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31B-085 (5) 65 HENSHAW AVE BP-2017-1329 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31B-085 CITY OF NORTHAMPTON Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2017-1329 Project# JS-2017-002200 Est. Cost: $150000.00 Fee: $975.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ALDER CONSTRUCTION INC 071067 Lot Size(sci. ft.): 5662.80 Owner: SCOTT JACQUELINE L& RICARDO B METZ Zoning: URC(I00)/ Applicant: ALDER CONSTRUCTION INC AT: 65 HENSHAW AVE Applicant Address: Phone: Insurance: 35 JEFFERY LANE (508) 246-4533 WC AM H ER5TMA01002 ISSUED ON:5/23/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:RENOVATE KITCHEN, POWDER ROOM, BASEMENT STAIRS, NEW DECK ENCLOSE PORCH 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: Housed 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 Signature: FeeTvpe: Date Paid: Amount: Building 5/23/2017 0:00:00 $975.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner gLaS .p�flri Filed BP-2017-1329 DL� APPLICANT/CONTACT PERSON ALDER CONSTRUCTION INC (5✓;E ttF.t� ADDRESS/PHONE 35 JEFFERY LANE AMHERST (508)246-4533 PROPERTY LOCATION 65 HENSHAW AVE MAP 316 PARCEL 085 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST . CLOSED REQUIRED DATE ZONING FORM FILLED OUT (16Fee Paid 6 Building Permit Filled out at Fee Paid T peof Construction: RENOVATE KITCHE , •u WDER ROOM, BASEMENT STAIRS,NEW DECK ENCLOSE PORCH New Construction Non Structural interior renovations Addition to Existing use) 45 , s—rri� -Coif cafe Accessory Structure Building Plans Included: Owner/Statement or License 071067 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9RMATION 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 Permit from Elm Street Commission Permit DPW Storm Water Management jet 21.1orac.r 4 4114111" 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. 4 t "-' RECEr :\t - City of Northampton '` Building Department ` , MAY 1 6 ?r 212 Main Street » = Room 100 r» _ L_ Northampton, MA 01060 n .,, phone! 413-587-1240 413-587-1240 Fax 413-587-1272 V-411:i4a,V1W'-11-11iiitcl.57)-415:itrreeftirtif 244' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: Thissection to be co/ �d m�ple by�office Map 3/6 Lot V Unit 1 ,, _C) Zone Overlay District �1 Gs L t ��5`t t - fie- Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: i..� .L.. (,5- t-IGv, S1ngJ2, {}J f_ ')c� �i7 e. `�-.r. Scaill (Akcc.Cc�'� i1 \e.1C, l‘ lc5r'TV`<=0 /1n.ek >� Wlc, Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: /� yy Cr�.1 t� � �Gf{ee_L-1 t / Ivl \ Name(Print) Current Mailing Address: coo - - ( 1f 33 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1 Building , ( c S C)C3 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Cri (90a Construction from(6) 3 Plumbing OO Building Permit' Fee 4. Mechanical(HVAC) ` A°�/�/ 5. Ere Protection // S—(20 6. Total=(1 +2+3+4+5) A. ( S--Q, Q, Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING All 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 Frontage _. • _ _.. Setbacks Front Side L R:-._ L: Rear 1 Building Height - - Bldg. Square Footage Open Space Footage - (Lotareaminusbldg&paved parking) #of Parking Spaces - ---- --- Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW a YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO (3 DONT KNOW O YES O IF YES: enter Book Page: and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW (3 YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained Q , Date Issued: C. Do any signs exist on the property? YES O NO g- IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO (73 IF YES, describe size, type and location: E. WII 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 © NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. a SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Wjndows Alteration(s) Roofing ❑ or Doors ELI Accessory Bldg. ❑ Demolition ❑ New Signs 101 Decks [ET Siding[211 Other[0] Brief Description vl o(Pmpgsed 1c�c / dcr ( %,� scmQ4 _i4, /v€ deck Work: �¢✓toVa r l ST c f e clox boa k. Alterationofexisting bedroom Yes - No Adding newn bedroom Yes No Attached Narrative ml� �' Renovating unfinished basement Yes No Plans Attached Roll -Sheets-'«-J Ba.If New house=a'ntkoraddition to sl- intthousina com`dfie-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 belowfinished 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 OORI�vt/CONTRACTOR APPLIES FOR BUILDING PERMIT Q/ V 11 I, J t ,as Owner of the subject property ,/�t r o Al(t1 1^/ r�,y� ��.r�1,r (�-/7'}r hereby authorize 3 e •M/v CA',Iu\ / / ` • "L ' y ' '^r ' • ttli bt to act o my behalf, in all rc otters relativ- to work authorized by this building permit application. Lr A. (.Ii ' S/9 /Zon- Signat r of 3 Date I, —2xucZ 'CX A M8ar re,v1/44 ran\abwrrer/Authanzed Agent hereby dedare 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 penaltiespof perjury. (`l9 CL l_ 2 '1"IN. r Print Nameet C1 Signature of Owner/Agent Date J ( SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: CoNot Applicable £ Name of License Holder: 6 c•1/4...)c c C •nt rt-1 • License Number 3,c 5C(1(`Cr-n Lc--”Nc C-5 - 6`7 Address Expiration Date A;,v( c�s oto0Z St6it, Signature `/t Telephone rot 6- S-3 / 1' CCc'�crco& cots+, 9:RectisterectHome lmpravementtonlradtor. , ''f Not Applicable E Company Name Registration Number Ft-fdcr +ruc torn . i 830 Address Expiration Date 3 � —S—effCi0.dN6Telephone m6 L 33 *iaLttimE !Met Cr too? SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(60 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 £ No £ «-x�tl llC QWnerIxet jt u 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,yon 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 The Commonwealth of Massachusetts pp— Department of Industrial Accidents _. .W! ; Office of Investigations —^'Mid 600 Washington Street fin= Boston, MA 02111 T�yti: www.mass.govfdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information , Please Print Legibly y,� Name (Business/Organization/Individual): r v A--e- Cm•n$ ,r}k8„ _ Address: -2,‹ """Se cci`e C-c,,,...e City/State/Zip: A-w.\ v'St- Vvt#% Phone#: C-011 - Zs-\6—ck5"')3 Are you an employer?Check the appropriate )ox: Type of project(required): 1.❑ I am a employer with 4, m I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [Z(Remodeting ship and have no employees These sub-contractors have g, 9 Demolition working for me in.any capacity. employees and have workers' caro insurance.: 9. 9 Building addition [No workers' comp. insurance p required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.9 I am a homeowner doing all work officers have exercised their 11.9 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MOL 12.9 Roof repairs insurance required.] r c. 152, §1(4),and we have no employees. [No workers' 13.0 Other,,,,,,,,, comp.insurance required.] 'Any applicant that checks bax ul must also fill out the section below showing their workers'compensation policy information, tHo meownern who submit this affidavit indicating they are doing all work and then hire outside contactors must submit a new affidavit indicating such. teontractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subconnactms have employees,they must provide their workers'camp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: cApeA es-04, Co I, tet,vl jyes r. Policy#or Self-ins.Lie. #: Expiration Date: Job Site Address: City/State/Zip: 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 MOL 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 hrvestigations of the DIA for insurance coverage verification_ I do hereby certify under the pains and penal ' s of perjury that the information provided above is true and correct. , Signature: �� re: .,1 Date: l c } t/I �ro �1 t Phone#: (L Official use only. Do not write in this area, to be completed by city or town official City or Town: PermittLicense# 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 ?, Massachusetts was" - c), c p DEPARTMENT OP BUILDING INSPECTIONS Z Y m 212 Main Street • Municipal Building \��✓) Northampton, MA 01060 SSyr W'J\'\ec. 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 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. Address of the work: L-te tiSkck -ke_ LoC$\ecw, 9t9A tMy , The debris will be transported by: iw SC,owA1 c' U-, The debris will be received by: Building permit number: Name of Permit Applicant 4�foce,C'm$k( A-1 c C'CVSfi v Date Signature of Permit Applicant 5/162017 City of Northampton Mail-65 Henshaw Ave \ `a fl Louis Hasbrouck<lhasbrouck@northamptonma.gov> 65 Henshaw Ave 1 message Louis Hasbrouck <Ihasbrouck@northamptonma.gov> Thu, May 18, 2017 at 4:21 PM To: adlerco@comcast.net Bruce, We need a plot plan showing the lot and setbacks for the existing house and the proposed deck, with distances to property lines shown. Zoning setbacks are 10'front, 10'side and 10'rear. We can't review the project without that information. See attached. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413) 587-1240 office (413) 587-1272 fax wi 65 Henshaw plot plan.pdf 153K htlps.//mail.google.com/mail/ca/a/0/pui=2&Ik=ec5f19a57e8view=pt8search=sent8Uv15c1d38e2b5979688sim1=15cid38e2b597968 1/1 65 Henshaw Avenue ON Northampton MA 01060 -r- mit1 _=i ' 0 IM-m Alt Z I 7 ..4 I 91 1 I 1` I I ,. — k S 's n o E. n F , to rT- 7 Cm a - ne0:441 DATE. 204 7.O 18 DRAWN BY. s 65 HENSHAW AVENUE Nco�rumr sco**.Ain NORTHEAST QUADRANT _-- .I NOHTHAMPiON,MA Wali leen Licensergrnawa: SITE PLAN la<Luelne��l@emellmm SPAR'NC C51