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17A-228 (2) ..< :,,. � ,.z,:�.., .- - . . _.. _ ; .,. . .., 4 J `. .. ... � _ .- � �- - t-. ,. 1 4�} �� Northampton, MA Property Detail Page 2 of 2 Additional Features: Basement One Story Frame Half Story Brick Trim: 0 X 0 Frame Stone Trim: 0 X 0 One Story Frame Remodeling Data: Open Frame Porch Year Remodeled: 0 Concrete or Masonary Patio Kitchen Remodeled (Y/N): Bath Remodeled (Y/N): Land Data Outbuilding Info Square Foot Type Utilities Type F Qt Value no Prime information Site 18,563 141,600 Type Qty Year Size 1 Size2 Grd Cond RS1 1� 1950 I I 120 ©� Acreage Type Street/Road Type Acres Value no no information information Sales Info Permit Info Date Type IVali dity Date 1 Permit # Price Purpose 05/30/2006 Bldg 207,000 A no information http://www.northamptonassessor.us/noho/propertydetail.php?map_no=l7A-228-001&page... 6/30/2008 Northampton, MA Property Detail Page 1 of 2 City OIL Northampton, MA: Residential Property Record Card New Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map-Block-Lot: 17A-228-001 Zoning: Assessment: Location: 105 LAKE ST Neigborhood: 5 Land: 1 z #Living Units: 1 Deed Book: 8732 Building: 1 Class: R-101 Deed Page: 321 Total: 2( Dwelling Information F Building Sketch Style: Col/Gam Year Built: 1950 Story Height: 1.5 Attic: None Basement: Full 23 Total Rooms: 6 Bedrooms: 3 13 Cone Patio 29g Full Baths: 1 Half Baths: 1 33 Exterior Walls: Frame 1 1 Fr Unfinished Area: 0 120 12 Ground Floor Area: 924 28 1 SFr#0 Total Living Area: 1737 g2� Finished Basement Living 0 X 0 Area: Basement Recreation Area: 0 X 0 Woodburning Fireplace 0/0 s Stacks/Openings: c s Metal Fireplace 0/0 Stacks/Openings: Heat/Central A/C: Basic Heating System: Hot Water Fuel Type: Oil Quality Grade: C Addition Information: Physical Condition: Average Interior/Exterior: Same Condition/Desirability/Utility: AV Lower 1 st Story 2nd Story 3 Vacant/Dwell/Oby Status: Dwelling St http://www.northamptonassessor.us/noho/propertydetail.php?map_no=l7A-228-001&page... 6/30/2008 HOME OWNER EXE IYIPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. 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 building department for the City of Northampton wants 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 occupanev until the work can be insuected. 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 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 _ 1 ho Conztnonwealth of Mrssacntcsetts Depar nment of :z zcsrria�:�ccidera Qr�i:i'eszi -az—F''.S J 600 TYashing ton Srreez — Boston,!tip=? 02111 x�'n�.tnass.goi'/dia `Yorkers' Compensation Insurance Affidavit Builders,/Con tractorsiElectricians,'P!umbers AI,T)Iicant Tnforniation PIease Print Legibly ?=3 - (Busines;'Organ:zal3on Individual,): address: City:%State/Zip: Phone T: Are you an employer?Check the appropriate box: Type of project(required): i.❑ I an a e-npIoyer with 4. ❑ I am a general contractor and I employees (full and/or part-time). have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or parmer- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp. insurance comp. insurance.+ requ red.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.(�] I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.7 Roof repairs insurance required.] C. 1=2, §1(4), and we have no employees. [No workers' 1..❑ Other I comp.insurance required.] 'Any appiicant that checks box=1 must also fill out the section below showing their workers'compensation policy inforration. Homeowners who submt this affidavit indicating they are doing all work and then hire outside contractors trust submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of tae sub-contractors and state whether or not those entities have e rzaloye s. If the sub-contractors have employees,they must provide their worke s'comp.policy number. I am an employer that is providZu workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name Policy:=or Self-ins.Lic.ir: Expiration Date: Job Site Address: City/State,/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S2 50.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Inver igatiors of the DLA for insurance coverage verification. I do hereby certify tender the pains and penalties of perjury that the in,ormation provided above is true and correct. �ianatur° = _� vy� Date: Phone=`- JICial LISe OIZII'. Do not write in this area, to be completed by city or town ojjiciaL Cin,or Town: Permit/License r Issuing Authorirt-(circle one): 1.Beard of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone SECTION S-CONS i RUCTION SERVICES g cons d Construction SuoerAscr I Not Applicable ❑ Name of License Holder: License Number ;ddress Expiration Date Signature Telephone I L Refi stered Home lmproyeriient Contractor---. Not Applicable ❑ .omoanv Name Registration Number .ddress Expiration Date Telephone ECTION 1:0-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M G.L.c.152,§:25C(6j) corkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result the denial of the issuance of the building permit. fined 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.CNIR 780. Sixth Edition Section 1033.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which helshe 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 hershe shall be responsible for all such work performed under the buildinz hermit. 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 15' (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,von 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. 1 Homeowner Signature SECTION b-DESCRIPTION OF PROPOSEC WORK(check all aoolicabie) New Hiouse F7 Addition Replacement Windows Alteration(s) F I Roofing Or Doors Accessory Bldg. Demolition I New Signs [p] Decks [177. Siding Other[pl Brief Desc:iption of Proposed Work: X a L3 Alteration of existinc bedroom Yes No Adding new bedroom Yes No Atlached Narrative y Ranovatine unfinished basement Yes Nc Plans Attached Roil -Sheet sa. If Ne w house acrd ar addi ion-to'exis ing 'Gornatet+'the faI[awina a. Use of building : One Family Two Family Other b. Number cf 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 Waadstoves 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. fieodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning reguiatiens? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER_AUTNQRIZATION. Tt BE COMPLETED==WFIEN OWNERS AGENT OR'C014TR4CTOR'APPL}E FOR BUILIIINGPFi?M]T i as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date i as Owner/A.uthcnzed Agent hereby declare that the sta*emerts and information on the forgoing application are true and accurate, to the best cf my knowledge and belief. Sigred under the pairs and penalties of perury. i =nnt Blame .�cr2t�r of�wne%'gent aT� i i i Section 4. ZONING I All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning I This column to be filled in by Building Department Lot Size Frontage Setbacks Front /► _._. Side L: ..__._ R _.._ _ L R _ Rear Building Height Bldg. Square Footage __....__ % Open Space Footage % _. (Lot area minus bldg&paved ---- narldne) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 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 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued:m� C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 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 con itnui plan that will disturb over 1 acre? YES 0 NO 9, IF YES,then a Northampton Storm VVater Mgnagemenf-Peimif from the DPW is required. Department use only * Ctt�x T Nor�f amnion Status of Permit- Ruilt�� peraCimeni Curb Gut/Drfveway Permit 2'J2 M ' n st eel sewer/Septic.AuailabiIity -3Roor 100 WaterlWelfAvailability " Mr. 01060 Two Sets of Structural Plans phor ,4? 8/-120 fax 413-587-1212 Ptot/Ste Plans. v Other Specify AR�TION 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: O J!-' I,C"_� nrz�wzlz� Map Lot Unit Ca`4 Zone Overlay District Elnt St District CS District SECTION 2—PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 7"i\c1 Y �*A Name(Print) Current Mailing Address: 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 a Bui7din Permit Fee 1. Building I O 9 _ 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) ' a C7, Check Number This Section For Official Use Only Date Building Permit Number Issued: Signature: Building CommissianeTtospeVto�_or w arngs° �' Gate File#BP-2009-0002 APPLICANT/CONTACT PERSON RIDEOUT SARAH ADDRESS/PHONE 105 LAKE ST FLORENCE (413)584-6796 Q PROPERTY LOCATION 105 LAKE ST MAP 17A PARCEL 228 001 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: CONSTRUCT 16 X 28 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 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 Commission Permit DPW Storm Water Management Demolition Delay 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. BP-2009-0002 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2009-0002 Project# JS-2009-000003 Est. Cost: $2000.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Groin Homeowner as Contractor Lot Size(sq. ft.): 18556.56 Owner: RIDEOUT SARAH Zoning:URB Applicant: RIDEOUT SARAH AT. 105 LAKE ST Applicant Address: Phone: Insurance: 105 LAKE ST (413) 584-6796 (� FLORENCEMA01062 ISSUED ON:711412008 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 16 X 28 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 7/14/2008 0:00:00 $100.00148 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo