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25C-231 PROPOSAL No. l 2I t Date S 2c�Zi3/ Sheet No. Proposal Submitted To: Work To Be Performed At: n 1 N rT,,_ . Street City State City State Phone Date of Plans Architect We hereby propose to furnish the materials and perform the labor necessary for the completion of Pt- " V'-4-?IC-4 s r C ,_, 19 .1 L -Are c4-j ✓^c �' i Et" i n`v:�i w ,-<-� ,�('�`'V��Z s i�� � PG�i 2 c Z �z sit e-G-=-- �[�'�/`e��1�r• C� 3 i7,0L _ ` , n x� -57-f �. G` ✓&YJ E6C <<J j�^t C /1� �.✓ �f fin, i s r G -�� N�o �� l F V-T c44--- -�- A �c "A ►T6 V 1,9- L L- --:F.--' C 0 �.j t-O 7-6 19A 7 ��= PC_`'F1�r S f— 4_i.[_ :f't� A4 c. 1/,4 L- , All material is guaranteed to be as specified, and the above ;;r n .�d n accordance with the drawings an:� specific �hmitted for above work and complet,d r kmF-i Gke rnar0.1 for I,e L"��t V N��t �� gllars1$ With n a a= fnllrn,%s .S' C-';- 7 �` e- L f�(' :S_(�\' f e-kl I _:��' (-! �� �'l._L-�-� Q t- ��� f"!tom- ,✓'r� l`L;•-' �� V .. �Z I t. � PTA �O e 'Nartilalliptoll g6 �ilasartrhttsctts m DEPARTMENT OF BUILDING INSPECTIONS 212 Alain Street • Municipal Building Northampton, Mass. 01060 ' WORKER'S COMWENSATTON INSURANCE A r AV1T (lic�tls^ciFcrmittcc) --------- "nth a principal place of business/resideuce at: 2 — 8`/'— C//72- (Strr.:t/ci tN 1st atd-r�p) do hereby certify, under the pains and penalties of pergtlry, that: O I am an employer providing the followint - orker's compensation coverage for my employees wor4cing on this job: (Lnsiranc~ company) -----(POIic:Nttnber) ---- (ExpirdonDate) ( ) I am a sole proprietor, general conu-actor or hotneowner (circle one) and Have hint d the contractors listed below who have the fo11o,Ving workers compensation policies: (Name of Contractor) (Insurance Company/Policy Numbcr) (Expiration Date) (Name of Coutr<ctor) -- (Insurance Compauy/Policy Number) (Expiration Date) (Name of Contractor) (Insurancz- CompanyiPolicy Number) (t:x,:.ration Date) (Name of Contractor) (LmLmnce Company/Pohcy Numb-r) (Expiration Date) (attadt additim�l chcet ifncceslr:to i:tchxic i:Zcczni.iec pataiainr,�ell c :�adei,;:.) - ` ( I am it &g e "'"r and have no one v..orking for me. ( ) I and I? lionle O\Vlle: pelforinlng, 111 the myself. NOTE:please be aware ttut\ti ilc bccnco\\tr_n\%bo r. ploy r, :s to c.) tr,air N'vlk en a Q\.ctli:&cf not mocc than ttuYw unit-s in u{iidt the h-,---Dwocr mina cc at tht g..cn.+s zp x,t,artt thereto a c rxt Ccncrally cccjid:rtd to be cntploylm under the wotk er cicx,saticn Act(GL152,=1(5))•ap;•ti_.,icn by a homco\vm for a bcuuc cc permit r.---y cv�kwc ti legal ctahts of an amploycr undor d.0 wo(kor's cotnpca•tion Ad.. I understand di t a copy of thi.cutcm.ca may bo forwn ded to tba Dcpwta—t of Ind+utrid Ac6'may OfGcw of 11 s" 'o for tl=c coverage verification and that failure to:xttrc covmgo tu-.d.-r scctiai I 5 of MGM,152 can Icad to tho imposition of cricnin l pccalt:cs oomiatutg of a fine of up to S 1 500, i:uprisoctnx of up to err}tar n.d civil perultia in tt c ftxrn o(n Step Wcric Ordr�-and a find o(S 100.00 a day aEairut trr_ - For dct.,-UDt dal u•c only permit Number _ lvf<zpll L.ot r SiguMure of Liccnsce/pumittee � S£CT'1042-„CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: 4 Not Applicable ❑ Name of License Holder : C 0, I�� License Number 2-5 cspw C _tea y V 7 Address Expiration Date Signature Telephone (] ` l 12-06 `f m pr vement,°oC'�'ntra for Not Applicable ❑ Company Name Registration Number -�f-PrL� (N 1/ 3677 Address Expiration Date 2C1 <<�l1(2`� E— � —O-L� Telephone 7 — �l �Z- ! l/ 12—a 0, SECTION 10-`WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152, § 25C(6)) 1 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...... IRL 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-DESt;RIPTION OF PROPOSED WORK(check all applicable New House ❑ Addition ❑ Replacement Windows Alteration(s)*\2k, Roofing Or Doors Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding Other [ ] �6 �,ySu Brief Description of Proposed Work: Rao P Sill^'G(.Sf J i IN I N Oa ws 6 Le-e_lc."Z(C �LuWQI ne(r-sNr� Alteration of existing bedroom Yes -*/- No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet 0 11a if Ne ho se H-d o addit on fo eXisti"nth using; complet tfi�f t"lo rd a. Use of building :One Family Tt�wo Family Other b. Number of rooms in each family unit: I b Number of Bathrooms `3 c. Is there a garage attached?N d. Proposed Square footage of new construction. NO Dimensions e. Number of stories? f. Method of heating? Cr 5 (wA irepIaces or Woodstoves © Number of each g. Energy Conservation Complianc A Mascheck Energy Compliance form attached? In. Type of construction e� 7`I LK Cr Iev.n)LEI < dN 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 0 , k. Will building conform to the Building and Zoning regulations? ___K1_Yes No . I. Septic Tank City Sewer yh<4 Private well City water Supply SECTION 7a OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AG3ENT OR CON TRACTOR APPLIES FOR BUILDING PERMIT` I' 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 l 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 Namr(�.& BLS' Signature of Owner/Agent Date t � Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF 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 % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 5C DON'T KNOW ' YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book _ Page _ and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES 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 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: r City of Northampton SusPermtt, 'Building Department COW Ct1t/Dr,ve 212 Main Street S� �rlSep�icA. Room 100 Wa e11 WelhR at Northampton, MA 01060w Sets fStr c Pal arts � r hone 413-587-1240 Fax 413-587-1272 Plot/Site Rla�ns Kg � OtherrSpeec ctfyz 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 - 1� Mo Map Lot Unit - k Q(e tt 0-h1 ��'�,( �'.•,/—� Zone Overlay District Etm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Np,4 Bo ti 39 .DIii.E lu I ,4A� . Name(Print) Current Mailin j3-Address: � s 95 — 00 / 7 S f: COCAYA c� Telephone Signature 2.2 Authorized Agent: ('tc+4- 11vH ! A_/ C jku 2y DR -F-`c._o rte-* c�- Name(Pr in Current Mailing Address: ✓r' 8 Y— W 72— ---— Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars) to be Official Use Only completed by ermit ap licant 1. Building (a) Building Permit Fee S d izA . by 2. Electrical > (b) "::aimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee A> cyu , •v 4. Mechanical (HVAC) ' 5. "Fire "Protection 25 6VD - W 6. Total = (1 + 2.+.3 + 4 + 5) t — Check Number ,,�h ?S` This Section For Official Use Only Building Permit Number: Date Issued: Signature:. Building Commissioner/Inspector of Buildings Date- File#BP-2003-0719 APPLICANT/CONTACT PERSON Richard Finn ADDRESS/PHONE 29 Hickory Drive (413)584-4172 PROPERTY LOCATION 157 BRIDGE ST MAP 25C PARCEL 231 001 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 7 5 7 '- Typeof Construction: ROOF SHINGLES,SIDING,WINDOWS ELEC&PLMBG SHEETROCK&INSULATE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 050848 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF,ORMATION 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 S t Commission d Signature of Building Official ate 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. 07 / ;- r'-Cfic'7/o2� 1 �� 157 BRIDGE ST BP-2003-0719 csls it: COMMONWEALTH OF MASSACHUSETTS "!ja•.Block: 25C..231 CITY OF NORTHAMPTON Lot: -001 Permit:.__ Build ng twat _ BUILDING PERMIT Permit# BP-2003-0719 Project# )S-2003-1164 Est. Cost: $75000.00 Fe�:_27 x.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: license: Use Groin: Richard Finn 050848 Lot_size s . ft. : 5837.04 Owner: BOMBARDIER RHONDA S CICHY& ZOtlLlg_LJRB Applicant: Richard Finn AT. 157 BRIDGE ST ..*, Applicant Address: Phone.: Insurance: 29 Hickorv_Drive (413) 584-4172 FLORENCEK;01062 ISSUED ON:3110103 0:00:00 TO Pt.RFCIRM '1 CIE FOLLOWING WORK.-ROOF SHINGLES, SIDING, WINDOWS, E-LEC & 1111'iBG, SHEETROCK & INSULATE POST"r,I-1IS CAP-0 SO IT IS VISIBLE FROM THE STREET insI ector of Pluming -- Inspector o%Wiring D.P.W. 'r Iluildisig Inspector [!n�,er;�!.►u�id: e Ocrvice: Meter-, Footings: itoua ll: �s�7/,�' �/IRough: y/�� G House# Foundation: •iveivay ht.,J: I'tnai: CfA4.jr;-_ Final: Rough Frame: ' U UO Fire De artriic . +' Ii,eplace/Chimney. All .1s Smoke: Final: O Y' G-z J kill; P'.",R!Aff MAY BE REVOK!KD BY THE CITY OF NORTHAMPTON UPON-V4 OLATI OF Ol. ll'I'c MULE'S ANll REGULA ' ONO. CCFri_iflCilte Of )CCU!�cl l' Si nature: =� Receipt No: Date Paid: Check No: Amount: 3/10/03 0.00:00 21751 $275.00 ?7- lz 212 Main Sheet,Phone(41315.7--!246,i7ax: (413)557-1272 OC7? S� Building C or-njssio-er-Anthony Patillo