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24B-080 (11)
56 BRADFORD ST BP-2000-0919 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24B-080 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2000-091 9 Project# JS-2000-1 691 Est.Cost: $5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Lot Size(sq. ft.): 10149.48 Owner: JENNINGS C.J.&LARGEY MEG Zoning:GI Applicant: JENNINGS C. J. & LARGEY MEG AT: 56 BRADFORD ST Applicant Address: Phone: Insurance: 78 UNION ST#2 (413) 584-5849 () NORTHAMPTONMA01060 ISSUED ON:4/21/00 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT WINDOWS,MOVE BATHROOM WALL,CHANGE DOOR FRONT TO BACK 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: 0.k. S-19-00 Stni-3 Gas Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: d/L! 7-j Q- iq /< // 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 4/21/00 0:00:00 578 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo File#BP-2000-0919 APPLICANT/CONTACT PERSON JENNINGS C.J.&LARGEY MEG ADDRESS/PHONE 78 UNION ST#2 (413)584-5849 Q PROPERTY LOCATION 56 BRADFORD ST MAP 24B PARCEL 080 ZONE GI THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �r Fee Paid f7 O Typeof Construction: INSTALL REPLACEMENT WINDOWS,MOVE BATHROOM WALL,CHANGE DOOR FRONT TO BACK 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 F OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS 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 Z-/-vI / -0 -1-61-7"3-17L Signature of Building Offici 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. • O \`. '.ai Department use only P . D {+ - 2 \ 70Cit of Northampton Status of Permit: i. t P� �� tIn .Department Curb Cut/Driveway Permit • AGO , \`212 Main Street Sewer/Septic Availability\,„000- ,0(W.'Y 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 Addres • This section to be completed by office 5/ Map C, f j Lot 2 a Unit �c/ O O(0 0 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: MQ.. -•c�,r ' -.f" �� ,r1 i yt�6V� 1 0 `I 1 " nip - Cu rent Mailing m ' int) • r� C g L 1�- Telephone Signatu - , 2.2 Authorized Agent: .. 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 30©n , -72) (a) Building Permit Fee 2. Electrical 1 `-5 U c d U (b) Estimated Total Cost of Construction from (6) 3. Plumbing I erg— 0r—n Building Permit Fee 4. Mechanical (HVAC) n ��l!/ 5. Fire Protection v U V 6. Total = (1 + 2 + 3 + 4 + 5) 507)-01. Q-o Check Number This Section For Official Use Only Ri,ilding 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 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 ,J Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: I (volume&Location) A. Has a Special Permit/Variance/Fi ing ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at thee egistry 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 V 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: :TION 5- DESCRIPTION OF PROPOSED WORK(check all applicable) New House 0 Addition 0 Replace ent Windows Alteration(s) 0 Roofing Or Doors Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] 1 Brief Description of Proposed Work: Moyle Aue.f b'"A Octet-i '�f'k°''�- Angt 'NhurS) Move Well i� ba[��rdom Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet❑ 64klf I tliJuhousc l + u° itio isti t ho ing.. amp ets.,t a fol oW l l a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: EQ Number of Bathrooms c. Is there a garage attached? NO I --,.-A-- . d. Proposed Squa - ootage of new construction. Dime,- ons e. Number of stories? f. Method of heating? eplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? Type of construction i. Is construction within 100 ft. of - lands? Yes No. Is co ction within 100 yr. floodplain Yes No j. Depth of basement or cel - loor below finished grade k. Will building ► orm 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 , 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 l (iii h ) • 1- � lam" ' , as Owner/Authorized Agent here r that the state t-nts and in ormatior the fore4 gap ication are true and accurate, to the best of my know g belief. c'-Ined under the pains and penalties of perjury. Print Na e ir- 0 ' AI/i, �`%' R' "- 21., 2.0e,ci Iria . - ,,f 41-r/AgentI r a Date I SECTION 8-CONSTRUCTION SERVICES Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone :'..F 1 s4'' tEE€�E E ....�..rh€ E EE �. ,«, €! €((E E€E f Not 0 I EI E € x € [ � E� E �`� n €. E € €€�. . ...-• .., a._ ' � 0 Applicable 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 bui 'ng permit. c'7ned Affidavit Attached e No HomeO wn r ption 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, - and Local Zoning Laws to of as setts General Laws Annotated. Homeowner Signature 0 ItMf PTQ ` �j`..It portliamptou : yla fflassRchfl6Ctts �m�� DEPARTMENT OP BUILDING INSPECTIONS 212 Main Street e Municipal Building Northampton, Mass. 01060 rs's WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, -- -- — — — — _ (liccu_scJpermittcc) with a principal place of business/residence at: (phonei )_ (stirs i/city/stalcJnp) 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 worng on this job • (Lnsurara Coomny) (Policy Number) (Exp:n r on Dale) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hued the contractors Listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance CompanyiPotic— Munk:) (Expiration Date) (Name of Contractor) (Insurance CompanyvPoticv Number) (Exnimion Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional dacct if noaassry to¢tcluck infvcx noo pertaining to all coa7ac..n:-3) �( ) I am a sole propnetor and have no one worldng for me. 1) I am a home owner performing all the work myself. NOTE:plcsc bc aware that wt jjo bomeawocn wbo employ pc.ons to do n- r-l+nnr cosmvare°err repair work on a dsv.Ding of not more th:n three)units in which the bomoowocr rcides or oa the grounds appurtenant tbccan arc not generally co¢rdccd to bc employes under tho workees ocmpcewaicx Aa(GL152,�1(5)),applicitioo by a bomoowva fore license or permit may the Icgal atoms of an omployx under tho Worlcoes Compem alien Act_ I understand dirt a Dopy of this carcmcat may be forwarded to the Dcportmma of loAirriJ AcadmC'Offioa of ln-.ur•noe for the coverage versa: too and that Enure to sown coverage under souion 25 A of MOL 152 can Ind to tbo imposition of criminal penalties com stimg of a floc of up to S 1.500.00 and/or imprisonment of up to Doc year end civil prnahia in the form of a Stop Work Order and a furs of S 100.00 a day agsin i ax. Ford,ere.,,r,t ux only / 1/ Permit Number qt:IP Map^ - Lot Si rc f Licr scc/Pcrmiucce