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24C-118 ---- 1 j ..,... 1 I I__ .....- ,-- _....... * ) 1 1 C -----, n \ -7 ., ->2r2/15 --..i- ....... -. - - ---- . i A ' 0 ' ..4 1 4 4, 412 -1 N .1 i ---------,_ j c 1 - i 0 - 7 16. di - - -- irr-214,14) t - 6n 71Z, t` I. 01 0 r- ■ ' ,.. ' 0 i S A >;.) 0 W S *Ilid _ --- -- 0 / MORTGAGE LOAN INSPECTION LOCUS A E BOOK 1885 PAGE 315 ms's 8O0K 527 PAGE 290 NAY BE SUBJECT TO A DRAINAGE PIPELINE CROSSING THE REAR of THE PROPERTY. • K war SAWN GARAGE • N 4 .._._�._.._` ALAN BOOK 207 PAGE 84 aer • PLAN BOOK 184 PAGE 5 2 WIRY N/F BIT. GARA' 4Y 1 'M' I 5TH AVENUE To: Merrimack Mortgage Co., Inc. Aim: First American Title Ins. Co. OWNER Michael J. Quinlan Maureen A. Quinlan I hereby report that the premises shown on this plan are LOCATION: not located within a Flood Hazard Area as shown on the 10 Fifth Avenue y Management Agency's Flood Northampton, Massachusetts ae s / 0 O SP j r (4 IA / A. E ) 4 5 5 14' "Tt C/No F2.m i 15r1 Z.K C ElL,tA � <sr� tv�a 2�� u r � ocTt. I r 2 w 2 i < 1 '-P2\541\AA 1 1 ! je 11 1, ,,C,i 1 ' dir-- , 1 601 1 i 1 , dc-------b, -----34-- , '--- r , ce /1‘ - A. z _ no-NAGA if . 1 ...125 on'20 , ' i '• r , yn 5) c? L'il T Q., 1 ,5 , 12 1. 1 \---,. I , , Arl 0 1 IA 0)' 0- : I. 1 ii 1 Vei L 1 2'. 00/ 4 " ... ,, ........* .....a......a...............a......**., 1 ' ? ,7„, 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 p ces quir that the buildin 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 -- permits- in -conj unction -to the_builrl'�ernit 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 t.. ` understand the above. (Home owner /re dent's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date / d . Address of work location /0 / Y'e'n /4^10 „ M 0/ 0 • The Commonwealth of Massachusetts T Department of Industrial Accidents Office of Investigations t v �' ' 600 Washington Street • [ — g Boston, MA 02111 s www.massgov/dia -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): - ��� ,. • Address: City /State/Zip: o Pne. #: e F,:- Are yo an employer? Check the appropriate box: , : ' ` Type of project (required): / 1. I am • employer 4. 0 I am a,general contractor and I 6. New construction emplo ees (full and/ or part- time).* h hese B red the sub - contractors 2. I atn a s• h e . proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and h• e. eioy ees These sub - contractors have. 8. ❑ Demolon for . , e in any capacity. .employees and have workers' working Y P ty. # 9. 0 Budding addition [No workers' c. y.,.. insurance , '- comp. insurance. required.] 5.,{_] We are a corporation and its 10.0 Electrical repairs or additions 3. I- am- a- �iomeovvn . _ ce _ have xe.rcised_thei�_. I-1: m repairs or additions - ...- all-work -- � > P myself [No workers' ,nip. e right of exemption per MGL 12.0 Roof repairs insurance required] t c. 152, § 1(4), and we have no .'' RA employees. [No workers' 13.0 Other comp. insurance required.} *My applicant that checks box #1 must also fill • ` ■ the section below showing their workers' compensation policy information_ t Homeowners who submit this affidavit - indicating ey are doing all work and then hire outside contractors must submit a new affidavit indicating such :Contractors that check this box must attached ati addi onal sheet showing the name of the sub - contractors and state whether or not those entities have employees. lithe sub- contractors have employees, they provide their workers' comp. policy number. I am an employer that is providing workers' co i ensation insurance for my employee& 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' tcompensation policy declara n page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MG c. 152 can lead to the imposition of criminal penalties of a fine up to $1 and/or one -year imprisonment, as well as civil enaities in the form of a STOP WORK ORDER and a firs of up to $250.00 a day against the violator: lle advised that a copy o 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 perjury that the in ormation provided _above utrue_arutcorrect_ Signature: \ Date` Phone #: 1 Official use only: Don t w this area, tto -be comp eted or tow 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 #: P Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." f r Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall" enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of thin chapter have been presented to the contracting authority." Applicants Please "i 11 O • as • area 4 ' 1 a • • . • . i..e . chcc 7$e c8 &� &pg'y c` `-yvuaiat23$19n-3Il if necessary, supply sub - contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees -other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' - compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self - insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. - Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple pezinit/license applications in any given year, need only submit one affidavit indicating current policy information, (if necessary) and under "Job Site Mdraoo" the applicant should write. "&I11uL.atiuus'i in (City or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that .a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each Year. Where -a dome owner VI' tizen �s obta i a Itcense or permit not related to.any business -or oramery al veni ire (i.e. a dog license or permit to burn leaves etc.) said person is NOT required: to complete this of ida t . The Office ofInvestig itiuus wtailtl 111.e to Ihanit you fn attbance for your cooperation and should you have any questions, pleasedo nothesitate to give us a call. __ - _._ Tfie Department's address, telephone and fax :The Commonwealth of Massachusetts Department of Jndual Accidents Office of Inv ¢a bons _. War Street - Boston, MA 02111 . Tel. # 617- 727 -4900 ext 406 or 1 - 877 MASSAFE Fax 617- 727 -7749 Revised 11 -22 -06 miss govidta The Commonwealth of Massachusetts Department of Industrial Accidents ;-' Office of Investigations '_ 600 Washington Street �. k Boston, MA 02111 ".„ ,—,� www.mass.gov /dia - Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): r- AK k(--- k L7 Address: _-2 % F ' City /State /Zip: � 5 � ' hone. #: 0 ( O 2 Are you an employer? Check the appropriate box: 1. Type of project (required): ' 4. I am a general contractor and I 6 ❑ New cons' traction ❑ I am a employer with mp1oyees (full and/or ❑ part-time).. have hired the sub- contractors am a sole proprietor or partner - ' on the attached sheet. 7. temode1mg ship and have no employees These sub contractors have. 8. 0 Demolition work -ing for me in any caps city. [No workers' comp. insurance emplayees_and have workers' a comp. 10. Electrical r a re ed 5. We are a corporation and its ❑ repairs or additions officers havexercised their �. ❑ I am a homeowner doing all work 11. ❑ Plumbing repairs or additions myself o workers' comp. rid t of exemption per MGL Y 12. Q Roof repairs 9. c. 152, §1(4) , and we have no insurance required.] t employees: [No workers' 13. ❑ Other comp. insurance required }. *my applicant that checks box 41 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 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 Section25A 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. Be advised that a copy of this statement maybe forwarded to the Office of Investizations of the DIA for insurance' coverage verification , :;:�.._ ___ __ ;r: , .._ I do hereby ce and e p penalties of perjury that the information provided_above ;^ re - cslrue�rid_carrect -- -. Signature_ -- Date: r���. (0.7 Phone 4: 4 I S i 3 — Official use only Do not write in this area, to be completed by city or town ofciaL 1 1 ""- - i or Torn: r ermitr�ieense # _ _ - _ Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town CIerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone #: A ` SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : t C_ J \ ( 4 — - - _ - - um or 2:2- C tP kc sr' . s k- s)2-7-0 Address Expiration Date �(3 Sz7`(3 z (o Signature Telephone 9:,Reclistered,,Home ImprovementContractor � .��r Not Applicable ❑ Company Name Registration Number 2_ - 2- g 4 c 7 C.;%-v. 1 (a) I eo i1 Address Expiration e Telephone S � � 7 �� / L __ SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 162, § 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 \e' No ❑ The_current _exemption for "homeowners" was extended to include Owner 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 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 tna a elan c. `. .$ . = w - v • d s- renerai -L-aws Annotated. Homeowner Signature . ,, ; .,/ , Af J SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House I:3 Addition 0 Replacement Windows Alteration(s) ®„ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [E] Siding [0] Other [0] Brief Description of Proposed 0 / g a l ( Work: F atTC 0)1 2 `�rL tire- /� . �) Wet et (/ 2 � / FI - -+ le _ 0 O y. Alt- of existing bedroom � _Yes No Adding new bedroom Yes No • ttache' Renovating unfinished basement Yes No Plan - ttached Roll .Sheet naf`(f Iew housefandar ackciit on - to ekittiiicr lic usitiq,:cornplete tf e`.folloiivi lia: 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 Ta OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , 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 Date I 6} /1-1. / , as Owner /Authorized Agent hereby declare th t he statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains andd enalties of perjury. i f Print Name Signature of Owner/Agent 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 vu‘ Building Department Lot Size .._._ .- Frontage Setbacks Front 6 Side L :___f....... R: _ L.! R: Rear Building Height Bldg. Square Footage i- % �lv , wig „, Open Space Footage (Lot area minus bldg & paved pairing) # of Parking Spaces Z Fill: I (volume & Location) — — A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW ot3 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 15 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. Do any signs exist on the property? YES 0 NO GI IF YES, describe size, type and location: D We e an ro osedchan es to or addition intendedfor the property ? YES 0 NO S YP P g P P Y• a 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 like IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 1 , City of Northampton Stasl'', . o' Building Department C '�t�,,e+aY..er ` 212 Main Street S e m ,z 7 ,„'";,,t,:: c -a � � N k` 3 N :�` Caro � .1 v .�U� Room 100 ;_ Il4a @ � � 0 g ; ' ') phone • - 587 -1240 Fax 413 - 587 -1272 P . s 1� � ''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 %� erttyAd PR-f- d Sr " 10 Fi PR-f- J Map Lot Unit ,l„ q O OH j � /� Zone Overlay District r J / v 1 EIrn.StrDistrict CB District SECTION 2 =- PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: E /E Al . 1 Af. Ie- i I-klt — 3 U!),$) _o d .-a...,,i fiv. A ) 0 l" -1tc, `�'J`'AA Name (Print) Curgent Mailing Address: 0/060 - e��'� Tele hone 7 �.t -L� / f' � . Siga urt e V/ 3 , g i - 5 / `-] 0 r 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 f g- d ° (a) Building "Permit Fee 2. Electrical / (b) Estimated Total Cost of a�i7 Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection � 6. Total = (1 + 2 + 3 + 4 + 5) i/'1 5 0 ' Check Number ?O 3 �/ G 0 This Section For Official ' se Orili Date Building Permit Number: Issued: Signature: + Building Commissioner /Inspector of Buildings Date File # BP -2010 -0582 APPLICANT /CONTACT PERSON ERIC HUTHER ADDRESS /PHONE 228 PARK ST EASTHAMPTON (413) 527 -4392 Q PROPERTY LOCATION 10 FIFTH AVE MAP 24C PARCEL 118 001 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 Typeof Construction: REMOVE WALL TO ENLARGE ROOM & ADD WALL TO MAKE NEW ROOM & ADD CLOSET New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 089270 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: t 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 r _ Z / volo) 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. i t '°`` ° °'' BP- 2010 -0582 GIS #: COMMONWEALTH OF MASSACHUSETTS , � 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 -0582 Proiect # JS- 2010 - 000834 Est. Cost: $14500.00 Fee: $90.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ERIC HUTHER 089270 Lot Size(sq. ft.): 6621.12 Owner: QUINTEROS GUILLERMO & ELSIE PARRILLA Zoning: URB(100)/ Applicant: ERIC HUTHER AT: 10 FIFTH AVE Applicant Address: Phone: Insurance: 228 PARK ST (413) 527 -4392 0 EASTHAMPTONMAO1027 ISSUED ON:12/14/2009 0:00:00 TO PERFORM THE FOLLOWING WORK: REMOVE WALL TO ENLARGE ROOM & ADD WALL TO MAKE NEW BEDROOM & ADD CLOSET 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: 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 12/14/2009 0:00:00 $90.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo