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38C-059 (2)
BP-2008-0406 GIS 4: COMMONWEALTH OF MASSACHUSETTS OSININNEW CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Catccory: BUILDING PERMIT Permit# BP-2008-0406 1'roject# JS-2008-000594 Est. Cost:$30500.00 Fee: $82.60 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: James Finn 088014 Lot Size(so. ]I.): 6011.28 Owner: MCELLIGOTT THOMAS&NORMA I Zoning: URB Applicant: James Finn AT: 392 SOUTH ST Applicant Address: Phone: Insurance: 21 Henry Street (413) 219-9151 () N O R T H A M P TO N M A01060 ISSUED ON:10/19/2007 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 16 X 24 DET GARAGE & INSTALL REPLACEMENT WINDOWS (FLOODLIGHT ON GARAGE MUST COMPLY W/ZONING) 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 10/19/2007 0:00:00 $82.601978 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2008-0406 APPLICANT/CONTACT PERSON James Finn ADDRESS/PHONE 21 Henry Street NORTHAMPTON (413)219-91510 PROPERTY LOCATION 392 SOUTH ST MAP 38C PARCEL 059 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out y Fee Paid /7pp� p� �ot� (Jo Typeof Construction: CONSTRUCT 16 X 24 DET GARAGE&INSTALL REPLACEMENT WINDOWS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 088014 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON Ilyy07MATION 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 OHO ZONING BOARD PERMIT REQUIRED UNDER: § ON F.COi'l' l OF Finding Special Permit Variance* &4P46C 413/ Received&Recorded at Registry of Deeds Proof Enclosed eOspL� w _ O , 2- 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 Co fission Permit DPW Storm Water Management # any Signature of 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. ,p DeParfinentose:only_ 3 4 City of Norimampton }} q (p StafasoEFanmZ _ ' ' Y Building Department 1J(55,‘ /' 5-cr3irlrtvev2, oK a- - -°- 212 Main Street Spwe PkgAtra ,-,._vim -,Y- -i Room 100 tirateiMteli'Aaaittab` ' - Northampton, MA01060 meSetS4SF[obtuiaffians---�T phone 413-587-1240 Fax 413-587-1272 Ptoeriactans = Othec5PetW _ ` APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION1-SITE INFORMATION _f."—1 r I _ L/ Lc' i 1.1 Property Address: ! pt This seco°°to be tatnpleter€bYoftice - 35L Sova-. 5+ OCT 1 C 2C069‘ii., Lot . —i --c Nora-r.,oh . Me., _ - L-- 2'0 overlay Drslnt[ L NT o- eo . tE .csDiskaL _ - SECTION 2-PROPERTY OWNERSHIP/AUTHORIZEDAGENT 2.1 Owner of Record: Ion 4 No(rht //IC 1. 392 5o,,{{, Sk, Nor$vi...pion 0(066 Name(P /004 I1 C�/FY p Cure ling Address: V Yom,//{'y. S6— X63 U Q file, ?aa- Telephone S�gnat re tt//// t/yy" 2.2 Authorized gent: ,,// // --,,YY Jaynes c met - C 4 S... p A . JI / ` >r 44 Name(Pnrl / Current Mailing Add - n/t S8c 6017 Signatu Telephone SECTION 3-ESTIMATED-CONSTRUCTION COSTS I Item Estimated Cost(Dollars)to be Official Use Only comcleted by permit aooiicant 1. Building 7(a)Euiloing.PennR Fee 30(Jo0.O0 - 2. Eeotrcal r ',(b)Estimated Total Cost of 5._,,,,60 Constructicn_frem(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection -jJl t�q / T 6. Total=(1 +2+3 +4-5) I ?O coo_ (JO - Check Number /971 I litY2 y4 This Section For OffieiaLUse Only ,.Date Building Permit Number. 'Issued: Signature: Building Cemmissicnedlnspectcr of Buildings Date Section 4. ZONING An Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size - 6000 Sy(4.- (.000 Froniage 6 0 , _II (g 0 Setbacks Front y3 de L; - R L.�3tl -t Rate Rear Il .� f �J Building Height / Bid_Square Footage Open Space Footage tail[area minus bldg&paved )310IM I �o I 90 ethane) _ Y of Parking Soaces Fill: n90 Q (volume&Location/ A. Has a Special Permit/Variance/Finding ever been issued for/on the site? -- NO DONT KNOW 0 YES © IF YES, date issued:- IF ssued:IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O • IF YES: enter Bock Page. and/or Document 9' B. Does the site contain a brook, body of water or wetlands? NO tik DON'T KNOW O YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained © , Date Issued: !, C. Do any signs exist on the property? YES O NO (031 IF YES, describe size, type and location: - D. Are there any proposed changes_to or additions of signs intended for the property? YES O NOsg) { IF YES, describe size, type and location: E. Will the ccnstn:cnon activity disturb(clearing,grading,eXcavaoon,or filling)aver 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO ,YpyYf 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 In Addition El Repiacemerti pws Alteration(s) Q Roofing 7- Or Doors W4' Accessory Bldg. Viet Demolition El New Signs (D] Decks [O Siding(D] Other[DJ Worki Eder Deicnppgn aPicA teclasbocat -i-Par C2 qJl„ Dv �xdilDi 1/t Alteration of existaig bedroom Yes 111,/, No Adding new bedroom Yes No Attached Narrative ' ` Renovating unfinished basement Yes No Plans Attached Roll -Sheet ¢a.in!ew'hottse-and dd€tion2a titintniihodst`raff,4eipm`pieie;FFte-EvUt Jihq: a. Use of building:One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms 0. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stones? f. Method of heating? Fireplaces or Woodstoves —Number of each g. Energy Conservation Compliance. Masscheok Energy Compliance form attached?, h. Type of construction f, Is construction within 1100 it.of wetlands? Yea No. Is constructionnWlthfn 100 yr. flrwJpiabr -' t'es -- 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 CITE Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO-BE COMPLETED WHEN' �j, OWNERS AGENTOR.CO?N�TRAC�TJO�RAPPLIES,F{OORBILDINGPyEgRMIITjj Q�; �,�(/ "{n 1,l,ftfi/11/11 P�FIA,/7i .t1i — �/tO7E( (•d h' - easeA"U (N as Owner of the subrect property JJ hereby authnze _�y_-ly4t$ RAI% to act on my behalf,in all matters relative to work iitho S riced by this Purist , -rout a lcation. tk(C f 73 .;..x." Q1C+o lj a : cot? Signature ature of 9 Date V . 00 I. TCA e,S 3/4"--tW`s -..- -- ... 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. r Lt.reots$ Rim in Print Name f m - — 7L0 42 Signaturee et/Agent Dale SECTION 8-CONSTRUCTION SERVI ' CES 8.1 Licensed Construction Supervisor: ''''',, Not Applicable ❑ Name of License Homer: JUnnt& (-hint.. License Number HO-1 Ry si 0F8o1lf Are-� /3-' )119- / / 51 irabon Date Telephone. .. l ff i? 4)( 7 SeHlt iTi[ererftionielhibmvetpentGbn$aMCr „'„ �. _ -tr` .,ti _ Not Applicable 0 ,�,yn <s «� _ isa9a) Company Nam Registra6.n Nu bet TrAbh(S les) 10 l7' . 06? Address r�CC p ( Expire•on D- S7 Telephone cti'.1.,tl'7/51 SECTION 10-WORKERS'COMPENSATION INSURANCEAFFIDAVIT(M G.Lc.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 permit. Signed Affidavit Attached Yes ❑ No Rik 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 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 fann structures.A person who constructs more than tine home in a two-year period shall not he 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 bglidin=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. Homeowner Signature _ The Commonwealth of,llassachuseus Department of Industrial Accidents Office of Investigations h ,e 600 Washington Street a.r..c >i -—p,_, . Boston,714 02111 g��, www-mass govhfia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plnmbers Annlicant Information Please Print Le?ibiv Name Cuia inesskerem ¢oMndivideaiis JG.MPd ['aMt } Gut's Ptwslet Address: 2) I4c.r-y....c4 rt/dr\ (-.t-„_ _ ±. Alen 0 106 Cis/State/Zip:n,.I Phone_ S-5. /7 Are von an employer?Check the appropriate box �r Type of (required): a. I am a general contractor and I 4 New project(ruction I.❑ I am a enroloym with - general nail andr`or part-time).? have hired Cho sub-contractors I as.a soleave no'ea r or pazV:er- Listed on the annched sheet I 7. TT Remodel* I t These stancons=cors have ship er'tha+e no �.eyees &- ��DemoliYiotl working for me in anycapacity. employees and have worksrs' P I 9, ❑Building addition required.] eq ted) ' am.Sara= comp. acorp.ce.• . rey ired.] S. C} We are a corporation and in S O.CI Electrical repairs or additions 3. I am a homeowner duisa all work ciucers have exercised their I L[3 Plumbing repairs or additions myself.[tie work-n'comp. right of exemption per MGT 12.Q Roof repairs insurance required]] c. 152, §1(4),and we have no �fql employees.No workers' lo.�Other (41.1400 m rti COZII(:.insurance requited.] -'""""'tir:.o vin mat:necc noir nnst also n ffit me soon meow smwmg Men.workers; mpcaan po __...__.. Ov st mPWns ew areswho scties this mune rhedan amerare sheet bowort the name hire osub-ccoaaacros mazetvbtarewaffidavit md�nve tcsnoees. fth.chcconabox maveenwioan Meyonaisheer:showing tweename cfrhe spoliyoir±c and sun wherver ornoetlaase moves have crmioyr3. I:the sub--cnerors'rxe eaq�io;rzva,Cry qua pmvide:hen workers'goo,?.Policy naGroe. lam an employer that is providng workers'compensation insurance for mi'employees. &glow Lc the policy and-iob site information. Insurance Company Name: Policy t or Self-ins.Lc,n: Expiration Date: Sob Sire Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as rectmred under Section 25A ofMGL c. 152 an lead to the imposition of aminal penalfes ofa tine up to 51,300,06 aa&or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of un to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the OfSce of In.veseeatiocs of the DIA for insurance coverage verification o Ida hereby eernAt aer the pains and pen ' ofperjury that the information provided ore: true and correct jg { eS7'atsary .._.. Date: J© /P i avec e: Sc.,.4, 00/ _ a ' Official use orris. Do not write in this area,to to completed by cim or town of agar City or Town:II fea PermidLicense Issuing Authority(circle one): L Board erson:ft5 3 Building Department 3 C attrowa Clerk 4_:1 etwLcal Inspector 5.Plumbing Inspector o. Other C onmr.Pe.-son: Phone �c— DEPARTMENT OF HlrILJD(C INSPECTIONS INSPECTOR 212 Main Street • Municipal Building Northampton, MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780ChIR 1083 4 to act as nis/ker construction sup::•i sor. The state defines `Homeowner as, "Person(s) who owns a parcel on which heishe 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 homeowner 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 railed 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)andafnal 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 untilthe 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 • Munderstand the above. (Home ow er/residen s signature r-questing exemption) I will call to schedule all req .red build g inspections necessary for the building.permit issued to me_ Date Address of work location `A(n1 A '- 5 tis )1) IC I I O 17, I C b T L- -- c) 8 0Z K keYn 1r T 4-s r - �' 1 • 4Y3. 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