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36-082 (3)
~ ` Troposaf Vinyl Siding =:Z:N N3et r f Roofing 1�'fa-em'Tprfon, MA 01060 Doors Awnings (413) 584-6571 Canopies Gutters A 411 4_ 1166�q Shutters MY,STATE,itaxi ZIP CODE I JOB DATY,OF PLANS JOB PHONE We hereby submit specifications and es6mates for: ,Propose herby to furnish material and labor-coinplel,-Illaccmdanct with Theallove SI)CCific;1IioT!S,for the stint"t: NO A4&voa Av All niaterial is guaranteed to he as specified, All work to he colitifileted in a work-lik-c inarmer acctirdirig Authorm-fl to slanalanl practims. Any altercations or deviation froin ahove specifications involvilig extra c,�si,%'ill he executeIl(inlyurx)n written orders,and will becolne an extra charge'Wer and ah��ve the estimare. All agree rnents contin gent upon strike-s,accidents or delays b evOlid our contro I 01-viier 1,-carrvt ire,T,,rnad(' Note: 'Mis prol—sal may he and Wher necmary insurance. Our workers are fully ci)vered bY Wi)rkmen's Ctompensation lilsuranr,. withdrawn byU.1 If"Of accepted willun—days. are conditions are satisfactory and are hereby accepted.You are authorized to Sl�llatl_tr e-Wh-ffe_,,ze do(lie work mspecified. Payment will be tile[L�outline I above. Date of Accerviance: ----- ------- --- ~-- 'A�o �,,�oy� (r,It� �f ��Rrtlla111�JfD1i C $Z 431achnsctIs* a DEPARTMENT OP BUILDrJ,'G INSPECTIOI.'S 212 Train Strect • Municipal Building Northampton, Mass. 010GO i i WOR G:-R'S CONQ ENSA nON 0,4SUR -NCD AFTD)A-vi-i" (li ccn per ctcc) with a prtricipal place of businessfresidence zt: — - lQ�Z3!� S Nd D (phone::) -By 6S71 ==uci ty/stalc'a P) do hereby certify, under dic pains and penalties of per'ury., :hat O I am an employer providing the following worker's comgcnszoon covem;c for lily employees worlang on tills jQb: I� (instir-:nom Comp zy) (Pciic: Nu-�r) -- (r pinion Dat`) ( ) I am a sole proorieror, geoeral contractor or homeowner(cu c:e one) anti have hired the coauactors listed below wbo have the following worker's compensation pokiest i I (t�OMC of Co-^- nccor) (xua-a n Dnic) j (N me of Cootrctor) (Insunnc; Comoan)/Poticl' \lances) (E.\Dimtion Dale) i (N-me of Coajncld:): (Laurance ComPZD)•/Potiq• Munbu) (Expirsdoo Datc) (Name of Coutmetor) (lasurancc Company/Pobcy Numbcr) kTxpiiatioo Date) (ttueb:d+uo«5.J 6ect.ffneoci.c:y to irYdtidc�iarormijen pertziains to.J 00am°-r�-3) i j I am'a sore-proprietor and have no one woridng for me. ( ) I am,a home owner performing all the work myself. NOTE:pteu be twat t=wU, bemcc w,Vcn�.bo Bpi%P,_om to cie M-j= ^+ —.1=00 c renal work an.d.•xi i--C of not mete th a t1 noe taitr is u-bieh the bomoowad rtsido or oo the p',,. tppartea: tbedo s-c oo(C >u-X-f 0 d�to be cmPi0yc3 ucl--the.. _c—p=-- oa AM(GUI 52-n l(S)),appliraboo by t boaooQaa fcr-Gc�_or P==c=y cwdcoac trc Ie1p1 n,n.,or—egtoy.c uodcr d10 Woticola Compomcaion A.,- i 1 ua'6'" .od dtat a of this mteaacm n be rcrw. i d to tba wpy Y Dcp.r��oa or Ind.+Sricl l�dmts'Qlrioe or t�aoc+for U. coves the veiretioa sad th t Lilts a to soaue bovcrase tsder,oetioa 23 it of MQL t 52 oa tad to the iapo:iioo o(aimio3!pcailsio comismg art Gx crup to S i}Oo.00 andfoc i nwi3o�0o:y o f up to ooc yr3r cod a%i1 po, join be roan ors Stop Wort;order sad a fin3 of 3100.00 t day tptiast CDC For&pum--a1 u.c only Permit Number 2—O� I, Lot Signattim of Lictns=/Pe e -- . �7 �DrZt��111�7�II11 i $ � �aasacbusetta DEPARTMENT OF BUILDD\IG INSPECTIONS r - INSPECTOR 212 Main Street • Muuicipal 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 his/her construction sups •,'isor. The state defines "Homeowner" as, "-Person(s) who owns a parcel on which he/she resides or intends to be, a orie or two - 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 eegulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfiil), 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 ofoccuoancy 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) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location ' r i ' a.in;eu3IS.muMoamol`I _.p?MouuV snne leiauao suasagosssuW jo a;e;S pus sons l 3uTUOZ IsooZ pus a;s;S`saotreuipap uoadtueq�tolq 3o f4i3`apoD Sutpitng a;s;S oq;q;tnn aou2ijdiuo io3-Xjij gisuodsai samnsss pue sogp=,,.iaumooxuoq,,pavf[siopun oqj ;ittuad s. U lapun noA io3)hoot uuoj.iad o;asig noA (s)uos.tad lo3 algvq aq utu no `pa;s;ouuy sme•1 Is.tauoD suasngossstW Dip jo(iproG to Stnlinsai}ou sounfut io3 sooAoldwg o;s.ta,Soidtug jo Alipyarl)£SI ioldet D pus (uo►;esuaduio3,sia)ltoM)ZSI.ia;dsto o;aouaiaja.z g3Tnn Isg;posups oq osiy •panssi si}mood scq;gotgm io3 jmm otgjo uoilaldtuoa uodn pus 2uunp`atua o;auni uuo g pannba.t aq Iltm alts qof aq;uo aouasa.td inoA iosi ua nS uol;an i;snob;Iut;os sy jp is NuiplInq aq;.iapan paluloj.15a K.iom Bans Ile ioj alglsuo sa.1 aq pegs ags/aq;rq; is>ogjo 2uipimg aEp of olgs;daooe uuo3 s uo`isiotpo 2uT I!ng atl;o;Ituigns IpIs,,ioumoatuoq„gonS .iaumoauioq a paiapisuoa aq;ou IIEgs polia isa -o,►u a ul auioq auo usq;a.iotu s;ani;suoa oqm uos.io sainlotuls uutt3 so/ptie osn guns o;A.iosmm somlon.t;s pagomop so pogosue`2tnll2enp Al!uie3 otAl io ouo a`oq of popuolui si io`si atag;gong uo`apcsai o;spualtn so saptsat ags)aq gottim uo pueljo laored a ti no ogm(s)uosiad:ianmoamog;o uot;lu3aQ T'S'£'80I uol;aaS uot;iP� g;XIS 08L HPVJ•.iosle.ia ns ss s;at:.iaamo ag;;t:q;papino.i `asuaoq a ssassod;ou soop oqM anq.to3 Isnpinipui us o2e2uo o;lautAoatuoq gonS molls o;pus sailTUM3(Z)oA14 so (1)auo,Io s ulllaa�Q pal nano-iaumo opnloui o;papualxa sera ,sioumootuoq,,.to3 uotldumxa luouno aqs ❑ --ON sal PegoeUV llneP!4V Pau6iS •I!wjed 6uiplinq aql;o eouenssi eql jo leivap eqI ui llnsai ll!M I!nepyle sigl apinoid of amlied•uoileopdde sigl gl!m pauiwgns pue pa;aldwoo aq Isom Iinepi,4e eouejnsui uoilesuedwoo sieNjoM l:11N)1lA1da1A 3�Nb2![ISNI I OIIVSN3dW0 .S9AMH M-0L N01133S auogdalal S� aged uogejidx3 ssaippy jegwnN ua;ejIsi6a�I aweN ue tuo3 --- O a u/a4 'T _ ❑ algeoilddd ION auogdoial ain;eu6ig a;eo uogencbc3 ssaippy p -E - p �S a- jegwnN asuaoil y :Ja i H asuaai-1;o aweN a eoi d ❑ Ig I. d'd ION :josin,ia ng uolpn4suoo pasuaol-I I•g 'SECTION?-S-:DESCRIRLION«OF BROP.OSED:W.ORK.(check-altaoolicable) New House [J Addition ❑;. Replacement Windows Alterations) � - Roofing ❑ Or Doors CQQ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding[o] Other[a Brief Descrip' of Pr osed "IAI �g S S Work: i U/NN( wjn/ / ,4 •� l Alteration of existing bedroom Yes No Adding new bedroom Yes No . Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet cuo3cisTita. 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 7,*,�OWfER' UT�,HO,_iZATJO� TQ BECOMQkTEDs Wt[EN ,OWNERSAGEI�7":'A,RCDNT,RAGJOR, PL' ,fORB`�11f::DING;PERMIT^` l 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 �� T �At2t,' J 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 /-2- 0/'> Signature of Owner/Agent Date Section 4. ZONING All Informatioh 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: Ra ! ! Rear Building Height r ---Bldg.Square Footage % 0 Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces 0 Fill: volume&Location A. Has a Special Permit/Variance/Fi d ever been issued for/on the site? NO © DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES 0 IF YES: enter Book ( Page j and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q 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 NO Q IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,txqFwation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES © NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. City of Nort.�ampton Building Department 212 Main Street Room 100 Northampton;'MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION;,1 SITE;:INFORII)IATION" 1.1 Property Address: h on�toe c m`fetd office ,�w Z... e L s I RTQ ORIZED SECTION:2 PROPEY V HP THAGENT., �i vFe"S,€P a M*y D k s ct�•K t;m n - 2.1 Owner of Record: All GIC l L- Name(Print), Current Mailing Address: Signature Telephone -.5� 2.2 Authorized Agent: F GlraRej T s�( /tj Name(Print) Current Mailing Address: 71 Signature Telephone SECTION 3 ESTIMATED'CONSTRUCTION:COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Pernif Fee 2. Electrical (b)Estimated.Total Costof Construction-from 6 3. Plumbing Building.Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Qp^— Check Number .- Tht`s'Secfion�Eo`r,Official"':Use'Onl Building Permit Number s'I�ssued: Signature: Building Commissioner/Inspector of Buildings Date i 237 WESTHAMPTON RD BP-2007-0702 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-082 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2007-0702 Project# JS-2007-001054 Est.Cost: $1200.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Ed Corbett Jr 116069 Lot Size(sq.ft.): 50965.20 Owner: HERZIG WALLACE B&LORRAINE I Zoning: SR Applicant: Ed Corbett Jr AT. 237 WESTHAMPTON RD Applicant Address: Phone: Insurance: 4 Reed Street (413) 584-6571 NORTHAMPTON MAO 1060 ISSUED ON:11512007 0:00:00 TO PERFORM 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: 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 1/5/2007 0:00:00 $25.003332 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo 237 WESTHAMPTON RD BP-2007-0702 GIs#: COMMONWEALTH OF MASSACHUSETTS Map-Block: 36-082 .CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category_ BUILDING PERMIT Permit# BP-2007-0702 Project# JS-2007-001054 Est. Cost: $1200.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group_ Ed Corbett Jr 116069 Lot Size(sq. ft.): 50965.20 Owner: HERZIG WALLACE B&LORRAINE 1 AT: 237 WESTHAMPTON RD Applicant Address: Phone: Insurance: 4 Reed Street (413) 584-6571 NORTHAMPTONMA01060 ISSUED ON:11512007 0:00:00 TO PERFORM 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: Final: K 011ll 07 IS THIS PERMIT MAY BE REVOKED BY THE 'ITY OF NORTHAMPTON UPON VIOL ON OF ANY OF ITS RULES AND REGU TION Certificate of Occu anc Sian. FeeType: Date d: Amount: Building 1/5/2007 0:00:00 $25.003332 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo