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38-052 (2) 37 LAUREL;ST BP-2004-0483 GIS#: COMMONNVEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: BuiidinQ Category: BUILDING PERMIT Permit# BP-2004-0483 Protect# JS-2004-0688 Est. Cost: $3000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 26397.36 Owner: RAY JOAN C toning• URB Applicant: RAY JOAN C AT. 37 LAUREL ST Applicant Address: Phone: Insurance: 37 LAUREL ST NORTHAM M PTON MAO 1060 ISSUED ON:10/30/03 0:00:00 TO PERFORM THE FOLLOWING WORK.-REBUILD EXISTING STAIRWAY 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 Occupant Signature: FeeType• Receipt No• Date Paid: Check No: Amount: Building 10/30/03 0:00:00 2718 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 4 File#BP-2004-0483 APPLICANT/CONTACT PERSON RAY JOAN C ADDRESS/PHONE 37 LAUREL ST PROPERTY LOCATION 37 LAUREL ST MAP 38 PARCEL 052 001 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 SO — Typeof Construction: REBUILIT EXISTING STAIRWAY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved 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 Commiss' o z� Signature o 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. s City of Northampton Building Department 212 Main Street Room 100 'North-qimp�on, MA 01060 (Lph6ni 413l` 8V-V 40 Fax 413-587-1272 � APPLIc",bN2fa CMTRUt,1,i ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE ION ~ This section"-obomp eE'"' bfifce` 1.1 Property Address: { �• , ; . , t td f''G e,oh erlay Des r' 4 Elrrt,St DIstrict SECTION 2 - PROPERTY( OWNERSHIP/,AUTHORIZED AGENT 2.1 Owner of-Record: Na rint) Current M nes . -r 71� �1 Telephone / si ture 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECT`ION..3"- ESTIMATED CONS TRUCTION'COSTSI Item 'mated Cost(Dollars) to be Official Us Est ' leted by permit applicant 1. Building ®/ � ©f (a) Building Permit Fee 2. Electrical v (b) estimated Total Cost of Construction ftom 6 3. Plumbing Building Permit fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 14Check Number c22ZZ I APThis Section.For Official Use Only Building Permit Number: _ D Date Issued: Signature': Building Commissioner/Inspector of'Buildings Date . r 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? NODON'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. Ar there any proposed changes to or additions of signs intended for the property ?YES No IF-YES, des6ribe size, type and location: .g SEC 0 A �+DN Q ROROS EDA�WQRKcheck fl a " Irca'bl" N xffVD :, 4 rr:,. ... . New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ _ Or Doors ❑ Accessory Bldg. ❑ DemolitionX New Signs ( ] Decks [ } Siding[ } Other [ } Brief Description of Proposed Work: t rI Alteration of existing bedroom Yes-.. No Adding new bedroom Yes X No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Rall 0- Sheet 0 ..a ear:_ dffrM dit�on toe ising _tffirgc "# " e' fAiow�n :: 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 Nc 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 SEGC�t31�;�� 1�YNrALlTHOF{IZATlON TO BE COMPL D WHEN �OWNES/�GNjCONTf2ACTOFt APPLIES FORBUILL7! G PERMIT I, as Owner of the subject property hereby authorize to ac: or my behalf, in all matters relative to work authorized by this ibuilding permit application. Signature of Owner Date I• , 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 Signature of Owner/Agent Date 7777777777777 SFCTON 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable1 Name of License Holder : License Number Address Expiration Date Signature Telephone Reg se e a mp o e entContracto " Not Applicable ! Company Name Registration Number Address Expiration Date Telephone ...._..... ..... .....-..... .. Y EGT 0� NW- INSLIF3ANCE AFFIDAVIT(M G:L. c. 152, §;25.C(6)) x�� v . 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. 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"homeo wrier" shall submit to the Building Official,on a form acecptable 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. zzHomeowner Signature StSANY,�U o " �,zf1t ziMW � � r�t�xsaacEtnsctls �� � ` > i=r• %y- DEPARTMEN71' OI' BUILDi?�G INSPECTIONS 212 Ma'm Street ' Municipal Building Northampton, Mass. 01060 ' �~ o.rith a principal place of bus' esslresidcnccc t: t�pllt)tle'=} LjG 11CI"U}` GCr-LLt}'. j)Cj1.'_Ii1C.; OI ',)C;' 111�t, :Viii. { } I am an employer providing thr- v.,ori_c;'s coltlpensa13011 c0vera��•c for Iny cmployees working on this joba {lrsa_ =a Compam,} (P c ic;Num,be r) (Ex#mt on Datc) { j I am a sole prow-11etor, y7enerL c-JIJITrCor rlonleot"I'"ner {ci;cie one) anti :Nave 'Hired the contractors listed 5e:v,v ^C) ilw it fvd .r;�% �; Jf Il ? Oil -DO.K.cs: �O i tt S GO lr:. ('amc of ContrnctOr} (?r15Ut DGS C01 ry^ :7'r;PGi1Cf t1llST1 r} (Z?: r%iG' DatC) {Name of Contmmor) (las-Llr,_nce Co`DaZYPG!i7, NiLmber; (3 :ui-atinn ate) ('Name of Contractor) (tns�Pnc� Co n-aa.,i�olic, Nu�x7ber} z=�.:r,a;oa Datc) ('Name of Cont ictor} - �t)SdPI1C' ��3I? ;yrl70iiCt 14it1Zlili r} (.�::i;'. :il ' DaitC} ^tLlGj1_.(i'"�ia Mal S'Kre:p..ry.�.+�_:'•�:^,_::7..,:,,, _ . C I mm a: ;ole 1)1'01?rielUi hila llClv'v I](� Clip .,'�)?�� i;f i IrJ -1=C` { ;III i? 110111e YYY 7 *.C7"I�F::,Icy u be ar-a;c that•.,'z;ac}xKrc:.�.,ir_rs,,;.�c:�;�!-;:y;r-^._�;,�t:>rri��:ainc�ct:.: n:r..:m cr::;-nir,� :>_.-_u;,,cl!i^:;�. not ux?ce ttLn thrm unilj in Ltf ctx }e 1; z .tz,x r or or: n,:t =*oyc's uz>cr the tvc;l::r'_cc _..-n t r_(�t.!,� :{`:a,:,:, ._. ? +-•�••r� -- '.;1 C:'icy a l":M..SGQ it'n[f iGT L 'CC7;". Icgil xtatut of en a;apla}W unur thn Worker'. or a_iiion.e. I u-'zdczt. d thz a co?y of t}u auy bo fofwtxrtio-J to t!n tY_Siuuxxxa:of 1,o&mr1:J MciLa,-.y O Hca of for tlx aovcragc vcriGctlon aid th_t f-ilwc to s- uc 001-1--r--y- 25A of:lGI.152 can to the imPO';itiOn o: cOo=isting of a fur_of up to S 1"500.00 nnt'Jcr i-:-nr:v L of::p to cr,;j-w!:.1 civil perzxllia in do fc r of a Ste; f T> of S 100.00 x dsy.rain:A rn-. - For dc¢uur,,r:l Lx.c crzty Ycrrnit Numtx:r _____ � `+�ztaLurc GritV of Nart4amptan 8'35 ACltliSttt6 DEPARTMENT Of BUILDI)NTG INSPECTIONS INSPECTOR 212 Main Street 0 Municipal Building Northampton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as has/her construction supc-.,isor. 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 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 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 1, understand the above. (1-ffi�eow`nner!re` ,i� ign`iture requesting exemption) I will call to scheduTe all required building inspections necessary for the building permit issued to me. Date__/_,LS/(w 116 Address of work location- y i r i w- t t4 ir' t t �+ 1 t i k r + r v