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25A-147 JUL-20-2005 WED 11 :57 AM OVS1893 413 587 3915 P 01 Jul 20 05 10:° la �e P.2 O�<AAM 11�O :• oaf+.-\ i =r � ~ �Il�,l fTf �ttl'f1�1;t711�1t011 j 1j� � �af-Yrh nt�tf s' DEPARTMENT OP OUILDNC INSPECTIONS I � l 212 Maio Street • Mucieipal Building l 140rthampton, Mots. 01060 WCFR_1t2IVS COI 'ENSA.TTO•N VSURANCE .AFM- A\nz- (lia:oscupermitecc) \vith a pruicipal place orbusioe reside,) at: ------ do herchy certify, under tbc.pzuts and pewlties of perjury., lut O I ant an employer providing the following hvorlcer's eorrlocnsz uon coverage ror my eluploy(.c-s woemng on tius job: Om fur-fl=CooFzm) (Potic�Nu=b¢r) - (Txpirtiop t7zL) O I act a sole proprietor,general conuaaor o CO cie one)znd li ve hired i the coairacprs fisted below wbo hzve Lhe fol{otviflg wor e s coamcasadon poficies' I (1'N4TIC I (Insurall%Comp3n)•fi'000i Numbc:) (C-_�pir-ouen Ditt) V.of Coao'aear) — (bwamcz Comnan-dPOUCV Nut+o:0 (C�pirrno1)Date) l (Nude of Coumao:) (lusurarle~Co IDpaDy/PoGq•Nareb.i) (E Date) (Nu to of Conaaaor) assurance ComparrylPoliey,Numb--4 (Expiration Date). t.oae6 adm.ivc.1-boo,if a.q..ry i.:w.tub:.f..m.ow p�.inie�r.!!eaxncn7l O I r'a sops-pFaprietot and bave no one worlang forme (ll,.l home owner perfonnitlg all the work myself. NOTE:dacte be ewwc dw�+bi1e homeokoen%to cav{%P—w a de xamau vao er cwo a e916i wNt w.#-16t el oe/mar td:a�hfoe rortt is vddey tAc bomnowoor x m tae Baypry 4-punea=tlr.———0-111,aepib.l m M �lor=+ oCs the MekerY mt�a;ea,w(6th s2aa t ts)1 wliaoan by.aom nava(a&liwze of permit m r-i&00 thr lcIPJ d ti s wi-r r uwl r tM W.&.e,Campoetiea Ad. 1 y.�a+..os o.....py or un m+c�mr m.y b.r..,..id.s�.u.thq,r:mod orLras+n!A.ofms OG...r Idu�wo.ra 1� ° i�.r.iGa7im a td tlV1(iLae to smve bolarCc rnda teaiao 23 A arl tOL I J2 w led to tb.i. otoae dui®a+l pawwa Q-1 i%a r fim err le it oo"Wt. i rap or Slot.00 ay api"m%c °°IevOimm or up to oo�ycttr ted ovil p®r.a vnc fee of $top Wo.t OraQ.ad• - ;kk rd 4P.I.I.MJ%A eMy Permi Hanks St ou:cJLi Pcrmiucc 4qi� )UL-20-2005 WED 11 :57 AM OVS1893 413 587 3915 P. 02 Jul 20 05 10:518 p. l 'e of XVrt4anlTVt= i ¢rrrrachorerts r DEPARTMENT OP BUILDING rNSPSCrIONS INSPECTOR 212 Miiin 5tre4t • Municipal Building NoMwnptcnr,MA 01060 HOM E OWNER EXEMPTION ACKNOWLEDGEMENT The State of Me s"achusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supt-viipr. The state defines"Homeowner"as,"Person(s) who owns a par:el on which he/she resides or intends to be,a ane or two 0,f17 _. 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 de,)artment for the City of Northampton vitnts.arrp person(s)who seek to w use the home oner exemption,to act as their own construction supervisor,to be aware that by doing so you become responsible for compliance with state build ag codes and fegulatiow. The inspection process-requires that the building department be called to inspect work it various stages,which include foundation/tootinte(b>ttore backfill), janotube holes efo pour),a rougb bVilding building inspMdon(Wf re work is concealed,inscdattion Inspection(if required)and x final building ingpectiog.The building departr rent requires these inspections before the worlds concealed, tail re to ncure these iw ections can result in failureto_obUin a certificate of occupancy gntil the work can be ins ec ed_ If the homeowner hires other trades to perform work(electrical,plumbing&gas)the homeowner will be responsible to snake sure that the trades hired secure their proper permits in conju action to the building permit issued,and that they get their required inspections.Pai:ure of the individual trades to secure the permits-and inspections as required can P1 AY the project until such tirne as the proper permits and inspections are made i understand the above. (So o /resident's signature requesting exemption) I will call to schiAule all required building inspections necessary for the building permit issued to mew. I Date Address of work location `"1 W �JQIlaCU���� JUL-20-2005 WED 11 :58 AM OVS1893 413 b8t Mb F. uj 6 -r 4- cox lo ,oLslo aA to I d \3 soaolUlae�SU �4Pr?}�I�,�_ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) 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...... ❑ 11. - Home Owner Exemption 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 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 es responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Laws and State of Massachusetts General Laws Annotated. Homeowner Sign e New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [ Siding[p] Other[C�J Brief Wo kDescnptio=e�� I( Alteration of existing bedroom V/Yes No Adding new bedroom No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. If New house and or addition to existing housina, complete the followin : a. Use of building: One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms 2-- c. Is there a garage attached? NO d. Proposed Square footage of new construction. Dimensions e. Number of stories? N� -1 f. Method of heating? w Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction M Q� i. Is construction within 100 ft. of wetlands? Yes v""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 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT property MAC 4 �l�'�?��_____ as Owner of the subject hereby authorize to act on my behalf-ia4gift4fters relative to work aufhorized by this building permit application. IV Signature of Owner Date I, ( as Owner/Authorized Agent hereby declare that the statem nts and information ori-the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the nd penalties of perjury. Print Name fil tool 6 Signature of r/Agent Date Section 4. ZONING All Information 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 Lot Size Frontage Setbacks Front / Side L: / R: L: Rear 7 2© Building Height ( Bldg. Square Footage % Open Space Footage % �� (Lot area minus bldg&paved parkin #of Parking Spaces Fill: volume&Location A. Has a Speci l 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 ® DON'T KNOW © YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO (D/'DON'T KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained O , 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 Q NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, excvdhon,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO ja IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton status of Permit: -` d ng Department Curb Cut(Driveway Permit -- -- 1l 12 Main Street Sewer/Septic Availability TRoom 100 Water/Well Availability, s J IU L 1 9 2005 No,rt MA 01060 Two Sets of Structural Plans phone 410-58 Tpton, 240 Fax 413-587-1272 Plottsite Plans Ds�?'!'tl��" r,er±�,•lr -�al Other Specify 777& .__"-�RPPLICATIMTO E T,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office H'i t�oq T( 0,t Map Lot Unit v V d C v - Zone Overlay District V Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of-Record: r-Signature me(P' I Current Mailing Address: `i Telephone 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 om leted by ermit applicant 1. Building _ J �l (a)Building Permit Fee 2. Electrical lJ (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) Check Number d This Section For Official Use Only Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2006-0077 APPLICANT/CONTACT PERSON MESSER TIMOTHY A&EILEEN A ADDRESS/PHONE 49 NORTHERN AVE NORTHAMPTON Q 584-7632 O PROPERTY LOCATION 49 NORTHERN AVE MAP 25A PARCEL 147 001 ZONE URB 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: CONSTRUCT 16 X 16 DECK&FRENCH DOORS 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 F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION 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 Street C ssion Z L IX.ZS 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. 49 NORTHERN AVE BP-2006-0077 GIs#: COMMONWEALTH OF MASSACHUSETTS Map-Block:25A- 147 CITY OF NORTHAMPTON Lot: -001 Permit: BuiidinQ Category: BUILDING PERMIT Permit# BP-2006-0077 Project# IS-2006-0102 Est.Cost: $7500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 5009.40 Owner: MESSER TIMOTHY A&EILEEN A Zonings URB Applicant: MESSER TIMOTHY A & EILEEN A AT. 49 NORTHERN AVE Applicant Address: Phone: Insurance: 49 NORTHERN AVE O 584-7632 O NORTHAMPTON MAO 1060 ISSUED ON.7126105 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 16 X 16 DECK & FRENCH DOORS 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 Sienature: FeeType• Date Paid: Amount: Building 7/26/05 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo k � w � rai x 7 MW f sa:,,�.- ;' "wool --rSa" di` -y s x "¢ f~ A X sa *f ♦ ^'. `°<. Me Was -4 3a >. e s� '`t ff � x a � x >Y F`s r� rv°f"' �'.:.. fi a' cz<. ,r�. 1 >��."�s- dwf- � �.' � ✓ sm -'ri"r k � �z�NE.. s �f aME gA +.�' s't 3a,'�` 's_�-�ss x�''�«� s t✓°.2` �.r � tit F 'd's !, a,�"e �� �' �y f, .� �- '_ -„«..,tae.. �, .b,. • .z,.�'�� rd,„ w - e �A s „+ fir" & '# +a'r f rki_. �" .'Y xf a"` d ,"d� r h ,:'z,' 'fy ,,�, x s°T' s •; S s x a ;R � 4w, a a r � -a `x y a ya t MOM Oda `S s :., �*� „y PQA NMI A Mmw c a s man, a WAY zoo x s a t � �5" •Y,. � r:.: , ' � �} �"aaz`r' �;K �-'� " �s+'#4 �' � '?-' `�,, ,p � � � r �.,> �r �e'•z eat ,� �s - it - ±�s��z -+��'�* ar�*��-e ��. «� r ,� -'� _. � :: � f. �� ' :! �✓. � � '�', � ,T' �,^r°s~ � �' � �*,�.� ''�`"� �d4-j-f��.�, � 's��r.+w°f` �� 1�..,;ra,. y..� .�a .. 3 � * �`z '� a ;� �� '` ��, ,� x�✓ a>'�,� � ��t t �� � c � .�� °�sue'` s �r � � a� 49 NORTHERN AVE �.- BP-2006-0077 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:25A- 147 CITY OF NORTHAMPTON Lot:-001 Permit: Building Cate&M: BUILDING PERMIT Permit# BP-2006-0077 Project# JS-2006-0102 Est. Cost:$7500.00_ Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: Homeowner as Contractor Lot Size(sg.R.): 5009.40 Owner: MESSER TIMOTHY A&EILEEN A Zoning:Ur.B A. licant: MESSER TIMOTHY A fit. EILEENA AT: 49 NORTHERN AVE Applicant Address: Phone: Insurance: 49 NORTHERN AVE O 584-7632 O NORTHAMPTONMA01060 ISSUED ON.7126105 0.00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 16 X 16 DECK & FRENCH DOORS 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-Ap, C s Ox Driveway Final: Final: Final: t� Rough Frame: 14 V R ON Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: THIS PERMIT MAY BE REVOKED BY THE Y OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGU TIONS Certif cate of OccuQan Signature: FeeType: Date Paid: Amount: Building 7/26/05 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo