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38B-111 (2) ,.. - - ) 1 1 . • Z • N to •••• . k , . c- • et - c�t�rp o (Z�ZXb � � °`� 0 N f., � � 11 YYYY r .. t "{ q f i (� ` ,F � ( v, , 1 C' v), x , .. t, .t.. ti % . _. ..4 . . - , , I - i, - • ..... . . ns . i. .N Q 1 �ca•.r_....�c..� r s., i ) ‘ • 4:-. • ..ila a r . ("y r 1 I z q___1 . 7 WRIGHT BUILDERS Z ff. O .4 : : , I N C' O' R P O R A T E D '�" ' ' 1 ^) 4 8 BATES STREET .' G 1) t�� .58 • NORTHAMPTON, MASSACHUSETTS 01060 Z n N ' 4136. FAX 413 -587 -92 3. a , •• 1'' °y "� , F O wash' Builders, Inc. • . Prepared for the occlusive use of WRIGHT BUILDERS, INC. staff, subcontractors, and suppliers. �..9 , 0 : All other uses prohibited.' . SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ c Name of License Holder : 03 e Bu 2 z e t l CS p� Eo License Number LA% Q 3 - es /Uo r+octvrnpto(, 01 0 316 /ao t I kdd Expiration Date 1 ---1 I 3- - ` 3glo — go 2 - ignature Telephone 9. Realstered Home improvement Contractor: Not Applicable ❑ 9 U - a) I \C - Q CS 1:0C • 10 ! r j 3 G Company Name Registration Number �{ 8 F50-- S t f o R . 6 / . 2 0 1 0 Address �\ ,1/ Expiration Date N C) ( 1f \( \AO V l 1 V 1� I !T V C v�O °Telephone ss6- & ;� 7 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 Cd No ❑ 11. - Home Owner Exemption 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 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 1- 1 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing r7 Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [p Siding [0] Other [0] Brief Descriptio of Proposed 1 (41kri'ic€ •4 7L de$ 3l%1 Alteration of existing bedroom Yes t/ No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes L- No Plans Attached Roll - Sheet sa. If New house and or addition to existing housing. complete the following: 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. Dimension e. Number of stories? f. Method of heating? Fi aces 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 - .nds? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or - - ar floor below finished grade k. Will buildi • •nform to the Building and Zoning regulations? Yes No . I. • • is Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, t k, \ & v 1 bve- A ba ( 4 , as Owner of the subject property } }- hereby authorize 1,k..) (` \-N Bu 1 `tie to act on my bet3alf, in all matt tive to work authorized blthis building permit applicatio . � 0 �1 i Signatu e o •weer Date kcl \&,,k ) C \ - i)lJ ] \ ( { f TV]L . , as Owne Authorized ge hereby dkklare that the statements and information on the foregoing application are true and accurate, to the best of w edge an belief. Signed under the pains and penalties of perjury. Ko e- Bu2ze 1 l Prin - 2? - 77. 11 ( Signature of Owner /Agent Date F - ■ 0 C i S(k O I/) � OE L L 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 .y Building Departme Lot Size Frontage Setbacks Front Side L: R: L: .. Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking S r, . - s Fil • olume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW 0 YES IF YES, date issued: t i l (4 (0 9 IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES G„ IF YES: enter Book t OO E 7 Page 2 O lb. and /or Document # 000310N B. Does the site contain a brook, body of water or wetlands? NO (2K 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 0 NO (E IF YES, describe size, type and location: 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 ® NO (D"'" IF YES, then a Northampton Storm Water Management Permit from the DPW is required. ' +. City of Northampton f , Building Department �� � I 212 Main Street i ? ,' D EC •J U L U Room 100 t ° e a $y t Northampton, MA 0106087- ;� r Y ), phone 413 -587 -1240 Fax 413 - 51272 � �� APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ON OR TW O FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: f This section Lot to be completed by office t t tU 11 rt. �'t Map N r M .4 y ,�� �� r G 60 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: �.!�� \� vv1 Qre i �- � �- l ss 1Yt�dtc le s+, 4'vnl�e rs f , )1) �'� r oo�2 NameR(P nt) ^ Curr Mailin Addr — SS / s: j �i1 X5 Y 14 �� `--' Telephone Signature YIP h 2.2 Authorized Agent : Name (P ' Current M Add �I13 5 � -- b' e 7 Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION 5 5 . `/� �� / � 14 Lt 1 ( -Pee Item Estimated COSTS Co st (Dollars) to be Official Use Only completed by permit applicant 1. Building o? S �� .. (a) Building Permit Fee 2. Electrical (b) Estimated Total Fee Cost of Constructi from (6) 3. Plumbing Building Permit 4. Mechanical (HVAC) 5. Fire Protection QQ 6. Total= (1 +2 +3 +4 +5) 5 0 0 ° � CheckNumber33 3 This Section For D ate Official Use OnIby Building Permit Number: I ssued: Signature: Building Commissioner /Inspector of Buildings Date • File # BP- 2010 -0636 APPLICANT /CONTACT PERSON WRIGHT BUILDERS ADDRESS :PHONE 48 Bates St NORTHAMPTON (413) 586 -8287 PROPERTY LOCATION 37 MUNROE ST MAP 38B PARCEL 111 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out p�¢ Fee Paid 237 - o? � Typeof Construction: CONSTRUCT 2ND FLR EGRESS (ALTERNATE DESIGN) New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 84280 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOXVIATION 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 - Permit DPW Storm Water Management Dem 'tion De 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. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning & Development for more information. 37 MUNROE ST e.✓t.t B k " BP- 2010 -0636 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B - 111 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit # BP- 2010 -0636 Project # JS- 2010 - 000422 Est. Cost: $2500.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WRIGHT BUILDERS 84280 Lot Size(sq. ft.): 8015.04 Owner: BREITBART WILLIAM & MYRNA Zoning: URB(100) /; Applicant: WRIGHT BUILDERS AT: 37 MUNROE ST Applicant Address: Phone: Insurance: 48 Bates St (413) 586 -8287 Workers Compensation NORTHAMPTONMA01060 ISSUED ON:1/13/2010 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2ND FLR EGRESS (ALTERNATE DESIGN) 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: I u ation: Final: Smoke: Final: 4 ` � 11/1 i FLA f f'�(j Co Prt it Ws' THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancyc' /? IO ijsignature : FeeType: ate Paid: Amount: Building 1/13/2010 0:00:00 $55.00 212 Main Street. Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo