Loading...
24A-027 (6) / 4 92 RIDGEWOOD TERR BP-2002-1085 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24A-027 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2002-1085 Project# JS-2002-1747 Est. Cost: $1500.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Harvey Messeck 104545 Lot Size(sq. ft.): 5009.40 Owner: MORINI LOUIS J&SOPHIE& Zoning:URA Applicant: Harvey Messeck AT: 92 RIDGEWOOD TERR Applicant Address: Phone: Insurance: 271 Prospect Street (413) 584-4460 NORTHAMPTONMA01060 ISSUED ON:6/7/02 0:00:00 TO PERFORM THE FOLLOWING WORK:STR I P & 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: 0 if' G•g I.O0 ..M tt41 • THIS PERMIT MAY BE REVOKED BY THE C Y OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND ULATI� O Certificate of Occupancy 55 Signature: Fee Type: Receipt No: Date Paid: Check No: C Amount: Building 6/7/02 0:00:00 2726 $25.00 • 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 92 RIDGEWOOD TERR BP-2002-1085 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24A-027 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2002-1085 Project# JS-2002-1747 Est. Cost: $1500.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Harvey Messeck 104545 Lot Size(sq.ft.): 5009.40 Owner: MORINI LOUIS J&SOPHIE& Zoning: URA Applicant: Harvey Messeck AT: 92 RIDGEWOOD TERR Applicant Address: Phone: Insurance: 271 Prospect Street (413) 584-4460 NORTHAMPTONMA01060 ISSUED ON:6/7/02 0:00:00 TO PERFORM THE FOLLOWING WORK:STR I P & 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 6/7/02 0:00:00 2726 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo Department use only. City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans_ phone 413-587-1240 Fax 413-587.1272 Plot/Site Plans_______:._.__.__._ Other Specify______ APPLICATION 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 , _ /doct I Map Lot Unit F.-e fk:l kn F--6oK Zone Overlay District �� Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ���� • ,�/ // I c5 o p h i e /i ,,-j ! , ?az ///i9 r Wood *. �G'��-hct kr, Name(Print) Current Mailing Adds: �vc—�� ))/dam-vt� Telephone (j�/ O Signature o j 2.2 Authorized Agent:1Q Xi-W/ct ve /�a�ss�� err �5 Pe�� 67, biF� Name(Print) Current Mailing Address: Signature Telephone SECTION 3 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building /3'/oo © � (a) Building Permit Fee .042. 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 This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Requfted by Zoning This "olumn to be filled in by B ding Department Lot Size Frontage Setbacks Front Side L: R: L: '• Rear Building Height Bldg. Square Footag Open Spa Foota o (Lot area n sbldg paved parking) #of ark' g aces F. I: olume Location) A. Has a Special Per /Variance/Finling ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued IF YES: Was the p•rmit recorded at the Registry o Deeds? NO DON'T KNOW YES IF YES: ente' Book Page and/or Document # B. Does th, site contain a brook, body of water or wetlands. NO DON'T KNOW YES IF ES, has a permit been or need to be obtained from the Conservation Commission? N•eds 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 k Or Doors ❑ Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: 56k , pPtf F-od� 6ti c� 5h t h cj /E. 1 �'1 LJ l 1 Alteration of existing bedroom Yes No Adding new bedroom Yes f•�J Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet❑ sa fvNeW house"`and4iFadditi iri toexisting:ho ifs ing,.coimplete the.:followin : a. Use of bu sing : One Family Two Family Other b. Number of room 'n each family unit: Number of Bathrooms c. Is there a garage attache.. d. Proposed Square footage of new con ction. Dime ' ns e. Number of stories? f. Method of heating? Fir>Aaces or Woodstoves Number of each g. Energy Conservation Compliance. Maschec Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. • etlands? Yes No. Is construction thin 100 yr. floodplain Yes No j. Depth of basement o ellar floor below finished grade k. Will building .nform to the Building and Zoning regulations? Yes No . I. Sept. ank City Sewer Private well City water Supply SECTION 7a 7 OWNER.AUTHORIZATION -TO BE COMPLETED WHEN OWNERS'AGENT`OWCONTRACTOR APPLIES FOR BUILDING PERMIT / C 4 F- 1 h I , as Owner of the subject property hereby authorize / / to act on my behalf i all matters relative t6 work authorized by this building permit application. G'L4-7-L-v Signature of ner Date (o' I, C �� ;� , as Owner/Authorized Agent hereby declare thAltir atements and information on foregoing application are true and accurate, to the best of my knowledge and belie . Signed under the pains and penalties of perjury. Q� 1/ 1 P /IeSS�C Print Name Signature of Owner/Agent Date 6/r/Oa SECTION 8 -CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder : !yd f ✓e J'fe5 S�'C ©0 69 L License Number a 7/ /as pec,`& w, /c.2- 9/ v Address Expira icon Date Signatur Telephone 9: re om em'ent'C4ntractor : ,, , 4, _ ,. 1� „. ' 4, Not Applicable /0/ vt y files.cec Cc' 701CC Company Name Registration Nurrhber 7/b e+ 9 ' /�/©► � 1�,-t cp co K_ >// / 0,2 Address ,�/ Expiration ate 3�T— Telephone T/,7`/60 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 7 wne Aemption ,Onle The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one( ) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license, i rovided hat 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 re.ide,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such u e and/or farm structures.A Berson who constructs more than one home in a two- ear 'eriod shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official t at 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,d iing 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 (Liabili of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated, ou ma le 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 Buildi g Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Anno .ted. Homeowner Signature 4�tiAM pi,_ pop _ ;fl �Z4 o Nartilamptatt __*_� B /vAs 1 l �tassatltristtts 'v Eilfille= — DEPARTMENT OF BUILDING INSPECTIONS ` 212 Main Street • Municipal Building Northampton, Mass. 01060 ' WORKER'S COMPENSATION INSURANCE AFF'U)AVIT I-, %1-key F /Ves ec. (li cen see/permi ttee) with a principal place of business/residence/ at: cO//noS c. , �� %t hir6 h. D/O / (phone#) .-Ck i(.6 6 (street/city/state/zip) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for m, employees working on this job: • - (Insurance Company) (Policy Number) (Expiration Date ( I am a sole proprietor, neral contractor or homeowner (circle one) and have t'i ed the contractors st e ow who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Da ) e. (Name of Contractor) (Insurance Company/PoLicy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration D e) (Name of Contractor) (Insurance Company/Policy Number) (Expiration D ) (Math additional sheet if nee5-,4.ry to include information pertaining to all contractors) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. • NOTE:please be aware that while homeowners who employ persons to do pnirAena ,construction or repair work on a the,lting of not atom than three units in which the homeowner raiders or on the grounds appurtenant thereto arc riot gmeraity ooamidud to be employers under the worker's compensation Act(GL152,sa 1(5)),application by a homeowner for a license or permit may etridmo the legal status of an employer under the Worker's Compensation Act. I understand that a copy of this etatemeo3 may be forwarded to the Department of Industrial Aoddeota'Office of Gnuranoa for the coverage verification and that failure to secure coverage under section 25A of MOL 152 an lead to the imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or imprison of up to one year and civil penalties in the form of a Stop Work Order and a fine of 5100.00 a day against tee. For departmental usso only Permit Number ‘ Map# Lot# Si f Lice/Pe ttec Date