Loading...
31B-023 (3) (�l s 3" , � �iassacf�uscffs � - DEPP RTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building North,unpton, MA 01060 HOME OWNER EXENIFTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 78OCNM 108.3.4 to act as Iis/her construction sup,-: • or. Tlie 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 back-fill). sonotube holes (before pour) a rough building inspection(before work is concealed) insulation inspection (if renuired) and a_fnal_buildinQ inspection. The building department requires these inspections before the works concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancv 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 aII required building inspections necessary for the building permit issued to me. V Date Address of work location SECTIONS-CONSTRUCTION;SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number �y r ( � ©8 / -;��1/ mac') 25 Address r� /, d D Expiration D e / C — 6-f D 49 2� Signature Telephone 9 Rdaisfele"el Ftiirtie lmprorererentlracetracfar- x_ Not Applicable ❑ Company Name 11 4 Registration Number '? 19Dnc�J' C`rJ .�9� Ati, >/1'A - �d Address ® f5 7o Expiration Date Telephone 4.2�0/Q SECTION 10=WORKERS'COMPENSATION INSURANCE.AFFIDAVU,(M G.L.c_.Y52x f 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...... ❑ 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.CNIR 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 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 Side R L:= - R:: Rear Building Height Bid-.Square Footage % Open Space Footage % (Lot area minus bldg&pared parking) #of Parking Spaces Fill: ; (volume&Location) k A. Has a Special Permit/Variance/Finding ever been issued/for/on the site? ...._.-SIP e -E)GN!:F KPPA1A/ I 1 YES ( 1 IF YES, date issued:: -T�J IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW ® YES 0 IF YES: enter Book Pager and/or Document#' B. Does the site contain a brook, body of water or wetlands? NO � DONT KNOW 0 YES 0 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: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO -0 N51 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 19 ALDF, ST BP-2008-0314 GIs #: COMMONWEALTH 01' ASSACHUSETTS Map:Block: 3 1 B-023 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category BUILDING PERMIT Permit# BP-2008-0314 Project# JS-2008-000445 Est. Cost: $7565.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DALE HAWLEY 055048 Lot Size(sq. ft.): 3136.32 Owner: SHEA MICHAEL H JR&JOANNE SHEA L.onmp,: uici- DALE HAWLEY AT.• 19 ALDRICH ST Applicant Address: Phone: Insnrance: P O BOX 273 (413) 667-3149 HUNTINGTONMA01050 ISSUED ON.9/27/2007 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE 8 FT ROTTED SILL/ONE FLR JOIST POST & FOOTING POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: deter: Footings: d k- l� ` / , O 7 Rough: Rough: House# Found atio n:L/ Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: — Kona:.: Insu!:l.tion: Final: Smoke: Final: ±"J to�� ��L�" Loa � THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS Certificate of Occupancy `� '' � Si2nature: FeeTvpe: Date Paid: Amount: Building 9/27/2007 0:00:00 S50.G08065 212 Main Street,Plior "�7-1240,Fax: (413)587-1272 Buildinlv C —: ,,er-Anthony Patillo