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32C-235 (6) Building Department 10, October, 2006 City of Northampton Subject property: 11 Williams Street Second floor apartment renovation and repairs. Complete bathroom renovation, Plumbing is currently leaking, walls and floor to be removed completely. New subfloor, underlayment, floor covering, dry wall, ceramic tile. Installation of new waste and water lines. Update antiquated electric wiring. Respectfully submitted; William J. Turomsha O¢�t1AMP DEPARTMENT OF BUILDING INSPECTIONS / INSPECTOR 212 Main Street • Muincipal Building No rdiampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 78OCMR 108.3.4 to act aS i.is/her construction sup,.: ::::or. Tlie state defines "Homeowner" as, " Per 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 a a ti U ifs �f �kiclrfIjumptotl - _- ?" e �Z+3�wcStasrlla - - —; o 0EPART1`6E14T OF ©UILDITjG INSPPCTFOt,S _ 212 Main Strcet Municipal Duildin6 Northampton, Mass. 01060 ZN,O RICE I Z'S C O tKP E NS ATTO N G-1 S UZ-A�CE A 177M A VIT (ti ccvsxlperms ttcc) %VlLh a plZncipal place ofbusiness/residence at: (phone:') (srr�t/city/sin I r rzi p) do hereby cerdf.-, under tic paint and penalties of pcgury, _h n ( ) I am an employer providira- the followinL workcr's comocnsabop cove Ige Lor 111y etuplovices \vortang on dus job: -- - --... onsvrancz-comp-:7-m') (PL ic: Nu--nirr) (E--'-piration D;,'-) ( ) I am a sole proprictor, geaeral contractor or homeowner (c de one) 2-0d have hired the coan-actgrs listed below who have the fotloWi_ag worker's comoens.,non pe}icies: (Nam-, Oi COCr::ao.r) (IIInt'r-alicc Company/i�cuc- 1 Lmh----) (t"-?:JIl'�L•Oi? t711C) (Name of Conmetor) _ 0jIS',I=c; Comoanvlpalicv N'LLM -r) (-Ekoir.:tion Date) (i[ame of Couzamdr) (Lasurancr Company/Poliq• tv;Lml-r) (Espiraaon Datc) (htamc of Cootzamor) (Lagun cc- Comc--- y/Policy Numbci) (Expirtioa Datc). (a¢1Gti_d�i�oca!rJCr�',if acocun-w c�ctuci-iafGtZal.�oa pc"t: to.11 { ) I am a sole proprietor and have no one wor}dng for me. '} I am,a home owner performing all the work myself. NOTE:pi=-,c be cwu thL t }c 6cmco.ivm rC,aspicy pc.-zoaz w do cam-c,n or rcp�Lu-ork as.d,,-U-,-�of ocx tnoct th=.a t;a, .=ru is w--6 t:bc bomw.-. c=de,c,oa the Qo,n z�purtcn�y.tbeeo�-c ox e- -Uy w=.d-ai to be cirployca 11 Lbc cc=pCiim Act(GL.t 52-=1(S)},=Pplia600 by a bomcoa-D=fv a titer or Pcx =Y--rdmcc trc IcIPI—of an czplayx uodar du Wwk4 e,Co�0o Act_ l uadcsuad di¢a Dopy or tbu mt®ca—y b» Lo Lb_Dcporcmort crincaatr;cl,~cndco>j ocLoo nr cr—ra L mvarkS,c Ycrirc3iioa a_'sd the U-Lzz to sca=bovzr&�unc!.Cr sociloa 2S A of MGM-151 can Icd to the P=i6m of a=iazl pcmttio ccov:.=g of a Gt orup to S 1}00.00 arWc< .of up to occ y--%r rod civil pavhio is tc roan of a Stop Word Ord,--=d a Pita of S 100.00 r d_y tpinA mr Fr, �,��Y � ____----- Pcrnvt NumUcr Afap, —_ Lot Si pia tun of crrzuucc e l SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: I(/�/,ALA License Number Address Expiration Date L�'��v s /�IA D/aS3 Signature Telephone 9a'Reia1steted:,Ff0me:l6pr6ementGanfraefor - Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10 WORKERS'COMPENSATION INSURANCE.AFFIDAVCP(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...... I] Oda 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:Per-son-(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 Northampton Ordinances,S e and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature J SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alterations) Roofing Or Doors F1 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [C] Siding[0] Other[0] Brief Description of Proposed "; l` CI- k 0 0 f Work:QC!1=U 'D=y_Wray T�rz m hh iw nia oT- RAIN COO 1110 JMJ< .4l 0 460L �CJO Alteration of existing bedroom Yes�_No Adding new bedroom Yes _�No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa Cf Clew 6&6 i of 1addltlol to.ezis �n4°r iousii�a�ca laCef h' 61Ca�in� : 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? t d. Proposed Square footage of new construction. Dimensions i 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 SECTI.ON,7a-=OWNER,ACITHORIZATION TO=BE COMPL'ETED=Wt.iEN- OWNERS`.AGENF.OR CONTRACTOR_APPLIES'FOR BUILDING PERMIT l as Owner of the subject property hereby authorize to act on my be If, in all matters relative to work authorized by this building permit application. Signature of Owner, Date l / /�ryj �(/�Q as Ownerffi tAl zgd 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 Name Signature of Owner/ gent Date ' ~ w ' 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 Frontage Setbacks Front Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces (volume&Location) A. Has a Special Perm it/Voranoe/Findi ng ever been issued for/on the site? �� NO tD DON'T KNOW v�� YES �� �~� IF YES, data issuod:! ! IF YES: Was the permit rd of Deeds? NO �� D �^� um / ^muvv ,Ex IF YES: ' onter Bonk | � Page: -- and/or Donumant#r— ----------` B. Does the site contain a brook' body uf water orwetlands? NO DON'T KNOW 0 YES 0 IF YES, has permit been or need tob* obtained from the Conservation Commission? Needs tobeobtained ~�/�� Obtained �-\ Date� \.� . � C. Do any signs exist on the property? YES � NO 0) IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES y—\ NO �\��~� `�� r--' IF YES. describe size, typo and location: E. Will the construction activity disturb(clearing,gradingexcavation,orfi||ing)over 1 acre orinit part ufm common plan that will disturb over Iacre? YESf l NO_4'% ^~� —w�' IF YES,then a Northampton Storm Water Management Permit from the DPW is required. �GpaJ 14F4e�4.t�J�VP'�xs xr��' t" f � k City of Northampton Status ofPerxnrt r B iiirlinn nep rtment 212 Main Street Sevuer -e0tic�arla6rlrtg Room 100aterellAyatCa6tlrtyr Northampton, MA 01060e�ata � � phone 413-587-1240 Fax 413-587-1272a a Ot peer �� � T APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH#,P E TWP FAMILY DWELLING CTION.1 -SITE',INFORMATION - Thf `section to be cornplgted by office Property Address: 4 K f (` ll�tq►�S STie cET Map; Lot; Uartt �Tid�d'ToAI JKra• - . : : u Zone °.Overlay Llistcrct ,L�fp,U.?"i /•tom!•-tT�Z, SC[r�►-rn FCcer� Elm�'St Orstnct - "CBr,}]rsfrrcf =' , `. �. cCTiON 2-PROPERTY OWNERSHIPI UTHORIZEO AGENT, 1 Owner of Record: 1 ueom A 58 FPUMT STREET pa Egx t41 lame(Print) Current Mailing Address: EEDS k14 6l0�,� Telephone signature /-//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 ermit applicant 1. Building �C�Gb• co (a)Building Permit Fee 4o.61� f 2. Electrical 1600,p° (b}Estimated Total Cost of �oQO o0 Construction from. 6 3. Plumbing Z5� °O Building Permit fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total =(I +2+3+4+5) (2600 , °O Check Number "S -- This-Sectiom-For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2007-0495 APPLICANT/CONTACT PERSON TUROMSHA WILLIAM J ADDRESS/PHONE 58 FRONT ST LEEDS PROPERTY LOCATION 11 WILLIAMS ST MAP 32C PARCEL 235 001 ZONE URC THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT $fie Paid 'zBuilding Permit Filled out Wee Paid fr 3 Typeof Construction Bath Reno Reroof 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 ',�, �)_� /0 3o 6 Si nature 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. 11 WILLIAMS ST BP-2007-0495 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-235 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-2007-0495 Project# JS-2007-000718 Est. Cost: $8000.00 Fee: $75.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOME OWNER EXEMPTION Lot Size(sg. ft.): 5532.12 Owner: TUROMSHA WILLIAM J Zoning: URC Applicant: TUROMSHA WILLIAM J AT: 11 WILLIAMS ST Applicant Address: Phone: Insurance: 58 FRONT ST LEEDSMA01053 ISSUED ON.1013012006 0:00:00 TO PERFORM THE FOLLOWING WORK.-Bath Reno, Reroof 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:,'()-,�(,.t) jl�'""Rough:/� ��a�J House# Foundation: Driveway Final: . r Final: Final: 1,J/o .2✓ /W,fi'L0 Rough Frame: 4/;5j;C Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: /(Fin0 al: Smoke: Final: p� 0.q $ "7 THIS PERMIT MAY BE REVOKED BY THE JYY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGUL IONS. t Certificate of Occupancy Signature: FeeType: Date aid: Amount: ' Building 10/30/2006 0:00:00 $75.003737 212 Main Sheet,Phane(413)587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo