23A-093 (10) 400.401.01100111"6`'..
BP-2004-0107
GIs it: COMMONWEALTH OF MASSACHUSETTS
O't CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit it BP-2004-0107
Project n 3S-2004-0172
Est.Cost:$8145.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
use G oup: TODD BOYNTON 126807
Lot Size(sq. ft): 13242.24 Owner: MERRIGAN MEG
Zoning:URB Applicant: TODD BOYNTON
AT: 17 FAIRFIELD AVE
Applicant Address: Phone: Insurance:
83 SILVER ST (413) 772-8829
GREENFIELDMA01301 ISSUED ON:8/4/03 0:00:00
TO PERFORM THE FOLLOWING WORILSHINGLE ROOF OVER 1 LAYER
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: Receipt No: Date Paid: Check No: Amount:
Building 8/4/03 0:00:00 2622 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
.. . -74-PW4 .x-C- ea^ie
City of Northampton
_ - eeng Department wt� f$) k rl oraw
, r` a't'2 S Main Street "ay .,t xlf. rat:, '
I oom 100 b aMiLth Aegi 1,61114
Nort pton, MA 01060 ,gertepeefee,
I
L f3hinW'Q1313-( 240 Fax 413-587-1272 ISOV fait
AeFF' `,tfhktY M,.'y TRUC , ALTER, REPAIR, RENOVATE OR DEMOLISH AONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
This section to.be campfeted by office
1.1 Property Address:
iMap lot ' ilnit
�7 ft/477d0 ,�f✓� r
tarp
rlie4re Zone :Overlayplstrtct__
Elm St..District CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
Owner of Record: ,,
,tieecf�rp,�u.`4,
Name(Print) Cs-rent MipngAtltlress' w_s
ieepione
Signature
2.2 Authored Agent:
S,ldi 57e—
Name i Pi nt) Cu;rent Mailing Address'.
77f-27/j
Signature _sem._ Telephone
SECTION 3 • ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
comoieted by cermit sort art
_. Rudding (a) Building Permit Fee
U mated Total Cost of
r r.:
Construction from(6)
3 Piurhlre Building Permit Fee
Ne r n - (HVAO) I
S. Fire frute ti¢n
6. fo aI tI + 2+ 3 r d f 5) � ti_ Check Number 4670 , $E„ „
_ - 755 �� This Section For Official Use Only
Building Permit Number. Date Issued:
Signature'
� 8uilding Commissioner/Inspector of Fit0ldings Date
9
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 Department
Lot Size
Frontage
Setbacks Front
Side L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding eve been issued for/on the site?
NO DON'T KNOW V YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of eds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. 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 property ?YES
No
I EYES, des5ribe size, type and location:
SECTIONS- DESDItIPTIONaOF:PROPOSED WORK(check all applicable) -
New House ❑ Addition ❑ Replacement Windows Alteration(s) 0 Roofing 4
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] tD�ecksDecks [ ]] Siding[ ] Other[ ]
Brief Description of Proposed Work: Re -/ar ✓t- QiP_oder cI ee
Alteration of existing bedroom Yes - No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0- Sheet 0
s__a!ilftNSWATiU5seianiliti =addition to existing housinm.-comoleteithe folloWitg:
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. Mascheck 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
k. WIII building conform to the Building and Zoning regulations? _ Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
, as Owner of the subtect properly
hereby authorize to ec: on
my behalf, in all matters relative to 'Noll/autho- r ny th s ouild mg permit application
Signature of Owner Date
I, /"%/ 44c as Owner/Au' ;heed Agent
—_.
herebydeclare ements andinformation on the foregoing application are true and accurate to thepest of my
knowledge d and that the sta{ u
and belief.
Signed under the pains and penalties of perjury.
Print ame�//// -- - - _ -- - -
' �- i7
Signatu - o(Owner Dat-
- .—.
SECTION 8-.CONSTRUCTION SERVICES
8.1 Licensed Construction Suer>) visor: Not Applicable ❑
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
•'.dRaty_fed"i a rn:nvetnen C., T." .i- r"e -ard",3731X„tbsbibc'4§fliblifDyriy •bN Not Applicable ❑
ffi
-
Company p �- Registration -7umber
/iy
-r> -15:117:1111ei
Address ' Expiration Date
Telephone ,'4 - —
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 affidavit
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... ❑ No 4
7P9r° liar 're .fi n
L. 1 ome:OO.wner-
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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 108.3.5.1.
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 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 Is which this permit is issued
Also be advised that sit' reference to Chapter 152(Workers' Compensation) and Ci .par ability of Employer to
Employees for injuries not resulting in Death) of the Massachusetts General Imes Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
I he 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 NI assach use tts General Taws Anuelated.
Homeowner Signature
•
S 41q ��.
.�`-'151}:4 -if 11i Nu thaul}3funI� �.1
212 Mani Strc 1 cipa I I3 : 1
(Y vg,:-
�j.
Nor that'll-di:, Ma,,a. 01000 ---z.,-.-c1.'
WORKER'S COM PENSATI(1 INSURANCE AFFIDAVIT
I
aa:lC v .�Olkl I IS IC.
st c Co(:,inn , b>_ ,, ,,;a;
ate _ , 111(2
. . . _
I4.:
Lo
ii
e;��r ) a (�tfp of Northampton ='*
a`er,-, f e �t,..,vh ..m 1=�/
gee DEPARTMENT OF BUILDING INSPECTIONS , =`'-I t-A.
INSPECTOR
212 Main Street • Municipal Building j
Northampton, MA 01060
e-
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as Isis/her construction sups : .lsor. 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 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 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
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
Complete Asphalt, Slate, and Rubber Roofing Systems and
Repairs, Siding, Chimney Pointing and Gutters
Customer:
Meg Merrigan aG3�
Melinda Shaw ) !/ kg�'-'
13 Aloha Dr. y71- 7�6�, vHadley, MA 01035 o447e
548-8150
Property @ 17 Fairfield Ave.,Northampton e_ntec
Fs-Pict 7//2
Work to be done: ,e&
Ve�
Complete main house: /allS
Remove and dispose of exterior layer of existing roofing material. a sQ
Tear down existing chimney to roof line,and re-sheath as required.
Install Tamko ice and water barrier underlayment on all cave edges and in valleys.
Install white Alcoa aluminum drip and rake edging.
Re-roof with 30-year Tamko Heritage designer roofing shingles, color to be chosen by
customer at a later date.
Install new Lomanco aluminum ridge venting system to complete main peak of house.
10-year guaranty on labor. 30-year Manufacturer's Warranty
Total Cost $ 8145
(Labor and materia))
Deposit required of: $ 4000 Homeowner: �_1W1��
Balance upon Completion: $ 4145 Contractor:
(Sign and return one copy with required deposit)