31C-023 (4) P.T.bX6 P05T5 ON 10" D GONG.PIER
2 1/2"
q'-q 1/2"
FLOOR J015T 51ZED
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BY SUPPLIER
L I�
olC
f' t P.T. FLOOR J015T 51ZED
BY SUPPLIER
0
_ Q
Nw TYPICAL 2'-b"X2'-6"XI'-4"
I d1 J COLUMN FOOTIN6
TYPICAL 4" �P LALLY
Cpl COLUMN I VITH 5PRlN6FIELD
Im CAP5 AND PLATES
sn
LVL BEAM 51ZED
o - BY SUPPLIER
I �
BEAM POCKET I-- — — —� BEAM P
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in
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64.
LVL BEAM SIZED -1 BEAM POCKET
BY 5UPPLIER
BEAM POC KET
UP
r
DEPARTIrLENT OF BUILDD\TG INSPECTIONS `+ °
INSPECTOR M Main Street a Municipal BuHding �a
Northamptcm,MA 01060
LOCATION
SQUAR:E FOOTAGB AMOUNT
BASEMENT @ :20
I'FLOOR(g.50
2ND FLIP @ 30
Y,FLOORS, FINISH ATTIC,GARAGE @ 20
DECK/PORCFES @ -20 as
TOTAL.. 3 G
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction`Supervisor: Not Applicable ❑
Name of License Holder: �e f f`l Ae c"}/ (","S J)S 6 �j
License Number
Address Expiration Date
Signattfre Telephone q
9.Registered Home Improvement Contractor: Not Applicable ❑
,r(A ! r' / I :S(i-J ("1',.'S lac[ T/G���
Company Name Registration Number
Address / Expiration Date
Telephone 7/j 7 I
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....... a,*- No...... ❑ U kJ
11. - Home Owner 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
J
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [ Siding[O] Other[pJ
Brief Description of Proposed
Work: � N'S�ev�7 jot x
Alteration of existing bedroom Yes_�No Adding new bedroom Yes /No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a. If New house and or addition to existing housina, complete the followin :
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 (V —i L tF
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 Yeso
j. Depth of basement or cellar floor below finished grade '71 1
k. Will building conform to the Building and Zoning regulations? r 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, /2�a'/ as Owner of the subject
property
hereby authorize �4,
to act on my behalf, in all matt relative to work authorized by this building permit application.
Signature of Owner Date
1, 2�2' t i=-L-e� 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.
Signe under the pains and penalties of perjury.
Print Name f
Signature of Owner/Agent c' Date 07 L) /�
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: L: R:
Rear _
Building Height
Bldg. Square Footage
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 W DON'T KNOW C) YES
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 W DONT 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 i
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO
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 NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
ity of Northampton Status of Permit:
O1� ilding Department Curt,Cut/Driveway Permit
12 Main Street Sewer/SepticAvailability
•N` _ �t�p�s Room 100 Water/Well Availability
°���o6crl m p ton, MA 01060 Two Sets of Structural Plans
;��cin9 A 01
��e�1� tiot`n�m a 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify__
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 completed b office
�i,'l� r,,f /f w / P y o
�%2laSiiUG.aP
Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
1'j d n d �� '.. `J (t��'S Jk'c '( �G�i lS� - ct;rr"`
Name(Print) Current Mailing Address: /
Telephone
Signature "
2.2 Authorized A ent:
zIt,/ki S/i1ff?
Name( 'nt Current Mailing Address:
`r _
Sig ature 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 Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) Check Number •
This Section For Official Use Only
Building Permit Number: Date
Issued.
Signature.
Building Commissioner/Inspector of Buildings Date
File#BP-2014-0934
APPLICANT/CONTACT PERSON KENT PECOY&SONS CONSTRUCTION INC
ADDRESS/PHONE 215 BALDWIN ST WEST SPRINGFIELD (413)781-7008
PROPERTY LOCATION 65 FORD CROSSING-A23
MAP 31c PARCEL 023 ZONE PV
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid / Q
Tvneof Construction: CONSTRUCT 2 STORY ATT/GARAGE, 7/31/14 AMENDED CONSTRUCT 12 X 14
DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 052589
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Zoved 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
Signa o it mg fficial 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.
65 FORD CROSSING-A23 BP-2014-0934
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 3 1 c-023 CITY OF NORTHAMPTON
Lot: - PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:New Single Family House BUILDING PERMIT
Permit# BP-2014-0934
Project# JS-2014-001615
Est. Cost: $260000.00
Fee: $1403.60 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: KENT PECOY & SONS CONSTRUCTION INC 052589
Lot Size(sg. ft.): 4500.00 Owner: KENT PECOY& SONS CONSTRUCTION INC
Zoning: PV Applicant: KENT PECOY & SONS CONSTRUCTION INC
AT. 65 FORD CROSSING - A23
Applicant Address: Phone: Insurance:
215 BALDWIN ST (413) 781-7008 WC
WEST SPRINGFIELDMA01089 ISSUED ON:311412014 0:00:00
TO PERFORM THE FOLLOWING WORK.CONSTRUCT 2 STORY ATT/GARAGE, 7/31/14
AMENDED CONSTRUCT 12 X 14 DECK
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 3/14/2014 0:00:00 $1403.60
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner