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29-254 (2) H A ��� 1 . .\ �! 1 ._'� �;,..� t 1 `� �.. ice` c.,,�' 1 1 ^. l _..� 4.:... , r. -, �, ��;� ,1 ,...4 �`�``^ ^. S C1 � �_ � ��' �,,. f„...`. �1 `.. ,i .. ?. � �"1� �...., �._ Y. � •,.,_� � � f1,n 1, �` ,/? \ �- ✓ `� S� t\� �- j ��l U _ �._.. �. � = > .:a�_ y\'' ��J r'�� > �� /, f/ \ .»..1 E h�.... rt... � .., ,� ? i � g C �� �� �`'� j �i ._._ __ .... _. r ,: ..� .,_ � � +�� _� 4 ` � f'� J ' I1 f { ,. �-/ � � r..1 .J' � �`� ' .. '� �, , ��� a, `'� �_. Z.., h � ,.+ .� ',� ., .. I'4 ,� i t ... � ..__ .__ '' �� �__. _t° @ E ..,.< { T,.�__... ti� � g ' i T � w; 555 ... _ ...,_. � ; t � _ 0 �. 3 i j ��,_ j ,...`"w I a 5f r f �\ � fF �as+ewar�au,m�+s�c,.wnwx�vnw+m. wn,es. �a.r .a.� -.,.v w.�i.+� ars+r�..rr.�ly: we+en�c..wxm, ema• m+r....,.„......w.u.,�.�.a....,r.,......�.�. } . j �' �� _ �4 y ara } i { �'} _ a .. - '' ��j' _ . � .�� � (^' — Y � a ` 9 {' _' 4 + ��' k �.`� �.� .? W � . � � � °� �� {: �.. ^:. �: ` 4 �� 9 Ar t Z 1 s f t y�y k G 5 � ` 1 � C - R y d 1' t 4 � f 1 } t r � � r h f J �� 9 a rl t i 4 r �StS/►MP� . 0 of Wart4amptou z $ �} �Ii[assac}(asetts i:. DEPARTMENT OF BUILDI?�,'G INSPECTIONS INSPECTOR '212 Main Street • Municip.-d Building North-,unpton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 78OCNlR 108.3.4 to act as his/her construction sups.:z sor. The state defines "Homeowner" as, "Person(s) who owns a parcel on which he/she resides or intends to be, a one or"two famITY -- 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 bui1 mg department for the City oTNorthampton 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 r'.egulations. 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 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 L 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 r h �.TrrrfllZ1llt33toI'll A E _qZcaaRchnscCIA, w o DEPA.R MELT OP BUILDING INSPECTIONS - 212 Alain Street ' Municipal Budding ' j Northampton, Mass- 01060 �Vor tLIt'S CONIPCNSA TO.N O'�SURA.NCE Al'FD�A.VIT __ �n ti slot (li ct�s�Jperml tfcc) %%IlLb a principal place of businessfresidencc al: "IL_ S'Y c (W A YY1P (phone') Sid `�s? (sut""t1c�rJ/slatrrfa p) i do hereby certify, under thc.pr_ins and pen2l6es of perjury:, hai j ( ) I :gym an employer providin3 die following'%voricer's cotnoens_­:jo cove Ike for Iny etuplovecs worlong on t111s job: j I , (tsar-any Conr,lay) (Polio:Nt;mb-cr) -- (r:pirtior,D2j.e-) 1 i - ( ) I am a sole prooneror, general c000-acor or homeowner (ci:cie one) and hive hired the consactors listed below who have the folio4vi g woFka s co�nen_�don pe��cies: (i SECTION 8-CONSTRUCTION SERVICES J 8.1 Licensed Construction Supervisor; }� Not Applicable ❑ Name of License Holder: Gl�7"� O 3� License Number C-;� / :5 Address Expiration Date Signature Telephone , Re'isfecetfom°e:1ni gave t=Ci►fraEt`a N�V Not Applicable ❑ Company Name Registration um er -__- � Address Expiration Date Telephone �Y �� SECTION 10 WORKERS'COMPENSATION INSURANCEAFFIDAVIT(M.G:L.c.1`52,§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...... ❑ «» 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-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 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 r R r . SECTION-5-,DESCRIPTION OF PROPOSED WORK(check aft applicable) New House ❑ Addition ❑:• Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks Siding(0] Other[[3] Brief Description ofproposed� Work: qC�G" !Lf JC 1C0 C�oC 7U gGC��C ' Lg-P l_'y� S7'c�c.� � h m ;FPr, 7 Alteration of existing bedroom Yes_ ,/No Adding new bedroom_ Yes 1� No Attached Narrative Renovating unfinished basement Yes _ ,i No Plans Attached Roll -Sheet Nevv Cio>trseyand' di�a tc x t�> c i© s cr cor pet tie f616 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 Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN .OWNERS AGENT ORCONT.RACTOR APPLIES.FOR BUILDING-'PERMIT I, h E, �CCA 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. 1/ ycX1 icy �. Ck, �JlPl�lo 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 es of perjury. r u r�- Print Name 7-2 1&106 Signature of wne/Agent 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 1 ^ C yam 0 l�U 174 Frontage Setbacks Front Side L: Rear ? '20 Building Height Bldg.Square Footage --( % Sr `- Open Space Footage / % (Lot area minus bldg&paved i LV !7 parking), #of Parking Spaces Fill: r I E volume,&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW Q YES 0 IF YES: enter Book Page and/or Document#;' B. Does the site contain a brook, body of water or wetlands? NO &""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 Obtained ® 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: E. Will the construction activity disturb(clearing,grading,excayabon,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 , NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. P City of Nortbampton MR6 oartmentStreet 100 r-N MA 01060 �s o �o Ca T'lan �� °� one 1 7-1�4 Fax 413-587-1272 IS x r:. APPLICATION TO CONSTRUCT,ALTER;REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1,-SITE INFORMATION This.section to be eompleted'bYaffce 1.1 Property Address�:^�, P►.1G2 t mjJ Zor►e O�erfay Drstrrct ;Elirr SL Oistrrct C�Dis ct� SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: so r, O uor'lbo k Qr career vn A Name(Print) Current Mailing Address: &-&SaS n " Telephone Signature 2.2 Authorized A ent: Name(Print) Current Mailing Address: �' �4.y Signature Telephone SECTION/1-ESTIMATED-CONSTRUCTION COSTS Item ~ Estimated Cost(Dollars)to be Official Use Only com feted by ermit applicant 1. Building (a)Building Permit Fee oo 2. Electrical (b)Estimated Estimated Total Cost of ���� Construction from 6 3. Plumbing Building Permit Fee D. oo 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) 5—v C Check Number � 46 This Section'FOf Official Use Only Date. Building Permit Number. Issued: Signature: i Building Commissioner/Inspector of Buildings Date File#BP-2007-0021 APPLICANT/CONTACT PERSON John Punska ADDRESS/PHONE 5 Dimock St LEEDS (413) 584-5533 PROPERTY LOCATION 85 OVERLOOK R n MAP 29 PARCEL 254 001 ZONE URA J�rUs i THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid uildin Permit Filled out wee Paid ,00 Z Typeof Construction:@14x16 deck addition New Construction Non Structural interior renovations Addition to Existing AccessoKy Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO MATION 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 _0-7 y b 6 Signature of Buildm 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. lo-T pcAN l�cLUoF� * Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. 85 OVERLOOK DR BP-2007-0021 G1S#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29-254 CITY OF' NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2007-0021 Project# JS-2007-0035 Est.Cost: $4500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: John Punska Lot Size(sq. ft.): 15812.28 Owner: Rosa, Sonia E. Zoning:URA Applicant: John Punska AT: 85 OVERLOOK DR Applicant Address: Phone: Insurance: 5 Dimock St (413) 584-5533 LEEDSMA01053 ISSUED ON:711412006 0:00:00 TO PERFORM THE FOLLOWING WORK.-1 4X1 6 deck addition 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 7/14/2006 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo