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24C-121 (10)
• • BP-2007-0015 GIS#: COMMONWEALTH OF MASSACHUSETTS mffigamoieris CITY OF NORTHAMPTON Lot: -001 Permit: Building Calego BUILDING PERMIT Permit 14 BP-2007-0015 Project# JS-2007-0025 Est.Cost: $2000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JALBERT ELECTRIC Lot Size(sQ ft.): 6621.12 Owner: Taub,Jennifer Zonine: URB Applicant: JALBERT ELECTRIC AT: 132 FRANKLIN ST Applicant Address: Phone: Insurance: 591 Elm Street (413) 734-4976 W SPRINGFIELDMA01089 ISSUED ON 7/6/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:Replace Kitchen wall 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 it 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: FeeType: Date Paid: Amount: Building 7/6/2006 0:00:00 $50.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2007-0015 APPLICANT/CONTACT PERSON JALBERT ELECTRIC ADDRESS/PHONE 591 Elm Street W SPRINGFIELD (413) 734-4976 PROPERTY LOCATION 132 FRANKLIN ST MAP 24C PARCEL 121 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid L--Building Permit Filled out (.,We Paid *So.vo 47.6, I Typeof Construction: Replace Kitchen wall 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 FOLLOWLNG ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO TION PRESENTED: pproved 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: C 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 071o610 _ Signature ilding 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. ."`�, e11:23-1- y. City of Northampton sofP ;' . D -= 7 � a Building Department 2e mR;as �s4 ''� . r 7 s �`_. 212 Main Street sewer? a 4" Room 100 M r ` Northampton, MA 01060 SE54ra' Plns" --� a�- Z. _ r phone 413-587-1240 Fax 413-587-1272 Otfie@SI eMY c .- .�,-ey t s.i APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION.t-SITE INFORMATION 1.1 Property Address: This sectionto tie completed Welke 11.1 Fgait 111^- t43�{rGa� ' eer ` :t24 Unrt zone •'1 t Ovedaythsterct Eiim LDistrfct - Callistnct SECTION 2-PROPERTY OWNERSHIP/AUTHORIZEDAGENT 2.1 Owner of Record: t< 'Et 779-2.,/ JUL 6 2007 _,1 Name(Print) Current Magna Address: Telephone '1$ Signature 2.2 Authorized Agent: 1.)-4LB6kt £Lfctn.'Lc— Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED.CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building W O ' ' (a)Building Permit Fee 5 /14-/ 000 2. Electrical I(b)-Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) t�� fY7) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number t$ y26 ( ¢ S0 iQCI _T This.Section For Official Use Only '-Date:- Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date $moo e • Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information 111111111 Existing Proposed Required by Zoning This column at be filled in by Building bent IMMINEEMIMM Setbacks Front t.. / Side 11111.111 ff\tt/\ Rear Open Space Footage Ellenlial (Lot ansa minus bldg&paved • in; se A. Has a Special Permit/Variance/Finding ever been issued forton the site? NO 0 DONT KNOW Q YES O IF YES, date issued:. IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW (a YES O IF YES: enter Book Page-, and/or Document 4' B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW © YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained . Date Issued: • C. Do any signs exist on the property? YES O NO a 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 f",1 ' IF YES, describe size, type and location: v�^ • E. WM the construction activity disturb(clearing,gradhlg,excavation,or Ming)over I acre or is it part the common plan that will disturb over 1 acre? YES © NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED.WORK(check alrapolicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors C Accessory Bldg. ❑ Demolition ❑ New Signs Cl] Decks [q Siding[C] Other[D Brief Description of Propos / cri � Ti Q Work: .cL rz .V N �// Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Bafifhtew`,koise'an�fioF`a""'d��orP'�a ezistinq hops'F€�s�coit9pfe��fi'IPov'ainq: 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 stones? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 fL 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? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION Ta-:OWNERAUTHORIZATION-TO:BE:COMPLETED-WHEN - OWNERS AGENTOR CONTRACTORAPPLIES.FORSUILDING PERMIT I y I, �A Vr.. I r y�J as Owner of the subject prope hereby authorize 3—.0 J./L/7// to act on m;behalf,in al afters lative to work autho ed by this building permit application. q yinsi�u Signature of Owner Date I, 3—D 77/.-- LMr2t.--1 /S� /a-Ler as Owner&�utry+n3,ed } Agent hereby declare that the statements and information on th21/511 fo going ap tion are true and accurate,to the best of my Knowledge and belief. Signed under the pains and penalties of perjury. ,,) off.•- .�i9 L/,J .21r Print Name ^ / Signature of OwnedAgen / Date SECTION 8•CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Homer 3Jf 3;9 Cf`"""1 020 1!p License Number S9 / i fi u- -5-PC /4.4' 61W9 ;40. aa�J Addross Expiration Date 1.G. 771 Y9a6 Signature / Telephone l[xmaua tT _=._fin ,,9%-n !a. ., . �`i Not Applicable 0 �)QIII Company Name Registration Number 7 , f ‘2,4o7 —_ Address Expirabo Date Telephone _ SECTION 10-WORKERS'COMPENSATION lNSURANCEAFFIDAVtT(MAL..c.tet,§25C(S)) Workers Compensation Insurance afdav0 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 Cl in :Js 47) ZVIill-. The current exemption for"homeowners"was extended to include Owner-occupied Dwellines of one(I) 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 1083.5,1. Definition of Homeowner:Person(s)who own a parcel of land on which hefshe resides or intends to reside,on which there is,oris intended to be,a one or two family dwelling,attached or detached structures accessory to such use and(or farm structures.A parson 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,tint he/she shall be responsible for all swat work performed under the buildine permit As acting Construction Supervisor your presence on the job site will be requited fromtime 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 iSd t� b Qtlwr p,, a, he i Of t nrfijatit} taii ii ' £ �t.ei.oin.rtt. _ sm. • Is r> - OEPnIiT 4E!C OP BUILDING INSPPC�'10 f.'S • 212. Maio Street ' Municipal Building — cs tler Northampeon, Mass. 01060 ' R`ORra.1t'S COITPENSATION INSURANCE AFFIDAVIT • (scene-cfperavnce) with a poncipal place orbusinesstresidenet at: (;hone#) ' (snc.Ucityfst4 Jc p) • do hereby certify, under the.pains and penalties of perjury; Siva • ( ) I am an employer providing the hollowing worker's compensation coverage for my • employees worbng on thus job. I (tar re. Coor_ce) ' (Pence Nunbcri fExpiraon Dat:.) • (<1 am a sole proprietor, general cow:raaor or homeok><ner (caste one) and have hired the conuacgrs listed below who have the Following worker's compenssanon policies_ (Num of Cent:naos) (Insurance Company/Policy Numtt_;) (Eeutmc_n Dari __ (Name of Conmaor) (Insurance:Cnmpaav,PoUo- Number) (E rnmuoo Dint (Name of Courant,) (snsmaoce Compaoy+PoUcy Namhe0 (E.lpindan Date) • (Name of Contractor) (insstr-ancz Company/Poticy Nitresi (Eap"vadoo Dam). (avast' 4Xioom isce itarermery b'uw'uo 'oa Maui n6 in.11 ewe-tor.) . ( i am a sole proprietor and have no one working for me. () I am.a homeowner performing all the work myself. Non:plc- ea reerc P•s weJe bee-evr°nm.arpiny to as^-•_.- r_---:erc-reyv wn m.a..atLr.of a«coat il=a_ce tat.,is°'=a VDC namaawaa nom Of 00 illf pM1,,oa 12p31+< unto,.=COC s--.>:ty aortalnne opieyca We,"tte wc3ay,¢:q�:im Aa(G4152,aI(5)1 repLaew by 4 hommeee fa a bc..cc perm we a.4ate.'LL< icy wu of m adore.node.Ga Worker'.Coweereweee ea r wadcntudthat a copy a Wu mina w y ly rv.m.6.d n ass poi....-ma 0rtdW:d tm. _eOl+o.ofWaa+S0.Ca- c W2l.gt.'eircEliw M N1 Chao ta.mtn'm..ensn lance tmioo 15A at.IOL 152 m lad to he lapa+a orcmiail Pa+Lie cani-mgot.an=ofw to st2fCP.Co tract'mw+r>ms orvp to ea r-rtad=.a pen..reeves r«m ar.5504W441/4 fO 'm' a(.I no.Ol)leo.,pais me _.-- Ger a preersd we we/ Porton Numbs: _ Maine'_ Lot I Sipiauuc of Licason/Peeniucc Once _. .J F. ait e (ri#p of Northampton a�mitetz=� s3s' DEPARTMENT OF BUILDING INSPECTIONS W' 212 Main Street • Municipal Building % INSPECTOR Northampton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supe: .1Sor. 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 building inspection (before work is concealed), insulation inspection (if required) and a final building 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