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42-134
884 WESTHAMPTON RD BP- 2010 -0059 GIs #: COMMONWEALTH OF MASSACHUSETTS Map:Bloc 42 -134 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categor Deck BUILDING PERMIT Permit # BP- 2010 -0059 Project # JS- 2007 - 001923 E st. Cost: $11198.00 Fire: $66.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: _ License: Use Group: ROBERT CARRIER JR Lot Size f.): 16117.20 Owner: MARTIN JEAN M - Zoning: SR(100) //WSP II A ppl i cant : RO BERT CARRIER JR Applicant Address: Phone: Insurance: 16 David St (413 52) 7 -0333 SOUTHAMPTON MA01073 ISSUED ON. 711712009 0.00 :00 TO PERFORM THE FOLLOWING WORK.-REMOVE UPPER AND LOWER DECK REPLACE IN SAME FOOTPRINT 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: 1�C� �`L ,,. . Rough: Rough: House # Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: '�tt• Insulation: Final: Smoke: Final: O h� �" x'49 AM THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULAT NS. Certificate of Occupancy ,� ``Si nature: . FeeType: Date Paid: Amount: Building 7/17/2009 0:00:00 $66.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - I.nthony Patillo ti x Pe�artent lase only - City f Northampton S�s o Peit RM tY p Building Department Eirb� 'tpixvevi�ayerrnit 212 Main Street ealrerSeptscAvallabi {ity . Room 100 a€lfNefl AVallabll� 9 Northampton, MA 01060 Trio Sets a�iacne1 phone 413 - 587 -1240 Fax 413 - 587 - 1272 tyt W APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLIS OR*O FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 PropertV Address seotior T" to e.o mpleted by office w e.54 oo liv .�, K(• Map Lot Unit Zone Overlay District j kIMSt.'District GB District SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record Name (Print) Current Address: Telephone Signat e 2.2 Authorized A ent: Ul u 73 Name (Print) Current Mailing Address: S,;L ? -®3 Signature Telephone SECTION 3! -ESTIMATED CONSTRUCTION COSTS Item Estimated- Cost - (Dollars) -to -be - Official Use Only com feted by ermit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Pennit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Z 92Z , pp Check Number 'Fills Section For Df#iciaC'CJ"se�On'i - -- Building Permit Number: Date issued: Signature: Building Commissioner /Inspector of Buildings - Date r Section 4. ZONING Alt 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 ry D .! _.. _._.._ Side L R ~.3 _...... Ream . Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bldg & paved p arkin g) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW YES IF YES, date issue& IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 ; YES IF YES: enter Book s Page and /or Document# „~ ~ B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0 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 0 NO 0 IF YES, describe size, type and location: r' E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors C7 Accessory Bldg. ❑ Demolition New Signs [0] Decks Siding [0] Other [a] Brief Description of Proposed t 11 +' Work: !1e ntiG+ t+Q Jr � S � `Zt L � .� �.� 1 Oe cfC , &D1 t co Aj ew i n! 5 .x: c ��' L..- Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa. lfi "Newhouse`antl alc;a�l��t�o�::to:ez>ISt�na� tiousingcarr `itrtete:the.fio[iow�na: 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. 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 -'TO BE'COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT`' I, Q as Owner of the subject property , hereby authori-ze �g, ,�Ctr- Ld ✓� v ��' ___ to act on my behalf, in all matters relative to work authorized by this building permit application. 7 —i6 c2 4 Signature of Owner Date I , Q"+ �� v" ✓ F rr as Owner /Autho_ r Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge an elief. Signed u the pains and penalties of perjury. CdOL'a" 4 C d*r_ -, P.l ^ Pri e i Signature of OwnerlAgent Date SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Constructio Su eryisor: Not Applicable ❑ Name of License Holder r 5 ? / sy License Number ! 1 50,4� a -1, 1") .� Mme_ f Addres Expiration Date Sign ture Telephone 9:. Registered.: ElornelniprcivernenGortcactor: Not Applicable ❑ olt33 Company Name Registration Number Address Expiration Date Telephone SECTION 10- WORKERS' COMPE NSATION INS URANCE AFFIDAVIT (M.G.L. c. 152, § 25C(s 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 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- th�work- for - which- this - permit-- isassued— -- - - -_.- - - - - - 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 The Commonwealth of Massachusetts Department of Industrial Accidents a 3 Office bfInvestigations , 5 600 Washington Street �-= Boston, MA 02111 www.mass.govI dia Workers' Compensation Insurance Affidavit: Builders / Contractors /EIectricians/Plumbers Applicant Information / Please Print Legibly Name ( Business /Organization/Individual): �` -' C-A-e-r ( -e,-" _ Address: (6 City /State /Zip:.5cJ[_,k Phone M ©_333 Are you an employer? Check thg appropriate boo: Type of project (required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part- time).* have hired the sub - contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10. F Electrical repairs or additions _ g �. F1 am a homeowner d°11 werk ______ - -- -- officers have -__ exerc thei 11 _Plumbin repairs or additions - — -_ myself. [No workers' comp. right of exemption per MGL 12. ❑ Roof repairs . insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13 • ❑ Other comp. insurance required.] *Any applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. , Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have employee's. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City /State /Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1, 500:00 and /or one= year - impnsvrixnen�- - as well-as civil penalties -in -- the form of -a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigation of the DIA for insurance coverage v erifi c ation. I do hereby ce i der the painnsend penalties of perjury that the information provided above is true and cori Signature:. Date: Phone #: O ficitil use only. Do not write in this area, to be completed by city or town offcciaL City or Town: Permit/License # Issuing Authority (circle one): - 1: $ear�i o1'I e lth-- ?— Bttildln epartinecil 3. Cily/Tuwu Cle k__�. -TI.. t �rical Inspector 5. PIumbinR Inspector 6. Other Contact Per Phone #: 45 MAT MW FOR REMMNG PURK 3 1,.201 x Plan Book 91 Page SAS) Lot 040 ic+'-"'0 r 0GG� Uj(kS xrr� 1 � a v� X9.9" Westhampton Road To , 9 The 8,4th•amptan. Savings Bank t The rLrut American Title Insurance Co. AM IULM M AN UOCAM OW INS WOW M AN? ? MT "C GUAM= AN OMMY WrAM "M LM UMM 4 !4� ANNOV T ®M A PLM MOO Ate+ 44 VOW CAS MM^ WKVW= MOS MOP CO MWAON RAMP A im .... DA:' Cl�4¢ E NOS 7"S PLAT i ll . paper QA V L OAN PWO6g O NLY AND OM M. SURVE —.low NOT I ORr"GE LOAN INMCn K AIT mom Northampton l&ssaachu*ett* Prepared far 4 Wayne 4 Jeoh Martin SrS Scale; 1 "00 ` �K7 t+ �1 k'5 t 7 tN � a 7; LP 1 I Carrieeg Carpentry and Drywall Estimate Robert Carrier DATE LiC # 0591554 16 David Street Southampton, MA 01073 7/712009 IReg #101246 Phone: (413) 527-0333 NAMEIADDRESS Jean Martin 884 Westhampton Rd Florence, MA 0106 2 Phone: 586-1105 1 DESCRIPTION TOTAL REMOVE OLD DECKS IN REAR OF HOUSE -Reconstruct new 2 level deck in similar foot print as existing, using all P.T. material. Left side of deck to have lattice installed to close in lower portion. 5/4 X6 P.T. cap to finish off upper deck rails. Deck rails to be 2 X4 P.T. rails with 4 X4 P.T. post and 2=36" P.T. balisters. Stairs to have Tail balisters and hand rail. Seven sona tubes for deck footings 4' in ground. New flashing installed between deck and house Labor $4,680.00 Material $1,724.00 -Removal and disposal of old decks 5485.00 -There has to be a layout of deck to obtain a building permit. Layout design, filing paper work for permit and permit $360.00 TOTAL $7,249.00 -Using Trek decking and rail system instead of P.T. Material $5,573.00 � i -Using T 11,19 TOTAL S 11, 198-00 JW, Front porch repairs $150.00 1/3 deposit upon signing of this Estimate 1/3 half way thru project Balance upon completion — -- -------- TOTAL $43.00 Ali work perfortned in a workmanship like SIGNATURE manner. (o -c Ci' a 4 A L On f E 0 0 ly bQ C8 x p. f • J t A S r` h 1-9 1 c_do Tj 0 = o E Oj