Loading...
24A-016 99 PROSPECT AVE BP-2004-0761 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24A-016 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2004-0761 Project# JS-2004-1111 Est. Cost: $9495.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: QUENNEVILLE'S SON'S ROOFING 111880 Lot Size(sq. ft.): 18905.04 Owner: FLYNN NICHOLAS D&KATHRYN K Zoning: URA Applicant: QUENNEVILLE'S SON'S ROOFING AT: 99 PROSPECT AVE Applicant Address: Phone: Insurance: 151 ABBEY ST (413) 536-6630 SOUTH HADLEYMA01075 ISSUED ON:1/22/04 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF 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: Receipt No: Date Paid: Check No: Amount: Building 1/22/04 0:00:00 13351 $25.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 11, l • City of Northampton • Sa tus'ot P I Building Department Curb Cutlf3 v y 212 Main Street er/Sepi a Room 100 a eraVeIl r at) Northampton, MA 01060 Twa Setsof t "c era phone 413.587-1240 Fax 413-587.1272 Plot/Ste. Other Specify � .. r. . 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: p +,� ,[� q � ✓� e� / r V c Map Lot Unit /t70( Lh j�ry -7r—°� 41� © one Overlay District EIm.StDistrict ,. 4"" CB District, , SECTION 2-'PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 44C_S , if atey FLñJV cr Ptoopeô 4v . Name(Print) / Curr t M i r lg Addres :2,69 co Telephone Signature 2.2 Authorized Agent: ar) 7enne g `l e says � � isf p kJO 0,/l Name(Print CurrhoJ/Mailing Address: / Sf J- (�(3) .5"3 ( - - L 3 Signature Telephone SECTIONr:3 - ESTIMATED CONSTRUCTION COSTS. Item Estimated Cost(Dollars)to be Official Use'Only mpleted by permit applicant 1. Building 6.1 (7 5 (a) Building Permit Fee 2. Elec.rical (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) -L q� Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date � 1 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 Front Side L: R: L: R: Rear • Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW ?C' 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 X 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 74 'EYES, describe size, type and location: r • - SECTIONZ=iD S 42.P TION OFIRROPOSED INORK(check 11 applicable)lavt4 iA� ..i�".'^Y'1W3ftYM 1Na1t1FfY'!?YY!11RfI�NPNRPztn'4s�+. sd 4d4* "YN TAP»- F3'i .v.:r. 94n 17'P A." 'i'k . New House 0 Addition 0 Replacement Windows Alteration(s) 0 Roofing Or Doors 0 Accessory Bldg. 0 Demolition❑R/ New Signs [ ]]i Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: !V ` , U✓ `'�CeY? ,5' V // �' `' 1./(7/� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet 0 6a - . ewT :nd or at ditionito exi lin housingAcomly ef'e thee following: 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 SECTJOTI� OWNERAUF�ORIZATION=TO BE COMPLETED WHEN W1�ES ENT,OR CONTRACfOR�APPLIES FOR BUI'LDINGPERIVIIT , � e aF l y , as Owner of the subject property P Y hereby authorize >✓ no e 'l/ ( II ' 5 n .I S i I / t7 ji to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date Okl)e-iln& vit `II✓ s 04 10 fiftP/V , as Owner/.Authorized Agenthereby declare that the statements and information on the foregoing app are true and accurate, to the best of my knowledge and belief. Sigaed under the pains an enal 'es of perjury. Print I / L/0 Signature of Owner/Agent Date . SECT0N33 CONSTRUCTION SERVICES ' 8.1 Licensed Construction/Supervisor: Not Ap licable ❑ Name of License Holder : ✓ 1f��/ / [ L/ License Number 15/ e cy, H417- Addr Expiration Date G �bG� 0 Signature Telephone Re gs e, Curie • vern ri ntracto " Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10 'WORKERS' COMPENSATION INSURANCE• .AFFIDAVIT(ML.-c.G 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 ❑. 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 I . 4 • . r -r - • fat S 1 V+H P7. .`_ i. s$. , (rxtyr of c.\a tllciinptail ,+'ZU eV ,Talasaacfltnsftta ^z `r��"+•• DEPARTMENT OF BUILDING INSPECTIONS m 212 Main Street ' Municipal Building Northampton, Mass. 01060 or . P , WORKER'S COMPENSATION INSURANCE : + mAv.T I, . 6t ti. -0 lay/ //a 3 Oin, 3 A60-7°/z51 (l i cznstercrtnittcc) with a principal lace of business/residence at: :c9cv ffo, t A-M . Dio-7(5- (phone\ 5-2 62,t263,0 1 - - (strca/ci ty/:,:at.ch-i p) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the followinn worker's compensation coverage for my employees working on this job: (Insuranc Company) (Policy Number) (Ex-pirauon Date) ` I a a sole proprietor, general Contractor or homeowner (circle one) and have hired •� m' ' contractors listed below who have the following,worker's compensation policies: (Name of Contractor) (Insurance Cornpan-,(Policy Number) (Expiration Date) • (Name of Contractor) _ (Insurance Compaay/Policv Number) (Expiration Date) (Name of Contractor) (Insurance Com anyiPolic-y Number) _ (Exp rtion Date) (Name of Contractor) (Insurance Comr yfPolicy Number) (Expiration Date) (attach additic,ctal sC:_-et if n.rcas.r to i r.!•.:.:ie i.trera.:icc ,:�:.in:.tr t.:ei1 ores-a..u.•.) i . I dun a sole proprietor and have no one workinci, for me. ( ) I am a hoille owner performing all the we ilivSclt. NOTE:please be aware that while hareowll_rya v•tro cap lay irse::to c.i atair:'r-ancc arr nG:en of::pair w'ni:c-t s d«cili^:,c. not more t to three units in ttitidi the 1:,,<ti~owo -rcic:a or at the g•-:•.;i,appurtenant tli.cto are ttct generally conk::red to be � cmployca under thetvoc� ra oa:� :.:_tirn Act(GI.152, s i(S)),z(:'�l:cztic::by a homeowner for a liecu cc p-r:ri:maymayc...'.r.;c t... legal status of an camloyec under the Worker's Consper-.s.tion Act. [understand that a copy of this castrn:cct may bo focx•tutted to:S»lY_tiort.•ucnt of Iacl+,tirial nead.ter&OfMoo of i:::vrsrrx for rho coverage ve ifictioo and that failure to sec.trc coverage under:o tion 25A of MOL 152 can lead to the imposition Ofr aind penalties comisting oral fine of up to S 1 Soo.00 ant"'cr in pry xnk.N of up to cry-y tr r.rd civil,penalties in ttc form of a Ste;;Wert;Ord-n and a fifes of S100.00 a day ag.in.t me. . - For deputmasal use only 55;:C.....-;:..."6 :1- 75.- ____—_—_- . Permit Number -------___________ Lot _. ,_.. Sif:D tturc oft .,...........ran...-......,... r; -,- r scZHAMp1. 4,;, $ (rz#fir �f �daz#1#�nt tnrt i_ _*_ r : rFt# ig855AChusett5• _ `_ 'i'-"'.Y' DEPARTMENT OF BUILDING INSPECTIONS �, =:= f /: INSPECTOR 212 Main Street • Municipal Building Northampton,MA 01060 . r 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:or. 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)z 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