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23D-001 (6) 51 NONC7 JCK ST BP-2002-0737 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:73D-001 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2002-0737 Project# JS-2002-1211 Est. Cost: $15000.00 Fee: $75.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Valley Home Improvement, Inc 060300 Lot Size(sq.ft.): 12501.72 Owner: BOUCHARD MARY J&M MORIARTY& Zoning:URB Applicant: Valley Home Improvement, Inc AT: 51 NONOTUCK ST Applicant Address: Phone: Insurance: P O Box 60627 (413) 584-7522 Workers Compensation F L O R E N C E M A0106 2 ISSUED ON:3/1/02 0:00:00 TO PERFORM THE FOLLOWING WORK:ALTER STAIRCASE & REFURBISH BEDROOMS 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 3/1/02 0:00:00 14710 $75.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2002-0737 APPLICANT/CONTACT PERSON Valley Home Improvement,Inc ADDRESS/PHONE P 0 Box 60627 (413)584-7522 PROPERTY LOCATION 51 NONOTUCK ST MAP 23D PARCEL 001 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out //`7 76 1 Fee Paid �` Typeof Construction: ALTER STAIRCASE&REFURBISH BEDROOMS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 060300 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved 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 C 'ssion 2 c Signature of Building 0 icial 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. 4 Vtae City of Northampton S tus'o Pe } ; ( l 1 i Department 1 g C7ui t �� it s, 31 }tom 100 . ffi Northa ton, MA 01060 B 5 -_; 240 Fax 413 587-1272 APIPLICATION TOR'lr9(yS RUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address: This section ttO be completed by,office (f �c9rt °7‘ 6.-/t c�/ Map L t Unit �JJd I 16,, Zone Overlay District Elm St.District CB District `' SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: S4 'n r Name(Print) ( acce(,J,f)e X3ocichar0 Current Mailing A dress: 4 - .._ --- ��. l �. Telephone. Sign.( re 2.2 Authorized Agent: V G gyp , /`� // t(o f//'f-9 /6, 6 er J-oe t )7 C-Ave, Name(Print) Current Mailing Address: CP/#4°P/ 7/.5- Signature Telephone SECTION 3 —ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars)to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 1_07 D 2. Electrical (b) Estimated Total Cost of 3,pa' Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2 + 3 +4+ 5) ,0491) Check Number 71,0 c � This Action For Official Use Only Building Permit Number: I -7 Date Issued Signature: Date Building Commissioner/Inspector of Buildings 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 vyl 0 Setbacks Front (7 Side L: v L e' R: d Rear '" 0 ✓ C ,t I Building Height 1 fBldg. Square Footage %+ Open Space Footage (Lot area minus bldg&paved parking) _ #of Parking Spaces Fill: (volume&Location) A. Has a Spe cial Permit/Variance/Finding ever been issued for/on the site? NO 4 7 DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO it 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 U 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 itions of signs intended for the property ?YES_ No (L/ IF YES, describe size, type and location: • `ECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable) New House El Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[��/]_� Other [ ] Brief Description of Proposed Work: r7//(j .S'A-i?'lnlc' - It � � �°Ytth �"917coow- I ow- Alteration of existing bedroom // Yes No Adding ne bedroom Yes No At g Attached Narrative❑ >1* i1,Lw SfiJ�ati. Renovating unfinished basement Yes No Plans Attached Roll ❑ . Sheet /ii rgr t e , 1f l+teWfhous -and orAddilti tii tO X.i ltigahn ting. comple t to fvl°Icii 1 n; a. Use of building : One Family v 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? �(/ f Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodolain 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 Z02,ch , as Owner of the subject property hereby authorize lt�G l � / �, �G 4' ^L d�l4'�'t"'l - - L to act on my be f, in all matters,crelative to work author' by this building p(fmit applicatio6. ,G 4 � Signature of Ow r gate / I, /1)CI`J elft fil9 ' , 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. Sign der the ains and penalties f perjury. /-4/ Print Name Signature of Owner/Agent Date SECTION 8 - CONSTRUCTION SERVICES .1 Licens.edConstruction Supervisor: `.ct Apo: cable ❑ Narr�°a of Lice 1= nse Holder : Nelson Shit lett 060300 Valley Home Improvement , Inc . License Number 340 Riverside Drive 9/02 Address Expiration Date Northampton, MA 01060 Signature Telephone 584-7522 9. Registered Home Improvement'Contractor; Not Applicable ❑ Valley Home Improvement , Inc. 105543 Company Name Registration Number 340 Riverside Drive 7/17/02 Address Expiration Date Northapton, MA 01060 Telephone 584-7522 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 denia of the issuance of the building permit. Sig-led Affidavit Attached Yes No ❑ 11. - Home Owner Exemption 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 he 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 $��% 9� fliassaclinsrihs °-4_t "'"' . DEPARTMENT OP BUILDING INSPECTIONS ti 1 212 Main Street • Municipal Building Northampton, Mass. 01060 '�.� r WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, Nelson A. $hifflett / Valley Home Improvement, Inc. (licenseeipermittce) with a principal place of business/residence at: 340 Riverside Drive, Northampton, MA 01060 (phone#) (413) 584-7522 (streekity/staff i p) do hereby certify, under the pains and penalties of perjury, that: ()9 I am an employer providing the following worker's compensation coverage for my employees working on this lob: American Int'l Companies C0.062543.74.01____ 2/1/03 — (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, 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 Com-pany/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 additional sheet ifneceazry 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 whilo homeowners who employ persona to do tr-aint..„nr e,construction or repair work on a dwelling of not more than three units in which the homeowner resides or oa the grounds appurtenant thereto are not generally coaiidered to be employers under the workers canpezrsatian Act(G1.152,s31(5)),1(5)),application by a homeowoa for a license or permit may evidence the legal statue of an employer under the Workers Compensation Act I understand that a copy of thin ataternent may be forwarded to the Dap:atm:a t of Industrial Acadeata Office of inauanoe for the coverage verification and that failure to segue coverage under section 25A of MGL 152 can lead to the imposition of criminal penalties comistiag 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 me. Signed this 07 7 day of iz,h For departmental use only ,� A Permit Number / L° Permit Map# Lot# ] existing vinyl windows y wood floor o.k. her `, attic access ' | � 2'-11 | UP c� _ no space in electric panel ] existing carpet existing bedrooms Bouchard Existing Conditions 1