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17A-062 (6) \ 4 r_.. -. _ N7037' 1„ _ W 709.26' in �. i c• v tl{ n ❑ 30.0' 28.3' CO . oc m remove N O o La / 1 IiN y� CO W. I 50.1' ._ �Qremov ■ m i7.s' 41 CO — M Q® z a 1 r BOOK 7897, PAGE 92 10, 535± SQ. FT. S 80'44'09" E 90.09' BRIDGE ROAD LEGEND O FOUND IRON PIN ■ FOUND STONE BOUND "PROPOSED IMPROVEMENT LOCATION" PLAN OF LAND IN NORTHAMPTON, MASSACHUSETTS PREPARED FOR JOSEPH ANTHONY LAMANNA & ERICA L. LAMANNA SCALE: 1"=20' AUGUST 10, 2016 KeOF \,, j HAROLD L. EATON AND ASSOCIATES, INC. RANE AU_*sit. , REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET — HADLEY — MASSACHUSETTS �\ IZER / x! 413-584-7599 eatonO oLcom413-585-597 (fax) email — hleatont�ool.com 'b sunvC- 0' 20' 40' 60' 243 BRIDGE RD BP-2017-0230 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-062 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT PermitBP-2017-0230 Project JS-2017-000388 Est.Cost:$155000.00 Fee: $1008.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DAVID FORTIER Lot Size(sn. ft.): 30143.52 Owner: LAMANNA JOSEPH ANTHONY&ERICA LAMANNA Zoning:URB(100)/ Applicant: DAVID FORTIER AT: 243 BRIDGE RD Applicant Address: Phone: Insurance: 32 Laurel St (413) 586-8965 NORTHAMPTONMA01060 ISSUED ON.:9/6/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:Demo garage and build new two stall garage with two bedrooms above 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 Sienature: FeeType: Date Paid: Amount: Building 9/6/2016 0:00:00 $1008.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner • 4' "oNI�J� DK File BP-2017-0230 '� APPLICANT/CONTACT PERSON DAVID FORTIER ADDRESS/PHONE 32 Laurel St (413)586-8965 PROPERTY LOCATION 243 BRIDGE RD MAP 17A PARCEL 062 001 ZONE URB(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 TvoeofConstruction: Demo garage and build new two stall garage with two bedrooms above New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: n Owns Planment s/Plot License / v Wei RM T �/ 3 sets of Plans/Plot Plan o 8 9 eG 0pr ,AC ' THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: a/ 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 it from Elm S -- Co ,:. ion TeX I�� 7-4/7K Si r-.Bu"ding to ficial 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 the Office of Planning&Development for more information. ---- - -" Department use only. - .1___ City of Northampton Status of Penult Building Department Curb Cut/Driveway Permit Pik 2 2 23W 212 Main Street Sewer/Septic Availability • Room 100 Water/Well Availability DEPT CF =.:goes Northampton, MA 01060 Two Sets of Structural Plans NORmA61vroN,SP o:wa phore 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 7�///` / !'f SECTION 1 -SITE INFORMATION 4 /7i, 1.1 Property Address: This section to be completed by office a Y3 ! Section 4. ZONING AU 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 C35- Frontage 90 051 Setbacks Front Side G.' 1 R: 1`).� L..AS 12:41 Rear y14,1 do:7 d3 Building Height 'a,7 Bldg. Square Footage IIS/•'C ll ° ICIO41 (Q Open Space Footage y (Lot area minus bldg&paved �9z7,� IQ7 )(o.S tom . parki) #(0f Parking Spaces •• Fill. ._ _,. •. (volume&location) A. Has aS eclat Permit/Variance/Finding ever been issued for/on the site? NO �- DONT KNOW 0 YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES Q IF YES: enter Book ', Page and/or Document#'.. B. Does the site contain a brook, body of water or wetlands? NO *1$ DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 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 common plan that will disturb over 1 acre, YES O NO cR IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition [a Replacement Windows Alteration(s) ri Roofing L✓II Or Doors O '4' Accessory Bldg. ❑ Demolition ❑ New Signs ID] Decks [C Min [ I Other(0] Brief Description of Proposed N451E4..'Ad4Rv tt 2415 F1474, II Work: 10 OW MO .9 SSRv 40.7,o[Pim OFF Msi of bcwsTi:y(., 1fe t 'QALAig+e0.£c2Cuf lsr'L'— Alteration of existing bedroom X Yes No Adding new bedroom / Yes No Attached Narrative Renovating unfinished basement Yes be No Plans Attached Roll -Sheet ea. If New house and or addition to existing housing, complete the following: a. Use of building: One Family DL- 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. 9010 $,F. Dimensions 300540.1 w.PtilCyc; tke &q.5 p rVAN e. Number of stories? yl- n f. Method of heating? Fa P.,454.6a •.. r /•( Fireplaces or Woodstoves Number of each_ g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction $j IGC rziMt. i. Is construction within 100 ft. of wetlands? Yes SL. No. Is construction within 100 yr. floodplain Yes t! No j. Depth of basement or cellar floor below finished grade CF -UL S4IC k. Will building conform to the Building and Zoning regulations? e Yes No. I. Septic Tank City Sewer >[ Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR � LI APPLIES �FOR BUILDING PERMIT I. tusk. - J4- ,as Owner of the subject property T �r / ��.�7Q^ hereby a - D4v"O / �>fr le,l to act• ehalf, ' all matters/. alive to work authorized by this building permit application. • R -- ?la 5"/C Sig ure of• ner Date /�•qCO-I, 'J ✓i 1 FA.71 C/), }s wRer/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. OAUfn koiC]ln— Print Na iat OW9)2' IIR Signature of Owner/Agent le SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not ApplicableeEEeqr Name of License Holder: 1/r'� in sDitE9._. CB .aOODuate. License Number Lau, C%. V&CifAAPLi�) - O(eu° 4 (o 140$ Add ss Expirbation plate 16—1V--13ici Signal I Telephone 9.Registered Home Improvement Contractor: Not Applicable £ On"" Pctr(ytJLS t03 1611 Company Name Registration Number '4/0 IOoif AddressExpiratibn Dae 9.14'x- Ak�Nf11PONAoo&t Telephone ‘04" -SS 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..CE No £ 11. — Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) or hvo(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 faun structures.A person who constructs more than one home in a two-year period.shall nK be cons'rtdered a homeowner_ Such"homeowner"shall submit to the Building Official,on a form acceptable to the Bitridibg 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 reguired,frotn 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 esulting in Ddath)of the Massachusetts General Laws Annotated,Vou'mav be liable'fof`'petson(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 __ The Commonwealth of Massachusetts IT ---= Department of Industrial Accidents !t Tpy± Office of Investigations : 'kj 600 Washington Street , ,er+ Boston, MA 02111 v " s. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /� Please Print Legibly Name (Business/Organization/Individual): OM C fti2T(KZ 3 C'(Liege5 Address: 30 NAIL VI, City/State/Zip: 10021:114 firatii/ (i,A }. O/l)f,O Phone #: t1 0 -0'''t a'339 q Are you an employer? Check the appropriate box: Type of project(required): I.R.I am a employer with �{' 4. ❑ I am a general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction listed on the attached sheet. 7. ® Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g. V Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.t 9. Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box al must also fill out the section below showing their workers'compensation policy information. tHo meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and slate whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. l am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �, Insurance Company Name: 0 tit 6 SEe'pQ t TY - Policy#or Self-ins. Lie. #: )' WS 5—9-)„I$sr's-- Expiration Date: `1/'/ I,Q�NO7t' eke('Job Site Address: 9: 5 ,KJ). City/State/Zip: f—[O,D iini ) Pitt oemr t 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 $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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerllfyyrnder the pains and penalties of perjury that the information provided above is true and correct Signature: fdl°A-�j✓f/JyV,/,{vL/ Date: glizal(fI Phone#: 1 f 3 - a 8"0 - 3 399. Official use only. Do not write in this area, to be completed by city or town official City or'Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: City of Northampton ayorr-Err- sus 1 `¢ Massachusetts * r q 4 `I DEPARTMENT OF BUILDING INSPECTIONS B ? IT 'I 212 Main Street • Municipal Building fNorthampton, MA 01060 rr tC.' INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION 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 any 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 occupancy until the work can be inspected. 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 I, 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 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. (9)41 A� Address of the work: ,9-N2(a G& /Q0 The debris will be transported by: &✓fa `t,j y� The debris will be received by: /1fcLgy &Cva tki Building permit number: Name of Permit Applicant t0`i-ert2Ti{2 e6frallit r, Date Signature of Permit Applicant I i' II i j .a'� 00C cl a ja- r- , �. is 'r' �t 1 `790hh t'' . i�3 „h? �1 ,�rQJd '.� tamyn�3U o� / Q1_ed ell q�,tyuc-a 4 - IFS s5� 'ctl ab r6 '— ili ffkt �a1:t . i 1 ti oncab9 <�Ub{ u) ..ti td, - �� narrt;5i \ 'asp- ' '., '` M --_s h i I (4-1;15 15 f 0,45 L„/Ss..___x ,, r ACC01213 CERTIFICATE OF LIABILITY INSURANCE OATE v25(M�oi6Y THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Nouse NAME: Ring 6 CuelAvan Inc. %uP Ern. (913)584-5610 ,Npy uvlsM-93zz F.O. Box 447 EawIL _.._._.. ADDRESS: 176 Rin Street Ring WSURHgSIAFFORgXD COVERAGE MMCt Northampton NA 01061 INSURER A:Oh3O SecuritY Insurance Co. 29082 _ INSURED INSURERa Safety Indemnity Insurance Company 33618 David Fortier Builders INSURER C: 32 Laurel St IxsMER o: INSURER E Northampton sa 01060 INSURER F COVERAGES CERTIFICATE NUMBER.'CD1642501438 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMPS SHOWN MAY HAVE BEEN REDUCED BY PAID MAWS. TNS POUCY EFF POLICY IMP LTR TYPE OF INSURANCE ' N D L9y0 POLICY NUMBER IMMG4NYTYYI IMINDON YY1 UMTS X COMMERCIAL GENERAL LUBILm EACH OCCURRENCE 1,000,000 I DAMAGE 300.000CLAIMS-MADE OCCUR PREMISES(Es o wra) MC555722O25 12/2/2015 12/2/2016 MED ESP INy 403241430 15,000 PERSONAL&ACV INJURY 1,000,000 GENT N'1.BrGATIELIMIT APPLES PER j GENERAL AGGREGATE 2,000,000 ) X POLICY Co-T LOC PRODUCTS-CCMP/OP AGO 2,000,000 OTHER. (Expense Mod Fader I --. .. AUTOMOBILE LIABILITY COMBINED SINGE LIMIT 1,000,000 _.. (Fa salient) B ANY AUTO BODILY INJURY(Pee per400 ALL OWNEDSCHEDULED AUTOS X AUTOS 6225303 10/8/2015 10/8/2016 BODILY INJURY(Per awtlatl) X HIRED MUGS v HON-0NNED PROPERTY DAMAGE AUTOS (Per extleoD uawred emu Bl spit lim* 100,000 UMBRELLA LIAR _ OCCUR EACH OCCURRENCE EXCESS IAB CLAMS-MADE AGGREGATE DED RETENTION WORMERS COMPENSATION PElI j0T1i AND EMPLOYERS'LIABILITY Y/N -.-STAWTE ER _ Fl pRopRETOR/PARI CERO ECUTIP£ N/Ai, EL EACH ACCIDENT 100,000 A IMyrensMain SRO OF OPERATIONS Mb* EL DISEASE- yO I MS55722835 9/4/2015 9/1/2016 EL DISEASE_FA EMPLOYEE 100,000 DE 'SCONPOLICY MOT 500,000 DE6LRBilOX OF OPERATIONS/LOCATIONS/VEHICLES IACOROlp1,pAatlowl Remarks Schedule,may be Mh[N6 If MOM aqw hreptlrtEl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POIJCES BE CANCELLED BEFORE City of Northampton THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN 210 Main St, ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUMORlgD REPRESENTATIVE ,u ® � s reser 198 �C 8•�� ORPORATION. All rightsrese_2 Bd. ACORD 25(2014107) The ACORD name and logo are registered marks of ACORD • ( • , e . INS025(201401)