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23D-012 (9) SoNcupeKsP- BP-2007-0285 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Black: 23D-012 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: chimney rebuild BUILDING PERMIT Permit# BP-2007-0285 Project# JS-2007-000431 Est. Cost: $3500.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MICHAEL T SICILIANO 152313 Lot Size(sq. ft.): 12588.84 Owner: FREEMAN OTIS STANTON Zoning:URB Applicant: MICHAEL T SICILIANO AT: 8 NONOTUCK ST Applicant Address: Phone: Insurance: 9 LIBERTY ST HOLYOKEMA01040 ISSUED ON:9/14/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:REPAIR/REBUILD CHIMNEY 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 9/14/2006 0:00:00 $25.00MO 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo f � 3t l]tf; J■ektC1S�F3 __ tty of Northampton sta€rv �� it� "� u 8iIldino Department out uuat 212 Main Street Room 100r � taa s 1 r' 106 Northampton, MA 01060 L phone 413-5871240 Fax 413-587-1272 Othecrreeifyl` µ., APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: Ttns section to be com leted b of ice Map Lot Unit 9 ()(•' ^ Zone Drstrct t \ "' ° °.'`. �istrrct;i �� _. . ,"_ CB Distr�cf � E�tt�St<. SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: n .) CI\ Name(Print) Current Maili d ess: �f Telephone Signature 2.2 Authorized Agent: Narin � ! 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 r-0$3 (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) 31CJ° Check Number 1"C This,Section For Official Use Only Building Permit Number. Crete Issued: Signature: Date Building Commissioner/Inspector of Buildings e 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 T Lot Size ______ __ Frontage __._- Setbacks Front Side L: . — R:.. . L:' R Rear ' Building Height Bldg. Square Footage Open Space Footage , % ; I ) } s' (Lot area minus bldg&paved l parking) i #of Parking Spaces Fill: (volume&Location) 1L. ' 1 A. Has a Special Permit/Variance/Finding ever been,issued for/on the site? NO 0 DON'T KNOW 0 YES 0 IF YES, date issued:1 IF YES: Was the permit recorded at the.Registry of Deeds? NO 0 DON'T 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 Q DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q Date Issued: C. Do any signs exist on the property? YES 0 NO t IF YES, describe size, type and location: 1 D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO O 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 Q NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. � s SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing n Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [p Siding[O] Other[I Brief Description of Proposed Work: tz ?A v/ ) c'1 �1'V1,1 vvN Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished baseme Yes No Plans Attached Roll -Sheet �v� T sa '[f.�lew iotxs attc acicl ©two;ext in roust F:at tp efe t WIPQ: 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:-TOBE.COMPLETED rtWHEN - ' OWNERS AGENTOR CONTRACTOR APPLIES FOR,.BUILDING;PERMIT ,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 ,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. Print me • Signature of Owner/A.e t Date • 4 • SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone :F a ritereVfr iiiibltriioi`rar�eirietibC+in't cio ; 1, it t 4E rc2 Not Applicable 0 Company Name Registration umber rniChCkk ( I ('-J)Ct u -8 (7 0, Address Expire ion gate L/6.Q (-- 5"- l/k'(\--Q__ Intl I Telephone WS 5 fc SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MG.L.c.152,125C(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 ❑ •Ybn.�3q^�eM`.&0 , �"�'n' ip• p�{*y..?,g q maw& The 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 be/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 Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature • 4 i • • a , / gA •z� i-12 oI ;ortliullli ton ) __5= S2 ue •f h • 8/ s .=-.--.- . , I���- DEPARTMENT OP BUILDING INSPECTIONS L _212 Main Street • Municipal Building Northampton, Mass. 01060 to• «`ORICLR'S COM ENSATION I S"(RA ' CE AFFIDAVIT . - --- —" . --'._.._._. _.- •--- ', (Ii ccns-'xJpermi ttec) with a principal place of business residence at (Shone:;) (sc=.tici ty/statclzi p) do hereby certify, the pains and penalties of perjury;`; that ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: - (lasuran=Cocipazya) (Pelier Numbcr) (T=;•piratior Date) ( ) I am a sole proprietor, genera! contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's cot pensznon policies: (Name of Coat^Cho") (InR?r-1. nc. Comoaiy/I oUCi Nu1[I1'-c:) (r`:ptiauca l)nlc) (Name of Conmctor) (Insurancc ComoaavPotic `anw) (E auation Due) . • - (Na me of Confraad.) (Insui-anca Company/Policy Nambu) (Expiraon Date) . (Name of Contractor) (Insuran Comeally/Potiey Numb r) (Expiration Date). (.rich:.d'!i:iccs1 6,-ct if occoot— to otclu&iaform,.•ioa peruriain.g to.11 coat-_co:s) - (‘.1)/1 am a sole proprietor and have no one worl;ang for me. ( ) I am.a home owner performing all the work myself. NOTE:plc.sc be entire tasa‘.L]e 6emeowocra w$o eatplay pea.at to do car e,00 c r ,rain.von ao a d••ett_,i.•of aor taoct than tt3ce=its in tc3icb tlx bocaoownc'amides or oa the¢—oud 19-puatco tbe-eo'- pot t-• :_tty cccsid3cd to be. cazploy -t•sits--doe•.vci dz o ,ica Au(GL]52.s 1(5)).o.pplinaoo by s bom000vc far c Litz.a pamit may c adcocc t.Lc Ic- ai*taozs of en ezgloy.,r under du,Wocieola Conapom.ctioa Act_ r uadurruad dui a Dopy of this mtcmcc¢cans bo C«-+.n to chc pop.omcat o(1•,1-■•e•i•1 nccd...,.'01 ion of t for Lb' CO va�^c wire tioa and th.r L•iltat to scnuc'covcrasc under azalea 25A of MOL 152 taa!cad to tba iatpositioa of-criminal pcaatti° coasuatg of a tint or up to St_,S.n0.00 utdfoc irriprisoarncm or up to one ytcr end civil pmal•,ica in t5c roan of a Stop Work Order cad a fish of 5100.000 a day against an. / / , • -• � For dcq.rtm'�u,c only -----�-----" /�y ,i� Permit Number "t1 l i ( Ma P^^_ Lot Sigp.Ztun of Licimuaipermiucc L}3te IC l ¢'Ct1AMp , i�1. 4 )1;1%,. r oaf Noz#Iptiitpfan • Z. OM- (J. DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction sup,:: ..isor. 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 any 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 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 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 conjunction to the building permit 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 I, 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. Date Address of work location PROPOSAL PROPOSAL NO SHEET NO. / tP`/.,_w,, / DATE PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: G NAME ADDRESS AD S 22)7 t f U ' t''''::' 1"-'"7 rr" DATE OF PLANS �e ,ri'?1:1 /4 ,. r //f 2F,,%„ , PHONE NO. ��* ARCHITECT '7:76 - We hereby propose to furnish the materials and perform the labor necessary for the completion of C g,', ,) t U c 7*-1 e-re O ia i h r-e-- r61ivii , 5- t' L. ,, Y ,...V.ET c 144--fir')I ('3 - T,`")to frit,0 ST t,> c K r to 07- 0 E. f- k' 4''a'? : . i t k %,c-1.3,4.1c.. k. C C.LA-0 t i t , 'i -'[° iC t-..i i c,', c- , (:(‘I ) �, � ;.-7-. - 4 11 ,._,. r ;°'"t e ,. - ' ' t ...) 4_.„�k s<„ ki C.` t 'i * 6.4 ) 1 ' t,C Vf la 1 67K) t~ ~) re i. , ,- --, ,. t J t a c.-, ( v.) r ! '-i 1,? el i ) ,'T 0"e::r, c • =`�l k''fr7"'s 7 tom ic:- ', t ''' ) ' C”, l S___(4C. .^"�.. ft' f,'.' '}';)! -.f` ii �.+'`f i i.✓ _ C/r t{,-t ..e.6,} t ),,c,-,S l P -(2 /-to r T i`' /GL ! '..4',/ +r l.r-'T .f C,d °z 1 el'i..s�°;�.r , ! Ft ?7` All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifi- cations submitted for above work and completed in a sub la tial wor C, fanlike manner for the sum of :51—-` 7o el oo Y; ,.),/i //c' ' ,_. -,,,1.- .,- f' Dollars ($ (2A3 :<'"Y .) ) with payments to be made as follows. A. Respectfully submitted f f ,, , r' Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge Per over and above the estimate. All agreements contingent upon strikes, ac- cidents,or delays beyond our control. Note—This proposal may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. , °t. Signature ._ 4('t'' ' :_.4,;',, r`.t Date t r 1 t x Signature .thamS NC 3818-50 PROPOSAL