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23C-049 0000-6176-6040 72 I 80 I 95 518 i 32 1 24 318 I 127 114 1 24 518 1 0 118 139 11116__ I I ll 125116 I i T12 5116 139 11116 CTI 0 co m 6 dz 14 `m m N N J� N Ui 6 Ul O] N W m as E N ink x-112 1116 1265/16 12 T371 b� lm w 1277/8 24 118 1 rn 4 114 32 1153/4 152 9'-10" --� ---2'-7- 112" -- 3 -911 31-51/211 r" El I � r' N 4 tier � N y l r' 9'-10" 2'-7 1/2" 3'-9" fi__ __ _-- -__ 3'-5 112" ----- --___—_ _--____ _-- OD a j = 1 Estimates-To be written 1. Barcroft email see 2. Bevan-Bogart write 3. Demers SH green house door see 4. Krauth eve job write 5. Shae Great room write 6. Kaye Thatch J&J Friday Estimates-written 1. 17/19 Condo spring work 2. Community Enterprises back door Call 3. Frey pole barn 4. Frey floor& shed 5. Hackerson Mt. Tom spring work 6 Roof's eve 7. Krauth spring clean up write 8. • ceiling 9. Rolfe April 17 10. Sola bathroom 11. Sessions 3rd Floor 12. Athena Warren 13. Wolpin Trumbull 14. Wolpin Cherry Estimates-Wait 1. Krogius 2. Lovendale 3. izzi basement be d & bath 4. Morrigan 5. Shed laundry room 1 31—^ rF 6T-6t1 zS11===j Acheson Company �} T 44 Willow 21-31811 11-1 oil kitchen&bathroom 2'-7 1/2" r N C� r<. 4 _ 2,_5„ LO I N C) � � I r CO CF) C0 N ' r CO CO 1-2 31811 21-211 21-311 T-1 1 l2" City of Northampton , Massachusetts 4, Y DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 st+yY- jit 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): Address: 0c ()gra City/State/Zip: Phone Are you an employer? Check the appro i to box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 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. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. insurance. 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] 3.F-1 I required.] a homeowner doing all work officers have exercised their 11.E] 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' 13.❑ 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: PV_t_1 tk - Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: 4 kA City/State/Zip: Nt7ri r rc -,ee (� 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 D tlr.insurance coverage verification. I do hereby cep nder"'the p` ' a` penal 'es of perjury that the information provided above is true and correct. Si atur-- Date: 3G 1�l 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#: Version 1.3 Commercial Building Permit May 15,2000 SECTION.1Q STM' CTUFrA--L EEER'R X3.-1- ,'.5_i-"'Vr_ f -....+�•e.- .•'T_ - � Independent Structural Engineering Structural Peer Review Required Yes y No 0 SECTION 1I=QNVFIERz KtJ'GHORIZ TIQL+f sT"E 'E t' OWNERS AGENT-O' R'CONTRACTOR 'P IES-fORBuIE Dj f ' 21f1411.; as Owner of the subject property hereby authorize � Cl� CP�� -t !to act on my beha ,' all matt -rel veto work authorized by this budding permit application. Signature of Ow ne Qate — _ - _ p 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. Sin er a pains and nalh penu Print Name Signature of Owner/Agent Dat SECTION:12--CONSTRtI�T OMSER1ffGES 10.1 Licensed Construction SSUR%n isor. Not Applicable ❑ -Name of License Holder y—��*�1`' - °-°-— L — - Ucense Number Address lExp�iration Date 3 Sign a Telephone SECTIDN:13 YIfEQRf HS CPM ENS I TfOi�INSEiRA -CMAIEEIDL IV 6 E.c f1 • - F r 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 0 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement�ows Alterations) Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition Er New Signs [0] Decks [M Siding [0] Other[0] Brief Description of Proposed -CGIjr„ Work: RC�v R Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. if Neriv house"an'd or addit ion,to ezistini`_h"ousing, co npiettii if 1676 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. ��. D' ensions e. Number of stories? f. Method of heating? ?Masscheck pla s or Woodstoves Number of each g. Energy Conservation Compliance. nergy Compliance form attached? h. Type of construction \\ i. Is construction within 100 ft. of wetlands?+ Yes No. Is construction ithin 100 yr. floodplain Yes No Depth of basement or cellar floor below finished grade 1• P 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 I, `.J( LL as Owner of the subject property hereby authorize to act on my r af, ifl all tters elative to work authorized by this building permit application. Signature of Ow er Date as Owner/Authorized Agent hereby decla at the stateme and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signef a pains and pen Ities pe jury. Print Name Signature of Ow Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: C_ X�.: .�� C S— 0 V/2 q-66 License Number 1, Addres Expiration ate ignature e o Elm`;Regisfered Home.lmprovement Contcactar Not Applicable £ Company Name Registration Number Al 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:-..xemption 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 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Tliis 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 a Special Permit/Yahance/Rnding ever been issued for/on the site? � ��. NO v�_�� DONT KNOW YES «��»r~t IF YES, date issued: ! IF YES: Was the permit recorded at the Registry ofDeeds? NO K � DON YES � � IF YES: enter Book Page and/or Documpnt# B. Does the site contain a brook' body nfwater or wetlands? NO 0 DON7 KNOW 0 YES 4M lF YES, has a permit been or need tobe obtained from the Conservation Commission? ��^�� n�- »�� Needs tobeobtained ��/v,� «_�Obtained x-� Date ' . -- �--- -� --� ��n'--- �� C. Do any signs exist on the proper� � � 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 d�& IF YES, describe size' type and location� � x E. Will the construction activity disturb(clearing, grading,excavation,or filling)over 1 acre orisit part ofa common plan ' that will disturb over 1acre? YES K 3 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ^ .' -- - City of Northampton Status ofPermtt � 1 s 'p r P it 4 5 kf i �'+�'�� ,f e� 5 �� ,, I Building Department Curb OUt/DCIe�vay Perrrit#vt n k D i , {�x i j 212 Main Street Seyrer/SeptieAvaital(ity i�. �k vix ri JUN — 2 2014 Room 100 MNater/lhle�EA�a�laIlltj� ' s ' Northampton, MA 01060 _T 1" Plans' 4 EI trio, Plumbing&Gas Ins e 13-587-1240 Fax 413-587-1272 PfoUSit�rl pians '�'' Northampton, MA 01060 f APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE.INFORMATION This secf�orr to be completed by office 1.1 Property Address.- w :\\d v: � r � Map Lot Unit 'FV�QaA.-,ce t G l 0462- =Zone Overlay Drstirict _Elm St:District CB District SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: , 1, c` CCU e� Name(Pri t) _ Current Mailing Address: e Telephone Signature 2.2 Authorized Agent: � �\ �'� ��'��ov.M\.e"v;1)1 �•�'A`— O i 0 , Name(Print __ Current Mailing Address: Signature Tele one SECTION 3-ESTIMATED CONSTRUCTION COSTS. Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building CCU (a) Building Permit Fee 30 c1- 2. Electrical 56) � � (b) Estimated Total Cost of Construction'from 6 3. Plumbing Cj 22 Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Z5 CU Check Number 5.9 6 This Section For Official Use Only Date Building Permit Number: Issued: Signature: C f Building Commiss'ionedinspector'of Buildings Date 44 WILLOW ST BP-2014-1279 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23C-049 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-2014-1279 Project# JS-2014-002149 Est. Cost: $20025.00 Fee: $120.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: R DEAN ACHESON 83968 Lot Size(sq.ft.): 57499.20 Owner: ST COEUR JILL Zoning: URAO16)/WSP(11W1)/WP(92)/GI(0) Applicant: R DEAN ACHESON AT. 44 WILLOW ST Applicant Address: Phone: Insurance: 6 NORTH MAIN ST (413) 268-0246 WILLIAMSBURGMA01096 ISSUED ON.61212014 0:00:00 TO PERFORM THE FOLLOWING WORK.REMODEL KITCHEN & BATH 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 Siiinature: FeeTvpe• Date Paid: Amount: Building 6/2/2014 0:00:00 $120.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner