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16B-001 (43)
41 MARK WARNER DR-20 BRIDGE RD BP-2017-0121 Gls#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 16B-001 CITY OF NORTHAMPTON Lot -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MOL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2017-0121 Project it JS-2017-000205 Est.Cost:$33200.00 Fee:$215.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: STEPHEN D ROSS 079160 Lot Siae(sq, ft.): 1296345.60 Owner: EISENBERG MARCY Zoning: SRIURA/WSP Applicant: STEPHEN D ROSS AT: 41 MARK WARNER DR- 20 BRIDGE RD Applicant Address: Phone: Insurance: 36 SERVICE CENTER RD (413) 584-1224 () WC NORTHAMPTONMAO1 050 ISSUED ON:81I12016 0:00:00 TO PERFORM THE FOLLOWING WORK:RENOVATE KITCHEN & MASTER BEDROOM, 2 BEDROOM 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: 00=7: 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: FeeTene: Date Paid: Amount: Building 8/1/2016 0:00:00 $215.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File# BP-2017-0121 APPLICANT/CONTACT PERSON STEPHEN D ROSS ADDRESS/PHONE 36 SERVICE CENTER RD NORTHAMPTON01060(413)584-1224 Q PROPERTY LOCATION 41 MARK WARNER DR-20 BRIDGE RD MAP I6B PARCEL 001 001 ZONE SR/URA/WSP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT 99 ��// Fee Paid LYPa/S Building Permit Filled out Fee Paid Typeof Construction: RENOVATE KITCHEN&MASTER BEDROOM.2 BEDROOM WINDOWS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 079160 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: _ A proved 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 D • o . ': a' ay 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. Department use only RECEIVED City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit k JUL 2 8 2016 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability or auivaeswsvrGpora �70tttlamptan, MA 01060 Two Sets of Structural Plans NOmHAMFI'QN,MAOfQNDne 4 3-587-1240 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#NFORMATION 1.1 Property Address: /T/his section to be completed by office tZo $t'1Aeec P-oA4 VJtT A-I Map /t33 Lot D Unit tv 0 g-r AAA PTO Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: fivcc.ct 5n/61 Name(Print) ,,,,jjj Current Mailing Address: Telephone in-- / ? 7 O Signatu 2.2 Authorized Anent: �T PN N b . ¢065 aJ'U c a/ate. 3GW S vtr CT'. gottl, NcV-tKMt� Name(Pri ,,,_ ` _ i Current Mailing Address:ig n u Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building Zr,.rj 062°r tc. (a)Building Permit Fee 2. Electrical a Udo e..' (b) Estimated Total Cost of Construction from(6) 3. Plumbing r/ g e) 'c' Building Permit Fee q.,( 4. Mechanical(HVAC) l 5.Fire Protection — ♦1if6. Total=(1 +2+3+q+5) -( -'j/ Zr/d-°L'CheCk Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissionedlnspector of Buildings Date SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ® Roofing ❑ Or Doors 1� Accessory Bldg. ❑ Demolition ❑ New Signs [DI Decks [q Siding[C) Other rn Brief Descri tion of Proposed IS/TeX-40R Pt;nknItRioNh: Work: 12 ...÷ OVAt'E- Y-ITr-e‘Valy , z,41 ttA6-r Tet¢Cc.1-4I z WIOD KWh (3 BelbRmrR Alteration of existing bedroom J< 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 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 y" I, 1APC.`( t.t' t'-u 7Ek=Ca as Owner of the subject property hereby authorize empF\ 'A. mes c eaJEeikL COA VC'cCTO to -et on my behalf,in matters relative to work authorized by this building permit application. 2_" 1S' Si•natu - d Owner t Date tp f\ b • W&5 ..QC--?AL coNTeAc-ToQ. .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. Signed under the pains and penalties of perjury. 4Teel-WEta b. g055 Print Name 7 ? ,07 gnat of Owner/Agent Date Section 4. ZONING Att information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be tilled in by Building Department Lot Size P/6` sA�I Frontage N it S M6 Setbacks Front Side L: ft: L: R: Rear N a cFV k'aE. Building Height NO cNANK.E Bldg. Square Footage % N O CNAAjc.E Open Space Footage "o (Lot area minus blag&paved NO C4 A N G.E. parking) 4 of Parking Spaces NO OMAN>~E Fill: NONE , (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW t YES O IF YES: enter Book Page and/or DocumentI B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW © YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES Q NO i s 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 03 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading, excavation, or filling)over I acre or is it part of a common plan that will disturb over 1 acre? YES d NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable^70 Name of License Birder eTE4 �-N kwb. &5 r1 _ 1( (.,t License Number 36 GiE(2-oIce ceArk-- k' Fc s,t) h.entiAmeTevy� 2lr 1 Address Expiration Date. 4kg " 5g4 . i2zA Signature Telephone _ (i !/ S.RAM, Home Improvement Contractor: Not Applicable CI Q}\at-) D - e064 G{=hJE /[t,. CCJ VTP1CTOR 15z) (J 1 Company Name Registration Number 36, ee,RVI are GE JT6f- Ro4D S/ G, ! /g Address Expirati n Date $JOL'TkkAMePTO/J Telephone X54 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 O No 0 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied.Dwcilin&s of one(I) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,grovided that the owner acts as supervisor.CMR780. Sixth Edition Section 101.3.5.1. 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 ander 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 persons) 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__ _