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39A-014 (3)
s 3 The Commonwealth of Massachusetts .11 ri City of Northampton Certificate of Occupancy In accordance with 780 CMR, Section 120.0 (The Seventh Edition of the Massachusetts State,' Building Code with 2009 IECC) this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified. Identify Name of Building of Space Within, Building Owner, or Permit Holder I Certificate No. Issued to Brian Kennedy BP- 2010 -0572 BP- 2010 -0605 Identify property address including street number, name, city or town and county Located at 22 & 24 Wright Avenue ' "� Northampton, Hampshire, Massachusetts Use Group Classification(s) Two Family Residential This Certificate of Occupancy is hereby issued by the undersigned to certify that the premise, structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall allow for the use as herein described and in conformance with any and all conditions as identified below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate, failure to comply with conditions or, tampering with the contents of the certificate is strictly prohibited. Conditions of Use Two Family Home - Safety and Structural Systems must be maintained. Name of Municipal Cha les Miller Date of Final Map /Plot: Inspection Ins 05/24/11 Building Official y �s P Signature of Municipal Date of 39A -014 Building Official ";79 Issuance 05/24/11 C C: __ ...000 .01111____ — 1 00-------- °°°' ii iii ---■11111111" ■1011101111.1111'-'-- • L■gI IIIIIIIIIIIIIIIII.alW lj i WIIIIII 1 111-11111— s 111111111111111 per, te rn )t . ' ------" ------- 5;6 k-_,--- --,--•-• 1 11345 ' 03400 rklid5 -/)1,c/L 4P 41°45 ‘ Vil \ \' tx,,Q Kni )4AV. 9 ' 4. ° Q2 P 5 .$,S'ocfN \S\ 4' 0 ,v.104CIAI t‘Ni -.4■. VIsh-0 \vag v marNt e N c\ y r", NIt Q S cVt' \A 07 tweike HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. 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 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 re quires 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 - - -- peinits- in-conjunction_to_the.building permirissued,_ 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 I, rA • understand the above. (Home owner /reside' signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Address of work location 9) tt LtArbto Ati V L The Commonwealth of Massachusetts ��— Department of Industrial Accidents i 1..... .7 Office o f Investigations • w._ 1, ° y 600 Washington Street c Boston, MA 02111 '''' 5.• www.mass.gov /dia -Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/PIumb.ers Applicant Information Please Print LeEibly Name ( Business /Organization/Individual): Address: City /State/Zip: Phone.: Are you an employer? Check the appropriate box: Type of project (required): J, 1.0 I am a employer with 4.. 0 I am a general contractor and I 6. 0 New construction employees (full and/or part-time).* have hired the sub- contractors 2. El I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodehn ship and have ploy ees These sub - contractors have. 8. ❑ Demolition capacity. employees andhave workers' working for me in any Y P ty 9. 0 Building addition [No workers' cone. insurance comp - msurartcce required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3. i. 1- am- a- homeo-waer- doing -all- work. 9 eersJ .ve i: xezcis_ed their _ 1 Plumbing repairs or additions myself [No workers' comp. right of exemption pe r MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required. ] . *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information_ I 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 naive of the sub - contractors and state whether or not entities have employees. 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 $1500.00 and/or one -year imprisonment, 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: lge advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. . _ I do hereby certify under the pains and penalties of petjwy that the information provided above_islrue.andcorrecL__- - Si . ture. .1. l ` Date: p 1 / �� ii y 7 - ? ? 7 a...____ Phone #: - - Official use only. Do nol write in this — area; lobe completed by city or town ofciaL City or Town: Permit/License #_ Issuing Authority (circle ape): I Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other r Contact Person: Phone #: SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature Telephone 9. <Registered:Home7inprovement Oan tor•...., ...._, .. ; o, , . ..'... Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone _ 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 Inilnii fl rttixe ifku n 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 Supervisut yuui presence on the job site will be roquired from time to time, during and norm 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 ` o ampton • r. mances, , . . . . " . i . r. . . - tt neral-Laws- Annotated. Homeowner Signature . y s SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or boors I:3 Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [[] Siding (f$(j Other [❑] Work: k: D Wor � l� Q� t 4 . fr A Ili .. A. l' .. / 41! y • al A. Alteration of existing bedroom Yes X No Adding new bedroom Yes C' No Attached Narrative Renovating unfinished basement Yes / No Plans Attached Roll - Sheet sa,. If and c :ac on to;ezis "tins fio corm) ete' # � e , ofio mg: 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 . 1. Septic Tank City Sewer Private well City water Supply SECTION Ta - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , as Owner of the subject props hereby authorize to act my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, , 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 and penalties of perjury. Brims i))( Print ame Signature of Owner /Agent Date /14h ' Section 4. ZONING All Info ati n Must Be Completed. Permit Can Be D ied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front' Side L.......... ____ R._____._.! L.A R: __ Rear _ ...._. "__ -- .. Building Height Bldg. Square Footage =-`"�- % , Open Space Footage % (Lot area minus bldg & paved parking) # of Parking Spaces ____ ..__._, Fill: I (volume & Location) _-. _ - . l ._._ A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DONT KNOW 0 YES IF YES, date issued: ; =' IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Pager ! and /or Document # „T B. Does the site contain a brook, body of water or wetlands? NO 7,1 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Du dny signs exist on the property? YES 0 NO IF YES, describe size, type and location: 11 a`any prn�ns ?_'c angps to nr .. - ttins signa intPn art r tT� prnperty 7 YFS 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, - .vation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO I 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • City of Northampton Stu Ptf Building Department Cui O�ra!i 212 Main Street se - vai Room 100 �a Northampton, MA 01 „v.= phone 413 -587 -1240 Fax 413 -587 -1272 : an 40htt ia APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1';- SITE INFORMATION This section to be completed by office 1.1 Property Address: cf t IA) f Ave, Map Lot Unit tone Overlay District EIm. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name ( Current �ailing l 3 g ?' 91173 Telephone Signature 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building ?CO (a) Building Permit Fee 2. Electrical / (b) Estimated Total Cost of ;LS Construction from (6), 3. Plumbing Building Permit Fcc 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 +2 +3 + +5) i ? � ® Check Number This Section For Official Use Only ` • Rate Building Permit Number: Issued: Signature: Building Commissioner /Inspector ofBuildings Date File ti BP- 2010 -0605 APPLICANT /CONTACT PERSON KENNEDY BRIAN ADDRESS /PHONE 22 WRIGHT AVE NORTHAMPTON (413) 387 -9973 0 PROPERTY LOCATION 22 & 24 WRIGHT AVE MAP 39A PARCEL 014 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REMODEL KITCHENS, BATHS,INSTALL INSULATION,VINYL SIDING & REPAIR FOUNDATIO New Constructi• Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN, FORMATION PRESENTED: Approved Additional permits required (see below) J ln te+KE. Np beTFCTdrC5 M k-15 i SE 6r,o,prr &P To ca PAC rr co bs 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 I2 ( I 6 �a Signature of Building Of icial 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. 47 " 2 if ol/ric 437 f by y (1 tir ( l • 22 8. 24 WRIGHT AVE BP- 2010 -0605 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 39A - 014 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 -0605 Project # JS- 2010 - 000799 Est. Cost: $12350.00 Fee: $74.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 6011.28 Owner: KENNEDY BRIAN Zoninti: URC(100)i Applicant: KENNEDY BRIAN A T: 22 & 24 WRIGHT AVE Applicant Address: Phone: insarance: 22 WRIGHT AVE (413) 387 -9973 () NORTHAMPTONMAO1060 ISSUED ON :12/16/2009 0 :00 :00 TO PERFORM THE FOLLOWING WORK: REMODEL KITCHENS, BATHS,INSTALL INSULATION,VINYL SIDING & REPAIR FOUNDATION - UNIT 24 - UPDATE SMOKE & CO DET TO CURRENT CODE 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:3 ' (fi i\. Rough:3 / House # Foundation: "3/ ✓ Driveway Final: C PA Atil ' Final: final: Rough Frame: O k 4 Mg) /© Lour. • Gas: Fire Department Fireplace /Chimney: Rough: 3 -11 -11( Oil: Insulation: 0K 4 .3(14 tali. S Final: q ,, °I( � //. Smoke: 4, . , uG . -t, j f,, $�` - ;•, Final: 04'1 5 1 -1/ cI14/1 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu •anc // Siinature: FeeType: Date Paid: Amount: Building 12/16/2009 0:00:00 $74.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo