Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
29-245
...r r-� - 1 r-- A OS�Il Vinyl Siding Corbett Home Improvement Windows Northampton, MA 01060 Doors Awnings (413) 584-6571 Canopies Gutters t"J Shutters PkoFOSAt suBMMED To j c r ',ll PW Ne (p " DATF xME-T 96 t;,/VC� �J� tJ l� JOB NAME CrrY,STATE art ZIP CODE �/ (� JOB LOCATION DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: 'Ado, i-0 W-t G OCJ x" ©It t z Vi<PrOPOSC hereby to furnish material and labcit-complete in accortIdnee Willi the above specifications,for the sum of: � ) Payments to be trade as follows: ! Dollars(1 ` J i ice/ All nraterial is guaranteed to be as specified. All Work W be anttpleted in a work-like utanner according Authorized to slandarl practices. Any altercations or deviation fran above specifications involving extra cx*o will he Signature .w;•9r� executed only upon written orders,anti will become an extra charge over and above the extignte. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado Note. This proposal stay be and other necessary Insurance. Our workers are fully covered by Workttten's Cotgoe.nsation Insurance. widtdrawn by w;if not accepted witltiit days. Acrentanro ofCTDrnnncnf I— __:..__ DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSA'T'ION INSURANCE AID ( AVTr with a principal place of business/residence at: 'l /I/ -(phone#)� 1057JI ( city/staicJaip) T do hereby certify, under 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: (Insurance Company) (Policy Number) (Expiration Dare) ( ) I am a sole proprietor,general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Dale) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml slwet if nxcsssry to inehule iaformatioa pertaiaing W all t�aLrndors) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:plezae be aware that while homcowocm who employ person:to do maintwsaa,cowtrur --repair work oa a dwelling of not more than throe units is which the homeowner midcs or oa the grma4 appurteaurt thereto are not gcnemlly o0widercd to be employers under the wort e's d1w Act(GL152.=1(5)�application by a homoownar fora hocase oc pernut maY evidence the legal flatus of an employer under the Wodroes Compematioa Act. I uoderstaad dma a copy of this cutemcat may be forwarded to the Department of Indu3bial Ae6dca&Offioo of Imurwoa for the coverage vrriHeatioe and that Wur+e to sm=coverage under section 25A of MOL 152 can lead to tba imposition of auliast pia owsbaidg of a site of up to S1,500.00 and/or impriso=cnt of rip to one year sad civil pent ic,in t6c form of a stop Wort Order and a fire 0(5100.00 a day agpialt ar— For dep 'I—calY /� Pcrtnit Ntltnber t'UP4 --Lot# '�±�;, SignahtreofLiccnsee/Permit#ter t „ $ 1 Licensed Construction Supervisor: A* Not Applicable O Name of License Holder: ��`O IMETT aft 7 M62 License Number _4 Sf- 41-30-0y Address Expiration Date Signature Telephone r... Not Applicable ❑ Company Name I Registration Number 14 Tr" S- /S- 0Y Address Expiration Date Telephoney� - �� S CTI (I WOEtI�EFtS'EtON[REf U-4 StiRA�ICE AFFIDAVIT(1W,:G L. c. 152,§25*V 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 Dwellines 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 10$.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 perso n 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 on 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 y n .r fiv M,.�P�Y,..»•.... .: ¢ ,r. ',c 5s Vii_-.. iiu <,.3*f6r"a., New House ❑ Addition ❑ Replacement Windows Alteration(s)❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition❑ New Signs [ j Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: (I W1 Low—e- Wwo Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative D Renovating unfinished basement Yes No Plans Attached Roll D• Sheet D 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. Mascheck 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 j, Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? -Yes-No . 1. Septic Tank City Sewer Private well City water Supply lZ I, as Owner of the subject proper hereby authorize to act my behalf, in all matters relative to work authorized by1his building permit application. Signature of Owner Date 1, T �£ r J� 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. �nla�AQr� l Aoeto -.-n— tip' ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW __ YES 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 NO IF YES, describe size, type and location: D. Ar there any proposed changes to or additions of signs intended for the property?YES No IF YES, describe size, type and location: �^ 1 uuaing uepartm�nt 212 Main Street Room 100 or hampton, MA 01060 phone W 13- 7-1240 Fax 413.587.1272 _�_....m-lu�hu ii�SPECIIi1SVS _� tCAT11iV TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 'SITE INFORM"QN 1.1 Property Address: A6 OUP-4- ��z AEI it ist►�' SECTION 2= PROPERTY"O.YVNERSHIP/AlJ7HQRIXEp SCENT 2.1 Owner of Record: K Eel S!zo T7- Name(Print) Current Mailing Address: Signature O g Telephone sg6— q 2- 2.2 Authorized ent: Name(Print) Current Mailing Address: 4'ay-bS'�►�_ Signature Telephone Item Estimated Cost(Dollars)to be p�ic,iai Use Chly completed by ermit applicant 1. Building (a) Building PerrraEte " 2. Electrical (b) Estimated Total Cost of Construction from, 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(I + 2 + 3 + 4+ 5) 20 Check Number This SeC 100 Foc'Official tlsg Aril ¢uildirr Permit'.Nutaiber: Date tssu @d� $4 naiture Bu idir►g G0M."I ssionetllnsp ct4r of��t irgs .... ;ate, 86 OVERLOOK DR BP-2002-1100 GIS#: COMMONWEALTH OF MASSACHUSETTS jp:.Block:29-245 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2002-1100 Project# JS-2002.1764 Est. Cost: $3200.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor., License: Use Groin: Ed Corbett Jr 116069 Lot Size(sq. ft.): 15028.20 Owner., SCOTT KENNETH P&MARYELLEN Zoning:URA Applicant.' Ed Corbett Jr AT. 86 OVERLOOK DR Applicant Address: Phone: Insurance: 4 Reed Street (413) 584-6571 NORTHAMPTON MAO 1060 ISSUED ON:6110102 0:00:00 TOPERFO"THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS 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: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. /''° Certificate of Occupancy si nature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 6/10/02 0:00:00 1607 $25.00 212 Main Street,Phone(413)587-1240 F Building Commissioner- A