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17C-017 (4) 1� 7�j �r Q6 10 /uovo, F--� _ a - r lorer-C�P, t4A- �i ex.Sk;�1 3 31 V f � r 4y�3 3�� �•, �� TyY �ot�- Northampton, MA Property Detail Page 1 of z City of Northampt on, MA: Residential Propertv Record New Search Propert y Type_Classification Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map-Block-Lot: 17C-017-001 Zoning: Assessr Location: 106 NORTH MAPLE ST Neigborhood: 5 Land: #Living Units: 2 Deed Book: 5420 Build] Class: R-104 Deed Page: 92 Total: Dwelling Information IF Building Sketch Style: Conventional Year Built: 1900 Story Height: 2 Attic: None Basement: Full 16 Total Rooms: 10 1�'Waod Deck Bedrooms: 4 2�s Full Baths: 2 Half Baths: 0 30 a Exterior Walls: Frame 1$ NUB 18 Unfinished Area: 0 (E 52 Ground Floor Area: 1152 Total Living Area: 2385 za 5 0 5 5 zs Finished Basement Living Area: 0 X 0 E�18 Basement Recreation Area: 0 X 0 3 Woodburning Fireplace 24 Stacks/Openings: 0 /0 Metal Fireplace 0/0 Stacks/Openings: Heat/Central A/C: Basic Heating System: Stream Fuel Type: Gas Quality Grade: C+ Addition Information: Physical Condition: Good Interior/Exterior: Same Condition/Desirability/Utility: AV Lower 1st Sto 2nd Story Vacant/Dwell/Oby Status: Dwelling ry C Basement One Story Frame lone Story Frame Additional Features: http://www.northamptonassessor.us/noho/propertydetall.php?map_no=l 7C-017-001&page... 3/11/2008 Page No. of Pages 7- PROPOSAL SUBMITTED TO PHONE DATE — , 11R-IIT JOB NAME, I ic CITY,STATE and ZIP CODE JOB LOCATION or,e ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: ea A- -' h, )X, A n cG7orv,-\ ?-V TIC "A rcoAc Vc '4 bt' bc X CN; v YC i^„L propOSC hereby to furnish material and labor complete in accordance with above specifications, for the sum of: dollars($ Payment to be made as follows: 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 strikes, accidents over and above the estimate. All agreements contingent upon Note:This proposal may be, or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. withdrawn by us if not accepted within days. Our workers are fully covered by Workman's Compensation Insurance. >Arreptance of proposal —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature/ ji to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature \ �oritceoa r TQY,:" �-.' \j ie } ! �;" q -a.,..-�.._............_._........�.....:-„...-._... ,ter_-y...../...r._- ..� ..... �. ......- _ 0-t S- fi t s� J a l �\ �rz ;III \l ' L vectC fZa Y r r 9 v Northampton, MA Property Detail Brick Trim: 0 X 0 +Open Frame Porchl Stone Trim: 0 X 0 10pen Frame Porch Remodeling Data: 10ne Story Frame Year Remodeled: 93 IFrame Bay Kitchen Remodeled (Y/N): Yes lWood Deck Bath Remodeled (Y/N): Yes Land Data Outbuilding Info Square Foot Type SQ Utilities Type Feet Value no Prime information Site 22,284 142,900 Type Qty Year Size 1 Size2 — no information Acreage Type Street/Road Type Acres Value no no information information Sales Info Permit Info Date J1 Type Price Validity Date Permit # Price Pur 07/01/19 jLand + Bldg 46,336 0 //9307 Land+ Bldg 23,700[::= no information http://www.northamptonassessor.us/noho/propertydetail.php?map_no=l7C-017-001&page... 3/11/2008 One y �I 4 j F x }ig l t - y 4 1 O 7%1 f lop P• 4 y, ,+.w,:ww..w..s,a.....«..-_.+m._......,.+a-.n,+�-..�. .:......x x......:. +,.....y....... �...r�.....::_. ..-...r���+^f+:«w...m --. ...:-... ..... 9 T ot< 4 IRA IT Jt I Y d l: a s13 „ l J 4' x10 �� ti ix Ae, CUSTOMER'S ORDER NO. PHONE DATE NAME ADDRESS SOLD BY CASH C.O.D. CHARGE ON ACCT. MDSE.RET'D. PAID OUT QTY. DESCRIPTION PRICE AMOUNT TAX RECEIVED BY TOTAL C PRODUCTS,o All claims and returned goods must be accompanied by this bill. ^"h i AW TRAVELERS J WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6KUB-0071 L65-A-07) RENEWAL OF (6KUB-0071L65-A-06) INSURER: THE TRAVELERS INDEMNITY COMPANY 1. NCCI CO CODE: 11347 INSURED: PRODUCER: BURROWS, BRIAN DBA BRIAN AXIA INS SERVICES INC BURROWS GENERAL CONTRACTING & 73 MARKET PLACE 95 SOUTHAMPTON ROAD SPRINGFIELD MA 01115 WESTHAMPTON MA 01027 Insured Is AN INDIVIDUAL Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 11 -21-07 to 11 -21 -08 12:01 A.M. at the Insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA o B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work In each state listed In Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 100000 Each Employee �-°— C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, If any, listed here: +� COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and schedules: o SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE o� a. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information Is subject to verification and change by audit to be made ANNUALLY. TRAVELERS J� WORKERS K ER SCOMPENSATION HE AND E MP L OY R E S AB Lf ! IT L YPOLICY °,— A Custom Insurance Pre BURROWS BRIAN DB A BRIAN BURROWS GENERAL CONTRACTING & 95 SOUTHAMPTON ROAD w WESTHAMPTON MA 01027 w ^w r o� w �_- Qw s� ' yi� J`JZ�� ��nz,aavnrtzl:�atf6t G�� sixJ.;tZ�:suvG Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: W / i":-m Board of Building Regulations and Standards Registration: 152935 One Ashburton Place Rm 1301 Expiration: 10/14/2008 Boston,Ma.02108 Type: BRAIN BURROWS GEN CONTRACTING&HOME IMP BRIAN BURROWS 95 SOUTHAMPTON RD. ,a.nGZ.aa.` — —=s- --�----- — _. WESTHAMPTON,MA 01027 Administrator Not valid without signature u Ionanu�n�W�l� o l�crs.u�c�us�l BUILDI License. C NSTRUCTN SUPERVISORS j Number: CS 092972 ? 10/09/1973 Birthdate: 92972 t Expires: 10109/2009 Tr.no: l 1 Restricted: 00 ;3RIAN BURROWS - 95 SOUTHAMPTON Roo 027 WESTHAMPTON, MA Cotpmissroner for <^rai.[an, MA QICoc The Sta,,2 of /f3SS2CL'L'S� aiIOWS use home vW ter the l:Z'ider%SvC-i'va I08.3,4 to >r r� T T 11^x".' `-`� Ti'•>. .Ci �� <::T f l+f l< H- s �{S) constu-L ct_cr -_ t:� d�.�nes nom: tivTle� t cr a� Iwho owns a parcel, on which he/sl_e resides or intends to be, a one or two family ,v ir:�, a.aclied or detached su L cures accessary to such use and/or fz 4 Tctin�es. persoa_vyho const-ucts more than one home iii a tWo-year period sl,,all not be considered a home owmer." T-he enl for h-e Clv� any per scn(s) who Seek to use the h6me OS4Mer ex=pLon, to act as tueil C riu ca^:nstrC- u —"W= SUP , twat by doi:` so you become responsible for compliance with state buUdin-codes and regulations. The inspection process-requires that the building depar=ent be called to insper worms at va ious sues, which include founda on/footinQs ('before baclTilll. so-notube holes (before oour). a rou?h building insnection (before work is car enjed i isulatiab in-sz;ectian (if reg.uired) an-d-, mal_b diva.irs-aectio.n_ The b Ti. ding depa=eni re mires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occuaancv u -w rlk-tar—be-insde`ted.- _ l tae meow Len hires other trades to per To=worl-(elects loaf, plumbing&has) tae ho=eow-ner-Will be res onsible to ma.'ce sure*hat the trades hired secure their proper pe�f:its In Ccnjurc`Lion to the building pe=—,L- issued, and that the-get their required inspections.Faihze of the individual trades to secure the permits and inspections as re wired can DELAY tae projec u_rtil sick time as the proper pe. its and inspections are made T Trderstand the above- (Home owner/resident's SiQnat-Jr e requestin=eleniption) I w11 rail to schedule a I rewired buildin,inspections necessary for the bu1IdinV pe=t issued to me. y Date Addiess_ott work- location Department ofIndatstrial Accidents — Ofjce of In vestig ations 600 f ashing ton .Street T�= Boston, ALA 02111 ;vw v.mass.gov/dirt Workers" Compensation Insurance affidavit: Builders/Contractors/Electricians/Plumbers Ar)21ic;tint Information Tease Print Legibly Name (Business/Organizationilndivi(qual): A AA . City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project(required): l.❑�I am a employer with 4. ❑ I am a general contractor and I employees (full andior part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ I�emodelin�C, ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.+ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions ❑ I am a i.omeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp, right of exemption per NIGL 12.❑ Roof repairs insurance required.] ' c. 152, §1(4), and we have no employees. [No workers' 13.7 Other comp. insurance required.] a.ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Ho-reo�vners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. c onu actors that check this box must attached an additional sheet showin-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. lain an ernplover that is providing workers'compensation insurance for my employees. Below is the'policy and job 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 tine up to S 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DI_=\_for insurance coverage verification. I do hereby certil,7 u-nder-tlrc-pains crud peer ies-o- peKjun,-that-the information provided above is true and correct. Sil riature: Date: Pl.cne =: �k___rrricini_zs.�e_o:21u__Du_._not�vriteinlhis_nreri�to_be_comoleied by city or town_ofj1ciai T Citw or Town: --Perrnit,license# � Issuing Authority (circle one): 1. Boa-d of Health I B-aheling Department 3. C1v1-i71_o1 n Clerk — Electrical Inspector Plumbin, Inspector I� o. tUther ,, �I SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: j3r}c,rt R"C(`c,•J5 C5 CRa41)A License Number %7 ZJ• ltd eS 1�cx►�►�}e�r1 MA- O 1 D Z 7 10 4cC1 12=9 Address Expiration Date �:�_ =-- Lf 13 SIR 20 Signature Telephone 9.Registered Home Improvement Contractor: Nut Applicable ❑ ►Sa9 3S Company Name 1 + + Registration Number 8ri 5(Ln 6Lkrib.J Cs�►ecu( Ce�4rexc ng f"tlme ir*��ro.�ew.e�'►� 10 h Lt/20k>9, Address 1 Expiration Date ciS S004.-Lw4en Cam' ttrt��n M-4 Telephone Hl3-S�7-£xi26 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M'.G L.c.152,§ 25C(6)j 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....... Ek No...... ❑ 11. - Home Owner Exemption 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 Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature 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 [0] Decks [K] Siding [p] Other[0] Brief Description of Proposed Work: Q"wQ1A% ©C iwJ -eX;S+iny i e%- c'5 Alteration of existing bedroom Yes X No Adding new bedroom Yes t No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet 6a If New house and or addition to existing housing, complete the following: 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 l 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 , 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 Name Signature of Owner/Agent Date 1 4 Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete 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: 5— Rear -- -- _._. .,_: Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bldg&paved J" parkin_) #of Parking Spaces Fill: (volume&Location) _. ......... . .. A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , 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 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 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 2,42 Main Street Sewer/Septic Availability -- - - ^-" Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans �yE R pb&e 8-58 40 Fax 413-587-1272 Plot('Site Plans ,SS Other Specify 4 AP ION TO L0► �.7t UCT,AL ER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 6 SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office IOE I1/c�,1t,� rqie St. Map Lot Unit r l'egce MA Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: -et Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: Rr;c.n `f5 1-,xk-Z4c,\ i?,A. Name(Print) Current Mailing Address: /'i1 14 _ 413 P9a tD Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com leted by ermit applicant 1. Building b s� (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 Z it 6. Total=(1 +2+3+4+5) T �3 6Sv.o,, Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Cornmissionerllnspector ofBuirdmgs--- Date File#BP-2008-0771 APPLICANT/CONTACT PERSON BRIAN BURROWS ADDRESS/PHONE 95 SOUTHAMPTON RD WESTHAMPTON (413) 527-8920 PROPERTY LOCATION 106 NORTH MAPLE ST MAP 17C PARCEL 017 001 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: REBUILD 2 PORCHES New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 092972 3 sets of Plans/Plot Plan THE FqLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON 1 N F M ATION 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 Commission Permit DPW Storm Water Management Demolition Delay Signature of Building Official Dat 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. Ftwwnr A � "k City of Northampton BUILDING INSPECTION LABEL i4d �V �P P FR V E I Inspector Date a ' BP-2008-0771 106 NORTH MAPLE ST COMMONWEALTH OF MASSACHUSETTS GIs#: CITY OF NORTHAMPTON Mau:Block: 17C-017 Lot: -00t PERSONS CONTRACTING SS TO THE GUARANTY FUND (MGL 142A) Pernrit: Building DO NOT HAVE ACCE BUILDING PERMIT. Category: Permit# BP-2008-0771 Project# JS-2008-001192 Est. Cost: $8650.00 Fee:-$-50.00 Cost. $ PERMISSION IS HEREBY"GRANTED TO: Contractor: License: Const,_Class_ BRIAN BURROWS 092972 Use Group: Lot 4'ze(sa ft). 22302.72 Owner: JENKINS MARY ANN Zoning: URB A lica�tt: BRIAN BURROWS ---- A T- I 00, i ORTI-i MAPLE ST_ - - - phone: Insure: Applicant Address: (413) 527-8920 95 SOUTHAMPTON RD WESTHAMPTONMA ISSUED ON:3/24/2008 0:00:00 TO PERFORM THE FOLLOWING WORK:REBUILD 2 PORCHES POST THIS CARD SO IT IS VISIBLE FROM D.P.W.THE STREET Building Inspector Inspector of Plumbing Inspector of Wiring Service: Meter: t'ndcrzt,rountl: Footings: Rough: Rough: Rouse# Foundation: Driveway Final: Final: Final: Rough Frame: Fireplace/Chimney: Gas: Fire Department Insulation: Rough: Oil: cinai: OK Final: invoke' CIHS PERiNUT MAY B E REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Si nature: Certificate of Occu anc �+ aid: Amott:Da e t Feel P: Building 31124/2008 0:00:00 $50.00263 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Conunissioner-Anthony Patillo