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30A-025 (4) 38 LEXINGTON AVE MA* SSACHUSETTS BP-2021-0034 GIs#: COMMONWEALTH OF Map:Block: 30A-025 CITY OF NORT (HAMPTON Lot:-001 'PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS, Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY.,FUND (MGL c.142A) Category:shed BUILDING PERMIT. Permit# BP-2021-0034 Proiect4 JS-2021-000049 Est.Cost: $10000.00 Fee: $48.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq.ft.): 13068.00 Owner: BLATHER WILLIAM Zoning: URB(100)/ Applicant: BLATNER WILLIAM_ IAT: 38 LEXINGTON AVE Applicant Address: Phone: Insurance: (413).584-8917 O� NORTHAMPTON MAO 1060 ISSUED ON.7/10/2020 0:00:00 TO PERFORM THE FOLLOWING,WORK:10X24 SHED POST,THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring . D.P.W. Building Inspector Underground: Service: Meter: I/' Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fire place/Chimney: Rough: Oil: Insulation: Final: Smoke: Finial: 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: i Building 7/10/2020 0:00:00 $48.00 I 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner z�o►z o z� -� M DFOR The CorttfNonwaallb 9f lbla mohmalta Board of Build Reguladom and Staad€�de CI CM1 8z Ma5mlimm Staam l�Wldlas Cad® 989 C l l�lp l '1�Z c)11 m K NC Dull tie P@fdt Appliaatim To Cons m9l,�palf,ftnovats Or Demolish a lleviyad kfin-2011 's m ®see=®r App Family Dtvolfing o z ` hlo Omdaii For Official Vee Only U) rinit Nu®ben 7 Date Applied: po tiulidlna Offi ial(print Nam) ��Mlwpgmr@ 09(a SECTION is SITE INFO 112A`l ION lel Propety Addrum 1.2ae ar e�lap&Pared Numb :A _ a� l:l fl la tlti�as a@@® ted atfaet? @� a® up` aanber paml Plurubar 1,j zontnn 1qferma"eat — llsd p�epar Dimmolousi Snl®g DIs��IFtat Aropubw Um Lo!gree(§d ft) 1,0 Building Selbaeb§ fl _ Front Yard side yatds Boar YUA Requiredpfnlded R19quirA provldad Aa€lWNd pfavidad 1.6 ate �imi Y.(M,Q.!_,u,44,F04—) 13 Flood Zone If forandom 1,8 so-impplapoaal 8Ya1@Mt pubo@ 8 private 0 Z01101; — auuldo Flood Zone? muuleipall ll Oil alt@ diapogal aFaietn 8 MCA if ago SECTION 21 PROM,RTY OWNERSUIP1 " I Owner,of Re arlla i77eLr 'ploreece' Ah mob'L a®e Fi�tl 51ly state,UP 3� Le-xj'pj+vr Ave, 4r3-i23"9?9q Wj'1j612if tri w►Afl.u►w► Na:and_ireet Telapitoxie Smil Addm§§ 6ECU PI 39 A96Cl PTAON OF PROPOSED WO-WO(ehaeb all that apply) 14eW Eoutruvredo i® EX16ting Building 0 Dearer-Oeeupled Cl I f. palrbm 0 Alloratlua(e) ® Addition 13 Demlillua ® Memory Bldg:V !Number ofualla I odief ® gp5alf�� _ Bflef Peiigfipd@it®f pfopeaed WoflO:_L_ X 2 Ca Rota EalimaWd Cm1bt @ffielal utl OWY (�abof and Mataflale 1.Dalldll S S JID1006 * i, . eliding Permit Feet� lndleate how ft lo deleftained: 2:Eleetfieal l�landard CIVITOW11 Applleallott ft � � M Two!Pf®Jeet C@ata ftm Mi fnaltlphof x S.pld®bing 2, ®tlisrFam.- 4,M@ehonleal (HVAQ fiat: 2w0 .2� z Sh >zea z =1:11�lggliatdeal ife du feaal®tt T@tal All Fe®a.ll `1`fl Z94id ok NOS F9�a,cheek-Amount: , Ceah Amovut,d,Total PFejaal cast! s jd 096 is Full 8(hotandittg fdalati®s Dug.. SECTION 51 4ONSil'RUC11ON SERVICES 0.1 ConAlr fetlou Supcf°vlsori Lkwnse(CSL) _ �ieenee�atahef �plfetlaa Bete Name @I 5L Holftf blot CIL Type(§ce below) No.and direct Type M§@flpt!@tt 11fes4@ted(BuIldlogg tip t@ 31000 @ui fij �! C1'a6Yn,Mate, 1P R lioAdi3Eadl 1&2 Pantil�t Dwalllna M Manan R WS in aEv and 1 n IF Solid Fuel Darting AppliaHeo nsu att@H $e a ten@ Email @ddwdo^ Um R@gist@rcd 11®riE@ Improv@mm CEmtrastof(1-110) MC Company Name or C Regi@lN1111 aHte i�lir!te strati'@n A�ttttt of ��plfat an®ate No,and swet Wall addfe§§ City/Town,City/Town,Mate ZIP Fete bane SECTION tai WORUORS' COMPENSATION lNSURAWCE AFFIDAVIT(1l-W.Le&109a 9 25C(6)) wafftaf6 compensation Inguratice affidavit must be oomplmd and stibmilrcd with thin application. p'allura to provide Us s af�davlt wl.11 ff @§ul■ yl t In ih@ d@aelf ni�agl of the Inaaano@ of the building permit, i 51pod Affidavit Attached? S .trio....® El SECTION 9ai O%VER AUTHORIZATION TO HE CONIMTEIa WMN ® ER'S AGENT OR CONTRACTOR APPLIES FOR DUMPING PERMIT 1,as®(tater of the cabjc@t pr@pofty,hmoby authorize to act all my behalf,in all matters relative to wort mithmizd by this building permit application, Pftnt owfieflo fame(bleetrottie dlgnatufg) bate SECTION 9bi OWNER'OR AVTl909JMD AGBNTDECLARATION By ontering my name below,I h@f@by attm udder the pants and pcnaltiss of pof)ury that all of tho Information cmitainod in this application is true and amufam to the best of my knowledge and Understanding, Pont givooflo of Authorlmd Ag@nt'a Name-(111eet[®ai@ gttaEafe) 13ate 1yOTESE 1. An®tt►nor who obtalm it building permit to do his/her own war%of as @vvnHf wit@ hires an tttifmgimmd,c@titfamof (trot fegistercd in the porno Improvement Contractor(WC)program),will�have access to the afbllmli@n iC.�.i pfagfam of guaranty fund under V iL of 142Ai Other important lufartaadon on the HIC Pfogfatft can be Ibund at :w-as ieavlaim Irtfbfimati@n an th@ Construction Supervisor lyWnso can be found at��tviu,rfla�aiaae�/des bi When§uktafitlil work � loaned,provide the ailbrinat on below, Fetal fl@of of@a(sq.fti) 'eft& (inoiuthng garage,finished bubommlattles,dabs or porch) ®fans living arca(sryi ft.)_ � Hfibitabie foam count C� Number of firoplime6 Number of bcdfoom� number of bathrooms --0- Number of half/baft Typo afhcating system Numb@f of d@ole!pomhcs Type of @o@Hng 6ybtota Euelescd Qpc] 3. "fatal Prj@Et squaro p@omg l Eimy be substituted fbf"Total Pfo)est Usl" ��- The coaaaa e0aaabai?tllaOfMM'saghl-mgm R I C0a18a ay mad,slabs 1#0 B®sl'taaaj,MA 02114-9917 Wof"1£@f:$'comp@ugatiou 1'.df urau c Afdavitf Build �/�sutre@tetra/l le@ i@laa6/l�ltlt li@a'a6 TO B#9 MVP WITH TM p�l�li 10 AUTIROWTY. AmIleaut tafacwtMoo ,96 Msit Lealblw N=@(li@aiti�J€fg�ifaftiett�divldttal); i1✓o°11; f�1 131 rrt— At@§int city/stato/zip: �-i 0 t o IUPC 0169,2- phgA@#: `I13 —`l �3 Are,yea an employer?Che-Wk the appropriate bora TY,@ of Project owdred); I:©1 am a amphtyef with empiey s(tail andlof pitatime)Za 9. Now @sn§IfM@d®n 1 am a aale ptoptistof of pafMohip and have no employm wedilog faf ftte in , @in9do11ng ao @apaet:(NA mimes,emap:kiumw fegaifed:) ®Dofnoliti@fi : a bolneosrnef doing an eyotlt taynif two Wa&Nl comp,laattr+�ttee fegaifed:j; 4,©I am a bomeoeusfEd Will be hLqflGontmetofa is @end"at ail svodt@a m e ., 10®Building addition d f pfep..tt3� i avi11 N§M that all saunters either have evofkam'eampeaeation inaafasee of are sole Blgetf iM repm ar additimm pfopf ews with ao empfoyesa, ��.®plunfl�ing t apalr�of Addi€tonta d:c!f ata a genetai @oataaet®f and i have hired the aalt°@eptfa@roan llatsd @a the atmsbsd sheet: i�. loaf f aifd Thou sdb=..aanetota haYQ smpiaym and have wulig ,@amp:Mannas d:®Vde are n eatg@attisu and its®��Itays��es@tasd daaif-rl�ht st'er�empt<ae psf iyl�ly B: f�.®gkh8g 192,§1(4),and sae have no amployee.[No tvaflteaa'camp:ingwanae feQa*ed:j eMy appBRttt that @h9@1t:5 boa 91 mast matt fill OR the se@den lNlaev AftWiag their avaf M5,@ompeaaatinn palley infafmatiatn: f Homsomem who sabntit this affidavit indieeting they are doing all swat and timm hk a3ablde enata!otem anent wlintlt a aces+affidavit indleat!gg mb: fewlantora that ehe&tea bur,Maar auNhed as addictaQal§hest E;hosving the RNP-0 af1hs nab-fo11100m dod state whether of not them eaddsa have em to ees: If The sI&@aatraateaa have emftloym,they ataat pfavids thelf wodm,winp, oli amber. I aaal 01 eaafploygr that b proiddhis woa°diepal e®aiipgim4doti laii Awane@ fop away employees. Below h adie polley andjeb alae laa�aiaaadQai� Wi fanoo Company Nt'mat Policy 9 at 50..W.M. _ plt ail®n D'at@. Job Site Addm§gz. CitylstattiMp._ AttMA a copy ofth@ workers't'o®p@watiou policy d@0111f ation Pao@(§hawing the pougy1flainkf and a.'lpiration datp). Mum to nasus aovefap as required under MMOL @: 192,025A la a miminal violation puni®hIabl@ by ti fluo up to 91,500.00 andlor dwzyoar impriwnwat,as gall as @ivil panaldo in tiro fbim of a STOP WO b�kR and @ fin@ of up to S290AD a day against tho viaiator3 A copy ofthir atmmont may be fbreYafdt;d to the®#dao ofIfivolgad®n®of tlio DIA fbr hiaurffnao @even v&dfiogdon, 1 d®diei�e adpo alai @P the pada p acid p mall of ppy ni y dw dig loaformadoti pro tdied above k(rug said aorp e� G ®fflaW aame unity. Do mini'wilt lit ably'aage,to be eeatipleaed by go ai'i'wou offield City or`l'@ilifat p@rfuit/Lle@u@@ 0� Muft Authority(&@l&ora@)f 1.Board of Walth I Building B@paM@at 3e City/Town Cl®rls 4e Bi@trtrfeal 186pt:s1'oa plumbing ifutap@ator tin oftr Coutaat pergoef phou@#I The Cit- ®f:�hampton c 4 Building Department Phano (413) 589=1246 Fox (413) 589.1292 CONSTRUCTION DEDIR-18 AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In with th@ pr®vialong d MOL @40, 04, a @onditlan d Building erffilt Numbar i§th@t all dabfla malting fir@m thl@ w@rk @h@II b@ dl@pons@d d In @ pr-aperly lla@H§ad waate diap0601#a®►lity 06 dofln@d by MOL a 111, 61 60k TH@ dabrla will be diap®aid ®t ire: LmHondPaa►lity. 23 0h3-r-qv1 Rd, dAory\iqbn /A 01600 Th@ debria will 6a trangp®rt c! by., Nama d Haa►ar Own V r / )1 .�w1 BignatarV9' d Appilmt a _.-_-- City of Nprth -ptan gig tta$n S"r gt a MMjMpgJ DMIl"y i9Slat9g�8d1, 9@�9 ''�- .a . IVA ism hop (Moapt montk dmj,year),hembJ depooe and stole fire foli wings #R6 ml�logal Ham 1 artr eEeldng a building permit pYYMrtf to flm iaott made,exemption to fits pertuff requirements of the l�Weachuaoffe State -Building Cole, codified of 780 CW 11015.1,3.1, in connection witit a project or worm on a parcel of land to which I iwld legal title, 2. 1 ant not engaged in, and ,flay project or work for which 1 ant emking the aforet mAtiotaol Iffinfeown0m' exerrtptiota, doee not involve fixe field orectlon of tr nufactured buildings wh-ucfed in accordance with 780 CAM 1111.RS, a: 1 gwifiJ under°um Sfafe Building Code's d-ef nitfou of!'lmmaowner'ae de nod of 780 SMR 11011.12- Pmm(e) who owm a pared of land on whl6 ha/oh@ r@*Id@A or fritends to mid@, @ra which thea is, o_ is hntmded W h�, a oars= g=-f��y.dwdUg, alta d or dated §tMectms accomry to such usa and/or fam Amduro. A pmon Who c@fwttdd§M@f@ rim oa h@-41e k a tv@6y@m pfd ohah net baa co-midmd a hom amim, 4. 1 do not hold a valid M000acitneette coingtivcion enper-olelon license .lad, mopf to dl-W extent flof I gaaalifiJ for and will abide by fire State Building COMO requirertaenfo for fire smpapoiolon of fire project or worm on my parcel, I arty not engaged in coraetruction oupe1Vielon In emmocfion wail my p1,4ect or work- involving conotraagHora, recotaetp4ction, altmation, roppair, rWraooal of, dgmalifion involving any activity regulated by any provision of ON State Building Coale, 5. If engage any other!person or pereone for mire in connection with die nforettaenfionod project or work-on my pareel,I achimledge Umf I am required to and will act no olio oupepuie®r for said pr9ject or work signed unar tit.pains and penalfiee of pedury on dais day of�✓� � 20.a '4 ��igna�u CITY OF NORTHAMPTON SETBACK PLAN PA(cA 3i,A- 0 2-r MAP,-- = LOT116 LOT M-AR LOT DIMENSION o,& §109 VARF3 91DI!VARD--L PROM 11 1JAM FRONTAGE NDICATH LOCATION AND 01 N19 W ONS OP ll OU&CIARAC111.ADD1110145 OR ACCE-95ORY BUILDINow lip SUH11 TO INCL DI FRONTACIR AND LOT SIZ11 I SOUARK PHEY OR ACRI291 4I , _ _ I ' � -- --- •-- -i �''�'i t? Imo' L S i�� � � , , , , i : 1 : , I I i I I ! A.n.... 1 , I I , I r I ' r ; , , L ....:..,..., v. .. I I r „`... L....... ...... I I I. i , : t i .,..fir r✓; I I 1 I ! I ! I .... r I I I i ' I ' I ,.v norr,rn+w.m.nwwrn.,,Iir..•nvne»,.n«n ww .,r. 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