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16B-001 (28)
'0 �� O® � N R'1 lfe� rr, QI 44 Ify+ ate Ali 1�� Ilt 1 I A - I of Niorilial"ID1 DZP/_k-j-?.dE7v'7 OF BUILD-rNG INSPECTIONS 212 Alain Surer tguvicipal I3u:ldIT, Northampton, A'rass. 01060 \N-'G JCCjZ'S CfJN&ENSA'nON MS TZA-NCL F TI}F `IT Ziter Saloomey, Owner of Saloomey Construction, Inc. .kgLb a pr,-10'pal dace. o;hls-1nesslresidence aI_ 48 East Otis Road, Otis, MA 010253 413-269-4360 do hereby cerdf�, under Ihc.pai s and penalties of pefJury; All (X) I an an employer providing the fdllo.ving vorkcr's coulDc:as2 c(3ve L-e :or II}y eznplovices Won-jag on zlus job: Alea North America WC1049789 (^ ,t--M=Co0P .n) (Peiic;l:L cr; (Lpirdor.Dom) { ) I a(n a sole prODfirnror, general coo aczor or homeo a.n (ci:c:e one) a,d hax-e Me conua-morS .1ste,'- belot-v i4bo hzve the IollovJLriQ v`oreLr`s C-om? •CC on poticieS_ (Wamc O: cane-a "ior) Comp I' obc-i ?�jLrn�.'p 4` 37a`JL4 S�3;C1 (N:mc of Coacaczar) ~(I.nsdj-zac-- (--.omrja—,v/?olic-; NuoL---f) (—Dcpiraoa D:.tc) Nzmc of ConzSC16-') -- (aS1L-aza(-- Company/%Uci tvumbc:l) FEgirdoo Daze) (?Fame of Comraaor) tInesurz- �CorncauyPolicy Numf,:s) Sxp. aeon Dal-)- (zt7y mar t h fa�oc,._-r to e�cha��tora.�x pcfnsW.ls to.SI occ-cc o) { ) L:S0!C prop,mLUI az a 'have no oar worming for me- { } I am.a home owner perfor MUC a>I the work myself. 111371 ptr._se b,-cxuc t*e- +t,1e h xiz w°,io cmpicy pc:,.=to do of a of tnorc Lf rut .s tix bocn�nG r=id=a oa the �c'��ax I2v d cd to tr on=:p .._ .A--(GL I52-=I CSC =+ppVtcz.son by a bo=na<x Ic-bt—_cc Pamil to C-61:0"ttN ic•yS r svc a ea-*I"oadas dso W w'c.oCt�.o�par�at,iou.1e1 t wades-...mod Caa:*mq or L,,:- � y be r-- ,d.e u- O`S,o«« mK-asc w^ii ctioc=�!?mot f ilc-t w coif Ua4c use mc`ae saxioa 25A of MOO 15-2 r.trtd I.the=='-6- of esarnsl pcaal>,r3 ooc -ica ela rM.*rug w S)30Q-00 asfdlor oCup to t.form or.S.cp+Nark Ord,-.ad ism oC St 04.Q0 a d:y z�u3c ipcj�r/a�v,t Numbc Si aZdZC OI L s,rr/3�crr',iticc L 1' SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor Not Applicable ❑ Name of License Holder, titer Saloome y 018780 License Number P.O. Box 1203, Westfield, MA 01086 11 /13/09 Address Expiration Date -269-4360 Sigma re T epi>�e Me otn `r-: Not Applicable .❑ Saloomey Construction, Inc. 100978 Company Name Registration Number P.O. Box 1203, Westfield, MA 01086 6/24/08 Address � Expiration Date Telephone 413-269-4360 SECTION 1'0 WORKERS'COMPEN ;ON-INSURANCEMMD Vff(Ml G.-L=- b2,§`25C(&)) 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 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 1083.5.1. 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-vear 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 Annoiated Homeowner Signature Sr=CTION 5-DESCRtIaM OF i'ROMSED-WORK lchedc all�) New House A,d�i on ❑ Runt Windows AHeratiOn(s) ❑ Roofing ❑ Or Doors Accessory Bldg. tr..t Dertrtoiition ❑ New Signs [1:31 Decks jC7 Sidng[0] Other(174 Brief Description to 7� " St le Unit per drawing on file. W orlc y - Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Rertovating unfinished basement Yes No Plans Attached Roll -Sheet S- a. Use of budding:One Fatuity X Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? Y d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? PROPANE GAS Fireplaces or Woodstoves Y Number of each g. Energy Cdnservation Compliance. Masscheck Energy Compliance form attached? h_ Type of construction L Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodpWn Yes No j_ Depth of basement or cellar Moor below finished grade k. yifiil building conform to the Building and Zoning regulations? Yes No, I. Septic Tart7i City Sewer X Private well City water Supply X SEC�iC�t,CZ�-�?1AI�IERAt1�l4) �'IOIa�- ��Q:BECDMi.'iD �t E)iEI tNERS�AGH+f� �C?�G�R�kP)?f�Ea�£iR$SB�ta��ilf�f t Ziter Saloomey as Owner of the subject property hereby authorize Ziter Saloomey to act on my behalf,in all rrgftm relaWe to work authorized by this building permit application. re of Owner Date f, Ziter S a l oomey 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. Ziter Saloomey Print Name gna of Owner/Agent Date ' Section 4. ZONING JUI Information Must Be Completed.Permit Can Be Denied Due To Irummpiete Infonnation Existing Proposed Required by Zoning Tbis column to be filled in by Building Department Lot Size Frontage Setbacks Front Rear Building Height Bldg. Square Footage % 7- Open Space Footage % of Parking Spaces A. Has a Special ever been issued forlon the site? NO 0 DON-r KNOW 0 YES 0 IF YES, dateissue& |FyE8: VVosthepennitrecorgndatthe-QegiotryofOeadu? ' NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page, ' and/or Document# ' �� �� �� B. Does the s�econtain a brook, body of water or�xw�lznds? NO «�� DON7NNOU� �~� YES �_� IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs tmbeobtained �—� Obtained »�� �a�o�s�m�' v~� «�� ' ' C. Dm any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? yES ���—� NO v-��� IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,gradingexcavation,nr filling)over 1 acre orisUpart,�o common plan that will disturb over 1acre? YES �� NO ��` �� �� }F YES,then a Northampton Storm Water Management Permit from the DPW isrequired. City of Northampton - Building Department 212 Main Street Room 100 rM Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH ISH A , ONE OP. FANTILY DWELLING 1.1 Property Address. : Lot #17 Mark Warner Drive f } Bear Hill Estates _ 20 Bridge Road Northampton, MA 01060 " - -� SECTION Z PROPERTYUVINERSHIPIAITfH©RIZEDA61 !i 2.1 Owner of Record: Bridge Road LLC P.O. Box 1203, Westfield, MA 01086 Name(Prird) Cunetst 1g 4 3 6 0 Telephone nak TO 2.2 Authorized Agent Ziter Saloomey P.O. Box 1203 , Westfield, MA 01086 Namg;;- Current Ma�ung Address: 413-269-4360 —siwMiyi Telephone C.ONSiRUCTION:C0 - Item Estimated Cost(Dollars)to be official use only wrna leted by rmit applicant ant 1. Building �i?e�iitFee � 7 00 2. Electrical (.l natedtaEst of 1 Gaon ::s 3. Plumbing � /! / 06��D -`8u'#rs Pennit-Fee 4. Mechanical t,HVAC) 5.Fire Preiec lion 6. Totat=(1 +2= 3 a+§) 3 j Ghecic Number - This.,Section-ForOfficbd UseOrdy Building Perna Nur r: lsmjed. Signature, t BtackV Ccmmjs ratnspecW cE Bukhwjs bate File#BP-2009-0144 API LICANT/CONTACT PERSON SALOOMEY CONSTRUCTION ADDRESS/PHONE P O BOX 1203 WESTFIEL 69-4360 PROPERTY LOCATION 20 BRIDGE RD I t MAP 16B PARCEL 001 001 ZONE URA THIS SECTIO R OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT FSg Paid LAfu' ding Permit Filled out ee Paid l .� Typeof Construction: Construct Single Family Home 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 INFORMATION 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 Permit DPW Storm Water Management Demolition Delay ,;4� (1 /2,0 0y 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. BP-2009-0144 GIs 4: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON 40010*001AW 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-2009-0144 Project# JS-2009-000184 Est. Cost: $244435.00 Fee: $1401.95 PERMISSION IS HEREBY GRANTED TO: Const. Class: 5B Contractor: License: Use Group: R4 SALOOMEY CONSTRUCTION Lot Size(sq. ft.): 1296345.60 Owner: BRIDGE ROAD LLC Zoning:URA Applicant: SALOOMEY CONSTRUCTION AT. #17 MARK WARNER RD - 34 BRIDGE RD Applicant Address: Phone: Insurance: P O BOX 1203 (413) 269-4360 WESTFIELDMA01086 ISSUED ON:812112008 0:00:00 TO PERFORM THE FOLLOWING WORK.-Construct Single Family Home Type "B" 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 8/21/2008 0:00:00 $1401.95385 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo