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32C-159 (2) j,k o-i t" &.T,-, 6�� & / g -ba 4e304ODH seating space seating space 8'-10 1 5/16" 8'-5 9/16" N N N � W W 4-8 9/16" 5'-7 1/2" � C G 6410 Z42-4 2669 J 9'-3 1/16" 0-0 o 0 00 o a CD a� c c 304ODH 304ODH attic ttic c fv%v s V"n� e e Le i gcT4(/e wko e eveA.`v�.sS i le J.�.ee p e � o T,6,-r. � 3040DH I 3040DH I I , I I I � I ED E I FROOM BEDROOM I 7'-11"x 15'-1" 9'-3"x 13'-7" I ° I F:71 EL� 2368 2368 $ I I , I 0 5'-2"x 15'-0" J IL Ig 2668 2668 i I 8 : 12 8 : 12 OF UP 8 : 12 I I � I co $ 2668 2668 2468 2668 I S I I � I I I = I Is ° I I BEDROOM BEDROOM g I 14'-4"x 11'-7" 14'-7" x 11'-6" I I I I I I I I � 3040DH secondfloor 309ODH I 3040DH secondfloor 3040DH I — _-- - — _ _ _ _ — .__J LIVING AREA 1084 sq ft FAQ �� G� C � MC 9S CEC� , - _ � 1 ©' ' MAY 21 2014 L pt (j 5 e'/ Electric. Plumbing&Gas Inspections Northamptci - - W936 W3020 W2136R -1- �++ W1836R W3221 936R B35 13CB35 '89 J 39 Q I09R 89R' � i Ef BATH BATH m '-1" x8' - " x8'-11"L� L 21se zlse _J 2668 2668 _ 0 (.J o C7t � O 1'-1" UP UP a 14-6 3/16" C S/Ca J C� 14'-2 9/16' 0 S 3040DH 3068 3068 firstfloor# 04ODH firstfloor# 11 �r LIVING AREA 1080 sq ft the discrilation of the work at #9 and 11 kinaslev ave # 1 added new haft bath on the first floor#9 and 11. #2 replace all the dry wall for whole house. #3 replace two full bath on the second foor. #4 added two new bedroom on the attic. #5 re place the whole house's floor. #6 update all the electrical including hot wire smoke detector. #7 update all the Vumping up to code. #8 update all the insulation to code using r 18 for all the exterior walls and r 38 for the attic i ^m �Q •® jJ S3 Yet 8 yy 2 w up u q io c w J Si7me 9114E�fi S •� S.;i2 R 91:1.S-}E FFTT w ®G? •� .4LI5$•A£ �s�:d�rrkrYrirYW wrr�x, � t �~arr��rwNCw�yrwo �sa�lrra�� rr+�rr�rrrsw�M/'RML•r�►v.MC, r•••• •••• rrrf�*,> wr�MMc ..- �...rD ESIU�HER r...........PR01 ECT .rrr..�.�k .......�.. � B � _ SH EET TITLE City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: LISle d lde The debris will be transported by: Grp The debris will be received by: Valle- �Building permit permit number: Name of Permit Applicant Date Signature of Permit Applicant City of Northampton _ ,a z Massachusetts *+ ,- . DEPARTMENT OF BUILDING INSPECTIONS ,* a 212 Main Street • Municipal Building �Jjs 4 Northampton, MA 01060 Jp�t^Ay�lati 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 inspe ns ar 1, 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 S Address of work location The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street r Boston, MA 02111 �► www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer? Check the appropriate box: Type of project(required): . I am a general contractor and I 1.❑ 4 I am a employer with � 6. New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. E] Demolition working for me in any capacity. employees and have workers' g E] Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions . 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. 152, §1(4), and we have no employees. [No workers' 13T1 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 under the pains and penalties of perjury that the information provided above is(rue and correct. Signature: 2 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: Not Applicable £ Name of License Holder: Ali License Number IC ( �= g ((410, �;? _,� oil ly 09 i� �� Addre Expiration Date Signat a Telephone ., 9.Registered Ho -`me.lmpi`ovement Contractor Not Applicable £ Company Name Registration Number Address� Expiration Date j D G �G �(� `on Ci P��b Telephone ZS 7 WS; Cy r /C ` 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:Exein ion: 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 108.3.51 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. t l r� J 'A A SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) J New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ R ng ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ELI-- New Signs [0] Decks [0 Siding[0] Other[0] Brief Descriptigf5of Pr posed �^ 1 , �( /1 C�f'•°� Work: a- D 441, Alteration of existing bedroom_ Yes ✓No Adding new bedroom V Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Rolf -Sheet sa:If New house and or addition to exlstinq liouslnA; cornp(ete the'followlng: a. Use of building:One Family Two Family_ y Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? I\J L d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves __� L _Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? In. Type of construction_ ro 4T_ i. Is construction within 100 ft. of wetlands? Yes L,/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 V No. I. Septic Tank City Sewer--tom— 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 to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I 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. 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 Building Department Lot Size Frontage _ .......—__-.__ Setbacks Front Side L:= R:�_._..-....� L:�.-.-._—_-� R:= Rear ]- Building Height Bldg.Square Footage— --_._- YO Open Space Footage r-._,_„1 % (Lot area minus bldg&paved �----; azkin ) #of Parking Spaces 1---- Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW YES Q IF YES, date issued:'----------_�. IF YES: Was the permit recorded at the Registry of Deeds? NO C) DONT KNOW e.1N' YES Q IF YES: enter Book i Paged and/or Document# i B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO Q IF YES, describe size, type and location: f j D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO Q IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. use only t r L A J City of Northampton Status ofPrmit r �' A '� Building Department curb cuUDrl�leay Permit 212 Main Street 8ewerlSeptrc Avait'a`ti)Irty �- 4 r� A , i MAY 19 2014 Room 100 Water/tert#�1✓atlaCiilliy u Northampton, MA 01060 7wa sets of SON af Plans j ; s 13-587-1240 Fax 413-587-1272 P[ntlSi#e Plans +ry ;� i3 i rE , y Eectnc,Plumbing&Gas in r 4iR �u , i a t aF Northarnpton.MA 01080 t7tlter S�?eGrf 5+ 3 r APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE.INFORMATION Thrs sectron to be completed by office!. 1.1 Property Address: i } ky Map Lot Unit Zone _ .Overlay D►strict r _ Elm St.f]rstrrct: CBDrstrrct SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 11 Al© W 11/6u" I�% Oe r_! ce r S Name(Print) �� �.. Current Mailing Address: Telephone �1,� � 5 Signature 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 completed by ermit applicant 1. Building (a)Building Permit Feb 1. 1 2. Electrical (b) Estimated Total Cost of C*&V Construction`from 6 3. Plumbing C'7m Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissionerllnspector'of Buildings Date File#BP-2014-1216 APPLICANT/CONTACT PERSON MINH LAM ADDRESS/PHONE 106 FALLSTON ST SPRINGFIELD (413)237-4156 PROPERTY LOCATION 9 KINGSLEY AVE MAP 32C PARCEL 159 001 ZONE URC(100) THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinlz Permit Filled out Fee Paid Typeof Construction: RENOVATE KITCHENS, SHEETROCK,INSULATION ADD 1 ST FLR 1/2 BATH& FINISH 3RD FLR ATTIC SPACE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 08469 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON I MATION 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 De if y Signa uilding O is al 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. 9 KINGSLEY AVE BP-2014-1216 GIS#: COMMONWEALTH OF MASSACHUSETTS Ma:Block: 32C- 159 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2014-1216 Project# JS-2014-002057 Est.Cost: $50000.00 Fee: $300.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MINH LAM 08469 Lot Size(sq.ft.): 3005.64 Owner: NGUYEN TIMOTHY zoning URC0 00) Applicant: M I N H LAM AT. 9 KINGSLEY AVE Applicant Address: Phone: Insurance: 106 FALLSTON ST (413) 237-4156 SPRINGFIELDMA01119 ISSUED ON.512712014 0:00:00 TO PERFORM THE FOLLOWING WORK.-RENOVATE KITCHENS, SHEETROCK, INSULATION ADD 1ST FLR 1/2 BATH & FINISH 3RD FLR ATTIC SPACE 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 5/27/2014 0:00:00 $300.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner