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17C-153 (5) Ouruiew Build home office (approx. 29'x 19') within existing barn structure at 92 High Street, Florence. The raw partitioned space already exists and primarily requires electrical, insulation & heating to be added to make the space usable. subcontractor items Electrical - install new 50 amp sub-panel in barn & wire room for outlets, overhead lighting & space heater. - install overhead lighting fixtures. numbing - run natural gas line from home to barn (adjoining via 2-car garage) - install &vent Rennai space heater (38,500 btu). Insulation add blown-in insulation to 3 walls. add fiberglass insulation to one short wall (approx. 9'x 19') add fiberglass insulation to ceiling &floor (each approx. 19'x 29') add vapor barrier to ceiling &floor Drywall - new drywall for ceiling (approx. 19'x 29') plus one short wall (approx. 9'x 19') COnstfllCtlOn add framing to one short wall (approx. 9'x 19') to accept fiberglass insulation & drywall). I FUTURE(replace two existing windows I FUTURE I install new plywood sub-floor on top of existing barn flooring I FUTURE I install carpet over new sub-floor NOTE - ail items above marked I FUTURE I are not scheduled to be done immediately - they will be done in spring at earliest. new office N garage = house (92 High Street) 19 ft. h barn O O GrifV of Narf4autptail z s 1�835AC1(1i8ttt4 DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building ' Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMIZ 108.3.4 to act as 'his/her construction sups:­,,ii sor. 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 accessonj to such use and/or farm strictures. 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. (Home owne /resYrequired's signature requesting exemption) I will call to schedule building inspections necessary for the building permit issued to me. Date Address of work Off �t. location 5 /ov�ti�t, rl� 0/06 Z O Oy �{ �, C�i,zi�J z�f ��L7z-tilt'ittt}��att - 6 r�.2�i33 ACE}it5tlta L)EPfu'LTl.1ENr T OF EUILDI)�G INSPECTIONS 212 Alain Street ' Municipal Building j Northampton, Mass. 01060 WordCER'S CONITENSATION INSURANCE A FEDAV1,T �,+qfw ki v itli a principal place of bush ess/re:; dcticc at. °lZ l� `1f �ln�chc� l7 olo z rpll':)I1� _ �� ------ - -- - -- -- - — - --------- stn�UClt,t;s'• ��ap) CIO hereby Cer—LLI}'' UI1:1cI d1C h 111-s ani] pen S"IC., C)i I am an cmpioyer providing the i011O'.'viI1S. '•:01:Ku'-S COIIIDC11SZLIOD (.0VU2.`C for my employces wor diig on t its job: (Insurance Compam) ('G:ic,'Ntlrnbcr) ---y ('rte.int on Date) XI am a sole proprietor, gt"Itral C::nxnc`or o: tlon�eo.�zler (cLcle one) and lave 'Shred tht-, Contractors listed beio i 0 il� the fp11 :tL:v jocks—,"S Cot peI1S� Or1 )0!IC'.�5: 00Aam_ (1:IIILC Of CORD l iG') (�IlS ^IlG l CIrn:T"i:�G(SCf N=bc-) (Nan 1e Of C0➢tT Daic) (Name of Contractor) I ne^ ,� _ \ -7. D ate) - (Name of Comrictcr) —- (Insamnc:. Come,a }'!Police Numtr_r) Dare;- f"ILILl ':7 <LIl it SUIC l?l OprlC�Jr i'.it' l n—v,; 110 Oil 1;1 viii{ for me. a home i}W?1C' tiC!�i�i IIl111� all i NO71i:p1Czu b4 a:.21C tlst.r ilc tx r�o.;r «:-�r.:,�1 ;r. _ n;S>:<< :u�c�a::r r m Cr:-pair <<,:i;-.._ «cl!ir. riot uncc tILII thrbc uni!a In tctc+l;hc f:;,:r-�:�-cr-rCa.:. �cr a:•`�.:�.:,�:;�z urtc[�.:r.1 LF ct�a:r rx:t Ccrsall}'cc�:::c:::2c:� —ployc-3 urv-' t tSr:vo;}:r.ca--.__m it ((,L!52 !(sl: ai: ._-_tic:: a F. ;aro::,cr`cr Icgzl rtatuz of as cployec under thn We k? 't t Co;.:;xrrition;,xf- I undue-=t.+.nd ihi:x cmy oI Skis ctita::s:nuy bo fa�'.ucirf to tI»IYtiortz�rsL of In�iz:ri:.l M�ls:t�Cilicv of l:a.uia:a for 11x covcrrsc vtrif cation and that fl-fLxc to a-z,:r. 25A of?.tCl.152 cxn[cad to the in"Sitioa ;c 1 pa aL.cs comuting of a fire_of up to S 150U.CvJ ? a:}.�.'cY 2^:;:r,.r.�t.;,1�f:• in fir,:}-:s a..'1 evil pczultia to 9�I�mn C•f a$!r� �'�i C?;h>=t:;.1 a f -C 0CS10.0 00 a dsy stain mc. F,dq:uVIYS YII LLk G11�' ! v tO�rifl'�i PcrInit N'1111tY.:T_ SECTION 8 :CON STRU_CTI.ON SERVICES 8.1 Licensed Construction Supervisor: Not Applicable Name of License Holder License Number Address Expiration Date Signature Telephone ztme�hip yemenVUo " Not Applicable Company Name Registration Number Address Expiration Date Telephone SECTION 10;WORKERS'COMPENSATION 1NSURANCE 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...... ❑ OWN 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 d assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Lo I Zo ing vs and State of Massachusetts General Laws Annotated. Homeowner Signature e � i SEC'FfONSDESGRIPTONOF==PROF.OSEDQYVORK checkll hcale z New House ❑ Addition ❑ Replacement Windows Alterations) Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ) Brief Description of Proposed Work: hgl4tle iCL i'1 bK✓'7 (Cl4fi✓ic4j, he, -f WiN-✓ La'!Sf✓wd io r) Alteration of existing bedroom Yes V No Adding new bedroom Yes 1/ No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll 0- Sheet 0 -ftevot"se'ati �oawd>Ition.to.xisting.housirig�co.mpeefleffollowrng: 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. bimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck 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 77a�{1N[ ER�117T1 ORIZATION TO;BE COMPL"EYED WHEN OWNEFS'AEi © CONTRACTOR#APPLIES FOR BUILDING PERMIT I, � NFvl�V as Owner of the subject property hereby authorize to ac;. on my behalf, in all atters r lative to work authorized by this building permit application. tv 12-11 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 I t?�L1 Lv Signature of Owner/Agent Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: L: R. Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location 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 DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO V' DON'T KNOW 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 _ No IF-YES, describe size, type and location: City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 e phone 413.587-1240 Fax 413-587-1272 P 1: APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOL IAN A,ONE QFT 0 FAM)1,Y D?►NE1~ NG u. SECTION 1!-SITE INFORMATION 1.1 Property Address: }dam This section to l compI d�y office 12 Piji(15t F1ayew-ca t rrf Q/*Z Zone Ouerta: try r r c � � �sx EImStDistrictu CBDistrtct � - :, �. ., u , SECTION 2 - PROPERTY:OWNERSHIP/AUTHORIZED;`AGENT 2.1 Owner of Record: `7ANrol2rl l� GIZ x;14 5/. , Elm 179 010k-2- Name(Print) Current Mailing Address: yl�- Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION=3 - EST.I'M TEDCONSTRUCTION GO"STS Item Estimated Cost(Dollars) to be Official Use'0rily completed by ermit applicant 1. Building Z, � a ` OBuilding Permit Fee 2. Elec.rical 20 00 (b) Itimated Total Cost of Construction:from. 6 3. Plumbing 1 P(2 0 Building Permit Fee 4. Mechanical (HVAC) 190v 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number This Section For Official Use Only, Building Permit Number d Date Issued: Si'nature: Building.Commissionerllnspector of Buildings Date File#BP-2004-0472 APPLICANT/CONTACT PERSON KAYE SANFORD&MARY C DONOVAN ADDRESS/PHONE 92 HIGH ST Q 586-4823 Q PROPERTY LOCATION 92 HIGH ST MAP 17C PARCEL 153 001 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 37 Typeof Construction: RENOVXTE BARN FOR HOME OFFICE(ELECTRICAL HEAT,INSULATION& MINOR CONSTRUCTION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THFApproved OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INTION PRESENTED: 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 lO L L LaQ3 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. 92 HIGH ST 3 BP-2004-0472 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Biock: 17C'- 153 -'r CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2004-0472 Project# JS-2004-0673 Est.Cost: $7000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq.ft.): 16335.00 Owner: KAYE SANFORD&MARY C DONOVAN Zoning:URB Applicant: KAYE SANFORD & MARY C DONOVAN AT. 92 HIGH ST Applicant Address: Phone: Insurance: 92 HIGH ST O 586-4823 0 FLORENCEMA01062 ISSUED ON:10123103 0:00:00 TO PERFORM THE FOLLOWING WORK.-RENOVATE BARN FOR HOME OFFICE (ELECTRICAL, HEAT, INSULATION & MINOR CONSTRUCTION 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: Receipt No: Date Paid: Check No: Amount: Building 10/23/03 0:00:00 3857 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo