38B-101 Anne Murdock and John Townsend
46 Munroe Street
Northampton,MA 01060
January 7,2009
Office of the Building Inspector
Puchalski Municipal Building
212 Main Street
Northampton,MA 01060
To whom it may concern:
We have hired Nicholas Jones,a contractor,to weatherize and renovate part of our existing,freestanding
garage.The space to be renovated is approximately 60%of the structure.It will be used as a work
space/studio for Anne Murdock. It currently has no plumbing and none will be added.It will not be used
as a sleeping room or dwelling.If you have any questions,please feel free to contact us.
Thank you very much!
Anne Murdock
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John Townsend
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EXPECTING TO BUY 3 NEW WINDOW
4.•••• FROM THE RESTORE �+'
(CANNOT GUARENTEE R VALUE OF WINDOWS)
STUDIO/WORKSPACE
(14'X 14')
•■ WALLS 6"DEEP,DENSELY PACKED WITH NEW DOOR OPENING
CELLULOSE INSULATION (R20 OR GREATER) 4--
(FOAM WILL BE ADDED TO EVERY STUD ismomp
TO MAKE WALL CAVITIES THICKER
SO THERE WILL BE PLENTY OF CELLULOSE.)
CEILING R40
FLOOR JOISTS WILL BE PRESSURE
TREATED 2'X 6's ON EXISTING SLAB.
(RIGID FOAM TO FILL JOIST BAY)
- GARAGE/STORAGE NEW WALL
EXISTING (WILL REMAIN UNCHANGED)
WINDOW
EXISTING
Ale- 4411""" DOOR
_
EXISTING
DOORS
2.5'
STUDIO
2.5' 55' 4 ■
GARAGE
90.5'
HOUSE
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75'
46 Munroe Street
.\ The Commonwealth of Massachusetts
Department of Industrial Accidents
` Office of Investigations
' "' 600 Washington Street
4T ,77 ;' Boston,MA 02111
'€ter, =" www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information �! Please Print Lesibly
Name(Business/Organization/Individual): / �' c i u. ftxc 0 I-0 '{ ___
Address: \\J 5 C Ls 1),1,1 f )4,4 .
City/State/Zip: L) tc) & M o lu'i?2 Phone#: I 1 3 6 5 -1 'I 2_`7
Are you an employer?Check the ap,ropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.[KI am a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.x 9. ❑Building addition
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 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.0 Roof repairs
insurance required.]t c. 152, §1(4),and we have no 13.❑ Other
employees. [No workers'
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 certify,, er he ins and penalties of p jury that the information provided above is true and correct
Signature: °7 �'� '�' Date: t k,e
f �
Phone#: t! 3 --G 6 5 7q-2.7
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#:
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: -�' Not Applicable ❑
Name of License Holder: /V 7 L fl 1,� V �°�) g
License Number
Address / 1 Expiration Date
7 t,
., , L(l —f $ 7ti.Z
Signature Telephone
9.Reaistered/H/ome Improvement Contra-c-tor: Not Applicable ❑
V tr lc ,ot,S +/ J c✓Y 12 I t g\
Company Name Registration Number
175 at-6`1vw A wv FiA 5-110 )2_010
Address �n vt/1 1 Expiration Date
Vta�,?f� ► r l4- b i t�'l Telephone X115 613 792-7
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 Qp No ❑
11. Home Owner Exemption
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
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition El New Signs [p] Decks [Q Siding[p] Other[pl]
Brief Description of Proposed
Work:aSAJOW TiPJ /9-ni WEH71462/Z/kl6— 66% OC EKI IJCrG/17zAC9�,
Alteration of existing bedroom Yes " No Adding new bedroom Yes fo No
Attached Narrative Renovating unfinished basement Yes p 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, /Wile-7h uA c{C. /1(14) dtIPA1& J,i.S€v]D , as Owner of the subject
property
hereby authorize 0Ciei 2,09S %/O/ff S
to act on my behalf, in all matters r tive • . . . _ .. ized .y this building permit application.
Signature of Owner Date
I, / ' 'v[�./Gt C f j 0 i' , as Owner/Authorized
Agent hereby declare that the stat ments and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under he •ains,:nd penalties of•-rjury
r/f"
Print N mme
/ V l/la keS 6 ,T1, 1 I i ��
Signature of Owner/Agent Date I U
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 Il
Setbacks Front IOW uo
Side L:_ Z r r R: SOFT" L: R:
Rear 2 FT
Building Height ji PC-
Bldg. Square Footage 2.0
Open Space Footage
(Lot area minus bldg&paved Nlfif
parking)
#of Parking Spaces
Fill: N/A,.
(volume&Location) !
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 0 DONT KNOW e YES o
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO e DONT KNOW ® YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , 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 0 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 ® NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
LcU9 Room 100 Water/Well Availability
— Northa mptgn, MA 01060 Two Sets of Structural Plans
phone 413-58)7-1244 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
L/ Muove6E. Map Lot Unit
W6Z7OVV1.? . '1cr/Ytr°- O/ u
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
.ein/NE MuPDOCK f JoW Q 44,mcrn/2o, si-'., Ato2 ii-M xi,ihA-o/oao
Name(Print) Current Mailin Address:
_, / //3S5 ?2-`Z5
.��.. .�� 1 lessillIF Telephone
Signature
2.2 Authorized Ascent:
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 (a)Building Permit Fee
�5'Doo . D0
2. Electrical !O�O Dd (b)Estimated Total Cost of
Construction from(6)
3. Plumbing
C • 00 Building Permit Fee
4. Mechanical(HVAC) /.SU O • zsp
5. Fire Protection b 0 0
6. Total=(1 +2+3+4+5) • Gb •00 Check Number 39 y3
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2009-0632
APPLICANT/CONTACT PERSON NICHOLAS JONES
ADDRESS/PHONE 175 CHESTNUT PLAIN RD WHATELY (413)665-7927
PROPERTY LOCATION 46 MUNROE ST
MAP 38B PARCEL 101 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 3(�p.3Sj
Fee Paid 79'77
Typeof Construction: CONVERT 60%OF GARAGE TO STUDIO SPACE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 066878
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOy.MATION 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
01//2/09
Signature of Building fficial 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.
•
BP-2009-0632
GIS #: COMMONWEALTH OF MASSACHUSETTS
, CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit# BP-2009-0632
Proiect# JS-2009-000916
Est. Cost: $7500.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: NICHOLAS JONES 066878
Lot Size(sq. ft.): Owner: MURDOCK ANNE E&JOHN TOWNSEND
Zoning: Applicant: NICHOLAS JONES
AT: 46 MUNROE ST
Applicant Address: Phone: Insurance:
175 CHESTNUT PLAIN RD (413) 665-7927
WHATELYMA01093 ISSUED ON:1/12/2009 0:00:00
TO PERFORM THE FOLLOWING WORK:CONVERT 60% OF GARAGE TO STUDIO
SPACE
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 1/12/2009 0:00:00 $55.003993
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo