23D-010 (5) 24 NONOTUCK ST BP-2002-1083
GIs#: COMMONWEA'. TH OF MASSACHUSETTS
Map:Block:23D-010 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2002-1083
Project# ' JS-2002-1745 .
Est. Cost: $15300.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: AVALON INDUSTRIES 131375
Lot Size(sq. ft.): 14505.48 Owner: AQUADRO THOMAS
Zoning: URB Applicant: AQUADRO THOMAS
AT: 24 NONOT "::4 ST
Applicant Address: Phol-e: Insurance:
199 CRESCENT ST (413) 34S-4444 ()
NORTHAMPTONMAO1060 ISSUED ON:6/11/02 0:00:00
TO PERFORM THE FOLLOWING WORK:REMOVE & ADD WALLS TO ENLARGE
EXISTING KITCH, BATH & BEDROOM, ROOF & REPLACEMENT DOORS & SHEETROCK
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: y1r/' (n, _ Rough: ?peg_ 61. House# Foundation:
Driveway Final:
Final: /l lyy 2 Fina y�i� 116 2-
f l""�
Rough Frame:
g Opt' 8'1-Da -' �'�
Gas: hio/t9/ ('b G Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
ak -G -QQ9 „,..0
Final: Smoke: 047k Final: k I a.'/3_ e5...7
G;. . „,e
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy % Sgnature-:� '' 7-- %
Fee Type: Receipt No: Date Paid: Check No:/ Amount:
Building 6/11/02 0:00:00 1870 $50.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2002-1083
APPLICANT/CONTACT PERSON AQUADRO THOMAS
ADDRESS/PHONE 199 CRESCENT ST (413)348-4444() > y3}- J
3 ?
PROPERTY LOCATION 24 NONOTUCK ST g 9O /
MAP 23D PARCEL 010 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out p� a/ D
Fee Paid
l/ 5
Typeof Construction: REMOVE&ADD WALLS TO ENLARGE EXISTING KITCH,BATH&BEDROOM,
ROOF&REPLACEMENT DOORS&SHEETROCK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 131375
3 sets of Plans/Plot Plan
THE FO OWING 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 Stre- ►ommission
a6 /6 2-0°Z--
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.
P gy a s .,
of Northampton S t * `.
Q �' ding Department Cu; I,D s
�. 212 Main Street - 'e( :;.- � ti
I ' _ 7 n Room 100 lnla er
I I JUN 2002
itharnptonMAo106o Twc� etsa �,` :„emu ,
L phone 44413 537 1240 Fax 413 587 1272 Plot/Slte�l?1 � `
DEPT OF Bt11tDING INSPECTIONS QterzSpec�fy .. k `key
+�, ;, aAt�T�t; Aid nr�;:r� w.,.F
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This sectionto be completed by office
^,}
Map C Lots / Unit
oeq NO N tutu.C K 37-eee:r
/43271 aw9faiJ 14. Q1((4Q Zone `Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
7Z e,yAS /9Ntt Ac /-6 _199 i!'�s e �?z-.PA�
Name(Print) Current Mailing Address:
y3- 3ye- y4/4/V
Telephone
Signature (,
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature 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 lOOO (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
_ S! 000.6:70
4. Mechanical (HVAC)
1 5. Fire Protection 300 CAD
6. Total = (1 + 2 + 3 + 4 + 5) /S j�. 00 Check Number// $.5a—
This Section For Official Use Only
Building Permit Number: ip6)'io Date Issued:
Signature:
Building Commissioner/Inspector of,Buildings Date
r ,
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size /q•3 7•
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
/B Pr
Bldg. Square Footage , , pD
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW .)‹. YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO `1 DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO A
IF YES, describe size, type and location:
D. re there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
r
SECTION DESCRIPTION,OF.PROPOSED WORK,(check=all applicable)
New House ❑ Addition ❑ Replace ent Windows Alteration(s) .] Roofing X Or Doors
Accessory Bldg. ❑ DemolitionD New Signs [ ] Decks [ ] Siding [ ] Other [ ]
Brief Description of Proposed Work: /�a1sI f��.sii — "- 'di%. Z./A.0sta
, vv/ �y�rA//.1 aT.►/I fit?
Alteration of existing bedroom x Yes N� Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll 0 • Sheet 0 /
Sa-1f Neva tiousexand orgddition to existing housing; com"plete5the';�followii g: N/4.
a. Use of building : One Family Two Family Other l
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. Mascheck 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
I, -7,4 MSS A(1)LIA PIO , as Owner of the subject property
hereby authorize AVa4.1-0 Ovshele.t to act on
my behalf, in all matters relative to work authorized by this building permit application.
- r A � C aZ
Signature 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
r
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 3K
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
9 Regisraed rH" `iiirImproVemenrContractor: zoatz_,,ttl �,,,,__,_,
,,,� t,,i Not Applicable El
2,'47/D/U , ws7 $ /3/375'
Company Name Registration Number
/5"-/s r t r '/ Ape L v. 564,-1 .e/I, f4 , 6,99 7(/a�aor-
Address 6'24 — 7?�9 Expirat on D to
Telephone 73a - 8909
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.
kflomeowner Signature G�i
. .
•
04.t ttAM P1.O
Id (rxi cf TBrt1 &m full _#*_�
�du 4 ). l i
��t ` E' 6 icssac nsetls =`!
/ y)=ire' VaL
i = DEPARTMENT OP BUILDING INSPECTIONS di °—_
212 Main Street Municipal Building
Northampton, Mass. 01060 ' r'
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, /U. ScbTT/t/"c6/7 .- I3i4 /41/.4 6,0 ..7 .J'c .- 7-t3
(lice nseeipermittee)
with a principal place of business/residence at:
•
/57ç. .GC<arr. r•'4( ff�..P. k.,,_5 'k2 Ati.D/v f (phone#)_ 73,1- -95',?,
(street/city/stale/zip) 001(e- 7?-?-9
do hereby certify, under the pains and penalties of perjury,642 am an employer providing the following worker's compensation coverage for my
employees working on this job:
C i ,%-z1 '/ 'G/ - 3/B- 3?s-v 2. -O / ) -..1-6?--- 0.)-
- (Inrance Company) -
(Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additic,o,I sheet if necessary to include infwmiiioa pertaining to all contractors)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plc,ar be await that while homeowners who employ pa-so=to do mairrtn„rxr,corzs7vntioa or repair work on a dwelling of
not more than thrto units in which the homeowner resides or oa the grounds appurtenant thereto arc riot generally ceos:doted to be
employers under the worker's comps nsaticn Act(GL152.ss 1(5)),application by a homcowoa for a liccax or permit may evidence the
legal status of an employer under the Worker's Compomatioa Act.
I uaderstaud that a copy of this ctatcmcat may be forwarded to the Department of Industrial Accident?OM oo of Insuranco for the
coverage verification and that failure to secure coverage undesr section 25A of MOL 152 can lead to the imposition of criminal pcnalt:es
consisting of a fine of up to 31,300.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 3100.00 a day against mc.
For departmental tsso Daly
Permit Number
II/ / �� Map;{ Lot# .
gnature of Li... .,fermi 11r D: e
I 11
A
LAL
I
;� to&1--
�N <t�...)
A1r
1,
7 1.
6 s / y -�
1 • .
i
,
1 t w
, , ,
•i
,....i[1 t
1 t t JUN - 7 2002
. .
1 i 1 1
i
DEN Dir Rim DING! SP CjIpNSr
kInpT,, :-7(•?.1 (`. ,
''( --_..,---.-.<,........,,,-.-......,......-,..----..--. ..„,..--
_-.
.;.,,,,,f.,/
1
1
1 6
,
Jr( 1
+ ...._.., ....., •--..-\
?It16)Mak...._..... ,--, ..... .
•
i U
1
I 3
1
, - 14 (A)11U
,E..,... . r.,
, 4
•.
. ,
. ,
Y