Loading...
25C-001 (4) Job Details Demolish room ceiling, etc Demolish rotten flooring Sister 15 joists Redeck 2 @ 14'x 14' Repair northwest post& west sill;temp. support&prep Front, south, and west corner support posts:demo. &prep Repair post, tie, &sill Support,strip;& cut rot First Floor Entrance: two front posts Repair posts Support joists Dig,prep, &support x 3 Replace front sill: Install sill x 4 Attach joists Repair floor Fix big doors Repair windows x 3 Dig&pour footings x 3 Below Reinstall posts x 2 Install one new post Ten braces Repair roof decking Up Repair three big joints Sister/repair thirty rafters Siding repair estimates: North gable 20% North wall 50% East wall 30% West wall 30% Front wall 25% Exterior Eave repair estimates: Bed& crown 120'of each Fascia&soffit 120'of each Repair transom Repair big doors Repair human-sized doors Install three fixed windows 7-IV 'vJA S 13 0 1 PJ I —K .15 -p Y,I Vl c I' p Nr 1 I x "I �j A\0 kjp--,P, 2- x.-/ Vltlk Q1.,A- "X I A)l b YCAQC 1,LA NovIl, Not +b 5coje i3o i All 117 An X4 .sv, ---------------------- Cot At X1 . 7 a- -xu C-7 7 City of Northampton �5 s,. Massachusetts �wS 4 YY � Val' %X � DEPARTIWNT OF BUILDING INSPECTIONS *t ;ter SJ b1 212 Main Street • Municipal Building Northampton, MA 01060 sstrjy°yjil INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. 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) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 M www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): j.Y' j �I �I-) L L1 `�"o 1'1 Address: �J -Q 1 4 z City/State/Zip:,-_Q.f' A ,,Al c, r 9 r .3 Phone #: Are you an employer? Check the appropriate box: Type of project (required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. F-1 New construction 2C4I am a sole proprietor or partner- listed on.the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are:a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 1525 §1(4), and we have no employees. [No workers' 13.F-1 other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHo meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nd the ains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: +n Not Applicable £ Name of License Holder: F---t Ir '001 1 Z+ License Number Knoivis- AL% 4 J ) Address Expiration Date �--�A 11.1 ._ 'L-11 (k. r) I 0 5 Signatur _ Telephone 9 Reaisfered Home Imairovement Contractor: ._ w' _.,.,, ;; Not Applicable E i J 4 3 Company Name Registration Number �( 7 14• Address Expira ion Dat 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 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. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 1 Accessory Bldg. Demolition ❑ New Signs [O] Decks [[] Siding[j ] Other(1] Brief Description ppf Propos d (,� , \ Work: �� w.4�i'at� A'C> "Ae- ("�T Y'fc' '� � l f aI �� � �a I'> �1�� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.If New°`hwse'and or.add'ition Yo`'ezisting.h'auslng;:complete the:followlna: 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 WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR.BUILDING PERMIT as Owner of the subject property hereby authorize (r��•��5y �� to act on m behalf,in all matters relative to work authorized by this building permit application. Signature of Own r Date 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. Yom ) S '__---{-"�., � ��•� �� G 1 - Print Name � "� Signature of Owne/Agent ate . ~ Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Building Department This column to be filled in by Lot Size Frontage Setbacks Front Rear Building Height Bldg.Square Footage 010 Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces A. Has a Special Permit/Vahnce/Fi riding ever been issued for/on the site? �� �� NO �� DONTKNOW YES |FYES, dateis:ued: ` �� IF YES: Was the permit recorded at the Registry ofDeeds? NO K j DON O YE �� -__0- IF YES: enter Book L Page and/or Document# �� B. Dues the site te contain a brook' body of water orwetlands? NO ��, DON7 KNOW v�� YES IF YES, has a permit been or need tobe obtained from the Conservation Commission? Needstobeobtained �- � Obtained »�� Date |ssued. ' �~� �_� ' C. Do any signs exist on the property? YES v 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 r�~� _ IF YES, describe type / ' ' . E. Will the construction activity disturb(clearing,grading excavation,orfi0ng)over 1 acre nrisit part ofa common plan ' that will disturb over 1 acre? YES K ) NO IF YES,then a Northampton Storm Water Management Perimit from the DPW is required. � ^• City of Northampton Y , f � ,r Pi "S4'k �e �5• A I�``hg,n s e k`s.:� Evil ,re It I f I F r An��f Building Department �ur6JCtrt/DrfyewayPerrrttt ' CI I 212 Main Street i 9r L ceP ri j i'} ei�u}ai�V'dl5l7 a b 1 ty ' L llin hh MAY 19 2019 Room 100 I tJ �i �,� orthampton, MA 01060 Two S+rts;¢t strrur1 PtansF , k, �" {i 2 f if Tr'�.f l L 32a 1 S i 7C'j !2r L 4 L I Electric, F ti {�A 3-587-1240 Fax 413-587-1272 P[of/Slte Plan's`,#w I, vy �' ''a Y C l`h ii R!C 0,. r,, �� ,.... , '1U6o N APPLICATION TO CONSTRUCT,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 6. �' Map Lot ` Unit Zone Overlay District _....: ;Elm St District CB District SECTION 2.7 PROPERTY OWNERSHIP/AUTHORIZED AGENT- 2.1 Owner of Record: M1a�Otzc � C � ItK�N-�T'� Na Pri ) Current Mailing Address: 1(t E e� f �^ Telephone Signature 2.2 Authori Agent: Name(Print) — Current Mailing Address: t, t� -��. - ( N� 7 u M Tele o Signature h r p 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) (" 1.)k j Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/inspector of Buildings Date File#BP-2014-1209 APPLICANT/CONTACT PERSON KRIS THOMSON ADDRESS/PHONE 362 KENNEDY RD LEEDS (413)549-1027 Q PROPERTY LOCATION 108 NORTH ST MAP 25C PARCEL 001 001 ZONE URC000)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building_Permit Filled out 0 Fee Paid Typeof Construction: REPAIR BARN SILLS POSTS&SIDING New Construction - Non Structural interior renovations Addition to Existing Accessory Structure - Building_Plans Included• Owner/Statement or License 084152 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 Permit DPW Storm Water Management Demolition Delay 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.