29-183 (2) — -.�PropoSClf— vinyl Siding
WindOIA'S
Corbett Home Improvement Roofing
� I�dwrs li
Northampton, MA 01060 Awnings
i�
(413) 584-6571 C`nop1e`
C;Utters
� 9o'& C�(J� Shuuers
PkOPOSAI.St BSt rl'1tiD To PHONE DATE
IHFP I / 5 VV�V✓� �a/V JOB NANtE
ll
lTI 1�.4 ) JOB LOCATION I
'. _}.5 Ili.:mil l'C'IIDE 111 111�A
DATE OF PLANS JOB PHONE
I! \�c hcrehy submit slecihrllu t is 111d estimates for:
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�! 975- j r
(We (j)ropose hereby to furnish material and labor-complele in accordance.with the ahoy specifications,for tike sutra
1'aynirms to he wade as follows: //V 14-1(14' 3; dw
i
:111 nedrrial is guurutJrrd to hr as specilied. All work to he compleled in a work-like wanner according Authowed �v
I,>r adard Practices. AIIV altercations or deviation[rum above%pecihcauolls Involving extra costs will he Siguarrire
xe.aI Vd kutly uPtu1 written orders,and will beadwe an extra charge over and ahove the estitnate. All
:� rrenirarc cuNin gent upon strikes,accidents or delays hr d nd our c ourul. Owner to curry tire,tornwlu Note: Tlki.e parfxtsal clay he
� �. Po y. y
and k,iher ueeessary insurance. Our workers are gully covered by Workwen's Compensation Insurance withdlrawu by us if nol accepted)wdlull days.
Acceptance of Troposa[-The above lxices,specihcalious
are CoIIdItIojI,,,are.satisfactory and are hereby accepted.You are aulhnnzed to tiiguawre
dlo the wdxk a.s specified. Paynfeut w I he faille as outlined)ahoy.
I,
�� Uale d,f At":,! nn: Signature
�A
¢{tIMfPJO
Z'O a
a e Grit-r of wart 11aillptell T
se �astsarllnsclla
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 "
WORKER'S COMTENSATION INSURANCE AYMI A.VTT
(Ii censerJpermi flee)
with a principal place of business/residence at:
A/ (Phone#).-,
( city/stat Jrip)
do hereby certify, 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:
assurance Company) (Policy Number) y (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)
(Name of Contractor) �Jasivanee Company/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) ~Utsumace Company/Policy Number) (Expiration Date)
(attach addidocAl suet ifnaD=ury to inchxk infottnsSioa pertaining to all coatrad o)
I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while bomwwnas who aaploy pasom to do=,.h mznx,coasuuctioa or rcpak work on a dwctliag of
not Moen than throe unit+in wtvch the twmoowncr Mid=oc oa the gtw.ncis appwtenaat thereto ace not gcoav2y oowulasd to be
cmploy+a3 under the worker's dim Act(GL152,ss 1(5)),aW iration by a homoowna for a lioc=or permit may cvidcooc the
1eg21 ctstua of an ompleyor under the Work &Compoosatioa Act
1 understand that a copy of this ciatcwaa=Ay be forwnnied to tho Deputmcot of loduihial A=dca&Moo of Inaatum for tho
coverage vu-&cstioo and that failure to sowm coverage under soctioa 25A of MOL 152 can lead to the iasPCUifioa of aimi W Peaaltitt
SFCTiO,N$ .,ON5TR400 N SERVICES
$.l licensed Construction nSrnSup--`errvhviss8or`` /� Not Applicable ❑
Name of License Holder : EDUx�fI�.V O1R f''�s1tZ dz7y�0
License Number
ketr.J Y-Jo-o y
Address Expiration Date
Signature Telephone
W 10110M i it
Not Applicable ❑
OEM ,a tx-rMAT: 1/466?
Comp acty Narr 1—� Registration Number
Address Expiration Date
Telephone 52W—k7/
S hT1t N 10-WORKERS':C4, N1 tNSATl0N:U_,, AN,.E,AFFI DAVIT;(M.G.I c. 152, §25G(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidi
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... No...... 0
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)famili
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner act
as su ervisor. 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 tl}an 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 buildine 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 liable for person(
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
•
s
4 P
E�TION 3=DE5
R f f b pf
New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ) Siding[ ] Other [ ]
Brief Description of Proposed Work: N s4n u, i i vIN 6t1�N D S W LQ(,J-� s
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll o - Sheet 0
#' ntQ zis# fi cis e# i .
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. Mascheck 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
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
ARE=ON TO BE0f1�V1Pi. ED WHEN
G4APLtIS FaR BU#CD( Pf;ftlVl7
as Owner of the subject prope
hereby authorize to ac
my behalf, in all matters relative to work authorized by,this building permit application.
Signature of Owner Date
T L0R 1b£—) -T— JAR 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.
u
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
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 DON'T KNOW YES
IF YES, date issued:
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:
n Arn Ohnrn i„ ,.. -A,4;};n.+n of .....,., ;-4�,,..,.-A lC-- ll.,.. ,,,,.1.,9VCC1
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
phone 413.587.1240 Fax 413.587-1272
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: -
/0-5
Elf t�L{,rS_.�.,� '. data" . - - � `�
SECTION 2'- PROPERTY O /A
WNERSHIPUTHaFtI�ED Al EN'
2.1 Own r of Record:
&74�
Name(Print) Current Mailing Address:
Telephone
Signature � _.
2.2 Authorized Agent:
wIgg IN —r
Name(Print) Current Mailing Address:
7. S9 y• 65'7/
Signature Telephone
S CT10 3 ES'f'JMATEDyCdNS
Item Estimated Cost(Dollars)to be Dfficial Use Only
completed by ermit applicant
1. Building (a) Building'Perfri
2. Electrical (b) Estimated Totes OOS1 of
Construction L frorm.6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3 + 4 + 5) Check Number
This Section Far Official Use;1!Lhl-
,
Buildin d Perm it Number:_; _ _ Date issued
105 BRIERWOOD DR
BP-2003-0606
GIs#: COMMONWEALTH OF MASSACHUSETTS
Man:Block:29- 183 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-0606
Project# JS-2003.1003
Est. Cost: $4975.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: - Contractor. License:
Use Group: Ed Corbett Jr 116069
Lot Size(sq.ft.): 10367 28 Owner., JONES PETER A&ELEANOR B
Zoning•URA Applicant: Ed Corbett Jr
AT. 105 BRIERWOOD DR
Applicant Address: Phone: Insurance:
4 Reed Street (413) 584-6571
NORTHAMPTON MAO 1060 ISSUED ON:116103 0:00.00
TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT 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: Q 1< J $-b'3 ••�
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
Fee Tyne: Receipt No: Date Paid: Check No: Amount:
Building 1/6/03 0:00:00 1805 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo