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43-063 (7) BP-20040005 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot:-001 Font: Building Catecorv: BUILDING PERMIT Permit u __. BP-2004-0005 Project s 3S-2004-0005 Est. Cost:$4600.00 Fee:$25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Orono: B & R Siding 100465 Lot Size(sq. ft.) 15 115.32 Owner: MCELROY PATRICIA L Zoning:SR Applicant: B & R Siding AT: 40 DUNPHY DR Applicant Address: Phone: Insurance: 781 Bridge Rd. (413) 586-4167 Workers Compensation NORTHAMPTONMA01060 ISSUED ON:7/1/03 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL SIDING 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: Receipt No: Date Paid: Check No: Amount: Building 7/1/03 0:00:00 18823 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo y. - Departrpentuse I —T C ity ofN rtIlfmpton Status of Permit:- t (n�C'ullrin I..sl zI SUDS/b Curb Cut/Driveway/2m "v+t rr os C.�' _ l L*,._ II ' MPH. :tree{ SewertSeptio ailab i yet . sA,e¢v e ve �, it 1 II + m CO Water/Welt'Ava`llilablllt e'?^` 0Ii- 4? A.'? rpA �r+ I Irr'nn Mk' 01060 TAO Sets of Struetural /pans 1 1N1_ — + I P 1? a — .e, R '(-13 i _ Plot/Site Plans - ) r hr I.6ki,l©R JD-O-BNSTRLICT. ALTER, REPAIR, RE-NOVA-FE OR DEMOLISHA ONE OR TWO FAMILY DWELLING ..Sect ... ........... .__........_. _ I SECTION 1 - SITE INFORMATION L-- This section to be completed by office 1.1 Properly, Addres5 Ts Map _ Lot Unit vii a Ty) A- n to c.c.:— Zone Overlay District__ I Elm St.Distri _-Se ct CO District _ - -- SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 21 Owner of Record: ATic: /c. / < , C 1 ,y lyst) {, p4v Li p. 1 >/' .) \+ wr) / /oC - ,4'. - Y';1 i}- Jlc2 &d_ 12.2 Author ,ad Agent: -- C R.,1.-v / h) L 1'.:J pAi31/47 . h 4C�r /.3121 '/�,e /sc"-( N o/2,l/;Aj r .2TOA: f"'r+' z >7 1 1;.;-„ s /, ics 5 —//t 7 _ Sect-- Sect-- SECTION 3 - ESTIMATED CONSTRUCTION COSTS 1 I(- r 1 rn to 'best allay=_7 ; "_ Offtss .;se Only tee a. trafat t ebr a f I /1 i6OO T . t ft frau, s Sect — . ` Building Permit F'ee 2:__ 9i< gt ,_ nr.n L! Sectio :. — , " ._Sect I'hIs Section For Official Use Only Building Permit Number, Date Issued _.. ye ' Signa'ulr. _ t L J IGr g ey,II aIvlonc n +dorof t arta gs 'wt., 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 Dcpartmeni Lot Size Frontage Setbacks Front Side I; R. L: It:_ Rear Building Ilcight I11dg. Square Footage Open Space Footage ,a (tui arca minus Licht,@ paved parking) e of Parking Spaces Fill: (vblunu&location) I 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 # N. Does the site contain a brook, body of water or wetlands? NO _ DON'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. Are there any proposed changes to or additions of signs intended for the properly?YES No IF YES, describe size, type and location: _ _ __— SECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicabj) New House 0 Addition Il Replacement Windows l Alteration(s) [.I Paoli 0 Or Doors O Accessory Bldg 0 Demol t'mnl l j New Signs f I Decks [ Siding [ Other f Brief Description of Proposed Work- Alteration e k Alteration of existing bedroom Yes -__ No Adding new bedroom Yes _ Nc Attached Narrative L: Renovating unfinished basement e_ No Plans Attached Roll U-Sheet 6a. If New house arid or addition to existing housing; complete the following. a liso of huilding One Earn•ly iamiiy P.her b. Numberr of rooms in ach 'Toms io Nua of Bathro ms C. Is there a garage attached? Proposed Square footage of new r construction Dimensions e_ Number of stories? f Method of heating? ___.. _.. Fireplaces or Woods:oves Number of each g Energy Conservation Compliance _ liescheck Energy Comoliance m'el attached? lyoe of construction I Is construction v.:thin 100 ft of setlidrdte (es No k construction within 100 z: 'Hoop aim Yes Depth of basement or cellar floor below tinished grade k. Win building conform to the Policing and Zoning regulations? _ ms Nu I. Septic Tank City Sewer Private well City wader St ppiy —_— SECTION 7a -OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT e C / 4 __ �. EIP O�Yj caner f t subject prop hereby authorize (� 1/J: /-1 L /$ 2.4 I �' my h ha f #1! matt r,hn,n_ r p ` th 1 n, te r n o / , \ _ -_o > Signature of Owner Date p :Cr."I'1 ' f`' Laver/Eutnorized Agent hereby declare that the statements and intern anon on the foregoing application true and accurate to the best of my knowledge and belief. Signed under the pains and penalties of perjury. r—r r0 "LAIt Ann e ( Signature of Ormx4Ape t Date SECTION 8 -CONSTRUCTION SERVICES 81 Licensed Construction Supervisor: Not Applicable ❑ n Name of License Holder : Ega.) P-) 6 /3 )64Oi /� License Number f rY�G� J' ^ rr 11.E ✓��� 0 • d Addressa Expiration Date Signature / Telephone 01` a 7 - a Ri,RegisfeiedrN rifle- Improvement Contractor:..,, , „„,,, Not Applicable IT nny Na' /c- 3%71)(10 J' ,J,QTa✓ Tic? Compo ny Name Registration Number do Address Expiration Date ' 7/. ' ;20;20144 O)O6 sirelephone 5-01 -7/w -7 -01 —7/w7 fl e `/ O .2-oo / SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. C. 152, § 25C(6)) / Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this athdavd will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes © No ❑ i `.,Home Owner Exempt o 'Ihe current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) or two(2) tamilie 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 construets 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 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 fir 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 Gencral Laws Annotated.you may be liable for person(s) you hire to perform work for you under this permit. 'Elie 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 _ tply D,croI;I», i.,ajP - '(. ( 'IFin)tc;' hi Yc IY - mil 41-2,2 Is1 eyLra .. I_- 1 _ ::❑ ( ,\AIC C:' � .Iltii I'IJ„) c.. A 0P ����tf t o,o-/tart,'-5i�- ram J ,nf )yo.ta ! * d-2. 911 .I.L. . ... ... . f:)V V;1.ISLI );oll .Y.t flc(Y) � 2L[ iUU.1A ...i, o=� l �) (t:FT uu}rPuuyptn =O S:.AFIP�oh \ M.q Lifp of Northampton C1= anti !•lie lOnse.cpil,.n.