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31B-027 (6) 1 ALDRICH ST BP-2006-1312 • GIS#: COMMONWEALTH OF MASSACHUSETTS "ap:Block: 31B -027 CITY OF NORTHAMPTON )t: -001 Permit: Building Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2006-1312 Project# JS-2006-1323 Est. Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Sizeisq. ft.): 5575.68 Owner: WIJNHOVEN ROBERT A Zoning;,l`x(: Applicant: WIJNHOVEN ROBERT A Applicant Address: Phone: Insurance: 1 ALDRICH ST O 585-5812 O NORTHAMPTONMA01060 ISSUED ON:6/5/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:REMOVE 2ND FLR KITCHEN TO CONVERT TO SINGLE FAMILY 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: d a D} (��� 0� 12 67 � Rough Frame: .p> I p 01 N rink 5TO f► NiS Fireplace/Chimney: d io(b 3 U"7 • Gas: Fire Department Vtor(o ; on: Insulation: OK 1%3 o7 U /S Final: Smoke: d./— ..f�"„)%2- Final: ©is-- - 2cca THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS'' -- _ Certificate of Occupan Signature: FeeTvpe: Da a Paid: Amount: Building 6/5/2006 0:00:00 $25.002892 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo • - 1 ALDRICH ST BP-2006-1312 GIS#: COMMONWEALTH OF MASSACHUSETTS iV :B1octr 3IB-027 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2006-1312 Project# JS-2006-1323 Est. Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 5575.68 Owner: WIJNHOVEN ROBERT A Zoning: URC Applicant: WIJNHOVEN ROBERT A AT: 1 ALDRICH ST Applicant Address: Phone: Insurance: 1 ALDRICH ST O 585-5812 O NORTHAMPTONMA01060 ISSUED ON:6/5/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:REMOVE 2ND FLR KITCHEN TO CONVERT TO SINGLE FAMILY 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: Date Paid: Amount: Building 6/5/2006 0:00:00 $25.002892 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo • File#BP-2006-1312 APPLICANT/CONTACT PERSON WIJNHOVEN ROBERT A ADDRESS/PHONE 1 ALDRICH ST NORTHAMPTON 0 585-5812 0 PROPERTY LOCATION 1 ALDRICH ST MAP 31B PARCEL 027 001 ZONE URC THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ��� — Fee Paid of Typeof Construction: REMOVE 2ND FLR KITCHEN TO CONVERT TO SINGLE FAMILY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO)BMATION 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 Commission cgt - _ 0 vo z a6 Signature of Buil ' g Official 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. ._---- 1 Dep t use only E C LSU E City of Northampton StatusAf Permrt: � nl Building Department CutJDriveway Permit '"1 212 Main Street Sewer/Septic Availability I JUN - 5 2006 j Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans__ ` I phone 413-587-1240 Fax 413-587-1272 PO tans '" APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING :SECTION 1 -SITE INFORMATION 1 1.1 Property Address: This section to be completed by of(iCe 1 4 LTD c.1cAl ` E T Map Lot Unit NOS N Met- O t O tA 0 Zone Overlay District i Elm St.District CB District ................... SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT .............. 2.1 Owner of Record: Imo, ot3otr IN I T N ttu j E te,N si I tJ��� I MA Name(Print) M CurrentMailing Arddrecg t PI— Telephone Signature 2.2 Authorized Agent: N v\ 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 0 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of W Construction from(6) 3. Plumbing 0 Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+q+5) Check Number a 5' — This Section For Official Use Only BuildingPermit Number: Date 1 Issued: Signature: Building Commissioner/Inspector of Buildings_.__. ,. Date # # ## # # ##### ### ### ### #### ## ## # ## #### # # # # # ## # ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ### # # ##### # ### ### ### ### #### #### Job : 70 Date : 3/1/2006 Time : 1 : 07 : 37 PM Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing proposed Required by Zoning l This column to be filled in by N A tAfiV.t Building Department Lot Size 7 Frontage 1 out Setbacks Front Side L•' ' R L:i, R: Rear x s Building Height Bldg. Square Footage % . Ivoo .• Open Space Footage (Lot area minus bldg&paved 4...b. • parking) • #of Parking Spaces 1 . Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW a YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NOer DONT KNOW Q 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 0 NO GY IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property 1 YES 0 NO IC:e IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. # # ## # # ##### ### ### ### #### ## ## # ## #### # # # # # ## # ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ### # # ##### # ### ### ### ### #### #### # Job : 66 Date : 3/1/2006 Time : 1 : 07 : 27 PM SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing n Or Doors 0 Accessory Bldg. ❑ Demolition ZJ New Signs [CI] Decks [0 Siding[E] Other[E7] Brief Description of Proposed t) ‘/�,,- - 1_ 1 _ Work: \ ��� ; \CI-WM otAA�'[14,0A IW1e�I/ v�\r S\ Vc ..-c ' 1 Alteration of existing bedroom Yes x No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 64,If New house and oradtlittOnlo existintiiiousinch coifplete the foRQ € : /-IA 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 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 under the pains and penalties of perjury. P int Name. ....... '`} Signature of Owner/Agent Date Wd ET : LO = T : awzs 900Z/T/E : agPQ 09 : Qoj #### #### ### ### ### ### # ##### # # ### # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## # ## # # # # # #### ## # ## ## #### ### ### ### ##### # # ## # # SECTION 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable Int/ Name of License Holder: License Number Address Expiration Date Signature Telephone 9.Rettistered Home tnPrOvement Contractor: Not Applicable Gl/ Company Name Registration Number Address Expiration Date Telephone 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 . '' me der. X The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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. /Iomeowner Signature -- �_ # # ## # # ##### ### ### ### #### ## ## # ## #### # # # # # ## # ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ### # # ##### # ### ### ### ### #### #### # Job : 56 Date : 3/1/2006 Time : 1 : 06 : 56 PM 'scSt1AMpi, � :taPaz#Northampton * • L _ P, Y* �+� I $ 1 � 8 l ^ =`i —aasacF�usctln C:r • �i°" DEPARTMENT OF BUILDING INSPECTIONS di 1 `- INSPECTOR 212 Main Street • Municipal Building �� 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 supcHsor. 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), 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 II, -- -- _« 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 C / o Address of work location C •d onr •rn re, -,-, 9nii • ,. I l��T tW r pTOy 1- Ae `�, '/�'.ye .. (yrh of Ior±! ainptoii / _— A .Y'.rZ/f �iasa.rftnsrlte" _ .11 C - D,EPARTXiENT OP BUILDING INSPaCTiO1d5 di —. • e.Ntt 212 Main Street Municipal Building Northampton, Mass. 01060 r''" ti '(13RICLIZ'S COMPENSATION tNSURA CE AI ek ,f1 . 1 I, —._ k, t.". A_ V‘-\(►.V (1iusJJpermi ttc) with a-€u -8f--lazes-i- WA, r n t: • I kCv\c Ave Af ,V 11Gti; v,. f'it '1 (phone:') i--03 :c ec-�r�,l2....-- r; i (sa-r_tJarr/ 'DP) ; D do hereby certify, under the pains and penalties of-perjury, dui A.:- ( ) I am an employer providing the following t::orkcrs compensation coverage for my • employees vorbng on thus job: ' (1nsti.ran Comp-Icy) (Polio: Nun r) (r':•pinion Dai.) - ( ) I am a sole proprietor, general contractor or homeowner (circie one) and have hired the contractors listed below who have the following worker's compensadon policies: (Name of Contactor) (In urancc ComoarryPotic— Numec:) (E ut—uuon Date) • (Name of Contractor) -- (Lns.lraacc Comaa}vPo!ic— N11.0crr) aikvir,:tion Date) (Name of Coaracto,) (Instuaacc Company/Policy ivumbs7l) (Exairciop Date) I t (Name of Contractor) (Insuranc Comcacry/Policy Nt1mbcs) - (Ex-piration Date) t (.rich . c4moos!hoc ifnocciry to c,ctu&infortru. on per-oiaing to allocctrc.cora) 6 1 ( ) I am a sole proprietor and have no one woriong for me. I am.a home owner performing all the work myself. NOTE:p1e3c be.wart Ifi..k-I .Je bocncowocra,vbo ccccploy pa-soea to w r^a%n<-,,.,,s. -.:c ap c rrnu woric on.dwcll_i:of ant more t1L.3 Lb-0=tfRs in vOainh the bornoowoa-raic;a or CO the cry.,o,'a zppuutea-.=tbc-co i-c Doe C.11+coa;d.-cd to be enploy -,ucd.r the a t cc�rr-a.y—.-•ica Act(GL192=1(5)),:.pplit:sboa by a bomcoax for c lip-c•permit r ,y cvidcncc the . le-ssi rtas+<of en.• ,foyer uodcr dap Wodcol. Q ACC- • I uodcstand dare a Dopy of thi.on,./..coccu may bo for,vurd..d to Lb.Doperamecs of 10 rial Ann./cots'Offsoo or 4a+- oe for the coves-z.gc vcrjf oboe.ad th_.t Liltnn to Est Lo'rcTasc trndcs aoczion 2 S A of MOL 152 can Ice'to the ice,,elect of airmail peathic oonnaixg of a floc of up to S1.500.00.r,dtor iictprixxmocca or up to ooc yc-.r r.od coil pr<„tict in tSc rota of.Stop Work Ordc and a rim of 5100.0o a thy ap,iast me _..._. ... For dcpr—m__�Iu.c y �'' _ t1 _ p„L '— rcrmJt It7XJ __________Lot • l- ¢Si�aturc of Licasctlpermitcc . ... --