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18D-053 80 DAMON RD#1304 BP-2007-0542 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18D-053 CITY OF NORTHAMPTON Lot: -023 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category_ BUILDING PERMIT Permit# BP-2007-0542 Project# JS-2007-000787 Est. Cost: $2925.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Coast.Class: Contractor: License: Use Group: Fd Corbett Jr 116069 Lot Size(sq. ft.): ..O'vner: KIROUAC JENNY Zoning: GI Applicant: Ed Corbett Jr AT: 80 DAMON RD.#1304 Applicant Address: r°none: arisii a ri.,c,. 4 Reed Street (413)58.4=6571 NORTHAMPTONMA01060 ISSUED ON:11/13/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT WINDOWS & PATIO DOOR POST THIS CARD SO 1T IS VISIBLE FROM THE STREET BuildingInspector Inspector of Plumbing Inspector of Wiring D.Y.W. p Underground: Service: Meter: Footings: g 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 11/13/2006 0:00:00 $25.003278 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo S. -rvvii,lAkT f -14_ )1-ir? 94- os •p/o LvAity5 TYCO pvarn c 41, asr,V) h(?,-tV,5 -f-, ,t,, c "r")' Id ay Wno?) '? -v4ey • . Th j Ci of Northampton s . 2cQ Building Department ci s[;CuUDg ewa emi '�a� ' - N0• 212 Main Street Sewero. air uh z 'nNS Room 100 Wa er el ila.ih " Northampton; MA 01060 Tw�O e s o u ural P a" • " phone 413-587-1240 Fax 413-587-1272 totlsit :.Ian 4 ` APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING „� r.,rrt SECTION;1 SITE INFORMATION 1.1 PP Address: wrr*ooperty This sectiori to be completed by office DArn o� Rc� UN►t Y. 3o y . Map ---- Lot Uti3t / Zone .r Overlay District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT • 2.1 Owner of Record: ae, `I' l IeouAe-- Name(Print) Current Mailing Address: Telephone 6yr�Signature 2.2 Authorized Agent: PC/r�,4RC) T Coil�.�- ��� y Rey& s>c N '40.. Name(Print) Current Mailing Address: 5''8 41— Co 571 Signature Telephone SECTION.3--ESTIMATED'CONSTRUCTION=COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building .(a):Building;Permit Fee 2. Electrical ,(b)-Estimated Total Cost-of Construction:-from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) c9. i— '$ection Fornffici Check Number �� 02 9 TTT al°Use'Only Building:Permit Number Building � Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Informatibf 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 I I I I Frontage I II i Setbacks Front i Side L: R:I I L: R:i I I Rear I I Building Height 7" "1 • ,--. L_____I r-77-7. Bldg.Square Footage % ' I Open Space Footage (Lot area minus bldg&paved I parking) #of Parking Spaces Fill: 1I i i 1( I (volume*Location) A. Has a Special Permit/Variance/Fi ding ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DON'T KNOW 0 YES IF YES: enter Book 1 j Pagel j and/or Document#1 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 Q Obtained © , Date Issued: L C. Do any signs exist on the property? YES © NO )8( IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading ex ation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES © , NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. r.: SECTION 5-:DESCRIPTIONOF.PROPOSED'.WORK(check-athapplicable) New House n Addition ❑ Replacement indows Alteration(s) Q Roofing Or Doors [%I Accessory Bldg. El Demolition ❑ New Signs [1:7] , Decks [Ej , Siding [CO] Other[I ] Brief Description of Proposed work: 0 11 H VrWy) W i rJow.c N) LOW t GJ i�ss, had . L > io &C�2 i edaixg D, Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet _ e _. art c rrefir a SIiing6a n,sCd e a liiu ra 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'Ta iOallf, lER 1�t1THO1 ATfO 'traE COMELETE I-[E D WN} OWNERS':AGEtlTAR`CQNTRACTOR PL1E-S FQR B1JItDItNG 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 Owner Date I, 6/a/9/eel J (oe_ep " LI IZ ,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. (CA/Awed 7" neregerr-- Print Name Signature of Owner/Agent Date SECTION..8-CONST(2uCTION SCRVL S i 8.1 Licensed Construction Su ervisor: Not Applicable ❑ Name of License Holder es AI T I&Y J1T c O(9) '1S-O License Number Li Reed S. Nv„e3-40 -o,J MA 01060 1/— 3-08 Address Expiration Date e,i.,....../7 Signature Telephone • ems ec•'.�:o-`_, . o -r;;_me`?-a. r'v;oK ,:" :::":- 1 v r Not Applicable 0 CO K t3e-57' f iOi2c,: —1—/ O Mg ve- i e/vj- -- /J 6 D(0 9 Company Name Registration Number Li Kiev sit ,tiD,641,,,� .t/ , ©/o‘D j- i. -O6 Address /_ Expiration Date - 6..—,...-7-7. Telephone 7 , /—(J.57l SECTION 10 WORKERS'COMPENSATION INSURANCEAAFFIDAVIT(M.G:L,c.152,§;25C(6)) 1 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 X No 0 • 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 ,- t �� ;�t , �ztp al NUr iyamptan • 1- -'�=" / 9��..;'zip �'� assar _ —_ `�'. = 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 sups:','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 T 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 tegulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfiil), 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 t . • • • Q-S t tN f pi- - R� , y� `I.IO2 of Icn f17amptcp • 1 yet $efFi'��,'r�.i E Ota3sa r nulls' `= DEPARTMENT OP DUILDr),c INS PECTJOI:S ' -.E‘._--:--: 212 Train Strcct ' Municipal Buntline Northampton, Mass. 01060 isr WORKER'S COMTENSATION G\ISUTZANCI✓ AFFEDA.Vl-I' L, _6//,./ALed 1( f.0 zerst-r __. (licca Jpermilt`ee) with a principal place of businessfresidence at: y Re2s> S Nd -1 of ,4 e/0(04 (phone) 5 / 6sj/ str=vci p) do hereby certify, under the pains and penalties of perjury, hat • • ( ) I am an employer providing the fohiowino.wvorker's compensation covem3e for my employees worUng on this job: . annul ce CoL anv) • (Policy Nu_'abcr) (Expir.•uon Dalt_) ' ( ) I am a sole proprietor, general contractor or homeowner (ciscie one) and have hired the contractors listed below who have the following worker's comoenszdon policies: (Name or Contr ctor) (Insuranc- CotrpanyiPolic— Numh..::) (F_\pirauen bate) • (Name of Coaoacior) (Insurance Company/Policy Ntumc_r) (i xoinion Date) • (Name of Coerracio;) ansuranc; Company/Policy Nambcr) (Expirdon Date) (Name of Contractor) (Insurance Company/Policy Numbu) (Expiration Date). (.rich sdutiocai sbcce.ifinecca.t_-y to cac_u-inform,-ioo pertaining to.JJ ooa--e.o:3) - • I am'a sore proprietor and have no one working for me. ( ) I am,a home owner performing all the work myself. NOTE:plea be awue dos'.i is boaaeo aors wloo=ploy pa'soas to cis r.,ir,•-,••,, or..-sc.,ao c rcpair work op a d...rh c of tint mort tb.to throe tits is taltiel1 the boenoowoer raid=or on t .c crab. 4 appurtenant tlrao arc Dot geaeruy oopidved to be caiVloycr uade the ward crh r.,•-p.—./ioa M(GUI 52ss 1(5))-applin.000 by a boa fcr a lies_er permit rr_y evidmoc the lewd ata_yi of an.rtloy.r under dap W orfcoet Compoon tion Aoc. I node:wand dui a copy of tbia csa®em may b.forwarci.el to the Dep.nmoot of Indus-rid Aceidordo'Ohio.or laaar.00e for dr coverage vcrirr3uoo cad thet L-ilwe to tenet:`covcrage tandcr soaioo 25A of MOL 152 na led to the ia;rosaioa of aimiaal panties comizaig of a fiat or up to SI 00.00.ndfor Campaiyoemocml of up to ooc yc,r rod civil penal-jet is t5c form of a Stop Work Ord and a Gm of 5100.00 a day apical r>x Fad u.c only • permit Hurnbor 11 7-0 6 ),gyp=__ Lot K SiBoaturc of LiconsaJPc Late -- - TrOpOSar Vinyl Siding , ,---4-- • , Corbett Home Improvement Ra Roofing 11 4 Northampton, MA 01060 „Door`s •': I. I''It (413) 584-6.571 Canopies H�t` t) be Y 1 06 L7'" f:�J✓�7 /5-0 Gutters es PR(tPt>SALSt CBMl1-IED TO Ve,VPJ X) //co Ptr PHONE 5T 3•-3(.'7c , DATE Qe /4 &006 s,REETON i) / goi.i Ave t 6)Nick h JOB NAME - _— CRY,STATE,awl ZIP CODE P r1i.4/' JOB LOCATION r• 7 DATE OP PLANS JOB PHONE We hereby submit specifications and estimates for: -Lc__ Li MM)dane . V1w1 I i4L 3 D6ri64 ;-vN, Arlveteo -s. /. 0i-f - ' 61,~4-sS . ,/2 .SCE-e,vs. ('o1Orr c1,= 01-k- NC 4 i eS . Achm Jrvvm ee',/Sir riC of e e-/rc, ) , .so)/4Lie ✓ 9O 31 v x yy%a r, 3a c g95,z 4 3/3/r X - yy I/.2. }4LL. ii/A-L qi 1 6 i? a Do. Ceder Al . L04.1-.�' la )4-1(,(,-w✓ (t,Ars. No 6 i1 S. Scree,' Tbv i 1 v 14-/ m w Ce)Jsfiecc. 0r/ ear'/OrC,_ NE7t) JAI �cs u►'l- i S,,v1 etAi ` � S>d , ` /Sot 5J CSFPRI:U, NCIX. il-lT:f C `.i + TrASE D S L Te Tropose hereby to furnish material and labor-complete in accordance with the above specifications,for the sun of:4 Dollars t$ �n ) Payments to be made as follows:Aid d MA 104 u at,Ai Je 4 �/' v ,,� n�� id„ v�! �i Kl'`rvi b J�V1+q/ �!1`a"/YTW µ �Alt material is guaranteed to he as specified. All work to he completed in a work-like scanner according Authorized to standard practices. Any altercations or deviation frost above specifications involving extra costs will he Signature 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 our ,ntrd. Owner tin carry fire,tornado Note: This proposal may he o and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if riot accepted within days. Acceptance of Troposa[-The above prices,specifications g ,.- ..,tic:;:z.c,c(c. are conditions are satisfactory and are hereby accepted.You are authorized to Signature do the work as specified. Payment will he made as outlined above.. Date of Acceptance: 1 I/Xl V 69 Signature J