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29-248 (10) i I I j I I I i i I I i I, I I i i i i I i I I I I i i i I I I I i i i I I i i i • (IMPORTANTf MESSAGE) FOR_ v(t/�C LL.Cit..' -x3.114r DATE `d�3f C12 TIME P.M.�'�✓ ■ M if /�/►�-- O F CS ? b PHONE fir ' J429 -. 1/7 . AREA CODE NUMBER EXTE SION..' ❑ FAX ❑ MOBILE AREA CODE NUMBER - TIME TO CALL TELEPHONED , PLEASE CALL; _ -. CAME TO SEE'YOU -.. WILL CALL AGAIN-.'-: -"---,‘ WANTS TO SEE-YOU RUSH RETURNED YOUR CALL'- SPECIAL ATTENTION . MESSAGE 4 ' • I ,,.r.i., .p• I 1 a - / , /' S IGNED jr; i• ' -, / `, * FORM 3002S MADE IN.U.S-A. • itiork„ _ April -•1 l RR APR I I I991 C. Mason Maronn 18 Ellington road DEPT OF BUILDING INSPECTIONS Florence,Ma. 01060 NORTHAMPTON,MA 01060 City of Northampton Building Inspection Department Building Permits Northampton, Ma. 01060 Dear Sir: RE: Permit #565 I would like to get an extension on my building permit #565 with regard to putting a deck on to the back of my home. There was a short delay in my receiving my building permit which caused me not to start my deck as I had planned. Now that the weather is starting to improve I would like to get started on it soon. So I am requesting that you grant me an extension. Thank you, J , Ct'7� //�"tfi'?.c/7z�-�_ C. Mason Maronn 10/1112002 10:05 4132532384 NORMAN 'JEXLER PAGE 01 w - !. , CP qz 't! . ,', -Lt 62 ,r‘, i ' I tt ■ yip iq ______"\.J.1,0 N. �t cM X, } c w �. a r ri , ., 0 J ui 11.4 io Cil 3 to t 2 k.1)), Ir 54 ii 01.._, r 3 .-0 -f-- ,A____I__ if _ I1 0 r 1- ....ri t4-----*-----... - . . _.- �_-._ -- :—..-----.—/'` rl 06 AP: 4 • • OWNER tli„0 MA-2v fq , 60/LIJ/,'L SHEET LOT ADDRESS t* 8 " t,2? 414'7I8 APPLICANT C TELL y-3 j 9 co ZONE !,C aiii ADDRESS M r �'� U DATE OF APPLICATION ttfd(F7 ZONING APPLICATION APP. DATE FEE PLAN _ 4?Lf/r(i7 */41,Q14diket)tr1/4_ 1;t-4 BUILDING PERMIT ISSUED DATE FEE d0 PLAN 0_167e/ .4 :,:..,/. a g. igaeo.d.3;I.oa ■1: b. 11 2-c))2,,vv i �� , > , tr'IAIL' A. r�,? ')(,V a,1 fl_a .46 ho m 1 , 10/17/96 - Construct detached car •. _.- :: •• CITY OF NORTHAMPTON FINAL APPROVAL BY DATE BUILDING INSPECTORS t-46 ORD URTIFICATE OF LIABILITY INSURANCc CSR SF DATE(MM/DD/YY) CAPB50 09/10/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION IRM Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Barry M. Stephens, CPCU HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 73 Market Place, P 0 Box 4580 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Springfield MA 01101-4580 , Phone: 413-781-0416 Fax:413-734-8525 INSURERS AFFORDING COVERAGE INSURED ,INSURER A: Peerless Insurance INSURER B: A. I. M. Scapes Builders & Landscaping LLC and Taos Enterprises LLC INSURER C: 851 Roaring Brook Road INSURER D Conway MA 01341 1 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY MM/DD✓YY)E' DATE(MM/DDNY)) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY CBP9607382 06/25/02 ! 06/25/03 FiRE DAMAGE(Any one fire) $ 100000 L CLAIMS MADE :LX J OCCUR MED EXP(Any one person) 1$ 5000 ' X Owner/Cont Prot. PERSONAL&ADVINJURY 1$ 1000000 GENERAL AGGREGATE $ 2000000 1GEN'L AGGREGATE LIMIT APPLIES PER:I PRODUCTS-COMP/OP AGG $ 2000000 X POLICY PRO- JECT LOC AUTOMOBILE LIABILITY 1 COMBINED SINGLE LIMIT I$ 1 ANY AUTO (Ea accident) ( ALL OWNED AUTOS I BODILY INJURY (Per person) $ L,SCHEDULED AUTOS ' HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) I PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY I AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY j ±EACH OCCURRENCE $ 1000000 A X OCCUR CLAIMS MADE CU9609382 06/25/02 06/25/03 AGGREGATE $ 1000000 I$ DEDUCTIBLE X RETENTION $ 10000 I$ WORKERS COMPENSATION,...D I TORY L I I iT X I ER EMPLOYERS'LIABILITY TORY LIMITS B WCC5002974012002 06/25/02 06/25/03 E.L.EACH ACCIDENT $ 500000 E.L_DISEASE-EAEMPLOYEE $ 500000 EL.DiSEASE-POLiCYLiMIT I$ 1000000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Commercial Construction Contractor CERTIFICATE HOLDER L N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION CITYN-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City of Northampton NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Building Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 212 Main Street, Room 100 Northampton MA 01060 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _IRM Insurance Agency, Inc. ACORD 25S(7/97) ©ACORD CORPORATION 1988 rf • (txt trf Northampton ptn =*_) a 9= r�$ -� � �!�t r4 1:V• sB. saaxcE[ttsrtta _ • ..0'W. DEPARTMENT OF BUILDING INSPECTIONS •WM itir 212 Main Street • Municipal Building Northampton, Mass. 01060 ow' WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, ' 0 0(- -..bm. SPA,0.__A 601 ' to 4116tilL-See Ai • (i•. ' - permittee) with a principal place of business/residence at: 251 e(XX-relV &CEP ' fad I / 1/ / onef) ��/� C(-` 7S9 (ctreet/city/ zip) do hereby cert.- , under the pains and penalties of perjury, that ( I am an employer providing the following worker's compensation coverage for my employees working on this job: Lam: 6'. apioyt t-3 ji s.Co. 5-0o d.9 7 i tc,,oc9 6/x,16,3 - (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) .r (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additic ,1 sheet if nccesssry to inch information pertaining to all eoatradorr) ( ) I am a sole proprietor and have no one workdng for me. ( ) I am a home owner performing all the work myself. • NOTE:please be as that while homcowncrs who employ peters to do maintenance,cuostmeioa or repair work on a dwelling of not more than throe units in which the homeowner raider or on the grounds appurtenant tb to are not generally coardacd to be cmploycr under the worker's compersathen Act(GL152,s3 1(5)),application by a homeowner for a licaix or permit may evidence the legal st=t>>e of an employe under the Workers Compensation Act_ I understand that a copy of this rtatcmcnt may be forwarded to the Department of IncimM al Accid a?Ofrioo of Innauwco for the coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal pcnallies consisting of a fine'of up to SI,500.00 and/or imprisormxtrt of up to one year and civil penalties in the form of a Stop Wok Order and a fine of 5100.00 a day against t t C).) ) For dcputm�al t'a°city 1 : 17 - ----- Permit Number Y -/) v Ma p:l Lot . Signature of Liccnsee/Permittee Date t. wow 1`� v+ SECTION 8-CONSTRUCTION SERVICES • 8.1 Licensed Construction Su ervisor: Not Applicable ❑ Name of License Holder : (..401.j62(6 L��'� C� �� � ��7 License Number P)1C-AOL,4 isr-666_e vrill 0 t30 Address Expiration Date 46 Signature Telephone G"'" e r }fie?S P.Ce 111@ 1111 t illem @11 Ti Ya er ,'' ' ta fi gl§, ` °' Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152, § 25C(6)) J 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 the building permit. Signed Affidavit Attached Yes No ❑ 11:741 omeOwner:E yem ,tiara 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 ocal Zoning L ws and State of Massac•uset s Gene al Laws Annotated. i)- �-�-- 45/ / �`' /Adz/L.2 / Homeowner Signature �G�� ✓ g - d• #>-` .1. I • SECTION 5 DESCRIPTION'OE PROPOSED WORK(check all'applicable) - New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [✓( Siding [ ] Other [ ] Brief Description of Proposed Work: 5 '0' t'__ 6,zcC 4/ e-Pe_'¢(- - is /7)------ Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet❑ 6a If Ne 3iiii e" and or addition ci*65 hint noosing,Fcomplete the folloiiiiiti 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. j Mascheck Energy Compliance form attached? h. Type of construction WO0 D` i. Is construction within 100 ft. of wetlands?, Yes "( No. Is construction within 100 yr. floodplain Yes K No '� j. Depth of basement or cellar floor below finished grade /M. k. Will building conform to the Building and Zoning regulations? K Yes No . I. Septic Tank City Sewer (NC Private well City water Supply SECTION 7a,-OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT'OR CONTRACTOR APPLIES FOR BUILDING PERMIT - I ,�C-1-1-7,•—fig !-\ , as Owner of the subject property 1 hereby authorize �eC,OQ 6VI 0 �(S • ' # lit to act on my beh If, i I matters rel tiv b't`oo'"work authorize. .y thi b Iding p pplication. e 6f 4;:gf-d71.",----Li '7,/2--A 2_ Signature of Owner / Date I, r i;r\n , 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. Si . un r the p .ns "alties of perjury. _.1. Ai . A_ / 4V It r Pr' t Name --/ �44C∎:1: Ll d :I♦ A A Signature of Owner/Agent Date *two I Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department l/ Lot Size P1(4- Frontage ki(161 Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage J� Open Space Footage (Lot area minus bldg&paved i parking) i #of Parking Spaces — NM Fill: I (volume&Location) /1)//1' A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES V IF YES, date issued: /q(U. IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW V YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO I DON'T KNOW 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 NO V IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location: • • \ \I L 'A j� �� � � �► .f Northampton °� � .ing Department `® ® � v"i 4- 2.002 Main Street S e 1 � _ " •oom 100 • e f e � � DEP10f 9U1Lolcry� INSPEIC14 I�� tha pton, MAO 1060 Se e ' `� 4 n MP0ii*Aai D3' ' 240 Fax 413 587 1272 P o'ISIte,Pla - :� : APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to becompleted by office 1.1 Property Address: " I e Elf h n map, e ? Lot - Unit fi iC9 f-�ee /if 4, ���/ ,� �� Zone Overlay District Elm St. District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: C. 1 r .,-earl( or I 1.:Name(Print) _ ��,l �j \ Current Maili dd s _� 1 1 / 4%. 4,„_„.4_,„, d.,,, Telephone Si:nature 2.2 Authorized Agent: _ N t) Current Mailing Address: C.rik4 W it o/JVI c L ---- yi 3- 362 - 71" Signature Telephone SECTION 3 ESTIMATED CONSTRUCTION COSTS Item I Estimated Cost (Dollars)to be I Official Use Only completed by permit applicant 1. Building I.2 Ltif-L9 (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 &//5 cO5c)Q .This Section For Official Use Only Building Permit Number:'.PJ` ". 03 -6455 Date issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2003-0353 APPLICANT/CONTACT PERSON DOUGLAS BLOWERS ADDRESS/PHONE 851 ROARING BROOK RD (413)369-4759 PROPERTY LOCATION 18 ELLINGTON RD MAP 29 PARCEL 448 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT ' Fee Paid Building Permit Filled out Fee Paid 07 Typeof Construction: REBUILD EXISTING 24 X 15 DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 021087 3 sets of Plans/Plot Plan THE LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS 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 Conservationn Co sion Permit from CB Architecture Committee 2 c5 o z_- 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. 18`ELL114GT.ON BP-2003-0353 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29 448 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2003-0353 Project# JS-2003-0583 Est.Cost: $12000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DOUGLAS BLOWERS 021087 Lot Size(sq. ft.): 12893.76 Owner: MARONN C MASON&BARBARA A Zoning:URA Applicant: DOUGLAS BLOWERS AT: 18 ELLINGTON RD Applicant Address: Phone: Insurance: 851 ROARING BROOK RD (413) 369-4759 WC CONWAYMA01341 ISSUED ON:10/9/02 0:00:00 TO PERFORM THE FOLLOWING WORK:REBUILD EXISTING 24X 15 DECK 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 10/9/02 0:00:00 6115 $50.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo