43-063 (5) 40 DUNPHY DR BP-2001-0245
GIS#: COMMONWEALTH OF MASSACHUSETTS
May:Block:43-063 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2001-0245
Project# JS-2001-041 1
Est.Cost: $4200.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
UseGrouo: B & R Siding 100465
Lot Size(sq. ft.): 15115.32 Owner: MCELROY PATRICIA L
Zoning:SR Applicant: B & R Siding
AT: 40 DUNPHY DR
Applicant Address: Phone: Insurance:
781 Bridge Rd. (413) 586-4167 Workers
Compensation
FLORENCEMA01062 ISSUED ON:
TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House if Foundation:
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 9/6/00 0:00:00 17236 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2001-0245
APPLICANT/CONTACT PERSON MCELROY PATRICIA L
ADDRESS/PHONE 40 DUNPHY DR
PROPERTY LOCATION 40 DUNPHY DR
MAP 43 PARCEL 063 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
lypeof Construction: Siding
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 100465
3 sets of Plans/Plot Plan
THEkfOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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 C ns�ion Permit from CB Architec e Cimmittee
s AC%1'%�C/ Zo00
Signature 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.
•
•
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: ° it 4
q0 D Nfreit4v, )J 2 i L c. • oSi+
t Y q £
F - 0/06 �ir
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED�T
2.1 Owner of Record:
f2g7 MC 5J ' ' C
R/GIA Gd d-� 90 •,,'p. . ��V
Name((P,atrrth Curre ,planing ANG�ddres tri.4v
ta \ V lP_ ICIZin� �t
TelephoJ OG
Signature
2.2 Authorized Agent:
ato) a L 1�(eaoy 7Yi Tor
Name(Print) Curre Mailing Address.
GT�Tnn) yyi �SL' /67
Sig ature d Telephone
SECTIONS-ESTIMATED CONSTR CTION COST"
Item Estimated Cost(Dollars)to be 4 Official Use Only
completed by permit applicant .a
1. Building5`aoa % (a) Bui[diing Permit Fee
2. Electrical (b)Estimated Total COAtdt:
ObtialayctiOn from,(0). . .
3. Plumbing Buildi .,� er
t i
4. Mechanical(HVAC)
5. Fire Protection r
6. Total =(1 + 2+3+4+ 5) 471a.06 97r Check Nilfrnber 1' 2,;(4. iy,. }.
Section r6r OfItNat Use O '
Sodding PermmNUnaber: Date Issued,
l .: �,•:; . .
Signature:
Building Commissioner/Inspector of Buildings ..
' Date:...
Section 4.
eaa, 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 DONT 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:
D. Are there any proposed changes to or additions of signs intended for the property?YES
No
IF YES, describe size, type and location:
eisISCTION 5--DESCRIPTION OF PROPOSED WORK(checlS all aoolicable)
Z
New House 0 Addition 0 Replacement Windows Alteration(s)0 Roofi 0
Or Doors 0
Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks [ ] Siding Other [ ]
Brief Description of Proposed Work:
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
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?
es.. 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-TOSE ieLJ� ED WHEN
OWNERS AGENT OR CONTRACTOR APPL)ES=FORi U , PERMIT
I, Ani(IA }91c E//L47 , as Owner of the subject property
hereby authorize El.tZf4: r) L e2w9o/ to act on
my beha in all matters relative to work authorized y this building permit application.
. - S d0
Signature of Owner Date
I
I, G/+a I ..) L 19)0 4'0 y aster/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.
wSigned under the pains and penalties of perjury.
e..ela) a 1... 4 (z/4Dy
Print Naamee`t,-c—_
el
Signature of Owner/Agent D J a
•
,LSECTION'B-CONSTRUCTION SERVICES
,.1 Licensed Construction Supervisor: / ``�/ Not Applicable 0
Name of License Holder: 5 4F,/J L � A�"9�J7 01404'i
/ License Number
42/ 17 ✓J
Address ��� ,r �/ Expiration Date
k 17)2 1� MAT
-
Signature U Telephone 'r/g
aw
1. .n.;,rw'" Not Applicable 0
f33c x_ s 0.NG S 2' c., )oo4'Ls
Company Name Registration Number
f$/ JAR, Jye,
Address
d/� // 1 y�- /, Expiration Date
rjV14ho,D74A/ /r// ' Telephone 3rid"7/67
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.GA.c. 152,¢236(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 0
eleN
ro . x
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings 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 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
I
•
raatlwrnao4
reA r. e Uiti of Por-tllant} ttm , •
4e •
DEPARTMENT OP BUILDING INSPECTIONS
272 Main Street ' Municipal Building
Northampton, Mess. OIO60
WORKER'S COMPENSATION INSURANCE AFILUAVIT
Oiccustripernuttrc)
ioth a principal place of business/residence at:
- ��+,j'
)11.41 (IMO :) ,'bs� ./ •
—'j (rota/ tytstamuip)
do hereby certify, under the paws end penalties of perjury. that
(y), t :m au employer providing the Following worker's comneas_=io::cove:e e i f my.
employees wonogg au utiS job.
Li. t erVi / RNs ' ZNC, p-3/5. 3a179i-oto o$-is-aOzI
/r. ^t= f:orae.:ny) (Policy Nu:nirr) -_..... (r:1urtuon Data)( ( ) lam a sole proprietor, general contractor or homeowner(ci;cie one) and have hired
the coaaanions listed below who have the following workers C atncnsation policies
(Name of Cow.mao:r) (IE}si r .. CmnoanyipoUef Nmnbcr) (Us:n;m:on Dav)
it
(Nome of Coniracior) Cnuwzma Como-day/Bolick Nmac^r) (irsfarnnon Dale)
(Name of Connie t) (Insurar.. Company/PoUcy Number)...� (Ifdrartino Date)
(Mame of Contractor) (lnsatranat Cowpony/Policy Nombre) (avounnon Daic)
()arab retccl,a:lPocncmast!uAlefn<ni es 5 crtao>'s to.0 vurstsets)
( ) I am a sole proprietor and have no one working for we.
() 1 am a home owner performing all the work myself_
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