25C-260 Troposaf
vinyl st.ltt,�
Corbett Home Improvement
Northampton, MA 01060
(413) 584-6571
1'6,4')NAL SUBWITED I I PHONE 7,!;' DATE
12 � JOB NAME
I-ill-1-1 A IT,:11"ZIP C)ODE T,v JOBLOCATION
A r'C A
DATE OF PLANS JOB MONE
We heichy submit specifications and estimates tor:
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0 e-e-6,- Y,
lie, '7 jo e
4K1 -Tj—V L
We (J'h-opoSe hereby to furnish material and labor-ct q,1plele 111 accordance with I t I ke above,specifications,for the Suitt of
Dollars(S
1',} iivnis to he inade as follows
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t
All Authorized
jT' 'i.ijjdaropfaclices Any altercations or deviation tram shove specifications 111villving extra c('Slv will he Signature
up,ri written orders,and will become an extra charge over and ahtivc 11he estmiatc, All
I agrr 1HWn11 contingent upon strikes,accidents or delays heyond our control. Owner to carry fire,Ionia& Note: This proriosal stay be
ai,,!Ahvr iivcessary insurance. Our workers are fully covered by Workmen's C,miperisatwn Insurance withdrawn by us if not accepled wItj6II_day.,.
�cceptatice of Troposal-The above prices,specifications
u' —ndillons are satisfactory and are hereby accepted.You are authorized to Signature
iki th,work ass specified. Payment will br/ t 11 1 above
)aic of Acceptance: Signature
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SECTION 8 - CONSTRUCTION SERVICES
3-1-Licensed Construction Supervisor: Not Applicable ❑
Nameo_f_License Holder -
~ License Number
„ Expiration Date
azure Telephone
9. Regisfered hlorn Inibrovement'Contractor ,z. F.t ,rc�a� L.Au, .w ��a,.•:.- ;[ Not Applicable ❑
::ompany_NName Registration Number
;s Expiration Date
Telephones���� �57�
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this a`r
t �r, ',-;e denial of the issuance of the building permit.
Atf,da'f t Attached Yes.. .... a No...... ❑
11 Home Owner�Exemption
I he current exemption for"homeowners" was extended to include Owner-occupied Dwellings of one (1) or two(2) faml �-
and to allow such homeowner to engabe an individual for hire who does not possess a license, provided that the owner nct�
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 thc-
or is intended to be, a one or two family dwellim,, attached or detached structures accessory to such use and/or faun
structures. A person who constructs more than one horne in a two-vear period shall riot be considered a homeowner
''ho—icowner" shall submit to the Building Official, on a form aceep?able to the Build no Official, that he/she shall he
responsible for all such work performed under the buildint! permit.
,�s 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 he advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers tz�
1:mployecs for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for pers-)r
you hire to perform work for you under this permit.
1-he undersigned"homeowner" certifies and assumes responsibility for compliance with the State Building Code, City o`
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
N 5--DESCRIPTION OF PROPOSED WORK (check all applicable
I Addition ❑ Replacement Windows [Alteration(s) ❑ Roofing
Or Doors ❑
Biagi Demolition❑ New Signs [ ) Decks [ j Siding [ j Other f
posed `Mork S�77t►� goo
r:1 Yes - – Nu Adc'' rg new bedrourn _-
Renovating unfinished basement Yes
;meet
Ntw n_o:use;and or ad`dition�to ezistftig; housing; complet0th-e following:
�e gamily - Two Family_ Other _
t w,,minr of Bathrooms-
of.'ached?
of new construction. _ — Dimensions
F�repl, or woods`.ove Number
Mascheck Energy Compliance form attacned?
1 '? f we _.:IUS thin ,U i)laIf'
-,iiar floor below finished grade
--r to the Building and Zoning regulations? _Yes _ No .
ty Sewer Private well _ City water Supply
OtiYNER AUTHORIZATION - TO BE COMPLETED WHEN
AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the suhlec'.
to work authorized by this bu,1rf11)g permit apQ:ication
G�je
and information on the foregoing application are true and accurate, to the best of m
penaities of perjury.
Date
E Vu E !! o ampton
D
Buildin artment
12 Street !Y �
JUL 1 6 201 R om 00
'I
N ( t� ton, MA 01062
DE� MP10N In 0 0 N 240 Fax 413,587 1272 t $
NORTHAMPTON,
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
,TION 1 - SITE INFORMATION ` C���
gpert _Address .This section�to be coJmpleted,by office
Otf' �` �CaMTJ+J�'�t Map''' ,,,,• Lot y �: �� s°��Urtit`
,��,.x33. �!'� k ✓,
Zone` .0verlay District
Elm St. District CB District
T!ON 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
-)caner of Record:
otl:7 ,�✓
Current Mailing Address.
— — ----- Telephone —_
Au_t_horized Agent
CCV —6- t4e-&- V-- �toe,v 7
Current Mailing Address:
Telephone
-CT10N_3 -,ESTIMATED CONSTRUCTION COSTS
Estimated Cost (Dollars) to be Official Use Only
completed by perm t appl car'
(a) Building Permit Fee
(b) Estimated Total Cost of
Construction from 6
hi Building Permit Fee
nic,al
VA C) —
, P��techon
(1 + 2 + 3 + 4 + 5) -� Check Number
_. This Section For Official Use Only
^g Permit Number: Date Issued:
Building Commissioner/Inspector of Buildings Date
1"T�MMETARY : , < BP-2002-0054
GIS#: COMMONWEALTH OF MASSACHUSETTS
.« CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:roofin BUILDING PERMIT
Permit# BP-2002-0054
Project# JS-2002-0077
Est.Cost: $2200.00
Fee:$0.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Ed Corbett Jr 116069
Lot Size(sq.ft.): 829818.00 Owner: NORTHAMPTON CITY OF
Zoning.URB Applicant: Ed Corbett Jr
AT. BRIDGE ST - CEMETARY
Applicant Address: Phone: Insurance:
4 Reed Street (413) 584-6571
NORTHAMPTONMA01060 ISSUED ON:7116101 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE GARAGE ROOF
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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 Sienature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 7/16/010:00:00 0 $0.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo