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17C-154 (5) i Edward Cohen Dormer Detail/top view roof structure detail 88 High Street Florence, MA Existing structure is shown in darker shade existing members cutback typ. \ facia board detail Edward Cohen Dormer Detail/side view construction 88 High Street Florence, MA darcker shade indicates existing structure two structures of this nature will exist on each side of the dormer Edward Cohen Dormer Detail lfront view framing detail 88 High Street Florence, MA The dormer will be framed with 2"x4"and 2"x6"members. The exterior will be covered with plywood, Tyvek, and siding. All exposed wood will e primed and pain side view ------ ------------------------------------------------------------------------------------------------------------------------------------- .......... .......... .......... ........... w 0 shingled A pJV 0Gd roof 0 ................ .............. ............. ............ ............ 2"x6" members 16" on ctr. 4"x6" header 2"x4" construction Andersen awning window here Andersen awning window here ---------------------------- --------------- F�l ------------------ approx. 7' Existing structure 01-0-L Iz I 51V; U House as it exists now LL HD=H House with proposed dormer 2.5 Jo 13903 O-Z- 3 - - 165 82.5 82 ............ Lzfy of Wart amptan z 1�83ERClt3[StttB 5T DEPARTMENT OF BUILDD`G INSPECTIONS INSPECTOR 212 Main Street • Municipal Building ' Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 78OCMR 108.3.4 to act as l is/her construction sups-, iSor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department 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 regulations. 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. Mpoige 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 °E Qf.�it-) Of ��CTLfI�cilll�Jf011 _ _- —= g .• E Ica%AC4nrc116' © DEPARTMElrr OP BUILDr>\G INSPECTION'S ' 212 Main Street Municipal Building Northampton, Afass. 01060 j WORICCR'S COiNEPENSATION MSURANCE Al, (li ccnsa•Jperm�ttcc) %%,Ith a pi-b-icipal place of business/residence at: (phone') ty/sta.tc/a P) do hereby ce `, under tic P z_ins and P enalties of perjury.;7; :hai ( )' I am an employer providing die follow=-, tivorkcr 5 comoensZt;on cove age for lm` • etvplovccs Nvor>Jng on Uns job: (i>LCUS-mac Conrad) (Pclicr?;u_-;ter) :pirrion DzL) O I am a sole proprietor, general contractor or homeowner (ci cie oee) and have hued the conu-aCors listed below who 1-iave the following worker's 'on po!icies: (i+3IDe O. CO_nr^ci0'1 (Insunncc Compan)-IPohCf (Ex>tnwuQ-, bate) (Name oC Coomaor) (insurance CoinoantivPo!.imr \Num6cr) (L x-mr,:don Date) (Name of Conuaao,) (Insurance Com>zan)/Poi q Numb--r) (Expirrioa Dau) t (Dame of Contractor (In_SUraac-- Comrzny/Policy Number) (Expt,,6on Daic) . (--h=iditiocal 6ca.iracacasO•to incur iafores.a�oc pataiains w all ooaTro:a) . ( ) I am a sole proprietor and have no one working for me. I am.a home owner performing all the work myself. NOTE:plcsc be cw lrc(ti,.�t]a 6cmcv+era wbo c:�loy pcz ooa in da + c�c ao c rc air-ork CM.d..cn-Z of one mot th-x t.'1o_-—tr in inlet the bomco,r raid.or oa the p-oun...xpputte�•^ theca e c ace Ca Xy to be empioyca unr a the uuic{a 0=::P ,;oa Act(GLI5L=1(S)�zWLic.6=by a hommava fcr e lice or pc mx l cr=y evid=-LLe Icgal n=�„of e7 exployx under dro WorScolc Compomatioa Act I—Zcr toad tha a copy of this cba_c=may bo foi-+.nr,ied to LE-Doportmrn¢of 1n6 aid A—dc.&C ffM—of ls- • for the cover `C lc tioa and 01-t C iJ c=lord to the union orcimiaal peailt= eoan-L tg or a fmc orup to S I Soo.00 and/or jmqwtyo�of up to ooc ycr Lod a,i7 patio in t ,form or.Stop Work Ord . d. fim 0(51 DODO i d:y Lpja-A me For dcp.rta>;'t use only - PCTfft1f 1`t t1IIlb1 - —_ e/ac rrru ttcc �Ce ) f t , SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone Not A licable .❑ 9 Re4tsterecl Flomeiibrovernerat Contractor. PP Company Name Registration Number Address Expiration Date 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...... ❑ : �qav 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 an cal Zoniy,41aws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition Replacement doves Alteration(s) Roofing Or Doors W' Accessory Bldg. ❑ Demolition Iz New Signs [I]] Deck [ Siding[ED] Other[C7] Brief Description_of Proposed Work: l�l�r1l?Y7 �li�i Kr �_%��i, .L. i✓�6 '[ ��l` ,flG ' / l,r�hrs;�r7' Alteration of existing bedraMn �_---` es No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a:WIN Bo se arr+�o dd trorita ezis#nq housEttg oiYip e#e o lasitrti q: 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-OWNERAUTHORIZATION-TO.BECOMP.LETED WHEN OWNERS AGENtOR'CONT RACTOR,APPLIE'S'S,FOR"BUILDING PEkma I, 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, 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 Nam wnertAgsnt Date 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 filled in by Building Department Lot Size Frontage Setbacks Front Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bIdg&paved #of Parking Spaces (volume&Location) F A. Has a Special Perm it/Vahance/Findi ever been issued for/on the site? ���� �� NO \�/ DON7 VV KNO YES x_� «/ .~ ' / / ~y IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? ' NO 0 DON7KNOW 0 YES IF YES: enter Book Page. and/or Dooument#� B. Does the site contain m brook, body of water nr wetlands? NO %,j, DON7KNOVV x�� YES IF YES, has permit been or need tube obtained from the Conservation Commission? Needs tobeobtained �-� Obtained «-� Date v.~� �~� ' ` . C. Du any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: � D. Are there any proposed changes tooradditions of signs intended for the property? YES 0 NO 0 IF YES' describe size, type and location: E Will the construction activity disturb .grading or filling)over 1acre or isdpart o�ocommon plan thaw0disturbnvor1eore? YES [ l NO K^� �� �L IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ` �epatetati�sexs� "F' Ity of Northampton S� SC1fEla � � zga5z 15 Ilding Department �12 Main Street >^ 2006 Room 100 Nbrtha pton, MA 01060 �o � � �* � bone 413-587- 240 Fax 413-587-1272 �� �ans� APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -'SITE INFORMATION 1.1 Property Address: This section to be completed by office T r 111611 STYX Maps Unit Zonei Overla(Distract RWOA K F) Min O/cx/- EIrnSL L1�stnct C�Distnct SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing �/, Address: Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTIOR COSTS - Item Estimated Cost(Dollars)to be Official Use Only com leted by ermit applicant 1. Building 000 (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/InspectorofBuildings Date File#BP-2007-0122 APPLICANT/CONTACT PERSON COHEN EDWARD N& ADDRESS/PHONE 88 HIGH ST FLORENCE (413)585-9326 Q PROPERTY LOCATION 88 HIGH ST MAP 17C PARCEL 154 001 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: SHEETROCK&INSULATE UPSTAIRS BEDROOM HALL Wp BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOIVIATION PRESENTED: L/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 09 C ° 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-2007-0122 G1S#: COMMONWEALTH OF MASSACHUSETTS t6& C" 3 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2007-0122 Project# JS-2007-000183 Est. Cost: $3000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 13590.72 Owner: COHEN EDWARD N& Zoning: U" Applicant: COHEN EDWARD N & AT. 88 HIGH ST Applicant Address: Phone: Insurance: 88 HIGH ST (413) 585-9326 () FLORENCEMA01062 ISSUED ON:81912006 0:00:00 TO PERFORM THE FOLLOWING WORK:SHEETROCK & INSULATE UPSTAIRS BEDROOM, HALL & ADD-,BATHROOM DORMtR"r9/5/06' 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 8/9/2006 0:00:00 $50.001132 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo