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29-106 (3) FROM ANNE YOUNG FAX NO. : 5275648 Nov. 20 206 93:14PM P1 AGREEMENT TO ENTER UPON PROPERTY TO no REPAIRS AGREEMENT,made title day of November,2006 between BERNICE PRINCE at Sx Bridge Road,Florence,Hampshire Connty,Massachusetts,by and-through EDWARD F. CZERAPOWICZ under her Power of Attorney,heteinaftet called"Grantor" THEODORE D. TOWNE of,fir_ Q s�cc� Yr tt kk 01o!0-1 bter+eioal�er called"Grantee". — Grantor hereby grants to Granwe permission to enter upon the premises known and designated as 540 Ryan Road,Florence,liampshirre County,Massachusetts€or the following purposes: To make repairs to the chimney,roof and flashing of tfie residential sttuetuwe located upon the premises. The Grantee,his heirs,successors or assigm,shall hold the Grantor,her heirs,successors and assigns,harmless and indemnify them from all costa,damages and loss incurred as a result of any claim against the Grantor on account of any activity on the Grantor's property and from any loss,damages or costs claimed by any persons,which in any way may be attributed to the Grantee's activities,or those of his agents,or his contractors upon the premises. The G7antes ii nther agrees mt to make any claim,against Gn mtor on account of any injury incurred by him,his agents,or his contractors whre on the property, and agrees to hold the Grantor harmless and indemnify her against any claims for injuries to others incunred on the premises while said repairs are being made_ All costs incurred for the repairs shall be home by the Grantee.In the event that title to the premises is not transferred per the Purchase and Sale Agreement between the parties dated November VV�- 2006, Grantee agrees he will maim,no claim against Grantor,her hears, successors and assigns,seeking reimbursement for any amounts paid for materials,labor,or otherwise expended in making the allowed repairs. SIGNED AND SEALS IN THE PRESENCE OF I. JOE V01:1— WTMSS BEMCE PRINCE, by and through EDWARD F.CZERAPOWICZ under her Power of Attorney,SELLER WITNESS THE DOR.E b.TO�,SAYER t�um�r=x,�nocs�saonauenumo�000�sos.nocr y TOOf�j tI313NI�H 'IIgMQ'Ip� 006699S CT6 M 6T:ST Now 90/09/TT a � n �ASSAChlifi[SS9 �� DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street * Municipal Building Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 78OCNM 108.3.4 to act as pis/her construction sup,,,: .,: or. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough buildinz inspection(before work is concealed), insulation inspection (if required) and a final buildinz inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work(electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location ,t (r1113 cf O ffla1lt1)fall 4 p DE PAR OF BUILDING INSpecTio?,S 212 Alain Strcet Municipal Dui!ding Northampton, Mass. 01060 WOM=- R'S C0*1VII'1✓NSATION •L,NSURANCF :" F_=, AVj-T' (Ii cctuxlpc;-mI tt'cc) v,r]Lh a prZncipal plane of businesslresidencc at: KC11 Gil LAci noic'r (Phone-') `.� L 7- y U VS (suit/city/sZa.irizjp) �} CJ 1 U 1 -7 do hereby certify, under tbe.pains and penalties of perjury, h;l! (Vain an employer providing die followine- worker 5 comnens_n:Jo, coverage for Illy etnplovccs v,,or+3ng on Cins job_ 75'-k 4 —7- 7- C) 7 (ir_stLr-� COEI=y) (Poiic; Nt ter) ( ) I am a sole proprietor, generai contractor or homeowner (ci:c?e ont) =d have hired the coonactors listed below wbo hive the follo%ving worker's c000en&,_Dion paicies: (�`+amc u.Co_a::�aul (Ir1Rr1nG; Colr:oan}/i'oUC; ?�rum�c:j (F_>:_�i,-d�oc I�atc) (N=c of Coom(7or) (Ins--u=cc ComoanyvPoli - \um-r) (Emir,Lion Date) (Name of Coouacto.-) (Lnsurancc Compan�/Po�c� tvbu) (Expirdon Dalc) i i I (N2-Mc of Coor?aetor) (I.nsuranc-- Comp;zmf/Policcy lrus,t�z_r) (Expiation Da!r) , (nc.ac�_ddr�ocaJ dca,if ncx�n to mc!ud;�nforn<,_:�oo p_,t to.JJ { ) I am a sole proprietor and bave no one working for me. ( ) I am a home owner performing a1i the work, myself. NOTE:pl=sc be aw.uc oti wt1ij.bcmcovvcn vrbo csplay pc.c=La d •c rrzc.uric oa.d\,c1-Z of twt tacce the t-ro �r� s u-tzeb the bocmowoc raider«ca the p-ouacl,z�yl�cv ri the c n z c o-x C,,Yy o-mod.--Cd m be euVIc)-=uxc the�si;r-�-cc=pe - ca Aa(GL152_=1(5)�=pp U=6cn by e bomcoa=far_Gc5=a p =c ,�y c id fc IeIPJ rL-t ,of ea--Moyer wader do Woclk lL Co¢�pomitioa A,cf- 1 uadc sraad th->ooyy orbs:.rat®ms—y be f«---3-d to tb�t or orzoa or L­fa 16- cove->g'c ve Sc1-'0c eM d"L L--hac to uoirc tovcrasc trod-- scecioe 25 A of),t4L 13'1 m Ion to Lbx L ioa of c-iminal pca w,= ooaw.rxg of a Gae orup to S 1 500.00 for or up L7 ooe y=r cad evil petit a n rSe form of,Stop Work Order cad A rim 0(:S 100.00.day cVjnst me For dq.rta�=�u.c m1y perIDll NujMb= _ d,, 6 6, 1,�p�-- Lot .of Li crmiu= J SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: \ Not Applicable ❑ Name of License Holder: �}I L n y (Z !�W WE e7 1j 7�2- License Number Address /1 Expiration '" — Sigture V Telephone 9.Re4istered.Home Im[i�ovement Contractor rt ,, Not Applicable ❑ Company Name Re isTration Number Z 1 acs y\.1) � v'7 'i I 2 I o—7 Addreesssl_� (L e Expiration D to Telephone —3 5-2-7-10 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.......`0 No...... ❑ 1`1 _.. lomerOwner.Egeinp on 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-wuna_parcei ofland 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 Or Doors D 1 X Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [E] Siding[O] Other[O] Brief Description of Proposed Work: f::?T-J-,-( P -► r- © ��Z- Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa-If New-House-and or-=addition to ex�stina liOUSlng�=complete the°foll"o"w ncl: 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? l l,- f,, d. Proposed Square footage of new construction. DimVe ions e. Number of stories? f. Method of heating? places or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction L Is construction within 100 ft.of lands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or ar floor below finished grade k. Will building G orm to the Building and Zoning regulations? Yes No. 1. Septic Tank City Sewer Private well City water Supply SECTION 7a- OWNER AUTHORIZATION-TO BE-COMPLETED WHEN OWNERS AGENTOR CONTRACTOR APPLIES FOR BUILDING PERMIT l as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date { 1 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. Print Name Signature of Owner/Agent 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 Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces (volume&Location) i A. Has a Special Perm it/Vorunce/Fmdi ng 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 ofDeeds? NO DON7 VV KNO YES IF YES: ' enter Book Page i i and/or Document �� �� �� B. Dues the site contain a brook' body nf water urxvodands? NO \~� DON7 KNOW \_� YES \_/ IF YES, has permit been or need to be obtained from the Conservation Commission? Needs tobeobtained /-� Obtained �-\ Date Issued: i ! \~�/ \_/ ' ' C. Do any signs exist on the property �� ��� YES \_/ N0 \~�/ IF YES' describe size, type and location: ! | D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, gradingexcavation,or filling)over 1 acre nrioh part o[o common plan that will disturb over 1acre? YES [ ) NO C } �� �� IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 4 Department:use only City of Northampton status©fpermit }} - X Building Department Curb VDnyeway Permtt .'. f a' 212 Main Street Sewer/SepttcAvailabii�ty Room 100 Ali ya�tab�,ty k Northampton, MA 01060 '�s €sruc}aa>PI'ans phone 413-587-1240 Fax 413-587-1272 PlatGSlte�lans OtEier ecl 5 �' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR bi�MOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: 4/0 /��yC h y��� Map Lot Unit Zone Overla ❑�stGict ft?{'1 C-e i a7+ 1 Y Elm St'District ? `CB Distnct SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ��2Ti1i C �rI o Name(Print) / + Current Mailing Address: C/W-, Telephone Signature 2.2 Authorized Agent: TNEa®okk Tocxwe 21 L6Lpviu.f (Z8 , EASTI1At46M Name(Print) Current Mailing Address: --) 4—sZ_zL,__ :�72 Signat a Telephone SECTION 3-:ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (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=0 +2+3 +4+5) Check-Number ' This SectiornFor-Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2007-0574 APPLICANT/CONTACT PERSON THEODORE D TOWNE ADDRESS/PHONE 26 CHURCH ST EASTHAMPTON (413)527-9060 PROPERTY LOCATION 540 RYAN RD MAP 29 PARCEL 106 001 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid L"Buildin2 Permit Filled out G,fee Paid y 2 Typeof Construction: Strip and Reroof New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 /t 21 0 6 Si nature 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. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. 540 RYAN RD• BP-2007-0574 GG COMMONWEALTH OF MASSACHUSETTS Map:Block: 29- 106 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category BUILDING PERMIT Permit# BP-2007-0574 Project# JS-2007-000842 Est. Cost: $3500.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THEODORE D TOWNE Lot Size(sq. £t.): 16291.44 Owner: PRINCE EUGENE A&BERNICE Zoning Applicant: THEODORE D TOWNE AT. 540, RYAS! Rr) Applicant Address: Phone: Insurance: 26 CHURCH ST (413) 527-9060 EASTHAMPTONMA01027 ISSUED ON:1112112006 0:00:00 TO PERFORM THE FOLLOWING WORK.-Strip and Reroof 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: OK 03116(07 Lp tilt S THIS PERMIT MAY BE REVOKED BY THE CIT F NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULAT S. Certificate of Occupancy Si nature: FeeType: Date Paid. Amount: Building 11/21/2006 0:00:00 $25.002227 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo