23C-064 (4) 105 WILLOW ST BP-2006-0873
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23C-064 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0873
Project# JS-2006-1345
Est. Cost: $36351.00
Fee: $188.75 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: NORMAN TEBO 001221
Lot Size(sq. ft.): 58806.00 Owner: LEMPART WALTER E&MARY D
Zoning: URA Applicant: NORMANTEBO___
AT: 105 WILLOW ST
Applicant Address: Phone: Insurance:
489 WEST CUMMINGTON RD (413) 634-2234 ()
C U M M I N GTO N MA01026 ISSUED ON:3/7/2006 0:00:00
TO PERFORM THE FOLLOWING WORK:REMODEL DEN & LAUNDRY ROCM
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:x/546 /✓pi 4/ House# Foundation:
�_, Driveway Final:
Final: 6 -30 -eg aFinal:
Rough Frame:Qr ct_y_U!o
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation: o/< O`flo6/by LeytS
Final: Smoke: Final: ok 7'/,2.OG ..1,
THIS PERMIT MAY BE REVOKED BY THE TY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy7Signature: `���'`- '�'�`' K�
4
FeeType: Date Paid: Amount:
Building 3/7/2006 0:00:00 $188.751211
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
03/08/2006 11:00 4136340161 ,3C.r069 TETON BUILDER'I. PAGE 01
City of Nortp3mptort ;, ti -'_� �'
t Building Department 1 _ '_ .7-, -
• 212 Mein Street _._ _-- -_ =— _ : « — _ -=• r
Room 100 h ,';� �- z- --4,:;tie. .1
Northampton;:MA 01060 1 s .i �„ _,-.. _.-.,z `" " ' `*` '
phone 413-587-1240 Fax 413-587-1272 • Y j ti: '+ t<"If.,
AM
PLICATION TO CONSTRUCT.ALTK REPAIR.IReNOVATI OR DUMOUSH A ONt?14R TWO RANI 4MY�.1.ING
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eCiDNt- 1 ter:. �•;r _ r
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Z.1 Owner of Record; '
wa.l-cr E. a rui Mars, Lem}:›arl- i 0. .I t aw M . 'FtC1 T
Name!Print"r ,i (} C- Conant Wang Adwaes=
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i . on Sat LctPiirr.. to w +dkc�t r )tam ni-ei Q - %I
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Kerr . Estimated Cost Pekes)is be ended Use Ontr
compteted br Permit 60011ant - u --
1. Building r{A) V eMitt P 40/F/0 0 d.0 o
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2, Fiectricei 7it5111recert Oiat q 6e 3G f
3- Pk,robing
_ _ .-Biuldirge Renoir-Fee , al
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4. 1ule�lorpCX1)fMVAC)
6.Fire Rs04tion It/�r ........
b. Totai=R 1 +2,+3+4+3 j a j r7s, -cheek Number . b �� 1
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Building 1ni Nuelbert. --• , ••,• ..__,----_ .. i —
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1 Building CommisOvr1w1N+sP Po`Wi IW . - Date _
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03/08/2006 11:00 4136340161 TETON BUILDERS PAGE 02
t,...... .. .
•s1C-/9.t.t wP.Tltah ° 0 tu4a4 1
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New Hausa El Addition j.,• Raplveemant]lllb�owa LAtMratlon(z) ;n D
Or Qaa+rs i�� !
Accessory$ldg. Demolition New Stoma, tleeke jr:] Siding other[t
—
r— t ►. I.:
f Proposed ..
Wort�escription o f 47. b i9Uiv tr y Rea/rig�-pact-41i Slit Cj� .
Alteration of existing bedroom Y t,/ _ea No Adetinp new bedroom Yes { le/_N
p
Attaded Narrative • Rewinding unfinished bseetTent Yee Jr"-
Prams Attached trial! -Shedd
..7 Tr, e_ .i__ !,g. .,_,,ri,t j.si -; t .:1 _ ,',1•- +6�t1.}'�--`f ,:. a.i __4L. . --' .�..�_ "" _
a. uxe rat building:One Family - Two Family Other
b. Numb* of room
s in each family unit Number of Bathrooms
c. is there a garage attaotted?
d. Proposed Square footage of new constriction. _Dime scone
•
e. Numbs of Aeries? ,. ...._ ....
.
f. Method o/heating? cee or woodeovMs_ j �_Number ,
Pingea each
g. Energy nservston Camaliance. Marwcheck Energy Compliance fbrnr attached?
h. Type cons>ructbf► __
I. Is co etien within 100 it of wetlands? Yes No. Is onnetrudipn vdthin WO yT navoplein Yes, ....„•No .
j. Depth bs=entent or ClQar door below finished arsda
k. Will Ott rota conform to the 6utlding and Zoning regutedOn ? Yee NO.
I. Septic tank City sewer • Private WOO City wetsr Supply
i
.' N 7 -.ovni!!noontOttiaricow[" ... - - '!rl1dQ?hh Pik,'--^''>
I Lal _• U /) Le'1. 7' . 1 ,as r of the subject
Ia mFAItY / s
hereby a , • .ie ♦ 4 i.. . -
US act an ban ,ul . mason;relative to work authorized by this Witting • t application. a.
tare d ' r Dais •
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ro( •T .sears ;fi —gel - - i and information on tba foregoing application era trim' iiCturete.to the of my knowledge
and .. 7 .
Signedp�u rthe pains anti penaitiee tlfpehjuty.
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File#BP-2006-0873
APPLICANT/CONTACT PERSON NORMAN TEBO
ADDRESS/PHONE 489 WEST CUMMINGTON RD CUMMINGTON (413)634-2234 Q
PROPERTY LOCATION 105 WILLOW ST
MAP 23C PARCEL 064 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out /1'��
Fee Paid / 5!j Q
Typeof Construction: REMODEL DEN&LAUNDRY ROOM
New Construction _
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 001221
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION 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
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
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 Commiss.
179
0
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.
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by office
105 VVI(lov) C: t.• Map L.-.7 - Lot (�� R t-j Unit
Pio Y Price , Nl 4 D iatfl 2 Zone u Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Wc�l+�r E. and Mav•-j Lem part- IGS lov`► Fl0r``ivw.e AAA
Name Print Current Mailing Address:
413 -5'�y - �4C1(e.
Telephone
Signature
2.2 Authorized Agent:
Mfi
ae :,I�_r.�i ref 4�Jr' t C�dhn onit„ 7� N �Sw
�Dm� lod
-r r; � 0 tCJ?E> -96(13
Name(Print) Current Mailing Address:
SDI - Z '��
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item - Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee F1000, 00
2. Electrical (b)Estimated Total Cost of
Construction from(6) ) C-i )2(
3. Plumbing Building Permit Fee g1 W 1( C
4. Mechanical(HVAC) �%'
a
5. Fire Protection �g (/ (A(h
N k`i>
6. Total =(1 +2+3+4+5) ,3 (C ) 357 Check Number I 2--11
This Section For Official Use Only
I Date
Buildina Permit Number: 1
JJueu.
Signature:
Building Commissioner/Inspector of Buildings Date
j d (Ai ANl'Q,S
Section 4. ZONING All 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 °-
Frontage — I
Setbacks Front I i
Side Rear
Building Height L: ( ! L:�� R:
I : 1
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jai
Bldg.Square Footage I
Open Space Footage %
(Lot area minus bldg&paved
parking) '
#of Parking Spaces
Fill: i�
(volume&Location) '
A. Has s a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DON'T KNOW Q YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book I Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO er DON'T KNOW Q YES
IF YES, has a permit been or need to be obtained from the Conservation Commission? '
Needs to be obtained Obtained 0 , Date Issued:
trxA
C. Do any signs exist on the property? YES 0 NO
V
IF YES, describe size, type and location: I i
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO
IF YES, describe size, type and location: I
E. Will the construction activity disturb(clearing,grading,excav • ,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q ,. NO
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 ❑ Addition ❑.; Replacement j ws Alteration(s) n Roofing n
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [p Siding Or Other RE117—
f-lt f c .)f L
Brief Description of Proposed • '
Work: f e,m04e.i J7e %✓ 4- L-iwi'•d1.`y R,on, , (.XISt(t 1eRc-.)
Alteration of existing bedroom Yes v/ No Adding new bedroom Yes V No
Attached Narrative Renovating unfinished basement Yes ✓ No
Plans Attached Roll -Sheet
sa. fikle"�>kiase''''''-ana-fl aaclr ilin. zrstrif. ii lath,cor pEefe.hTtr tro—WA q:
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. Masscheck 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
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, MA,-A,—L/ /) . Le{'r,✓1'�lur-/ ,as Owner of the subject
property hereby authorize A/O1Y11/&`7 / EbO
to act on my behalf,in all matters relative to work authorized by this building permit application.
LA1/4.4_ ,_, 7- Le. K- 5 • •7 -
Signature of Owner I F Date
I ,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 Name
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES r
8.1 Licensed Construction Supervisor:y / n/ T / Not Applicable ❑
Name of License Holder: Te.T'n/ l3v/Ide.1�S //F'"L'Y'`h9/f11/ I ?id7L1 20 1 2 a I
License Number
1-1 8 l r C .'/11 in//v1TP i2r / d C U/YJ/n r,vy%./v /'/f9• 7 i - 0 7
Address Expiration Date
Signature Telephone
9i Reitsfere '>fome:Tnpcave)ienf Eonff=aior ,m :`s'„ a Not Applicabie��❑
Company Name Registration"'Sib"
er
7?e-t,iv L31J r-M; 7 - It, - d 6
Address Expiration Date
?-? krc Ci u/7,n i t//To y 4' f £t notr ' if, Telephone �31/ Z2 .
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 Ii' No ❑
11 -"fo E ner x D Q
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 108.3.5.1.
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 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
r
V,4v 47.'* f '�l•nancllns.Ile'
-a- DEPARTMEAJT• OP BUILDING INSPECTIONS J
212 Main Street " Municipal Building
Norihampion, Mass. 01060 rr'' "
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WORKER'S CONATENSATTO.N O`ISUR CE AIFI,i_DA\ ri.'
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1 (li=as..:/pc1-m.itt=) _ .... - -
'i with a principal place of business/residence at:
•
YS� �✓. G ,.V� Lira/1 i —MI � (phone.') 6,,3if -a 2,23
•
(ar=l1city/s atr/Zip)
do hereby certify, under thc.pains and penalties of perjury, hat
( ) I am an employer providing the following lworkcr's cornpcns20on coverage for my •
employees wvorldng on this job:
•
•
r-n Conn:cv) (Policy Nt= cr) (:7:-pirtior.Daiz)
(VI am a sole proprieto , general contract or homeowner (ci:cie one) and have hired
the contactors listed below r e following worker's comnen_sadon policies:
WAS5.2 51
fnrytiey Elac, .5eitv;cr, --111AT1Gth qi 6etlIv6-e -1;15. Co, /Q ,3/, 0G .
(Name of Contractor) (III uranc Colnoar yi?oUci Nun7_<r) (F__`:piruuo Date)
(Name of Con-actor) (Lasurancc ComoaayiPotici Numb'r) (fix- imiion Date)
(Name of Com-actor) (Insurancn Co milazry/Po(icy Numblr1 (EExpinaon Date)
(Name of Conaaaor) (LnstIran= Company/Policy Numb:.r) (Expiration Date),
(oath addr occ.1 o .if occc.._-y to cxdU info,- oc pcia 1. to.11 co --tnz) •
1 ( ) I am a sole proprietor and have no one woridng for me.
( ) I a -i.a home owner performing all the work myself.
NOTE:plc-so be tugs Val:...I:L k I:rcmcvN.1)cm who c play pc-tom to dz r r^,- ,cs.:caoo c trots.,ork as. - tt:^-of
not most thr:tit-rr_t:ra in which the boo:cowoc-raider cc co tho p-ounoS 2.7purtco tbc- o c-r oo(c=c..11y cod..-cd to bo
ctpLc- wads the t rc, ---"?.-_-•lc AC(GU152. 1(5)), p1:n,ioo by•bot:1=0wx lc:lip-cc panic troy c.-id_voc tho
le-p.l c_^,•of oo. loy.r uodc-r the W ockolL Coaxpom.tioa Ae_
I I uo x tbx a aa
Ac'aad . oopy of Ili. tolacta m d Gpay b.focaurd.. to LSo o oot of 1•..ks,'id A.cn1...a'' o 15 of t, oo-' oe for th.
covcto-c vcif ctioa td th t t:iltac to socurt:tovciae_,'- --zonioo 25 A of MQL 157 ca led to the i^.'+•+ti:ion of cimia:1 pr-^,hits
izc of a rite orttp to S 1_00.0o au&dfor i=prisoczcx=1 of up to ooe roc:eo_d.il prn•Fuo is 6c form of.Stop Work Ord ."and.
Ifim of S 100.00 a thy.. .iX1 me
i
For. '.. dc9.rc.-'.t u.c only
I Permit Numbs -
/17ifYlmm ry /.e.ern . 3 3-06 l,tan:: Lot r
i Sipatirc of Lira^. fPcc-rniucc 1F_Ce I 1ili
Crzf cf1'trrl�ttntun I =*—� /.
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Sassacliusetis
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— DEPARTMENT OF BUILDING INSPECTIONS =__: =/
INSPECTOR 212 Main Street • Municipal Building S`,y.
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 his/her construction sup;:.-if.gr. 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 i egulations. 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
r
ti
4 �f l 4,"jt• Massachusetts _ �_
"�' DEPARTMENT OF BUILDING INSPECTIONS � � _. i
INSPECTOR 212 Main Street • Municipal Building '`>o,M—
Northampton,MA 01060
FAX 1 5 1 - 127Z
fL .e.a s \(-) N AS ALK thO (u 0
p, q.(ru-r A 0D RET U r(iN Try I S.
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�� .l1l. TETON BUILDERS
III I 489 W. Cummington Road PROPOSAL
mr.....` CUMMINGTON, MA 01026-9603
H I C#1 0 5 3 01 Page No. 1 of 1 Pages
Office (413) 634-2234 Fax (413) 634-0161 (JOB NAME/NO
Joel Hinton 634-2159 Norm Tebo 238-5302 Remodel Den & Laundry rools
LOCATION
To: ....................... .. Walter Lem art .. . . . 105 Willow St.
105 Willow St. Florence, Ma. 01062
PHONE DATE
Florence, Ma. 01062 \_ 584-0496 3-1 -06 J
We hereby submit specifications and estimates for: \
" > Strip & re-move rubbish •
Re framing
Set new windows & Doors
Electrical ( see attached)
Plumbing & Heating ( see attached)
New insulation
New siding '-zx6 cedar
Interior---under layment ready for carpet or tile
Trim---Doors/windows/base board/shelfing/wainscoting
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>WE PROPOSE hereby to furnish material and labor—complete in accordance with these specifications,for the sum of: \
Thirty-six thousand Three Hundred Fifty-one dollars($ 36, 351 .00 L
Payable as follows:
$12, 000. 00 to start
Remainder as per billing
All material is guaranteed to be as specified.All work to be completed in a workmanlike manner Authorized - RAw
according to standard practices Any alteration or deviation from above specifications involving Signatu
extra costs will be executed only upon written orders.and will become an extra charge over
and above the estimate.All agreements contingent upon strikes,accidents or delays beyond NOTE:This proposal may be withdrawn
our control.Owner to carry fire,tornado,and other necessary insurance.Our workers are fully by us if not accepted within 3 0 days.
covered by Workmen's Compensation Insurance.
ACCEPTANCE OF PROPOSAL—The prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do \
the work as specified.Payment will be made as outlined above.
Signatutla "`-'! Dates0 Signature Date J
E or
it
e in - so h Vval l
5hertx5
sansizJ
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h 6)(1-h w a,t l
Desk
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$ 0 I
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11��1 -!—s 19
ue
VIVACIANtreirIS:=4,i
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