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38B-206 (3) Client #: 15874 RAINB ACORDT. CERTIFICATE OF LIABILITY INSURANCE DA OU9 ) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION King & Cushman, Inc. ,- , ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Kin & Streets 1 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR g ' ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 447 - -- -- Northampton, MA 01061 • I JUL INSURERS AFFORDING COVERAGE NAIC # INSURED ) 9 INSURER A: Liberty Mutual Ins. CO. Rainbow Home Improvement ■ INSURER B: 128 Ryan tual • ,,,, OF INSURER C: Florence, MA 01062 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRL DATE (MM /DD/YY) DATE (MM /DD/YYI GENERAL LIABILITY EACH OCCURRENCE _ $ COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISES (RENTED occurrence) $ CLAIMS MADE n OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENII_ AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY n JECT fl LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ _ n OCCUR n CLAIMS MADE AGGREGATE $ DEDUCTIBLE _ $ RETENTION $ $ A WORKERS COMPENSATION AND WC231 S339542028 06/17/09 06/17/10 WC T SATU I TORY 11MITS S FR OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $100,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Northampton DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL in DAYS WRITTEN 212 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Northampton, MA 01060 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTH RI D R) EE T E ACORD 25 (2001108) 1 of 2 #S8101/M8100 SMF © ACORD CORPORATION 1988 �L (I J .v1 .'_'V Lam ± t r r ?"'.'.. 1�LJ ± (7-;: / 1 � J ,ttta:sarimsrts R _ LSP RT2■12.-:_NT OF BUILDING i SrEG' iOtiS - - INSPECT• 212 Main Strut • MunicipalBuiIciing a � � i Nortbapton, MA 01060 HOME HOME OW D MU"F, G l.! t � l `s E E TIO � CKNQWLF FMFNT 1 1� �i �v -...d_ The State of Massachusetts allows the homeowner the right under 780C v 108.3.4 to act as his her construction sup ," 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 backfll). sonotube holes (before pour). a rough buidine inspection (before work is concealed.). i sulatian- inspection (if reanired) and.afnat bui - lino . 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 ran-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 • understand the above. (dome 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 A c ; The Commonwealth of _krassachzsens Deya; -mennr of fndusrriaj_l cc-id enrs Office of Investigations � — '" JUL - 9 2(39 600 i�ashingron Street ,;. Boston, .414 02111 G _ / L -- JV47 i1�.ix /dia Workers' Compensation Insurance Affidavit: Builders /Conn, actors/EIecr Applicant Information Please Print Legibly_ Name ( 3usiness /Organization/Iadividua1): �C,.+n .,; AVva.'. v\ Address - WC". ( `' .7 . city/state/zip: CsS 1 .., CALo ne L\\5 ° - , 1 Are you an employer? Check the appropriate -�b x: Type ofproject (required): I. ❑ la rt a employer with 4. L� I am a general compactor and I employees (full and /or part-time).* have hfred the sub - contractors b• ❑?yew construction 2 i am a sole proprietor or parer- fisted on the a ched sheen 7- f Re-mod-74Th These sub-:mat-actors have I Demolition sil'i.1:r.2. - have n0 a,•'•llOyeeS h S. D D 2mOiIuOII wor1cfro for me man capacity. employees and have workers' y e y 9_ 1[7 Building addition n•. cozim. insn ce.< 1 ..- w„rkers' co rp_ Ms-,uanc.. refit ired_J 5. E3 We are a corporation and its I0.❑ Eleca repairs or additions officers have exercised then 11. Plumbing repairs or adriziors - ❑ I am a homeowner doiry all work ❑ °p myself [No waiters' comp_ rift of exemption per MGL 12. Q Roof repairs Tr.c apace requ>i ed ] t c. 152, §1(4), and we have no cmployees. [No workers' 13.1,1:1 � comp. insurance rued.] - - - - --= v applicant at cn nom F-1 I um= aso ail oat me sermon oe:ow snowing then wort- -rs' co non policy mforffiaoa - T Hom=wnets who submit this andavit indicarinst they are doing all work and then hire outside contractors musts:*h a new affidavit indication such. :Conn -.tors that car...k this box mustai ached an additional sheet showing the name of the sub - contactors and stare whether or not Mose entities have employees. If the sub- conz<actors -nave employees, they roust provide their work' comp. policy nunioc I am an employer that is providing workers' compensation insurance for my employees Below is the policy and job size _information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiiarion Date: Job Site Address: t-,\ rese.. -\\%.n `, City/Stare/Zip: %)C, N4n (L • 6\ O( 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 prra i es of a one up to $1500.00 and/or one -year 77***+r sonmeat, as well as civil perk fries in the form of a STOP WORK ORDER_ _ and a fine of up to $250.D0 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DLk for ins.Lance coverage verification. I do hereby cerdfy under the pains , perzoJ es of per jury that the information provided above is true and correct - Si antre= -__ 11 _ - - -- Date: 1 - (- 1 Phone#: t\ \7 ' 16' S -4 101 r l t j r i ci ei ° ert. : iy: .Da not ware 5 th s area, to be completed by city or town officiaL City or Town -- —_. _____ -- Pe rini- t'Liceaise Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5_ Plumbing Inspector 6. Other Contact Person: Phone .. 1 1 1 1 1 1 1 -A, 1 _. 1 1 • 4 0 E ffi c iency y Certificate Insulation Rating R -Value Ceiling / Roof 30.00 Wall 20.50 Floor / Foundation 19.00 Ductwork (unconditioned spaces): Glass & Door Rating U- Factor SHGC Window 0.30 Door 0.23 NA Heating & Cooling Equipment Efficiency Forced Hot Air Furnace 93 AFUE Electric Central Air Conditioner 13 SEER Water Heater: I ! Name: Date: Comments: . Vapor Retarder: Vapor retarder is installed on the warm -in- winter side of all non - vented framed ceilings, walls, and floors; or it has been determined that moisture or its freezing will not damage the materials; or other approved means to avoid condensation are provided. Comments: Materials Identification and Installation: • Materials and equipment are identified so that compliance can be determined. Li Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R- values, glazing U- factors, and heating equipment efficiency are clearly marked on the building plans or specifications. Duct Insulation: D Ducts in unconditioned spaces or outside the building are insulated to at least R -8. O Ducts in floor trusses above unconditioned spaces or above the outdoors are insulated to at least R -6. Duct Construction: LI Air handlers, filter boxes, and duct connections to flanges of air distribution system equipment or sheet metal fittings are sealed and mechanically fastened. U All joints, seams, and connections are made substantially airtight with tapes, gasketing, mastics (adhesives) or other approved closure systems. Tapes and mastics are rated UL 181A or UL 181B. ❑ Building framing cavities are not used as supply ducts. D Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. Li Additional requirements for tape sealing and metal duct crimping are included by an inspection for compliance with the International Mechanical Code. Temperature Controls: • Thermostats exist for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and /or cooling input to each zone or floor is provided. Heating and Cooling Equipment Sizing: Li Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. Circulating Service Hot Water Systems: ❑ Circulating service hot water pipes are insulated to R -2. • Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R -2. Certificate: D A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R- values; window U- factors; type and efficiency of space- conditioning and water heating equipment. NOTES TO FIELD: (Building Department Use Only) Project Title: 41 Manhan Street Report date: 06/30/09 Data filename: C: \Documents and Settings \user \Desktop \Res ck 41 Manhan.rck Page 3 of 3 CI REScheck Software Version 4.2.2 Inspection Checklist Ceilings: ❑ Ceiling 1: Flat Ceiling or Scissor Truss, R -30.0 cavity insulation Comments: Above -Grade Walls: ❑ Wall 1: Wood Frame, 16" o.c., R -19.0 cavity + R -1.5 continuous insulation Comments: Basement Walls: ❑ Basement Wall 1: Solid Concrete or Masonry, 7.5' ht / 5.8' bg / 5.8' insul, R -10.0 continuous insulation Comments: Windows: ❑ Window 1: Other, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2: Other, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Note: Up to 15 sq.ft. of glazed fenestration per dwelling is exempt from U- factor and SHGC requirements. Doors: ❑ Door 1: Solid, U- factor: 0.230 Comments: ❑ Door 2: Solid, U- factor: 0.130 Comments: Floors: ❑ Floor 1: All -Wood Joist/Truss:Over Unconditioned Space, R -19.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Heating and Cooling Equipment: ❑ Furnace 1: Forced Hot Air: 93 AFUE or higher Make and Model Number: ❑ Air Conditioner 1: Electric Central Air: 13 SEER or higher Make and Model Number: Air Leakage: ❑ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights are either 1) Type IC rated with enclosures sealed /gasketed against leaks to the ceiling, or 2) Type IC rated and ASTM E283 labeled, or 3) installed inside an air -tight assembly with a 0.5" clearance from combustible materials and a 3" clearance from insulation. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U- factor of 0.50 and the maximum skylight U- factor of 0.75. New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Project Title: 41 Manhan Street Report date: 06/30/09 Data filename: C: \Documents and Settings \user \Desktop \Res ck 41 Manhan.rck Page 2 of 3 el t REScheck Software Version 4.2.2 Compliance Certificate Project Title: 41 Manhan Street Energy Code: 2006 IECC Location: Northampton, Massachusetts Construction Type: Single Family Project Type: Alteration Heating Degree Days: 6404 Climate Zone: 5 Construction Site: Owner /Agent: Designer /Contractor: 41 Manhan Street Marian Aubuchon Tom Malone Northampton, MA 01060 41 Manhan Street Rainbow Home Improvement Northampton, MA 01060 128 Ryan Street 413 - 586 -3757 Florence, MA 01062 m.kene @att.net 413- 885 -9038 tom @rainhome.net Compliance: Passes Compliance: 0.0% Better Than Code Maximum UA: 128 Your UA: 128 Gross Cavity Cont. Glazing UA Assembly Area or R -Value R -Value or Door Perimeter U- Factor Ceiling 1: Flat Ceiling or Scissor Truss 435 30.0 0.0 15 Wall 1: Wood Frame, 16" o.c. 467 19.0 1.5 21 Window 1: Other 70 0.300 21 Door 1: Solid 42 0.230 10 Basement Wall 1: Solid Concrete or Masonry 443 0.0 10.0 30 Wall height: 7.5' Depth below grade: 5.8' Insulation depth: 5.8' Window 2: Other 28 0.300 8 Door 2: Solid 21 0.130 3 Floor 1: All -Wood Joist/Truss:Over Unconditioned Space 435 19.0 0.0 20 Furnace 1: Forced Hot Air 93 AFUE Air Conditioner 1: Electric Central Air 13 SEER Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2006 IECC requirements in REScheck Version 4.2.2 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. k - �a Name - Title Signature Date Project Title: 41 Manhan Street Report date: 06/30/09 Page 1 of 3 Data filename: C: \Documents and Settings \user \Desktop \Res ck 41 Manhan.rck Northampton, MA Property Detail http: / /www.northamptonassessor.us/ noho /propertydetail.php ?map_no... City of Northampton, MA: Residential Property Record Card New , Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map- Block -Lot: 38B -206 -001 Zoning: Assessment: Location: 41 MANHAN ST Neigborhood: 12 Land: 98,000 #Living Units: 1 Deed Book: 3714 Building: 84,900 Class: R -101 Deed Page: 212 Total: 182,900 Dwelling Information Building Sketch Style: Ranch Year Built: 1950 Height: 1 Attic: None Basement: None Total Rooms: 5 4 ( 4 Bedrooms: 2 4 E 4 Full Baths: 1 4 33 Half Baths: 0 10 Exterior Walls: Asbestos s D s 10 Unfinished Area: 0 10 Ground Floor Area: 990 30 1 Fr 30 Total Living Area: 990 cap • ort o Finished Basement Living 0 X 0 20 20 Area: Basement Recreation Area: 0 X 0 33 10 Woodburning Fireplace 4 " 4 1/I , Stacks /Openings: Metal Fireplace 0 / 0 Heat /Central A/C: Basic System: Warm Air'. Fuel Type: Gas Addition Information: Quality Grade: C Physical Condition: Average Lower 1st Story 2nd Story 3rd Story Area Interior /Exterior: Same One Story Frame 990. Open Frame Porch 48 1 of 2 6/27/2009 8:16 AM Northamptdn, MA Property Detail http: / /www.northamptonassessor.us/ noho /propertydetai1.php ?map_no... Condition /Desirability AV /Utility: Vacant /Dwell /Oby Status: Dwelling Additional Features: 200 Brick Trim: 0 X 0 Frame Utility 60, Wood Deck 16 Stone Trim: 0 X 0 Wood Deck 16 Remodeling Data: Year Remodeled: 2007 Kitchen Remodeled (Y/N): Bath Remodeled (Y/N): Land Data Outbuilding Info Square Foot Type Utilities Type FQ t Value no Prime information Site 4,590 97,950 Type Qty Year Size 1 Size2 Grd Cond no information' Acreage Type Street /Road Type Acres Value no no information information' Sales Info Permit Info Date Type Price Validity Date Permit # Price Purpose 01/01/1993 Land + Bldg 96,500 0 08/17/20071152 4000 2 -4X4 W /D &HOTTU 2 of 2 6/27/2009 8:16 AM SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: �� " I - Not Applicable 0 Name of License Holder : i " i �. \Uv' v Cf li 53 Za 6 License Number VaA 1. ,. 9- Z k rnQ• 0\041- -1c la Address Expiration Date 3 -I 3� I \ Signature Telephone .. 9. Registered Home Improvement Contractor. ' . =' ' ' ,'' ` Not Applicable ❑ Company Name Registration Number ) 1--- %4, c CA roc. (.4 C) k Ob Z- W y — uS10 Address (� Expiration Date Telephoner s� j,S -4&W - 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 ❑ No ❑ 11.. - H ote Owner E xe ion . 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 -vear 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 ofEmployers 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 • Tito - SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House n Addition J Replacement Windows Alteration(s) Roofing n Or Doors O Accessory Bldg. ❑ ° Demolition ❑ New Signs [0] Decks [CJ Siding [O] Other [❑] Brief Description of Proposed Work: Pa/ Z beZ¢ay1.�� k (; �h kNor." Tea" (tun. lorictOng 04- e Alteration of existing bedroom V Yes No Adding new bedroom V Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa If'' New' house and ar addition to exsst nq housing, comUiete the following: a. Use of building : One Family V Two Family Other b. Number of rooms in each family unit: Number of Bathrooms 2 c. Is there a garage attached? hd •1 1 • d. Proposed Square footage of new construction. VW ti Dimensions S X 30 L e Number of stories? V nt' f. Method of heating? yucca._ \C --C l r Fireplaces or Woodstoves t Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction KEN4/1 Ii i. Is construction within 100 ft. of wetlands? Yes V No. Is construction within 100 yr. floodpiain Yes No q 11 j. Depth of basement or cellar floor below finished grade 14 M k. Will building conform to the Building and Zoning regulations? ✓ Yes No. o. 1. Septic Tank City Sewer // Private well City water Supply v SECTION 7a - !OWNER - AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT • ' f \cs ■ ■‘r% ` rJI3 Gsr , as Owner of the subject property hereby authorize (Cu emAl\\tNMQ- r?NtM[„ank to act on my behalf, in all matters relative to work authored by this building permit application. Arm ( 0 '�) f () Signature of Owner Date " k VAC \(W L- , as Owner /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. Signed under the pains an penalties of perjury. Print Name Signature of Owner /Agent Date Section 4. ZONING I All 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 I Side L: 15._.., R:.,,1.'+ L:.... R Z�..(. Rear 35 : IS .. Building Height , " Bldg. Square Footage Open Space Footage ._ .. (Lot area minus bldg & paved J I I Seyi narking) # 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 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES Q IF YES: enter Book Page and /or Document # 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 Q Obtained Q , Date Issued C. Do any signs exist on the property? YES Q NO O 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 0 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 t,unrrrton plan that will disturb over 1 acre? YES Q NO IF YS, then a Northampton Storm Water Manageme itPentitfrom the DPW is required. t Department use only . CitvQr'lorthampton Status of Permit: �.--�� bul Ig Department Cur�b.Cut/DrivewayPermit \ 2 Main Stree Sewer - /sep is Availability Ro Room 10 WatecMlel] Ayailabil 4� hampton MA 01060 Two Sets of Structural Plans J UIRh(t� 4-587-24 o fax 413 -1272 P►ot/SitePlans + Other.Sperxfy APPLIC T. c TER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1\ INFORMATION 1.1 Property Address: This section to be completed by office t` toan■rsAA Map Lot Unit Zone Overlay District Elm St District CB' District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: '�c1ac an Qar•1b0r.�cxN t1k n14N1r�an S 4- \ Wo p u met (Print) Curril/ng,Addres r �� 7 5 �? Telephone Signature 2.2 Authorized Agent: "Th urrt6 \Q - \ T tL r Q L - cAc•�(x. mc, 010k 2 Name (Print) C urrent Mailing dress Val — 8r8's` -qubT Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building permit Fee 2. Electrical (b) Estimated Total -Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6 6. Total = (1 +2+3+4+5) Z'1 < Q 1 Q 1' - t i Check Number ! 473 ? T i ection For Official Use Only I t Date Building Permit Number: i i Issued: Signature: Building, Commissionedlnspector ofBuddmgs Date File # BP- 2010 -0002 APPLICANT /CONTACT PERSON THOMAS MALONE ADDRESS/PHONE 128 RYAN RD FLORENCE (413) 885 -9038 PROPERTY LOCATION 41 MANHAN ST MAP 38B PARCEL 206 001 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 /a-a-- * 7 / ) ` (Q d` Fee Paid Ttipeof Construction: CONSTRUCT 14 X 30 ADDITION(2 BEDRMS & BATH) & RECONFIGURE REAR HALF OF HOUSE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: � ,,�� Owner/ Statement or License 055236 �`� I.�� �!' ��i sets of Plans / Plot Plan THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON I F ATION 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 Demolition Delay Signature of Building •ffrcial 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. -Si . 1t\ ‘ki 1 kg\ s% 4V) 41 MANHAN ST BP- 2010 -0002 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B - 206 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP -2010 -0002 Project # JS- 2010- 000002 Est. Cost: $127079.00 Fee: $762.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THOMAS MALONE 055236 Lot Size(sq. ft.): 4573.80 Owner: AUBUCHON MARIAN E Zoning: URB(100)1 Applicant: THOMAS MALONE AT: 41 MANHAN ST Ajplicant Address: Phone_ Insurance: 128 RYAN RD (413) 885 -9038 FLORENCEMA01062 ISSUED ON :7/17/2009 0 :00 :00 TO PERFORM THE FOLLOWING WORK: CONSTRUCT 14 X 30 ADDITION(2 BEDRMS & BATH) & RECONFIGURE REAR HALF OF HOUSE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector / Underground: Service: Meter: . /� c clE( 07/(770 /1 4' , Footings: !! (( Rough. (, ; �, ,+1 t7 1/ Rough: � House # Foundation:©N �C t�` 0 ✓ 5 rivewa Final• d G Final:j0 -07k / 1�'IA e� /d /A I09 JJ f Rough Frame: O / - 8.0? Gas: Fire Department Fireplace /Chimney: Rou h:9 0 apil: Insulation: A ? Final / 04 6 Smoke: Final: ® f6 t o r THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGU TIO ►. . ✓ /j Certificate of Occupancy Signature;- FeeType: D , e Paid: Amount: Building 7/17/2009 0:00:00 $762.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo