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38B-097 (5) rr" City of Northampton " Massachusetts DEPARTMENT OF BUILDING INSPECTIONS �g ° 212 Main Street • Municipal Building ) Northampton, MA 01060 da�jY INSPECTOR Louis Hasbrouck Phone: (413) 587-1240 Chuck Miller Building Commissioner Fax: (413) 587-1272 Assistant Commissioner FAX THIS TO: 413-587-1272 REQUEST FOR PERMISSION TO VIEW RECORDS OR HAVE COPIES OF DOCUMENTS MADE *PLEASE KEEP THESE DOCUMENTS IN CHRONOLOGICAL ORDER* DATE: MAP: BLOCK: O 9-� 36 Munroe Street FILE ADDRESS: John Moriarty NAME: 436 Dwight Street Springfield, MA 01103 ADDRESS: 413-755-2128 PHONE #: E-MAIL: john.moriarty@mass.gov UNDER MASS GENERAL LAWS WE HAVE THE RIGHT TO MEET THE ABOVE REQUEST WITHIN TEN (10) DAYS OF THE ABOVE LISTED DATE. c.l ') 1 '� `� l 36 ML ROE ST SP-2019-1222 C-3 1�*: COMMONWEALTH OF MASSACHUSETTS MV:Bl k: 3813-09-1, CITY OF NORTHAMPTON i-9t.Ml PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit; Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) CawWry:Mnovation BUILDING PERMIT BP-2019-1222 JS-2019-001977 Est, CL)sr_ ]L. ) (LOO, PEXMISSION IS HEREBY GRA.IVTED TO. Contractor: License: ROBERT WALKER 03478� L2uize(sQ. ft.): 6664.68 Owner: &HODES AMY 1,& ERIK S ning: U ZoRB(jkQjZ Apglicant.- RQagRT WALKER AT. 36 MUNROE ST Applicant Adm thonf_.- Insurance: 36 Service Cenjer (41315g4-1224 Workers Cqm2msafion NORTHAMPTONMA01060 ISSUED QN.-511412019 0:00:00 TO PERFORM THE FOLLOWING WORK.-3RD FLOOR BATH REMODEL, KITCHEN RENO, PORCH WINDOW REPLACEMENT**SEE PLAN NOTES SMIOKEICO ALARMS PO,ST THIS CARD SQ IT IS VIS, .LVLE FROM TUE STREET ln%pector of Plumbing I*spector of Wiring D.P.W. It Inspector ("isderground: Service: Meter. Foodw: Rout h: Rough: Hotw# Foundatko: Driv way Final: Final: Final: Re"k Fran. Gas: Lire RlDIttMent FireplateCitinney: Rougli: (11 . L twelation; Final: Smakli Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Fed'ym- Date raid: Amouni; Bud fts 5/14/2019 0:00:00 $683.00 212 Main Stmt,Pharr(413)587.1240,Fax-,(413)587-1272 Louis Hasbrouck-Building Commissioner Department use only City of Northampton Status of Permit: - Building Department Curb Cut/Driveway Permit 12 jVPUVED Sewer/Septic Availability R Water/Well Availability Nort ampkon, MA 01060 Two Sets of Structural Plans— ,r phone 413-5 7-1 40) ac J13-5 127 PlotJJSite Plans Other Specify _— APPLICATION TO CONSTR CT, TER,isEPWA RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address; This section to be completed by office –^� ✓" Map Lot C .1q f Unit I Sri Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: - ,'4T - ?� f .tz t6 IN N Name(Print) Current Mailing Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant ri I Building C1 (a)Building Permit Fee 2. Electrical - (b)Estimated Total Cost of Construction from 6 3. Plumbing c� Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection lll!!! 5. Total=0 +2+ 3+4 + 51 000-- Check Number This Section For Official Use Only ate Building Permit NumberIssued: Signature: Building Commissionerlinspector of Buildings Date EMAIL ADDRESS (REQUIRED, EITHER HOMEOWNER OR CONTRACTOR) SECTION 5-DESCRIPTION OF PROPCISEf)WORK(check all applicable) New Nouse ❑ Addition Q Replacement Windows I Alteration(s) V' RoofingED Or Doors ❑ Accessory Bldg. ED ❑ New Signs [©j Decks 10 Siding[0] Other(C(j Brief Description of Proposed Work ' r t' �t ,x � - L Alteration of existing bedroom_ Yes No Adding new bedroom _Yes _,_ /No Attached Narrative _ Renovating unfinished baseme! t Yes ..__iZ"' Plans Attached{'P6(1 Sheet 6a. If New house and or addition to existing housing, complete the following: --' 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. �nsio e. Number of stories? f. Method of heating? , places or Woodstoves Number of each _ g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 fl. etlands? �Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of baseme cellar flfloor below finished grade k. Will b g conform to the Building and Zoning regulations? Yes No, I eptic 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 subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of OwneV Date as OwneriAuthorized 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 Name Signature of OwneriAgent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: j= Not Applicable 0 Name of License Holder t t M . -va _ C, — 6 > A- I "' License Number Add,ess Expirati n Date 4._ - CZ 4 S�ur.�yr,r e Telephone 9. Registered Home Improvement Contractor: Not Applicable D Company Name Registration Number Sv/ 1 31 Address Expiration Date Telephone 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....... O No...... 0 City of Northampton Massachusetts 1 DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building Northampton, MA 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: (Please print house number and street name) Is to be disposed of at: 11 tN t t r<�-ti kl-r, T, (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Signature of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed.