17C-167 (10) x-ucnicng er nume nepa1r
•�••••�• 305 Russell Street, Hadley, MA 01035
2 Maxine Circle, Easthampton, MA 01027
4�
"a 2 0 2001 NTRACT
June 14, 2001 `
DEPT Of BU410lNG 4NSPECTIONS
NORTHAMPTON,MA 01060 � � �6b I
Name: Norma MacDonald one No.: (413) 586-370
Address: 40-42 High Street
i
Florence, MA 01062
This is a contract/proposal to build enclosed porch at the above address. Contractor agrees to tear
out all existing rail and window systems. All debris will be removed by contractor. New rail to be
framed up in 2x10 to accommodate post. Outside wall to be sided with vinyl. A screen and storm
window system to be installed to enclose porch. Interior of porch wall will be waynes coated tongue
and groove. Permit for said work will be furnished by builder and posted at job site.
All work described, including all lumber and materials, for stated work will be charged at a rate of
$6,980.00. All other work in addition to the above scope will be charged at$39.80 per hour.
License and insurance paperwork is enclosed. Owner agrees to pay for all paint and/or material in
advance. One-third (1/3) of total contract price is due at start date. Balance is due upon completion.
Please make all payments payable to ASAP Painting.
If you agree with the above proposal,please sign below and return to my attention.
40-2�
Owner Con actor
Hadley-(413)586-8010 Easthampton-(413)529-1929 jr Fax- (413)586-8051
i
¢�tiAMJb
$ 6 �laaxdlttactta'
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(lipermittee)
with a principal place of business/residence at:
yoS evs 5 cG ST J q,06<,V 1440 (phone#) '� K&I Q
(street/city/state/rip)
do hereby certify, under the pains and penalties of pegury, that.
(14) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
611--F r-,0 C- p�rT�a Gtr ,ul v�1 0 0.2
(Insurance Company) (Policy Number) trat Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following workers compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sleet ifneceuary to inc}ude information pertaining to all ooatraciors)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while homeo-Avers who employ perlom to do m mums n c combixfion or repair work on a dwelling of
not mote than three units is which the lwmeowncr resides or oo the grounds appurtenant therdo arc not generally ooandered to be
employes under the wodca's Cation Act(GL152,Ss 1(5)�application by a homeowner for a Gecruc a permit may evidence the
legal slaters of an employer under the Workees compemation Act
I understand dhai a copy of this rtatcmcoi may bo forwarded to the Deport need of Dial Aocid= Offioc of Iawfln a for the
coverage verification and that failure to seatro coverage trader sectioa 25A of MGL 152 can lead to the'impositioa of airni Al Ixnaltics
mmisiing of a fine of up to S1,300.00-&-imprison of up to one y=and civa penalties in the form of a Stop Work Order and a
fine of s 100.00 a day against me.
L° For nl rrso aoly
` U/ P��t Number Lot#
Si of Li ,c ermitlee e
s
SECT.fON 8 CONST.RO `PION 5EFtVIC,
771
8.1 Licensed Construction Su ervi or: Not Applicable ❑
Name of License Holder : CS 0 7 y 7U J
/r ,fir License Number
C/1 /o/G)'s t/c )
Addres Expi Date
S() f�7 St
Signature Telephone
P Not Applicable ❑
Company Name Registration Number
G s /rac,�sscC s� 1/ g/ 0 Cl
Address Expiration Date
Telephone cS�� oI
,SECT ION=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....... M No...... ❑
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
----
GTION 5 DESOR P ,ION OF PROPOSED O c 1 as cable
�i i ,
New House ❑ Addition ❑ Replacement Windows Alteration(s)91 Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[u] Other [ ]
Brief Description of Proposed Work: RjL010I, C,."4
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet❑
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. 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
SECT]ON 7a''-OWN.ER,AUTHORIZATION TO BE COMPL&tD WHEN
QWN I S AGENT..Ot2 CONTRACT(}R 4F�P1:I S FO OUILbl1 � PERMIT
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 d&1are that the state nts 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.
�tam► �v�� �
Print Name
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: - R: 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 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:
Dty of Northampton
ilding Department
jUN 2 d 2001 212 Main Street
Room 100
pEp1OFBUILDINGINSFECfIONS Nort ampton, MA 01060
07"AMPT01"l, 7-1240 Fax 413-587-1272 t :
..P
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
'r This sec sort to be comp #ecl by t�fft _
1.1 Property Address: y 6j p
C Mai %et �5, Ufil y
M 1 Z0x >fverlay Disrict
Elm St'District CB District
SECTION 2-:PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
ti01?M-0 /4Q &1voL6
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
/v\ 1(��yLe /�1Q,�l�vc �i L�CIs�1VQM,p/UN
Name nt) Current Mailing Address:
S0?Cr,
Sign ure Telephone
SECTION 3-'ESTI FATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 9�d U (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 ection For Official Use Only
Building Permit Number: Date Issued:
Signatute:
Buiidir,,g'Commissioner/Inspector of Buildings Date
File#BP-2001-1088
APPLICANT/CONTACT PERSON JIM BOYLE
ADDRESS/PHONE 2 MAXINE CIRC (413)529-1929
PROPERTY LOCATION 40-42 HIGH ST
MAP 17C PARCEL 167 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
T eof Construction: REPLACE RAILING WINDOWS SIDING&INTERIOR SHEATHING ON EXISTING
ENCLOSED PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 074700
3 sets of Plans/Plot Plan
THE FJOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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 Co ission Permit from CB Architecture Committee
L6/tQ7
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.
?;`2 tIT BP-2001-1088
`CIS#: COMMONWEALTH OF MASSACHUSETTS
sBlpck, �c- i CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2001-1088
Project# JS-2001-1920
Est.Cost:$6980.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JIM BOYLE 074700
Lot Size(sa.fn: 31798.80 Owner., MACDONALD NORMA
Zoning:URB Applicant. JIM BOYLE
AT. 40 - 42 HIGH ST
Applicant Address: Phone: Insurance:
2 MAXINE CIRC (413) 529-1929 Workers
Compensation
EASTHAMPTONMA01027 ISSUED ON:61261010:00.00
TO PERFORM THE FOLLOWING WORK.-REPLACE RAILING,WINDOWS,SIDING &
INTERIOR SHEATHING ON EXISTING ENCLOSED PORCH
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 6/26/010:00:00 1290 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo