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31A-014 The Commonwealth of Massachisserrs - _ Depa,•-rren. of n ustrial.4ccr»ferrs - r-- 0,75- ce of Invesri� arw s 600 Washington Sr: eer = Boston, M4 02111 www. 7nass.S o1 /t1a Workers' Compensation Insurance Affidavit: Builders/ Contractors ,ElectriciansiPlrumbers Applicant Information Please Print Legibly Name (.?�usiness/Organiza '12y \'S�C on/Individua1) : I k e_ti �OCI _1.'�f._ _ zddr ess: e\Q C itti-;'State/Zip: vpc X 74$\ Phone -: y \3 - - Sd'1,- 3\\0 Are you an employer? Check the appropriate box: Type ofproject (required): i 1. Z I am a employer wi:h y n I at? a general contractor I 5. �; <�v construction employees (full and/or part-time).* have hired the sub - contractors U : � 1 2. ❑ I am a sole proprietor or partner- listed on the arched sheet [I Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition employees and have workers' 9 ❑ Bul working for me in any capacity. , fti�iv add lion [No workers' comp- insurance comp. insurance.: required.] 5. Q R e are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing a1 worms officers have exercised their 11.0 Plumbing repairs or additions myself_ [N o workers' comp_ right of exertzption per vIGL 12.0 Roof repairs insurance required.] l" 5. 152, § 1(4), and we have no employees. [No worlds' 13. Other I i comp. insurance required.] • `any applies= that checks box #1 mist also 5n out she section below showing their workers' comp nation policy i.fommdon. Homeowners who s;ibt•.it this affidavit indicatu:g they are doing all work and then hire outside conaactors must submit a new affidavit indicating such. - —actors that check this box must attached an additio:.ai sheet showing the name of the sub-corm and state whether or not those =tides have employees. If :be sub- contactors have employees, oio_yees, they must provide their workers' corm. 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: is\ cp — Policy # or Self -ins. Lic. T: �C_ Vq - 3`e:;:`2`i Expiration Date: - a.'QS - \a Job Site Address: aaq \\e • City /State;Zip: Npr ^ .�0 \ObD 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 ofMGL c. 152 can lead to the imposition of cr;rniral penalties of a fine up to 31,500.00 and/or one -year innrisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 3250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DLz for insurance coverage verification. I do hereby cerr _ under the pairs and penalties of perjury than the information provided above is true and correct. Signature: Date: -`. - \\ Phone -: I O f f icial use only. Do not rnrite in this tires, to be completed by city or town ofciaL City- or Town: Permit'License Issuing Authority (circle one): # Health ? o� . a ` 3. City /Town Clerk 4. Electrical Inspector 5. Plumbing 1.3oar Building repartl:.ent I 6. Other iI l I Contact Person: Phone 4: SECT :ON 8 - CONSTRUCTION SERVICES 1 + 8.1 Licensed Cor•.s`truc: ion Supervisor } Not Appiic Ie D Name of License fiolder : ey \'(1 C � Ne\ License Number ° b . c�CZ.�e.�. �scc�� \O- - \� kccress Expiration Date >ian ture Telephone - Deis`u:redlHotneli nzrovemerteC'ontracfar , i ` - -,', Not Applicable ❑ :omoanv Name - Registration Number N\ \ o\oa 7 "1-\1:. - .ddress Expiration Date A .t)L\ Telephone "'S - ECTI 10- WORKERS' GOMp> isjsTmON; URAAI.CE A IDA IT (Rai_ c.152,-25C(6)) 'orkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result the denial of the issuance of the building permit aped Affidavit Attached Yew ❑ No g • The current exemption for " homeowners" was extended to include Owner - occupied Dwellings of one (I) or two(2) families and to allow such homeowner to enzage an individual for hire who does not possess a license, provided that the owner acts as supervisor. C�IR 780. Sixth Edition Section 10833.1. 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 -vear 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 workperformed 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 die 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 Bulletin° Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated Homeowner Signature 1 SECTION 5- DESCRIPTION OF PROPOSED WORK !check all applicable) i New House ED 1 Addition C Replacement Windows Alteration Ro Li ofing r—� I Or Doors , ! I �- I Accessory Bldg. ! _ ; Demolition U New Signs [I:21 Decks jL i Siding jl✓j Other [0] i Brief Description of Proposed 1 Wcr : `eac \'cVc, , \Voroc∎ `etc cb vas w c -, Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovaiira unnrished basement Yes Nc Plans Attached Roil - Sheet sa. 'if N�cr FrQUSa o�r_Qdaxtortozist>na =fio using. COrtan[t tie fai(aci: I a Use of building : One Famiiy Family Other • b. Number of rooms in each family unit: Number of Bathrooms c. Is there a Garage attached? C. Proposed Square footage of new construction_ Dimensions e- Number of stories? f. Method of heating? Fireplaces or Wcedstoves Number of each g. Energy Conseriation Compliance. Mass check Energy COrnpiianc faint attached? h. Type of construction 1 :. Is c rstrJc ion within I GO f` of wetlands? Yes No. Is corstruc��ion within 100 yr. focdpiain Yes No I Depth of basement or cellar floor oe!cw t his ed . Crace i k Will building ccn:c= r• t c ::,untid■ al :u Zurit la r �'uiaticr;s? re= NC . t t Sectrc Tank. City Sewer Private well C -/ Ha der Sr.cciv I SECTION 72 OWN R AUTROrRiZATION _ i O'SECOMPGi c.) -WrEN -" O4 KERS-A &ENT 0rtCf5 i AGT5rR-Ar IES �aasturbima -pmm�i - _ 1 as Owner of the subject y h hery authorizE V�S1�. 1 �L`2 to ac eb my beh in all matters relative to work authorized by this building permit application. - cc 77 A Signature of Owner Date I � \.,� r�J . , as Owner/Authorized `"-.gent hereby declare that the statemen ts and information on the foregoing appli are true and ac. irate, t0 the best of m y wnedge and belief. Sicced under the pains and penalties of perjury. I Print Name • 1 Scna,.r_ ::r ; wrer /= - 7 * .. '" "= b - y e w � .-s= x z - 4 ' °. �- � �`° ti ` �`� �� �� Section 4. ZONING f Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This coiumn to be filled in by L I I i I i Ii T J JIJ J i Building. Depart ment Lot Size • Frontage J _ _ _ _ __ -_. - - - -.__ ____ _ Setbacks Front i I _____ - Side L:' .. R: L: R_,_ m Rear �.- Building Height 1 - -- I Bldg. Square Footage 1 7- 7 % 1 7 j _ Open Space Footage % I i , . (Lot area minus bldg & paved ----- oarhdng) # of Parking. Spaces Fill: _. _ _ -�.__ _ Fill: &Location) m`T —rn A. Has a Special Permit/Variance /Finding ever been issued for /on the site? NO i1 DONT KNOW 0 YES 0 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 # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0 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 k®iI IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 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 pfan that will disturb over 1 acre? YES 0 NO 41'4 IF YES, then a Northampton Storm Water ManagemenfPeiniitfrom the DPW is required. Department use onIJc O 4 2 City of Northampton Statu of elm G Building Department Cure Cut/Dnveyvay Peimr) • r 4 212 Main Street sevrrerlSe fabtJa = 1 Room 100 IN -t.z It ten.Air aN 7 a bility `� Northampton, M,"-. 01060 Two Serfs S truc3ttrat Plans , p X13- 587 -12 0 Fax =13- 587 -1272 Pintlsrte Pans d . °* . " ff�erSp APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE EE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE. INFORMATION f • 1.1 Property Address: This section to be completed by office ��q .. .\�1�c> � - Lot Una Zone Overlay District EIcri S t "District CB-District I SECTION Z PROPERTY OWNERSHIP /AiJ N HORIZED AGENT f 2.1 Owner of Record: �r \ter - .y Nam. a aq , tyoc ."rint) Current Mailing Address: / / � � \� - q'� - 3'85 Sign- j' -06.-_,.......... • Telephone Sign - 2.2 Authorized Agent 1�e � vs. or �� q� .. -,�.- »� •� I. Name (Print) Current Mailing Address: �� Signature Telephone SECTION 3 - ES11MA -TED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be I . OfcaS.U.se Only completed by permit aDolicant 1. Building ° J�� • ruiJdr1iitEee 2. Electrical !! La :Tat - mated Total •Cost of Constructibn:frona -(6) 3. Plumbing ( : Bui Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 1 6. Total = (1 + 2 + 3 + 4 + 5) '. • °SC7Q • I-Check Number 77 7 '1 This Section For Official Use -Only Permit Number: -{)ate - Building Issued: Signature: Building.: Commission ` erJlnspector:- ot.I3unamgs Date File # BP- 2011 -0890 APPLICANT /CONTACT PERSON KEVIN NETTO CONSTRUCTION INC ADDRESS/PHONE 90 Southampton Rd. WESTHAMPTON (413) 527 -3168 PROPERTY LOCATION 229 ELM ST MAP 31A PARCEL 014 001 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 4 77 ` Typeof Construction: ENCLOSE PORCH /WINDOWS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 1317 3 sets of Plans / Plot Plan THE FOLLOWING TION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION P SENTED: 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 Pe 't from Conservation Commission Permit from CB Architecture Committee (../ from Elm Street Commission DPW Storm Water Management g Demolition Delay 9 /0 Signature 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. - 229 7/7/ • , H i _ .._,.. ----., -,,, / ) Li _ 7- 1 ,-. /•,11...4Va. --- . __J _ . - I i 1 ! : -- " , ___1 I r , -_,...-- . , /I. , ! V i -4- I 1 \ I , r / --- Al , 7,r i e- . J/ 4 , 9 '-'- 7 Am , --:' (-4../ ;7 6 - / .j5:53,,m,Airj '\\ The Commonwealth of Massachusetts Department of Industrial Accidents • - 1. = Office of Investigations : �° 600 Washington Street 41 =n Boston, MA 02111 www.massaov /dia -Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Org i7ntion/Indivithnal): 'e c. - Address: qp City /State/Zip: ��e�oZi�c� . �1\A. Phone. #: \3 - : \■o.'e) Are you an employer? Check the appropriate box: Type of project (required): 4. I a a g enera contractor and ® I am a employer with t\ 4l d 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 e ioyees These sub - contractors have. 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. Building addition required) 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 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 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. :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: /S'N\ Policy # or Self -ins. Lic. #: \�C.\D'al1 .1 Expiration Date: -a, -a.'S - a.0 \\ Job Site Address: ''''.R �ct1 City /State /Zip: \Ob 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. 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 certify under the pains and penalties of peduty that the information provided above is true and correct Sienature: C Date: G J- \a. — \• Phone #: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License 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 #: Versionl .7 Commercial Building Permit May 15, 2000 r.. SECTlON.10. ,STRUCTURAL PEER REVIEW_( O CMR" 11J Independent Structural Engineering Structural Peer Review Required Yes 0 No 1/l4 SECTI O [ -11- 4 Oit1_NEL AUTHORIZATION ; TO BE OMP � WHEN OWNERS.AGEN.T Ott. CONTRACTOR,APPLIESOR Bu LDW.G'PERMrr I ____ "5 i - e- j , as Owner of the subject property I hereby authorize `fir 4V • e- • \ e--C ` t ` t , to act half, in all matters relative to work authorized by this building permit application. on . Signature of r Date i y I, ? si \'fN C . ' , 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 penury. vi ,(. N Print I - \.: \(!.. I Signs of OwnerdAgent - Date = SEC'TI O N 1 - G O&STRUCTIOf ER - - - 10.1 Licensed Construction Supervsor Not Applicable ❑ Name of License Holder l 2 . 1 2 � \ r Q- ► V' (C> i 1 C)CN3 \71 3 License Number 3 ! 11' A ..._ k :Iv - ��-•∎ \sue �'IL • 2 3. NI. .11■••■ Vin. • ►,- i !1C: ... Z!. - 1 \ SI i Addr Expiration Date I _ ��-� -ay - - � \ems Si tore Telephone SE TION't3 -WORKERS - COMP_.ENSATION CE FFIDAY[F-(MiG L_c.152 525C - - 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 ie4 No 0 - Version1.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN =AND UQNSTRU.CnixN-SERVICES fORBUILDI NGS- AND,S3RUCTURESSU83ECTT0 CONSTRUCTION .CONTROL PURSUANT TO t80 CMR 11SICONTAINIRG MORE TEIAN 35,000 -C.F OF ENCLOSEOSPACE) 9.1 Registered Architect Not Applicable ❑ Name (Registrant): _ Registration Number i Address ! I Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility t � Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility s � i Address Registration Number j s Signature Telephone Expiration Date - � Name Area of Responsibility Address Registration Number 1 1 .I Signature Telephone Expiration Date Name Area of Responsbifty i I Address Registration Number i t � i Signature Telephone Expiration Date 9.3 General Contractor V`eN.IWN r • �`p �J.`yc1�i.���c1 C C1c Not Applicable ❑ Company Name: Responsible In Charge of Construction Addr CAA. Signature Telephone Versionl .7 Commercial Building Permit May 15, 2000 11R ; Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size ` I e 1 Frontage I s Setbacks Front i `t i L: R:' 1 L:l i R:I I r 1 Rear i i --uitdmg Height , ' ,----- _ Bldg. Square Footage i I 1% 3 I Open Space Footage tt (Lot area minus bldg & paved ■ I I 1 1 i Wig) # of Parking Spaces i i , i I i Fill: ' P (volume & Location) i A. Has a Special Permit/Variance /Finding ever been issued for /on the site? lr NO �4, DONT KNOW 0 YES Q ' IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES Q IF YES: enter Book Page, and /or Document it! 1 B. Does the site contain a brook, body of water or wetlands? NO ►;4 DON'T KNOW Q YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO . IF YES, describe size, type and location: i D. Are there any proposed changes to or additions of signs intended for the property ? YES © NO IF YES, describe size, type and location: j 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 Q ` NO 0: IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Versionl _7 Commercial Building Permit May 15, 2000 SEtnto k- tioVitiVIlOR S f ORlPROJE t*TESS THAN 35,000 CUBIC-t t O ENdif 3 t -E - Interior Alterations ® Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing❑ Change of Use 0 Other ❑ /,, d o n Brief Description : Enter a brief description here. 'c ,. s■kw,9.5 \N-..' \ \x)A-424: W \VNN::.4.ch Of Proposed Work: E w., rea> C , a .g � 'SECTION = `A USE- GROUP AND NS UCTtOI+t — - USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A-1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑ - — A-4 ❑ A-5 ❑ T 1B I ❑ ❑ B Business ❑ 2A E Educational ❑ 2B 1 ❑ F Factory ❑ F - 1 0 F - ❑ 2C ❑ H High Hazard ❑ 3A I ❑ I Institutional ❑ f-1 ❑ 1- -2 0 1 - 3 ❑ 3B ID M Mercantile ❑ 4 ❑ R Residential M R -1 0 R -2 0 R -3 0 5A ❑ S Storage 0 S-1 ❑ S-2 0 5B ! ❑ U Utility ❑ Specify: i L M Mixed Use 0 Specify i S Special Use o Specify: COMPLE E.THIS,SEGTIOAI IFEXISTING BUILDING- dNDERGOING RENOVATIONS ADDmONS -4 R-CHIXNGE 1N USE Existing Use Group: t I Proposed Use Group: Existing Hazard Index 780 CMR 34):I 1 Proposed Hard Index 780 CMR 34): i l za - SECTION'613UIl DING HEIGHT`At4U AitEA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION x �, ,, ' _ _ Floor Area per Floor (sf) - = ' - _ * 7 ,-, x 3rd I 3rd ! i 4 u, 4th # i r f =, Total Area (sf) i Total Proposed New Construction (sf) k; °,.` , i i s Total Height (ft) i � � -- -. Total Height ft ; _° 7. Water Supply (M.G.L c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone ! Outside Flood Zone❑ Municipal 0 On site disposal system Version 1.7 Commercial Buildin Permit May 15, 2000 s City of Northampton -- Building Department 212 Main Street - Room 100 -- � 0102 i, J:G r'l Northampton, MA 01060 E- - : 6 -- i phone 413 -587 -1240 Fax 413 -587 - 1272 ;. , s , t T x APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTIONIL STTE:1N1=ORMATIOIs1 `_ -_ ' s 1 "- sectr�p1 eted.iiyio�r. :__ -- - 'M - Property Address: � r _� ,4 � e i 7 Y s E B B F � i � SECTION _- PROPERTYO 1'IG 7 r ...,„,„,„„ : „_______ 2.1 Owner of Record: le/(N - " \`R`C1e-.6 @1 i 1 \\ Q...,t,,\Q`C1 Q, tZ1,\NW • Name (Print) ' . ` Current Mailing Address: '�`� -q1Z -31'5 �ignature Li /L ✓��� Telephone 2.2 Authorized Agent: -+ w I V.V N N e �0%"1Z C 1 1'(1C 1 i ' r � 11�- »�' v• n i 4 1• _ t 1i N. V.i. 6d1 Name (Print) Current Mailing Address: Signature , _ IA Telephone _SECTION. 3 - :ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be - Official Use nnty completed by permit applicant =- _ . 1. Building Vat ` SC e O g (a)-,Buildng 'ermitFee 2. Electrical I ; (b) ,Estimated Total Cost of 1 'Constr .icticin from (6) _: 3. Plumbing i i Building Permrt i 4. Mechanical (HVAC) I 5. Fire Protection I 6. Total = (1 + 2 + 3 + 4 + 5) Ctaecic. Number r IP0 - :,' _ -T his Section For Official Use _ Buitdiiiag Pec pt NTi nb - issued; Signature: Building Commissioner/inspector of Buildings Date File # BP- 2010 -1009 APPLICANT /CONTACT PERSON KEVIN NETTO CONSTRUCTION INC ADDRESS/PHONE 90 Southampton Rd. WESTHAMPTON (413) 527 -3168 PROPERTY LOCATION 229 ELM ST MAP 31A PARCEL 014 001 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 d �� Fee Paid ,'J S� N Tvpeof Construction: REPLACE KITCHEN CABINETS /COUNTERTOPS,UPDATE BATHROOM FIXTURES /WINDOW New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 1317 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN 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 (J Signature of Building Official Date g g 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. n9 4.14,ST. : BP- 2010 -1009 GIS #: COMMONWEALTH OF MASSACHUSETTS M tq k 31A.- 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: BUILDING PERMIT Permit # BP- 2010 -1009 Project # JS- 2010- 001484 Est. Cost: $12500.00 Fee: $75.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KEVIN NETTO CONSTRUCTION INC 1317 Lot Size(sq. ft.): 16596.36 Owner: FINNESSEY RON Zoning: URB(100)/ Applicant: KEVIN NETTO CONSTRUCTION INC AT: 229 ELM ST Applicant Address: Phone: Insurance: 90 Southampton Rd. (413) 527 -3168 Workers Compensation WESTHAMPTONMAO1027 ISSUED ON:5/17/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: REPLACE KITCHEN CABINETS /COUNTERTOPS,UPDATE BATHROOM FIXTURES/WINDOW 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 5/17/2010 0:00:00 $75.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo