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17C-170 Troposa! Vinyl Siding a Corbett Home Improvement Windows Northampton, MA 01060 Awnings (413) 584-6571 Canopies Gutters �ji 2 Vj�O— Shutters PROPOSAL SUBMI TED TO �"` ,,CQ�G! PHONE - —S-13/ DATE Q G STREET J 9-1 NAME CRY,STATE,nW ZIP CODE d JOB LOCATION �— DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: VL it asa 7 3 Al Y2-)( /z S 3� 11,51-2-z 3')a x �/ /v '72 : s l- �- � 1' s, (We(PPOpOSe hereby to furnish material and labor-complete in accordance with the above specifications,for the sum of: Dollars Payments to be made as follows: ,`6 MQ�Le4 n_„w�jI j&-1Aw(u All material is guaranteed to be as specified. All work to be completed in a work-like manner according Authorized to standard practices. Any altercutiums or deviation from above specifications involving extra costs will be Signature executed only upon written orders,and will become an extra charge over and above Ilse estinWe. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to curry fire,tornado Note: 'Lis proposal may be and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insuranc withdraw s if not accepted within days. Acceptance of TropoSaf-Tlte above prices,specifications are conditions are satisfactory anol are hereby accepted.You area rized to Signature =P. gj do the work as specified. Payment will made as out ned Date of Acceptance: ` O Signature SECTION'.5--DESCRIP..TION2OF PROPUS„Eb"'W.6FtK(check aIV 061icable) New House ❑ Addition ❑:,. Replacernert Alteration(s) Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks.[[] Siding[0] . Other[Oj Brief Description of Proposed / � � `' Work: /-3 �YIAI &,,V Z I—f Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6 FROff fl S 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 I 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�iO ft Ark ��!ATiA�O ,- C01V[ ETE[`WHE�1� OWNERS AGEN GORCON GTOI PL1 fOR�BIiL 1PERMIT 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 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 nder the pains and penalties of perjury. Print Name Signature of Owner/Agent Date SECTIQN..8-CONSTRUCTION ERUICF. i 8.1 Licensed Construction Su`ervisor: , Not Applicable ❑ Name of License Holder: NV Sn License Number L4 aged s-� No Ar%oho, MA 61060 y- 3—o6 Address Expiration Date W Signature Telephone =9� eg"` isleredorn�rnp`tm"e 'o"�i1 0 Not Applicable ❑ C 6 K�t✓� �drh� _L .v.�o ve-1h noy-Tl L� D(0 9 — Company Name / Registration um er Address / Expiration Date Telephone 6 �7 4/ OS71 a SECTION 10-WORKERS'COMPENSATION:INSURANCE.AFFID`AVIT 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(l) 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 bome 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 buildine 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 ��O4T �O a $ ,„Crzty of Wartt ampturrl DEPARTMENT OF BUILDD7�G INSPECTIONS r INSPECTOR "212 Main Street • Municipll Building Northampton, MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/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'twofa�mzVy _ 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 fegulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), cnnntnbe hnle_c (before nour). a rough buildinginspection (before work is n(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 17f �\Trfrf!}alllpto>,t - { g ' E ��+:3aRrftacrtls' - — w.. DEPARTMENT OP DUILD0\1C INSPECTIONS 212 Main Strcct Municipal Duddinp. Northampton, Mass. OlOGO «'ORI•C[:RIS COVtPI✓NSATIO.N MSURANCE Arl=I S..VIT. I (1J CCIlSx�(XTiTJJ[ta) �I'll th a pri,lcipal place of businessfresidence at: su-muci P) do hereby ce ', under tic. ?ins and Penalties of c r7 `. :1121 ( ) I am an employer providing the follo% coinocns2don cove age for Illy em lovees worn on uus •ob: � P g 1 I (Incur-� Comram,) lPclic: NLaocr) -- (a-pir_t on Day.) ( ) I am a sole proprietor, geaeral contractor or homeow"Cer(ci cie one) and have hired the coouaccors listed below cvbo have the following worker's cot oef1_non pOLICies: i (i+amc of Contncwr) (Insurzinc^, Coinpa31)'ClioUCi Dnkc) (Name or Coomcior) _ (Las razc; Comoaa`vPoIjMI Nunlcrr) (L»ir uon Date) i (Name of Contractor) Ozsura.ne: Ccmpao)-/Pobc)- Number) (Expiruoo Dale) (Name of Contractor) Gnsurancc_ Comcany/PoUcy Numbs) (Expi-,doo Datc) . (.a ,mh-ddii�ocal c'.xet,if noasary to c�cjv<Sc wforwLdoo pczt.lainr a tiu oo=--_.con) XI am'a sole proprietor and bave no one woridog for me. ( } I am..a home owner performing all the work myself. NOTE:plcx be Lwzm th..K1Jo bcoxo,vcn to c=pl%➢ctom m LID of cot Mors tb-tlsx=iG is u-Scb tb.bomoowoer recd=cc cc the pound,s�purten-rl tb,-_o a ax g•..=Ry= idaai to be miplor uadc the K-t;�s oc••k-.:4w Ari(GL1152.n 1(5)),Lpplinnoo by.bomcoa-oa for a liC>;x a panic t>_y cvidr—t1:c lrgsl ctzaas of.=c-r_ploy.c uoder da W ockxe.Coo�pom.lioa Act I uod=rt the.copy of tbia =a®W my b.for+ard-d to th.Dcp.rtmcw o f I,odut i d A—&,=&OIM—or Iruaraooe rot t6. oov=vge vaeirasioo and th1 L•ilut to saws boverasc t s.oaion 25A of MOL 151 can led to the impaxitioa or-i-6--1 prnaW- ooaiitrag of L tint of tap to S I}00.00 and/or 6mp-isoomcn oC up to ooc Yr r.nd c,il pcoilua uti dSC form o(.Sting Wort Ordc a d' fix=0(:S 100.00.dsy tplart me rot d;.=^L..=t U, only - Pcrmit Numt--r — l/-L-0J Mapz _ Lot Sigatum of Liomscc/Pe -___fie Section 4. ZONING All Informatl6h Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by :r Building Department Lot Size Frontage Setbacks Front Side L= R:= L:!= R:= Rear 0 Building Height ---— Bldg.Square Footage 0 Open Space Footage (Lot area minus bldg&paved % parking) #of Parking Spaces 0 Fill: r A. Has a Special Permit/Variance/Fi ding ever been issued for/on the site? NO © DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW Q YES 0 IF YES: enter Book — I PageF 7 and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q 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 Q NO �2( 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: E. Will the construction activity disturb(clearing,grading,tx9ovation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO i IF YES,then a Northampton Storm Water Management Permit from the DPW is required. c � City of NortPampton Building Department 212 Main Street Room 100 Northampton; MA 01060 phone 413-587-1240 Fax 413-587-1272 , e APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION,1 -SITE INFORMAXIOt� 1.1 Property Address: 4 � r/�// �+aa saga's 5sli#"S➢! 'a'rtf�Q �i9d�` "wa' '��r�l��._a,; Urns a�i��.W,�S� ,ss i4a 3 �G-4 tY.a% zLOn, Yyer)aYu. SECTION 2-RROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Own r of Record: �Qrr--y 1C.A/ s, - Name(Print) Current Mailing Address: r Telephone Signature 2.2 Authorized A ent: F 11A RcJ T eo Rae-` y, /j 140/ Name(Print) Current Mailing Address: Signature Telephone SECTION 3.'-'ESTIMATED"CON STRUCTI6WCOSTS: Estimated..,._.�.. __._ Item ed Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)`:Building Permit'Fee 2. Electrical (b).Estimated Total Cost-of Constriction from 6 3. Plumbing Buildings Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) ' Check Number This'Sect'on For Official Use'Onl ,� `Date Building'Permit Nnmber l's"sued: Signature: ' Building Commissioner inspector of!Buildings Date 34 HIGH ST BP-2006-0506 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C- 170 CITY OF NORTHAMPTON Lot: -001 Permit: Bulldi Category: BUILDING PERMIT Permit# BP-2006-0506 Proiect# JS-2006-0754 Est.Cost:$3250.00 Fee:$25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Ed Corbett Jr 116069 Lot Size(sq.fQ: 14069.88 Owner: SURGEN PAUL C&LOTTIE B Zoning,URB Appiic:ani: Ed Corbett .is' AT. 34 HIGH ST Applicant Address: Phone: Insurance: 4 Reed Street (413) 584-6571 NORTHAMPTONMA01060 ISSUED ON.11 1712005 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 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: nil. Insulation: Final: Smoke: Final: 0 J' /J- /-4-0-5-1&�, THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeTyue• Date Paid: Amount: Building 1117/2005 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo