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06-032 (3)
59 LEONARD ST BP-2005-1087 GIS F: COMMONWEALTH OF MASSACHUSETTS Map:Block:06-032 CITY OF NORTHAMPTON Loc-001 permit: Buildi g Category: BUILDING PERMIT Permit BP-2005-1087 Project# JS-20054477 Est. Cost: $1000.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: use Group:_ Homeowner as Contractor! Lot Size(so.IQ: 27660,60 Owner: ROCKETT JOHN P&JOAN E Zoning:URA fipplicant: ROCKET JOHN P &JOAN E aIT.: 59 LEONARD ST Applicant Address: Phone: Insurance: 59 LEONARD ST LEEDSMA01053 ISSUED ON:11I05 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE WINDOWS & DOORS ON PORCH 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: 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 5i2nature; FeeType: Date Paid: Amount: Building 5/5/05 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patilto r .... !:.. ..'.2....":"‘- a -4A t only .. - Cityof Northampton StaluflfPemp' +_ Building Department Curt . ya"t ; 'aeRnd t q— 212 Main Street 01 i, _,1 4- - Room 100 aternWen Availability �>-^' Ss, Northampton, MA 01060— T ofStrucl -_ , phone 41Y-587-1,240 Fax 413-587-1272 Ofher Sped( . "x" APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION - This section to be completed by office t.1 Properly Address 5 y Leonard 5+ Map Lot Unit, 1, eeas, ilia _ Zone Overlay District Elm St District CB DbWct SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 24 Owner of Record: .Lchn t .)uan I?Octek- cy teonurd 5.1- Leeds jfta oro r3 Name (nnt) Current Mallin Address: a g5-74– 7 7 s- . . k. y6LVn (-L'L{CX'ut telephone Signa re 2.2 Authorized Agent: Name(Prim) Current Mailing Address: Signature Telephone SECTION 3(ESTIMATED CONSTRUCTION COSTS tern Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building t 0 p J (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) �, OOO Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature'. Building Commissioner/inspector of Buildings Date Section 4. ZONING All Information Must Be Completed, Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This solemn to be filled in by Building Department Lot Size ..___. . _.... _.. .._ _._.... Frontage Setbacks Front Side Hear Building Height i 7+ — Bldg.Square Footage /p' ...; 46 ......... Open Space Footage (lot area minus bldg&paved Pulsing/ d of Parting Spaces - J Fill: _ ivoiume&Luenion) A, Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES o IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW ® YES 0 IF YES: enter Book Page g } and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW O YES (J IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained 0 Date Issued: C. Do any signs exist on the property? YES Q NO ()1 IF YES,describe size, type and Location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO IF YES, describe size, type and location: E. Nall the construction activity disturb(clearing,grading excavation,or filling)over I acre or is it part of a common plan that will disturb over 1 acre? YES O 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 ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs (CA (CI Decks [El Siding[DI Other( Brief Description of Proposed l f AA rcp�QWG/010 S G11d (/oorS 0 Work: n Pxls'✓•l/15' Cl orc�r Alteration of existing bedroom Yes No Adding new bedroom Yess / No Attached Narrative Renovating unfinished basement Yes _ . No Pians Attached Roil -Sheet 5a. If New house and or addition to existing housing.Complete the following; 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, 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 It Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank_ City Sewer Private well City water Supply SECTION la-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,Tohn foc..h. + Joan .Uch/f ,as Owner of the subject o rt P Pe Y hereby authorize r[,.✓, (, — C^-�! / FL4/C to act on my behalf.ir�all matters re ative to work authoriz d by this building 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 SECTION 8•CONSTRUCTION SERVICES 8.t Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder'. License Number Address Expiration Date Signature Telephone 9.Registered Home Improvement Contractor.. Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10•WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§2SC($)) 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 0 No ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or nw(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 buiidino permit. As acting Construction Supervisor your presence on the job site will he required from time to time,during and upon completion of the work for which this permit is issued. Also he advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)ofthc Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeownercertifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,S_iit - S----____. 9and Local Len ng Laws and State of Massachusetts General Laws Annotated. Homeowner Signature ti. �,V “-L t a 16.0C(C661( ittchip M , Citg of Northampton -a � a a"afti pr; gt.s...ga..u. is ---al= we DEPARTMENT OF BUILDING INSPECTIONS Kilt" _1 INSPECTOR 212 Main Street • Municipal Building Nurthunpton, MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction sups.. icor. 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 i`egulations. 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 L J GCI n Ir0 C kC PA- understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date 3/4 /0 S Address of work location S9 Leon ecz c1 51- t d S .Ni LA...._ • OQ_SltAtf P3O � p• r e of PaJ:tI)Dtltpton 1 �= 111,1 +,f ,i u.noh ncalb' eeeJ '__ a — DEPARTMENT OP BUILOrNC INSPECTIONS• 212 Main Street ' Municipal Dnlldiag Northampton, Mass. 01060 r' W'ORKER'S COMPENSATION U SURANCE All ll),WiT — pimnsx/px..mince) with z principal place of business/resIdence at: - -- (phone) (smwUcity/natetrip) do hereby certify, under thepains and penalties or perjury, ilial ( ) I am an employer providing the following'worker's comoens-_:ion coverage for my • employees working on this job. (Inrcran¢Company) - (.Polley Number) (r'pirtio n Dave) ( ) I am a sole proprietor, general contractor or homeowner (circie. one) and have hued the coneacors listed below who have the following workers comnen_sadon policies: (Name of Con,ncor) (Insurance Company/?air/ Nurac:) (Exuin_on Datc) (Name of Cootroor) (Insurance CompanclPoUcv Nene ) (Eipirtion Due) • • (Name of Conramer) Msuranc Company/PoUcy Noshed) (Evpirrieo Dare) (Name of Contractor) (Insuranc Company/Policy Numt_r) (Expiration Dale) (mad itnnary e c===y''w pnienc re.0 me-.v:a) O 1 am a sole proprietor and have no one working for me. bhp' am a home owner performing all the work myself. NOTE plea M tern th bccoom+ensa..to=soplay pe*ooau y --nr= ntairweek menl y,of am nae th=thee?oua•'im Nc bamcwoe rod or m,k ouuMv+ap+^m_Wr..oc ooC 0'm.-JM==.:.0.---eda orcOloycovow ka,n-.-2.- no Pa(GUI 32.1n I(5)).+-PpUnboo by•bonny fc:bc'c a p -mnu=y C•43COCCLbc Icgl.uva of eo oder En I uoUcu4 ma ampy eriy.eatmm nay b( • 4 to tb.D.9..w-a of bA.r+:J..mmad O'$n*or n.m far W. covn.gcniGana and au Chin to imart bc.r..nte no=mioo 25A of MOL 132 an lid to the'r-' cemm o(e'm'°'i pe" i'a • a'm'acg o(a Got ofty to S 1}00.00.odea mpiacerana o(up to o c"tar..ud:Evil panic e thc form o(.Son Yin-Orth ud. (m o(SIOO.Oo a day.pica roc / /j For dmmm�y n.c ilii / ( aWr /L�f�— Permit Numtrs >ly O> NSP, Loin. e k Symauuc or LimssclPcrmiucc -