The URL can be used to link to this page

42-129 13rapasal Page No. of Pages NEWMAN'S CONSTRUCTION 697 Bridge Rd. Northampton, MA 01060 1139 413-586-1093 PROPOSAL SUBMITTED TO PHONE DATE STREET JOB NAME >>aoc- CITY.STATE and ZIP CODE JOB LOCATION > d,2nc�� , 4 a�a 2 y'�6 �SJ_`a•y�f,�I , ! /�� ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: OQ/� _.L,, s/�� y•�/".4r � c _ vr��f�c% .��` oa ¢zs�z.Yi�� S�•z � ct_s _ _ JC 3'f�// �'7`� G✓�� 7zs!,� .� _ .ts _�z�a f �/c✓�1 -sZl � Jf/p-t-�� 1�1 / loc-► ��_ .�3__ �r�rJi✓;-�/7 __ Al"07- _ ;17!5/&// OG-L fir_P2 /I=-71-1 p✓f/2 Wr prupgSr heretLv to furnish material and labor—complete in accordance with above specifications, for the sum of: ✓L Aan 4-- arl --- na dollars($ Payment to be made as lows: a' All material is guaranteed to be as specified- All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders, and will become an extra Signature charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This pr sal may be / Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not ac epted within Q days. Aire 1taure Of proposal —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. P yment ill be made as outlined:above. Date of Acceptance: �� 0 Signature z ,5 NORTHAMPTON . C.ITY OF Construction Deri i vi In accordance with the provisions of MG.L. c. 40 § 54, all debris resultingfrom any work --=:__-- cover-ed=by-a-Building Permit halt be disposed of in a-properly licensed disposal facility, _ - - - as defined by M.G.L. c..111- § 150A. Address of Work: z the,debris-will.be-transported by: - The debris will be received at: .. Signature of Permit Applicant Date Building Permit Number: r SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ a Name of License Holder: y A,25 w yh Ar ©A Y ` 6 License Number FZ (� cvM Y h�J Address Expirati n D to -(a 13 Si nat Telephone Not Applicable £ 9 Registered Home Imarovement Contractor :_. _, _,. . , ., .... PP / Co as y Name }S Registration Number 4 �., � �5.t ms.µ. � Address Exp tiara on-tea e 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. Ho-me Owner Ege"mption 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, t. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding [0] Other[01 Brief Description of Proposed �L Work: Alteration of existing bedroom Yes / No dding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. If New house and or'a diti6h to'existinq hou"sing complete.the followingl: 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. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction 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 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 1 , 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 1 /V as Owner/Authorized Agent hereby a are tha t e 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. Cy �'fWl,,Ad4 Print Z A7' Signature of Owne Ag nt Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zo ' g' This column to be filled in by Building Department Lot Size - Frontage Setbacks Front Side L:` I R:`___ LI—D R:I i Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved __._ ___,. parking) #of Parking Spaces -- — ..........._..,_.....,._.. .._M_. . Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES Q IF YES, date issued:' _T-y IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW YES 0 IF YES: enter Book L_ Paged and/or Document#L 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 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 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. Department use only R �n City of Northampton Sfatu ,ofPernir< "s kµ 3 ll V Building Department CUr�cut�Dne�vayetmtt i'` 212 Main Street Sewerlsepflcav'al.r'ibilty ` OCT 1 7 2014 Room 100 waterMtellavatlabllity}11 orthampton, MA 01060 Two Sets df StFUCtriral'Plarts leetric, Plumbing&Gas orie 3-587-1240 Fax 413-587-1272 ,.PI*of7Ste Plans; t ,i...... , Northampton,MA 01060 OtfterzSpec�fy h APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This seci►on to be completetl by office = ': :'Map _ � Lot Umt :Zone Overtay D�strtct - Elm St District CB District SECTION 2.-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: Name(Prix ) Current Mailing Address: Signat re Telephone SECTIO ESTIMATED CONSTRUCTION COSTS. . Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant O 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) Check Number This Section For Official'Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector'of Buildings Date 946 WESTHAMPTON RD BP-2015-0445 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 42 - 129 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2015-0445 Project# JS-2015-000819 Est. Cost: $6400.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CYRUS NEWMAN 064690 Lot Size(sq. ft.): 15594.48 Owner: BARANOWSKI CHARLES W JR Zoning: Applicant: CYRUS NEWMAN AT. 946 WESTHAMPTON RD Applicant Address: Phone: Insurance: 697 Bridge Road (413) 586-1093 NORTHAMPTON MAO 1060 ISSUED ON.1011712014 0:00:00 TO PERFORM THE FOLLOWING WORK.STRIP & SHINGLE ROOF 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 10/17/2014 0:00:00 $35.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner