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24D-299 (2)
19 HILLSIDE RD BP-2017-0530 GIS g: COMMONWEALTH OF MASSACHUSETTS Mao:Block:24D-299 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT__ Permit# BP-2017-0530 Project# JS-2017-000864 Est.Cost: $3200.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NEWMAN'S CONSTRUCTION 64690 Lot Size(sq. ft.): 5532.12 Owner: POPPER LEWIS M& SALLY D Zoning: URA(IOdy Applicant: NEWMAN'S CONSTRUCTION AT: 19 HILLSIDE RD Applicant Address: Phone: Insurance: 697 BRIDGE ROAD (413) 586-0273 WC N ORTHAM PTONMA01060 ISSUED ON:10/19/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE 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: FeeTvpe: Date Paid: Amount: Building 10/19/20160:00:00 S40.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 610, A-530 Delia n r u I # My of Ihlorrharpor. 5ads of 7e nR r) - , BJiI inc DeGa't•-1ev17 Cob;Cut/DrivewayP6mR r�(��.t—_—.. —P 212 Main Sue& r6eHE R8 ph Av lablh = ) I Room 10 Nater NeIIPvarl Illy - _ NC 'hampto^ MA 1060 ��j 8 lwo-S so atr aural PI rs - - �� vhon 49 -587-1240 Fa.^'13 587 "272 �PIoVSt PI s - Qthe=co city pEPr OF nhiWIF15G 11.T ON9 �r NOWHNAWON "NOtOoJ I. AYYLIGP.I�ON I O CONSTRUCT,ALTER, REPAIR,RENOVATE OR OEMOL H A ONE OR TWO FAMILY GWE_LING I SECTION 1 -SITE INFORMATION 1.1 Property Address: Int ecnontobe completed bh office l9///�/Si0 Z %l-ly`G Map = Lot - _ Urd /� kil -cone. overlay Disrmt - I w 010&01 St G .r = CS District- SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: / '� 2o�,� / (5--a//1/ /o ri /9 /hz //% o 4Jdroa Name(Pert) M in_Address sJ/3 ' 70gq— O/4 Telephone I Sigoeture 2.2 Authorized Assn': 1El , �7 Ir 4.d"( ` �` O15111dl Name P ) Current Maihno Adds ) I �� Hor3 '"0"r6'/d P5 Signature Telephone ECTION 3-ESTIMATED CONSTRUCTION COSTS I firS ea. Item Estimated Cost(Dollars)to be 1 Official Use Only completed by permit applicant I. - 1. Building I (a) Euilding Permit Fee 2. Electrical i (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Pratecttion F 6. Total=(1 +2'3+4+5) LCheck Number BC/5- 44,0 This Section For Official Use Only Building Permit Number: Date / ed: Bull Aammisslo, speoor of hulloing: Date F 5,241/ ° - r 1 Sectfor 4. ZONING Ar Infermates Muse 3e CoppleeeP serreG Can he Denied Due To IreamoFete Infornateen Exiling I Proposed Reprised by Zoning :m t `fiecin by F 4 IL g Deparrpsot II Lot$IDL I' <_..e.. �/ -1 ��Frontage _ ....,.-n ..,.� Side v Setbacks Front R . - I r w. R: )...�.. _....>_ I Rear BuildingHeight Bldg Sc-Wars Footage h t _, I Open SpareFootage j __ / I — C! r bus bldg&paved I . paltrier) totFaki_^Spaces I —. I ---- ---- I — Fur Eu? 8L acGxN �.... r....._.._�...., I .v.>...- A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued.: IF YES; Was the permit recorded at the Registry of Deeds? NO 0 DON p�KNOW' n YES 'aJ IF YES: enter Boor : Page--, and/or Document dl� B. Does the site contain a brook, babe of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? I Needs to be obtained Obtained 0 , Date Issued: __J4; ' C. Do any signs exist on the property? YES 0 NO 0 RYES, describe Size, type and location: D. Are there any proposed changes tp or additions of signs intended for the property ? YS 0 NC 0 IF YES, describe size, type and location: --___—._.,...�,_._.--._.,....�_._._____._,—_ P. Will the construction activity disturb Wearing, grading, excavation, or fil'ing)over I acre or is it pod Of a common plan that will dIsturb over 1 acre, YDS a NO 0 IF YES.than a N'orhamptcn Storm Stealer(dsn_ge er and from the DPhil qc :er I i SECTION 5-DESCRI?TDON OF PROPOSED WORK!check all aooficable} New House n Addition n Rapiawment Windows AI(eration(s) 1 1 I Roofing 3' Or Doors Cr Acce=ssory Bide. LIDemolition ❑ New Signs fCJ Decks fy Siding IC] Other[C] Bret Description of Proposed Work: _r r I 0 . ...P k- 4.L It lis, jr 1.....1 11.1I0 • Alteration of existing bedroom Yes No Adding nlObedroorn Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet tie !f{VeW house avail or addf.lon ter existtha hsousumq, corn.Pete the fofloWtgq: 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? Method of.heating? Fireplaces or Wocdstoves Number of each g. Energy Conservation Compliance Masscheck Energy Compliance form attached? K Type of construction i. Is construction within ^O9 ft of wetlands? Yes _ _ Na. 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 CO Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION•TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 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 tilr Y+'7. Y r°7' l7 fX' -�^' sz i Og trOtiirn �s.�- �< e' e 7'fi � � Era .,�-,,. � >y..,i:. I � e fig 5 5 , as Owner/Authorized Agent he—by declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and be f Signed under the pains and,p,�e.n��aatlties of perjury. (? £ WMliA) Print Name Signature de er gent Date SECTION 8-CDPISTRLfCT1O.v SERVICES E.1 Licensed Construction Supervisor: Not Applicable E N rneaLie9uHolder. �3 searika S —06976 License NU er 7 p � Address Epirati Cote La Signs: Telephone B Reaiste d Homelm.rovem_nt Contraco- L71:7_71_7:1 - j Not Applicable E �✓ ^ /17/c2 n7 Company Name Registaticn t III Number ber z I _ / r �D mb Address Evoir tion are M¢ pIob Telephone 4%3—¢6"1673 _ I SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(IM.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 nermit. Signed Affidavit Attached Yes _ No _ 1i. - offie.Owner Xe.EtDtio : The ccrent exemption for'homeowners"was extended to include Owner-occupied Dwellings ofone(I) cr 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. CM_R 780. Sixth Edition Section 108.35.1. 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 o the Building Official,or 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,von presence on the job site will be required from time to time,d&ring 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,von may be liable for pe-son(s) you hire to perform work for you under this permit. The undersigned`homeowner"certifies and assumes responsibihry 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 The CoYddJJ ehmeaf'2 ©TMass-handsets n Department fl'rihFf r tlai Accidents `t r6 1:tT. w",-7,`f—66 Office ref Investg th nes 1?,; tp-"`_,6 6t 60D Warningion Street 07-7 471 D . >„ ?Resect:, MA 02111 l nem w.mass.g©whella Workers'kers' Compens=aaam insurance -fslaanl. PLps.e:rafta*neract rs/Ell.eetrfclatns/Plumbers Anntiesnt information Please Print',evilly 1 • .. Name (BusinerrIOrge ,zzaationrindividduual): i - ) .-r - - . ,, at i IS city/state/zip: je .>, i{ , -..3.e Phone#s _.. - ---/J-55 u Are you an employer? Check the appropriate box: Type of project(required): I.H I am a employer wi`h 4. I am a general contractor and I 6 ❑New construction employees (full and/or matt-time).* have hired the sub-contractors 2.N I am a sole proprietor or parrer- listed on the attached sheet 7. H Remodeling ( ship and have no employees These sub-contractors have g, Q Demolition working for me in any capacity. employees and have workers' 9. —Building addition [No workers' comp. insurance comp. insurance.- required.] 5. We are a corporation and its l G._ Eleotical repairs or additions 3._ I am a homeowner doing all work officers have exercised their 11.7 Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL l2 17,'Roof repairs insurance reouirsd.]' c. 152, §1(4), and we have no 12g Roof [No workers' 13.0 Other,_ comp.insurance required.] - _ 'Any applicant that checks box 41 must also fill out the section below showing their workers'compensationpGAoy information the.meowners who submit this affidavit indicating they are doing all work and then hire outside.contractors must submit a new affidavit indicating such. Contractors that check this boxmust attached an additional sheet showing the name of the sub-contractors and sate whether or not those entices have employees 'gibe sub-contractors have employees,they must provide thefr workers'comp_policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lie. rt: Expiration Dater Job Site Address: City/State/Lip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGT c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DLA for incurance coverage verification. I do hereby r:ertify_ eJ� under the pains and penalties ofperjmy that the information provided above is trues and correct. .`)]kL/�antre: t / Dare: Phone#: '%/3' �6i 3j /6 `YO7 v Oficial use only. Do not write in this area, to he completed by city or town official City or Town: Permit/License D Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical inspector 5.Plumbing Inspector 6. Other r Contact Person: Phone if: _ \ CityS of o,� thaaup on s 8 1 4' ` Massachusetts t iJe it I �� t o _NT OF SUILLING ZNSISOTIONE 3 4 r a. . cin Street o Municipal ding Northampton, la MI260 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER E)GMPTION ACKNOWLEDGEMFNT The State of Massachusetts allows the homeowner the right under 7800MR 103.3.4 to act as hisiher construction supervisor. 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 dwo&P,rng, 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 reauired) 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 occuoancv until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbino & 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 understand the above. (Home owner/resident's signature requesting exemption) will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: � J4102. �Y✓= � The debris will be transported by: 4/ an/S &vrs/ The debris will be received by: city Building permit number: Name of Permit Applicant ///bid//41/ x Date *nature of Permit Applicant / ,_ PrOpOSAI _.... Page No. or .... Pages NEWMAN'S CONSTRUCTION 697 Bridge Rd. Northampton, MA 01060 1181 413386-1093 PROPOSAL 90BM0'I@O l0 —7), PHONE GATE ,/ ,, :,s jr_. /�yr /er/ rr 737`b'C,// /(cL747a STREET / JOB NAME _flyAr t?,12' fdacSi-CS CITY.STATE andzIP CODE JOBLOGA11 ci c /- - /Pta t✓ /% d/OE O J1.s,C. gpy'HITECT DATE OF PLANS JOB PHONE i __ We hereby submit Specificatere and estimates ter. V, y^ - _ / c, h ✓`7�.atilt... /9 CC/ J.aY.//Jl. / r.�i i2 .? or: 6.2/9/2 t3.)[C J.4 /42 4,05-.SK 5 a 10 37—.C.1 Eh'Se / C e1 � ..-�nS/�� /uG re rr.- rT c. . �LL /';tx'f s fi?4' �uifrr� t'yd/i./ Jc£ i '!il'_a,:_ Z.L.f.a-, f-- z/H/cs 1 ,5a:9P t).-t % (!15 . ✓-14.4sc47,set eat LG,a::L 7ifhet /c'.i 5//2D Gc6'=(.�._ J: 'eks� w. PT 'i�8 p' L-l�i;r.'C�./N h[,5/C f ..C451-.0,11 -, * Al .'n.-az. gez�1 � /..xJ.t.� ,c1—,,,1-5/,-,4, a5 .45-v/ Q/ 1 ,,w a.„- z„„ / ' A Lr v S I k /hloh s �c++ d£x_s "4-2:2,.< Gri�e.4h <4K st,✓J Li U OP 2 4. R' r C t /Y/? . . r ,,Fr_r LX.S 7r47j ,4772ev6's .y S.'rfir_A_ aft, 9 @Aa.: / 1 - tl/ rL / tscz}tl+ 35 <4cL \ a ° ; / "-A_ d ,•-..—tJ 7 c .cz n-cck. , { j4u<s L 0 Mr Propose herebye{ to furnish material and laborla —complete in accordance with above specifications, for the sum of: /A 4,7 / /1%%i + r -7' t:',:;(;);:‘,_ dollars($ 3 • ) <w t - Payment b be/able as iotlowa: ''� A8 materiel is guManteed lobe AS Scecit ed,AS work to be.completed m a wvlmanlike * tt. 2Qd 9 mHa' manner acrding to standadPacT alteration aro ce t- tm ti above pecateme Signature r" involving extra osis will be I d only uponnn. ordersand will becomean wire charge over and above the stimat All agreements Contingent upin strikes accidents F or delays beyond our control °w 1 ry Inc tornado and IM ec ry urance, Note Th s p o.,Sal r'.y be i Our workers are fulry covered by Workman&Compensation Insurance withdrawn by us J not ✓-pled within .7 days. / sp Acceptance are of Proposal are The above prices, authorized � / „p, and Gthewns are satsfactory and are hereby accepted. You are authorized Signature/ 4 --to do the work as specified. Payment will/be made as outlined above. / edSS— Date of Acceptance: R A ' /4 ..... Signature ....... \\_ %//