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39A-058 1 i s J 1 ---- -- 5/4 X 6 -- - _ 1 X 6 � ," �� rn 1 X 4 ` � _______________ LJ __ 1/2" MDO PLYWD SCOTIA ------t- �.„.._ ----- EXST'G SHINGLES -----___, IM 14e ?A 4 2 - As REeQ. 0 FRONT ELEVATION 4 SIDE ELEVATION 5 ALTERNATE SIDE 1/4 = 1 -0 1/4 1 0 1/4" l 0" MARVIN CLAD ULTIMATE DOUBLE HUNG CUDH2O18 X 3 RO 6' -5 1/8 W X 3' -8 7/8 H .t ..:- - ---------------? \ --;\ a li lli."1.5.1"1-1 -• .6"1"....... u C c 147 14 ti, e Td2-161-1 t 4.1 , - ca a l..> _VgfAc7f) kii- a WA' i-L- 1 4- v i pc7PorA til*‘-ti-kr"-.14 — — __— — ..... — — ..... .... " TAt.'1' ;2,112,51 1)46 / / Ny 1 \ k \ . 1 \ 1 .r---- ----------- 1 1 1 ' Proposed sunroom -------'----------- y . HOME OWNER EXEMPTION ACKNOWLEDGEM Yf ,r The State of Massachusetts allows the homeowner the ri under 780CMR 108.3.4 to act as his/her construction supervisor. The state def n `Homeowner" as, " Person(s) who owns a parcel on which he/she resides or int s to be, a one or two family dwelling, attached or detached structures acce ory to such use and/or farm structures. A person who constructs more than one hom in a two -year period shall not be considered a home owner." The building department for the i y of Northampton wants person(s) who seek to use the home owner exemption, to ct 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 processrequires 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 occunancv 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 --- - - - - -- -penits.- in-conj unction to -the building_permitissued,_and.. 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. (Home owner /resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Address of work location • t The Commonwealth of Massachusetts Department of Industrial Accidents =lei — P Office of Investigations • 1.... 600 Washington Street 0=451-=" Z Boston, MA 02111 •' • www.mass crov/dia Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): V4N 44' - A-- Cc) /....1....c.. Address: 1.4 . ilitc. l t P:b , r &8 _ N. City /State /Zip: 'SZ 1L.t eM phone #: j/7' t ' -.q Are you an employer? Check the appropriate box: Type of project (required): /,. 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. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no a ioyees These sub - contractors have. g. 0 Demolition employees andhave workers' working for me in any capacity. # 9. D Baudi Q addition [No workers' comp. insurance comp. insurance. required.] I..-i..- c- 5. El We are a corporation and its 10.0 Electrical repairs or additions 3. E I am -a- homeowner -- doings- allwork ave xer.cise their —1-L-0-Plumbing repairs or additions myself No workers' comp. right of exemption per 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 fin 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. TContractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those 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 formation 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 imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fur of up to $250.00 a day against the violator: 17e advised that a copy of this statement may be forwarded to the Office of Investisations of the DIA for insurance coverage verification I do hereby ce ' un , er the pains and pennities of perjury that the information provided above ii.truenrzd correct r ,/ Si•. to re. /���� ' �•a� !! '! 2 f . — Phone #: 1 - if/ `7 _` 53ac1 T T Official use only. Do riot write iii this arezz, io be completed by city or town offzciaL City or Town: Permit/License n Issuing Authority (circle one): -L Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: se I SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ / : Ant A ' Name of License Holder : TT r" /t lee- trill Y IV '>6 ?...cD 14 , 1 4_, License Nu ber Address / Expiration l ate Sign tur Telep one 1� ` Es3q 532.7 i 9: Registered: Home. impr'overiient:.Coiitractor , &.•; - . ,, ; ,4.. ,.., ,.., Not Applicable ❑ /P'^ Nrr- (P u( 1 3-2,1x72— Company Name 14 Registration Number cm inn. c -f/t - 1 t I r3 j 1,) ' Address e� Expirati n Dat l 5 '2. ` 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 A No ❑ .. Ilo m e Owner : iii T_he_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. M acting Construction Supervisur yuu presence on the job site will be required from time to time, during and uprm 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 'romances, . - .r o " . , ,• '• ° r ` , , s-General Laws Annotated. Homeowner Signature s SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House El Addition ❑ Replacement Windows Alteration(s) M Roofing ED Or boors CI Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [(_] Siding [0] Other [0] Brief Work Descript 42 J / f- T > . ! !'h16- or--at T2 Alteration of existing bedroom Yes x No Adding new �" Yes x No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a if Newf'house and o,- ad t tion t &existtnq housinci,, omplete -.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. 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 l I, h -K.,c LJ=lr w4 -f'%4 --P-- , as Owner of the subject property n/� h- ' 4 • autho 44 ' A to : ct o oeh f, in all -. -tters relative to •rk authorized by this building permit application. Sign of Owner r .‘ Date I < A 4 .z> VAN (N)A" T — , 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. -' A VfN 'C1)- Print Name A , r A A.,a Signature of 'Jwne 'gent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning r-' NiA2 O1 l This column to be filled in by tCra. Building Department Lot Size f . _.,,.., ___,_.. "_ .. __. __ _..._m Frontage _,. . . "..__ . .._. "_... Setbacks Front __ Side L :..__.___. R..._....._._i L:'." ..,_ R:..„..,„ ....„„ Rear_ Building Height Bldg. Square Footage I , % 7 ? ;-- --- Open Space Footage (Lot area minus bldg & paved _a parking) # of Parking Spaces _____ _ . Fill: �d �...__ (volume & Location) u...-.°.„.. , „ „„, _.,M._.,. .d: A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0;11 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 ` Page' and /or Document # B. Does the site contain a brook, body of water or wetlands? NO VIII DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: y C. Du any signs exist on the property? YES NO IF YES, describe size, type and location: 1 _._ - n — _._ - . _ n-- EF t-iera any pmpns? c angP to nu i_ : ttnns n sign t tha 7 YFS 0 NO 6 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 0 NO X41 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. p City of Northampton Department t>��raewa 212 Main Street sre�tatslt��S Room 100 1.6te Northampton, MA 01060 s u phone 413 -587 -1240 Fax 413- 587 -1272 o teblahs 4 r APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office I L ` , MAN P.7b Map Lot Unit N©t1� (F-`�t1 �( To N Zone Overlay District Elm St. District CB District SECTION 2 -- PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Current Mailina Address: ` - , Telephone nat ` '1 t' d S' Lt'c:›c+ 2.2 Authorized Agent: ti-- '`t71F i> 024 - A. 47 . 1- L ' >V1T M Rb C>1 Name (Print) Current Mailing Address: A Id Signa Telephone SECTION 3 ESTI ATED CONSTRUCTION. COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building i �� (a) Building Permit Fee / t 2. Electrical (b) Estimated Total Cost of j o� Construction from (6) 3. Plumbing Building Permit Fcc 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 1 e,C7 Check Number � 9V0 # - This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings' Date File # BP- 2010 -0623 APPLICANT /CONTACT PERSON JAMES VAN NATTA 731.1-63c1 ADDRESS /PHONE 403 SOUTH MOUNTAIN RD NORTHFIELD (413) 498 -2698 PROPERTY LOCATION 48 LYMAN RD MAP 39A PARCEL 058 001 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 /��' Fee Paid Typeof Construction: REMOVE WALL TO OPEN UP 2ND FLR PORCH TO SUNROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 040620 � 3 sets of Plans / Plot Plan i F I-6° R AA to ST 13 6 O P6 nt Fa-reirfil14414 A r- R� FR,A THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON NS Act IC n1 INFORMATION 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 ..� / A Z C> / Signatur e of Building fficial 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. 48 LYMAN RD BP- 2010 -0623 GIS #: COMMONWEALTH OF MASSACHUSETT Map:Block: 39A - 058 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2010 -0623 Protect # JS- 2010 - 000905 Est. Cost: $16000.00 Fee: $96.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JAMES VAN NATTA 040620 Lot Size(sq. ft.): 19209.96 Owner: WAGNER RICHARD & RUTH FOLCHMAN Zoning, : IJR13(100)/ A plicant: JAMES VAN NATTA AT: 48 LYMAN RD Applicant Address: Phone: Insurance: 403 SOUTH MOUNTAIN RD (413) 498 -2698 NORTHFIELDMA01360 ISSUED ON:12/23/2009 0:00:00 TO PERFORM THE FOLLOWING WORK: REMOVE WALL TO OPEN UP 2ND FLR PORCH TO SUNROOM. Porch floor must be open at rough framing inspection. 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: id ,-. f Driveway Final: Final: Final: �- /0 g Ot< i , �- Rou h Frame: � (1 � � c3k 2 131 t 0 LS"A, I (as: Fire Department Fireplace /Chimney: i t Rough: Oil: Insulation: c, . l 6 4(C 3 : 'j Final: Smoke: Final: oj<. 2/26((O 4.0 - t415 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy C Signature: C. 7190- 444 � � x FeeType: Date Paid: Amount: Building 12/23/2009 0:00:00 $96.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo