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31B-162 (11) FROM :FaEr i c i u s Spe c i d l t.i c s FAX Ldp. :467-7?E`; Mar-. 14 200E 06:41 PM PI P.Q. box 209 6RANOV MA 01033 FA8?4XVJS (413) 467-'7789 SPEaALTIM ORM PROPOSAL 8 arit.R�er 1-423-5864424 March 1 , 2006 steer .roe NAW 139 Elm,Strzot Go er'iNork CITY,BTAYE end bP ODOG d4C�.Qfi7171Q1f Northampton,MA 01064 ,wc r iMTe or nay MS WOW vYal ablraKRet>«+P+ lanmwdeetlre WWbr: 1,) ire ,fad i`.. ati �.$69 ,00.SS 740 40 AI $704y04 T+s# Ilew46'it3' # rovF4 3:3850:04 - 434 .04I42 3,) t ace 6 fluhges. I- 1460,00 *I- 1005= x11- $1470.00 .._,.. ..�. . 4,) Re-flash 5 dopro"s, &-$2645.00 II- $2780.00 III 675.00 __- 5.) Re-f t=h 2 new c�_r--$580"00 xr- 421.00 IIT-$590.00 6.) R- eptace�_metal dor"ar rocifs, I- $4905,00_II- $5445.00 TIT-`$5315,00 _- _ ---- .. ----� Install new 5'x 6' meta! roof, D- $1125.00 17- $1215.00 131- $119!5.00 Reptace 18' valley'and 8'x W eandingtwin 1-$2240,00 II- $2465.00 III-$2290.40 9.] Re to 21' valley,standtrt . _seart.d 10.) Flush old chimney. D $610.00 II- $655.00 111- $620.00 31;).Repa sFtomis.on 6 dormers, - $52 ;� ir wood 0, easen and return one copy.Thattic you. it irapOSC hereby to furnish rnaterlal and 19bor--oo"iete In wordano9 witfT O*vo V00106 00M for the sum of: I-20 oz.capper TI- 20 oz, least coat ca-Rper Ill--TC52 ;�;,� Varies �. t�gnreerrtlo Dtr mscl�as topowot afoul 4 rnerr't mterlat dettver y.Payrrtentw cis worts progresses. Satance due upon cam !e#ion. M ma"a geerufeed to be as apacna au wok io oe WW'BWO in a W*WA aOW Authnrt=da -- ffAMW W sftm6m pnadlR...,Any aY Wv"sr OeVfaUM*Om ab*vm Sp06flOtlI" in�ivtan ai�a+rata vili'ba ezltae r!dv `yslmari rudeer,7er�vigl boaxr.s an°wens ahero6 Mal and ebow firs as"Jmeta-AN ar++emr.+m earBnyae o.P�aM utffarr� jW or aeeya bft*W Oar aoc�dl.Qrnaor ra=+nY ors. a and aMesr eap irwutemn iWbse:�'h1s !"� Opr w cWn oat A*owered by Waormwft 06'11Pe Swam reurvae rri 1dmw n by 1+6 rt N04eA Nrdhir. :dam` ,,. C a � oral wnalnorw are satlsi CWY and AM hereby acxepted. You wo authorized 80waarra .to do...ft-4ma*-as-spuwG&dG. P .+fit be,made�4MAIdE 4Q RWWFAL TO/W 3S) d a3HiOa r rt�s��tr Zs Paz SCIOZ/LO/TO Rio � 0ti� (�rtL) of �,To tljallipjort _ �Zas5achnccI16" _ c� DEPARTMENT OP BUILDrNC INSPECTIOl.'s — 212 Alain Strect ' Municipal BuddirT e Northampton, Mass. 01060 WORIC R'S CO\i OLNSAIaON MSURA_NCF Ali I'DMVI-J' �iccnsxlpermittcc) with a pi-mcipal place- of business/res1dence at /O Droj w, ��v& 33(I:nonc`0&13.� – (snr°t/city/ alchip) do hereby certif);, under tic pains and penalties of perjury, ?hzl ( ) I man employer providing the following worker's comocnsa;jon covcc2ge for Iny elrmplovecs working on this job. (Insluan Cooe�y) (Polio; Ntt�irr) -- - (r:-pirauon Due-) ( ) I am a sole proor,etor, general conffactor or homeowner (cl cie one) and have hired the contractors fisted below who h2ve the foHowu' g, worker's comnensaon policies: ONI'mc Oi Co.nimci0') �111R1r�]Ill.:. COtIlD1I1}"/�GIJC-{ T\�t1I]1CC;) 1i-`pli'�t.n� D�IC ) -,ne of ConUacor m ) Msuranc: ComoauwPo!ie; Nulncsr) (Lx-pir,:tion Dare) (Name of Contractor) (IASarancz Compan}•/PoUq- Numbu) (E.N:pira lion Date) (Name of Contractor) Gnsuranc-- C0mpa0yfp0h Y Numb:-S) (Expiration Date) (noadl �O-,A rSccf ifncoct.ry to rs>GUCk iaform...'ioa pcsta.iain6 to.11 ooa,--cLo�. ) I am a sole proprietor and have no one wor--ing for me. ` ( ) I am.a home owner performing all the work myself. NOTE:plcsc be nwvut t1w tjo hoarox,1"bo employ pcsor w dD c c-tca, � cr mpair.ork on.d—AL-39 of oat moee ttia t L-iri in%,-b ch the twevoouver rtaido oc oo Lb,Qou�.,zpp,sten-rs thccto 11 ax G-- BV OZ.=d=red to be employes unr`.c Ltic wo k s ocma >c'. jr m Ap(GLI52-s 1(5)�application by e hocnoowv fai c Lcz::r---or pamn r=y c.idcocc LLc 1cg ctanu of en e gloyac uodc din Worker. Ac(_ I uodaSt d th.i a copy of thi.c=ucmcm my bo forw�ied to tbo Dcqut—ca of ln&wid n�doa&Offioo of tru-aooa for the oovaxSc vaif caioa°'-td UL-A L•ilta-c to soatrc covcrn�undcr zocUoo 25A of MOL 151 can la.d to the impositioa of aimioil paa W- coaai- m of a riot of up to S 1}00.00 and/or of up to ooc year and ci,.i1 pcn,hia.dx form of e Stop Work Ord-rind e rim of 5100.00 1 dny Lpinu tx For d�.rtn j u.c oily ('ci iIlJ l N UID bCr Lot SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: / Not Applicable ❑ Name of License Holder: ys�N S /`"�11�r'rC���; J�• �1 063�1"1111O License Number PC, vox -2-09 - C nA,,1,61 /�i 01033 1.2119106- Address Expiration ate Signatures— Telephone 9.Reallstered Home Improvement Contractor: Not Applicable ❑ us 54e1cl4 9410 Company Name Registration Numb r moo. .box 1709 - Gr�.9.,•6v /��' 0 033 /� O . Address Expiratio Date Telephone/-013-: ��2- SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 162,§26C(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...... ❑ 11. - Home Owner Exemption 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 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 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 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 Q DON"f KNOW © YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO W DONT KNOW O 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: 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 lO NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing jai Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding[p] Other[d] Brief Descri do��]]...,,of Pp posed n ` // / - / �s a A � /� , / Work: p /r�o/ACen�Hf d' ' rte •�/ ✓A eye As .mss � A� �� .v /�vc T' y CC[u$edl Se�Vc� l.�fl![V✓A� Lc"�� Alteration of existing bedroom Yes/No Adding new bedroom Yes _�No Attached Narrative Renovating unfinished basement Yes _�No Plans Attached Roll -Sheet 6a.If New house and or addition to existina housing, complete the followina: ,,ILA j p�;ks- 'AW6 a. Use of building : One Family Two Family Other /n1 OF y0u-r6' b. Number of rooms in each family unit: Number of Bathrooms I&IC) C/�LPNG1CS /N ,iAi'��a1R.4rvcE 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-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, t�P 12 as Owner of the subject property hereby authorize to act my behalf, in II m s rel ive to work authorized by thig building permit application. [G wure of er Date iw I, C1, /j ,� ,/� as Owner/Authorized Agent hereby declare tIAt the statements and in or ation on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. 7_isiN S "-- c Print Name 3 0 Signature of er/Agent ate Department use only of Northampton Status of Permit: i ing Department Curb Cut/Driveway Permit 1 2006 1 Main Street Sewer/Septic Availability MAY oom 100 Water/Well Availability _._— o Gil Q rtha pton, MA 01060 Two Sets of Structural Plans i)EPZ Ov BIJI�mI'��i* it (j6D13- 1240 Fax 413-587-1272 Plot/Site Plans NCR*NAtfrt� Other Specify 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 �✓, SIT Lot Unit / /5 9 ��./" T Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: // /v-/ X;01 /1 P /-69 S%. �/o2-rtrAi�aoTUii/ Name( in Current Mailing Address: � /- yr3 Telephone Signature 2.2 Authorized Agent: J/ Ivr�.v �. fAG?/� cicls Tie. �?o. 8UX :Zd9 �'.9•✓6,, /�??� G:0,33 Name(Print) Current Mailing Address: r / - 411-3 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building X211 350, 00 (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 ju This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-20'06-1233 APPLICANT/CONTACT PERSON IVAN J FABRICIUS JR ADDRESS/PHONE P O BOX 209 GRANBY (413)467-7789 PROPERTY LOCATION 159 ELM ST MAP 3 1 B PARCEL 162 001 ZONE URB HD THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Bu _t Permit Filled out _ Fee Paid Typeof Construction: REPLACE METAL VALLEYS FLASHINGS&METAL ROOF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 139409 3 sets of Plans/Plot Plan THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Pemlit 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 Co ssion OC96 Signature o uilding 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-2006-1233 G1S#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-1233 Project# JS-2006-1833 Est. Cost: $24350.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: IVAN J FABRICIUS JR 139409 Lot Size(sic. ft.): 44431.20 Owner: ROTHER BRYANT P Zoning:URB HD Applicant: IVAN J FABRICIUS JR AT. 159 ELM ST Applicant Address: Phone: Insurance: P O BOX 209 (413) 467-7789 GRANBYMA01033 ISSUED ON.511812006 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE METAL VALLEYS, FLASHINGS & METAL ROOF 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 5/18/2006 0:00:00 $25.006401 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo