16B-001 , MAY -13 -2000 02 :43 UNA 203 574 3570 P.01/01
1 4 0 6 °
1 - ° WO , ---__-_7 ---, - -;,:,- f , ' : -: , - r
\\ 111 93 t 1 C
f
GerY Contractor
P.O. Box 1203 * Westfield, MA 01096 •x(413)'269 -4360
May 13, 2008
City of Northampton Via Fax # (413) 587- 1272
Building Department
Northampton, MA
Attn: Tony Patilla
Re: Bear Hill Estates
Dear Tony,
Bridge Road, LLC is not installing bulkheads in any units that do not have
walk -out basements.
Per our earlier conversation, none of these spaces will be finished. They are
simply for mechanicals.
This is how these units are being marketed.
If you have any further concerns, please feel free to contact me.
Best Regards,
Zi er a oomey
CC: Pat Goggins
TOTAL P.01
L ° A '
ih:p. sF:
Q it of Nar#fyamptan i e..
'd k ,- 41 41 DEPARTMENT OF BUILDING INSPECTIONS __, _ '-
212 Main Street • Municipal Buildin
INSPECTOR p 1"
ow 5
Northampton, MA 01060
LOCATION 20 >C4,c gc \ S Mark Warn-er Of J�
SQUARE FOOTAGE AMOUNT
BASEMENT @ .15 15145 23'5'. 20
1 FLOOR @ .50 11 l Z. 5 U°
2 FLR @ .30 E I I 1E3,
E06 + /1
FLOORS, FINISH ATTIC, GARAGE @ .20 E v1� 1 0 1 U
DECK/PORCHES @ .15 1 3 1 19.
TOTAL 1,36g. 35
po(\ 1 b0 r Qerl;4 ca 6-Z-0' ) .-C :r a
L+ SA lit V►Jtifc Ullr: el sLN 2 A \od % - Arse. e0Ple C
1O USe On Ia+ 145-
1 3L, 3 5
— .1, I Gh . 110
P- 200) - itgri X 1 9 q 2 5
1 .
i * e (twit r o Northampton m pto n _ -*=° 1,
pp ► jJTrTassachuscffs 1 _
"`" DEPARTMENT OF BUILDING INSPECTIONS ' - =' = = �c
INSPECTOR 212 Main Street • Municipal Building ' >
Northampton, MA 01060 ,~ S ` • y
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:•isor. 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 struct 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
• •
-o k y (yi1 of North aril foil 1 ° -_-_,-
-
A S Q m E �1.,..d,ntrlln' •
' 1 17. -015; - , . LT .,
_ DEPARTMENT OP IIUILDrN.0 INSPECTIONS
212 Main Street - Municipal Building
Northampton, Mass. 01060 r'.,
} WORK: R COMPENSATION ENSURANCE AFFEDAVlT
I, . 1 } -Prek / �Ca /WPM . Cy26t .l ?ik_ r.
��
J (iicL-ns
v ith a principal place of business/residence at:
•
- t ,S 'RI (s - m A 00-63 (p ) (6 y l
ry
1 none`
(st city /stalclap)
-
do hereby certify, under the pains and penalties of perjury:; that
(VI am an employer providing the following worker's compensation coverage For Iny
employees work.ng on this job:
14. L,m, i"a kdi Z�f tU Poo- � �" 'i� )° /18)0?
ll
(Insurrnm Company) (Policy Nu r) (r .:piration Date)
( ) I am a sole proprietor, general coon or homeowner (ccie one) and have hired
the cone listed below who have the following worker's compensadon pol
(Name of Cont ^ci07) (Insurance. Cornp1Ay?oUCi NllIIli'r;) (x ?l auan Date)
,
(Name of Contractor) (Insurance CompanyiPotic Number) (Exviretion Date)
1 (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
i
(Name of Contractor) (I.asurance Comcany/Poticy Number) (Expiration Date) .
(naach sd•Sitoc.J �ct.ifnco=trt• t o i33dUU& inform. on pertaining to .JJ coca - .o
( ) I am a sole proprietor and have no one wonting for me.
( ) I am.a home owner performing all the work myself
NOTE: piece Ix C mrt tfi+• V.'tilc bococ i- '- � ovcno to <z plcy PC K11:11 to do • in e- . nnc CCU :a oo C moo'
CJ3 scot*. co t d..ett_g of
no( Doom th_ o Lt o . =its in uiycb t r ✓ocooc woo raid:= or on the grou.pd3 wpurtennrn. tbc uT ant cd.-^.1.1y OCCrd.TU4 to he
=1ptoye - unle the''xk z =- c xi Act (GL152s31(S)), r by n bomeoavc fcr c lie: cc permn =my cv?dm_c the
Ie t1 ctsasc of co cployx under ti. Wortdc Compomaiion Act
-
I undernaad did a copy of Unix ml,®cct may bo fo.r.ecdad 10 tb. Dopottmcaa of 1.. AccdeaU' OrGoo of Ic,t.raoce for lb.
covcntsc vciGO:Oloa And th_i L-.iltac to sxurt L-ovcrkg -n tndct zxtion 25A of MOL 152 con lad to the t=positzoa of a imin, i pca311i°
oocc ismg of a floc of up to S 1300.00 .rtdfor iiicqoriooacocai of up to one year . od civil pmaltic iA tic form of. Stop Wort Ordr and a
flan of S 100.00 a thy q;a.iast tnc
For dcparu r .a1 use Doty
as Permit Number
M __ Lot ^"
¢
e - J
Si L. tuyr of Lic�s m
rr,JPctittcc - -
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: C Not Applicable ❑
Name of License Holder : 2 14Qr S. bl
O ,S(3
License Number
P4). i ()x 1 2o3 kiJest'.-e)A MO 01c I1
Address ' Expiration Date
•
•'�.._ - • -4340
Signat e c latapko&le
9: Rentsteiedr#'lorrieTm roementidontracta t Not Applicable ❑
Company Name Registration Number
•
Address Expiration Date
Telephone
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.GL. c. 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 (b No ❑
. a i illl ..g_wn Df m
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
•
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House 21 Addition ❑ Replacement Windows Alterations) ❑ Roofing ❑
Or Doors E
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [[] Siding [O] Other [o]
Brief G+ Descriptio c Lot," �
DG�l�a��un ;ns f�
t)nY� of Proposed fu�+ D
Work: C S�r) �, � � \ 2" - ClOar AnA 3 Sc'"rSvl pox I,
Alteration of existing bedroom Yes X No Adding new bedroom Yes X No
Attached Narrative Renovating unfinished basement Yes le No
Plans Attached Roll - Sheet
sa I+ ew � -ous agd r dd a>r ialici'stlnc W6IislnCIA rOglit ete tge o`�Ila 6:� :
a. Use of building : One Family X Two Family Other
b. Number of rooms in each family unit Number of Bathrooms 3
c. Is there a garage attached? 7 es
d. Proposed Square footage of new construction. Dimensions
e. Number of stories? 2
f. Method of heating? n0iUrrA 3e4s CE,kgaasr Woodstoves 3AS Number of each I
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction 2%6
i. Is construction within 100 ft. of wetlands? Yes x No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade ( coA
k. Will building conform to the Building and Zoning regulations? X Yes No .
I. Septic Tank City Sewer X Private well City water Supply V
SECTION 7a - OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, 2 AQr 5 'Ouc` Lit , as Owner of the subject
property
hereby authorize Z t� Q r S cn \Oo MY, SollboN P Co' s4 r c� o
to act on my behalf, in all m tters relative to wo authorized by this buildint permit application.
S - 5 ors
Signat a of Owner Date
I, , 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
or s
Section 4. ZONING All 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
Lot Size
Frontage i
Setbacks Front
Side L:' R:' R:: -
Rear
Building Height , T
Bldg. Square Footage
Open Space Footage %
i
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location)
1' i
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:;
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 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 0 DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission? .
Needs to be obtained 0 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 0 NO Q
IF YES, describe size, type and location:
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 O NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
C ti
City of Northampton rs
Building Departmen " ° �
t
212 Main Street , � a � , 4 , �
Room 100 ,l : v 3,,
Northampton, MA 01060 m � P- . a
phone 413 - 587 -1240 Fax 413 - 587 -1272 4.
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This - section to be comptefed byoffice -
d g^ , ,ye.. RUct c` Map ` 4 Cat r " Urut
r Cr 4.r4Jc
�' k W� h s Zotte . Ov0 a - -'
-, /gyp
xEr 3t. D�stnct , k L 4. _ Caaistnct .
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
l ilc∎ ye Root\ ILC ?.(),&Ns 1203 GJeS- elc1 IMc, O1O&
Name (Print) Current Mailing Ai dress:
Telephone
Signature
2.2 Authorized Agent:
? --\er Scloop,� S4Iuot+,P Cons t cu c 4 o r' ?, 1203 LJes$'el1, I4c O10FC
Name (Print) / Current Mailing Address:
---d, CS2 y13 (13196
�igna ure Telephone
SECTION-3 - ESTIMATED.0 ONST ION. COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building 2.99 21 I (a) Buildin Permit Fee
2. Electrical 11 00d (b) Estimated Total Cost of
Construction from (6)
3. Plumbing , &OC) ,_- Building Permit Fee
4. Mechanical (HVAC) S
5. Fire Protection ,
6. Total = (1 + 2 + 3 + 4 + 5) 3232 '11 — Check Number
This Section For Official Use Only
... Date _
Building Permit Number. Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
' 0
File # BP- 2007 -1147
APPLICANT /CONTACT PERSON SALOOMEY CONSTRUCTION
ADDRESS /PHONE P 0 BOX 1203 WESTFIELD (413) 269 -4360
PROPERTY LOCATION 34BRIDGE RD - 5 MARK WARNER DR
MAP 16B PARCEL 001 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out ` � / ,p er
Fee Paid 3�J Y�+ / 99- a
Typeof Construction: CONSTRUCT 2 STORY SFH W /GARAGE /PORCH - HOUSE PLAN D
New Construction
Non Structural interior renovations '"�,I�i�!���'!
Addition to Existing 'v
Accessory Structure /
Building Plans Included:
Owner/ Statement or License 018780
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
A pproved 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
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.
1
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u ,t;tatAi c 171'�ob 7 C - '-7 2 4 22:2/,..
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__
The Commonweoltn of Massachusetts
V
Department of Industrial Accidents
i?1 = Office offnvestlyalians
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
name:
location:
city phone #
I am a homeowner performing all work myself.
[] I am a sole proprietor and have no one working in any capacity
I am an employer providing workers' compensation for my employees working on this job.
companynatne Saloomey Construction, Inc.
P.O. Box 1203
address:
Westfield, Ma 01086
(-413); 269_4360
city: phone: #.
Alea North America Insurance Co WC1049789
insurance co_ polity#
Q I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have
the foIlowing workers' compensation polices:
company name:
address:
city: phone #:
insurance co. palicg
company name:
address:
city: phone #: .
insurance co. policy # .
Failure to secure coverage as required under Section 25A of 11GL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and /or
one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DI ,-1 for coverage verification.
I do hereby certifi under the pains and penalties of perjury that the information provided above is true and correct
T
Signa -_ re – —.e rr.- �.. Date
} ! (413) 269 -4360
Print name E K 4 t 4., . Phone#
ifofficial use only do not write in this area to be completed by city or town official
city or town: permit/license # °Building Department
°Licensing Board
0 check if immediate response is required °Selectmen's Office
°Health Department
contact person: phone #; °Other
1 rev d 3x95 PIA1
4,1ti.AAt p2,
4 0, a5sachusetts
4 0� - ��'.5y� DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Municipal Buildin .
Northampton, MA 01060 ,~ 5 �
el
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.14 to
act as his /her construction sup,: ,. 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
The Commonwealth of Massachusetts
Department of Industrial Accidents
• 441E L Office of Investigations
m = �
600 Washington Street
� .4 _7
Boston, MA 03111
www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders /Contractors /Electricians /PIumbers
Applicant Information Please Print Legibly
Name (Business /Organization/Individual):
—
Address:
City /State /Zip: Phone #:
Are you an employer? Check the appropriate box: Type of project (required):
1. ❑ I am a employer with 4. I am a general contractor and I
employees (full and/or part- time).* have hired the sub - contractors 6. New construction
listed on the attached sheet. 7. ❑Remodeling
2. n I am a sole proprietor or partner-
ship and have no employees These sub - contractors have 8. ❑ Demolition
g for me in any capacity. employees and have workers'
working Y P ty. 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
officers have exercised their 11. Plumbing repairs El I am a homeowner doing all work ❑ g airs or additions P
myself. [No workers' comp. right of exemption per MGL 12. ❑ Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation 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 such.
:Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: City /State /Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone #:
Official use only. Do not write in this area, to be completed by city or town officiaL
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
SECTION 8 CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: y � Not Applicable S ❑
Name of License Holder : L I } °:' .J , j �%� Ot�;''11'. V ( � 10
License Number
P.b
•
,(Y. I 1,L)(. t 0 I i;
Address Expiration Date
L113 2 L5
Signature Telephone
- R"`istered��Horiie�nprave "mend merit : ors ._ Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10 WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 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 ❑
1 =1.. HomemOw.ner .Exemption
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
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
• New House XI Addition n Replacement Windows Alteration(s) n Roofing n
Or Doors Cl
Accessory Bldg. ❑ Demolition ❑ New Signs [lI] Decks [p Siding [C1] Other [p]
Brief Description of Prop sed i
Work: (t?n5t,t,t� S47/ , tloa e� c , to 2n�l �Ic .V' (Ana 3 SC�sc i^Grc�t
Alteration of existing bedroom Yes No Adding new bedroom Yes x No
Attached Narrative Renovating unfinished basement Yes X No —
Plans Attached Roll - Sheet
6a New house addition `to existing housing, complete thefollowing:
a. Use of building : One Family X, Two Family Other
b. Number of rooms in each family unit: (.3 Number of Bathrooms 2
c. Is there a garage attached? y e
d. Proposed Square footage of new construction. I � Lei C Dimensions
WL ' X cal'
e. Number of stories? 2.
f. Method of heating? fICA\l“'LA C,5 Fireplace or Woodstoves 5C 4 Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction LXG,
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 r a t
k. Will building conform to the Building and Zoning regulations? X Yes No .
I. Septic Tank City Sewer X( Private well City water Supply X
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, net- � p te`/ ViOCi 1-1-L , as Owner of the subject
property r
hereby authorize 2-% e( Sc'tco'e. C ."r _>°,'OoM0. Co Curl o 1
to act on my behalf, in all matters relative to v#ork authorized by this buildi permit application.
-- = I 6c
Signatur of Owner Date
, 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 4. ZONING All 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
Lot Size a . ___ -__. _._._....__.___., . _ __ __
Frontage —
Setbacks Front ___. Z-4)
Side L:_— R:'—e— L:__ R:v. -- /a , —
Rear - 24E)
Building Height
jai
Bldg. Square Footage % —
Open Space Footage n
(Lot area minus bldg & paved Z/D
parking) `
# of Parking Spaces
Fill: _.______ _ �_ �� —_ _ ______
(volume & Location) -----
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO Q DONT KNOW Q YES '
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW IQ YES 0
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW Q YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued:
C. Do any signs exist on the property? YES Q NO 4 711 1
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO Q
IF YES, describe size, type and location:
E. Will the construction activity disturb ( earing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES(,] NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Depa se ontq
ir` _. �' J` 5ks w' AddZCli S M `' .*; .'AJ 6. - 5A
City of Northampton S t a tus afem� e
Building Department C ttD€w euua�rPermtt K
212 Main Street Sew �
Room 100 Waterl fellAuaifabtaty
Northampton, MA 01060 T wo Set o 5truct�c Pins
phone 413- 587 -1240 Fax 413 587 - 1272 Plot/Site Ptana
Other Specify"
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE _O ,A �fg OR TWO FAMILY DWELLING
,._ ----' _'--t \‘C, f \' ,
-� `, � t, In .._._
SECTION 1 - SITE INFORMATION e-
- -- ,_ 1.1 Property Address: `� Th�ection to be' completed by office
c7 L' D (1 j t1CC4 4 Map Lot t Unit
\S Gio rnE ': - br + 11 ' Q ne _. - � r Overl District
e. E St. District CB Di
4 1 Ni strict
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: `` ,,
1 , :1 a _ye il o'�l a LL U. C� IZU 1.3�a ' e1 C � t" ri (31
Name (Print) Current Mailing Address:
Telephone
' nature
2.2 Aut orized Agent:
2 .e'-' Sc�,t(;'.,r ,. ` >�flc3 ,'. Cu S +; . - . ,R lac?'
U MCI Dick,
Name (Print I / Current Mailing Address: ....A
L ill t LGl -4 (:O
Si ature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building , , � �� , (a) Building Permit Fee
2. Electrical 1-1 1) L 0 — (b) E Cost
Construction stimated Total from (6) of
3. Plumbing V Building Permit Fee
4. Mechanical (HVAC) i
5. Fire Protection ! �- U � s £'t / °
6. Total = (1 + 2 + 3 + 4 + 5) `,21to Check Number j6g� 7 0
This For Official Use Only
Building Permit Number. I Date
Issued:
Signature:
Date
Building Commissioner /Inspector of Buildings
File # BP- 2007 -1147
APPLICANT /CONTACT PERSON SALOOMEY CONSTRUCTION
ADDRESS/PHONE P 0 BOX 1203 WESTFIELD (413) 269 -4360
PROPERTY LOCATION 20 BRIDGE RD - 5 MARK WARNER DR
MAP 16B PARCEL 001 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out MW j / b
Fee Paid J /1.96 • f
Typeof Construction: CONSTRUCT 2 STORY SFH W /GARAGE/PORCH, UNFINISHED 2ND FLR - HOUSE
PLAN C
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 018780
3 sets of Plans / Plot Plan
THE FO OWING 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 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 *ssion
2 erg
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.
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�! !�' ! I l 1 �f � ..--1 � G'...4 ' lam ; �' 1 v
R T D L 1 • �., . City of N ort h a mpton
BUILDING I NS P ECTION LABEL = . ° °,
Inspector ,p.,:... , ..) ., �
W ,,,,L.P.,,e__ A Date , N-
-
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20 BRIDGE RD - 5 MARK WARNER DR BP -2007 -1147
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 16B - 001 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- 2007 -1147
Project # JS- 2007 - 001837
Est. Cost: $223271.00
Fee: $1166.10 PERMISSION IS HEREBY GRANTED TO:
Const. Class: 5B Contractor: License:
Use Group: R4 SALOOMEY CONSTRUCTION 018780
Lot Size(sq. ft.): 1296345.60 Owner: BRIDGE ROAD LLC
Zoning: URA Applicant: SALOOMEY CONSTRUCTION
AT: 20 BRIDGE RD - 5 MARK WARNER DR
Applicant Address: Phone: Insurance:
P 0 BOX 1203 (413) 269 -4360 Workers
Compensation
WESTFIELDMA01086 ISSUED ON: 6/8/20070:00:00 .A rv► €Noeb OS (06]08
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 STORY SFH
W /GARAGE /PORCH, UNFINISHED 2ND FLR - HOUSE PLAN D
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector /
Underground: Service: 7 Meter: , a
Footings:
Rough: ;: " < , Rough: 7/ f,,, jf f House # Foundation: 9 C - /J 05( � ( ,,_ P��
tee . r Driveway Final: `�f
Final: `0.,,2 ..p k Final: cd.riZZ72i' S'4-Zd2/,/ 42.3/4., l OK yt9 � gr- Rou h F rame :
(buel23
Gas: Fire Department Fireplace /Chimney:
Rough: cf -as"G 9 Oil: ? Insulation:QFr sr- a ,
•
Final: /0 o7 , Sm oke : �t x # e 1
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS. `
' .' - ,,,e' -a—Z(4
Certificate of Occupancy ' 7 Signature:
FeeType: Date Paid: Amount:
Building 6/8/2007 0:00:00 $1166.1016974
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo