29-400 (3) y
91?ee 9�1
a
Board of Buildin Re ulations
} One Ashburton Place, m 1301
Boston, Ma 02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 09/25/1964
Number: CS 079531 Expires:09/25/2006 Restricted To: 00
JEFFREY C CRANSTON
PO BOX 307
WILLIAMSBURG, MA 01096
Tr.no: 3180.0
Keep top for receipt and change of address notification.
DPS-CA1 a 50M-04/04-G101216
Board of Building Regula ions and Standards
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement Contractor Registration
Registration: 101176
Type: Individual
Expiration: 6/25/2006
JEFFREY C. CRANSTON
Jeffrey Cranston
11 E. Main St/PO Box 307 --
Williamsburg, MA 01096
Update Address and return card.Mark reason for chang
Address F-] Renewal ❑ Employment [] Lost Card
DPS-CAt %r 50M-04/04-G101216
1 f'f
�r V)
j
i
{{
� f
i
�Y
g
I
f
Z
t
i
f
r
�wY
,3 '
ID
iy 4;4'
�_0 iI
� 1
a
i
I
m-
r+,
`4
i
w G
1}
t
Nn
�a
G ,
v Wood Deck
12.0'
Bath
'
Bedroom
Kitchen
fie--------�►
N Garage C
c 30 --�
Bedroom
Bedroom Living Room
40.0'
Y1
v
O.�StP�O
v
$� �$ "Lzty of 'Wazthaintptan z Z
: r
�Y`A55AC�IIStttE
DEPARTMENT OF BUILDING INSPECTIONS /
INSPECTOR '212 Main Street • Municipal Building '
Nordimpton, MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as l.is/tier construction sup��::'s:or. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be, a di e'or twv farm y --__
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 ebuilding department far 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 fegulations. 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
QA�tttit•rP�o t.. .
A� yE GIf�1 Lcf �Lt� �I}3111�7fD11 -
A E X31AchntclIs
w DEPAATt.1ENT OP BUIIDr�\,G INSPPCTFOt.'S
j 212 Main Strcct ' Municipal Budd;n�
?Northampton, Mass_ 01060
I ,
fT�T� T T
. . ` !�-R1 R'S COl'Ll 1.�NSlL O. '�S`ITA.NCE r�11'T';.1Jt'i.����".
---
piccnsxlpern,;ttcc} - --
�l.itb a principal place of business/residence at: -- -
(phone`-)
do hereby certify, under dic.pains and penalties of penury, hal
I ( ) I
am an employer providing the followin-,!workcr5 comocasation coverge for 111y
emplovecs wor�Jng on uuS job:
I
(Lamran=Conrzml) (Pelic: (r :pirtior. DzL}
( ) I am a sole promieror, general consactor or homeowner (c cie one) 2nd gave hired
the conmaCgrs listed below who have the follo•L-inQ worker's camoen_tz 'on pe>icies:
(Namlc Oi Co MIc,or) (In51 rant COMP3IT')folk,- !,,,UM..:-)
I _
(Name(Name of Conl-z.' Or) onsuraacc ComoaIIti/P01e; Nunc_r) FE»ir(ion Date)
(Name of Con=do.-) Gnsuraoe; Compzo}'/Pouq- NtunbJ) (ExDirtien Dale)
a
(Name of Contractor) Umsuran= Comraay/Policy Numb:.r) ( xpi-,don D'=).
(atts.cb_ddi�oc71 e>cC.ifacoa._-v to a�c.'.u��afor��oa pctn:a:.a6 to.1.1 ccrr:a) _...._--
I
{ ) I am a sole pFOpnetor and have no one wor4 ng for me.
( } I am..a home owner performing al-I the work myself.
NOTE:plea be ev zrt o.-v ]c 6cmc0,0c s,vbp deploy pe om t.a dz -• c=. a rgaa wor oa a d.•ct1=y of
not mote th=a 4ioe tni�is u'ye12 the bomoow rcmida or on the gmuzp a�r zppus,,-..•.-,tbe's ec Dot -�r.!}y a'd.-sd m be
enploy'uc?—the Ace(GUI 51-1(5)),=�pgdci6cc by n be meo a fc_6c:a pewit m=7 e,-idv tl:e
lc�.l n-•,.,or ea e;.ployx under the Work.da Compcmatioo A.ct_ '
I,+aaezzyad tip a Dopy ortbis eat=.w may b,roes ,d<d to the pcp,,,axoa arind+au;cl n cde OM_ rL=—ror t6.
eo a'Sc Q'°°vd th t La=-'to"cov11,61 uadc u=oa 23A of h(GL 151 can Imd to the im7asi6oa oreitaiasl Peaakic
coczi =S of a fiat orup to S I,S00-00 irtdfor ia�� orup b aoc yr r end 6Ni]pmahia in tic focm ON Stop Work O-de.ad a
fl=of s 100.00 i ds r a Coe_t�t
For desert��>1 use oily
PcTmlt NUmt)Cr
jjapX
T
S aueott.iccn_v— Pcrmittnc 05r-e I --
SECTION 8'-CONSTRUCTION SERVICES „f
8.1 Licensed Construction Supervisor: Not Applicable ❑
�_ -T (� fir, ,�,r.► u�� l
Name of License Holder: 1tr�i-1
License Number
Addre Expiration Date
1�
Si a elephone
gate-lstered`t-l6ff4,* r'We rentdContra.oc. Not A Ilcabte ❑
PP
Company Name Registration Num er —--- _-
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT'(M.G,L c.152,-5 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...... ❑
11«. AomaWre> g� �>t>
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 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,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check art applicable)
New House ❑ Addition ® Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [E3] Decks [p Siding[O] Other[O]
Brief Description of Proposed
work: � -
��11Z► A 1 e1�( b� - ���
Alteration of existing bedroom Yes i.-�No Adding new bedroom_ Yes _At-No
Attached Narrative Renovating unfinished basement Yes _L,,—Dlo
Plans Attached Roll -Sheet
:� _ ;_ ., ..�`4�,w«o .'fir.-: ',">
6a €xN'ev 46,d,sdrart* ma R,!6h dQ6ktSVnC_1 0-' srr cr�orl gCet kr ot�aur�rng:
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? :2 1-(y
d. Proposed Square footage of new construction. Dimensions 1X.)4
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 ►'/ ►^ti! _
i. Is construction within 100 ft.of wetlands? Yes --*No. Is construction within 100 yr. floodplain Yes_4_,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-TO.y6ECOMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject
property 1
hereby authorizers S
to ac on my behalf,in I m relative t work auuthonzed by this building permit application.
Signature of Owner Date
as Owner/Authorized
Agent hereby de are that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signeauder the�ains nd penalties of perjury.
Print
Sig re n Agent Date
~ �
Section 4. ZONING All Informatio'n 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 777.,;
Frontage
Setbacks Front 44
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bidg&paved
#of Parking Spaces
(volume&Location)
^
A. Has a| Perm it/Vandnoe/Findi ever been �suudfor/on the s�e?
N"' 0 DON7KNOVV 0 YES 0 �
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO �~��
� uu= . °Nv= 0 .^^
IF YES: enter Book Page ' and/or Duoument#
�� ��
B. Does the site contain u brook, body of water orwetlands? NO x���� DON'T KNOW �~� YES �~�
IF YES, has a permit been or need to be obtained from the Conservation Commission? '
' Nmedstobmobtoined �-
, Obto�ne� «r� Date
x_� �_� . �
C. Do any signs exist on the property �� ��8 YES �~/ NO v��
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YE8 0 NO 0
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre oris it part oyo common plan
that will disturb over 1acre? YE8K~_~) NO K }
/ ~�^
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
i
► r
City of Northampton P v
Building Department ' v er
212 Main Street w e c ai tt � a r} x
Room 100 Leilah
Northampton; MA 01060SefsctiialPlan� kin
� " ,
phone 413-587-1240 Fax 413-587-1272 Pto€5an �� NIP,
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1..-SITE'INFORMATION
1.1 Property Address: � Th section;to be completed by office
76 Sway a C,L c3
Overlay Disfncf
sElm St District,KGB D4stE�ct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
- 7� ��� �►�C ��
Name(Pri ) ' Currjkni Mailing Addr ss:
- -�
Tele one
Sign
2.2 Authorized Agent: R )-- // ,� (( .
...y4_S 401, 'lit vE-I+)a r,J� ?b �L�� r 4tlb ��✓'��7��ri1 t�s 024
Name(P' t) Curr t Mailing Address:
3 Sz
Si Te e
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item - . Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building '413,f 3, _ (a)Building:Permit Fee
S6 D
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) Check Number
This Section For Official Use Only
Date
Building-Permit Number. Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2006-0627
APPLICANT/CONTACT PERSON Jeffrey Cranston
ADDRESS/PHONE P O Box 307 WILLIAMSBURG (413)268-3504
PROPERTY LOCATION 76 SANDY HILL RD
MAP 29 PARCEL 400 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 7of 44 494446,
Fee Paid
Typeof Construction: CONSTRUCT 12 X 24 DEN ADDITION OVER EXISTING DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 079531
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFK!--M- ION 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 ssion
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.
76 sANDY HILL RD BP-2006-0627
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29-400 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0627
Project# JS-2006-0921
Est. Cost: $13500.00
Fee: $144.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Jeffrey Cranston 079531
Lot Size(sq. ft.): 11761.20 Owner: ARMSTRONG DEBORAH A
zoning:URA Applicant: Jeffrey Cranston
AT. 76 SANDY HILL RD
Applicant Address: Phone: Insurance:
P O Box 307 (413) 268-3504
WILLIAMSBURGMA01096 ISSUED ON:1211312005 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 12 X 24 DEN ADDITION OVER
EXISTING DECK
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 12/13/2005 0:00:00 $144.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo