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29-543
47 INDIAN HILL BP-2014-0715 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29-543 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-2014-0715 Project# JS-2014-001210 Est. Cost: $28000.00 Fee: $168.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JESSE MONTGOMERY 077410 Lot Size(sq. ft.): 15725.16 Owner: KELLY ROBERT J C/O EMILY A KELLEY Zoning: Applicant: JESSE MONTGOMERY AT: 47 INDIAN HILL Applicant Address: Phone: Insurance: 40 OAK ST (413) 585-8482 FLORENCEMA01062 ISSUED ON:12/13/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:FINISH BASEMENT (GAME ROOM & 1/2 BATH) - NEED RECORDED LETTER NOT A SLEEPING 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 12/13/2013 0:00:00 $168.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2014-0715 APPLICANT/CONTACT PERSON JESSE MONTGOMERY ADDRESS/PHONE 40 OAK ST FLORENCE (413)585-8482 PROPERTY LOCATION 47 INDIAN HILL MAP 29 PARCEL 543 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out D © '` O f/ G Fee Paid /f ou Typeof Construction: FINISH BASEMENT(GAME ROOM& 1/2 BATH) New Construction , � Non Structural interior renovations fe Lé.?Z '2_ �Ccf Qe `I e Accessory Structure Building Plans Included: Owner/Statement or License 077410 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INS F9MATION 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 e� •lition Dela /000' 73 ignature of:ui sing 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: p Building Department Curb Cut/Driveway Permit Y O r i...-.. 0 2 212 Main Street Sewer/Septic Availability L.`' Room 100 Water/Well Availability =,,. N Northampton, MA 01060 Two Sets of Structural Plans Li phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans ill °L Other Specify ?tit LICATION 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 1 1AiC(tci.r `# 1' Map Lot Unit T i o rc.VAC e 0 I fl 6 a Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 16_1-L.L.- .. -7 f � Ell; I t, 7 ..-L. [a n H-i I 1 QA. FF `c/I Name(Print) J t Currenailing A ss: 4M�3 d a So-- 70.so 46 _t ,.....E/ Telephone Signature 2.2 Authorized Agent: ZcSS e ___/,_131 9rne L 0 ©c k s1. .e/orCelcC MT Name(Print) Current Mailing Address: Signal Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building c d ost) (a)Building Permit Fee 2. Electrical 0© (b)Estimated Total Cost of 375 Construction from (6) 3. Plumbing 7 50® Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) c7dj X40 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: R: L: R: Rear Building Height Bldg.Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW lEr YES 0 IF YES, date issued: 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 ® DON'T KNOW tig YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 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 Q NO .e' 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. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [C] Siding[0] Other[0] Brief Description, Proposed d 1/ , rn@^� Work: .•��jj�f ��rn° trb©✓Yl a � 2 Alteration of existing bedroom Yes No Adding new bedroom Yes Attached Narrative Renovating unfinished basement Yes 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, _.../ /ii as Owner of the subject property hereby authorize -0-e Se 1'1 drt©me to act on my behalf,'all ma% relative to work auth rized by inis building permit appli tion. Signatu,= of Owner Date I,_ i -i-e 55e /loll Orn J , as Owner/Authorized Agen ereb declare tha a statements and information 9 Y at on on the�foregomg application are true and accurate,to the best of my knowledge and belief. i/� � Signed u •er i. pai s .•d p nalties of perjury. Print game .�..- / /-2/941_,3 Signat - of Owner/Ag-1 AIIIIII "-- Date r / SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: M Not Applicable ❑ Name of License Holder: —E'SS'. ' ` c Q77 -( t Q License Number LAO OG4 S - , etorctnce /IA . fog /� //..S-- Address n Expiration ate Sr Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ J rs5- . rl amc/y /7/ 95S Company Name Registration Number k© Oct. , fl e "4 ..c/-7` /y Address ,..- Expiratio Date ` �/ Telephone ZI. /3-75 eSU)) - .°...� �- 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 ❑ 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 --.. c - ...c. —..... c3 V) C .7 4 - 6 I : v C cP i, ) 21j—I 4 : 1 , i_,_____...---'""< ; / 4- 1,:16----/—/FT-77. i , ill • ___. c .4W) / 1 i \ 8r) , , (. 1 vi ....., i ., \\,4 1 Iti I 1 t Lill ji 1 h Or/ / ?' i i -1-- / ,1 . i t . 4 yr 1 2 1 1 . H V1 ! i 1 5`Ir-v—e7 ,491...,Axt-,c-a rIA I ri . 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