Loading...
24D-087 a BP- 2011 -0605 �3 GIs #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: B UILDING PERMIT Permit # BP- 2011 -0605 Project # JS- 2011- 000969 Est. Cost: $25000.00 Fee: $150.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JOHN LANDRY 093450 Lot Size(sq. ft.): 7927.92 Owner: STABILE JOHN T & PAMELA C Zoning. URC(100)/ Applicant JOHN LANDRY AT. 50 NORTH ST Applicant Address: Phone: Insurance: 104 NORTH ELM ST (413) 204 -9880 WC NORTHAMPTONMAO1060 ISSUED ON :11412011 0:00:00 TO PERFORM THE FOLLOWING WORK.- REPLACE ROTTED SILL,REFRAME 1ST FLR SYS,REMOVE CHIMNEY & PATCH 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 Sienature: FeeType: Date Paid: Amount: Building 1/4/20110:00:00 $150.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner t File # BP- 2011 -0605 APPLICANT /CONTACT PERSON JOHN LANDRY ADDRESS/PHONE 104 NORTH ELM ST NORTHAMPTON (413) 204 -9880 PROPERTY LOCATION 50 NORTH ST MAP 24D PARCEL 087 001 ZONE URC(1001/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REPLACE ROTTED SILL REFRAME 1 ST FLR SYS,REMOVE CHIMNEY & PATCH 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFqRMATION 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 -CL� A" //6,3/ Signature of Buildmg 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. City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413 - 587 -1240 Fax 413 - 587 -1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Prooertv Address j 4 ! - ,,.v s'f _ M xtl '� W ut� Y`" 4 - � M��ct �+dV.�"` A F'* .&n5 1 Y E K r. - qtly = to SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Current Mailing Address: �SR n 7 r Telephone 7 Signature 2.2 Authorized A-gent: AA Name (Print) Current Mailing Address: T 7 — %�3 - ,--k Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only, completed by ermit applicant 1. Building (a) Building Permit Fee " 2. Electrical (b) Estimated T.otai Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) - CCU Check Number 17 q �d This Section For Official Use On Building Permit Number. Date Issued: Signature:' Building Commissionerllnspector of Buildings Date Department use anly City of Northimpton Status of Permit: Build Department Cutb CvZriveway Permit 212 Main Street Sewer /Septic Availabiilty. . Boom 100 WaterNtileCl Av4ifabi1fty Northampton, MA 01060 Two Sets of Structural Plaria _ phone 4'13 -587 -1240 Fax , 113-587-12'72 PInUSite Plans Other SPeciN APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING I SECTION 1 - SITE INFORMATION 1_1 Pro crt Acf be section to e completed by ofFce P _� r Te ss. Zone overlay DiSlrtCt Elm St D &g #rlet CB District .—­ SECTION 2 - PROPERTY OWNER SHIPIAUTHORIZE D AGEN _._...._..— _... -- 2,1 Ow ner o f Record 1 r J N.:jmr Ir Cuirrnf Moiling �•� cf� . c. 5 ,t ✓.r ti I .,...,. Ala'? I• nr* 1 2_t nzed A Fn I 1 r'!i .'.,4 n UYC . urr ?nl 1�17n1�rt ! Mara,. ci r.nt r nl n /ldrirr �igrurturr' – � ^.�� _ � r•b ?pl?or1N __..._ -- •— ._ , SECTION 3 - ESTIMATE CONSTRUCTIO COS Esiimated Coll (L)oilar ^,) IC lea'. OffiCr2) Use Only i cam leled by permil @o iir Ary ? Building (a) Building Permit Fee :J C.'i�_c'rc sl (b) Estimated Total Cost of _ - Cons4naction from iG 3 1r, rrrl)inra _ Building Permit Fea r u Mccl•,anical (HVAC: Protection C hick Number Dom ,,..., _... This Section For _ _ teal U se `3L111dir)p oprmit t+lumbc -r Building ('omrnt �jonerllnspcetor of Ruikimq- r) rfn Section 4. ZONING Ail Information 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 — ,-V___`_.._____ 1 t Lot Size Frontage Setbacks Front _ �3 Side L: R:= L: R: Rear Building Height W Bldg. Square Footage Open Space Footage _ i _ % -- (Lot area minus bldg & paved L__.. par # of Parking Spaces -- , Fill: volume & Location) - i A. Has a Special Perm arian e/Finding ef�er n issued for /on the site? NO 0 D NT K W ® ! - YES IF YES, date issued:; j I t IF YES: Was the permit recorde at the Re' istry f Deeds? NO ® DO NOW YES IF YES: enter Book Page and /or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 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 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 O IF YES, describe size, type and location: i E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO O IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all aaialicablel New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [p Siding [ ❑) Other [❑] Brief Des of Propo d WOrk: O�c,i j% i r.� �� 5', �' , �i� ;G, ►�nY ?�+c �5 �cl i Y AVV0 L�� nn��c+y 7 ''•. ��. Alteration of existing bedroom Yes No Adding new bedroom Yes No / Attached Narrative Renovating unfinished basement Yes o Plans Attached Roll - Sheet 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 SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 541 /C as Owner of the subject property hereby authorize C 4 to act on my behalf, in all matters relative to work uthorized by this building permit application. Signature of Owner Date as Owner /Authorized Agent hereby declare that the staterfients 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. r Print Name 1 Signature of Owner /Agent Date . . SECTION 5- OESGRI ITION OF PROPOSED WORK �check all pipplicable) i Npw Hou."_ Addition F_ Roofing E] Ropllcement Windows Alteration(s) Or 77 Accessory Bldg Demolition N,w S iq,, [n, Oiucks ( M Skiing [MI Other F—T . —Sric.f — ;xmrinnnofexis«ngbcomorn_y*o No *dd|n9 new bedroom Yet —' No ' At,nc*edm�.Irrad"° Rerlo"ahmgun*mishou Yev pionxAl,nchcg Roo 8!7*ol | 6a. If New house and or addition to existing hoUsing IR com late the, following: o Vye ofm*'^dino.gncpmrrvly T*crvmvvOtwr______ . h w"mmcrorrooms in each flm/ly unit:____________ : is lh*/*o garage oMpohed'_____ � P,*p*"od,'.;q"o^prnntopcnf new nmnmrummn _ Dimcns/on �7 Numberofmv [ ' meVvodn/ p/mp|apam orvvopumoves Number of each p Ene.rpvCnnz.em"bonCompliancp K*arsr*cc* EncgyCompliannnformmnmcnou? ... ............ ... ______ | | � `ynporcnn�nnm�n____ �y . | / �nonm�,mon°wmm~oo o w�nmnwn� vc� No |nc"n�n�x|n° �N , 0� �mnu | re» m ..� . _ _____ wx " v,� pam o | n�u^ofha5i�nenxormmlavnoo, below finish od prad+ Se T 'Ink City Sower r"TIVm Weil SECTION 7a - OWNER AUTHOR LZATION - TO 13E COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR SUILDINC, PERMIT T17711 �Irclwrl Date as Ownr SECTION 8; ES 8 Licensed Construction Supervisor Not Applicable � Name of License Holder : � `I 42 y5 6 License Number Addrress Expiration D to Signature Telephone Not Applicable ❑ Company Name Registration Number /Z Y ,�/ Z2ez©i/ Address Expirafl Dat Telephone SECTION 1G :aAfIER$'EAf1�tRIE`AI=fH3At7' �M ( L. c�ig� ..26 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...... ❑ 1 ,111 iiii 1 1. 8 I MI 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 -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 persons) 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 • The Commonwealth ofMassackusetts Deparft ent of lndaaWd Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.rnassgoy /din Workers' Compensation insurance Affidavit: Builders/ Contractors /Eleetricians/Plumbe AvIDU I At Information Please Pritit I-e ibly Name (Business 0n:g A zrAwmwvwv&*: v; Address: _ _- lVar- City /StateJZip: 'Coe 0 0` Phone. #: Are you an employer? Check the appropriate box; 'typ of project (required); I . ❑ 1 am a employer *ft 4. (� I am s: general cotttractot ad 1 employees (full and/or part- time}.• have hired dse vib-oontrwtors 6. �rm construction 2_ 0 am a sole proprietor or Palm- listad on the ataehed sT�s 7. Remodeling f ship and have no employees These sttb- cotdractors have B. ❑ Demolition working for me io any upaciry , employees and have wo &= . t 9. [] Builft addition vw [No orl= co"P. insurastce AMP. inststaace• � l 5. We stye a corporation and its 1 -El EI0 i0W repairs or additions 3. ❑ I am a homeoswncr doing all cork often have a>sa sw uk 11.0 Plmd)ing repairs or additions right bf exempft per MGL tnys�t 946 c.1S2, and tie bm no 12. Root task ) t employes+• P40 wadmw 13.0 Otbcr + coal'. msuraaa regQhv&j •Mya�ptieaet Mtdtaexs boat 01 wantsho fill ore 16a sofimbeA w t 5eatnt dm&wottas• oonpass pctber iaiamatiaa t tiosnaoawess «6o - brait &k alGduvit ho sae do* aA work and dial Sine a midcaanaw moat man tVAIdt anew NAMvit kwketios svati. ZC nttiam that diode dais ban aruut snsdW at a"dmst dart d owiat the tit m attic aid +tore owbadta or net those entities tare eeapkyom It die snb emaiaottits Gave urployea, day must provide *eir v mbnI cowp pe6gatisaber. I an as MPloy er t1w is prowdlag workers ` eoinpensaaox brswdnce for any eawbom Below is dw policy and job site ieforntaation. Insurance Company Name: 8er Ue 5 1A lurv,.AC P �_ M Policy if of Self -ins. Lie. dl: �� �g 7 F Date: Job Site Citya wcaip: Attach a copy of the woulters' eoagwun don policy dedaradmt page (sboetog the policy number and espiration date). Fa vre.to seeore ccvcMp as required under Section 25A of MCI. c. 152 an lead to the - imposition of aimW penalties of a t5aa ltp to S I.SM-00 100t Owr7otr itasaome M w WA as CM2 penalties in to fa= Oda STOP WORK ORDER and a fuse of up to 5250.00 a day agiitist the viaWk. Be advised that a oopyof this Clow be forwarded to the Office of In Mg of the DIAjfor 'MEOW gamy venfrca bon. I de xwwbT fib' d FePebal" iParalNea elPcd&7 drat dre is tram lard con= ter r: O N&. amt w ide tit thin area, a � or IMM o�}claL : Ferulitlidcrdse d n4ty (gird* one): ealth 2. SuBding Department 3. City/Town Clerk 4. EteeuiW inspector 5. Numbing Inspector on• Phone if• /3 y � n , _`L ►L - r � IF - fir � � E 3 r I i _ - -- _._.- . 1 t 5t 11 Rl 1 113 J6)Ll- M SG? 3 IIL - .JIL rower, E �} � i l ____.._....__._.__ - - I i T ! 3 w f � � vf�nj !` i 1 I � 6 1 ilh .J L J L..•� ' � r � t r �� y � '�T