25C-240 (2) Crzty of Nort4anipton
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DEPARTMENT OF BUILDING INSPECTIONS
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INSPECTOR 212 Main Street • Municipal Building
5
Northampton,MA 01060
George A. Fournier',
Inspector of Wires
City of Northampton -
212 Main St.
Northampton, Ma. 01060
Francesca Piantedosi
227 Bridge St. Apt. 2
Northampton, Ma. 01060
RE: Points of information 527 CMR 4.00 and 527 CMR 12.00
Francesca:
In reference to letter dated April 14th, 2005 from K.J. & S.M. Kasa.
I did not notify Susan Kasa that she was in compliance with 527 CMR 4.00, This CMR is
enforceable by the local fire Department
In regards to the matter of having access to your Service Disconnecting Means
527 CMR 12.00 2005 Massachusetts Electrical Code,
Article#230.72 (c) Access to Occupants.
Copy enclosed.
Note Exception.
George A. Fournier
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/ice 14 /
Inspector of Wires
City of Northampton
04��MpTp
tie Crify of Norf4auiptrm
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., DEPARTMENT OF BUILDING INSPECTIONS /
INSPECTOR 212 Main Street • Municipal Building '
Northampton, MA 01060
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HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as iris/her construction sups ,, sor. 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
I, 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
Address of work
location
c' 'Ibi of arti)a1lip!Lill
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DEPARTMENT OI' IUILDMG INSPECTIONS
212 Alain Street ' Municipcnl Building
'Northampton, Mass. OJOGO T �'
WOPZ-=1 R'S CONITENT SATTON INSURANCE A FFEDAVI.T
i,
principal place, of busmcsshr s;dcnco at:
- ------ --- - -- -- ---- ----------- ------—-(�ho n e,-:'
- - - —--
do hereby Ccr-di}-; r.na r tic p<:nS anj pen;sties of�c:rjur��, :ha.,_
O I am an employer providing the follo',vint '•:UD't:Ci S col1incilsM10I1 COYCM:.,,C ?U' my
C111ployces Working on tlhis job:
ans=C--:. Coclpam') 0 c;N urn Fxr} ---- (e�.�.ir ri�n Dale)
I am a sole pfou lctor, -'tntFal. Gxltrac-,C Oi h011izOwDe:- 'C" de OIIe) a11G 1'.avC hllrtd
the contractors listed beiov- h0 z-`Or 2iPT$ cou?D°n-s�a 01!
("NT=c of Ccmn ,r%Polief Num>rr) (r_x,,;-a'L-1cn DatC)-
(Name of Contr<ctor) -- eI ISUr,_nce Co~ :}(Pclict' Nurlr) (l :lin, male)
("game of COIltnclor) (171 1 I1C^ t_O u�.:'_ 'i(�t�01SC: 1J Lt7I1}i'r) �i:Xj,'SC O�113ICj
- (Name of Contractor) —- (Ills Iallcti Ce1nr .},Policy Numb *I (Ii,, ,i aio Date}
(..^.tLlf3]�.d�1JCY:1]S_:'f't:...-:__. ;:�:.-_.�.<..."Y:-^..::C;:i_=._.... - _eii c;e_:_:�i::•.1
l l <L?? c Ule pl-Uprle:Ji r.:11 i]C1vC 110 olio ,.'o(-l-1ii,"' for i71;,
11?iIl a home CWller i ei:C' 1?1111` al
NOTE:ple:u be alrzt t!sZ. -,
CL; C::.'i`Cl CS:`.j::t l7�"`:?� -`.:
not ux-ce thin thma uni+,3 in tci:c+t r--: oc oc; r),:{Cctszll;i
c]zt7 to Y a�s un�,t tIr- e (Sl?.
cg�l el2vs of rn omplo}x uaCr tLx a holnco Nis`or :cc c cr p:r.- :. _
Wc�ri c1i Loi,w�'•,slion!.cL
I tu>dc-ztwd ih+t a copy oI this ctatci -t cuy bo fawn Tai to ttn D-Ji L--,d of Ind L,:,jc] Off',w of is s+ry:a for tix
aoverAse vciGciioo and th t Lilt to ta^!c cvt�r�ut 3: e�.iM 25A of?.t01.152 cw Ic d to the r'as t
comizti;tg of a fur-of up to S 1,500-00 arts'r ;'?to rr:-}:�e:.j Civil Ixnzltia in d c Icx7n of a S!r.+`•`c i.Ov e:1 a
Lrm of 5100.00 e dsy trs.in t rn-
_ F r dq3; tll—"j u.c qtly
Ycirnit rIumtr.r _—
_ 51
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;?afore Of i.ic�n
S�CTlON 8 CONSTRUCTION SERVICES
8.1 Licensed Constructions Supervisor: Not Applicable ❑
Name of License Holder : \ �--��[ ►13 a C3
License Number
U � s , -.0 s
Address Expiration Date
J A, SYJ�t" �J 0
Signature Telephone
e - :ere rn m r' uernen C ntracto Not Applicable 0
Company Name ,�� Rergis-tration Number
Address Expiration Date
Telephone_
SECTIOH10 1NORKERS' COMPENSATION INSURANCE;AFFIDAV.IT(MG z:. 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...... ❑
The current exemption for"homeowners"was extended to include Owner-occupied Dwelling's 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 assu s responsibility for compliance with the State Building Code,City of
Northampton Ordinances, Stat and Local Zo in (�Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature ����
.l 4
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P�10T�ffiF ROPOSEDMORK check )-a Iicable
�-�_ ,-_ - .ik+#T'.,3+.2r✓YLT.fk„'�..a.Rxv MYm._'!rtMY .isv!m'�. '�>v k-.L1s,Ya5.41 fit ftn�+:l.>�
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: Llk kt7f=:C3' J FLA vti
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0-Sheet 0
aq e o 961 a "di on to existing hou is .ng..eon ;e a die follow n :
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?
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
1. Septic Tank City Sewer Private well City water Supply
C ®� NE�F2 llT}fORIZATION TO BE COM,Ptiff 6 WHEN
OWNE�S� E( , 1CONTRACTC?R APPLIES FOR BUILDING PERMIT
��aSa- as Owner of the subject property
hereby authorize /3 y /3 l / ► l 60 Q 0 to act on
my behal, in all matter r ative to work authorized by this wilding permit application.
q- 7- p
Sign ure of Owner Date
1, a� as Owner/Authorized Agent
hereby declare thafthe 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 off perjury.
7_ ��A11B 011 —
Pnn ame
Signature of Owner/Agent 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
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&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:
ity of Northampton
��, r uilding Department
212 Main Street
? Room 100
•
L SEP ' 8 2004 thampton, MA 01060
hone 13.587.1240 Fax 413-587.1272 t:
DEPT nc BUItADING INSPECTIONS
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1!-SITE INFORMATION
£ This sec �on,to b acompl ed byoffice "
1.1 Property Address: P°=
l ,/ �
17 VV 1t �� „ / Zon Overla. D.-JAM,
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/ /v
EIm.St DisErictCB District
SfCTIfJN 2 - PROPERTY OWNERSHIP•/AUTHORIZED-AGENT
2.1 Owner of Record:
air
:Name rint Current Mailin Address: old��'7- is 6 y
Telephone
Si ature
2.2 Authorized Agent:
a 1A '.y o
Name(Print) Current Mailing Address:
Signature Telephone
SECTION-3:- ESTI MAT ED CONST:RUCTION.CO"STS
Item Estimated Cost (Dollars) to be Official Use'Onty
completed by ermit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Nlechanica! (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check number ORK
This Section For Official Use Onl
Building Permit-Number: Date Issued;
Signature:
Date
Building,Commissioner/Inspector of Buildings
227 BRIDGE ST BP-2005-0279
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C-240 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category BUILDING PERMIT
Permit# BP-2005-0279
Project# IS-2005-0363
Est. Cost: $4500.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Robert Thibodo 065699
Lot Size(sq. ft.): 16901.28 Owner: KASA KAZIMIERZ J&SUSAN M
Zoning:URA Applicant: Robert Thibodo
AT. 227 BRIDGE ST
Applicant Address: Phone: Insurance:
P O Box 201 (413) 586-0391
NORTHAMPTON MAO 1061 ISSUED ON:918104 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP, PLY & 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 Occupangr Signature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 9/8/04 0:00:00 2048 $25.00
,o.
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
fir..