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REFRAME WALL: ; 0 Z
- INSTALL SIMPSON ' f
SHEAR WALL BRACING (.7)
PANELS AND W 1
STRUCTURAL LVL
HEADER PER FINAL rn w W
MANUFAGTURER/SUPPLIE
R CALCULATION AND i II ~ = <o
SPECIFICATIONS 1 "
-Fi ML° NE?4 OPEN tN -. ` .: - w ° 3
FOR NE'M OVEREAD • " ` X 3€
DOOR -' -6 X 10-0
-FRAME NEW OPENING ! ` � r s' ▪ '. % w
FOR NEW 3' -0" X 6' -8" '
HINGED DOOR ;' ` _ .-,..'1',,,.'.:,',..,::"%:...:, O w
- VERIFY PRIOR TO ' I w
CONSTRUCTION: :=;; W D g
FINAL SIZE OF .' 4 g' ¢ 1-- z
OVERHEAD DOOR, LVL, ▪ ..r : D 4 D 4 D 4 D - Z g
AND SHEAR BRACING '? ; '• Q w a
PANEL. SIZING ro•' • i o
co
:.' D I I 4C 4C 4 ▪ . :: _ u, 0,
NEV 8" THICK FOUNDATION ., 0: • ' ` U z o
:- �" DATE : 0008.74
WALL ANDS "X16' '
FOOTING. BOTTOM OF ;�►: `.
FOOTING MIN. 4' BELOW D D D D � `
FINISH GRADE
i
2'6" 1 10' -0" 2'0" / 3 -0" �fi "
i
18' -0" y
Z 'I'
S HEET NAME
' 11 ' FRAMING
I DIAGRAM
C
SOUTH ELEVATION SHEET NUMBER
SCALE: 3/8" = 1' -0" SKI .0
10/27/2008 11:00 FAX 773 0896 FCCIP 200G/006
The Commonwealth of Massachusetts •
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plum5ers
Applicant Information Please ?rint Legibly
Name ( Business /Organization/Individual): O�-"C ��S(Ft�r Gal(
Address: ) 6 `-{ I\ . ELM S I 1 —
Cit /State /Zip: ` i o M T t Mk 0100 Phone #: W« SCI 3 0
Are yo an employer? Check the appropriate box: Type of project (required):
1,
Are
an employer with 4. ❑ I am a general contractor and I 6. ❑ �New Constructicn
Employees (full and/or part- time)* have hired the sub - contractors 7 p Remodeling
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. t
Ship and have no employees These sub - contractors have 8. 0 Demolition
Working for me in any capacity. - workers' comp. insurance. 9. 0 Building Additicn
[No workers' comp. insurance 5. ❑ We are a corporation and its 10. 0 Electrical repairs or additions
required.] officers have exercised their I
3. 0 I am a homeowner doing all work right of exemption per MGL 11. ❑ Pl bing repairs or additi ns
myself. [No workers' comp. C. 152, § 1(4), and we have no 12, Wkoof repairs
insurance required.ff employees. [No workers' 13. Cr Other _
comp. insurance required.]
* Any 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 sucP .
# Contractors that chock this box must attach an additional sheet showing the name of the sub - contractors and their workers' .
f am an employer that is providing workers' compensation insurance for my employees. Below is the policy and Job site informa 'on.
Insurance Company Name; A, I •1A" 1. M wro A 1-- _ _ f
Policy #, or Self-ins. laic. #: W1'47 t Z � 1 ® 5 7 ?A d (� cx7 eArintion Date: 1 0/ 2- 1 .l. __ .
Job Site Address: / l� (re 5e,�, -4 59 , Cit /State /Zi 61
Attach a copy of the workers' compensation policy decia ation page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGT. C. 152 can lead to the imposition of criminal penalties c f a fine ur to
$ l ,500.00 and /or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of uo to $250.00 a
day against the violator. Be 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 ce ��j t , der the pat and penaltie • • 'ury that the information provided above is true and correct,
Signature: dam o :A • Date:
Phone #: .11 IS 5 5 I. 30i-70
Official use only. Do not write in this area, to be completed by city of town official.
City or Town: Permit /License 0:
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 #:
Il _
5
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) El Roofing d
Or Doors ❑
Accessory Bldg. ❑ Demolition El New Signs [❑] Decks [[] Siding I❑] Other [0]
Brief Description of Proposed
Work: r, roe-c / / .2 > `2� oi P / : i = t , drr IV A
Alteration of existing bedroom Yes - %-V Adding n bedroom Yes No
Attached Narrative Renovating unfinished basement Yes �/ No
Plans Attached Roll - Sheet
6a. If New house and or addition °to=ex existing hou 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?
6
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. • etlands? Yes _ No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or - ar floor below finished grade
k. Will building conf• m 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
I, ( Z " ( F , as Owner of the subject
property T )j / -(
hereby authorize D /. vn (t vto r y
to act on m • - - in all matters rela ' - • work atrized by this building permit application.
■ic/! /� ■
---- Sg nature o - /�� ' /� Date
I, - 5 - 01. vk Z—c4..—CAr^ , as Owner /Authorized
Agent hereby declare that the statements nd 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.
TO t! L rc.- -•d`r�
Print Name
. -v
Signature of Own- Agent OF 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
Buildin. i partment
Lot Size
Frontage
Setbacks Front
Side L:— R L: R.
Rear
Building Height
Bldg. Square Footage
% _
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
,
Fill:
(volume & Location)
A. Has a Special Permit/Variance/Finding er been issued for/on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at t' e Registry of Deeds?
NO 0 DONT KNO' 0 YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, • a dy of water or wetlands? NO (2) DON'T KNOW 0 YES 0
IF YES, has a permit been • need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained
, Date Issued:
C. Do any signs exist on th; property? YES NO 0
IF YES, describe siz- type and location:
D. Are there any propo ed changes to or additions of signs intended for the property ? YES 0 NO 0
IF YES, describe ize, type and location:
E. Will the constructi in activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb • er 1 acre? YES 0 NO 0
IF YES, then a orthampton Storm Water Management Permit from the DPW is required.
7 ,
( ,�� City of Northampton
�-:, ti Buildi Department ' r
. `. 212 ain Street �� °.. _
c e s oom 100
Northampton, MA 01060 ° = �: `.�
phone 413 - 587 -1240 Fax 413 - 587 -1272 14
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
/ 2 C te5e + 5+ Map Lot Unit
r } 4€8 Zone Overlay District _
Elm St. District CS District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
A
Name (Prin i Current Marlin Address:
6D `l
� Telephone yr - — 13
Si ,����
2.2 Authorized Agent:
- 3 - 014 +A. L..vlih / 'T '/ 14k �L 5
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 LQ,Q,� a d (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) c200 • "/ Check Number Ai e jr' r
This Section For Official Use Only
Permit Number: Date
Building Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2010 -0325
APPLICANT /CONTACT PERSON JOHN LANDRY
ADDRESS/PHONE 104 NORTH ELM ST NORTHAMPTON (413) 204 -9880
PROPERTY LOCATION 152 CRESCENT ST
MAP 24D PARCEL 292 001 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 Oy` J3J �
Fee Paid 7
Typeof Construction: STRIP & SHINGLE GARAGE ROOF & FRAME NEW GARAGE DOOR OPENING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 093450
3 sets of Plans / Plot Plan
THE F 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
/
Signature of Building 0 ficial 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.
152 et° . t 1 ;rte BP- 2010 -0325
G1S #: 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 -0325
Project # JS- 2010 - 000434
Est. Cost: $5000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN LANDRY 093450
Lot Size(sq. ft.): 4965.84 Owner: CHAPUT CHRISTOPHER R
Zoning: URB(100)/ Applicant: JOHN LANDRY
AT: 152 CRESCENT ST
Applicant Address: Phone: Insurance:
104 NORTH ELM ST (413) 204 - 9880 WC
NORTHAMPTONMA01060 ISSUED ON:11/6/2009 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE GARAGE ROOF & FRAME
NEW GARAGE DOOR OPENING
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 11/6/2009 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo