23D-004 (9) BP-2007-0080
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2007-0080
Project# JS-2007-0126
Est. Cost: $1000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Craig Marney 057159
Lot Size(sq. ft.): 5270.76 Owner: SHALLCROSS DORIS J&LOUISE
Zoning: URB Applicant: Craig Marney
AT: 15 NONOTUCK ST
Applicant Address: Phone: Insurance:
P O Box 128 (413) 586-5512
LEEDSMA01053 ISSUED ON:7/27/2006 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL NEW WINDOW
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 7/27/2006 0:00:00 $50.004427
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2007-0080
APPLICANT/CONTACT PERSON Craig Marney
ADDRESS/PHONE P 0 Box 128 LEEDS (413)586-5512
PROPERTY LOCATION 15 NONOTUCK ST
MAP 23D PARCEL 004 001 ZONE URB
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: INSTALL NEW WINDOW
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 057159
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF 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 C 'ssion
2.
Signature of Building Official Da e
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 .fP „ ,a O
Building Department x"^ y u . ,-.
212 Main Street S we ea'a. ¢:, ;, ' `
Room 100 ei v
n �Iidrthampton; MA 01060 Fr e w kattu;a a _ .w
-. phone 413-587-1240 Fax 413-587-1272 'tvtils - a
,1 `Qthe pecify. 4. , 1,,,- „N*;-.,, ;c. a
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section:to be completed by office
1.1 Property Address: �° -. µ
/1.J��/c - Jp Lot Unit
,;Zone.:” Overlay District .
Elrrr$t District CB District .. .I
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: )� /y ,J/�/ yy/f r
1r?
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 r ' . _.. __
Frontage
Setbacks Front i
Side L: R: L: R:'
I
Rear
Building Height
1-
E -.
Bldg.Square Footage , % i
Open Space Footage %
(Lot area minus bldg&paved i j i i
parking) .
I
#of Parking Spaces
Fill: ;___. __ i
(volume-8c Location) E r i i
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW 010 YES 0
IF YES, date issued:;
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT 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 % 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 0 Obtained Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES l NO 0
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 0 r NO 2
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check allapplicable)
New House L Addition ❑ ReplacemenWindows Alteration(s) n Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [I= Siding[0] Other[0]
Brief Description of Proposed / p //J� ',
Work: - f 7't /VA, l-t SU c) (i![�►=' d r/v.'�. s�eV
Alteration of existing bedroom Yes / No Adding new bedroom Yes � No
Attached Narrative Renovating unfinished basement Yes V No
Plans Attached Roll -Sheet
difif NeW rouse hTrO' ctditi i» ez>E fi i x sen r o p e h f t a� >En :
of bu,ldin One F3rnay Two Family Other
a. LIzo 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 Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES'FOR BUILDINGPERMIT-
Odd/S �' J=1 (' dS`� ,as Owner of the subject
property cc
e).5
authorize r t / //1 ctn.)1-2-
to a.. . my beh f, in tters dative to work authorized this building permit application.
�'C'�c•�,r'Y''
0245-1 x-00 &
Signature of Own r Dat
,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 8-CONSTRUCTION SERVICES ,./-
8.1 Licensed Construction Su isor: Not Applicable ❑ `
Name of License Holder
Su
v 4 •n:r r t%3-7,5-7
.. License N be.
Addre r Expiration ate
))
1 !4 L5fE'Z37d
Signate Telephone
-.n am^� ;=+; .>' .' sir `s -a "± :"'.a
S f!3eq"f° t'e4if t a'i<ir mpra errre`e►t eint iitOe. _ 4. . Not Applicable ❑
Company Name .J� �l `/� j �j Registratio`n.Num er
Address io Expiration Date
PA... Telephone .3----1,:-J S i(3
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 ❑
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
Apr
•
•
•
p2. f
4:) "°?� (riff of North aiiiptoli • 1 �*
ervi -� a gi casachrtoctta- t� f
DEPARTMENT OP Bu LNG INSPECTIONS 4
212 Main Street 2s1unicipal Building r
Northampton, Mass. 01060
WORKER'S CONK ENSATION 6NSURANC1 AFTU)AV1T
- (li ccns.^riperuli etc)
with a principal place of businessfresidence at:
in
�iv�//40.,,:rbz,))•,/74 K09E' (phone ) S75:6)
(srr=,rlci rylst.liu da p)
do
hereb y certify, the pains and penalties of perjury, :hat
•
•
( ) I :stn an employer providing the following iworkcr's compensation coverage for my
employees wordng on this job:
(lnsur-_1*=Company) - (Policy Nu r) _._. (r:-piration Das.)
I '
( ) I am a sole proprietor, general contractor or homeowner (ciscle one) and have hired
the coon-actors listed below who have the fo lowiDe worker's coapen_sai on policies_ •
(NaraC of Contractor) (In franc-- Cotnpan}-i?o c NUSIt=C) -- (Ei;ptnmon Date)
•
(Name of Contactor) (I.nsurancc ComoanyPotic Nunc_r) (pinion Date)
{ (Name of Conliactdr) (Insurane:. Company/Policy N:unbJ) (E_xpiraon Date)
j
(Name of Contractor) (Lasuranca ComparyIPolicy Numb`r) (Expiration Date).
(.aar?a add:Deal if noocra_-p to inch,&•iaroraii7oa peta:aias to.11 ocaz;—tars)
'I. am a sole proprietor and have no one working for me.
( ) I alma home owner performing all the work myself.
NOTE:plcsc be aware 5emeotiven v.-be e¢xploy pe ons eo,30 trYaa work on c d of
ant aaect =its is wbirh the bornoowoc rondo oc CC the pour..:,opal trays tho-Go z:oa cocid.—cd to be
ciploycs=dz.-the..t.:ems- ---,:oa Ae (GUI 52=1(5)).arpplix oo by a botnoa c fc a li z .. ec pewit r..-y e.-rdmec the
lc p.1 noose of e-o es•.?ioy.c under rho Woes-or'.Coeaaam+lion A.. .
I undemajod th.1 a copy of this mtomeos m.y b.foraard.d to tbo Degnrtmx¢of Mo`c era1 015.4 or 4za -.one for th.
o c xse vciretioa sad th:.t L-.iltat to sawn: WrItt,T 1.133d C"sonion 25 A of MGL 152 as Ied to the inspacid=of cimicul pcooltia
corz o of fine of rep to S1,100.00 sndfor isocor of up to Doe yt✓e ad Cvtl pavltia is 5c form of•Stop Word Ordc cad
fim o(S 100.00 a day ciicZ roc
For dcp.rc.r'1 u.c only
I�CriII]t Nu ba-
�-1 c?` : _ Lot"
Silts of .t_ 'crmiucc trace I k
O¢5��p2. ,.
. ti
,► . :� �$ ,,.C�izEn of �ntrtmt �^ =#=�--
a) ti-St - lassacltasetta M.
It -may DEPARTMENT OF BUILDING INSPECTIONS AI_ =
INSPECTOR 212 Main Street • Municipal Building ,,• >'
Northampton, MA 01060 .
e
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction super.-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 structures. A
person who constructs more than one home in a two-year period shall not be considered a
home owner."
The wilding 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
i
r'