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03-023 (3) BOARD OF BUILDING REGULATIONS -icense: CONSTRUCTION SUPERVISOR Number: CS 014572 irthdate: 10/31/1952 Expires: 10/31/2007 Tr. no: 12040 estricted: 00 WILLIAM R CHILDS 132 ELM ST G HATFIELD, MA 01038 Commissioner 00-35,000 cf enclosed space (MGL C.112 S.60L) 1A-Masonry only 1 G-1&2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888)344-7233 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 100320 - - Expiration; 6/16/2006 Type: DBA Bill Childs'Yankee Millwork&Bldg William Childs 132 Elm Street Hatfield,MA 01038 Administrator License or registration valid for individul use only before the expiration date. If found return to: • Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 i of valid without signature ¢THtiMP�. $,. � �855ACh1CStif9 G, IT of Warf4amptan t DEPARTMENT OF BUILDINTG INSPECTIONS INSPECTOR 212 Main Street • Municipal Building O S Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as has/her construction super .'*,I or. The state defines "Homeowner" as, "Person(s) who owns a parcel on which he/she resides or intends to be, a one"or fwo farm y - 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 buil mgdepartment for the City of Northampton wants-any person(s)-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 iegulations. 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 rough building inspection (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 _ Date- Address of work location r A E ��c3aa<c3jcrsctla' _ 42\ DEPARTMEI-IT OP BUII1Df,,10 INSPECT 101.s 212 Main Street - Kunicipal Building .a Northampton, Mass. 01060 WOMCER'S COMPENSATION CISLTRANCE rtT'I"II�:i.j�Z�" (�; �p�tnittcc> %frith a prm- cipal place of businessfresidence at: -- - l 3 2 — L, i.� � tiT 1 ��t �t (l hone:) vZY7 —�r -Z6C? G.- C i cs 3 ( cirJ/stalctrip) do hereby cerdfy, under the.p?-'= and penalties of perjury., h�l ( ) I ru an employer providing die following .:orker's comoeasZ;io, coverage for Iny emplovices wortang on ties}ob: (L:su_ran=Comzzav) (PQUCc ( ) I am a sole proprictor, general contracior or homeowner(ci cie one) and hzve hired the CODUactorS lined below wbo have the foilo—Top, worker's comoen–saDon policies: (i+^,.1'1i c Oi Cont nczor) (Insaranccc Coinpan)-Pi obey DIIC) (Name of CODGaclor) (irslrne COmDaIIYROl1Ci Nuzncrr) (! fir uon Dale) (Name of Conaamcr) (In_siu-ante Compacy[PaUcy Number) (Expim6an Daic) (Name of Contractor) (Insuran(--Compatry/Poticy Num&r) (Expira6on Dal:). (ar-ch--d4j-,:oc71 6,c-irnc�_-T tz c,d�iafonn,Eoc pcw;aia.6 to.11 I.am a sole prop' and have no one woridng for me. ( ) I am.a hoc-it owner performing ail Lbe work myself. NOTE:plea>x aorarc e7,,•�+'l 1c hemcavvcn ubp m�loy petuni w d� -.;•-•,-,•••- cs.:c.,uo c rc�ir roric oa a d••�rt;^;,of twt mot�thy;t.'-w t�i'J is u+�i�the bomoouac roido of w ehe rS��zr'W�-=tbe•.n�i ox E^�.r.12y o��:d--od,o be eitpla ea unGc ttx�vo i e{ «�----'cz Aa(GUI =ePpliewan by a dommaxa fc_tip_«P—il—y e.-id-=else Ie6s1 n-=„of tz e=Ploy.r uo4,T dao Work olc Coa=aom..tioa Act_ I yodc -ad tha>oopy of chi+mt®cax m y ba for urdnd to tba c pncta. oft �•^^cl An�docu OT.-of Icur.000 for th. oovcx'^C"c c=ioa and U%-1 L-ilta-c to s.=='cavct-ao.-a U=dc==OQ 25 A al MOL 132 can lid to the=PcdItim of cimiosl pc^.311ia comcas of a G3C of UP to S 1300_oo=etdto< of up to ooe y-=-ead civ 1 pcsuhia is be form or.Stop Work Ordc and a r1i>r of s 100.00 d_y r Pj=t>x " ►Y Permit 1�iumt�c For d�.r�b c: © ort7 - of t_icrsC l- C 6ucc Ke I , SECTION 8 CONSTRUCTION SERVICES .r 8.1 Licensed Construction Supervisor: /�, Not Applicable ❑ Name of License Holder: "� < L L I rL '� C- ���" � � `' , o J y License Number i3 .z Lin 59— /41:1 PttCcc 1-1111- /old/ /o ? Address Expiration Date Signature Telephone ra:.,, ,..F.r w ,„y,.- °g. . teas 's"•r'^s�. •'•k ` .ry'r, `, 9wRe° rstered�I�omefint"ccivemen�.Co�tra�or � = � � �� � v - Not Applicable ❑ 9� Re istration�um er Company Name Address Expira ion Date t% t �' `` 2 Telephone SECTION 10-WORKERS'COMPENSATION 1NSURANCE AFFIDAVIT(K:G.L.s.-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...... ❑ . IaQ >r� � 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 r • SECTION 5-DESCRIPTION OP PROPOSED WORK(check'all applicable) New House ❑ Addition ❑:; Replacement Windows Alteration(s) Roofing ❑ Or Doors 17 Accessory Bldg. ❑ Demolition ❑ New Signs [ED] Decks [M Siding[E3] Other[E3] Brief Description of Proposed Work: L),e ef re,c—(i E� �' r°s r-- / ���t v e, m Alteration of existing bedroom Yes No Adding new bedroom Yes _X� No . Attached Narrative Renovating unfinished basement _X Yes No Plans Attached Roll -Sheet sa.Cf lVev o,ise aid o add><tiQ tc exlst� c 6aris ctce..:cor g�et . h' A ff ic�g: a. llse 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-x O.BE COMPLETED WHEN OWNERS AGENT OR`CONTRACTOR APPLIES FOR BUILDING PERMIT I .'4 d t (`�� I� as Owner of the subject property // hereby authorize 4- f L-(— L to f a S to act on my behalf,in all Ratters relative to wok atithorized by this building permit application. k_, 10 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.w Date ` � Section 4. ZONING A]I Informati6h 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 Rear Building Height �Lj Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces (volume-&Location) ^ A. H� | �nni��hu��R�i ���� ��d��nt�sh� ' x�~� v�� ^ NO DON7 KNOW «�� YES �~� ' IF YES, duteissumd: IF YES: Was the permit recorded at the Registry of Deeds? �� NO �� DON'T KNOW 0 ,,S IF YES: enter Book Page, and/or Document#' �� B. Does the site contain a brook, body of water orxmo |ands? NO »C� DON7KNOVV «�� Y[3 IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs tmbaobtained «~~\ Obtained �~� Date«�� �~� ' � C. Do any signs exist on the property? YES 0 NO Q 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. VVU *mconotrundonoctiv8ydismrb grading,excavation,n,filling)over 1 acre orisd part o[o common plan tho *i||distu,buvn,1oore? YES K ) NO KZl `�^ IF YES,then a Northampton Storm Water Management Permit from the DPW is required. City of Northampton Statuo i?etxs4 Building Department "'M 212 Main Street sr A r Room 100 r ett va a y� .AFe t i 4 ���brthampton; MA 01060 ets o�Stt uotrt�eLf'far s 4 phone 413-587-1240 Fax 413-587-1272 PlattStte 'Ians � ` A APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION'1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: 5 etQ C Map Cot U�rtt _/ Zone O�eclav f3rstrrct- �--'I'L�`��1.•r.� T.�) �v r n Cam. 0 EISY District.. .. _. .. ... GCB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: X,-,( " (D , Name(Pri Current Mailing Address: IV 0 Telephorq Signature 2.2 Authorized Agent: Name(Print) NJ Current Mailing Address: c�. U ( O 3 ---Zln/1 fc 2 y 7 ---"t 2(o 7 Signature Telephone SECTION 3 ESTIMATED CONSTRUCTION-COSTS Item - Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building �. �� �, c, (a)Building Permit Fee 2. Electrical 0 C) c� v (b)Estimated Total Cost of t — Construction from 6 3. Plumbing ,.`� Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) / o C Check Number d� This Section'For Official'Use Only Date` Building PermitNumber. Issued: Signature: Building CommissionerlInspector of Buildings Date File#BP-2006-0807 APPLICANT/CONTACT PERSON WILLIAM CHILDS ADDRESS/PHONE 132 ELM ST HATFIELD (413)247-9269 PROPERTY LOCATION 51 LINSEED RD MAP 03 PARCEL 023 001 ZONE RR/WSP 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: INSULATE&SHEETROCK 2 OFFICES&BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 014572 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF( MATION 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 Perot from Conservation Commission Permit from CB Architecture Committee Permit from Elm Stree mmission 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. 51 LINSEED RD BP-2006-0807 GIs#: COMMONWEALTH OF MASSACHUSETTS Ma :Block: 03-023 CITY OF NORTHAMPTON Lot: -001 Permit: Building Cateeorv: BUILDING PERMIT Permit# BP-2006-0807 Project# JS-2006-1241 Est. Cost: $16600.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: WILLIAM CHILDS 014572 Lot Size(sq. ft.): Owner: O'GRADY JOHN P Zoning:RR/WSP Applicant: WILLIAM CHILDS AT: 51 LINSEED RD_ Applicant Address: .Phone: insurance: 132 ELM ST (413) 247-9269 HATFIELDMA01038 ISSUED ON:211712006 0:00.00 TO PERFORM THE FOLLOWING WORK.-INSULATE & SHEETROCK 2 OFFICES & BATHROOM POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: y7 Footings: Rough: %- r -196 f^ � 1 Rough: House# Foundation: Driveway Final: Final: Final: b-/,440 � ��',� Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: O jC 6--3 p-o a THIS PERMIT MAY BE REVOKED BY THE CI Y OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy - Signature: _ FeeType: Date Paid: Amount: Building 2/17/2006 0:00:00 $50.002060 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo i