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23D-118 (2) 190 FELitAill,.; gal. . GIS#: _ Ni°, df___ ___ .-t 110i i z.._x ,: ,.... :;.)Cfi.l IS Map:Block: 23D- 118 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2005-0361 Project# JS-2005-0479 Est. Cost: $11600.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Gros_ Richard Labornbard____ 055340 Lot Sizc(q. ft.): 20386.08 Owner: WHITTIER NANCY E.& 7o,.:,-,.;.p„ :4 alicant. Richard._L abmpbaici AT: 190 FEDERAL-ST Applicant Address: Phone: Insurance: 119 Park St (413) 527-7427 EASTHAMPTONMF,0 1027 ISSUED ON:9/29/04 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL WINDOWS & INSULATION TO PORCH POST THIS CART) SO 1T' 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: y Oil• Insulation: Final: Smoke: Final: 0 k 3•(8 O5 —n THIS PERMIT MAY BE REVOKED BY TILE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF' ITS RULES AND REGULATIONS. Certificate of Occupant-� - ,,. ? Signature:- c' ' ' � Z5f5e.--......1 FeeType: _ Receipt No: — Date Paid:_ Check No: Amount: Building 9/29/04 0:00:00 3483 $50.00 212 Main Street, Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2005-0361 APPLICANT/CONTACT PERSON Richard Labombard ADDRESS/PHONE 119 Park St EASTHAMPTON (413)527-7427 PROPERTY LOCATION 190 FEDERAL ST MAP 23D PARCEL 118 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ie�r Fee Paid .970 3 to Typeof Construction: INSTALL WINDOWS&INSULATION TO PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 055340 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 *ssion ylicir2dy Signature of Buil mg ficial 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. 4 Department use only y rthampton Status of Permit: r-- a , partment Curb Cut/Driveway Permit 2 in Street Sewer/Septic Availability SEP 2 8 2004 \,� 100 Water/WellAvailability North mpto , MA 01060 Two Sets of Structural Plans L______ o_n_phg413-5R1-124 Fax 413-587-1272 Plot/Site Plans nrvT nr gl;llr!•"G INSPECTIONS Other Specify AAA (llohU -APPLECATiON 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 Map 3r) Lot Unit ,-- "E-i iPZ 5 Zone to!%''✓'-' Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: / M/t /7/ --yP�t' fi1Z/C4A4 Name(Print) Current Mailing Address: Telephone Signature 2.2 Au rized A ent: ,44/1 i69/e4-- 4---1-457-40kie,0774/ Name t) Current Mailing Address: p7- 7*27 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building /l (a)Building Permit Fee �CtD,vo 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 3 7g3 This.Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings- Date w Section 4. ZONING All Informations 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 i Side L: R:I 'L: R:I I I . t Rear Building Height l ' - 1 • -- I Bldg. Square Footage I , Open Space Footage 1 % , (Lot area minus bldg&paved 1 4 I I I i parking) t i #of Parking Spaces , Fill: , _ (volume-&Location) A. Has a Specs I Permit/Variance/Finding ever been issued for/on the site? NO DON'T 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 1 Page, and/or Document#1 • B. Does the site contain a brook, body of water or wetlands? NO SDONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO er IF YES, describe size, type and location: 1 1 E. Will the construction activity disturb(clearing,grading,exca ion,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 . 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 V Knows Alteration(s) Roofing El Doors [� Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [E] Siding[O] Other[0] Brief Des n of Proposer' p y� , ,,gyp n p Work: / 41.01 `-,, 5T74/G• ,00il/11 hi/I O0A,57 r"/f;9 ',NI f ti.s- /AlSa447 I Z lia/t Alteration of existing bedroom Yes '''/_No Adding new bedroom Yes L— No Attached Narrative Renovating unfinished basement Yes i:,---No Plans Attached Roll -Sheet sa.If:New house=and-or2additione to existinct.houstnortibCete-therfoIFovwit 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? /``"® r d. Proposed Square footage of new construction. Dimensions Z/ )( 7 e. Number of stories?f. Method of heating? /747-67,f X-1,0 Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction 70L i. Is construction within 100 ft.of wetlands? Yes if,'''No. Is construction within 100 yr. floodplain - Yes 410 P j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? f 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, ,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 Owner Date I, ���% f 1114 "l 44 ,as Owner/Authorized Agent ereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed a%c1 the pains and penalties of erjury.��� � Print Name 6/pr," Signature of Owner/Agent Date w SECTION 8-CONSTRUCTION SERVICES j-• • 8.1 Licensed Construction Supe Isar: /(/�� Not Applicable 0 Name of License Holder: /�-%-� U"M'1Li" osS3 re. License Nu ber // 7 rie'ir sz- 6--9-57- 1w-/g/t /o/xide Address Expiration Date Sign T phone f 6—02-7-7V-17 9:Regisfececf ire.fimproveiititi tiiitaactoi '_` z- „L. .„ Not Applicable 0 . O,-1#Y Company Name RegiS`tration Num er PChfI / Li LW-o f �e, 7. 3 aI' Address �i L�q �/ E/ Expiration Date �l ,'d 1 77 �/' /1/� Telephone S 01?r7V)? 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 Erdi No 0 11. 11Qlme-O neittExentlittan 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 be/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 p- i i - ` i �45tw-rnlo f — . R+ `�, CI (i ii Of �nr fl}a111pton 1_1 � � f �7[aaRrllnLltiD• � + �r_:►. DEPARTMENT OP BUILDING INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMTENSATION LNSURANCE AITT'D)A.Vl]' I, e .0 /, Iomh,t/ • (lic us zlpermittcc) with a principal place of business/residence at: // /41P/t _5/. 57/ '/11 (phoney') - -o) 7-•7r.Z 7 I (s ....t ity/stair zip) • do hereby certify, under thc.pains and penalties of perjury, that . ( I am an employer providing tSle following, worker's cotnpcnsauo, coverage for my employees working on this job. - (1..a.su . =Com77) • (Policy Ntunrrcr) c&zpinion Daz.) ( ) I am a sole proprietor, general contractor or homeowner (ci cle one) and have hired the co0n-actgrs listed below who have the following, worker's coopensaaon policies: (i+IInnc of Cont^cior) (Insurancz. Coinoan1i?ouc; NuEni'.:) _- lr`:plyduon Datc) (Name of Cottmciot-) (Insuranc:. Company/Pol.icy Numcsr) (i>Dtration Date) • . (Name of Coan-actor) (Insurance Company/Policy Numbu) (Expirrie❑Date) • (Name of Coatraetor) (Ln urance Company/Policy Number) (Expi.tation Date). (aO3tt aduooc.l.5.cQif cco=3....ry to inc.cnfortasioo port ioi.o to..0 t _ o:a) . ( a sole proprietor and have no one wog for me. ( ) I ama home owner performing all the work myself. NOTE:plese be ewarc el.=,vbile 6eup0.vcra who cceplcy pctoas to do r-‘;,-',--,_•-* =,=-:e.wo c repair work oa.d••<Uiz.F.of tux mote than t.�o_ mi's in u�ich the bomootwcr rc ido a-oa the vacua zppurtroo=thew c.-c co(c—x .11y oecs:d..-ui to be eitptoyca t,w the wa-k-ces cr-r -•-+ioa Au(GO S2s31(5))._pplic rioo by a botrwooroa far_!love a pemit tr=y a ideoec the Iesa.I clam of..o..=2loyar uod.,r dro Wod ola Com oon.tioa A . I node-stand tha a Dopy of this an t-s wo may bo foe-..ard.ed to tbo Copa.toecor of 1.v6,rcicl Aaadem-Y O1Loo of Its°Coe Lb' cove-aSc vcsiGctioo and that L•iltat to soaue'eo'cnt under 3cctioa 23 A of MQL 152 can led to the irtn,+eioa of cimiGil I+m+ltio cocr-Z i rg of a fine of up to S1,300.00 andlor itcprisocanc=ct of up to Doc yeo.r tod civil p•- •Ili=io tSc focal of.Stop Work Order and s _ II=o(S 1 .00 a day acainst me For dcp<ct .1 u.c only 9 ) /f'' r Permit Numtxs — / Map:—_ Lot 1 Signature of Li ctrrtiucc Date J, .1 scittAMpl. .9 ` 'o� , Crzty of North&flptnn • 1 ='`_=— "iA `�-4', 1i z 1:� $g*,:.;0�.0.a# Al'ilassachiisetts • ti-- _'X DEPARTMENT OF BUILDING INSPECTIONS = /: INSPECTOR 212 Main Street • Municipal Building -'`o,y_. ,. Northampton, MA 01060 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(.: ,i 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 r'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 Jropui1 Page No of Pages i (�, ARD LABOMBARD, JR. �� General Carpentry J �' SEP 2 $ 2004 119 Park St. 1i EASTHAMPTON, MA 01027 I (413) 527-7427 OE°T nF eulu'I"C INSPECTIONS PROPOSAL SUBMI `D�T NOr+` ct1:'jON µ, 0i060 PHONE DATE / / STREET JOB f9 JOB NAME Fe, CITY,STATE and ZIP CODE JOB LOCATION A//0 I)7214/ fr/YA/, /11r7 C7 6 ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: nA77/ /a-AWAVOI/11-S—': , OU,?r 6/1 57/4/+` 577, 1 //l/✓al/-s : fie OA"Ai/44 ' 72 '"" N 4/ &yr 64c- 549 P -s h/on, Cedli,4 ,�,&, #wW. flu Aluzze A/41 its /#/*t C &557 //V C4 NCC /,//7/ //- 9 od i9GtlN 5/ Cf -74., 5. , ,P// A/ /y7. 57 fF&-z". " A 1 'r , ize4-44,97'. FM 15/71Pi/fir 'Ma/ /f' 43 / 5U 271/fl /it) 4c ` ..x,9&(--, f>'. - 7vc ea- .4)uk, " a"W / ltlawl t /9#D /N5.7iiLL Y C ow-‘ ( C1,19AeatV I//A- Ad41x 7: ,E' -"/f,VE �r �/# - /` 7,47 ©,, E : t2bl Pic- i #41 oiv /ili : . (7 / W e 7 /AK-Z k- .9. fP o CIX(7-.5- /4I/SC. /P4 jex Avg %1,UiL c NG . lie Propose hereby to furnish material and an[ddlllaabo�r—completeo in accordance with above specifications,/ s,for the sum of: ELt/EAJ 7�Us //1 �/j{ / fr/v1lc [ dollars($ _ /1, (t2 - ea ). . Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized .(sty:11fraEYW involving extra costs will be executed only upon written orders, and will become an extra Signature charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be \Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days/ Arr thrice of Proposal _The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. Payment will be made as outlined above. Date of Acceptance: ,, 7/ it ) Signature Ac/t To Roo2t89eo