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24D-292F _ _ o61' REFRAME WALL: ci Z —INSTALL 51MP50N SHEAR YiAL.L BRAI j' N 9 PANELS AND LU STRUCTURAL LVL HEADER PER. FINAL 0)w m W MANUFACTURER/SUPPLIE w �o 0<212 K CALCULATION AND a SPECIFICATIONS : '. 0 . -FRvWr. N&% OPENING -. Ix FOR N&4 OVEREAS7 DOOR T'-6" X 10"-0" ._'•. s t —FRAME NEW OPENING FOR NEW 5'-0" X 6'-8" HINGED DOOR O w —VERIFY PRIOR TO CONSTRUCTION: "' g FINAL SIZE OF OVERHEAD DOOR, LVL,O AND 5HMAA BRACING w a PANEL SIZING v c g CL `p04O v - NEW 6" THICK FOUNDATION *.`4i �: 09D8.24WALL AND 5" X 16" FOOTING. BOTTOM OF 46. FOOTING MIN. 4 BELOWfir FINISH GRADE i ! 2'6" 10'-0" 2'0" 3-0" 4 18'-0" z SFEET NAME FRAMING DIAGRAM SOUTH ELEVATION EETNUMBER 1 SCALE: 3/8" = 1'-0" SIC ' 10/27/2008 11:00 FAX 773 0896 FCCIP 2006/006 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA, 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plunn Name (Business/Organization/Individual): Address City/StaWzip:�jzi�,!P�i (� I t h% ►"� (�1 Phone #: U l L Are yo an employer? Check the appropriate box: 1, 7m an employer with 4. ❑ 1 am a general contractor and I Employees (full and/or part-time)* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. t Ship and have no employees These sub -contractors have Working for me in any capacity. - workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. C. 152, § 1(4), and we have no insurance required.]t employees. [No workers' comp, insurance required.] 0 Type of project (requir d): 6. Cl New Construct; n 7, p Remodeling 8. O Demolition 9, O Building Additic n 10. O Electrical repair or 11. ❑Pl bing repair or 12, oof repairs 13. a Other � " Any applicant that checks box 41 must also fill out the scction below showing their workers' compcnsation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating t Contractors that chock this box must attach an additional sheet showing the name of the Sub -contractors and their workers' 1' am an employer that is providing workers' compensation insurance for my employees. Below is the policy and Job Insurance Company Name; AJ, M 1.1 nyTo - Policy #, or Self -ins. lemic. ``#: W`M Z 000 '� 7 7d 1 2_tXl� >�'ntion Date: Job Site Address: /l0 �r�514 n, City/State/Zip Attach a copy of the workers' compensation policy decia ation page (showing the policy number and expiration Failure to secure coverage as required under Section 25A of MGT. C. 152 can lead to the imposition of criminal penalties qf a fine uo to $ l ,500.00 and /or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of u to $250. 0 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of theIA for insurance coverage verification. I do hereby ce tfy der the Signature Phone #: that the information provided above is true and correct. _3QL Official use only. Do not write in this area, to be completed by city of town afoetal. City or Town:___ . Issuing Authority (circle one): 1. Board of Health 2, Building Department 6. Other Contact Person: Permit/License 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Insp k, Phone #: SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicablel New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [[] Siding [❑] Other[E31 Brief Description of Proposed (� , Work: -' ly &O � Y`21 wl P :J d� C OPI A `� Alteration of existing bedroom Yes ✓No Adding n bedroom Yes No Attached Narrative Renovating unfinished basement Plans Attached Roll - Sheet 6a. if Newhouse and or add s° exististg housing. complete the w"'aW' : a. Use of building: One Family Two Family Other / b. Number of rooms in each family unit Number of Bathroom c. Is there a garage attached? 1 j d. Proposed Square footage of new construction. Dimensions e. Number of stories? / 7 f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Z Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. etlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or ar floor below finished grade k. Will building conf m 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 r v to act on m in all matters rela ' work a orized by this building permit application. S nature o Date I, Ja 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. TV Print Name Signature of Own Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning I I Ibis column to be filled in by � #ufPu6jue8oucea (volume & Location) A. Has a Special. Permit/Variance/ Finding er been issued for/on the site? IF YES, date issued:. IF YES: Was the permit recorded at t e Registry of Deeds? IF YES: enter Book Page and/or Document #' - B. Does the site containbrook, dy of water or wetlands? NO 0 DON'T KNOW 0 YES IF YES, has a permit been need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist IF YES, describe siz type and Location: D. Are there any propo changes to or additions of signs intended for the property ? YES 0 NO 0 IF YES, describe ize, type and location: E. Will the constructi n activity disturb (clearing, gradingon, urfilling) over 1 acre oris itpart ofacommon plan that will disturb 1oure? YES� �� � NO K ��3 |F YES. dhen modhampton Storm Water Management Permit from the DPW \o required. SECTION I - SITE INFORMATION N' Cfty'of Northampton 1.1 Property Address: BL'ildi Department R-0 ain Street sk om 100 o 0( ofthampton, MA 01060 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT phorto 413-587-1240 Fax 413-587-1272 2.1 Owner of Record: xf Name (Prin 'APRL16ATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION I - SITE INFORMATION 1.1 Property Address: This section to be completed by office 17.2 Map Lot Unit 4cv\ Zone Overlay District Elm St. District CS District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: "7 Name (Prin Current Mailing Address: - Telephone Si 2.2 Authorized Aaent: 70� VL Lex-,,qh� rik �/t4, Name (Print) Current Mailing Address: Y/ ? - "?-0 y Signaturev Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building r, (a) Building Pennit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total= 0 +2+3+4+5) OriO Check Number 771-79" This Section For Official Use Only Building Permit Number: Date Issued: Signature." Building Commissioner/Inspector of Buildings Date File # BP -2010-0325 APPLICANT/CONTACT PERSON JOHN LANDRY ADDRESS/PHONE 104 NORTH ELM ST NORTHAMPTON (413) 204-9880 PROPERTY LOCATION 152 CRESCENT ST MAP 24D PARCEL 292 001 ZONE URB(100)// THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Typeof Construction: STRIP & SHINGLE GARAGE ROOF & FRAME NEW GARAGE DOOR OPENING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 093450 3 sets of Plans / Plot Plan THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER: § Intermediate Project: Site Plan AND/OR Major Project: Site Plan AND/OR ZONING BOARD PERMIT REQUIRED UNDER: Finding Special Permit Special Permit With Site Plan Special Permit With Site Plan Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Septic Approval Board of Health Water Availability Sewer Availability 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 Signature of Building O ficial 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. 152 ." BP -2010-0325 GIs #: COMMONWEALTH OF MASSACHUSETTS "44 4 0" CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) CategorX_ Pernut # BP -2010-0325 Project # JS -2010-000434 Est. Cost: $5000.00 BUILDING PERMIT Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JOHN LANDRY 093450 Lot Size(sq. ft.): 4965.84 Owner: CHAPUT CHRISTOPHER R Zoning: URB(100) / Applicant: JOHN LANDRY AT. 152 CRESCENT ST Applicant Address: Phone: Insurance: 104 NORTH ELM ST (413)204-9880 WC NORTHAMPTON MAO 1060 ISSUED ON: 11/6/2009 0.00:00 TO PERFORM THE FOLLOWING WORK. -STRIP & SHINGLE GARAGE ROOF & FRAME NEW GARAGE DOOR OPENING POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Underground: Service: Meter: Rough: Rough: House # Driveway Final: Final: Final: Gas: Fire Department Rough: Oil: Final: Smoke: Building Inspector Footings: Foundation: Rough Frame: Fireplace/Chimney: Insulation: 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 11/6/2009 0:00:00 $55.00 212 Main Street, Phone (413) 587-1240, Fax: (413) 587-1272 Building Commissioner - Anthony Patillo