31B-005 (7) b
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
ConStruciIon Su ervi;or i &2',Farm—m
License: CSFA-047146
�e:rte,IS
MARK F
231 W]BAWLEY iD Iwo'
Charkmont MA i133TV
JI I� Expiration
Commissioner 02/0912017
s
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Cgfltragtor Registration
Registration: 101536
Type: Private Corporation
I r =7- 1 !
Expiration: 6/26/2016 Tr# 254208
WRIGHT BUILDERS, INC. ? .
Jonathan Wrightm_ =;+ !1
48 BATES STREET
Northampton, MA 01060
Update Address and return card.Mark reason for change.
Address [] Renewal Employment Lost Card
scA 1 v 20"5111
Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Wegistration: d9�536 Type: Office of Consumer Affairs and Business Regulation
piration: Private Corporation 10 Park Plaza-Suite 5170
Boston,MA 02116
WRIGHT BUILDERS,.J,
Jonathan Wright
'� f c
48 BATES STREET
Northampton,MA 01060 -r" Undersecretary a' hout signature
f
s
y
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: (j,�� i CC
The debris will be transported by: C
The debris will be received by: t Ce tr-\i�
Building permit number:
Name of Permit Applicant �(�� �I ►�a
Date Signature of Permit Applicant
t
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Y ' C S
License Number
AA
Address Expiration Dat
Signature Telephone
9.Realstered Home Improvement Contractor: Not Applicable ❑
Y) 10155 Co
Company lame Registration umber
dress Expiration D to
� � '�; � n\0(0c) Telephone � � �u
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6))
Workers Compensation Insurance affidavi ust be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the build' g 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 and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
T
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ED" Roofing ❑
Or Doors E] I i
Accessory Bldg:' ❑ Demolition ❑ New Signs [0] Decks [p Siding[0] Other[d]
Brief Description of Proposed
Work: e D' (x �Cz; c i�� i - IL?-Y71 W hC i
Alteration of existing bedroom Yes ZNo 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 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. 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 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
t-4 ZZ'� —' - 1� as Owner of the subject
property
hereby authorize
to act orgy behalf in fnatters rela' e to work authorized by this building permit application.
SignaLue. wner Date
I, K w s( � j as Owner uthorized
Age hereby declare that a statemen and inf mation on the foregoing application are true and accurate,to the best of my knowledge
ahinelief.
Signed under the pains and penalties of perjury.
a J L
Print Name
I �Cl
Signature of Owner/Agent Date
r
-� l,�('��!! --�-c� Vie... I v1 -�-Xis�� �c�' `n�•
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Du o Incomplete Information
Existing Proposed Required by Zoning
This column to be filled i
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
parking)
#of Parking Sac
Fill•
ume&Location
A. Has a Special Permit/Variance/Finding r been issued for/on the site?
NO ® DONT KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO o DONT KNOW 0 YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO er",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:
C. Do any signs exist on the property? YES 0 NO ICJ
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, exca ation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
1 r
Department use only
RECEIVED City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
NOV - 5 2M 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
DEPT CP K!,«, ;r F'ccTIONS orthampton, MA 01060 Two Sets of Structural Plans
NoF:r".•,' P,,f, ne 41 -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 by office
Map �, _ Lot 0 015 Unit
l/ Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: r
,Ahk—tea ► �vt•��i Cool ,�I `C�(
Name-(Print) n Current Mailing Address-
Telephone / �
1KJ------, � I✓
Tlh
Sig tur
2.2 Authorized Agent:
L I? �� u 1�Jt zot Viers �_ {Qs�r��
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 ( Q " C 0 (a)Building Permit Fee
2. Electrical ( Nf� Ot (b)Estimated Total Cost of
1yiu Construction from 6
3. Plumbing (] q pZ Building Permit Fee
4. Mechanical(HVAC) �!S
5. Fire Protection !'/
6. Total= 0 +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-2016-0637
APPLICANT/CONTACT PERSON WRIGHT BUILDERS
ADDRESS/PHONE 48 Bates St NORTHAMPTON01060(413)586-8287(116)
PROPERTY LOCATION 83 ROUND HILL RD
MAP 31B PARCEL 005 001 ZONE URC(100)
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: RENOVATE FOYER,PWDER RM,2ND FLR BATH&REPLACEMENT STORM
WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildiny,Plans Included:
Owner/Statement or License 047146 JWL ,T,� C
3 sets of Plans/Plot Plan �/C��
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORI IATION PRESENTED:
pproved 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
Sig a of uil in icial 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.
83 ROUND HILL RD BP-2016-0637
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 3 1 B-005 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit# BP-2016-0637
Proiect# JS-2016-001058
Est.Cost: $53236.00
Fee: $351.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WRIGHT BUILDERS 047146
Lot Size(sq. ft): 62290.80 Owner: ELIZABETH FRASER BENNETT
Zoning: URC(100)/ Applicant: WRIGHT BUILDERS
AT. 83 ROUND HILL RD
Applicant Address: Phone: Insurance:
48 Bates St (413) 586-8287 (116) Workers Compensation
N O RTHAM PTO N MA01060 ISSUED ON:111912015 0:00:00
TO PERFORM THE FOLLOWING WORK.-RENOVATE FOYER,PWDER RM,2ND FLR BATH
& REPLACEMENT STORM WINDOWS
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 Siinature:
FeeType: Date Paid: Amount:
Building 11/9/2015 0:00:00 $351.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner