23D-121 (6) . t
186 FEDERAL ST BP-2000-0928
GIS#: COMMONWEALTH OF MASSACHUSETTS
vlap:Block:23D- 121 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: Deck Addition BUILDING PERMIT
Permit# BP-2000-0928
Project# JS-2000-1714
Est. Cost: $1700.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
Lot Size(sq. ft.): 8929.80 Owner: DECK FREDERICK&KATHLEEN
Zoning:URB Applicant: DECK FREDERICK & KATHLEEN
AT: 186 FEDERAL ST
Applicant Address: Phone: Insurance:
186 FEDERAL ST (413) 584-6896 O
FLORENCEMA01062 ISSUED ON:4/28/00 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 14 X 16 DECK
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 4/28/00 0:00:00 1601 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2000-0928
APPLICANT/CONTACT PERSON DECK FREDERICK&KATHLEEN
ADDRESS/PHONE 186 FEDERAL ST (413)584-6896()
PROPERTY LOCATION 186 FEDERAL ST
MAP 23D PARCEL 121 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid /6 T7 Z ' —
Typeof Construction: CONSTRUCT 14 X 16 DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
7TH OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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 ommittee
Z, LooO
Signature of Building 'al 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.
r I Department use only
U t 'qf Northampton Status of Permit:
B 'I '1g Department Curb Cut/Driveway Permit
R 2 6 2000 1 Main Street Sewer/Septic Availability,
Foam 100 Water/Well Availability__
DEPT OF DUO-;!NG INS rrppton, MA 01060 Two Sets of Structural Plans
NORTH' ' M; :1.6' • . '240 Fax 413-587-1272 Plat/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
Lek616,4.I 5rte-� Map d5 ;J Lot / 2 /r d Unit
-ribethee 01 n 6a Zone c./,"1t1.--- Overlay District_
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: `
Cre f?r►��< ova� \ ce l, C �e c\< I g re/cler4 I �hvc C� Poreace_ (n 4 016 6.
Name(Pr�51int)� Jj1JJL
^ Curr`p1 nt Mailing A dress:8`t
n a' bIn
Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed by permit applicant
1. Building 4'1 17 DO oo (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3 +4 + 5) 1101. Check Number /jo( I %
qq This Section For Official Use Only
Building Permit Number: /3°,6%if Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing ���i Proposed Required by Zoning
This column to be filled in by
;t,1
/. Building Department
Lot Size a(a•t'lfbc-/-'
Frontage I r9 ' • - am
Setbacks Front LID rR /O , f1 y 5!6 / c9 6
Side L: "3 R: ,�w L: / R: o1C2,y /`
Rear , ;\1T J5 6 / do
Building Height I
Bldg. Square Footage /C "" 1 % ('/9 � )
Open Space Footage V %
(Lot area minus bldg&paved ^� j�]�L 5)
parking) 'IA pi000 b(
#of Parking Spaces J�
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO V DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, bodyof water or wetlands? NO V
DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO V.
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
f
CTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition 0 Replacement Windows Alteration(s) 0 Roofing 0
Or Doors 0
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks X
Siding[ ] Other [ ]
Brief Description of Proposed Work: 1.)-e e- 4 V-t'" Ct LAC II.- 11 ok)_e /ii,(I,Ei.,
I 1 ��
___.
Alteration of existing bedroom Yes l"No Adding new bedroom Yes L. No
Attached Narrative ❑ Renovating unfinished basement Yes 1/ No
Plans Attached Roll D - Sheet❑
6a.-`if IsfewhotfitottitLor,a It i i1' fi Mtitt>ti nh ISi e orn Otte~t + oft li".. fl 4.1_
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. Mascheck Energy Compliance form attached?
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
, as Owner of the subject property
hereby authorize to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner * Date
! �- `.kn t1 I/i AFF1( _ , as Owner/Authorized Agent
hereby d are at the statements and information on toregoing application are true and accurate, to the best of my
knowledge and belief.
gned ?der the pas an t penalties of perjury.
len LiCi6—
tCLk-
Prin\Name =� f'`�� v 'C, - ,-- eu.k...._ 6
Signature of Owner/Agent to
g g
"CTION 8 -CONSTRUCTION SERVICES
Licensed Construction Supervisor: Not Applicable 0
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
1 ..RI�ar1.. �1ti .. re in �t4 �b k ..,,. 3 ..... . .: °': E` Not Applicable 0
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.GL. 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.
gned Affidavit Attached Yes 0 No 0
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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,S to o 1 Zoniig Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature tla;WP/ • . •",e-c.4,_
•
sc(ttAn p2,
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t}t cif of porf1ieimpfoil
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f�tasaachntrtta
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DEPARTMENT OP BUILDING INSPECTIONS di
212 Main Street ' Municipal Building
Northampton, Mass. 01060 '
WOR ER'S COMPENSATION INSURANCE AFIr')J)AVZT
(Ii ccvscdperuni tttx)
with a principal place of business/residence at:
- — (saint/ci t J/stalcrzi p)
do hereby certify, under the pains and penalties of perjury, that
•
( ) I am an employer providing the following worker's compensation coverage for my
employees woridng on this job-
•
(Ins-urzn= Company) (Policy Number) (Expirtion Date)
( ) I am a sole proprietor,general contractor or homeowner (circle one) and have hired
the contactors listed below who have the following worker's compensation policies:
(Name of Contractor) — (Insurancc Company/Policy. NumbcT) (1=x;irntion Datc)
(Name of Contractor) (Insurance Company/Polio' Number) (E»iralion Date)
(Name of Conuactor) (Insurance C,ompa.ny/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (ExoLranon Date)
(attach additional aleec_t if none:n ry to incru&tnformaaoa pertaining to all coo]-ar.-ors)
( ) I am a sole proprietor and have no one working for me.
am a home owner performing all the work myself.
NOTE:plcse be acruc that wbilo howcowocn who employ pcsons to do n—inrr�=rv+ comers: ion cr rtpair work on a dwelling of
not more then throe units in which the bomoow ncr reside or co the grounds wpm-imam the do arc one cc:pettlly considered to be
employers under the workrh ccmpcaatico Act(GL152,33((5)),application by s bomtoowocr fore Gaax or permit may cvtdmcc the
legal etanu of en ocaployor under tbo Worfrola Compeonatioa Act
I understand that a.copy of this statement may be forwarded to rho Deportment of taadsarrial Accidence Moo of Itr.us000 for the
coverage veriLestion and that failure to secure coverage under section 25A of MOL 152 cm Iced to the imposition of criminal penalties
ooasutiug of a fine of up to S1,500.00 and/or imprisooment of up to ooc year end civil praahia io the form of a Stop Work Order and e
are 0(5100.00 a day against Inc.
/ For „_-•*Ett• we only
/� Permit Number
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6 , 28/1999 11: 22 4135851012 LABARGE mat Ui
THIS PLAT NOT FOR RECORDING PURPOSES t3 K•17 4 8, PG,2-89
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I HEREBY REPORT THAT I HAVE EXAMINED tT
HE PREMISES,AND BASED ON DUSTING MONUMENTATION,Ail EASEMENTS, ENCROACHMENTS
AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES.I FURTHER
REPORT THAT THE P PERTY IS NOT LOCATED IN A FLOOD PRONE AREA AS SHOWN ON FEDERAL INSURANCE MAPS FOR COMMUNITY
NUMBER Z O j C3 7
D, 7f2 e3 - Parr 1 NOTE
S( THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES
NOT CONSTITUTE A PROPERTY SURVEY.
(•v E UiI tL REMov& a..-
MORTGAGE LOAN INSPECTION PLAT
GARAG /14(..7-6.0.. NOR -T N AM PTONI SASS ,
t'•-(OTd. . Po yoyou K,Vow
10PsrE OF 14UA1Tl_C‘( pLAu• D,Itvlp A.4 HA2CELk.A. A. VALENTA
ScgLe: L"=4p'
I_ T-E D
RlCtd J. LBa arge, Sr., Rrolan sd Proteasional Land Surveyor
tip Klnp StrN rth t, NO *mpton, Massachusetts wow-In w