Loading...
- . 9 FLORENCE RD BP-2007-0452 GIS COMMONWEALTH OF MASSACHUSETTS 44-090 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2007-0452 Project# JS-2007-000664 Est. Cost: $4800.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(so.ft.): 74487.60 Owner: BERGERON LEONARD&MARY ELLEN Zoning: SR Applicant: BERGERON LEONARD & MARY ELLEN AT: 964 FLORENCE RD Applicant Address: Phone: Insurance: 964 FLORENCE RD (413) 584-8040 O N O RT HAM PTO N MA01060 ISSUED ON:10/24/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:ERECT 12 X 20 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: 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 10/24/2006 0:00:00 $25.004048 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2007-0452 APPLICANT/CONTACT PERSON BERGERON LEONARD&MARY ELLEN ADDRESS/PHONE 964 FLORENCE RD NORTHAMPTON ZIN—$0q0 PROPERTY LOCATION 964 FLORENCE RD MAP 44 PARCEL 090 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ��� � � Fee Paid O` Typeof Construction: ERECT 12 X 20 SHED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved 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 ZC 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,Depar ent 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 o Planning&Development for more information. t Department use only -- r City of Northampton Status of Permit: �1 (� C [ M t Building Department Curb Cut/Driveway Permit t-� 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability OCT 1 6 2006 Northampton, MA 01060 Two Sets of Structural Plans_ 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:}- D / This section to be completed by office (y y /c r e !l C C 1e d Map Lot Unit NQ r 4 a^ `11 )-1 n/ � v/Q(, 2- Zone Overlay District "` 7 Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: keanard + Ha,ry £-7/en Re4.q-e -u/) 94-'/ Florence , d /V I#iu.n pim, MA Narr�,e,4Pri Current MailinAdd 5z �f�/((��^1 r V 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 �r} L� oo� (a)Building Permit Fee 2. Electrical W T (b)Estimated Total Cost of i/4 Construction.from(6) 3. Plumbing NiA Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection N/A 6. Total=(1 +2+3+4+5) y$da ,0 0 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 Pro"r0 P os€d £)l(s+) /1 C4 This column to be filled in by Building Department Lot Size nC/ Id �7 GLCr €. Frontage _/ .S' ! ' 12S ' — Setbacks Front _ Side L:. R: L: R: — • Rear 1 Building Height !L,p$ Bldg. Square Footage .2614+ % 130 Open Space Footage /- % �,�7�; (Lot area minus bldg&paved 96 Z ,, parking) #of Parking Spaces Fill: C �/A- [1j /1 (volume&Location) c/ A A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW (3 YES 0 IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW ® YES IF YES: . enter Book ! Page; and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ��4 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained o Obtained Date Issued: C. Do any signs exist on the property? YES 0 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 (2) 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 Ia 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 n Addition ❑ Replacement Windows Alteration(s) n Roofing n ��ryry Or Doors El Accessory Bldg. l�l Demolition ❑ New Signs [O] Decks [M Siding[DJ Other[ED] Brief Description of Proposed • i / J Work: Pre f I [ ('r ec4 Ion Aao S ' eG Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 0 ff'tte'tf'Aiatii&iT n d` iai atextsf n housx>f Cc i at&t ' foflovr iq: 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 BECOMP_LETTED=WHEN- -- OWNERS AGENT:OR.CONTRACTOR APPLIES FOR"BUILDING PERMIT I, , 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 I, ,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. Print Na 647fdALA/r.7451,,i Signature of Owner/Agent Da e SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: License Number Address Expiration Date Signature Telephone 9.:Registered::Home°finprovefienCContracfoi r .-„ ��„ . : F, .Z A Not Applicable 0 Company Name Registration Number 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 0 No 0 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_o-wn-a_parcei.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 La Annotated. / Homeowner Signature�i �'I%W e/ /���C��G✓ U { ' 1, -;;7/`•'' Cyril af IoirfIj�1111�Jf0Il -_ pS i.t& f • 3i. srcrEtnsrlla •o DEPARTMENT OP BUILDING INSPECTIONS 4 — 212 Main Street ' Municipal Building Northampton, Mass. 01060 \tar WORKER'S CO\'EPENSATION •LNSURANCF AITT) \'1T I, -- - - -- ._.... (1ic siipermittcc) with a principal place of business/residencc at: {phone/ ) (sot/city/st.a_tda p) do hereby certify, under tlic.pains and penalties of-perjury, 'dial ( ) I am an employer providing the followine worker's compensation cove rzge For my •, employees worn ig on this job: (I> .sumo e Conte') (Pclic; Nu r) (71:-piretion Dam ) ' ( ) I am a sole proprietor, general contractor or homeowner(ci cie one) and have hired the contractors Listed below who have the followving worker's comnen_sadon policies: (Name of Contractor) (In urancn CornoanyiPoUci Nam c:) (E: liduon Datc) (Name of Coatraor) (Insurancc Company/PoUc-, Numcnfr) (LZoirtion Date) • Mame of Contractor) c: Cam x irdo❑(I->uuran pan}•/PoOc�• t�:trs1W) (E D Date) (Name of Coatzactor) (Insurance Company/Policy Numbr) (Expirtioa Date). , (at:Lc_d1aioc7.1 cxc.ifo-,--.r•to'enc!u inform oo pctainins to di occar-_cow) i ( ) lama sole proprietor and have no one wor)dng for me. \1, I am.a home owner performing all the work myself. NOTE:plex be ew-yt dur„moo boc wocn µ.bo flay pc-um,to do c,.rr-,-,•rn c�.t.n e rgau wart oo.dwc11_;,of not coocc then . -=ram is inch tix bomoowocr raida or an the pvuncb x9purtco-=t ,o o r.-c Do(C=.rlly cocn_ds:Li to be caployez ttoG_-the v.-,cci; n-t.pc--_.,ion Act(GL152�I(5))•_ppI r.riw by.bootbonn000.-ocr(v:It or pn'mn rzy c.-:deaoc tre Icg;11 rtan..or ea co p Ioyx under rho Wor'c.olc Cot ratio,Ad 1 uodcrtind t11a x copy of t ti.mt®.o m..y b.for-r d. to the ID-op..rt000cxt of 1..A.,,ri l Acodcat&Offioo of 1,too-coo for Lb. cova-�-c va-if•cmioa and lh:t felt-c to socu c kovcrn&c tmrir-:cation 25 A of MOL 152 cut Icy to the impa.*tioa of cimic a]pcnallirs comi t.cig of a tint of up to S 1.t00.00.rtd/or iaptisotanc n of up to ooc yc_r rod evil pm•hia is be form o(.Stop Work(3r(1c ud. fur)o(S 100.00.day a,.irA ccc For dcpu toc=-•,1 it,.only ') // / /�//�' I�crznit Number f/A 1.turr of Lic=nscrlPc ucc e ) ¢StfAMPi. (Clip of Xortignitpfon • I21=a-.,-z. -o4A E-..44,-.t-m.-' - " =s = ;#Siv 'i 1► � � 1 A35R[171CStI13 --�_ . i DEPARTMENT OF BUILDING INSPECTIONS - 2= /_= INSPECTOR 212 Main Street • Municipal Building Northampton, MA 01060 . it HOME OWNER EXEMPTION ACKNOWLEDGEMENT • The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supc: , i::or. 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 any 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 faundationLfootings (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 v, , t d j em-t understand the above. ( ome owner/resident's nature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date /0`t, /6 Address of work location •Leoficife ,/ Nary E/len 8t r9 erd r1 9 V F/vte/ve fad 315 / Proposed 51744 / a`j i ,2'x 2a� / aS ' Th:*\ oo x N � 21 e x i s-f-u9 h ous e / 015 ' /_ /ores c c k o a d