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32C-201 (3) SECTION 8-CONSTRUCTION SERVICES 1 Licensed Construction Supervisor: i��� Not Applicable ❑ Name of License Holder: MA-F+ UC U/ CS o4,10- License Number g lo Addre s Expiration Date Z ignature Telephone r.,. ;, Not Applicable ❑ VJ415R it lt,� S 1m53(p Company Name Registration Number ,e* sfi "6�Ti-WFrnO MA cP 12(0 IV A dr s 1 //��-- I p Q Expiration ate 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....... No...... ❑ o weer - e>Ill� o 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 buildine 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 ACTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ] nef Description of Proposed Work:"b mI -Tw V wTIA wTuf-" t "-w NW Alteration of existing bedroom Yes _No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes _ No Plans Attached Roll ❑ • Sheet 0 VWJ p 12-� 'Tb 6 I�t 6as1 a `Ei se n d'drtron o ex s n o rn co e e he o Cowin 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? 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-70 BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ` . as Owner of the subject property hereby authorize Mftti � �v -1(� �1NS to act on behalf, in all-matters relative to work authlorized by this building permit application. Signa re of Owner - Date l� . as Owner/ 1wthorized A e 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 me LIJ4,r' Signature of Owner/Agent Date Section 4. ALL INFORMATION MIDST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Aw w ?I>J I)W-5 egt' - Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontase Setbacks Front Side L: R: L: R` Rear Building Height Bldg.Square Footage % Open Space Footage °'o (Lot area minus bldg&paved parking) #of Parking S aces Fill: vol e&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 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 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: 4 d City of Northampton S a & t Building Department t 212 Main Street Room 100 . Northampton, MA 01060 e phone 413-587.1240 Fax 413-587-1272 o t APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENgV T R EioLiSIVA t VE TWO FAMILY DWELLING JUN 1 6 2005 ; SECTION 1-SITE INFORMATION 1 �r is section o be ompleted by office 1.1 Property Address: f s '; "� � j/�� ///JJJ �//ry�� `/mil C M ny }'dk'in V• ✓ "'a• �I.(lL �M Zone �Overlay District` + � Elm St Distrkt •;CB District SECTION 2- PROPERTY OWNERS HIVAUTHORIZED AGENT 2.1 Owner of Record: p p F�1r. Na rint) � Current Mailing Address: Telephone ,�l 2.2 Authorized Agent: M Name(Print) Current Mailing Address: Signa are Telephone ��^^ SECTION 3 ESTIMATED CONSTRUCTION COSTS IG_ ► J. "' = Item Estimated Cost(Dollars) to be Official Use Only comoleted by ermit applicant y' i. Building (a) Building Permit Fee ^ /'J' �.(�. —� __ 2. Electrical d' lnJ (b)Estimated Total Cost of . a-� /o Construction from..6 3. Plumbing / 9�n� Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2 +3 +4+5) 5`' Check Nurziber This Section For Official Use a S -;.J• ."� ' Building P erms it Numb _ `* :l -. t N a D.a.te r :•. -gt}w,v, ;t ff..}'u S F",»�.R:lh S Y'a5,�-`^ti��i�'�`v.4 C' `kj�'J�L�+- �ki r ''"`N�s -. Issue u , }� ++ fix •y: °.� :q� P !. i. P •�`1r's�,w x; h P .'+,A�r��.', t�.e o"'S3 }+1., "'�` ' ,w LC .l.s 1^v •`R�:. s Y - �r..M �� a�C'- ��+t: {' +� P �r�i� y �'� � %��A4� 'GKS•,,� i `0t t�rA t3r4•a,J File#BP-2005-1285 APPLICANT/CONTACT PERSON Wright Builders ADDRESSIPHONE 48 Bates St NORTHAMPTON (413)586-8287 PROPERTY LOCATION 89 WILLIAMS ST MAP 32C PARCEL 201 001 ZONE URC THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 030 �40 01 Fee Paid Typeof Construction: CONSTRUCT NEW MSTR BATH&REMODEL EXISTING BATH New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included: Owner/Statement or License 047146 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION 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 S et Commission Signature of Building 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. 89 WILLIAMS ST BP-2005-1285 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-201 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2005-1285 Project# JS-2005-1715 Est. Cost:$32442.00 Fee: $130.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Wright Builders Lot Size(sq.ft.): 3789.72 Owner: LAMONDE KIRSTFNI UNGER& Zoning:URC Applicant: Wright Builders AT. 89 WILLIAMS ST Applicant Address: Phone: Insurance: 48 Bates St (413) 586-8287 Workers Compensation NORTHAMPTON MAO 1060 ISSUED ON:6123105 0:00:00 TO PLRFORM THE FOLLOWING WORK.-CONSTRUCT NEW MSTR BATH & REMODEL EXISTING BATH 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:4 Rough: , House# Foundation: Driveway Final: � f Final: ,/ vFinal: / r p� /� r% / l��'`"/ ! / Rough Frame: 6)�rl_ S ! Gas: Fire Department Fireplace/Chimney: Rough: Oil: - Insulation: /J Final: �� Smoke: � G I - -��- Final: � f O THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION,OF ANY OF ITS RULES AND REGULATIONS. ,M �r Certificate of Occupancy_ si nature: _ FeeType. Date Paid: Amount: Building 6/23/05 0:00:00 $130.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo