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CUSTOM SIZES /COL I R Xbi4702fi, b ...."
FREE I
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CALL YOUR DEALER 1
,.--,.''. :... ,. ALL KINDS OF CLOSED GARAGES a
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• COMPAR i PRICES AND apIts
NOTICE: Length-Wise Frame is 1 Ft.
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�a - 29 gauge � �,
Shorter Than Roof; except vertical k A
�Q STEEL Roof
carports. �,p�i ,
CE RTIFIE D P ricing - 2 1 /4
Available Upon Request - 1 20 YI
DOUBLE CARPORT
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framing o1
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5 Ft Leg normal u arx"
1 j . � 190 14 Gauge,
�;! , 1 AR ! 1 a >, i 2 iktt 14 Gauge likill
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14 Gauge �'� '��"� Galvanized Frame
Ft . ' 1 G,A,U,GE .
12 X 21 $ 995.00 18 X 21 $1095.00 20 x 21 $1445.00 22 X 21 $1645.00 24 X 21 $1845.00 12 x 21 $1195.00 18 x 21 $1395.00 20 X 21 $1645.00 22 x 21
12 1 26 $1370.00 18 x 26 $1520.00 20 x 26 $1770.00 22 x 26$2030.00 24 x 26 $2270.00 12 x 26 $1545.00 18 x 26 $1745.00 20 x 26 $2095.00 22 x 26
12 X 31 $1545.00 18 x 31 $1845.00 20 x 31 $2145.00 22 X 31 $2395.00 24 x 31 $2745.00 12 x 31 $1795.00 18 X 31 $2045.00 20 x 31 $2345.00 22 X 31
12 X 36 $1765.00 18 X 36 $2115.00 20136 $2465.00 22 1 36$2815.00 24 1 36 $3165.00 12 X 36 $2045.00 18 X 36 $2445.00 20 x 36 $2795.00 22 1 36
12 X 41 $2045.00 18 X 41 $2445.00 20 x 41 $2845.00 22 x 41$3145.00 24 1 41 $3545.00 r 12 x 41 $2495.00 18 x 41 $2845.00 20 X 41 $3195.00 22 x 41
Tam A T TO C 3!LVIO. „„ X -7 g11V l'illti7j 1- iii 3 C CR io 3
STATES:Massachusetts,Rhode Islan4,Malne,Conneakut,New York,New Hampshire, Vermont.
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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 requires that t he building depa rtment 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
- -- p its- in- conjunction_to_the_building_permitissued,_ - 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
1, J z7 Z f1 2 sclo 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 wore d G P 4Lf location 7 4 . Pem
,q ttr e 1
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 .wfiti f Office of Investigations •
_ "- T 6 Washington Street
�' Boston, MA 02111
„� www.mass gov /dia
-Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/PIumbers
Applicant Information Please Print Legibly
Name ( Business /Organiiation/Individitnr):
Address: -
City /State /Zip: Phone. #:
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
listed on the attached sheet. 7. ❑
2. ❑ I am a sole proprietor or partner- Rymodelin
ship and have. no loyees These sub - contractors have 8. 0 Dertolon
working for in any capacity. employees and have workers'
- 9. Building ackiition
[No workers' comp. insurance
c insurance.
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3. am a.-homeowner-doing-all-work- 9 eve cxezc�s d her __ 11:0 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 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
employees. If the sub - contractors have employees, they mustprovide their workers' comp. policy number.
Iam 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 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. lye advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do_herebj, under e p , i, r - , d p .. (perjury that the infonnation provided_above is true and correct _- _
Signature: /7 Date: / .(
Phone #:
Official use only_ Do riot` write in this area, — ta be completed by city or town official
City or Town: Permit/License # ._
Issuing Authority (circle one): -
I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector_
6. Other .
Contact Person: Phone #:
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: �` // /✓� / Not Applicable ❑
Name of License Holder : r
License Number
f �
r G pie/m.416e 14 9938'
Tzeg Expiration Date
•Yis-s -o 'zr 9-i3- Z'//
Signature Telephone
9..Registared;fiome lrntiroveinentCO itractor ,. .. 5 .i; ,.. .; .. z Not Applicable ❑
Company Name Registration Number
. J far e - ).vix,q... is /mod
Address Expiration Date
, , AV/ is '� ; r Telephone) 0 cP 'e5 � 7 Z Z -» ZO /c
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 ❑
H ►� ,:qT.1143me
_ The_ curr -ent_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 1083.5.1.
Definition of Homeowner: Person (s) who own a parcel ofland 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
art amp on 411 a e . • • -. . .4 • .
- _ . - `» - 'rat-Laws-Annotated.
Homeowner Signature
L -
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. tsli
Demolition ❑ New Signs [El] Decks [Q Siding [El] Other [ID]
Brief Descripti of Proposed / Harz Arg / � Work: e' ' L ���c
Alteration of existing bedroom Yes No Adding new bedroom Yes _ No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
sa 'if Nernc t ousefand oi'eiidWotrto existing bousinq; 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. 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 confomi to the Building and Zoning regulations? Yes No .
I. 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
1, , as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner i Date
l0/Wk.?) 7 PVS �� , 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 der the pains pe of perjury.
Prin
07 0 vi,_g?f
/ "
Signature of Ow rir. gent Date
. •
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 in by
Building Department
Lot Size _ __,_ fir_
Frontage N ! ._ _..._,_.._..
Setbacks Front ; TRU &elf
Side Ly .115/_: L ....... R.__.... . . _ -___
Rear L f(&
Building Height
Bldg. Square Footage ` ryry ? % i___, ,
Open Space Footage %
(Lot area minus bldg & paved ,_,
parking)
# of Parking Spaces r__.m_._..#
Fill:
i P�
(volume & Location) _. -_ .. _- -, . ._
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 Pagel and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO AI DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , Date Issued
C. Do any signs exist on the property? YES 0 NO *�
IF YES, describe size, type and location:
D. Af ff ere anypoposeA ' "c hdhgel to or adfitiorls orsigns intended the property ? YES 0 NO
'AO
IF YES, describe size, type and location:
E. WiII the construction activity disturb (clearing, gradi . ex - vation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO 44,
.."4
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
•
•
City of Northampton StatofP�s�
Building Department Ii�m m y s
212 Main Street
_ Room 100 �. " °Y• m E ���
Northampton, MA 01060 •
phone 413 - 587 -1240 Fax 413 - 587 -1272 s - frj r! n
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
/ CLIl Map Lot _ Unit
R dhA.2. 4C A ` Zo'ne Overlay District
'EtritStr District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
ettfi
Name Current Mailin Address:
/
f �l : _'�..i Telephone
Signature Site "cc2.]S �
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 0 a (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. Total = (1 + 2 + 3 + 4 + 5) Q 2 � r'Z) Check Number
• This Section For.Official Use Drily
Date
Building Permit Number: Issued:
Signature:
Building .Commissioner /Inspector of Buildings Date
File # BP- 2010 -0401
APPLICANT /CONTACT PERSON RUSSELL DAVID J & ELIZABETH A
ADDRESS /PHONE 148 RYAN RD FLORENCE (413) 586 -0428 Q
PROPERTY LOCATION 148 RYAN RD
MAP 22D PARCEL 030 001 ZONE URA(100) //WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out z �J a r•-
Fee Paid (� o5 (p l�
Typeof Construction: ERECT 18 X 21 DET METAL CARPORT
New Construction _
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans / Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO 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
20, ;" 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.
•
I48 RYAN RD BP-2010-0401
GIS #: COMMONWEALTH OF MASSACHUSETTS
Ma 1oek: 22D - 030 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -0401
Proiect # JS- 2010 - 000540
Est. Cost: $1052.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 22041 .36 Owner: RUSSELL DAVID J & ELIZABETH A
Zoning: URA(100) / /WSP Applicant: RUSSELL DAVID J & ELIZABETH A
AT: 148 RYAN RD
Applicant Address: Phone: Insurance:
148 RYAN RD (413) 586 -0428 O
FLORENCEMA01062 ISSUED ON:10/19/2009 0:00:00
TO PERFORM THE FOLLOWING WORK: ERECT 18 X 21 DET METAL CARPORT
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 /C'himney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 10/19/2009 0:00:00 $25.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo