32C-284 (20) 3 MONTVIEW AVE BP-2020-0365
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C-284 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Stair BUILDING PERMIT
Permit# BP-2020-0365
Project# JS-2020-000610
Est. Cost: $2500.00
Fee: $656.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ADAM BELCHER 104221
Lot Size(sq. ft.): 4486.68 Owner: OPPENHEIM CAROLYN
Zoning: URC(92)/ Applicant. ADAM BELCHER
AT. 3 MONTVIEW AVE
Applicant Address: Phone: Insurance:
P O BOX 1354 (413) 539-4937 WC
NORTHAMPTONMA01061 ISSUED ON.9/20/2019 0:00:00
TO PERFORM THE FOLLOWING WORK:EXTEND LANDING ON FRONT ENTRY STAIR
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 Signature:
FeeType: Date Paid: Amount:
Building 9/20/2019 0:00:00 $656.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2020-0365
APPLICANT/CONTACT PERSON ADAM BELCHER
ADDRESS/PHONE P O BOX 1354 NORTHAMPTON (413)539-4937
PROPERTY LOCATION 3 MONTVIEW AVE
MAP 32C PARCEL 284 001 ZONE URC(92)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIS
ENCLOSED REQUIDATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: EXTEND LANDING ON FRONT ENTRY ST
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 104221
3 sets of Plans/Plot Plan
THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
,1-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
Signature of girifdinj 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.
Department use only
City ofNorth; ���I� � ,ttus ermit: y —
'� BuildingDe MmAn b Cu Drivewa Permit
,vx �
212 Main tree Se er/S ptic Availability
l�y
Room 1 0 W er/W II Availability
2019Northampton, A 0'06F Tw Set of Structural Plans
phone 413-587-1240 ax 4587-1272 PI Site sans
-- DEPT OF eUILmw-,mspFc7,Oftr S cify
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 comp ed by office
Ma Lot p
c-) fo Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: p
Name(Print) Current Mailing Address: S Li -Q T �2
Telephone 1
Signature
2.2 Authorized Agent:
,4'�', 9 064 (t_,, jw,✓�- o
Name(Print) Current Mailing Address:
41
Signature k/ Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
Sao, c.v
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee boo
4. Mechanical (HVAC)
5. Fire Protection
6. Total = 0 + 2+ 3+4+ 5) `L S'o o .6 o Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
VU
a� y
Building Commissioner/Inspector of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
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 t 2
Setbacks Front 91 -t
Side L: u R: 3 Z L: 0 R: 17-
Rear
2Rear l Z Z
Building Height Z g
Bldg. Square Footage /Shr. % ICGL
Open Space Footage %
(Lot area minus bldg&paved 3yL'r 3`f if
parking)
� 2
#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 (?r YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO Or DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO
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
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 a
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 ❑ Replacement Windows Alteration(s) E5 Roofing ❑
Or Doors 17-1
Accessory Bldg. ❑ Demolition ❑ New Signs [[I] Decks [p Siding[0] Otheir[CI]
Brief DescJri tion of Proposed
Work: f="p*end` 10-016 nA a-,- �C-r1- antic 5k-.2,r
Alteration of existing bedroom Yes `/ No Adding new bedroom Yes / 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 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 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 CONTRACTOR APPLIES FOR BUILDING PERMIT
I, S &C:] ZL I OV 11G�71 -- , as Owner of the subject
property VV
hereby
hereby authorize �Z i , ��✓
to act on my behalf, in all matters relative to work authorized by this building permit application.
n
ci
Signature of O ner D to
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.
Signedunder the pains' and penalties of perjury.
/n
Print Name
6�//L
Signature Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: „��c�t/ _ CS ` kO L`2"2
{� tee- n License Number
�^� V f��cw� h . moi V�C��', l /O /7 111
Address Expiration Date Q)-,-k
Sign re Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
M4Li,-- &tckij- _ 14 T z-3 1
Company Name Registration Number
0 s'A �f ���u . �g opo �v /27 126
Address Expiration Date
Telephone
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....... EY"' No...... ❑
The Commonwealth of Massachusetts
Department of Industrial Accidents
f Office of Investigations
UVIL
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): Belcher Woodworking
Address: P.O. box 1354
City/State/Zip:Northampton, MA 01061 Phone #:413-539-4937
Are you an employer?Check the appropriate box: Type of project(required):
1.® I am a employer with 1 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 9 Remodeling
ship and have no employees These sub-contractors have 8• ❑ Demolition
workingfor me in an capacity. employees and have workers'
Y P tY• 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.:
required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions
3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.❑ Other
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 check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.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: Traveler's
Policy#or Self-ins. Lic.#:7PJUB9F74883718 Expiration Date:6/15/2020
Job Site Address: 3 1;t64 � AVP- City/State/Zip: / r--_v 1a Ai A c J dG u
Attach a copy of the workers' compensation policy declaration page(showing the policy number ani 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 insurance coverage verification.
I do hereby certifyder hep ns and penalties of perjury that the information provided above is true and correct
Signature: Date: 9//,// ,
Phone#: 5// 63i_11934
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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City of Northampton
r •"f Massachusetts
4 s .
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street •Municipal Building
Northampton, MA 01060
Debris 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.
The debris from construction work being performed at:
(Please print house number and street name)
Is to be disposed of at:
\/'q 11 Aa ►�-
(Ple se print fiame ajd location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
9N
Signat a of Permit Applicant or Owner Date
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
MONTVIEW AVE
72'-11"
SIDEWALK.
7-3 1/4" 18'-9"
DRIVEWAY
ADDITI
13-2 1/2'
2'-D..
0.
54'-8"
62'-2"
80'-4"
1��'�ooduaor.�ir�
P.O. Box 1354
CLIENT JOB DESCRIPTION DATE Noctha pton NR, 01061
Page 4 CAROLYN OPPENHIEM ENTRY STAIR LANDING EXTENSION PLOT PLAN SEPTEMBER 12, 2019 belcA 1
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P.O. Boz 1354
CLIENT JOB DESCRIPTION DATE N—th..pton W1, 01061
Page 1 CAROLYN OPPENHIEM ENTRY STAIR LANDING EXTENSION EXISTING LAYOUT SEPTEMBER 12, 2019 belcA�ww@cp�iicom
LANDING
4�-0" DN
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2-0'
-------------------
P.O. Box 1354
CLIENT JCB DESCRIPTION DATE W.th—pt..MA, 01061
Page 2 CAROLYN OPPENHIEM ENTRY STAIR LANDING EXTENSION PROPOSED LAYOUT SEPTEMBER 12, 2019 bl,herwwegailcom
EXISTING CONCRETE FOOTINGS Al
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MATCHAM
EXISTING PRES. TREAT. FRING AND DECKING
-2X8 016 0.C.
-5/4 PT DECKING
-4X4 POST AND 2X4 TOP/BOTTOM RAIL
-2X2 PT BALUSTERS
LEDGER ANCHORED TO CONCRETEFOUNDATION N/
SLEEVE ANCHOR 3/8^ X 5^ 2016' O.C.
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P.O. Hou 1354
CLIENT 108 DESCRIPTION DATE North-wton MR, 01061
Page 3 CAROLYN OPPENHIEM ENTRY STAIR LANDING EXTENSION ELEVATION SEPTEMBER 12, he2019 uB1h413053 7
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