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23A-010
32 PARK ST BP-2006-0362 GIS#: COMMONWEALTH OF MASSACHUSETTS Mao:Block:23A-010 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0362 Project# JS-2006-0531 Est.Cost:$4000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: John Punska 100795 Lot Size(sq. ft.): 18251.64 Owner: WAGNER ROBERT D&MARY E Zoning:URB Applicant: John Punska AT: 32 PARK ST Applicant Address: Phone: Insurance: 5 Dimock St (413) 584-5533 LEEDSMA01053 ISSUED ON 10/5/2005 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE MAIN HOUSE ROOF 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: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Sienature: FeeTvpe: Date Paid: Amount: Building 10/5/2005 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo City of Northampton u, :- > Y8 " Building Department r 212 Main Street 1�7ri "`A'"' '" - ' rt Room100 rcl l as' res uc� Nortgamptorr, MA 01060 Craikkii -• t .x phone 413-5B7-1240 Fax 413-587-1272 b -A, • -..,%. az*^"—s APPLICfCTION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: • This secgon to lie wmpleted by office i.Mgp 'Lot , a Unit - 4 d S� "Zone OveHay Astrid �w12 h d-Q Mfr a s ono- C cepwnc[' SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of R,e�grd�: 1�Le � � 14)4ctor- Sd P44.k ST Name(Pont) Current Mailing Atli' mo- U10(o i 1 r Ivra�rA ca cn4tA , Telephone is�ignature?� SB h` 3-1-6 2.2 Authorized Agent: j O{1vi u AS C Nig cry' ST Leek m4 Name(Print) 7 C. Current Mailing Address: L/E/ '� (—TV— 5-53 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item - Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building efts GYX�,W (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of ConsWction from(6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection (/��r 6. Total=(1 +2+3+4+5) r/UUU• a) Check Number fly This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Informatibn Must Be Completed. Permit Can Be Denied Due To Incomplete Information 111.111111111111. Required by Zoning This column to be filled in by $uiidieg Department Setbacks Front 1111111.11 Side Rear Open Space Footage EIMISEll (tot ane minus bldg&paved arum: • MNIMMMM A. Has a SSppeci�ermit/Variance/Finding ever been issued for/on the site? NO DONT KNOW Q YES IF YES, date issued:, IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES 0 IF YES: enter Book Page' I and/or Document 81 B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? • Needs to be obtained © Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO l.J • IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO IF YES, describe size, type and location: E Will the construction activity disturb(clearing,grading,excav n,or filling)over I acre or is it part of a common plan that will disturb over I acre? YES Qr NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all apfhicablet New House ❑ Addition Q Replacement Windows Alteration(s) (l Rooting "'--" Or Doors ❑ Accessory Bldg. ❑ Demolition 0 New Signs [al Decks I❑ Siding[C] Other[CO Brief Desufption jqf Proposed Work: Strx ma4vn A”.con SL 41ee d /1a cm eot?z 3u aspl.ttsi..stP Alteration of existing bedroom Yes £- 14o Adding new bedroom Yes S No Attached Narrative Renovating unfinished basement _ Yes t — No Plans Attached Roll -Sheet is ifNew house-iika $"ddition.ide i thiobousirria:corhpletah e:fgilowinq: __ a, Use of building:One Family _ __ Two Family Other b. Number f 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 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? _ Yes No. I. Septic Tank—, City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TOBE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES.FOR BUILDING PERMIT I, ?oLe(f W a Slut ,as Owner of the subject property ('`'/� ,• hereby authorize , oks i I.0 13; to act -my behalf, in all matters relative to work authorized by this building permit application. (/ 4k�• LAI _ 4 ay— os Signature of OwnerrDate I, ffj 14 to 771.4.1A.e., r^x' as OvmertAuthonied 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 pai nd penalties of perjury. v illtA IA 14.3 4.4 — Pont Nam .. /a l'i/bs Signatu ..• r• ler/Agent bate SECTION 8-CONSTRUCTION SERVICES +- 8.1 Licensed Construction Supervisor: � '` ', r, Not Applicable 0 " Name of License Holder: 011}1 Y ^ YJI Q35Tra License Number bb1Yntr _ ST- Let d MA" a/ 31 a11> Address bruin:Ilion Date Signature Telephone *:`Wif o "'"".>3 ..:44. cd—c-ik 1 »r.. .-stet =t Not Applicable 0 b it VS- i Gompanv N e Regisiration um er ' ' '-' bWO 4c. s7- tends 07,9- (O/as/c* Address q Expiration Date I( ro Telephone �i-IS-51T SECTION 10•WORKERS'COMPENSATION INSURANCEAFPIDAVH(toy,c.152,§28C{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 ❑ No 0 e mom ]]a The current exemption for"homeowners"was extended to include Owner-gccuoied Dwellines 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 10833.1. 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 Mall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that heishe shall be responsible for all such work performed under the bmidine 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 ._ • R9lMrn I. dub-\ .4opry (yit� of �al-floiltpfo)t 1 £ 9.1”.arhas.lt. t_. DEPhATMENT OP OOIIDlNG INSPECTIONS 212 Main Strca T4uviupnl Building Northampton, Mass. 01060 w'oruait S COMPENSAIION GNSURANCE AFFIDAVIT (Iicrosccitxtmittcc) with a principal place of business/residence at: ----- rA+rnock_ leoSs, )444 (phone`) seisq 53l (fa ct/titydnudnp) do hereby certify, under the pains and penalties of perjury. that ( ) I zm an employer providing (he following lgorkcr's compcnsenon coverage for ifly employees working on this job. tura' c Comp-goy) (Policy Nct() (Lepir_ion D.ie} ' • () I am a sole proprietor, general coon-actor or homeowner(c c!e one) and have hired the counciors Geed below who have the following worker's c ocperszdon policies: Calton of Co.=.tanor) (Inauranc Company/Policy Num=c:) (Sipa-non Dnc) (Nina of Couu nor) Rrsurzoc Company/Polis' N uabb_r) (intitatiof Das) • (Name of Coouaclor) (Insurance Corona-cl iPetic} N:rsbr) (E-pin4ev Dale) (Narue of Coovactor) (.aruranc Company/Policy Numbr) ( rpindoo Date) 'ufov.dmsa—at t .11 cort..=an1 ( I am a sole proprietor and Gave no one worinng for me. ( ) I gin home owner performing all the work myself NOTE:Arse be Enc tb.*:tic boccs to matin pacts t.fa tqu„aa a. to som-..e..-nam or cc..me p^•-. meter•••- sae<-t :gloyc ..ui�..." c'a xa(C 652=1(5)).a?vtic:oo M.Somco t (a:bw.a pQ+ait a:).nMas LLr I.pl n.au or u gleyr wa4r do Wehd. As. I theretry Maxis a — .o y b(u+aN.dm the Daynmaw of a cid nmha9 oro. rIztkr ler N. mc>5e wcifavum vel W al aifian zt to scan Swvcreevac. roxioo 251 of MO1.Mon ou bel Uu.ixq�rtia O on Pa+Qio a asssm of t Cron of.p ..e oe of up to oa yv- u2 civil pm.l*.ie esv.t ef.Stop Week ode.nd. lar ors Loo.Oo;aq y CM, fore, - -'iluoumly _ Parma Naobt lop:_ Lod Si ofLia secjPcrmiucc 155te ___ . .J 04K PT •'PI'\ g• pie, Tap of Nettlynu iiunn t 9TH' rka. •aeeetirNnsette Ix 1 - b -•Pw1, DEPARTMENT OF BUILDING INSPECTIONS (, INSPECTOR 212 Main Street • Municipal Building Northampton,MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT • The State of Massachusetts Slows the homeowner the right under 780CMt 108.14 to act as his/her construction super-r sor_ The state defines"Homeowner" as,"Person(s) who owns a parcel on which he/she resides or intends to be, a dile or two fahu'ly---- 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 t`egulations. 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 1, understand the above. (Rome 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