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07-045 (2)
BP-2006-1257 GIS it: COMMONWEALTH OF MASSACHUSETTS ,• CITY OF NORTHAMPTON Lot: -01 Permit: Building Category: BUILDING PERMIT Permits BP-2006-1257 Project it JS-2006-1862 Est.Cost: $3200.00 Fee:$25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: TIMOTHY J LUCE 149288 Lot Size(sq.ft): 21780.00 Owner: OLBRIS CHESTER F&STELLA M& Zoning: RR Applicant: TIMOTHY J LUCE AT: 284 NORTH FARMS RD Applicant Address: Phone: Insurance: P 0 BOX 14 (413) 387-9800 LEEDSMA01053 ISSUED ON:5/23/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:ST RI P & 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: FeeType: Date Paid: Amount: Building 5/23/2006 0:00:00 $25.00315 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo • • orthampten -t! - —= —�UI ��aPa(ffnant ' '-�� r-u� .'�-' _- 21 ' ' pi 100 ain Street a-V .� n�- Northampton,INA 01060 S-"°r''y ice"' :... '-Xt v , phone 413 1240 Fax 413-587-1272 i x - sa APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION t-SITE INFORMGTN)N 1.1 Properly Address:__. :.. -:i 'ZRiee ljon b6e cgmPfeted6lp ffce ' 't/ itiOR,m TArzmS R04b ..•^lutap.Y t'aR.. `. - .- TJoiL FLor2eneIel 4/19 010 6ari- D�ed'mosmcl xEMrrSt'nLstrY[ ce.pim�L SECTION 2-PROPERTY OWNERSHIP/AUiHOR/ZEOAGENT 2.1 Owner of Record: -_ . IcL. br2.44l U'L MA Pit ?.. L,luba (94, 6215 �isU /00/C17-7fQof-CQICMc 7<r) Name( t) Current Mating Address: �' Telephone c70 i - 469 -.1634 Signature 22 Authorized Agent _ l/mott_v T Loc ?c tOIC /0- Lr 5. V/Ao(o53 Nam r\' Currant MatingAAddreess:: y/r4 - J 31 - / �)6 O Sig re Telephone SECTION TED-CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be - Official Use Only completed by permit applicant 1. Building y 32C la),Building_Petmi Fee 2. Electrical ;(G):Esti atedTotal Cost of -...-ConsttiKtion front(6) 3. Plumbing 'Building:PennitFee. 4. Mechanical(MVAC) 5.Fire Protection 6. Total=(1 +2+3+4+5) 01 °-:- Check Number Slits$ecfowfbrOffidal Use Only Building Permit Number _Vete.. Issued: Signature: al- ung Cammissicnerflnspector ofBuildings Date Section 4. ZONING An knfa nati&t Nun Be Compuned.Person Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This=nom to be fined in by BeuN®g Department Lot Size Frontage —. ] Setbacks Front `, t—I I • Side L:c-1 R: i '1.4.__4 Rd i Rea = ` Building Haight i'--^7 i _- .._ Bldg.Square Footage 1 ' i °/. T I i-1 Open Space Footage % (La mmaminwbidgepaved i I '1 I 1 1____1 C paths) #of Parking Spaces 1-- i'-" FRL fvalw &mrmliw) < -, 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.' I IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES O I IF YES: enter Book iI Page and/or Document/ I B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 ', Date Issued: `_ C. Do any signs exist on the property? YES Q NO 0 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 0 IF YES, describe size,type and location: E. WN the construction activity disturb(d om ring,grading,excavation,or filling)over 1 acre or is it part of a cmon plan thatwif disturb over 1 acre? YES r NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTIONS DE'1RCRIPTION OF PROPOSED-WORIC(check attapdicabj New House n Addition ❑:; Replacement Windows ANerationfs} ❑ Rooting Or Doors 0 Accessory Bldg. ❑ Demolition 0 Now Signs [O] Decks [C] Siding[O] Other[m Brief Desc iplon of Proposed Work: _ �`}Y CNtiriltvtY � Alteration of existing bedroom Yes No AddingiwWf/ledroom Yes No Attached Narrative Renovating unfinished basement Yes .�No Plans Al/ached Roll -Sheet itimew. -mat. a. ..sa of bddl:g:One Family Two Farniv Other b. Number of rooms in each farcy unit Number of Bathrooms e. Is there a garage attached? d. Proposed Square footage of new consmrcdon. Dimensions • e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each__, g. Energy Conservation Compliance. Masschedc 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. 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" -ttfVECOF@tttw WHET OWNERS AGENT ORCONTRAACYOIRAPPLJ S`FORSOLIWNGPEZiWT LIIAA 6LRki-C as Owner at the subject property hereby. ...yyy;:iii: r f tt?70 t ©1 LA) C.1-: to act onj . 4 al matters relative to wag autlwrsed by this building permitpp Signature d. Dam .l - / /00 /A k// r LU Cr as Owner/Authorized Agent hereby declare that the statements and Information on the foregoing application are tare and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. (. Imo -1-Wv y! . L oC Print Na Signiture of OwnerfAgen Date SECTION e-CONSTRUCTION SERVICES ,c at Lionised Constntctioa Supervisor: Not Applicable ❑ Name of License Mower: License Number Address Expiration Date Signature Telephone H= clIt A lit "i"'-'s 'Y' v- m3a-`a «a..sza. t.^�-`, '_ Not CompanyAppTificebiee� —"'—' 0C$J Company Name Reg - fsr Geer 5 p Address Eau I. Telephone vs 3d l JJQ3 SECTNIN:10.VORkERS'COMPE$a&nONINSU*Y tsffi HbAV)1'"(12 n.c..4.2j25C(0)} . .. 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 builpuma. puma.Signd Nlidav8ACnda.d Yes....._ fY . No 0 r=:E, .. nw aI ah lr zY-year•in The current exemption for"homeowners"was extended to include Owper-otenoial Dwe&iaes of are(I) or two(2)families and to allow such homeowner to engage an individual for hire who does not posses a license,provided that the owner acts as supervisor.CMR 7816 Sixth Edition Snet101%10E3-5,1. jjefinitton of Homeowner Person(s)who own a parcel of land on which he/she resides or intaids 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.b person who constructs mere then one beam In a two-var period spall not be aneddercd a Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official.that hdabe shall be responsible for aB such work performed under the beihihre watt As acting Construction Supervisor your presume 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 Nabk for person(s) you hire to perform work for you under this permit. The undersigned-homeowner"certifies and asnmtes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts Genal Laws Annotated. Homeowner Signature • • ^a 4 (1itp; of larfllautpfoit f6 E— DEPARTMENT OP BUILDING IN$pGCrtONS • 212 Main Street ' Municipal Building Northampton, Mass. 01060• .. . ._ ._._.WORKER'S COWQ'ENSATLO.hi -[NSURA.PICE AFGTf1A.viY • h '7 MO /Asi J Lu CE - Qin'nsYtpermittcc) with a principal place of busin//esslresidence at: , ( T30 x 1 - & �Sr A D/053 (phone) 9r3- 38 -7,60 (m=Udtyf9ltrlap) do hereby ccnify, under the pains and penalties of perjury, ha ( ) I am an employer providing the following nvorker's compensation coverage for my employees working on this job: Ciusuranc Coormav) (POIicI Nwnbcr) (Expiruon Date) ( ) I am a sole proprietor, general contactor or homeowner(circle one) and have hired the coin-actors listed below who have the following worker's compensation policies: (Name of Con^cor) (Insurnnc Company/Polis,:Numb() (r3.?iauon Dntc) (Name of C000znor) (lasu'aoc-CompanvrPoticr Nur r) (Expinaoo Due) (Name of Concacuk) Unsuranc Compaoy1Poticy N oWvf) (Expndoo Date) (Name of Com:ramor) ,(tusurapm Compzay/Policy Numb--r) (Fx➢irauon D2}e). - . (anatn dacvl tha ifs: --y m bcwh iorormarw pnia ar a.1 00==e-ar4 ((�I a38 a sols proprietor and Save no one working for me. ( ) I mita home owner performing all the work myself. NOTE pmx W ant 4a r4k bamaten *ocmpleypaam am r-:..,-..,.-v ce.®a rove ani m.a ll=yot oat aae am sfroinza4 MINS&ibe bava.acerarla or Daae gratal.gpamst,arca...vt g=allly axaidead ro be e apioy=we=ae anta4 mixicraiea Ae(6I11.32a1(3)),Wdiorim by a boamaaa In t tic=a;wait r=y .A.,..>.- kp1w.' a clan mrlry.r nada-a.Wake,eotapwa.tpa Ace- "err et a"erT.( .ammse mybn fiaward.dto u.Wgaaee.rla jiO4 amaW Ora abounces cot W. Wall Ord c•ad as Ghat aaaaolavmec.wic avaa 13A 00.40t,151 m India sir as it uJ ' - •paabic Er ail m-Grit .r, 21,S00.00 to.on wa �=aaaeu Dray le yea ia.a pact v OC*NI O .r.Owa•.N. iazi ire:- , Cur`s of X hsmty - E l s J aa.�.. m -==_a AIL?�-�`'.) DEPARTMENT OF HtR7DD1C+INSPECTIONSe. -,-===-.- ,t INSPECTOR 212 Main Street 0 Municipal Building Northampton,MA 01060 = 1 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the fight under 780CMR 10$.14 to act as his/her construction supef.isor. The state defines"Homeowner"as,"-Persoi(s) who owns a parcel on which he/she resides or intends to be;ao�or'ftwlJandty - - 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." ..__..... TR-building department for mecity ofNortlamptoiflwants-any pason(s)-who-seekto. . ..-. use the home owner exemption,to act as their Mon construction supervisor,to be aware that by doing so you become responsible for compliance with state building codes and[sgulations. The inspection process requires that the building department be called to inspect work at various stages,which include foundationffootinns(beton bachfdl), sonotnbe holes(beforepour).a routh Nadine issnection(before work is concealed),insulation insoection(if reunited)and a final building hisoectioatThe building department requires these inspections before the wok is concealed,failure to secure these inspections can result in failure to obtain*certificate of occaoancy 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 is ue&and that they get their required inspections.Failure of the individual trades to seance the permits and inspections as required can PELAY the project until such time as the proper pant and inspections are made i, - 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 Address of work location i