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31B-082
29 EDWARD$SQ BP-2005-1241 GIS s: COMMONWEALTH OF MASSACHUSETTS MVIBlock:31B-082 CITY OF NORTHAMPTON Lot: -001 Pmmmr Building Category: BUILDING PERMIT Permits BP-2005-1241 Proiects 3S-2005-1658 Est Cost: $1200.00 Fee:$25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Robert Thibodo 118441 Lot Size(sa.ft.): 5793.48 Owner: PROCON SOPHIE A&JANE PROCON Zoning-UR c Applicant•. Robert Thibodo AT. 29 EDWARDS SO Applicant Address: Phone: Insurance: P O Box 201 (413) 586-0391 NORTHAMPTONMA01061 ISSUED ON:6/13/05 0:00:00 TO PERFORM THE FOLLOWING WORKSTRIP, PLY & 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: Houses Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department FireplacetChimney: 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 6/13/05 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo r amity of Northampton Flbuilding Department 212 Main Street Room 100 JUN - 6 2005 No th8mpton, MA 01060 phone 418.58 1240 Fax 413-587-1272 .APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING i SECTION 1 -SITE`iNFOHMATION 1.1 Property Address: x•°` 'gI ...+i'. fc z^:' a I� IiLI III 1 J U0 c, C�rt I l I ri ¢Ef rstnct . DI not SECTION 2- PROPERTY OWNSRS) ,lo*UTti0,'#!ZED-AO'ENT. 2.1 Owner of Record: 1t 11 I h t"� k �bI..J Oh-•� S 5 (1 are Nam= Current Mailing Address: �— �1 ,�'C Telephone L Sign t re r -s 2.2 Authorized A ehn1T_. � �0r��V+1 Name(Print) Current Mai!Ing Address. S � Q �.Q. Lli -sa�� b �3 owl\ Sign$Ign to Telephone SECA©N3 - ESTIMATED COt35TRUGTION`CBSTS Item Estimated Cost(Dollars) to be Ol l Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Elecirical (b) --mated Total Cost of Construction Brom.'.6 3. Plumbing Building Permit Fee 4 Mechanical (-VAC) 5. Fire Protection 6, Total = (1 + 2 + 3 + 4 + 5) Check Number This Section For Official Use Only Building Permit Number: Date Issued Signature: Building Commissioner/Inspector of Buildings Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This calumn to bi,filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L R: Rear Building Height Bldg.Square Footage Open Space Footage (Wt area minus bldg&paved parking) #of Parking Spaces Fill: volume&Wcation 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 # 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 IF-YES, describe size, type and location: New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing lv Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ J Brief Description of Proposed Work: v t t Alteration of existing bedroom_Yes,No Adding new bedroom _ Yes _ No Attached Narrative 0 Renovating unfinished basement _Yes No Plans Attached Roll O Sheet 0 1 D - IStI�f3F' 1. n', C an r a. Use of building i One Family Two Family Other to. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. bimensions e. Number of stories? I. 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. Will building conform to the Building and Zoning regulations? Yes_No . I. Septic Tank_ City Sewer_ Private well, City water Supply_ IZIUT+ION TO�BECOMPiO AAA,u -14i �_: - TkRv{tPPL'7�5+F'OR'BUILT311�G PERK71Tv' ^."—" =Yb CO \ as Owner of the subject property hereby authorize 0� u O to an.on my be If, in all m ers relative to work authorized by this 'building permit application. Signatu of Owner Date Date r O vJ�h1� 1, 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 me �-jQ..,.—Ae Signature of Owner/Agent Date XR, STdiUCTION SERVICES A 8.3 Licensed ConstrygtiCervisor- Not Applicable ❑ Nuri Naol License Holder () G S� R (— C4 License Number dress Expiration Date Signature Telepho e , . Not Applicable ❑ o L 11 � 4 lI �Co n Name °� Registration Number �� 1V �J AA�ress Expiration Date Telephone— � -6 6%3 _ 5yfv ,7JMPEN5A71ON-IN RANC4FFIDAVIT(fr1:G.i.4. 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 per/mit. Signed Affidavit Attached Yes....... ❑ No...... (7 i The current exemption for"homeowners"was extended to include Owner-occupied Dwellines 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 108.3.5.1. Definition of Homeowner: Person(a)who own a parcel upland 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 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 maybe liable for persons) 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 Loc ruing Laws and State of Massachusetts General Laws Annotated. Homeowner Signature ' a GctiA�h '- r a Usi}r tf �Taltllt�m}�tnn Drf' vRll.fENI OF OUIIDrNG INSPLCI'Ions 212 Mein Street ' Municipal DviliGng 12orth alnptol:, Mage. 01060 NVORICGR'S COMPENSATTOIN IT'SUI ANCF /iFFM,,V1.T h ----._______ vnth a principal place of businCSS/nsidonce ec lstrcctia I�!::�:.�IziP) CIO hereby cer¢ly: unNer the p,-:;ns :;,d penia ties n.perjury, a:a! O I ma a❑ employer providing the ;olloaing ctorkcrs compcnsnuon covelage 60r my employees working on this job: (tmuanc Compavy) (PoGc:2.'�Tbcr) CFwiraoon Dzcc) O I am a sole proprietor, general c�nmcor or hoincolwer(circle one) and 'nave lured ffia contractors listed below rho is.`c the `oLa-,-ing worke-s compensz on po!ic=s' (Name of Conrmetor) Qn%=C� Comonar/Polic✓Nwnbcr) ( :nuor. Dxtc), (Name of Contr..nec) Oasurancc Com'a'—dPdie✓ Nuin, ion Dia (N'amcof Conirdclor) ;In,.mnrCom�.s /Ynllc: NwnMr7 ; '.tea L'alc) (Name of Contmctar) JnSLraact Ciini=y/Poticy Numbs) (H Pi—c ion Dare) (YJ 1 in]] ii sole ;'10prlcio: '1:11 11aVt 110 OTIC 'S dr!9:1y f0; me O I inn : home ow')e. .all h0'If_olox n pore Lbo il,rtn Wvt, Lw `n � F'_rtco�'r,.Lhe"e a..n 1 pex+ill .. q ti legal nae.�ofm.¢mlay.r uo,.r lyn Wn4eh�,ao„_K - I wrdear.nd Ne a ordY o!Ihi.n.,cs.c..Y�rv�-.W«m:a 1`rlwu-�elLMu.iJ Mifm'Y C:Ge<ef!.:n.mm 6r LR °'6'�vcifclim cM llur Llu.2 ro f:cL -u,1-:i.-..i,-•:Sn.o/!.ICt.151 cao lr�,c ll><�.mNa�timo!r.:moi::l P�-a1_• mr inca ofar.of upmSI3W.WaM'a�N;,r��a.::=or;;�mvaevr:d c�il;cnaltio iridal,wncf.S!m,vay.QS=ar4. frc o(SID1W a 'uy r�in�n:. e4; ,amral 1) Per ntl Numbs _ _ Mae!"_- �1 -• ttwH TQ N GritV of arthamptan d Auaeohnertta DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Sveet • Municipal Building -y Nurthampum,MA 01060 y HOME OWNER EXEMPTION ACKNOWLEDGEMENT i The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as !.is/her construction super:isor. 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 my 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 Dour), a rough building inspection (before work is concealed), insulation inspection (if required)and 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