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23D-014 (12)
566 ELM ST BP-2006-0024 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D-014 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0024 Prot. 3S-ject# 200 -002 69 Es Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Ed Corbett Jr 116069 Lot Size(sq. ft.): 18687.24 Owner: MAILLOUX STEPHEN P&NANCY A Zoning:URB Apwlicant: Ed Corbett Jr Al ."iCZI) ELM�LI ST Applicant Address: Phone: Insurance: 4 Reed Street (413) 584-6571 NORTHAMPTONMA01060 ISSUED ON:7/8/05 0:00:00 TO PERFORM THE FOLLOWING WORK STRIP & 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: 6K 7-..1q.05�d M THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. "------ Certificate of Occupancy Signature: ------ —els'r-#'7-->") ,/ FeeType: Date Paid: Amount: Building 7/8/05 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo "I5- • . - k JJ kitr OrtOMPtOn nDepartment ain Street Sewer S.ep . I L JUL 8 2005 .‘m 100 ' - VV atertkelMmailaoili Nort mpt on, MA 01060 r'''-'qtC'rVf4Aat' 2titit,e5to • u __ 301,11,tra Apo 7-12A 0 Fax 413-587-1272 -iohthqitt4,Plac, • , • • ,L115t. tt4 7Z4.'1" ,10.4 01060 2• • .4 '•••••• " •,t4)- •rt,r.44,' `----AT-7PLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 SITE -.• INiAION 1.1 Property Address: „4„ ^ 4r. • • _ -_ 566 Et ' s • 'fdatel,J,411'6%., • ,c4 . El ' •`*C '61c- - - SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: S3ale /A(-9/71d t•r4 Name(Print) Current Mailing Address: Telephone ,..5**-89 7 g6vSignature 2.2 Authorized Anent: .C;7/41A R dT CoR6-eir -- xcZ q sie '40,\I Name(Print) Current Mailing Address: C5 -61 657/ Signature Telephone -SECTION 3-ESTIMATED-CONSTRUCTIONZOSTS - item - Estimated Cost(Dollars)to be Official Use Only completed by permit applicant •1. Building -(a),Building Permit Fee 2. Electrical .(b)-Estimated Total Cost of - Construction-fro-m(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) /1 y661 Check Number ThiS'Seciion,FtirOfficial Use Only _ • - : Building Permit Nijitibar: •- , , _ ;.J.Issued: Signature: r Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Informatibh Must Be Completed.Permit Can Be Denied Due To Incomplete Information • Existing Proposed Required by Zoning This column to be filled in by Building Department : Lot Size Frontage I Setbacks Front Side L: R:I L:I I R:77 I I Rear Building Height Bldg.Square Footage % Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces I Fill: ' I I (volume&Location) A. Has a Special Permit/Variance/Fi ding ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW35( YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? • Needs to be obtained Q Obtained ® , Date Issued: C. Do any signs exist on the property? YES © NO )8( IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading ex ation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 , NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION=OF:'PROPOSED:WORK(check-all-applicable) New House n Addition n: Replacement Windows Alteration(s) n Roofing K, • Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [C7 , Siding[O] Other[lam] Brief Description of Proposed 5mi Roe / Work: '!,� /� /)kvyLr Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa t a ous i i i vtls n usi qg.co ple tithe otlavrc q: 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. Masscheck 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 . I. Septic Tank City Sewer Private well City water Supply SECT ION_7a ,,OW. ERAUTHORIZATIO [. PTO BE COMPLETED'.WHEN:' $.. T, UILUING PERMIT` OINNERS`,AGENTAR CONTRACTOR APPLIE�SFOR B , I, ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, C�daigiP/ T CO213 d ,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. Print Name Signature of Owner/Agent Date • SECTION.B CONSTRl3C`rOW.S.ERV10ES ;I' 8.1 Licensed Construction Su ervisor: Not Applicable 0 Name of License Holder: (CC.iN/91CCI 1 Po R ae/ cyR O V) 4/So License Number L4 R-e-ec1 &- NOv2-0\Ar tJ m A o)obo 1/- 3- o , Address Expiration Date ( 7 . S8y- (o571 Signature Telephone nRecifttete' i nih tan 3htracti)» . , Not Applicable 0 C6Kee- E0/46 Jn, ,2o�rhC'v _ /11 a69 -- Company Name Registration Number t/ glAt s74 iudiyLh, 244t/ .;94 ©/o‘D 5' is--o G Address /_ Expiration Date - 6--s--7:.--a_Telephone 5 ' /—6571 - SECTION`10-WORKERS'`COMRENSATI&(INSIRANCE_"AFFIDAV►T(M:CL c '1g2,§l56(6))c • . 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 X No 0 • 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 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 r „ .�ztV” of Xarthamptart • 1^ =— _ /, ��i .man (�ilessachusetts "� -_�� .- ��^* DEPARTMENT OF BUILDING INSPECTIONS = INSPECTOR • '212 Main Street • Municipal Building Northampton, MA 01060 s •,, r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supc:•,•i 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 r • �041 i11J-f pi.. `°= `— ) `'lE (rri� of '.Itt� f1la111}1toDl 1 = a24",- '''3e ❑ _ •w1�� - flaJaRrllnLrllD• f w DEPARTMENT OP BUILDING INSPECTIONS l • 212 Main Street ' Municipal Building Northampton, TTass. 01000 WORKER'S COl2PENSATION GNSURANC:L. AFFIDAVIT IT • Ehi .._..J ( ' (i ccnsxipermi ttcc) _.._.—_. with 2 principal place of businessfresidencc at: y R6-23 ] Se Nch2d-46riaiexl Mi e/o60 (phone:=) J`�B� (057J tsij c Jd ty/stalch p) do hereby certify, under ilic.paiiis and penalties of-perjury, :hat ( ) I am an employer providing the following kvorkcr's compensation cove age for my Cluplovecs working on this job: • (Insur.,.oc Corer_-n•) (relic; Nu•abcr ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the conuactors listed below who have the Following worker's coDoens2don policies: (Name of Co, c,o ) (tn2ranc Comoir ri'ctic Numcc:) (ExpiratIon Datc) (N:mc of Coup-Timor) (Insurance Company/Policy Nuzncrr) (%zpir•:tion Date) (Name of Contactor) (Insurance Compare}'/Polio' Nusbc.r) (Expir ioo Date) • (Name of Contractor) (Lasuran Compaay/Policy Number) (Expiratioo Date). (a coca+ :ddit o=d exct.it acxs,1•to ctciv&infocj oo pctainin6 to.11 c _c.on) • I am a sole proprietor and have no one worldng for me. ( ) I am,a home owner performing all the work myself. i NOTE:pl.—.r be aerlrc the.\+1z..1c beco o..vers..bo employ pctoat to So r- -«-•, -.:r-Joo c pole on.d.. pot mote th:o ttJ�o_��is«bio�tlx rip"' c1L^�of W[Doo"`"DQ 7LEfd7 or OQ[11C O-pyoayrizrd Ll1C'L':0 LT oat c^J.T.UV 0.^U:d.TC.d to LC caiployesunee the svcc—c cc=pc-t•coArl(Gul52aI 3 1 rt.^,•or ea ( )�:pptiat;w by•boo (a c bc�.«lu,uit r>_y e.idcaoc the c'S'� cs;,loyK uodcr t!>o Worti.ol.Cocop.. .,y;ns.Act I u.ode'ruod tit a copy or this mt.®cxa m..y b.ror+.vd..d to Lb.p.ep..rtmmt of IoA..r'ie1 AeodootY Ottoo or trar.00a for tb.• oovc zb'c vcif colon and th.t L-..ilta-to solue Lvvcryse under suction 2.3A of MOL 152 c.c tad to the izrpositioo oraimiaal pr-r++itic oocaisisqs of a fox or up to S 1}00.00 tndfor imprisoarocai or up to ooc yt_t Lod civil p-o•Ilia io 6e room a'Stop Wert Order tad. Goo 0(5100.00 t thy tptiost coo_ For ^ • ' i ,�.,�/ Pmitt ttlmrbcs y cz /'U7'CA'i Map: Lot " Signa ture of LicnscrlPc Date _- l (--' Proposa[ 1 Vinyl Siding j- - - - • . Corbett Home Improvement Winds ow ''J Northampton, MA 01060 Doors ".sit' I.1.,I�111 Awnings f / (413) 584-6571 / `` Canopies Gutters C-44 )it Olo`/ es ?Q's7 4 S?J Shutters PROPr1SAL V.SUBMri'IEDTC r + Af //'Z, Al A; 11 0& V y PHONES-2 V 6 Mil4y ,Q4 OL STREET S6(Q EL.* SY- "/7 JOB NAME CITY,STATE,awl ZIP CODE y'.n,Q JOB LOCATION �. 1 DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: I) SThiP ,4 Lc _ ,,di Z.. /524f)i.1 A 01-C 2) T1.E--1-4,JW4-er(. a K>e. o,.i epve-S Y�l1-cy''s� Alzoogd Clime 3) f}C.L elw-J sic /coo- DGscK. Na f L'_ouci-ed Dv (.e_4--A..14-4-eit_ ISt 2Le rC wi I1 A e- Cov-ercei by Fa.T- fp ( g' S if/di irc. 4)(/frytAvp.& DK4)--- eJ,c 1i) Rl d o tie- 4s aJ 'CA-KA i) wVeAld- Fps ge.mi tot, o 1 S/- 1- S'D//--� UrJ l4--- 040/ el914 et< 0 a rd.f� os j 9 6�X .Se v,f a r .i vui-(.,�i4 oD 64 ) N dT 3;N a'v6ccl Ai Alp,-�D4 1 /t Ru bb etch, Roar"a AI Rts�,c Fi Poor- ti )c7CPLACE G -- aJ' ow Pie ono--crF C4 ACtc" w4 0wN C�Y7 �r - MLc�S-/ A 4.U UM /17)N S01 PO4- -cl 'may s /Accine,f :2 so, eTPRA- Nic.ikilc r s1--i 1�i s�C 4cold ifoior �NC� � itieR44// m„a-S. (We TrOpOSe hereby to furnish material and labor-complete in accordance with the above specifications,for the sum 41y a Dollars(S I j `+`6-v Payments to be made as follows:141 11 /1 s,i_ tips l a.r1 pdM/, f 4u 1 All material is guaranteed to he as specified. All work to he completed in a work-like manner according Authorized to standard practies. Any altercations or deviation from above specifications involving extra costs will he Signature executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes accidents ur delays beyond our arntrol. Owner to carry fire,tornado Note: This proposal may be and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within �e days. Acceptance of 9roposa[-Tile above prices,specifications are conditions are satisfactory and are hereby accepted.You are authorized to Signature. do the work as specified. Payment will be mark as outlined above. �� Date of Acceptance: --02) `OS` Signature /4- �O , �[