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29-044 (2) A W Roofing Corbett Home Im rovement p rnU�\� ���-•. Rooffining g H �7� m S'n Doors 1 V Ort alTlPt011, MA 01060 Awnings (413) 584-6571 Canopies Gutters PkOPttSAL s`tr�B/yurrrEn lY1 �j�7q.yQ f�'�'rV L-(J l'Lt;N jc'{�'1� PlK1NE�Z/ 41 t/ DATE /�r t L. STREET J V� '/{'j Kj )5 ,.1 JOB NAME /04M- / L 1 MY,STATE,a%t ZIP CODE � "TOJ�I �J� JOB LOCATION 3' 3 Aowv L DATE OF PLANS 1OB PHONE We hereby submit specifications and estimates for: L-1 Rt AU Y\ J'M t0 L4-- 4a0 3� �'�/i' CK 1 4. ` �� vim / r ✓3v dst lei' �C/',� �_ �.,� i✓ C��/�� L _ / Jo✓ 64-ek cWe TropoSe hereby to furnish material and labor-complete in accordance with the above specifications,for the sutra(if: /► ollars Payments to be made as follows: 1/3 ,`� ©il J LJ � All material is guaranteed to be as specified. All work to he completcvl in a work-like manner according Authorize+l to standard practices. Any altercations or deviation from above specification involving extra c(MN will be Signature executM only upon written mil s,and will become an extra charge over and above the estinude. All agreements contingent upon strikes,accidents or delays beyond our antral. Owner to carry fire,tornado Note: This proposal may he and other necessary insurance. Our worker%are fully covereAt by Workmen's Compensation Insurance. withdrawn by us if not accepted widen days, ,4cceptAnce Of T' rOPOSGIC-Me above prices,Npecificatious /��/''�--• are conditions are satisfactory and are hereby accepted.You are.authorized to Signature,r1�-----�--�„- do the work as specifiedl. Payment will be m !e as cwtlined above.. Date of Acceptance: Signature 4�tbAkRfPT a� e (ritll Of XcIrfliallip toll Baiaxrhttsctta ' m DEPARTMENT OF BUILDDIG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (licerl_scclperni ttecj iul a l:ruicipal place ofbusiuesslresidence at. (strxUcity/statrJzip) -- do hereby ce.i-tify, under the pains and penalties of perJury, t l�at O I am Llil employer providing the following •,vorkei-s cornpciisatioll coverage for my eluployees working on thi-�,job. (Insuu Ice Company) (Pale,Number) (Expiration Daze) O 1 dill a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers compensation policies: ('M nc of Contractor) (Insurance Coma..ay,i--v.tcy Num)cr) Expiration Date) (NPnne of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Nance of Contractor) (Insurance Comp;-liy/Policy Number) (Expiration Date) (a¢aa:idr_'itioail s?fcct iFncc sury w inc}udc infocmatioa pertaining to rill ccr.raGOr�) 1 gun a sole proprietor and have no one working for rile. O I any a home owner perfortuing all the wor;tc mvsclf. NOTfi:Please be aware that wino 6ancowtxn wt o cr play pc o;s to c5�t:a Lr.sn anntrta� o or repair wnric oo a dwelling of rot nxxro thin Litco tuuU is win�'t the futncawixr zrsidc�cx ar th.:�ourx�zPl;uticeyu tlxrcto ere�xt gcrni-ally watidcrcd W be r-:mr loy-e;�under the tvoriCct'i am{±c-:�tiat Ac7(G..152s 1(S)),r.r�iieacivn'dy e hotnco«�rs fur e li�tisc oc perau,rimy cvidcaoc the r�l ctzuu of an omployot untie tho Work—'K C<xn{xanation Art- I undcrrl d that a ooFY of this ctat.cmcnt may bo forwarded to tho Dcpa to ,i of 1n-iu3tjial Ar,6altY Oflioo of f�+'+*°o°for tim covasgc va-ificsiion and that failure to acatrc covctngo uDdcr SCCI oa 25A of mu,152 cjn Icad to tho nipas.tion of aunmsl pcailCcs coca,;t g of a frnc of up to S 1,5oo.00&rKvot imprisonnx of up to orx yTar and civil pmaltia in the form of a Stop Word;Or+dG and a firm of S L OO.QO t day tgliml m-- LL ---��uao«ity mber �Z Lot# r� Signature of Licensee/Pernuttce ��e Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed �Required by LomnL 1 his column to he filled in hN Building Ocpartmcnt ; Lot Size --- - -- --- --- — i Frontage Setbacks Front Side I R: L: - R - I I Rear I Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bldg&paced arking) # of Parking Spaces Fill volume&Location) ---_.__ __-- -------.._.. ___---L-----.--- 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 Rook _ Page 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 thc, Conservation 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. Are there any proposed changes to or additions of signs Intended for the property " No IF Y S. describe size, type and location:_- SECTION 8 -CONSTRUCTION SERVICES o ceased Construction Supervisor- 'pct Applicable ❑ rq, me of License Holder l � - - --- License Number ' I 1\/ /,I 1-4 l -- Expiration Date ?ele)norie 9Regf"sterednHbmelmp`rovement C 6 E ,.. Not Applicable El Conipany-Name Registrat on Number �l Expiration Da e -, 1r� {� - J �ele� i0ne L f SECT ION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) .. _ "� l��en<<9t UIl InS�.'df1Cc dff!Ua� 'il�t JC Cerl�l� eted .fi,' ;u!`�rlilte(i Woof t i ', dpphcatiorl_ I-�ilur(� tG pruvidc .'lid J" ult in the denial of the issuance of the building permit davit Attached Yes .. r c m 1� - � � gome�®wne�r E�em�ATtori Ile current exemption for"humeowners" was extended to include Owner-occupied Dwellings of-one(1) or two(2) famihc�, 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 hcishe resides or intends to reside, on which tirerc is, or is intended to be, a one or two titmily dwelling, attached or detached structures accessory to such use and/or farm �nuctures A person who constructs more than one home in a two-year period shall riot be considered a homeowner >uch "honteuwner" shall subutit to the i3uildin'l ()fl-tcial,on a !,)I!I] acceptably to the [3uilding Official, that he/she shall be responsible for all such work performed under the buildint; permit. 1s M1111-1 ConsU-uction Supervisor vour prrscnc�: on the iob itc mll time to bate, duriu and upon ,omplction of the work for which this permit is issued. ku be advised that with reference to Chapter 152 (Wof kcrs Contpensatiun) and Chapter 1 53 (Liability of Employers .0 l,,nplo}ces for in;uries not resui 111L in Death; of the Masslchu;c is General I-aws ,Annotated, you may be liable for person', ant hire u> perlon-nt tier."ou underthis permit re undersi�aned "homeowner, :entities and assumes responsibihty for eomphi ince with the State Building Code,City of 'vorthampto11 Ordinances, state :111,1 Local /onin, Laws and Boric ol,Massachusetts General Laws Annotated_ I omeowner Signature r SECTION'S=.'DESC�2IPTIOI�O'F-RROPOSED WORK•(checkall applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs f ] Decks ( ] Siding ( Other Brief Description of Proposed Work I1a �e- �j infCl j — - I Alteration of existing bedroom ______Yes No Adding new bedroom _ Yes No Attached Narrative ❑ Renovating unfinished basement Yes Nc Plans Attached Roll ❑ - Sheet ❑ i - sa If New hot"S'°'se Nara UFF"Mdition to, °%comp16tekthe fdiI ink: 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? Method of heating? Fireplaces or Woodstoves_ Number of each g. Energy Conservation Compliance. _ Mascheck Energy Compliance form attached I j h. Type of construction construction within 100 ft. of wetlands? Yes No. Is construction within 100 r. floodplain s y 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 BE COMPLETED WHEN OWNERS:AGENT 0,R2;CONTRACT.OR,APPLIES'FOR;BUILDING PERMIT as Owner of the subiecl hereby authorize my behalf, in all matters relative to work authorized by this building permit application Signature of Owner Date �v as Owner/Autl,orizF � hereby declare that the statements and information on the foregoing application are tnie and accurate, to the hes', knowledge and belief. Signed under the pains and penalties of perjury. Prin ame Signature of Owner/Agent Date v � ( of Norfh II i !���� St'at it t� " I ding `�ep�3rtmF�n' Cu'rbCd D "�ery e°• t'��� 12 MaII? Street Sewer/Sep t1C is �p JUN - 6 2042 Room 1 0 ,W W` a erlWe orth 1 1)f I MA 0 Sets S 'r eu.a Plot/SItePlansg x � � DEPT OF BULDiNG l olON$ f. NORTU,M-70r41 ".A 0!0;0 [Other Specify����� APPLICATION TO CONSTRUCT. ALTER. REPAIR. RENOVATE C)R DEMOf !sH A ONE OR TWO FAMILY DW!- SECTION 1 - SITE INFORMATION 1 Property Address. This section to be:completed by office ,y .y 3� 1 !�/�i2 Let .,lup ;t Zone ____ ---_-Overlay District Elm St. Districl CB District ECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Loom++4 2.2 Aut-h-orized_Agent: lie iPriratl n•� si (Irrss i F-n It L'G_ SECTION 3 - ESTIMATED CONSTRUCTION COSTS Officia !Jse Ord,,, completed by perm �r -f Fee Building Permit Fee I �r r OteCfr� .�t� - -- -Q - a� C7 This Section For Official Use Only Building Permit Number:__ Signature: - Building Commissioner/Inspector of Buildings i��te • M,��"'� r ��, r Q;. � _ _,_.i__�".�._ 33 PIONEER KNOLLS BP-2002-1078 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29-044 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2002-1078 Project# JS-2002-1737 Est.Cost: $5000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const..Class: Contractor: License: Use Group: Ed Corbett Jr 116069 Lot Size(sq. ft.): 11979.00 Owner: LOWMAN KAREN Zoning:URA Applicant: Ed Corbett Jr `4T. 33 PIONEER r\NOLLS Applicant Address: Phone: Insurance: 4 Reed Street (413) 584-6571 NORTHAMPTON MAO 1060 ISSUED ON:616102 0:00:00 TO PERFORM THE FOLLOWING WORK.ST R I P & SHINGLE ROOF 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:QK (o- !y. O a 44�v THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTIAIVIPTON UPON VIOLATI N OF ANY OF ITS RULES AND REGULATIONS. sZ5�9e- Certificate of Occu anc Si nature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 6/6/02 0:00:00 1606 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo