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32C-288 (5)
� Vroposa! r Vinyl Siding Corbett Home Improvement Windows in "' Northampton, MA 01060 Awnings (413) 584-6571 canopies Cl �// Gutters b Shutters PROPOSAL SOtBMrrtEDTU / J ��K PHt>NE�p.Z�� Q DATE ^ 07) of „ ti lkFf i f��'t. Q lUB NAME -—'— ` CITY,STATE,—I ZIP COME JOB LOCATION .....—----- DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: / r ki vl0 "JAI 4141;— lk J r /CGI� S t %b 2- &et ej A/ . ,,y en JArl-iL &em& 'Fct--�-g 4 '-h�) )014 - f3S5• std ' 2 Ail� Nj *� EA ( �- CWe Propose hereby to furnish material and labor-complete in accordance with the above specifications,for the sunl of: Dollar;($ ) Payutegtstobe made as follows:� / _ f/ IF f I All material is guaranteed to be as specified. All work to he completed in a work-like manner according Authorized •� to standard practices. Any altercations or deviation from above specifications involving extra costs will he Signature executed only upon written orders,and will become an extra charge over and above the estinate. All agreements contingent upon strikes,accidents or delays heyund our control. Owner to carry fire,tornado Note: This proposal may be and other necessary insurance. Our workers are fully covered by workmen's Compensation Insurance. withdrawn by us if not acre tool witlun days. r Acceptance of TropoSaf-The above prices,specifications are conditions are satisfactory and are hereby accepted.You are authorized to Signature do the work as specified. Payment will be niadeasas outlined above. Date of Acceptance: �U-0 l Signature Flo :�0sb (rLZf�3 of �\TQrfljal.11pf011 - )t E �1a31Achntctl.' — DEPARTMENT OP DU(LDrNG 1NSPPCTIONS 212 Main Strcet Nfunieipal Dudding Northampton, 7Tass. 01060 Vrr O R CE R'S C O i\U EN S Ag7O N M S LTR-A ti CF A ITl'3)AVIT \%rich z principal place of businessfresidence at: - `7 ��2-' s /lid 4 0 (pnone) -'501y 6�7� sn-�tl ci t J 1 sta_trl ci p) do hereby celYif)--, under tJ)c.p?-MS and penalties of perjury, hzt ( ) I am an employer providing the followine-, %vorlcer's COIDDCns-;iop. cove Mee for Iny Ctvployccs worming on ties job: Qn --n=Coor c)-) (Pout-, Number) --- (T';-pirrtion tDaL--) ( ) I am a sole proprietor, general contractor or homeowner (ci cie one) aad have hired the coouactors listed below who have the following workel s coMpen-sanon po—Ides: ( +IISI1C 0; COn(^Ci0") (Insurancz Coinpari)-i-PoUcy ?�IUr71LQ) tt_.''JIIJ 4? DaIC) - (Name of Cooczcior) (lnsurznc:. Comoa.a"./pOuLv `urilcrr) (Lxwz6on Date) (Name of Coatraeto,) (LaaLranc:. Company/Podcl' Numbj) (Expire don Date) (Name of Contractor) J-cs rangy Compaay/PoUcy Numbr) (Expindoa Datr). (ata�u-�r `A�'�oca1 L'xct,iC nccaal•to a)GrulSc tarormi'i oo pertaiain�to all era-..r_o-�) - I am a sole proprietor and have no one wor4dng for me. ( ) I am,a home owner per{orT=o all the Nvorl; myself.ZD NOTE:plcsc be conic tb--•t tc hem mcn utQ 4==91aY par-a=to d—u—'-z of ant more th-M L-"--rata is%�Oeh ttx bomoowocr resido cc oa dhc pound zFparLcw—,= Cx-.try In be —VIOye3 untie ibc..= c{x C=* *'en An(GUI 52-m l(5)�:q Ptirsaoc by.homcoaae fv a 6c=--,,:or permit rely CN-dco c the . Icpt n,,.,oC en c,loy.r under ttw Wocir-0fa Co�.1;oa,nd. I -d-- d due>Dopy or thi•cW--.a my be r«----d.d to ebe Deq.rcmf�erinduSri cl neodr� offion er trr.+u+nra roc th. > i wvc�e`�O�O°*�tStrt L-iltac w srnrrc tovcrabe trader soa.ion 23 A of}.toL 152 as lad to the'^�"�"�1Oa of aimia.>J prnoltic 0 a of a rux oCUP to 51}00.00 WZICr esprixx�ocup to Doc yr=r r.z�d aN-it poxhia in do Cam of.Stop Wort Orxia a-A Crrn oc S 100.00 a day LplaA me For 6�.rta+��u,e on17 Lot S i gnnWrc or Lia=iscdPc O4�HAM p�O �Gi acssAC1f 1c8ttf5 DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR '212 Main Street • Municipal Building Northampton, MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 78OCNM 108.3.4 to act as his/her construction supe,•isor. The state defines "Homeowner" as, ".Person(s) who owns a parcel on which he/she resides or intends to be,a die e"or twd-amid - 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 fegulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before baekfill), sonotube holes(before pour), a rouzh 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 projecf untii 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 r c SECTION_$ OQN�510151R1y�CES tl r 8,1 Licensed Construction Supervisor: Not Applicable ❑ _ t Name of License Holder: e-ce— w6ir License Number L4 ae-eCA S-� A)f)R+�AND�otj m r4 (!31066 4- 3-O(6 Address /w Expiration Date Signature Telephone e Not Applicable ❑ AMC- 4V,.Dino v mei✓j— & D 6 9 Company Name Registration um er "--" �-t°�� <S f rtl��2��i� / ic/ DI s� 4/0�d 6-- /,S--O�o Address Expiration Date c !� Telephone-5.�—05Z/ SECTION 10-WORKERS'COMPENSATION INSb7-k11—0 �1F�ID`AVITS{M CrL 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-year period shall not be considered it 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 haws Annotated.-- Homeowner Signature r I 'SECTION"5--DESCRIP.TION6F:RR'OP,bSED',WORK(check alFapnlicable) New House [] Addition Replacement Vftdows Alteration(s) Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [C]] Decks [Q Siding Other[lam] Brief Descri Eton of Proposed W ork` f,> yjw,'. w ew Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 11TtT 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 L 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 OWNF_RAt1THdR►Zk.T 00 1_T BE COMPLETED WHEN OWNERS AGEN> Oi CONTRACTORr PLIES FOR BUIL'TjINfG#FERMI7 I, 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 I ,hq e Z T 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. Print Name Signature of Owner/Agent Date Section 4. ZONING All Informati6h 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 :r Lot Size — __-� Frontage Setbacks Front Side L:= R:= L:� R:r_ Rear Building Height Bldg.Square Footage Open Space Footage % C� (Lot area minus bldg&paved t parking) #of Parking Spaces 0 �� Fill: volume*Location A. Has a Special Permit/Variance/Fi ding 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 © DONT 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 O DONT KNOW W YES IF YES, has a permit been or need to be obtained from the Conservation Commission?��-��` Needs to be obtained 0 Obtained ® Date Issued: -� C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading ex ation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO i IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 'P CI of No m.pton in p rtment � 3 212MinSteet F�p6m 10 jo A 01060 "Lb&T-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 7 SITE INFORMATION Thtsrsectton�tole c n`tet db'"office vM 1.1 Property Address: t=� 9 a N. ,. SECTION:2-PROPERTY OWNERSHIP/AUTHPRIZED AGENT 2.1 Owner of Record: I Y1�V.L 'T-AN%V, Name(Print) Current Mailing Address: ' Telephone Signature 2.2 Authorized A ent: Name(Print) Current Mailing Address: Signature Telephone SEGTION.3=EST IMATEQ'CONSTRUCi ION=COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)<Building Permit'Fee 2. Electrical (b)�Estimated TotaL,:Cost of '`Corsfr3ctior�e"m 6t 3. Plumbing Building PermitEee, 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) oew) Check Number Tl t's'S4dtio&',Offrciff.Use On! 'pate Building Permit Number Issued: Signature: i Building=CommissionerAnspector of Buildings Date 44 PENCASAL DR BP-2006-0041 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29-288 CITY OF NORTHAMPTON Lot: -001 Permit: Buiidina Category. BUILDING PERMIT Permit# BP-2006-0041 Project# -2006-0058 Est.Cost Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Ed Corbett Jr 116069 Lot Size(so. ft.): 13329.36 Owner. JANIK MICHAEL Znn`ng-TT PA Ann1h-,mt: Fri ('r%±Lft lr AT. 44 PENCASAL DR Applicant Address: Phone: Insurance: 4 Reed Street (413) 584-6571 NORTHAMPTON MAO 1060 ISSUED ON.7113105 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL REPLACEMENT WINDOWS & SIDING 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: bi 18 v Lc"u t 5 THIS PERMIT MAY BE REVOKED BY THE CI Y OF NORTHAMPTON UPON VIOLAT OF ANY OF ITS RULES AND REGULATIONS. Certificate of OccuRancy Si nature: FeeType: Date Paid: Amount: Building 7/13/05 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Conunissioner-Anthony Patillo