25C-200 (7) 2 LINDEN ST BP-2020-0207
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C-200 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Deck BUILDING PERMIT
Permit# BP-2020-0207
Proiect# JS-2020-000348
Est.Cost:$1010000.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: DAMIEN MCNALLY 88874
Lot Size(sq. ft.): 6969.60 Owner: MCNALLY DAMIEN T&KIMBERLY A SOBIESKI
Zoning_URC(100)/ Applicant: DAMIEN MCNALLY
AT. 2 LINDEN ST
Applicant Address: Phone: Insurance:
170 LOCKE HILL RD (978)467-7667 ()
WENDELLMA01379 ISSUED ON.8/22/2019 0:00:00
TO PERFORM THE FOLLOWING WORK:REPAIR 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: 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 Si_Jnaturc•
FeeTyipe: Date Paid: Amount:
Building 8/22/2019 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2020-0207
APPLICANT/CONTACT PERSON DAMIEN MCNALLY
ADDRESS/PHONE 170 LOCKE HILL RD WENDELL (978)467-7667 Q
PROPERTY LOCATION 2 LINDEN ST
MAP 25C PARCEL 200 001 ZONE URC(l00)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tyneof Construction:_REPAIR DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 88874
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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
Demolition Delay
L Z2-Zo P9
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.
Cell 0/u/1 ra4y *
Department use only
'q; � City of Northampton Status of Permit
>; t Building Department Curb Cut/Driveway Permit
Ilk
212 Main Street Sewer/Septic Availability
Room 100 WaterMell Availability
` Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specity
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1.1 Property Address:
This section to be completed by office
, n�
2 linden st Map � Lot d- v Una
Zone Overlay District
Om SL District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Damien McNally 1701ocke hill road,wendell,ma 01379
Name Print) Current Mailing Address: 978-467-7667
Telephone
Signature
2.2 Authorized Assent:
Name(Print) Current Mailing Address:
sigraUre Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 18000 (a)Building Permit Fee
2_ Ekm*ical `3��� (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
(n��
4. Mechanical(HVAC) / )C
5. Fine Protection v
6_ Total=(1 +2+3+4+5) Check Number ✓� /
This Section For Official Use Only
Date
Building Permit Number. Issued_
Signature: Z Z" 201/
Building Commissioner/Inspector of Buildings Date
dmcn78 @ gmail.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER O`: C='=T=:ACTOR;
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: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
padding)
#of Parking Spaces
Fill:
volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES O
IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O 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 O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Heeds to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES, describe size, type and location:
c-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 O
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 ❑
Name of License Holder: Damien McNally C— 5- % --I
License Number
170 locke hill road, wendell, ma,01379
Address Expiration Date
Dmcn 978-467-7667
Signature Telephone
9.Reaistered Home Improvement Contractor- Not Applicable ❑
Q D 1 °I 12
_Company Name Registration Number
S— ZO
Address nn f� rr II Expira n Date
6L IrjPMClJ Telephone919 � 966,
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 huilding
Signed Affidavit Attached Yes--... Pe",
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Rep�iarl°. -.av":
D
Or
Accessory Bldg. ❑ Demolition ❑ New Signs 101 Decks fW Siding fr3t Other fill
Brief Description of Proposed Existing deck repair.New Framing*lingsf decking and footings.Digsafe called and given the oa.
Work:
Alteration of existing bedroom Yes no No Adding new bedroom Yes no 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 cob f:... , - ••
l c. is there a garage attached?
d. Proposed Square footage of new construction._ _ Dimensions
i
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
I
g. Energy Conservation Compliance. Massebeck EnOrgy Counpiiar-1co fi;aii attlfi-t=-'?
h. Type of construction
Yes No. Is construction within 100 yr. floodplain Yes No
iar floor below finished grade
k. Will building coniotm to ttte Building and Zoning reguiabons? Yes No.
1. 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
1,--_0 1�ti e� ��`� as Owner of the subject
property
hereby authorize
•„ • ,n ,.."► ,►,n�f :n..0 fn!!!t,.�..rn!n!i..,,fn.,nf+:n!.Jthnri7ed by this building permit applicatiu1�.
111 _ - . .................. '
1 Sinnahire of Owner Date
CA
i --.
1
II ^^ as Owner/Authorized
1 A 0
Signed under the pains and penalties of peg'
F)WA leI
C
Print Na
C �Y= / OIL
sionature o e)dLent Date
City of Northampton
Massachusetts
G
A.
� N
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street •Municipal Building v� a
Northampton, MA 01060 rst-jy 3•�<��
Debriss Dig _
In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building
-hu c:.:mi fuction activity governed by this Building Permit shall be disposed
v.ins u t;rop:,rly al facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
(Please print house number and street name)
Is to be disposed of at:
Q/1 C Gin 0
(Please print name and location oY facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Signature of Per pplican r O er Date
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Dopartment as to the location where the debris will be disposed.
City of Northampton
Massachusetts
V' l-I]•y
�rlip DEPARTMENT OF BUILDING INSPECTIONS
y t 212 Main Street • Ilmicipal Building c
Northampton, lY 01060 '6''cy -:•�ti
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and,
or renovations on detached one to four family homes.Prior to
—1% must be registered as a Home Improvement Contractor("HIC").
TUF fly !,I... '_' '_<,i the"tocu,struction, alteration,renovation,repair,modernization, conversion,
improvement, rernoval, demolition, or construction of an addition to any pre-existing owner-occupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be
.lone by registered contractors.
Note.If the homeowner has contracted with a corporation or LLC,that entity must be registered
Type of Work: �)o ra, gePa Ir Est.Cost:_, ®Q�
Address of Work: 2 t nA r, ��aM'P C)tI 4,
Date of Permit Application: g / 9
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law(explain):
_Job under$1,000.00
_Owner obtaining own permit(explain):
Building not owner-occupied
Other(specify):
t: 1 R OWN PERM IT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CC-k".rR 1^?'OPE OR S uBCOINTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FORANDDOti.^.='__._._ "" =- - = = ==.. "°_wv::.`_`.: .' _;... ° °,. ,JND
UNDER M.G.L.Chapter 1,12,%, . - _ __ - tilt
PERFORMED UNDER THE -_-
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
Date Contractor Name HIC Registration No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
Date 6wner Name a Signa ure
The Commonwealth of Massachusetts
y Department of Industrial Accidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www mass gov/dia
11 urkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name(Business/Organization/individual): KAQ JkA
Address: 1-40 poc ko- A
City/State/Zip: L&]?n&j 1 &dA 0137'q Phone#: (64 altz
Are you an employer?Check the appropriate box: Type of project(required):
1.[3 I am a employer with employees(full and/or part-time).' 7. ❑New construction
2.R]I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling
any capacity.[No workers'comp.insurance required.]
9. ❑Demolition
3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t
10❑Building addition
4.01 am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.r-JRoof repairs
These sub-contractors have employees and have workers'comp.insurance.:
I ❑
(} We ant a mauaaiion and its officers have exercised their right of exemption per MGL c.-
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
"Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t♦Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
=Contractors that Cheek this box must attached an additional sheet slitminr,i1u;nail-\n ll�e wl.i\a ni a\%iln�ii.Rl-iaie-11,011w,of wi Ii UK rniilir�havr.
employees. If the sub-contractors have employees,they must provide their workers'comp,txllicy 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:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/StaWZip:_
Attach a copy of the workers'compensation policy declaration page(showing the policy u:rmL•:i».:�°c:oYE:e`•; `3e.e;.
Failure to secure coverage as required tinder MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains and naldes of perjury that the information provided above is true and correct
Signature: t08 Date: L1 1 a
Phone#:
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#:
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