Loading...
36-111 0=21 rrrrrrrrrrrrrr rrrr ■ rmrrrrtr rrrrrrrrrrrrrrrr rrrr onnurrrrr ■rrrr rrrrrrrrrrrrrrrrr ROOM rrrro rrrrrrrrrrrrr■ rrrrrrrIrMrrrrrrr rrrrrrrrrrrrrr rrrrr►Irrrrrrrrrrr rrrrrrrrrrrrrr rrrrrrrrrrrr OMEN r rrrrrrrrrrrrrr rrrrrrrrrrrrrrrr rrrrrrrrrrrrrrr rrrrrrrrrrrrrrrr rrrrrrrrrrrrrr rrSEEN rrrrrrrrrr rrrrrrrrrrrrrrrr rrMrrr+rrrrrSOME ■rrrrrrrrrrrrrr■ RESUME rir SENSE r ■rrrrrrmsrrrrrrrrrrrrrrrM ORErrrr ' rrrrorr ►,�rrrrr ■rrrrrrrrrrr SEE r■ ■rrr �rrUrrrrrr rrrrrrrrrrrrrrrr rrrrvoomrrrrrrr rrrrrrrrrrrSEEMS rrr� rrrrrrrrr No's rrrrrrrr MOM r ■■rrirrrrrrrrrrrr USSR rrrrrrr ONO rr ■rrrrrrrrrrrrrr rrrrrrrrrrrrrrrr` rrrr Inure mom rrrrrrMENO - Mrrrr� ■rrr rrrrr ��rrNOON rrrrrr,a rC - rrrrrrrrrrrrrrrrrrrrrrr was rrr rrrrsrrirrrrrrrrr ■rrrrrrrrrrrrrrr OEM rrrE rrrrrrrr�r rr rrrrrrrrrrrr mom rrrarrrrrsrrr�a MORE rrrrrr� i NONE rrE OMONIE rrr rrrrrrr. .� rrrrrrrrrrrrrrrrrrrrrrrmrrrr now rrrrrrrrrrrrrrrrrrrrrrro�aror rrrr ■■rrrrrrrrrrrrrrr rrorrfrrrr rorrr ■rrrrrrrrrrrrrr■ rrrrrt rrrrrrrrr ■rrrrrrrrrrrr■ r rrrmrrm rrrr OMEN r morrow rrrrrar rrr arodomrrrrrrrr■ rrrrrrrrrrrrrr■ ■am"Mrrrrrrrrrr rrrrrroirrrsrrrr ■r�rrrrrr�cR Mrrr rrrrrrf rrrarrrrrrrrrrrrrrrrmrrrr rrrrrr0 rrrrrrrrrr ago rrrr rrrrrr morrow rumor rrrrOMEN rrrmrrrrr ■rrrrrrrrrrmrrirrrrrrrrrrrrrrrr ■rrrrrrrrrrrrrrrrrrrrmrrrrrrrrrr rrrrrrs■rrrrrrrrrr■rrrrrrrrrrrr■ rrrrrrrrrrrrrrrrrmr■rrrrrrrrrrrrm rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr mm _ rrrMOROSE rONE rmom rrrrrrrrrrr■ i ■!!■■■m�!lmmorlrlm!lmr�mrlm!!lrmmmror ■!r!!!!mmommommommomr + !loi mr�a000 MONSOONS moms mommommomommlrrr m!m!!m!!lmmrom r! mmomm momm!!!!l ■!■!m!!omlm!lrrmmmmml�rmmrommlmmm ■!lmommmommomomroommml��!rlrolrlmloo !!!mommr!!!!lmmiimmommommommli!! !■i!!ommoom!!!lmmimm!!m ONES!!i!m ■!!!!!!!!!!!!molm!!m!i!!!!'mlmmm ■!!!m■!i!m MEMO mmlONE omm mmromom ■!!ru!!oommmm!!!momom. , !!r!!_N mom !mm!©!mmomm!!!m!rlmmm �lmrm lrrm smomemommommm ■momm ummoommmm mom!lmkah olmor� !•mm moom ummommommm oirm ■tumr!■wmrlm mommemoommomom so MONO mommomomomomom M mmocammom 0 M mosommmirmmmmm!lmmom ownumm■r pow ■!!!!!!!!!!!m!m SOMME!li b=wrm;@2■ ■moommommommom NONE r!!!!liR "! !moor!!sommommum mom!!Imo!!lRior01, !!!!!!!!!!!m!■ !!m!mlr r!moommoom ■ommoommoommon 0 mom!lmmirm!!!!0 mommommm!!!mlm orommmr!mmrlr mrlm ■!!!!■!!!!!rlmmm►momm ummmmmmmmi!! ■ENNOM!!!!!rlM rlroromom mommummom !!!!mommomm!!m!!lmMlcmm!i!!!!!!m ■!!!!mm ommom!!!!rlmm mrs ami!!!!!!! ■!!!!!!0!!!r!!!!!!!!!ii!!MEMO !!■ so •�' d R O�'Ct1AA1P�0 tifA Gritp of Wart4amptan z � � Sri lassacl�icsctts `' DEPARTMENT OF BUILDING INSPECTIONS / INSPECTOR 212 Main Street • Municipal Building Northampton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as !-Is/her construction super-,, 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 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 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 regulations. 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) will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location a C�zf11 z�f trz t(��illl}�tnll _ _ g^ 6 fil:sencElccsctts � f w ^� m DEPfu2TlvfENT OP BUILDING INSPECTIONS 2!2 Main Street ' Municipal Building Northampton, Mass. 01060 WORFCEr,,'S COT,4TENSATION INSURANCE kF+FMAVI.T I, (]iccr..c:Jcr;mi(iC^) v"Ith a principal placc of busirless/re: deuc_ (sire icitfs:=lc/!p) do hereby cCIcif;, tII](Ic1" Illc halilS �''Ild pC:il 1t1CS of pc lll� iilf!E I ?n1 an CIIlp!Oyei provi Ins the i0110',vil?C '•;OIr_CI`S COII9pC;1S8U0I1 cOVCI'a' C Eor II7} employces working an Lhis job: (Inslrmc: Compam') clic;NtI Ifxr) ---- (Expir t%n Da c) �i a sole provrictor, general conirc`cr o-cm , (circle one) and have hired �kl nt7actors l.lsteC be!0�-r;;'li0 l?�'.'C th i0i1 ,'v ;S COCIoeII�?�Oit u0!iC:CS: ---- (TjIIS11C Of�,011[I<1CLOZ} (IR ERG" I.,CZIl :?'r:t Ol1L f `�U3T1�C) �- �) (Na.mt Of Collt?,cioi) ii00 Date) (1�'Iamc of Cotitmctor) (1rlslrancz Datc) - Name Of Cont-actor) Date) T aIII a ;;OIC p1 Ul?CICL'Ji i il'1 hni;'; no 7i:: "J�7�iii' fo m- am a home NO'I'fi:plcvsc 1�c ai�-arc tI-si-.� 'Ic lxc:c:nttrs«:-c c.--F 1^�1*:-:=�:n.'.�::_.•_::aacc,cxc_r.:�_im cr: ;:air«,,;:_,-;-���c!!i::g c. not imcc th:n Hiroo unity ir,wLch cr oc;'`u t cr_1 LhcRC t k t Ccrtally a ::;..r, :a t ca ploycs ucv'e tlr.twc;a' cG x-=: 1;cn u :r ....'<n e _ ( ., : ) i - ` L'1=1=a -r^.:i legal aatuc of an cmployoc W)u' t!_•c Wockcic o;er ition eA,cL I unde-sl.sad thst a copy of this C.1tc:=!a:sy Eo to tl»IYSxirL.rn:of J Actzdmtf Qt.loo Of!:_a for tlx cova&&t vaificlion and the t f:dlurc ux-_.-.zccicr 25.4,of ML01,152 can lid to Qx rnpasitiaa ;r ir_1 pall:a comisting otn firr_of up to S1,SC0.00 nt 'cx i^:i�rivrz:e:-1 of::p to or.-}-�e-.j evil pensiliu in do(inri of SIC",'�'nY- =_=•� lirm oCS100.00 s diy igaiwA w-. r cr ciriovrrntsl use arty I�CTlillt NtlII1lT'.:T _l i natureofi.iccnrcJf'�rnliar.• SCT30N8 CONSTRIf,GTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature Telephone Rep 5tere �` me ,mQro�ern'enttContractor.� — _= Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTIONIO WORKERS'COMPENSATION INSURANCE-AFFIDAVIT(M.G:L. c. 152, § 25C(6)) . .. �.K�. . :.. 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...... ❑ a 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 acecptable 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. �omeowner Signature v x S:ECFION " DESCIR P"FION205 ROA ED NORK check liwi`Qv 11 a I:�cabfe _� ' .� -' New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: , &Ai- Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet 0 6afifi�N;ew�"ouse�ndor c�dr-`fion�toezistingw°tiousing:5compl'e�e fie`�fo°t~lowing_: 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. bimensions 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 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 SECTfOPI � WNER-ALITHORIZATJQN TO BE COMPLExTED WHEN OWNEf S GEf 1 OR CONTff&TOR APPLIES FOR B':UILDING PERMIT as Owner of the subject property hereby authorize C �Uj 'Sj� to ac;. on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I' 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. 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 DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT 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. Are there any proposed changes to or additions of signs intended for the property?YES— No IF YES, describe size, type and location: r City of Northampton gg- Building Department ` � 212 Main Street x Room 100 No mpton, MA 01060 hldh�"4 3Z-1240 Fax 413-587-1272 4 � �x APPLICATION-TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION. This sectil- tame completed by office 1.1 Proneriv Address: x r f � 3 G 0 je.5 ! I 'J Mapsot tint 7 Zane < � ��� � ' Overlay Distrct SECTION 2.-PROPERTY'OWN,ERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(,Print) Current Mailing Address: Telephone �J _ /6 / Signature 5 2,2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION.3-ESTIMATED CONSTRUCTION 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 Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2+ 3+4+ 5) e)00, d . Check Number This'Section"For Official Use Onl Building Permit Number: 6 Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2004-0738 APPLICANT/CONTACT PERSON LEBEAU SUSAN ADDRESS/PHONE 223 BROOKSIDE CIR FLORENCE (413)584-6045 Q PROPERTY LOCATION 223 BROOKSIDE CIR MAP 36 PARCEL 111 001 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid ' Typeof Construction: RENOVATE BATH MOVE SLIDER REMOVE 2 WALLS New Construction Non Structural interior renovations Addition to Existing Accessory 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 INF9RMATION 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 Stre Commission �' 2A O 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. 223 BROOKSIDE CIR BP-2004-0738 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36- 111 CITY OF NORTHAMPTON Lot: -001 Permit: BuiidinQ Category_ BUILDING PERMIT Permit# BP-2004-0738 Project# JS-2004-1066 Est. Cost: $8000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot size(sq. ft.): 18251.64 Owner: LEBEAU SUSAN Zoning. URA Applicant: LEBEAU SUSAN AT. 223 BROOKSIDE CIR Applicant Address: Phone: Insurance: 223 BROOKSIDE CIR (413) 584-6045 O FLORENCEMA01062 ISSUED ON:119104 0:00:00 TO PERFORM THE FOLLOWING WORK.-RENOVATE BATH, MOVE SLIDER, REMOVE 2 WALLS 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 Sitmature: FeeType• Receipt No: Date Paid: Check No: Amount: Building 1/9/04 0:00:00 MO $50.00 212 Main Street,Phone(413) 587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo