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23D-046 (8) 117 RIVERSIDE DR BP-2007-0238 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D-046 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: chimney rebuild BUILDING PERMIT Permit# BP-2007-0238 Project# JS-2007-000361 Est. Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MICHAEL MCKENNA 132070 Lot Size(sq. ft.): 10018.80 Owner: SWEENEY NORA A&JAMES SHARP Zoning:URB Applicant: MICHAEL MCKENNA AT: 117 RIVERSIDE DR Applicant Address: Phone: Insurance: 209 POMEROY MEADOW RD (413) 527-1266 SOUTHAMPTONMA01073 ISSUED ON:9/1/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:REBUILD CHIMNEY TO ATTIC FLOOR 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: FeeType: Date Paid: Amount: Building 9/1/2006 0:00:00 $25.002625 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo Department use only cei ,of Northampton Status of Permit: ��I ing Department Curb Cut/Driveway Permit ' \U ,11?.. Main, Street Sewer/Septic Availability • 6 3 A 200Q �''Rbom 100 Water/Well Availability l' Au Northamton, MA 01060 Two Sets of Structural Plans `� ne 413�`587-1 a40 Fax 413-587-1272 Plot/Site Plans t �' nrc — Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: n j/ 7 I`-2w,�svk P 'lam Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 3Mes L . , 1 iVor,f 5�.).e e�,&i l/7 £ P-9/. R2 /Ubv^�h 0+rnp)in Name(P'�) Current Mailing Address: L � (35_ Telephone Sclirignature � ��� fi -A. 2.2 Au •ri ed •s ent: `4."--— • __. 41 ACA / a m (.161 6/norr Nt42 4.1 ,2& s'TO Vi Name(Print) /4/12 y Current Mailing Address: =�� / V/3 - S27-/04g 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 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number *'25-- This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date I ` A 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 Setbacks Front r—! Side L:._ ' R:... L: I R: i 1 Rear _� Building Height I i Bldg. Square Footage % -- Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces I I Fill: (volume&Location) • i` i i — A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page: ' and/or Document# 1 B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW © YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained 0 Obtained Date Issued: C. Do any signs exist on the property? YES I NO 0 IF YES, describe size, type and location: I D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO Q IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. F 7 - SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House E Addition ❑ Replacement Windows Alteration(s) IY I Roofing n Or Doors E Accessory Bldg. ❑ Demolition ❑ New Signs [Cp] Decks [[] Siding[O] Other Brief Description of Proposed /+ Work: k 11 0 l �\"t iti J ) c Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa1f.IVe'witi�onse�a�ir��oracicliflorr�to ezistinq tiousin�grnmp'fie�e�le �o�nnng: 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 ,as Owner of the subject property hereby authorize to act on my behalf,in all matters rel ve to work authorized by this building permit application. i�vz.G%-./ 8 3/6 Signature of Owner Date ,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/Age Date • SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: (dt ik i �- C /7 Cf 657 60 7 License Number 3o/ PoN9-ta, r co 1C/ So0A0v,#61-0 0)68 Addres Expiration Date Signature Telephone )1100/06 9 Registered Hdme mprovemerrt-ContrkTOE T -' ` •� ) �` �,_ x�.,r".; � a�, :�_ ..�;.�:=�.k�:: x; Not Applicable ❑ S op\ l3�CI'76) Company Name Registration Number SPVYNIN Address Expiration Da - Telephone �//D1 J66 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 0 ll me`0v t.;E err>pt n 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 gip-\ fi.�-iw.r pray << �i/ of Northampton I _— - p t? ! E �t:s.nrllntlle' voli4 > ?!'7 DEPARTMENT OP nUILDIN,G INSPECTIONS 212 Main Street ' Municipal Building • Northampton, Macs. 01060 to,. 'O•RIC R'S C O MT E S ATIO N CI S t RAN CE A FTD)A VU • I, ipli (c4„,g4__( s.,.. .___MCke(11 _e__ ____........... __ ........... .. .... ___.__. (Ii ccnsJpermn ttcc) with a principal place of business/residencc at: ct1 ✓2-•� /07AphOnci;) V/3 S'e 7lea a©�' Pm�y ��a� VO� o sc r/tit y/szate/n ( r p) do hereby certify, under the pains and penalties of perjury; _hat ( )- I am an employer providing the following worker's comocnsanon coverage for my employees working on this job: (basur_=Comte) (Policy ?:u_-n.ocr) (I mir::uor, Date) • • am a sole proprietor general contractor or homeowner (ciscie one) and have hired e conua t steel be ow who hive the following worker's raepen-s26on policies: (Name of Coatracto-) (In urancc Comourviouc; Nu.m=cr) (E.xpirucon Date) - (Name of Contrc ior) (insurance. Company/Policy Ntuilc-cr) (Expiration Date) . (Name of Conuacio,) (Lasurancc Company/Policy Naza r) (Expiration Date) (Name of Contractor) (liasurant Company/Policy Number) (Expiration Date) . (au�ch zoit:ocii bcci if00000l.ry to c)chtd.inforzsoc pcswoia6 to.11 000=r--r�rs) { 4I am a sole proprietor and have no one wog for me. ( ) I am.a home owner performing all the work myself. NOTE:plcsc lx cw-Nt rfi,..4 lc bccoco ocrs u•bo rmploy pc-soaa to do r-. -+,--, c��,taco c ropair work cra.d..c11.ini:of on t>zoce th_n Li rw_tMil.,in w its the botnoov'ocr rt oido or co the crouo6 zppurtcnazc t c .n s_-c vx cz _lIy oc=id.-cd to Lx c tploycs one-a-the vi rya cc--,?----lion Act(0L152..731(5)).:Qpticuioo by o bomma-oa fors Fig_or pumit rn=y evid,cc the • lcsul n.a-'uz of ea<xployor uodcr tiro W oric.ces CocQ.eca..yioa Act_ I uadcatLad tbsx.copy of thi.rat®cm rn.y be for,..."1.44 to tbo pop.tmwt of l.+�'r=io Asnacose O(Loo of Loott ooe for tb. oovc.Sc vaiGoaioa o d t t Lilta-o to cw-iuc'covct-nsc t•oM-scct,ioa 25 A of MOL 15'I can Icr-d to the i itioa of ciminol pco oltza of.floc of to X 1}00.00 andror �um8 up cct of up to trot yca.r rid civil Qca.hua is 6c form oCa SsoQ Work Ord .aad. rim o(S 100.00 s thy.pticA me F« =--5JtsKonly Z___e_Z-.41.____'‘"7 Permit Number).•f3p�__ Lot "Signtturc of Lirmiuct Date - F 1 W4p7. _ � �$ Q XtIr of Xnzt ampten • z — /. -�1ry.f��1► �'�' J to cl71I ttt5 ^ _-, ez„it. -~ - �1 '�" DEPARTMENT OF BUILDING INSPECTIONS _'•. -=/; INSPECTOR 212 Main Street • Municipal Building 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;: ... sor. 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)t 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