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23D-168 (5) 134 MAPLEWOOD TER1 BP-2001-0908 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23D- 168 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: windows replaced BUILDING PERMIT Permit# BP-2001-0908 Project# JS-2001-1637 Est.Cost:$3200.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: RICHARD NELSON 123663 Lot Size(sq.ft.): 44866.80 Owner: HARRIS EDWARD Zoning:URB Applicant: RICHARD NELSON AT: 134 MAPLEWOOD TERR Applicant Address: Phone: Insurance: 39 KINGSLEY AVE (413) 268-9335 Workers Compensation HAYDENVILLEMA01039 ISSUED ON:5/14/01 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL (2) REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 5/14/01 0:00:00 1479 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo Department use only R E C E 0 wCi' lithamptonStatus of Permit: :ui • epartmentCurb Cut/Driveway Permit21n Street I .• 100 Sewer/Septic Availability_ _ _ MAY 1 4 UUl Water/Well Availability._ Northa pto , MA 01060 Two Sets of Structural Plans DE� 03 -124 1 Fax 413-587-1272 Plot/Site Piar.s RTHAMPT ,MA 01060 Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING X Ck / Ili? SECTION 1 - SITE INFORMATION ylw /1 Property Address: Mfittizik This section to be completed by office 134 1„ j� 'Axed Tperace, Map Lot UniL Jrk /ayj YQ , 0/d 6 ® Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: riskv2A..„6.4 Name(Prin Current Mailing Address: Telephone Signature 2)2 Authorized igent: 1�, c /0 �� Av '�Z 6 ��j' NNW ame r 4t q( / ( ) Current Mailin Ad ss: � 't / 0)74/ Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant v. Building g200 O0 (a) Building Permit Fee t 2. Electrical (b) Estimated Total Cost of 116 Construction from (6) 3. Plumbing N� Building Permit Fee 4. Mechanical (HVAC) ,/ 5. Fire Protection he ATotal = (1 + 2 + 3 +4 + 5) T?C-l) iC? Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date C Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Fro t Side L: R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: &Location) ((;)lume Has a Sp-cial Permit/Variance/Finding ever been issued for/on the site? No ' ate DON'T KNOW YES IF YES, date issued: / IF YES: Was the permit recorded at the Registry of Deeds? / ' NO DON'T KNOW YES IF YES: enter Book Page and/or Document # 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 Obtained , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location: SECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ] rief Description of Proposed Work: r iG /�C _ © 1Ci [r�G (,il 0�►i f� % KA Alteration of existing bedroom Yes V No Adding new bedroom Yes ki No Attached Narrative❑ fRenovating unfinished basement Yes V No Plans Attached Roll ❑ - Sheet❑ use ld a dditio t Istt o)- - r 3V o p e= e foirdWit g: 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. Mascheck 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, , 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, , 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 unde e p . s and enal ' s of ju . Drf VSirint Na • ,/ �: D/ na ure of Owner,,:en Date i 4r-45,`v SECTION 8 "CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder : License Number Address Expiration Date Signature Telephone e Not Applicable e i erea Home ImprovmentCanfracto ElyxR,. Com`mny Name -. Registration Number , ciokr\L tr • Address \./ Expiration to Telephone- k O � rg-6 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 0 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 d. 9 i QIit al Norther tpfint a6ji1assaclinsetts DEPARTMENT OP BUILDITNG INSPECTIONS • . 212 Main Street ' Municipal Building Northampton, Mass. 01060 •"'y WORKER'S COMPENSATION INSURANCE AFFIDAVIT 1, R 1 cioaf-A P4 / (licensee/permittce) with a principal place of business/residence at: o1039 * 2 ky51\(2.9 'I vJ, /--ki/knok TC1 . (phone#) tv�-'61�J (stttxt/ statrinp) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: -(Insurance Company) (Polic Number) (Expiration Date) �(,,�) I am<asso orop ietor general contractor or homeowner(circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml sheet if ne +.ry to include information pertaining to all contractors) I am a sole proprietor and have no one worldng for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that while homeowners who employ persons to do crtairarnsore construction or repair work on a dwelling of not more than three units in which the homeowner resides or on the grounds appurtenant thereto arc not generally considered to be employers under the workers ration Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the legal status of an employer under the Worker's Compensation Act I understand that a copy of this rt.r,-,n,ns may be forwarded to the Dept/toast of Industrial Aoeidea&Offioe of Insurance for the coverage verification and that failure to secure coverage under section 25A of MC3L 152 can lead to the imposition of criminal penalties consisting of a fine of up to 51,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine of S100.00 a day against me. .. 1. / 4, For use only ! � _ li/rl�j7 Number � c% L� hfa Lot# " r St cif Licensee/Permittee i a*Xtne i ty Jr/ ' l'Ashih, ,,..-- - tk rip • , _ A jailie, 17 (4,1Mi ,)'L) OW MOM 41, ill Zb9i:336+eoar /141 91-. g' //' 'I/ (-2--jk e � 1 mat -uu) custom feemorewk'Addirtons•No'pld•trtslotsIOut d 1-44 n X IV, NiaY 1.;tUIJ'J -21 7Y 96'..-1,33 ENams Ft's larris 134 mammas Tars' Mortharriptan. MA U'lUISU Re:Replace 2 existing wood sitdina windows on southeast corner over garage door. Remove existing sliding winnows. Remove and repiace existing Board and Batton exterior siding only around decimeter of windows, not to exceed 80 sq. ft. total. ef ame and�R.O. Windowslate wn�k�eng openings to#ow�glass, �ithtte�ll whitew to tagae sliding windows. 4' / i r .,wide x 4 sash pulls and screens, grids are traditionaa 7/8', with let �a�n�zontaligr sid bars e Onlyd 2 etlns right 8te eft bars as apes d on lynx window and door stet dated round new window openings, fix existing cracks in sheetrock around window openings only. Instal/ new trim around 2 windows. No interior painting included. No etectrlc,al or plumbing included. �1� tot 4/ice Labor and Materials $3.200. 5 9 0/ Aii work wild be compete°to Blass State Building Dade. Estimate is good tar thirty days and requires 1a caown upon approval of COMIC!, W gown atter windows are►ntd8gteJ anct tinai ird oue upon ctflmptebon. 39 KM6stEv AVENUE •HA'r ENV'A1E, MA 01039 (4 i i3)'Lbt$A 30 Hares Page 1 of 2 (4,1 '767 lode , eff mum 1111159o / ilk,: 39 KingsMiw Avenue I" 41346E-9435 salt n72unf':wmirommiemmoing2I1P5121, Custom tea' s and Additions •Nawaad•,na.io+.i+rae tJ►ey I "1171,1/- 11e, 015- /vre Ed Hanis Faye Harris 134 Mapreawod Terrace 11/11471-cr/ - /6/ Northampton, 11AA01 i hereby propose to furnish. in accordance with attached specifications, all material and labor necessary to do aenerai repairs on home for the cost listed in specifications. Ali material is guaranteed to be as specified. All work is to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the above or attached specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. It may require payment of extras in full before work is carried out. Ali agreements contingent upon strikes, accidents or delays beyond my control. • .. d. Note:This proposal may be withdrawn by me if not accepted within 30 days. Payment Terms: 1/3 due upon acceptance of proposal, 1/3 due after windows are Installed and final 113 clue upon completion. ACCEPTANCE OP PROPOSAL: The above or attached prices, e the work tla nnssp ari ed conditions are satisfactory and hereby accepted. You are authorized r1 Date of acceptance: /c1 �- Signature ��'' Signature 39 Ki, stEY AVENUE D 35�, MA 0`.039 li rris+Pape 2 401