Loading...
18C-088 (3) , PT : ,..., ,, , , , -i.- ' i i !1 i: i t '`,; i ' l i iii :I i ii i 4 i 1, 1 ! ti: ; 4 ' :i il ;■ II t!, ,, Ems tut( I), fak uu 1T 249 P;1: ti e--I":1c-.. , _It ,t I 1.2 A i ,J9 titt . ()E,-7CK. uG zpo es 1:, , Rook. 2/ 1,1 _ f' P t d PI Le,:l.,f,t 'it 6, i.e.-"te:its*, t" _ 2 Nt PT , eA7teiti •• No ie.- ". fi(-4-- FiG..! Tr.,( 66,,, ..,... 'cl l#6E _ i . _. 0 ,,....-- . ' , o te, wf:t4: cti ( c_CD 41 . i 1 1 i . AS 75. - 3 - 01.s - r 7 "anotsr pos ''r Tr) co'iNic.. Po' CR-, .. ,... ., S I PE_..,„. Y cil -. C 1 ( ..c, T1 pc) E. o V-- , , 1 7 it),tiot:iiiit 4 3 sim ik 5 f : ',' . * 0 iti 1 , PScIttj 3sr."QG TIE ; 0 f' .; ss 0 It il s i , s II Itt it 4 s' e st 1 i r i ,t, 2,....14 4: i , V-=2 : 1.-4-! 4 - - :-. 1.1 .). lLi iii V: A li Po 1:1 t'. AP..atty 6 0,E ti ';'-' -a- i d ■ 3 -0 5 law % c c? _ *--------- e fri — ........—..„......_".....,, " ------, TO tious SI' i' 5 Ote.... P. tti e0 i.) f! I) 1 l' 1 1 4 ) ) 1 i S / (. 1 PSO 0) ,.. R-C I'd(' T e t t a . 140 i i t i f i i , ,,, r, T T - s I. 11 p i si Ktk.,, , FtYyt ,___/ , t , , , 1 1 1 1 , GempE , i At _ 5 ---- t I 1 i , 1 — L ./ - "\ .,.... 2 71 t-! t5T T q 0 ST km 1.C ri cr ‘ I' Tv K.' t M M 0 ( 0 60 TRAVELERS J� WORKERS COMPENSATION AND -PPr O I [ f ', j f j I t J r?p EMPLOYERS LIABILITY POLICY O 1 1 TYPE AR INFORMATION PAGE WC 00 00 01 A) JUL 2 8 2011 POLICY NUMBER: (6KUB- 4717P37 -4 -11 ) NEW-11 INSURER: THE TRAVELERS INDEMNITY COMPANY 1 NCCI CO CODE: 11347 INSURED: PRODUCER: GIANGREGORIO, ROY DBA FINCK & PERRAS INS AGCY CONTEMPORARY COUNTRY BUILDERS 6 CAMPUS LANE 82 COLES MEADOW ROAD EASTHAMPTON MA 01027 NORTHAMPTON MA 01060 Insured is AN INDIVIDUAL Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 06 -25 -11 to 06 -25 -1 2 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in ° item 3.A. The limits of our liability under Part Two are: ° ° Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit ° Bodily Injury by Disease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE / /C--// 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY . DATE OF ISSUE: 07 -20 -11 AA ST ASSIGN: MA OFFICE: ORLANDO INDUS AFF 161 PRODUCER: FINCK & PERRAS INS AGCY 28NJK 000017 SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Q COLA /0(7 Q C 020 L S 0 62- 57 License Number g L CO 1 -ES M.A pa v R JA . Na;27 t-1 A v-I v► rc; - HA 0/060 42SI2, c7 3 Addre Expiration Da e �� . >.„,. C13 Salo ? Signdture Telephone 9 Realstered Home Improvement Contractor Not Applicable ❑ e. c) w 6 d 4 . Po & +.e.: -i e O v l y W A ( - -4 P v t - - S 1 t 330 Company Name Registration Number g 2_ c _ o c- F"S IM 614 0 Gu.a 0_6. iti -c)P -T Nitro. e . tU , tM A © (.7&o. 6 /0 -1 / Z Y t 3 Address Expiration Date Telephone '(13 -5 &C_ l 7v$ 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 t`, 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 El Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [DI Decks [0, Siding MI Other [1 Brief Description of Proposed Ti E F E L ( G GJ Noos E t t v OC tC P fit S a,cu, STut . M P Ef t t2 O AM AC 'fU Work:ClltSTING E (T & &tc to -V- -5101 NCI 9..00 rt N V RA FTEP S iRd•JA w1 kJta t,oci.k ( lvyet � Alteration of existing bedroom Yes X No Adding new bedroom Yes )C No rocapet Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll heet 2 04 E 6a. it New house and or addition to existing housing. complete 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, et_o 5 E i--E1 (--1I -1 , as Owner of the subject property hereby authorize P- ` GtAd•- elckiO 0 A a- O0--r am 1 / 4 , C u A. euit -6 Eta S to act on my behalf, in all matters relative to work authorized 4t 's building permit application. ,i Signature of Owner Date I, R.0 Gi 4N G Goat° / b B 14 ex, tr TC -f PCJPP -HRN covivrk. `1 i3C.OIe -S , 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. L I Pr to (A_..6°MO Pn Name / - Signature of tamer /A ent 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 a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW YES C IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW 4;6 YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO C DON'T 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 NO YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 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? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. __._ Department use only �_ City of Northampton S'tatusofRerrrm�::. Building Department Curb C rivewa+Permit MAY - 9 2012 212 Main Street Sew rtSepati v�h pity Room 100 C t teriWell Availak3 t DEPT. OP BUILOINU fNSPECTION8 orthampton, MA 01060 Twee Sets of fititrral la NORTHAMPTON MA ° fbno �I 3- 587 -1240 Fax 413- 587 -1272 PI-otiSite Plans Other Spe4* 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' 2.72_ H A9 i Fie-Lb ST. Map Lot Unit tOci R- Ti-tA PTv iV, N)4 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED' AGENT 2.1 Owner of Record: EG -p(SE LEl (tl L7 Z i I ti ST. i k i * 1 1/1MPTO/ 01/4 Name (Print) Current Mailing Address: O t(6d ,( L�, Z 6-e` ,„ Telephone —s " t 6.1 a Signature 2.2 Authorized Agent: C-,i t�IQ r,GR to 82 Lzs 6•fE�Ocw �D, PogT+pt9M P7 i l�il Name ( •nt) Current Mailing Address: Ot c\ \.,n,. 4 {13 ` .SSG- 7 70 & Signature Telephone SECTION 3 - EST D CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building Z o, s-c)Co ° _ (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) 2 - 0 t S O an Check Number do g i 3 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Corrlmissioner /Inspector of Buildings Date File # BP- 2012 -0970 APPLICANT /CONTACT PERSON ROY GIANGREGORIO ADDRESS/PHONE 82 COLES MEADOW RD NORTHAMPTON (413) 586 -7708 PROPERTY LOCATION 272 HATFIELD ST MAP 18C PARCEL 008 001 ZONE RI(100) /RR(100) /WP(37)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �u � 0 /9 Fee Paid C7 3 Typeof Construction: REPAIR DECK,SIDING,ROOF,RAFTERS & WINDOWS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 062571 3 sets of Plans / Plot Plan THE FO ' OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF 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 t- • i p •• ela ,, / 7 ( 5 6, 17 Signature of 'I wilding I ficial 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. 272 HATFIELD ST BP- 2012 -0970 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18C - 008 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-2012-0970 Project # JS- 2012- 001687 Est. Cost: $20500.00 Fee: $123.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROY GIANGREGORIO 062571 Lot Size(sq. ft.): 27834.84 Owner: LEIGH EARLE WARNER & ELOISE B Zoning: RI(100)/RR(100)/WPC37)/ Applicant: ROY GIANGREGORIO AT: 272 HATFIELD ST Applicant Address: Phone: Insurance: 82 COLES MEADOW RD (413) 586 -7708 Workers Compensation NORTHAM PTONMA01060 ISSUED ON: 5/11/2012 0:00:00 TO PERFORM THE FOLLOWING WORK: REPAIR DECK,SIDING,ROOF,RAFTERS & WINDOWS 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 5/11/2012 0:00:00 $123.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner