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Poured Concrete Foundations
HARRIS & GRA Builders & General Excavators Bulldozer&Septic S Work
Septic Systems
.J.O. BOX 300 MAIN STREET ASHFIELD MASSACHUSETTS 01330 413-6284771 Remodeling&Custom Homes
Post&Beam Specialists
MARGE BARNETT 12/06/07
108 NORTH STREET
NORTHAMPTON, MASS . 01060
TEL. 584-6561 CELL. 237-6166 WORK-238-4128
SITEWORK, CONCRETE, & CARPENTRY, AFTER VISUAL INSPECTION W/MARGE
FURNISH MATERIALS, MACHINERY, AND LABOR FOR THE FOLLOWING:
• RAISING OF WEST END & SHORE
• REBUILD NORTHWEST CORNER — SILL WORK
• CHANGE OUT 8"X 8" HEMLOCK CORNER POSTS—FASTEN ON NAILERS
• REPAIR PLATE & TIE BEAM — NORTHWEST CORNER .
• 4 CONCRETE PIERS FOR POSTS BASES (4' DEPTH)
• PROVIDE EXCAVATION & BACKFILLING FOR CONCRETE PIERS
• OBTAIN POSITIVE DRAINAGE AWAY FROM NORTHEAST CORNER OF BARN
NORTHERLY TO STREET, WEST SIDE OF DRIVEWAY.
• WE WILL HAUL DEMO—WASTE & DISPOSE OF W/TIPPING FEES .
(GENERATED BY HARRIS & GRAY)
• OBTAIN CITY OF NORTHAMPTON BUILDING PERMIT W/FEES
REMOVED FROM ORIGINAL BASE FIGURES — TO BE DONE BY OTHERS :
--SLATE REMOVAL & FUTURE ROOF
--RAFTER REPAIRS
--REMOVE DECAYED LOFT
--REPLACE 2 CEILING JOISTS IN SOUTH EAST ROOM
--REPLACE VARIOUS FLOORING SOUTHWEST & NORTHWEST CORNERS
--BOARD UP WEST & NORTH WALLS W/VERTICAL SIDING
--REPLACE & REPAIR CROWN MOULDINGS—SOUTH—WEST—NORTH SIDES
--CONSTRUCT 1 Q 8-9' DRIVE—IN DOOR BAY IN — WEST END
OF BUHZ)D G 21;S--17=0'VS
P
I NS P-Z C T 0,
2112 Main S Lrtt:i • Municipal B uildirg
Norrbampton,MA 01060
j7VrXJ-PTjn7' A('`VNr)WT,E.DGEMENT
of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
a�ne State
a-SELSS,11jer construction sups. The s+LaZ-- 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 atwo-year period shall not be considered a
home
The building-department for the City of Northampton wants any person(s)who seek to
use the hone owner exemption, to act as the"own constrjctio"n szzippe—r,,iico—r, 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 backTill).
sonotube holes (before nour), a rough buildins,inspection:(before work-is
concealed). iwulation inspection (if rwulred) an-d-aThial-buildinei=ection. 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
untfl-&e-work-can-be-inspected-
If the homeowner hires other trades to perform work(electrical, plumbing Eas& a
, ) 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
IM
inspections.Failure of the individual trades to secure the permits and inspections as
required can DEIAY the project until such time as the proper permits and inspections are
made
and and the above.
(Home owner/resident's signature requesting exemption)
I will call to schedule all required building inspections necess for the building permit
Issued to me.
Date
Address of work
location
---------- ---
77ze
D e
CITIr.en:Of In
0 'Ce of In-yeszigazions
600 Washin-rLon Srre_-r
Boston,_U4 02111
WKW.MaSS,-0V1d_,a
Workers'"Compensation Insurance.4--fEdailt: Builders/Conrractors/*Ele.c-tricians/Plumbe.-s
ADI)Ikant Information
jVame Please Print Lea-ibly
Cl��es&'QLm2r-'=-oil,lndividual-):ff/I I &T2A Y Cct,(TJ2A - pu ZRn 11 Y
-Address: &( MfiIN STREEF
C'tY-/S tat--,zip E I E L Q 11 M A V Phone
A --thep --r.2te box:
,re you an emDlo-ver?Check -ppr_., Type of project (required):
IV I am a e= I am a genera]contractor and I
7� I .- 'A 6. _NCW construction
lover Wifn 4-
employees (full and/orpart-tizne) have hired the sub--contractors
I T I partner- on the att,ached sheet_1 am a sole proprietor or p Remodel
Ship q-,J have no�Io;gees These sub-`ontractors I -
01iLL011
WC),larg for me in any capacity. 10 and have wo=_Is
9. Building addition
LrNo wolkcrs, co=p.=s-=ancC COMC.=Zrance.-
L We are a co-moration and its 10- Ele--=Ca-7 r=airs or addirions
❑ T am a homeowner doing all work I I.❑Pitunbizz r--pairs or additions
I- oficers have exercised their
myself [No workers'C rigbt of exemption per MCTL
comp- Roof re-pain
ins=ance required-]t C. 1527,§1(4),and we have no
employees- 1-1,70 Work=, 13&Other'
_��e
co=-_insu=nc-_required-] OF FRIA90t1k)
on poncy=5rz=on.
T
ET
,iomeo-mers who sabmit this affidavit indicaan o they are doing aR work and then hire outside co;ttracctorz=is--,submit a new affidavit indicating such.
:contactors dial check this box must-attached as additional sh=*sho-ffi:g the n=e of the sub-contnict=and state Whether arnot those=titics cave
=npicyees_ If the szb-_anzzcwn.hive ettTio/e=,they Host provide thcr work=,C==.POHL-.'numb=
am an employer that isproviding workers'compensation insurance for my employees Below is the policy andfob see
information.
Insurance Company Name:_'M C -rMSIJ'RAAICF— R6:EMC.Y XNC,
Policy or Sells ins.Lic.
: (A C I q to S Expiration Date:
Job Sire Address:0 og- NaTm mr--
F-T_ City,'StatL-!ZiP.NaRrkitfKemNgK�ts
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date)-
-Failure to secure coverage,as required unde-. Section 25A of MGL c. 1522 can lead to the ir=ositi
on of criminal penalties of a
fine up to S1,500-00 and/or one-year in:ipzasormezt; as well as civil penalties in the form of a STOP'WORK ORDER and a Lae
of up to$250-00 a day ag-
6e violator. Be advised that a copy of:his statement may be fonvarded to the Offict of
Iuvemeations of the DLd for ins=urance coveraze verif-cation.
1 do her under the pains and pen of
perju7 •rh,=the infornzarion provided above is true and correct
Date: 2
Phone A 1 7 7 1
vil-i-MV,=-'ONLY. Do not write in Vz!s area,16 be cumpiered by ciry or town officiaL
___CRy or Town:
Permit/License
Issuing Authoriry(circle one):
L-Board- of Hez-1- -__ Department 7 City/Town Clerk 4.Electrical I
Health 2.Buildin-a Inspector 5_P1117mbing Inspector
6. Other
Contact Person:
r
SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: 'C !7 Y/V O(yo &RAY �J 01aH 9"1 I
License Number
-,U, T O X �3 00 )+SH F I E L J�, hn RSS; G r 33u ()q lay 1,5-6.
ress Expiratio Date T-
- 4t 8-477
Signature Telephone
LtAJtAA
9.Registered'Home improvement Contractor: Not Applicable '
/n/)0 Co
Companv Name Regi r ion Number
Address Expiration qe�
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. Ho>re Owner Egeon
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 c he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or ched structures accessory to such use and/or farm
structures.A person who constructs more than one home i a two-vear eriod shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the ildin2 permi t
As acting Construction Supervisor yol pr ence on the job site will be required from time to time, during and upon
completion of the work for which this pe nit ued.
Also be advised that with refer ce to Ath)pte (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not result g in f the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work fo you u er t s p it.
The undersigned"homeown rti s a d sumes responsibility for compliance with the State Building Code,City of
Northampton Ordinancsa Sta an Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Suture
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
1y
New House ❑ Addition ❑ Replacement Windows Alterations Roofing
Or Doors
Accessory Bldg.aE Demolition New Signs [0] Decks [Q Siding[p] Other[p]
Work:Description of Proposed J JACK u e � Q{6pA 1 R IJ�9 L�"LN""'� �1�'A
Alteration of existing bedroom !� Yes V- No Adding new bedroom Yes V Nc
Attached Narrative Renovating unfinished basement Yes ��No
Plans Attached Roll -Sheet
6a.If N, Ftause and"ar add100 L existing �;�sjnq, Co the'#oI[owin :
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? Ll
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation plian
mce. 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 CONTRACTORAPPLIES FORBUILDING PERMIT
_M 19 PGE RA jZ N j-1 as Owner of the subject
property ,,
hereby authorize 1 ,0 Y AA M[:) GIZi9 Y 114 A W t S P v�_,IS`Y
o act on my behalf, in all;ma tters relative o work author4zed by this building permit application.
e�-
Signature of Owner 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 ana penaities of perjury.
Print Name
Signature of Owner/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
Lot Size
Setbacks Front
--71,1-1-1- Z-'
Rear
Building Height
Bldg. Square Footage %
Open Space Footage
(Lot area minus bid.-&pav
A. Has a Special Permit/Yariance/Fi d been issued for/on the site?
NO \_��� DONTKNOYY YES \���
�
IF YES, date issued: '
IF YES: Was the permit recorded at the Regi of Deeds?
NO ~~~( � DON7KNOW YES 0
IF YES: enter Book Page and/or Document#'
��
/-
B. Does the site contain a brook, body of water orwetlands? NO v�� DONTKNOYY \~� YES V�J
IF YES, has a permit been or need tobe obtained from the Conservation Commission?
Need- -- b- b /-� 'ned - Date Issued:
L�-_-_---_-.-_-__---_-_-_
C. Do any sign- rope�y� Y�� i ) NO a
--------- ���������
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
IF YES, describe size, type and location:
E. Mill the construction activity disturb(clearing,grading . or filling)over 1 acre uris it part ofa common plan
that will disturb over 1 acre'? YES ��� l NO ���
��
|FY88.-tFiii6-@-Nof6a-m-�-t-o-hSfo-rm—TV��t-e-'Mana—gem6-n-f�Permit from the DPW iorequired.
Department use only
-City of Northampton Status of Permit: � � f r,
.. G ,
--Building Department
Curb Permit -
212 Main Street SewerlSeptiic Availability
Room 100 WaterllNeliAyailabiiity,
Northampton, MA 01060 Two Sets ofStructural'Piian
- ''
phone 413,-587-,,,1240 Fax 413-587-1272 Plot/Site Plans } j
Other Specify 1 D`-`w
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING `
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address:
I Q
9- o-RT F1 67 ) F ET Map Lot Unit
1\40'RTh AtKPZ N, Vl P f O)0(;9O Zone Overlay District
Elm St District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
MA-9GF #JOS M-N s , No,z7-Hfti►-tMtA, MMSS. 010(aO
Name(Print) ) Cu ent Mailing Address:
Telephone
Signature (`.
2.2 Authorized Agent:
--R1qymcNo (r2 AY C3, ti 30O.AS'H FIELD., MASS. 01330
Na Print) , 121 y Current Mailing Address:
4 [7 i3-&;2,q-+7r7 i
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 10 (a)Building Permit Fee
a �
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 Check Number 9
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
- -- ' — ---- — —
Building Commissioner/Inspector o w mgs Date
108 NORTH ST BP-2008-0584
G1S #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25C-001 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cates<„y_ BUILDING PERMIT
Permit# BP-2008-0584
Project# JS-2008-000899
Est. Cost: $25000.00
Fee: $125.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: HARRIS & GRAY CONTRACTORS 024991
Lot Size(sq. rt.): 33628.32 Owner: BARNETT PAUL C&MARJORIE CHAL
Zoning:URC Applicant: HARRIS & GRAY CONTRACTORS
AT: 108 NORTH ST
Applicant Address: Phone: Insurance:
P O BOX 300 (413) 628-4774 WC
ASHFIELDMA01330 ISSUED ON:1211712007 0:00:00
TO PERFORM THE FOLLOWING WORK.-JACK UP & REPAIR BARN FOUNDATION
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 12/17/2007 0:00:00 $125.0016443
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2008-0584
APPLICANT/CONTACT PERSON HARRIS&GRAY CONTRACTORS
ADDRESS/PHONE P O BOX 300 ASHFIELD (413)628-4774
PROPERTY LOCATION 108 NORTH ST
MAP 25C PARCEL 001 001 ZONE URC
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: JACK UP&REPAIR BARN FOUNDATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 024991
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
l�Nf2MATION PRESENTED:
j 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
/Z/17/107
Siunature 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.
BP-2008-0584
GIS#. z COMMONWEALTH OF MASSACHUSETTS
ss,a 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-2008-0584
Project# JS-2008-000899
Est. Cost: $25000.00
Fee: $125.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: HARRIS & GRAY CONTRACTORS 024991
Lot Size(sq. ft.): 33628.32 Owner: BARNETT PAUL C&MARJORIE CHAL
zo 11111 1_)RC Applicant: HARRIS & GRAY CONTRACTORS
AT. 108 NORTH ST
Applicant Address: Phone: Insurance:
P O BOX 300 (413) 628-4774 WC
ASHFIELDMA01330 ISSUED ON:1211712007 0:00:00
TO PERFORM THE FOLLOWING WORK.-JACK UP & REPAIR BARN FOUNDATION
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
tTnderground: 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 12/17/2007 0:00:00 $125.0016443
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo