17A-149 (8) To: Northampton Building Department
From: Patrick Mahoney
(413) 584-8944
Date: 05/22/2001
Re: Framing Plan
Homeowner seeks to construct a new 10' by 12' deck secured to the existing structure at
28 Fox Farms Road in Florence.
Framing will be:
• 2"x 10"x 10' ledger, secured to 8" concrete foundation with '/2" lag screws and
anchors
• Doubled 2"x10"x10' beam, (span=7'-4")
• 2"x8"x12'joists (span=9')
• 4"x6"x4' posts on 10"x48" concrete footings.
• 5/4"x6"x10' decking
• 36"high railing with balusters spaced no more than 4-3/4" apart
6'
,..........z..........,
45' Shed= w 45'
80sgft
81'
r�
15' Garage= Breeze
440sgft way=
120sgft
House=
1168sgft 15,
30'
a`
Patrick Mahoney
28 Fox Farms Road
Florence, MA 01062
04/24/01
Scale V=20'
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DEPARTMENT OPT BUIIDDZG INSPECTIONS '
212 Main Street Municipal Building
Northampton, Mass. 01060
WORNEWS COMPENSATION INSURANCE AFFIDAVIT
AAal
permitiee)
with a principal place of business/ widen at:
AAA
(sU=t/city/state/2ip)
do hereby certify, under the pains and penalties of perjury, that:
O I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance 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:
w.. (Nae�of Contractor) (Insurance Company/Policy Number) (Expiration Date)
m
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(]"lame of Contractor) (Insurance Compaay/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(atta.Ch additional alreet if noes=y to rnCllldC information peru ning to all coC!bmd )
O I am a sole proprietor and have no one working for me.
9Q P&n a home owner performing all the-work myself.
NOTE:please be aware dul%e@a boarowoers who employ pcnoas to&mamto nce,consuucuoa or mpair work an a dwelling of
not more than time um u is which the homeowner resides or on the grounds appurWe thereto are cot emeraily wondered to be
employers under tho vmck er's compensation Act(GLI 52,=1(5)),application by a homeowner for a Gc=e or permit may c%idcdm the
lepl ctabu of an employee under the Worker's dompemation Ant.
I understand that a copy of thu uatemmi may be forwarded to the Doputm� of Iod+utrial Aaciden&Offioe of Tmuc*nce for the
covesxge verificstioa and that failure:to secure ooverago under secUoa 25A of MOL 152 an lead to the imposition of aimhd penalties
oomisting of a Fine of up to S 1,500.00 and/or imKboameat of tip to one year and civil pmiltia in the form of a Stop Work Ord-and a
firm of S 100.00 a day agtiinst me.
►�D� l For depwtDCOW use only
'✓� Q� a- 0 r Permit Number` ` gyp# Lot#
Signature of Licensee/Pe ttee
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:---------------- --------------------------- -------------------------------------
License Number
-------------------------------------------------------------------------- ------ ----- --- -
Address Expiration Date
---------------------------------------------------------------------------
Signature Telephone
9.Registered Home ImImovement Contractor: 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...... ❑
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 ena�;�cal tate of Massachusetts General Laws Annotated.
Homeowner Signature I
SECTION 5 DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [� Siding[ J Other[ ]
-----------------------------------------------------------------
Brief Description of Proposed &*V5- '{yv`/v( - 0'tw lox /a. deck
Work: 7
Alteration of existing bedroom------Yes___Y`_ No Adding new bedroom-------Yes x_ No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - he
6a. If New house and or addition to existing housing, complete the following:
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. 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
-------------------------------------------------------------------------------------- as Owner of the subject
property
herebyauthorize ------------------------------------------------------------------------------------------------
to act on my behalf, in all matters relative to work authorized by this building permit application.
--------------------------------------------------------
------------------------------
Signature of Owner Date
------ -!%(-_- _ _______________________________, a Owner Authorized
Agent hereby declare that the statements and information on the f egoing application are true and accurate,to the f my knowledge
and belief.
Signed under thgpain$and penalties of perj ry. ' - �w
V� 'l�------------------------------------------------------
-----------------------
Print Name /A
/V( U ----------------- - bta 1--------------------------
--------- ------ ------------------------
Signature o Owner Agent Date
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 N-750 I q75 O J
Frontage
0-0 i t / �
Setbacks Front 30 3�
Side L: (s R: S L: I R: ( � 15
Rear (�
Building Height
Bldg. Square Footage
Open Space Footage %
(Lot area minus bldg&paved
parking)C
#of Parking Spaces S 7fi
Fill:
volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW x 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 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 x
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:
�n Dispartfi nt use
v Northampton Status of lPermit
Q it g Department Curti Cuoveway Perri it .
MAY 2 3 2001 Main Street SewrlSepticAvaltability
om 100 WatertUUeil,Auailaitity _ _- _
ham ton, MA 01060 Two Sets!of Structural.Paris___
BUIl0
OEP10F l
�P 6� 587-1 40 Fax 413-587-1272 P[6� ite Pfans.„-
NORTHAMM N, Other Specify
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: .-)g prx f _y�S / a
t7JX 1yl Map-� ---- Lot-L _L---- Unit_ _-----
AA A- Q 1 OCe Zone------Overlay District_----
Elm St.District----------- ------ CB District__ ----—----
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
i' Ma(�w AAA o 100 a-
-------------------------------
------------------
Name(Print) Current Mailing Address:
---------------------------------- ----------------- Telephone
Signature
2.2 Authorized Agent:
vurt^-�_1
----------------------------------------- ----------------------------------------------
Name(Print) Current Mailing Address:
------------------------------------------------------ ------------------------------------------------------
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building ( � S (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)
This Section For Official Use Only
Date
Building Permit Number:----- Q 77�-1------ Issued:----------------------------------------------
Signature: ---- -------------------------------
------------------------------------------
Building Commissioner/Inspector of Buildings Date
File#BP-2001-0971
APPLICANT/CONTACT PERSON MAHONEY PATRICK&CYNTHIA
ADDRESS/PHONE 28 FOX FARMS RD (413)584-8944 Q
PROPERTY LOCATION 28 FOX FARMS RD
MAP 17A PARCEL 149 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiny,Permit Filled out
Fee Paid 1141Y (A50—
Tvneof Construction: CONSTRUCT 12 X 10 DECK
New Construction
Non Structural interior renovations
Addition to Existing_
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
TH OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § _w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § _w/ZONING BOARD OF APPEALS
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 Co ission Permit from CB Architecture Committe
Z 00
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.
28 FOX FARMS RD BP-2001-0971
GIs#: COMMONWEALTH OF MASSACHUSETTS
C:=:
7k*'149 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Deck Addition BUILDING PERMIT
Permit# BP-2001-0971
Project# JS-2001-1738
Est. Cost: $1250.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor., License:
Use Group:
Lot Size(sq. ft.): 14810.40 Owner. MAHONEY PATRICK&CYNTHIA
Zoning URA Applicant: MAHONEY PATRICK & CYNTHIA
AT.• 28 FOX FARMS RD
Applicant Address: Phone: Insurance:
28 FOX FARMS RD (413) 584-8944 ()
FLO R E N C E MA01062 ISSUED ON:51241010:00:00
TO PERFORM THE FOLLOWING WORK.CONSTRUCT 12 X 10 DECK
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 5/24/010:00:00 1018 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo