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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
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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
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198 �C 8•�� ORPORATION. All rightsrese_2 Bd.
ACORD 25(2014107) The ACORD name and logo are registered marks of ACORD • ( •
, e .
INS025(201401)