25A-138 (2) George Koeber
12 Grass Hill Road
Haydenville, MA 01039
(413)665-9576
Email: eeorgenmarv@comcast.net
Construction Supervisor: CS063492 HIC License Number 120754
Proposal for residence of:
35 Day Ave.
Northampton, MA 01060
We propose specifically to:
Strip existing layers of roofing slate and underlying wood shingle roofing on main house and to
strip asphalt shingles from porch roofs. Existing board substrate will require application of a
layer of 1/2 cdx plywood prior to re roofing.
The new roof will include snow and ice barrier applied to the eaves and valleys,30#felt base
will be applied under all other areas to be shingled, Valleys to be .032 gauge aluminum,
premium grade aluminum drip edge on eaves and rake. Ridge vent will be installed on the one
ridge where the chimney is located.
Project cost$8,500 based on the use of a IKO Harvard Slate colored asphalt shingles. $x,$66 is
due upon acceptance of this proposal.
Balance due upon completion of the project.
Any additional carpentry due to unforeseen rot or decay or other circumstances revealed after
stripping the existing roof will be charged as time and material ($40 per hour per worker plus
material as required.)
Dumpster will be provided by and at the expense of the homeowner.
The terms of this proposal will expire if not accepted by December 17, 2005
i
oposal s. mitted by George Koeber Date
Accepted by Customer:
Date
- �'r18558Ch1ISttfS _
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 780CNM 108.3.4 to
act as his/her construction supc: .`,sor. The state defines "Homeowner" as, "Person(s)
who owns a parcel on which he/she resides or intends to be,a one'or how_anu y --
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 persons)-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 backfill).
so_notube 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 occupanev
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
L 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
j
¢•(1WfP�. J..
Urif� of {nrfl�aiit�toii - _
AE .51 csanr3lnsrlla'
- i
DEP/1RTMEN7 OP BUILDr)\G INSPPCTIOII°S
212 Main Strcct . 'Municipal Building
Northampton, Mass. 01060
. WORIC:.RIS CONIPENSA'nGN MSU A� CE AFl�j�.11,
i
I
I -
I
(lI ccnsxJperZnittcc)
,IrlLh a principal place of business residence at: - -
1 a 62,c 5� � L � � � (phone=') 6 6 S `i Ii -7 �
(sa=Jcirr/ ap)
L
do hereby certil--. under the.p,--uu and penalties of perlufy, hai
( ) I am an employer providing ille following worker's cocnocnsa1J01i cove age for Iny
1
emplovccs «'oriong on tills job:
(L^..sur-aa= Conr,-z) (Polio:?:Lmbccr) -- (':pirdor, Dale)
i
I am a sole proprietor, general conn-aczor or hotneow70er (cc:e one) and have hired
tine cone actors listed below rgbo have the following worker's comoep—talon policies
i
(N=c Oi Co:?C=Cior) Uri--rancc Cofnpany)"Gbc- NLIfrLC:) D11c)
j
(NZMC of COUG-2 I0-0 (Insv-aacc Companvipoum, NUMcCT) (i:a-oirtion Dse)
I
(Name of Co CIO.-) Qnsurancz Compzn}•/paucy N;7sbzr) (Exairadon Daic)
j
i
(Nzmc of Co¢tractar) (Insuran= Compzay/Policy Numlr:f) ( lpifddoa Datc).
(aa,A addi-Eocmi 6c--,irnceczi:j to incur iafora..coa petniai.t(6 w.11 oo�-so:�)
j
am a sole proprietor and have no one working for me.
SKI
( ) I
I am.a home owner performng all the work myself.
iNOTE:pl-..be acrxrc th•.N Ie bC�9KLC Z K1)p QaPl-J FG�4III LO fSl -• c=,=Joo c rgaa K-ark oa r d..-1L.Z of
ao(mere ter.Lou=h,is%vbi'ea the bomoo—=-road=or oo the�azarS appur, the eo r z ooe C= zUy to be
-=zplcr--clad-the KKK c=:p,-- �=p,=(GUI S1-1(5)),=ppU=-6 a by s bommava fc a 6c=—a panic car--id—cbc
I lc•g.l ctayc of en ezployx under den WorS•„o�r C.odpooaation Aer_
i
I'4cr'y d tb�a a 0oyy or this mLc may be f—urd.d to the Dcpertmcraa of Ind asr;cl A=&.,Ly Omoe of try for the
cova'XEc vciLczioa and the L-ir=c to s¢z.trc'eo%c x,&�to&G 10cmioa 13A of MOL 151 eaa Ic%d to the i=Pc:SBioa orc-imiaat pc=hi=
eo i rxg of a floc of trip to S I-OO.00= &C)c impZiwamr oCup to ooe yr_r rod evil p�Pue in be form of.Slop Wort Ord-and
fizz of 5100-o0 a day cp=me
For d,,,,r==1 u.c 01277 —•---
l/ perm7t Nt7mt>c:
�)L -—
S7�u.Z• fLi�.r_JPcr-lntv�� ce I I h
6
SECTION 8`-CONSTRUCTION SERVICES J
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: (I C 2 `i a IC CJ e
License Number
Address Q p S Z Expiration Date
Si ature Telephone 1
�'_5 7 G
9�,,Re' fered3 Hbhffig fim"coverrient Gontractom '> <` Not Applicable ❑
Company Name Registration um er
GP -7 -57-Y
AcAress Expiration Date
Telephone A/, 7 G
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...... ❑
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 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.
Homeowner Signature
f
i
a
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House [, Addition [],: Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [[:I] Decks [❑ Siding[E3] Other[p]
Brief Description of Proposed
Work: S� 4 c
Alteration of existing bedroom Yes No Adding new bedroom Yes No .
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Rolf -Sheet
tusd an e�actctHid f ex199il a'r1ft l is E�b>�eftif���fa��o —
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 7a-OWNER AUTHORIZATION-TO BE COMPLETED HE
WN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDIhCG PERMIT-
1. 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
-e 0 e� � P as Owner/Authorized
Agent hereby declar at the s atements 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
L 41 112FIA
Signature Owner/Agent Dat
~
`
Section 4. ZONING All Informati6n 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
Rear
Building Height
Bldg.Square Footage
Open Space Footage %
(Lot area minus bldg&paved
#of Parking Spaces
(volume-&Location)
'
A. Has e| Perm it/Vurionua/F ndi ever been bsuadfor/on the s�e?
No' 0 DON7KNOVV 0 YES 0 �
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON7KNOVV 0 YES
IF YES: enter Bonk Page:'
aQ and/or Duoumant#
�� ��
B. Does the site contain abrook, body of water orwetlands? NO v���� DON'T KNOW ��, YES v��
IF YES, has permit been or need to be obtained from the Conservation Commission?
'
Needs tobmobtained x,� Obtained v�� Omt� [ssma�'
��� «_� . .
C. Do any signs exist un the pruperty �� ��� YES x_� NO �_�
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0
'
IF YES, describe size, type and location:
E. Will the construction activity disturb grading,excavation,nr filling)over 1 acre nrisd part oVo common plan
tha ~i||dismrbmm,1oore? YESK ] NO K }
~~� > ~�^
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
City of Nortf;lampton
Building Department
212 Main Street
Room 100 r eu ti '
Northampton; MA 01060
phone 413-587-1240 Fax 413-587-1272 PlotfSi
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLi$H,A ONE OR TWO FAMILY DWELLING
- -- - i NOV 1 .8 -'005 �
SECTION 1 -SITE INFORMATION
T is seh*«rr l,P��� to fftce
1.1 Property Address:
j ����f �v-'E Zone OverlajrDisfnet
Elm Sf:D�strrct 'uCB D�stnct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT`
2.1 Owner of Record:
Name(Print) Current Mailing Addre :
Telephone
Signature
2.2 Authorized Agent: y,(
C'4) 1? C�� T ( u e �� c .c� y u '
Name(Print) Current Mailing Address:
ti a
Signature Telephone
SECTION 3-ESTIMATED"CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building O (a)Building Permit Fee Z ��
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) Check Number �-
This Section For Official Use Only
Date
Building Permit Number. Issued:
Signature:
Building Commissionedinspector of Buildings Date
I
File#BP-2006-0583
APPLICANT/CONTACT PERSON GEORGE KOEBER
ADDRESS/PHONE P O BOX 507 WHATELY (413)665-9576
PROPERTY LOCATION 35 DAY AVE
MAP 25A PARCEL 138 001 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 2S•o o 27-$2
Typeof Construction: Strip slate,install plywood and shingles
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 120754
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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 Commission
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.
35 DAY AVE BP-2006-0583
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25A- 138 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0583
Project# JS-2006-0856
Est.Cost: $8500.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: GEORGE KOEBER 120754
Lot Size(sq.ft.): 6621.12 Owner: HOYE JOHN H&ELEANOR M
Zoning:URB Applicant: GEORGE KOEBER
AT: 35 DAY AVE
Applicant Address: Phone: Insurance:
P O BOX 507 (413) 665-9576
WHATELYMA01093 ISSUED ON.1112812005 0:00:00
TO PERFORM THE FOLLOWING WORK.-Strip slate, install plywood and shingles
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 11/28/2005 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo