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C i Wcv { s S l � 1 s k , i k j3 j r FF C J n- 12-Iq Northampton, MA Property Detail Page 2 of 2 Brick Trim: 0 X 0 Lower I 1 st Story I 2nd Story Stone Trim: 0 X 0 10ne Story Frame Half Story Fram Remodeling Data: jEnclosed Frame Porch Year Remodeled: 0 jEnclosed Frame Porch Kitchen Remodeled (Y/N): lFrame Bay Bath Remodeled (Y/N): Land Data Outbuilding Info Square Foot Type Utilities Type Feet Value no Prime information Site 4,500 122,630 Type Qty Year Size 1 Size2 Grd RG1 � 1925 0 252 Acreage Type Street/Road Type Acres Value no no information information Sales Info F Permit Info Date Type I Date Permit # Price Put 01/17/2002 Land+Bldg 160,000[= ino information http://www.northamptonassessor.us/noho/propertydetail.php?map_nO=25 C-104-001&page... 4/27/2007 Northampton,MA Property Detail Page 1 of 2 City of Northampton, MA: Residential Property Record New Search Property Type_Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map-Block-Lot: 25C-104-001 Zoning: Assessr Location: 29 GRANT AVE Neigborhood: 8 Land: #Living Units: 1 Deed Book: 6507 Buildi Class: R-101 Deed Page: 261 Total: Dwelling Information F Building Sketch Style: Conventional Year Built: 1908 Story Height: 1.5 Attic: None Basement: Full Total Rooms: 7 15 6 Bedrooms: 2 EFP 72 Full Baths: 2 Half Baths: 0 32 Exterior Walls: Frame Unfinished Area: 0 2 D Ground Floor Area: 1123 60 1.5Fr 2 Total Living Area: 1981 7 Finished Basement Living 0 X 0 Area: s Basement Recreation Area: 0 X 0 Woodburning Fireplace 0/0 3 Stacks/Openings: s Metal Fireplace 25 0/0 Stacks/Openings: a Heat/Central A/C: Basic Heating System: Warm Air Fuel Type: Oil Quality Grade: C+ Physical Condition: Average Interior/Exterior: Same Addition Information: Condition/Desirability/Utility: AV Vacant/Dwell/Oby Status: Dwelling Additional Features: f--� http://www.northamptonassessor.us/noho/propertydetail.php?map_nO=25C-104-001&page... 4/27/2007 04SK�1p�0 $ � �rlassadtusrffs - n DEPARTMENT OF BUILDD\,1G INSPECTIONS /= INSPECTOR 212 Main Street • Municipal Building >a, ,. Nortlu-anpton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as nis/her construction sups::,, sor. 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 -homeowner." 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, d/ understand the above. (HoAe rner/r ent's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date y I � d Address of work location �C2 C1` � A�f- 1, 6✓,./ a The Commonwealth of Massachusetts r Department of Industrial Accidents qz� W Office of Investigations �1 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 441'7 Address: 2-Gl City/State/Zip: A,-. /V / - Phone#: 1-112, j b 1 C7 Are you an employer?Check the appropriate bog: Type of project(required): 1.0 I am a employer with 4. F-1 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.0 1 am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance. $ 9. E] Building addition required_] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners 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 andjob 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 pains and penalties of perjury that the information provided above is true and correct. Si ature: ''`I Date: V , 2-1 _ Phone#: &6- 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 License Number Address Expiration Date Signature Telephone 9 Rdgistered Home lmprovemerif Cori"tractor, m „-. ,°,`,..,, 4.._ _,-x... Not Applicable Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT T(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...... ❑ I It Home..Qwner Egeriiption 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-vear 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 ca o ' g L s and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check.all applicable) New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [lam] Decks 14, Siding[nj Other[[D] Brief Description of Proposed Work: /14 n 0/ 71 l Z k /cj z2G c < - Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa._lf New house and or:additionto ezistinq housing;- the following: a. Use of building: One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms 2- c. Is there a garage attached? d. Proposed Square footage of new construction. 2 Z J Dimensions e. Number of stories? / , 3- f. Method of heating? (I/ L Fireplaces or Woodstoves -1 C ) Number of each i g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction_ W,,111) C i. Is construction within 100 ft.of wetlands? Yes P' 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? A'�f 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, '� °iZ '� as Owner of the subject property j hereby authorize S to act on my behalf ' �r ' ork author ized by this building permit application. Signat of Date I, as Owner/Authorized Agent hereby de that the atements and infor ation 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 Y , 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 to t tC Building Department Lot Size _...�.! TI- -- --.-- Frontage ---- - --- - Setbacks Front j - �-�- , - - � Side L W��_.� R�� L:��- R:_,�i Rear 7 ' V Building Height Bldg. Square Footage % p Open Space Footage a� (Lot area minus bldg&paved r '/ 6 parking) #of Parking Spaces - Fill: - -- Al�� (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO � DONT KNOW Q YES 0 IF YES, date issued:. IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO G DONT KNOW 0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES NO 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 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Departmetuse an}y _City of Northampton Statuso ermtt x - \' Building Department Curb€taUDfivewayPerrratt 212 Main Street Sewer/SeptrcAvailabikty Room 100 VSiaterfVlfell Av �tab�laty r�y!) Northampton, MA 01060 Two Sets of Structural Plans �.'hone 413 7587-1240 Fax 413-587-1272 Plot/Site Plans` Others eci P fy=.. APPLICATION TO CO* 'ERUCT,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: ✓ iv C� t� Map Lot Uc�it Zone Overlay District t ��//2 � Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: 7 Telephone Sign ur 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 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) 4 V p7l Check Number s This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector'of Buildings Date File#BP-2007-1001 APPLICANT/CONTACT PERSON MORIN JEFFREY A& ADDRESS/PHONE 29 GRANT AVE NORTHAMPTON (413)586-3987 Q PROPERTY LOCATION 29 GRANT AVE MAP 2 5 C PARCEL 104 001 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 Typeof Construction: CONSTRUCT 12 X 19 DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INSVIATION 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 Commissio 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. BP-2007-1001 GIs#: COMMONWEALTH OF MASSACHUSETTS !' t: 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-2007-1001 Project# JS-2007-001622 Est. Cost: $1000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq ft.): 4486.68 Owner: MOM JEFFREY A& Zoning:URB Applicant: MORIN JEFFREY A & AT: 29 GRANT AVE Applicant Address: Phone: Insurance: 29 GRANT AVE (413) 586-398Z_0 NORTHAMPTON MAO 1060 ISSUED ON:51712007 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 12 X 19 DECK 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 5/7/2007 0:00:00 $50.00114 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 29 GRANT AVE BP-2007-1001 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25C- 104 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Pert: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2007-1001 Project# JS-2007-001622 Est. Cost: $1000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 4486.68 Owner: MORIN JEFFREY A& Zoning:URB Appiwant: NA.O(R J`!Vrm T Fi Oc AT: 29 GRANT AVE Applicant Address: Phone: Insurance: 29 GRANT AVE (413) 586-3987 O NORTHAMPTONMA01060 ISSUED ON.5/7/2007 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 12 X 19 DECK POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring �S��t Underground: Service: <. `, ®t:° City of Northampton Rough: Rough: BUILDING INSPECTION LABEL Final: Final: ld0/ inspector Gas: Fire Department Date Oil Insulation: Final: Smoke: Final: 0 L7- 0-7 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS, �! Certificate of Occupancy �'" =�t�--�" Signature: FeeType• Date Paid: Amount: Building 5/7/2007 0:00:00 $50.00114 212 Main Street,Phone(413) 587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo