17A-207 (7) ,
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SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
W �' �t�b�„�-s a 8'V #--c a
Name of License Holder:
License NumbNei
JVT Pt)4- ,H-MP-fo r� M,4- 3
'
Address Expiration Date
Signa re Telephone Q CGJ
91.`Reglstere'd Home ImproveKnent Ccinfractor.,: Not Applicable ❑
W—(,t)+-r— 6wI'c�ex-s
Company Name Registration Nu ber
�f 8 h —� sue'. , 103 R7r 6-4AP-f-bfJ M� b/,"���
Addr Expiration Date
1�- /Z;l /&, 0 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...... ❑
. -,HOW f`Wner Exe�ip'�ian.
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
s - �
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alterations) ,� Roofing
dr^Dt7orr
Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks .[Q Siding[O] Other[E7]
Brief Description of Pr s d 6 f4E ....
gggg i �
Work: f 0
1- OLIN'//J N UL-1 3'"� o Iw/�Gt� �j`l.�'NF I��AP�CA- 11'I��N
Alteration of existing bedroom Yes__X_No Adding new bedroom Yes _No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa' tf NeTvtr t><a rse akr:d..ot`;addltlon, ' e li` 1Lh o�tsin com. � l€ 'tk�efi fl w n'':
a. Use of building: Onq 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. Dim ions
e. Number of stories?
f. Method of heating? ireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. etlands? Yes No. Is construction within 100 yr. floodplain Yes No
J Depth of basemen cellar floor below finished grade
k. Will build• conform to the Building and Zoning regulations? Yes No.
I. tic Tank City Sewer Private well City water Supply
—�--
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject
property
hereby authorize
to act on my 15 alf, in all matters relative to work authorized by this building permit application.
ignature of OW491 Date
I, 'c"t�ey2-5 INC- ' as Owne uthoriz
gent ereby declare that the statements and information on he foregoing application are true and accurate, to the best of mdge
'an
Signed under the pains and penalties of perjury.
c..
Pr' t Na
Signature of Owner/Agent Date
a fl-u, �- ;�° �oN 1Ni1�h'� �c�'�-n'►�"lr
:p o-t-P l�r PA r o- �-+v�1S�E• l
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be fille y
Building Departm
Lot Size _
Frontage n_. __........ ........d. A..
Setbacks Front
Side L: _ .. . ' R.... _v L:,,,,,
. ..__ ... m
Rear _ .,...$
Building Height
E,.,,.,._. ... .........
Bldg. Square Footage
Open Space Footage °
(Lot area minus bldg&paved
parking)
#.of Parking cos
Fil • ,
olume&Location) i._
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO•' DON'T,KNOW 'YES
IF YES; date issued•
IF YES: Was the permit recorded at the Registry of Deeds?
.'NO 0 DON'T KNOW ... YES .
IF YES: enter Book Pagei and/or Document#l 3
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 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 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,exc ation, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
d►
' u Re artrrtept use arty
City of Northampton
' Building Department Curia Cul[1esayerrnrt � �
212 Main Street se�nre�'/septle A�ra�lablllty
Room 100 Vllatrltttletylairlity �
Northampton, MA 01060 two Sets c��Struct��e Plans
y F
phone 41S,-58,7-1240 Fax 413-587-1272 Pfo to PI rt
APPLICATION T.0 CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY,DWELLING
SECTION 1 SITE INFORMATION
1.1 Property Address: This section tobe completed by office
Map LotUhit
R
(� Ic ( Overlay District
9 ' St.District CS'Disft ct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owne Record:
� 131 Itn H(.e- sfi., 1:14 E WC6
Name(P' Current Mailing Address:
�P Telephone
igna ure
2.2 Author ed Agent:
Ilup_,,Fir ��. cer�-s - �vv2��.c;. g gates �'r•� I�a��r,g.,�pr�ni
Name P' / Current Mailing Address: �p
V 7/ _ A/
A ure ` "'VVVIJJ Telephone
SECTION 3=,ESTIMATED.CONSTRUCTION COSTS ,
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applica nt
1. Building / ID 0 �• �• (a) Building Permit Fee
2. Electrical 1} . (b) Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) 0 1
5. Fire Protection
6. Total=0 +2+3_+4+5) . Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2008-0353
APPLICANT/CONTACT PERSON Wright Builders
ADDRESS/PHONE 48 Bates St NORTHAMPTON (413)586-8287
PROPERTY LOCATION 131 NORTH MAPLE ST
MAP 17A PARCEL 207 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 00 0q
Fee Paid
T_ypeof Construction:_ADD 3RD FLR HYDRONIC LOOP HEAT,BLOWN IN INSULATION&
REPLACEMENT WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 84280
3 sets of Plans/Plot Plan
THE FO ING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO AT10N 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 Commi n
Signature of Building Official Date
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.
BP-2008-0353
GIs#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2008-0353
Project# JS-2008-000508
Est. Cost: $19618.00
Fee: $90.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Wright Builders 84280
Lot Size(sq. ft.): 49222.80 Owner: WALDER MARTIN J&JOAN
Zoning:URB Applicant: Wright Builders
AT. 131 NORTH MAPLE ST
Applicant Address: Phone: Insurance:
48 Bates St (413)586-8287 Workers Compensation
NORTHAMPTONMA01060 ISSUED ON:101512007 0:00:00
TO PERFORM THE FOLLOWING WORK.-ADD 3RD FLR HYDRONIC LOOP HEAT,BLOWN
IN INSULATION & REPLACEMENT WINDOWS
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 10/5/2007 0:00:00 $90.0027637
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo