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23D-084 (4)
53 WARNER ST BP-2009-1033 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23D-084 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2009-1033 Project# JS-2009-001491 Est. Cost: $19000.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PAMELA LEBEAU 064756 Lot Size(sq. ft.): 25308.36 Owner: O'LEARY THOMAS M SR&PHYLLIS Zoning:URB(100)/ Applicant: PAMELA LEBEAU AT: 53 WARNER ST Applicant Address: Phone: Insurance: 248 Bryant St (413) 296-4506 CHESTERFIELDMA01012 ISSUED ON:6/23/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:DEMO & REBUILD 6 X 12 ENCLOSED REAR PORCH,NEW DOOR/WINDOWS/SIDING,RENO KITCHEN 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 6/23/2009 0:00:00 $55.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2009-1033 APPLICANT/CONTACT PERSON PAMELA LEBEAU ADDRESS/PHONE 248 Bryant St CHESTERFIELD (413)296-4506 PROPERTY LOCATION 53 WARNER ST MAP 23D PARCEL 084 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out „O�d? IkS— Fee Paid (� Typeof Construction: DEMO&REBUILD 6 X 12 ENCLOSED REAR PORCH,NEW DOOR/WINDOWS/SIDING,RENO KITCHEN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 064756 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay t‘jr9/00? 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. • Department use only City of Northampton Status of Permit: "IS Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability lr ----T� Room 100 WaterlWell Availability Northampton, MA 01060 Two Sets of Structural Plans JUN — phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify 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 5 3 (2-^( 12— Sf - Map Lot Unit CC H a b I U h Z Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: MA-0 irt-S C(L -24 3 tocQ t€ 2.- M,A .c10 Name(Print) ,,,n�, Current Mailing Address: yL ar/4,�1scc 4 Telephone (j Signature `i Q a1 2.2 Authorized Agent: cam.=' � —tzr Nam Pri t) Current Mailing Address: h. ( cTQ�Sigture Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by_permit applicant 1. Building-I-t-,ovµ-bA-Ato (a) Building Permit Fee tZ,i ©00 2. Electrical 'j (b) — Estimated Total Cost of �t 000 Construction from (6) 3. Plumbing .La 2 D©O Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection (Q" 6. Total= (1 +2+3+4+5) $. I [ O� 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 .1ICISYR:a-1' L:'. _ e R: __., 7737 ---__ Rear . Building Height _� _?..r ,16 t `Affi g-e e- Neat . Bld . Square F tole" 3__ !foo --I1 127 e_ic aC— vo l o __.____ Open Space Footage (Lot area minus bldg&paved . C /O parking) Pr. r ' � i1 i #of Parking Spaces «-- Fill: i (volume&Location) - ---- H - #t -- A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued:! 1 IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book ^ Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO R DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: i _____ C. Do any signs exist on the property? YES 0 NO AZ) . i IF YES, describe size, type and location: i D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO , IF YES, describe size, type and location: 1 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 0 NO (14 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 7 Addition ❑ Replacement Windows Alteration(s) Roofing y�. Or Doors Z2. <" Accessory Bldg. ❑ Demolition 5E1 New Signs [0] Decks [E7 Siding[igtj Other[O] Brief Description of Proposed I Mew Fc0 4-6a.4iOI' AL(3-1.4.) c Work:';,rttaLiSi4 JcsiSVlf 12r92 r'T�c�2..c' C AptmQ hoc t4 L 1 .e3)L) l� W n4�ow S Alteration of existing bedroom Yes K No Adding new bedroom�J Yes 1,( No`� `� Attached Narrative Renovating unfinished basement Yes _ Z No t-kba, `-� c.d)R Plans Attached Roll -Sheet 1YYTTT 1c.t-f sr L4)4,2 PUcti 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,d-- Tl4c1A-t.P . I)\ Lem-i 2 Lk , as Owner of the subject property L-��''(� hereby authorize d 14 l� - 1� `-) to act on my behalf, in all matters relative to work authorized by this building permit application. ,/mod/ 00f2�2 414t cft Signature of Owner • Date I �� L ) , 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. Ct.i/A Print a e Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable(�❑ Name of License HolderT0i1L1 E�i� LJ�� Jf CS J '7 7570 License Number 2 € ` Li Avi-S(-- C 6e P& Viri-..r,1,6r7 _ 7I i Zo ID il Addr ss Expiration Date CJ —a\.�, Lit 3 `mil S6 CF Signature Telephone 9.Registered"Home Improvement Contractor y_ .„ Not Applicablepp 0 •= - Ci S i�� — :7 U - ( 0 1.O Company Name Registration Number Ii (o_ 2Di0 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 No 0 xIL. Home Owner Eemption 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,you 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 The Commonwealth of Massachusetts v. - -M Department of Industrial Accidents . ._4., Office Office Of Investigations 1=-4-T!= 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): _ Address: '2S49N . City/State/Zip: C -egire -P, 'KA Phone#: —21 1 —4SZJ� Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. gNew construction employees (full and/or part-time).* have hired the sub-contractors 2.rifl.I am a sole proprietor or partner- listed on the attached sheet. 7. 1.Remodeling ship and have no employees These sub-contractors have g. 41 Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I 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: — Policy#or Self-ins. Lic. #: 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 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 for insurance coverage verification. I do hereby c .fy under the pains and penalties of perjury that the information provided above is true and correct. / Sienature: Date: I y O Phone#: l-Q L 3 ' (ca y- ( SD 4,4 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#: 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 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 I, 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 , i I Sir in .. I , i 1 a•A‘0 1 ; 1 1 i i • . .i . I t isi.f,i1 E*6471 34,141 14,‘ 4 l ; • - 1121 I t. 442. ; .. . .. . r 4:. Ad i l i ,,,,,• lif ' i.4.-- ______ Ls_4r-- ---- : . 1 , . . I . i i..,_ ' if • PL.' . ta.--0 „ ........ .,,, , 6-3 • Demolition Permit Sign-off Sheet (supplement to permit application) "• Li Lam`( ,hereby supply the following releases as part of the application for a permit to demolish the structure located at 53 pr2t\t(—g.i e(o ff► �-(p and is shown on the Assessor's Maps of as being on Map # Block # Lot# and is currently owned by i>tyc-, (3' l i p • 3.A 7-7 62Ft j t7 c5 Z 1 t, O The sixth edition of the Massachusetts State Building Code, 780 CMR- section 112.0, states in part "A permit to demolish or remove a building or structure shall not be issued until a release is obtained from the utilities, stating that their respective service connections and appurtenant equipment, such as; meters and regulators have been removed or sealed and plugged in a safe manner." • No utilities are connected to structure being demolished Date: 51— tdc$igned: OR find sign-offs below Gas Co. Date: Verified by: Telephone Co. V—i Zs Date: Cc,b.(CPI Verified by: rt2v4(atc t o `ice3o'? 3 Dtc& SrrEE Electric Co. Date: Verified by: Public Utilities (Municipal) Date: Verified by: Health Department(water) Date: Verified by: Health Department(sewer) Date: Verified by: Health Department(baiting) Date: Verified by: Fire Department Date: Verified by: Department of Labor& Industries Date: Verified by: (Asbestos/Lead) 413-781-2676 DEP air quality (if necessary) Date: Verified by: Name of demolition debris hauler : �{ y-PAS Location of licensed demolition debris landfill -ig-b0. Notification of adjoining pro rty owner Date: ,24, gSigned: Signature of Applicant cukijk o q,ujz--JDate: 4 Ito I p This sheet must be returned to the Inspections Department along with a completed application for a permit,a site plan,and any other applicable information and fees. Demope12.doc 1/99 tit -6-1 L tt 1'z ---4---"---46---Thr-3 'Xn714'e.7'J4ai'a+ s rrya l J !-21 'VI 0-4 [ - it 1 i INI . t,01 iAr (� }ii tv to ic. - _9. or''0-1 SC`n t,r...'.1N)iCn p ..„,,,,„,„...„ .000P ---it_ ii, i �9 tV I` -mod„ T1-9 11 aoa� �- .A--- a�v -7sela atol unioc ancog sad aaue2s�onocu!W ' `-.st.:;tcz.y;,r .C. 111 P2'1'- i?bpi'onry r. I / ►`� jV .,"`NO - .-c'''' " . 0 rat roar...t-.a w rmr••r v.r.t mot+r �soddrtn 6aFstraq =aau natal •zno volt anp s r.rwr tons u w a V Awreo*,pram it-ortxda J A I I . - iNirO'0O t, .74 k4'az,. li ,-1w 7 -_rn----1:,----.--.7,::- -_____.,__.______ - t ll .7 1 r , 't 4'Z6.. ,e11 `i-i- ,4-,."6 ----" 'NP}. A -9 pi1-}-C 1 S rt q . i 7. 1 �,� t 1 - s \ `-1^ty V?Zt as HEADER LAYOUT s I . -k c., .. :'. Pt, - Post 4 Beam Material W (IS Ca..5 t41hl ilm" f>w 1 LAN 11'47 WW1 Qty. Product Length N eAltrsi ytf. : ,� R. 1 ► RS 2 UP 02 2 x to log 0" 1 ' R2. 2 v V 4' o" 4-1H3. 2 v v 5' 0e qi Total length, 42' 0" R9y 2 1 3/4x, 1/2 Versa-Lam 8P 2.0-3 10' 0" o ►(, , - Total length, 20' 0" , 4 11 2 1 3/4x11 7/0 Versa-Lam aP 2.0- .--0—,.. to W Total length, : • 1,4x1 N 2 Itr _ AAll product names are trademarks of their respective owners 1 T ' FLY _ 4 PLY k t i ,.... ?C4 id c.lh.n: %....•.10P A layout has been created using the information from the plan provided, and/or verbal information t �� r.k. Miles . Oft general contractor. r.k Miles assumes no responsibility for this layout if .. 't'' Incorporated ad during construction or any of the structural members shown are not supplied by r.k. Miles s ,is the responsibility of the building contractor / owner to install and / or oversee the installation . :; l 4 l the engineered wood components to assure compliance with the manufacturers apecifications.lf any Job Name: 5" C �M�. r Scales 1/4" • 1' Is are made to this project after the completion of our layout contact AK Mile' iiately , Filenames,"`y. ..44:•-uas,..c ..,.-; — .., ,, rsc7411 r . i ...______, 1 1....0_00.mikt S 1 tztoolz.. ,-, 1.1. A I . , . -4- . d i 1 ) I t. 1 eg...Svs.V16145 K4a-4„.,„, 0 -1.1 4-1 t f Z i- i f4. 1 ri 01, , to .. cr_._ e -.......,,, , 1---AAtirl C,,--.7.?•-‘5 1,1 ti$ . . , i ! Co . . . . , c4 ' •, . ' I c , . . ••. . . . _ It.g.3-5-01/4 At° 1 1 ttra', I 4/ 1- 44.144 e-64 .31 . --- -T-7 -1 4,1-7 ,.,/\N„ ! I 0 3 . /-N 12 fni.50 '-- . „e : I 4 b? 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L'd • Minion' distance per Boise joist hole chart. 1 ',-fl wrZoc, 2 t K1�(.-tom . ta_ •4.1 05%D r M G� 1c i; V t . y L. . ` '9 !/2« ► .• Ex5i54,4 ;„ Lo - _ ae ,0 C-4 6"--. - — m 3t ..T . t.o..,._ - .c -D002 s s p.t eck, f 1ta j J l..L.. 12"—•'/`....— 1 a ELL.) , S3 t.}!"0 g. °Lk,,,,,a Y`i.. i 24"-emu--- 4" - HEADER LAYOUT 1, . „, i , . • ;. ., , ....., ,. ,. , . ),2,,,A,..\,,.... .0, ..„..,„,4.•!!,.1:1ti,,,,l,,e5), M LA, - 2. eu t Post & Beam Material ' 1 `+t' 11114 i Type Qty. Product Length M k/ai al,. . 1'# 4y. , I - Nl --2 BPI" *2 2 x 10 10' 0" s NZ. 2 v v 6' 0■ rft N7, 2 v v Total length, 49'00" /(� Nov 2 1 3/4x9 1/2 Versa-Lam 8P 2.0-3 10' 0" (l f !'", y, -- Total length, 20' 0" t ' • s.7 11 2 1 3/4x11 7/8 Versa-Lam 8P 2.0- <,-,cr= t$ Cw Total length, , . a,p,( N ';...�. All product names are trademarks of their respective owners t _ 4.. i Layout has been created using the information from the plan provided, and/or verbal information ' .i Pig I !' r.k. Miles the general contractor. r.k Miles assumes no responsibility for this layout if .. It1 Incorporated ed during construction or any of the structural members shown are not supplied by r.k. Mile■ II, p the responsibility of the building contractor / emuto install and / or ovaraea the installation N l the engineered wood components to assure compliance with the manufacturers speciffcstions,lf any Job Name; `: w` :'1' CP 4t7/•�fa;,N scales i/1" . 1' es are made to this project after the completion of our layout contact RN Miles flimsily Filenames ...t+.. nu ...I'oiw': �....,...,.w..., ..,... r1CTAn /' I •-' - NJ 1 i 0 ( -6 i (y. P 34 -p 1\i ..h 1 i J ... , 4---1 i X , 1 1 . , , imowsomr.71 e.13,-!?Sawn) oftim I NI!(6- f . 1 A ril 1 I . Z ! ! ! 41,0477' ...........,_ .._. ........„._ , ._..... ___,... . . .,. . . ,.. ...,. _ .. . .... __ 4- 53 it aN&Qt‘r€:R_ -, '-'7 -Ftcialites"--