tif 0 / t o v j License Numb r (orcinc c /44, 0/06_2 / 0 i vim" Address Expiratio ate 4 // 3 — -25 C7YcP 9, Telephone 4 2e isfexed "ome n r iiiiii ' orit ieto e ... : ' Not Applicable ❑ Se5 OntM1 e,, f 4-/ 9- L i Company Name Registration umber -" - _ _ 1 --1 (v c% /0 I y /os_ Addre / � �� �Q s� Expiratio Date b('Cf1C e Y '' ' 01 �� o c 7 Telephone-51)-57—(N " el SECTION 10- WORKERS' COMPENSATION AFFIDAVIT M.G. 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, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two -vear 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 [ C Replacement Windows Alteration(s) Xr Roofing le Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs ID] Decks [C] Siding Other [D] C41.1447744 S Brief DescriAtion of Propos d / Work: S CCM r T wn fi r - efri ode i e? ("lam 0 . N c t 74700,- Alteration of existing bedroom / v Yes No Adding new bedroom Yes ✓ No Attached Narrative Renovating unfinished basement Yes i■ No Plans Attached Roll - Sheet '"` L -` .tea.., . ,t;; t b,T.. ' . ." s-- tea' — " "' _. -� > ,.. .., w. ,e,^�.^ Y,;,, _ ..Y &'�s«,'"a�. sa `Tf l+ ew cease . i i ial xt tmctzh otasinq comb ete the lowin : a. Use of building : One Family Two Family Other !� b. Number of rooms in each family unit: 7 Number of Bathrooms c c. Is there a garage attached? /1/0 vv�� / //� d. Proposed Square footage of new construction. c9,9 Lf Dimensions i& i e. Number of stories? .. f. Method of heating? c << irecrn rick i,.)c.kce Fireplaces or Woodstoves 0 Number of each g Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction \.kJ' F 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 Y Private well City water Supply Y SECTION 7a - OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENTOR CONTRACTOR APPLIES FOR BUILDING. PERMIT I, , 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 I, _ Tl J5C ftCtCr e , as Owner /Authorized Agent hereby declare that the statem is and in ormation on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. i- : 55c /Tail Ume Print Name ! Sign - r-!•liwner /Agent 'iate qt Section 4. ZONING All Informatibn 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 i s Frontage !z I3 1 Setbacks Front !,P71 ; 071 Side LT R: L:' 17 i R:1 /J_ : `�.3! Rear loo 20 Building Height - 1 Bldg. Square Footage 1 1 I I I i I I, P Open Space Footage % �---- (Lot area minus bldg & paved I ! 1 I I ping) . f I 1 # of Parking Spaces Fill: / ' ° (volume* Location) t A. Has a Special Permit /Variance /Finding ver 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 0 DONT KNOW YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? • Needs to be obtained 0 Obtained Date Issued: ■ C. Do any signs exist on the property? YES 0 NO e 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 e( IF YES, describe size, type and location: F 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 0 . NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • w City of Northampton f� �- , i • ------,-- - 777 -- F,.., - Building D f.,1, t f 1 i c ; 2 t , . ,---: -- �\� T �,, ?i il: , Ai i 12 Main Street ° i '1a.� r r : �r. `i Room 100 -. ;f ^ t,. Northampton, MA 01060 1�, T U Q 2 8 ZC�I)one 4f3 -1587 -1240 Fax 413- 587 -1272 e L-- — Atieti�fC% ��( ONST CT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 1 ... _,... , - tin x SECTI 1 - SITE'INFORMATI This section to be 1.1 Property Address: complet by[ office .. ` / 14 5 S vc -t �5:f Lot �` u , /1/0 - ► 3 MID hzr) t'I 4 Xo ' Overlay Dis riot 6'Elm S&iiistnct ` I? >_ .... x aCB.Distnct ,' SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print Current Mailing Addre 14/?— S (ri cP Telephone 3ignature 2.2 Authorized Agent: (955e c/wtr /? Z Lam!' 3"9 L C 25 x`1 �i0.s.> Name (Print) r Current Mailing Address: i/► Li/ 5 �S ( ig ' Telephone ''SECT19 -:ES f(u D CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 5 LOO. (a) Building Perm Fee / 2. Electrical / / �"y)' (b) Estimated Total Cost of v"' d Construction from (6) / © Building Permit Fee 3. Plumbing $ j 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 9c cc?) Check Number This Section For Official Use Only Building Permit Number . Date ' , = Issued: Signature: , i Date Building Commissioner /Inspector of Buildings File # BP- 2005 -0817 APPLICANT /CONTACT PERSON Jesse Montgomery ADDRESS /PHONE P 0 BOX 329 LEEDS (413) 585 -8482 0 PROPERTY LOCATION 54 MASSASOIT ST MAP 24C PARCEL 072 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid h Building Permit Filled out Fee Paid 094, 4 13 Typeof Construction: CONSTRUCT 16 X 14 2ND FLR ADDITION (BEDRM) & REMODEL ENTIRE 2ND FLR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 077410 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFgRMATION PRESENTED: v 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 Signature of Building Offic .1 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. 54 MASSASOIT ST BP- 2005 -0817 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24C - 072 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2005 -0817 Project # JS- 2005 -1136 Est. Cost: $98500.00 Fee: $377.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JESSE MONTGOMERY 077410 Lot Size(sq. ft.): 15855.84 Owner: FERRARA JAY Zoning: URB Applicant: Jesse Montgomery AT: 54 MASSASOIT ST Applicant Address: Phone: Insurance: P 0 BOX 329 (413) 585 -8482 () LEEDSMA01053 ISSUED ON:3/11/05 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 16 X 14 2ND FLR ADDITION (BEDRM) & REMODEL ENTIRE 2ND FLR 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 3/11/05 0:00:00 $377.50 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo 54 MASSASOIT ST - BP- 2005-0817 GIS #: - "COMMONWEALTH OF MASSACHUSETTS • Map:Block: 24C - 072 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2005 -0817 , Project # JS- 20054136 Est. Cost: $100500.00 Fee: $377.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JESSE MONTGOMERY 077410 Lot ize(sr. ft): 5,34 Owner: FERRARA JAY Zoning: URB Applicant: Jesse Montgomery AT: 54 MASSASOIT ST Applicant Address: Phone: Insurance: P O BOX 329 (413) 585 -8482 () LEEDSMA01053 ISSUED ON :3/11/05 0 :00 :00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT 16 X 14 2ND FLR ADDITION (BEDRM) & REMODEL ENTIRE 2ND FLR, 4/14/05 REPLACE 1ST FLR WALLS W/2 X 6 • POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: 542,1keter: Footings: Rough /CTA % Rough: 5—I i i l o ,l/ House # Foundation: / Driveway Final: Final:9 f l•�' Final: 4Y 40��1 Rough Frame: QK 5 p 7. 0 -(24 Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: / - �", k rte Final: Smoke: Final: 0 Q -Q OS � _'/_ THIS PERMIT MAY BE REVOKED BY THE CITY 1 F NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. / r :-°,7 Certificate of Occupancy Si. nature: FeeType: Date Paid: Amount: Building 3/11/05 0:00:00 $377.50 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo