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17C-106 (2) J�F ��amrvn�r�a�i ¢�=���za:taclztute�Ca Board of Building Regulations and Standards T HOME IMPROVEMENT CONTRACTOR.. Registration: 149288 Expiration: 12/15/2007 Type: Individual TIMOTHY J LUCE TIMOTHY LUCE 122 AUDBON RD. �.rf.-�° ,�Tt*✓ LEEDS,MA 01053 Administrator License or tegistration valid for individul u before the expiration date. If found retu only Board of Building Regulations and S rn to to: One Ashburton Place Rm 1301 Standards Boston,Ma.02108 Not v id out si gnature 4StlAAIP�' r 3 • Oi � � �iassacl�useifs DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR "212 Main Street • Municiptl Building Northarnpton,MA 01060 - HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as-his/her construction supw visor. The state defines"Homeowner" as, "'Person(s) who owns a parcel on which he/she resides or intends to be,a one o`r tivo f� 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 home owner." The ui ng department-for�We City OTN rftmpton Wants-MYperso }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 fegulations. 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 roueh buildintinsoection (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, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit - issued-to-me. _ - - Dates Address of work location r t J1. Lx t -s 0 r w`Q DEPARTMEI.rT OP BUILDtJ�,,G INSPPCTIONS 212 Main Street Municipal Building ' Korthampton, Mass. 01060 WO-Iual it's C01ITENSATIO.N MSTMA. I'CE A , , A.V1T' Lu cE __..._._..._._.._._. _ -- pi ccnscclperm;ttcxx) • %,ktith a principal place of business/residence at: ko,/I _ (phone 41:3- 39q— EOO --- (satxr/ci t-�/SUttJa p) do hereby cerdfy, under tbe.p?ins and penalties of perjury., h?t ( ) I :rn an employer providing die Poll I XVIDQlv:orf:cr's cornpcnsa:io;z Cove=. ove��e for Inv etuplovices worlaing on tills job: (In_nimnm CO nn: ') (Polic:Numb r) (a-pir-atiorr Dai--) ' ( Y1 am a sole proprietor, general contractor or homeoi�r-ner(ciscie.one) and have hired the coaa-a(:tors listed below wbo have the following worker's comoens2don pakles: ('`i lw= Of Con-t^acii-) (lnsuran= CoinpaMv?ouc (YtipIrajon D.itc) (N.mc of Conamaor) (1ns''ara cc CompanvJ?OjCv `urnc_r) (-Lt-ptr.tioA Date) (Name of COUMCIa;) (Insul-anc—c Compan y/Policy Numba) (Exaira6o3 Date) (Name of Contractor) (Insiaran<--Comrany/Foticy Numbrr) iEapiraon Date). ca'aa/,.ddi 051 cC.ifuec�rti•to ctc'udc iar«m.3cc peruiainc w.A aoc-_coa) (1 1 am a salc prepretor and Save no one working for me. ( ) I am:a home owner performing all the work thyself. NOTE:pies=be aurart tbe.%mac hcc=O, n.v50 ct=ploy peom to d�r. ,.-. �raao a rgaa work a�a d t!L of aoc mats the o it:--tea in aa'ach the bomoowuc rondo or ac the Veua6 spp=%--�the eo et am C= -Jly oee-d,-od to be �IO�"'�`_�wa'1:c�Y�'�---•'m Aa{GLIl S?.a t CS)��ptiatioo by a homm4ac fc a lick or pcmit rzr nidcxc cLL Iesai ns:ta[of as—;Ploys under dto woke.Goosq..c,,a Act. [404e+e-ad that a copy of tbie+nI-ttbay b.for.,wd.d to th.Dep.rtmem orlD&L3:rW A.4..3 Off w of 4svnooa for tb. —V-Xf c"ciGetiaa and that i drat to[=tarn:tooaor v tmdct-c iow23 A of MOL 152 cao Ie d to the e=,o tioa o(cimioal penalties eomi.iaa of a rt=e orup to S I„}00.00 arolce�iaa�o(up to one y-rr r_ad ei%-a peoahuo io 6�rortrt of a Stop Work Ord=+ad a rte o(SI00.00 a day apjt mr For dct7.rtc+=si u.e only SECTION A-CONSTRUCTION SERVICES J 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address E)piration Date Signature Telephone S�Reaisterir�re' tnvra�emtrls o Not Applicable ❑ 07 L,v c...r— Comparn Name Registration um er Adoresss Expirationpate Telephone 4/3-S a -WORI RS : N SECTION 10- COMPENS/ O NSURANG LG 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...... ❑ 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.C—MR 780, Sixth Edition Section 108341. Definition of Homeowner:Person(s)who own a parcel of land on which helshe resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached stuuctures accessory to such use and/or farm structures.A person who construSh more than one home in a two-year period sbaR not be considered a homeowner. Such"homeowner"shall submit to the Budding Official,on a form acceptable to the Building Official,that he/she shall be responsible for aU 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 Hable 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 r I l , SECTION 5-DESCRIPTION.OF.PROPOSED W.ORIiC(ccheck,al"Policable) New House Q Addition Q:;: Replacement Windows Atteration(s) Q Roofing Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [CI] Decks [p Siding[Oj Other[01 Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet a- 1J d bu ding:One I•amil, Twn 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. 1. Septic Tank City Sewer Private well City water Supply SECTION Ta-OWNER UTk N61ikTl N �TOa$)rOrJIfIIP ED`wn OWNERSAG&tbkGONTRA ORi PETE fOR'B�]ICtXIt PER1YItt as Owner of the subject property r hereby a nze on M behalf,in all matters r ativ to work d by this building permit application. Si - Owner Date L c e ,as Owner/Authorized Agent hereby declare thfat 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. lmorhu U Print Na / Signature of OwnerlAger 'Date Section 4. ZONING AU kdormsFtbn(dust Be Cornpk t>ed.Permit Can Be Denied Due To kwompiete Won=ion Existing Proposed Required by Zobing Thus cobmm to be felted in by Burldin8 Dgwunmt :r Lot Size Frontage Setbacks From Side L= R:f ! 'L= P- Rear �-� �^ Building Height !4 - Bldg.Square Footage % j Open Spwe Footage e #of Pwidug spaces Fill: f ' (voh m ik t ocatioa A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DON'T KNOW Q YES IF YES, date issued: } IF YES: Was the permit recorded at the Registry of Deeds? NO © Dow KNOW Q YES 0 IF YES: enter Book I Pager ; and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 Dow KNOW Q YES Q IF YES,has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained 0 Date Issued: C. Do any signs exist on the property? YES 0 NO 0 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 Q IF YES, describe size, type and location: i i E. Will the construction activity disturb(dew tug,gradliv,excavation,or fitAirig)over 1 aere or is it part of a cominon plan that will disturb over 1 acre? YES © NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW Is required. �t R City of Northampton Building Department 212 Main Street Room 100 Northampton; MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR 18IIOLISH A ONE OR TWO FAMILY DWELLING SEC170N41t�MtFORtiAA'E10Nt g 1.1 Pruoerty Address: /,LM tild ."•*stia' `�"r'U.;" '��1..�-.a.'—t-.�a' "�^'�,� „�. �� f� .sew--+s � SECT-10 2 y 2.1 ` of ILA Telsphone SkjKature 2.2 Autho ed Aaerit~ Current Wiing Address: Sigrahxe Telephone llt _ Item Esftated Cost(Dollars)to be 016c iai Use Only feted by eirem aswarit 1. Buildinga `utgPelmiit Fee 0 2 Electrical ,. j froir of ignicti 3. Plumbing - BuPen7ufee 4. Mechanical(WAC) S.Fire Protection 6. Total=0+2+3+4+5) L JC7, Gtiedi Number z .. Thts'SactiiidEr`°t�ir-E�Ose:, $aTd"ingPerrru't;Num6er=- � '� Signature. r Bui�ng:Commissioner/lnsps of&ddiirgs- ode 75 HIGH ST BP-2006-0982 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C- 106 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: roofing BUILDING PERMIT Permit# BP-2006-0982 Proiect# JS-2006-1460 Est.Cost: $l 1500.00 Fee: $25.00 PERMISSION IS HER F,BY GRANTED TO: Const.Class: Contractor: License: Use Group: TIMOTHY J LUCE 149288 Lot Size(sa.ft.): 10323.72 Owner: STONE SUSAN C Zoning:URB Applicant: TIMOTHY J LUCE AT: 75,HIGH ST Applicant Arldressi. Phone: Insurance: P O BOX 14 (413) 387-9800 LEEDSMA01053 ISSUED ON:312312006 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. OL(1 2,,7/06 THIS PERMIT MAY BE REVOKED BY THE CI Y OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu anc Si nature: FeeType• Date Paid: Amount: Building 3/23/2006 0:00:00 $25.008587 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo