23D-010 (7) 24 NONOTUCK ST BP-2005-1190
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23D-010 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# :BP-2005-1190
Project# JS-2005-1611
Est. Cost: $139500.00
Fee: $695.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class_ Contractor: License:
Use Group: Mill River Builders 009224
Lot Size(sq.ft.): 14505.48 Owner: ZORN PAUL M JR&SARAH W
Zoning:URB Applicant: Mill River Builders
AT: 24 NONOTUCK ST
Applicant Address: Phone: Insurance:
164 Riverside Dr (413) 586-5629 () Workers
Compensation
FLORENCEMA01062 ISSUED ON:6/15/05 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 19 X 18 BEDROOM/BATH ADDITION
& 6 X 16 4 SEASON PORCH
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: j# -' r .%i, Rough:f 1/31 s—'- louse# Foundation: (.9 p r'r
6 - 3
Driveway Final: �
Final: / 0 Final: /3/L'6�/I iAf
<4,6,42) V Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:O1( 'I.-,5 173
Final: kaZ U 0( Smoke: Final: O
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 6/15/05 0:00:00 $695.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
•
I
717q29/ 474°11 eJ
lipcwg v/./ 2./p 2,3/4-yr
File#BP-2005-1190
APPLICANT/CONTACT PERSON Mill River Builders
ADDRESS/PHONE 164 Riverside Dr FLORENCE (413)586-1849
PROPERTY LOCATION 24 NONOTUCK ST
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 4160•1
Fee Paid 4 S k5
Typeof Construction: CONSTRUCT 19 X 18 BEDROOM/BATH ADDITION&6 X 16 4 SEASON PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 009224
3 sets of Plans/Plot Plan
THE F LOWING 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 Commissio•
Signature • Buil•g 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.
0, .t MAY 21 !Ay 6 nn,5
• --- 1 7."'•a 4,- .14 4 t ` �e® as r a - n , .
City of Northampton r
Building Department �. E. s
212 Main Street Se °
t- T® t
c mo
� � - �ti A as .,, r
Room 100 .i ' r . ii 'Northampt n; MA 01060
phone 413-587-1240 Fax 413-587-1272 Pl. ' 1� »
70th c^ ..,t,„...,,,,.;� na..01`" ..:.- , , eiy., - '
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:
c'1 ,/la/ f 4- S-r '� Map Lot *It-
t0 �4C ,� MA aI t (o.2. Zone Ovetla Distract
Elrt Sf D�sYrrtti KGB Distract"
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record: ) f
Name(Print)
6 t , 1M2 0N4
Signature ���rr
2.2 Authorized Agent: /we-�(°�
F-DuoAsz-l . -c5v-,•\ 1,6A IM..l RJtv ev`/c1," 7z) sk6-/ J E--
Name(Print) 4 Q/Q C
�L T7 L7N
Signature
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to
completed by permit applice
1. Building _...�.
/1 -, /4t/.
2. Electrical S. (b)Estimated Total Cost of
�� 30D• Construction from(6)
3. Plumbing A• G a C,0O• Building Permit Fee
a
4. Mechanical(HVAC) ?, 7 S •
5.Fire Protection}} ,$-007•
6. Total=(1 +2+3+4+5) �.p /31 5-�• Check Number )(4(p o ( (QQ�"�
This Section For Official Use Only v
Date
Building Permit Number Issued:
Signature: '
i
Building Commissioner/Inspector of Buildings Date
t'
Section 4. ZONING All Informatibf 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 .:,-,...2a:j 3•yb 6 F• ! SA- -F..._
Frontage 1 /21?'•.v3 I S A'Y1 - i
Setbacks Front :Z—j.' 16.2,41' i 2O
Side L: R:3$.II L:1 /fl 3 R:38\K"i LAST Lill-r
37-'
Rear i� _'= 2
Building Height , •.
3
Bldg.Square Footage % _ 3
Open Space Footage , % i ' 40'(Lot area minus bldg&paved 1/31414 t
parking)
#of Parking Spaces i Z '` 2.--.; `
Fill: , l Nal�f, L \ � _ s
(volume'&Location) t� W l'
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW , , YES 0
IF YES, date issued:i
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book Page? and/or Document#'
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission? .
Needs to be obtained Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO te
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES (3 NO CI"
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 r NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required. .
•
•
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House [1 Addition [�:, Replacement Windows Alteration(s) n Roofing
Or Doors 1$]
Accessory Bldg. ❑ Demolition ❑ New Signs [C7] Decks [Q Siding VC Other[0]
Brief Descr'ption of Proposed
Work: A-DD 11/0, ,TE,e aZ 111%..2-fr.. d►kArs-t-f 150.A•-r '41 $g.-Ac,5 dry Pd
Alteration of existing bedroom Yes No Adding new bedroom Xs Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attache -Sheet
'=s �x �7 F°`k..-ros3.,->?_�"". °°�=�.`'�„.^u.. ,„,�x�=«° ,s,��xs,„. �s�". sa� �-rerz�w.�-my.RS xr.�-'� -"m' �„r,�:
6a ff New lo'ruse andrordditt_on o. xrstt—rrdr ousinq..complete.:the' ar-Grt q:
a. Use of building:One Family X Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached? /4O � J // /
d. Proposed Square footage of new construction. "�5� �7� Dimensions /9x. / O i 41:4-T' X ` ` .
L'
e. Number of stories? 2—
f. Method of heating? th'T Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. 1 €i7 Masscheck Energy Compliance form attached? 7 g_S
h. Type of construction
i. Is construction within 100 ft.of wetlands? Yes X No. Is construction within 100 yr. floodplain Yes 9< No
j. Depth of basement or cellar floor below finished grade
621
k. Will building conform to the Building and Zoning regulations? X Yes No.
I. Septic Tank City Sewer x Private well City water Supply ,
SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT.OR CONTRACTOR-APPLIES FOR BUILDING PERMIT
S fit✓�--` �� e)4 _ ,as Owner of the subject
property
hereby authorize � w P &A W1
to act on my beha f,in all matters relative to work authorized by thit building permit application.
1�q. z4. J,iv-s
Signature of Ow er / Da
.. .. ... .......
1, E'‘b W ck-;L" CZ' S _- , as Owner/Authorized
Agent hereby declare that the statements and inform ion on the foregoing application are true and accurate,to the best of my k o ledge
an3 belief.
Signed under the pains and penalties of perjury.
Print Name
►� �' 025–' V
Signature of Owner/Apart Date
•
SECTION 8-CONSTRUCTION SERVICES f,_
8.1 Licensed Construction Supervisor: Not Applicable ❑
c
Name of License Holder: �, ,.L.447-Po� t�`
j�i " v CO'/��7
CC License Number
61666 I o
Address Expiration Date L;) ri c.561 6'6 Signature Telephone
,Ti a is a etWif a npri ve nen` o iaCtoc ` * ':
. .�. - . ...;,� �. , � Not Applicable ❑
Company Name Registration Number
Addrqss Expiration Date
B�`7"� ✓ O A l
ANA`'1 Telephone 17 3 s ?re/
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 ❑
1314: ' o la ONinerviTArtuytton
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 108.33.1.
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
•
•
- ENERGY CONSERVATION APPLICATION FORM FOR
LOW-RISE RESIDENTIAL NEW CONSTRUCTION AND ADDITIONS
710 PAR App dix J (-etfe-ctive 3/1/98)
F,ppll art tsiame: /ILU et Ora-(_-�� '-te.A.K Site Address: O( JYO. oT �•
Appl,cant Address: /69 IFrit.4. i11�- ikiy/lawn:
j `.5. g .VJ Grouo: O J -b
V�� 0/6(e 2- Oztc of Appl:ca'lor,: S- b
�f 1 (a Abdication S atiir : ✓ ft 11
Anr�l lr Tnt Pt,rrr- `J ^l/V,.�u� - J,gr, •.�.- _,
C.E?arrcx P-tJt (cit'leck or )z
O Prascriptive Pa:kage r!_,rniteo to 2- or 2- family ,rood`rime-buildings cleated with fossil fuels Only)
Pacttiac-e (A throug;i KK from Table J52. tb): Hating Degree Days (t1DD ) from Table J5.2 la:
(For iiorris d. through i., fill in all values t;iat apply from Table J5.22
a. Gross W>ri1 Are_e sq. f- f. Wail RVafzrz R-
b. Glazing Area E Floor R :'atue n-
c- Giezing%.(1 DD z b--a) h. Basement wall
fia7i" l I- 'ai r v• Siet) ?DrIt--ier
e. Cenling R-value 3- 1- Heating AFUE
u C�n cne—nr Per`rormance: 'Fianna! Trade•O'i?` (Limited to wood or metal framed buildings only)
Clima-Fes. Zae(fr-orn Figure J6.2.2) 0 Zone 12 ❑ Zone
Attach Trailre-Off Wori hect from ADper 'i ),[and iiVAC Trade-Or vkrisheel. if applicable)
Q MASc h e, k Soitwa rr •
Attach Compliance Report and Inspecpan Checklist printouts.
r�
iJ Sy,;icris Analysis OR 11 Renewable Energy Sources
Attach Mass Registered Arohitec_t or Engineer Analysis
J ALTERNATIVE FOR ADD1 TiONS ONL Y: q
a. Gross Waif ± Criiir?g Area/ . sq. ft. b. Glazing Area'/4 sq.tt. c. Glazing o (103 x b--a) {,?
O ADDI ION a-im Glazing , (c.)up to may use 780 CMR Table J] 1.2-3.1 below:
jMAXIMUM Minimum R•VaSucs
Fenestration Coiling Waif Roof - Bascrrt-rt Wall ; Slab Perimeter, Dept I
}
_
0.39 R-37 R�I3 j R19 R-10 1 R•10.d !t.
❑ -SU^:ROOrr," addition (Ereater than 4.C7 giazing.to-wall and ceiling gross area)
Attach -Consumer Information Form` from 780 CIfR Apps-ndir B.
Omcial's N me: Lr*Y 7'/ /774(0 Dfcial•s Signature: u
AppticEtron Approved 55-- Denied ❑ Date of App oval/Denial:
RGas.o:(s)or Denial. (prv'id- additional details as needeQ on back side)
Z*.L Srrsaaz tom d*l+u- iarh-C namg ar Una-1�
4-�t PTp (�
'fie e' e �Z� L NLI 'ta11tpio1I i
*=o
a�+� stiilassactinsetts =_• _
�W DEPARTMENT OF BUILDDZG INSPECTIONS
212 Main Street ' Municipal Building —=
Northampton, Mass. 01060 �'
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, 0Aw k(-A. k-e-ti-TSt-L‘ fl!S A Al, l( 0 e--e____- I .t..,.t 1,8 f_(Z-�.
(licensee/permittee)
with a principal place of business/residence at: A
•
/e-h( R. s.,a IJe. . &A, rTt-t�.r) 1 ,_ AA ,(O #) 2ti3 s-%(.. szal
(street/ci ty/stable p)
do hereby certify, under the pains and penalties of perjury, that:
()c I am an employer providing the following worker's compensation coverage for my
employees working on this job:
4-A-iniPocz 6s(eO1& -933x ?G2 - - 1- ot,/ - I g-os-
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, ;-aeral con■ote s' e 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 Colnpany/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional shod ifnoccssary to include information pining 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:please be aware that while homeowners who employ pazoas to do ms intenanrc,constnt ion ar repair work on a dwelling of
not more than throe units in which the homeowner resides or on the grounds appurtenant thereto are Dot gala-ally ooarulcred to be
employers under the worker's compensation Act(GL152,ss 1(5)),application by a homcowoor for a license or permit may evidence the
legal status of an employer under the Worker's Comptmaiion Act_
I understand that a copy of this statcmmt may be forwarded to the Department of Industrial Accident.'Office of Insurance for the
coverage vc ificatioo anti that failure to secure coverage under section 25A of M(7L 132 can lead to the imposition of criminal penalties
consisting of a fine of up to S1,500.00 and/or imprison of up to one year and civil penalties in the form of a Stop Work Order and a
fine 0(5100.00 a day against me..
For d c p s r t m e r s t a]u s e eery
—
Permit Number
� S- i=0S" Mai Lot#
_ ,.
�� _ � Sire of Licensee/Permittee 1