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29-135 (4)
_ 30' - - 6'9 i 12' -'I - 6,5 - 10'9 I _ `f' BATH N615 x 5'10 - _ 1V6 6 00 00 N KITCHEN f :; MAS FR BDRM 10,9 x 11,8 9'2 _ 14'$ ' 9°2x1 i�4 LIVING -..- 14'8 x 11'4 I � - g-2 t 7`1 98 LIVING AREA 20,4 - %20sgft - - - - 30' (rifL) of k1orfllailiploit �Z�7enrhntclte DEPARTMEIJT r ` � OP BUII�(1\G INSPPCTIOI<'S 212 Mti'M Strect ' Municipal Building Northampton, Mass. 01060 `'YORKER'S COi 'U'ENSA'nON INSURANCE AF MANM' (liccusxlpern�ittcc) \),rtth a PI-mcipal place of business/residence at _ LI i ig- QI fJ6,;t °�� (stir-...t/city/staicrz�p) do hereby certify, under the pains and penalties of penury, ?112! ( ) I un an employer providing the iollowint� worker s colnnens.:�ot: covci-a,�e for my employccs working on uhis job (LSll Dc-. Cocn=v) --- — (Polio; Nu--abccr) Date) ( ) I am a. sole propr,etor general contractor r}hotneowver,( ie one) and have hired the con ractors Listed below v,Lo h2ve the foLlo%vwQ worker`s com:;en---Uon policies: (Name Oi Co:-,Imcio") (111R1mlic:. Comoa7 -ill oL c "4IM,---) (Name of Con(ractor) (lasunflcc Comoan�•iPo!ic-,, Nurncrr) (Expo:Lion Date) (Name of Connacto;) (Iasuranc CompaoyfPopc) Numbu) (Exo ---boo Datc) (Name of Contractor) (Iasirancz- Comp;ny/PoLicy Numbs) - (Expu-,lion Date) ( ) I ama sole propnetor and have no one working for me. ( , I am,a home owner performing all the work myself. NOTE:pl=s be v{�Jc hoar��n u1>o caTICIy pc-zocs W rrpav,,ark on,d,,,LL g of not mocc t1�o l.`lzr_ i'�i.�ulrC the L»=, o-Dv rtaid�oc oa the p-a.,.n4�z,-�p�uteci_n tbrr,.n rr-c ox�->.:_ity ai:d--�d to be e,'t,loyc-a unG t<>:`xi-r-er _lion Acl(GL152,:s 1(5)�mpplint on by a hemp o-Dcr fnr c L^ c<perm t rn-y e i&mcc Ul c Icg1 rtanu of cn cs.,>Ioyor undrr dw Worlorr Coazp�Ac_ I und—L—d dw a oopY of tai. may bo fo�to Lb,.p� -y or l..hz i j Arov �OfLioo of tnvri000 for Lb. oovcrxSc vairctioc And t1u r--d rc t,o secure co-cT udder soczioa 25A of 1.{OL 152 c o Iced to the iazposilioa of crimuw pcailtin .. oomistmg of a tint of up to S 1-500.()0 110cx Of up W cn> year eaI c��i)pm.ILa io Lk form of a Sta�>Work order lod a Gm o(S100.00.d:y rpmi ar_ Fa dq,+nn�-=J u�c«ily 7 3 -00 PCT I1JI Numbar Lot Signatilrt Liccs>scc/1'cniuttcc ��e �kECTION 8-CONSTRUCTION SERVICES -.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone NIEMEN, ,W. a Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION'10-WORKERS' COMPENSATION INSURANCE AIFFIDAVIT(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 of the building permit. ' ned Affidavit Attached Yes....... ❑ No...... ❑ rg ��h i �, � 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 Zoni g Laws and State of Massachusetts General Laws Annotated. Homeowner Signature 9 CTI 5-. TI© O S ;,.WO e b New House Rf Addition ❑ Replacement Windows LAIteration(s).10 Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes X No Plans Attached Roll ❑ - Sheet❑ a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms - c. f c. Is there a garage attached? d. Proposed Square footage of new construction. Zc7 I'u(nl-0 Dimensions e. Number of stories? 9 f. Method of heating? G/ Fireplaces or Woodstoves " Q Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? Type of construction Ax L 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? h Yes No .YY 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, Tn1GS Piflr*<-TT as Owner of the subject property hereby authorize to act on my behalf, in all matt r relative to work authorized by this building permit application. .; — ignature of OxW. Date � n?GS M 0 e11" 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. ned under the pains and penalties of perjury. q 11 Me-I' /y/©#'_t't- Print Name 7-3-00 ignature of n r/Agent Date r :.r 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 Lot Size 7 16.'-10 Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage D 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 DON'T KNOW YES _ IF YES, date issued: A,'qo IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW /\ YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO 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 IF YES, describe size, type and location: & loaL Gh"01:Zn W5S IAI!!�frl ffor11 ©F H005C D. Are there any proposed changes to or additions of signs intended for the property ?YES_ Nom IF YES, describe size, type and location: City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 3 ¢: phone 413.587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION''I-SITE INFORMATION This section to'be corn et ff 1.1 Property Address: 3 RIM Li I Yy�h r�J f I D171 CL Me ®1 DG �MA� Stviskricfi SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Jgftle-s theft; Tr 311 l n&� 006.2, me(Print) Current Mailin Address: ".0.1 L13 - 5 '�- S�'L14 Telephone Si ature 2.2 Authorized Agent: ,, } J)tne-S l��f�c-tTf LIJ Name(Pr t) Current Mailing Address: -�- LI 13 - y ignature Telephone SECTION'3 k ESTIMATED CONSTHUCTIOWIC.O S Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 00 (a) Building'Permit Fee 2. Electrical ¢/ (b) Estimated Total Cost of `f' /.S d o Construction from 6 3. Plumbing 4 / 0 0 a Building Permit Fee , 4. Mechanical (HVAC) / 5. Fire Protection 6. Total = (1 + 2 + 3 +4 + 5) y Soo Cheek Number This Section For Official Use Only Building Permit Number: "� Date Issued: Signature: Building Commissioner/inspect6r of Buildings Date File#BP-2001-0010 APPLICANT/CONTACT PERSON MOFFETT JAMES ADDRESS/PHONE 341 RYAN RD (413)585-5844 Q PROPERTY LOCATION 341 RYAN RD MAP 29 PARCEL 135 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 _ jypeof Construction: REMODEL KITCHEN CHANGE LOCATION OF DOOR&WINDOW&ADD SKYLIGHT New Construction Non Structural interior renovations Addition to Existing AccessoKy Structure Building Plans Included• Owner/Statement or License 3 sets of Plans/Plot Plan THEFOELOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: !//Approved as presented/based on information presented. eW 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 Conservation Commission Permit from CB Architecture Committee Loot) Signature of Buildin fficial 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. 341 RYAN RD BP-2001-0010 GIS#: COMMONWEALTH OF MASSACHUSETTS r* Map:Block:29- 135 CITY OF NORTHAMPTON Lot: -001 Permit: Buildin Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2001-0010 Proiect# JS-2001-0010 Est.Cost: $14500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Lot Sizes . ft. : 21780.00 Owner. MOFFETT JAMES Zoning.URA Applicant. MOFFETT JAMES AT: 341 RYAN RD Applicant Address: Phone: Insurance: 341 RYAN RD (413) 585-5844 (� FLORENCEMA01062 ISSUED ON.7/7/00 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMODEL KITCHEN,CHANGE LOCATION OF DOOR & WINDOW & ADD SKYLIGHT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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 sienature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 7/7/00 0:00:00 174 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo