43-064 (9) s BP-2004-0047
GIS#: COMMONWEALTH OF MASSACHUSETTS
SitiolAsA64 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0047
Project# 3S-2004-0083
Est.Cost:
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ALBERT HERSH JR 083152
Lot Size(sq.ft.): 15202.44 Owner: JOYCE ROBERT C&VICKI E
Zoning: SR Applicant: ALBERT HERSH JR
AT: 48 DUNPHY DR
Applicant Address: Phone: Insurance:
47 STONERIDGE DR (413) 582-0684
FLORENCEMA01062 ISSUED ON:7118/03 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 12 X 12 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: O_k 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: Receipt No: Date Paid: Check No: Amount:
Building 7/18/03 0:00:00 1061 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File q BP-2004-0047
APPLICANT/CONTACT PERSON ALBERT HERSH JR
ADDRESS/PHONE 47 STONERIDGE DR (413)582-0684
PROPERTY LOCATION 48 DUNPHY DR
MAP 43 PARCEL 064 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid /66/
Typeof Construction: CONSTRUCT 12 X 12 DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 083152
3 sets of Plans/Plot Plan
THE FO OWING 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
9�Permit from Elm Street Commission
� 7�iG/b3
Signature of uildingOffic' 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.
of Northampton S e uebf (ir :a `.
ti o -'al !ylding Department Cu b ai g YR5g40111f -----,11851:-
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` t ( �,�n '"�7.�1 3\12 Main Street Se rt., � .ilfi x_ , -trf,
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'C ro `'-'3 N'pfTTm npton, MA 01060 Tw 41,11i n-Trl`tl7 _ -r =;t
i' x'117 I phone 4': 58711240 Fax 413 587-1272 Plo 7S ti r � - a,
Cy
1 • ONSTRU T, ALTER, REPAIR, RENOVATE OR DEMOLISNCta 8 st .y
A ONE OR 7WW DWELLING
FAMILY DWELLING
SECTION 1 - SITE INFORMATION I
---- This section toile completed b office
1.1 Property_Addre;,s. p �$
1 l g dv h y der fthie k)( Map 'f�i� /'t Lot fO Un,f
{{ Zone. 51�*T Overlay District_.
Elm St. District_ __..._ ... CB District __,
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
12.1 Owner of Record:
,� y fl c -
z z Authorized Agenji q7 ST-oue Kt d?e a1
RL b c k Vie Cc" 1-1
it, , - \O 68_,P•-c(c.
Win- tori
1.SECTIQN 3=ESTIMATED CONSTRUCTION COSTS
mate. Cort (Donors) o El 1 t Official Use Ortly
__._..
completed b,perrn•.t opial no it L..-._--
Lill'tirn, (a) I-mg Fornit Fee
_._--__..— -- ._. —'r
irnzt:d Total Cost of
I rs uct=on fromCC)
3 TN Jo,' rg L -- i Building Permit Fee
c
b Ori i . 2 2, 1- -;) I I th trt Nth -Noir _1/46/
1 AV
This Section For Official Use Only
Building Permit Number Di t(,�( Roo Issued:_
Signature: -
Building,O'ommissioner/Inspector of Buildings Date
I
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size r4:r. �Sf 12-0_
t
Frontage 1 CJ
Setbacks Front (98
'
Side L: lT5i R: g`^/t L: R: �U
Rear 70'
Building Height
Bldg. Square Footage
Open Space Footage
(int area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of D s?
NO DON'T YES
IF YES: enter Book Page .__ and/or
Do ument #
B. Does the site contain a brook, body of water or wetlands? NO V DON'T KNOW
YES
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 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF-YES, describe size, type and location:
SECTIONS-aOE'S i: 0o 3OFPROPOSED.WORK check all a•slicable -
New House ❑ Addition ❑ Replacement Windows Alteration(s) LI Roofing 0
Or Doors 0
Accessory Bldg. 0 Demolition❑rr�� New Signs [ ] Deck V Siding[ ] Other[ ]
Brief Description of Proposed Work: d K \2 ((fl f_(_
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative O Renovating unfinished basement Yes No
Plans Attached Roll o . Sheet
;y IfANM a s llibt a'dtlitin toraigtiiiMibl singsc6in Ie'te'Sftfee1f6Glo iiir:
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- Mascheck 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-CONTRACTORAPPLIES FOR BUILDING PERMIT
I, , as Owner of the subject property
hereby authorizeto a_: on
my behalf, in all matters relates. to work authorized by this buildinng permit application_
Signature of Owner
Owner Date
, 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.
(s\ be(t k-\e1c 1 _
Print me 1 ,/?
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Consjpoctiojn�Supervisor: Not
t} f ty�.`t Not Applicable 0
Name of License Holder '. Pl U(*( k �`{�^ 4� ' \_
License Number
`{7 _St 1•2,e,_ 4;;_c\a/ c c rt _ os 315 o
Addre.v /,,j(.,�j �7 Expiration Date
Signature Telephone 7-1 V^ d,N..+'K-'
8k1: 9C-1EailiGTil"i7d[IT3iSYit" Not Applicable ❑
Company Name Registration Number
A . , HeIt:)t\ C_ O0S-T...`oc1iON/ R - ( --. ?CoS .__.
Addresst Expiration Date
y7 S (C)tJE; 0, , • -F' A. s-, Telephone 3 �'a-ObSL�
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 afiidav,.
will result in the denial of the issuance of the building permit
Signed Affidavit Attached Yes 6 No 0
: - ' ,Olne ..RPYv. . 'x• it pft a
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 he
responsible for all such work perforated 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 pe mit k issued.
Also be advised that with reference to C. rprer tag(Workers' Compensation) and Chapter 153(Liability of Ely'lovers to
Employees for injuries not resulting in Death)of the Massachusetts General laws Annotated, you mar 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 Slate of Massachusetts General Laws Annotated.
Homeowner Signature
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