35-057 (2) . ... •lliyl JiWµl�
Corbett Home Improvement Roofing
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Northampton, MA 01060 Awnings Doors
(413) 584-6571 Canopies
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STgt f o /4 lUH NAME F}1Yj F.
CrrY,STATE.aM ZIP OoM JOB LUCATTUN ^-
DATE OF PLANS JUB PMN_E
We hereby submit specifications and estimates for:
Lip ICL
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Ve CpropoSe hereby to furnish material and labor-complete in accordance with the above Specifications,for the cunt of-
Dollars( G b )
Paynhents to be ntade as follows:
All material is guaranteed to be as specified. All work to be completed in a work-like manner acconling Autmtizecl
to standard practices. Any altercations or deviation from above speeificatioas involving extra ctist$will be Signature
executed only upon written orders,and will become an extra cliarge over and above the Wittate. All
agreements contingent upon strikes,accidents or delays beyond our control. Owner to cagy fire,tornado Note: 71tis proposal may be
and other necessary insurance, Our workers are fully covered by Werktnea's C"a n"nsatioo Insurance. withdrawn by us if not accepted within days.
A-
cceptance of Tropo5Af-nie above prices,specificatio ns
are conditions are satisfactory and are hereby accepted.You are authorized to Signature do the the work as specified. Payment will be trade as outlined above.
Date of Acceptance: Signature
Tro,posar
Vinyl Siding
Corbett Home Improvement Roofing
Northampton, MA 01060 Awnings Doors
r
(413) 584-6571 Canopies
Gutters
s a y yam- Shutters
PROPOSAL SUBMMED TO (11MC4 1Lr S/4-r)f nM?M —o DAIE V LfAA-C. fp Cl/
S7JtEET /J 1 N R,0 JU$NAME
CnY,STATE,aW Z1P CODE }'' JOB LOCATION
DATE OF PLANS n' 1, JOB PHONE
We hereby submit specifications and estimates for:
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C¢ PrOPOSC hereby to furnish material and labor-cotttplete in acardance with die above specifications,for die sum of:�
lays(S�`...,`x'J� )
Payments to be made ac followsN�
foF
All nnaterial is guaranteed to be as specitio d. All work to be completed in a work-tike tnunner according Authorized
to standant practims. Any altercations or deviation front above specifications involving extra eo sts will be Signature
executed only upon written orders,and will become an extra charge over and above the estimate. All
agreements contingent upon rtrikes,accidents or delays beyond our control. Owner to carry fire,tornado Note: This proposal may be
and other necessary insurance, Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within..._..._.._days.
m DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ` Municipal Building '
Northampton, Mass. 01060
wORKEwS COMPENSATION INSURANCE AFFMAAVIT
with a principal place of businesslresidence av
NO N 4 9 7-105'7')
( city/saata2ip)
do hereby certify, under the pains and penalties of pedury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (1 xpiratfon 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/Pofiey Number) (Expiration Date)
(Name of Contractor) (Laurance Company/Policy Number) (Expiration Date)
(Name of Contractor) Gnsurance Company/Policy Number) (Bxpim6m Date)
(Name of Contractor) (Laurance Company/Policy Number) (Expiration Date)
(attach additioad shoe:(if necessary w iDdu&information pertaiaing well ooatma f3)
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 awatn nisi wbilo haawowom who ctnploy pi=cas to&maiuimance,corm czioa or repair wotit on s dwelling of
nrx a-,a than throo units in which the homeowner r=dcs or oa the group d3 appurteaant thacto sic Dot 6cocrally 000sidcrad to be
cnV4OYC n under the worker's compc asaiion Act(GL152,ss1(5))�application by a homcowocr for a Berns-*or p-Ma MAY Cvidcace lb:
legit ctatua of an oaiployat undartha Wodula Conopemation Act.
I uadent*nd trot a copy of this ttatcmeat may bo farwardad to tho Depvu=cd of IO&L.'bial AxiaW&offloa of lmurance for the
coverage va fitattion and that failme to sw=covetago(order soctioa 25A of MOL 152 cad Lead to tbd imposition of a imi w pemwes
oauistmg of a-fine of up to S 1,500.00 and/or imprisonwica of tip to one yt w and civil pcnsSia in the form of a Stop Wort Otdc sad a
fi m 0(200.00 100.00 a day apainA toe.
F"detpai>—"�L1O O4ty
�® permit 24umbex
Lot#f _
Signab=�Qfu u/p ermitttx
r
4
8.1 Licensed Construction Su''p__``rerv^visof`` Not Applicable ❑
Name of license Holder: r�f 'Jr�V L �� � &7y-400
License Number
14 keetJ s-)- *30-01/
Address Expiration Date oe
&Cvw ?,
Signature Telephone
Not Applicable ❑
Company Name Number
Ll & "a ST - /s'- 01/
Address Expiration Date
Telephone —
S rfil± t1 1NQ�Ki:i2S' r DMPI_I SATt�N= ANGE�AFFIIDAV (M:G:L.c. 1S;z.§25I,
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 hive 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
> 7
INa
New House ❑ Addition ❑ Replacement endows Alteration(s) ❑ Roofing �(
Or Doors
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding( ] Other[ �
Brief Description of Proposed Work: I P od -54,
J7US j// /� tf j„/ i ,� dt✓S lJ W_b s
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0- Sheet 0
ffifflMONEWOMMEW
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
as Owner of the subject proper
hereby authorize to act
my behalf, in all matters relative to work authorized bythis building permit application.
Signature of Owner Date
I, &A t' ErT"'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. r t M�o 2
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 %
(Lotarea minus bldg&.paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Perm it/Variance/Fin�diing ever been issued for/on the site?
NO DON'T KNOW a/t1� YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter gook 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 __X,
IF YES, describe size, type and location:
D. Ar there any proposed changes to or additions of signs intended for the property?YES
No
IF YES, describe size, type and location:
(� paing uepartment
12 Main Street
Room 100
1 Q x^02 N rtha pton, MA 0106
hone 4 58 1240 Fax 413-537-1272
phone
H ,ti>>
� ,
APttC$ 0 CONSTRUCT,ALTER, REPAIR, FENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INF 104FA 100
1.1 Property Addr s S. �
SECTION 2 'PROPERTY O.VV UT�Igf fxEt�A UNT
2.10 ngr of.Record:
Name(Print) Current Mailing Address:
Telephone , Q
Signature
2.2 Authorized Agent:
EJ)L )AgjN -1"�'a�i13e�--
Nam ^e(Pri t) Current Mailing Address:
Signature Telephone
Mi
S CTOPI COS'Citl �tX31T
.� �.
Item Estimated Cost(Dollars)to be 4ffidial us. 01-Ily
completed by ermit applicant
1. Building ',(a) Building Permit Fed
2. Electrical (b)Estimated Total Cost of
Constructionifro.,O 6
3, Plumbing Building Permit Fee'
4. Mechanical(HVAC)
5. Fire Protection
6. Total =0 + 2 + 3 +4 + 5) 1 Check Number &2 21 1
Sec.#lbw or Official IJse°:Ont ,,
Building Permit Number: Date tssued;,-
k
Snature. —
uildln 'CoMrn� ssiahewitnsl a tpi f.B°
y N
l BP-2002-1097
GIs#: COMMONWEALTH OF MASSACHUSETTS
15-057 CITY OF NORTHAMPTON
Lot: -001
Permit: B u i I d i n a
Category: BUILDING PERMIT
Permit# BP-2002.1097
Project# JS-2002-1761
Est. Cost: $8950.00
Fee: $25.00 PERMISSION J S HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Ed Corbett Jr 116069
Lot Size(sq. ft.): 17380.44 Owner: TESSIER C ILE V&
Zoning: SR A Ucant: Ed Cort ett Jr
AT. 955 RYAN R
Applicant Address: Phone: Insurance:
4 Reed Street (413) 584-6571
NORTHAMPTON MAO 1060 ISSUED ON:6/10/0 0:00:00
TO PERFORM THE FOLLOWING WO :STRIP & SHINGLE ROOF & 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: Met r:
Foot ngs:
Rough: Rough: How e# Foundation:
Drivi way Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CI Y OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Si nature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 6/10/02 0:00:00 1607 $25.00
212 Main Street,Phone(41 )587-1240,Fax: (413)587-1272
Building Commis Toner-Anthony Patillo