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22D-070 (11) .�. s.�. .._ _ Yra .. xrT=p,.eiwr•i� tn:.�aN:MM.u�?T Ul Northampton,MA Property Detail file:///C:/CRUCIAL/property_#ssessor.htm City of Northampton, MA: Residential Property Record Card New Search Property Type Classification Code Reference_Card 1 of 1 Parcel-Location-Zoning-Assessment Map-Block-Lot: 22D-070-001 Zoning: Assessment: Location: 86 FLORENCE RD Neigborhood: 6 Land: 111,300 #Living Units: 2 Deed Book: 6411 Building: 174,400 Class: R-104 Deed Page: 23 Total: 285,700 Dwelling Information Building Sket Style: Conventional Year Built: 1887 Story Height: 1.5 V Attic: None Gi— Desaiotor/Area Basement: Full ^{ �<� 2 14 2 4 M. r/B _ r Total Rooms: 8 1E1H '17 ! 53 B - ;� � ' 536 sgft Bedrooms: 3 zFi C:1Fr 18 sgft Full Baths: 2 3 536 stt tl ( D:1Fr Half Baths: 0 10 � ( ! 120 stet E:1Fr Exterior Walls: Frame C 54 sgft 2 14 5 c F:EMP Unfmished Area: 0 14 1 Fr 168 sgft Ground Floor Area: 294 5a G:ss°Hsgft 1.5R/B Total Living Area: 1912 z1 294 "38 qft Finished Basement Living �+ 1Fr 1:Wood Deck 120 68 sgft Area: 0 X 0 8 EMP14 Basement Recreation Area: 0 X 0 6 8 *88 10 Woodburning Fireplace Stacks/Openings: F ' Metal Fireplace 0/0 Stacks/Openings: Heat/Central A/C: Basic f Information: Heating System: warn,Air Fuel Type: Gas Lower (1 st Story 2nd Story 3rd Story Area Quality Grade: C Basement One Story Frame Half Story Frame 294 Physical Condition: Average One Story Frame One Story Framer 536 Interior/Exterior: Same One Story Frame 18 Condition/Desirability/Utility: GD [ne Story Frame r 120 Vacant/Dwell/Oby Status: Dwelling [—One Story Frame T 1-54 Enclosed Masonary Porch 188 Additional Features: Frame Overhang �— 96 Brick Trim: 0 x 68 Frame Overhang r 38 Stone Trim: 0 X 0 � I Wood Deck [—F-68- Remodeling Data: - _-- Year Remodeled: 2002 1 of 2 3/23/2007 11:11 AM �•St�AMP�, Lif-0 of Nort4alliptoll L Z $� � �1'ilassaciluseffs �� e q - �, DEPARTMENT OF BUILDI7hG INSPECTIONS / INSPECTOR 212 Main Street • Municipal Building Nordiwnpton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CNM 108.3.4 to act as has/her construction sup,: ,i sor. 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 foundation/footings (before backfill), sonotube holes (before pour) a rouzh 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of In vestigations a 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legiblv Name(Business/Organization/Individual): PA-IT— Address: City/State/Zip: 6M ' Phone.#: j r- -7 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition o workers' comp.insurance comp.insurance.$ equired.] 5. F� We are a corporation and its 10.0 Electrical repairs or additions 3.9 I am a homeowner doing all work officers have exercised their I LE]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' 131-1 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. tContractors 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 Investieations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: " !�L/C P( Date: G�(R;k4j-7 Phone#: ��t� �25 -03777 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 License Number Address Expiration Date Signature Telephone 8.Reaistered Home Improvement Contractor: Not Applicable ❑ 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....... ❑ No...... ❑ 11. - Home Owner Ezemodon 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 It Replacement Windows Alteration(s) Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding[Q] Other[❑I] Brief Description of Proposed Work: �(r�J�.c �k��`���� `��..✓ �aSe Alteration of a)dsting bedroom Yes No Adding new bedroom Yes �—/N(o Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.If Now house and or addition to oxist-Ina housina, om to the fol win : 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? '1 d d. Proposed Square footage of new construction. 5 .r`rS 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 __SL._No. Is construction within 100 yr. floodplain Yes 6/No j. Depth of basement or cellar floor below finished grade_ In(k k. Will building conform to the Building and oning regulations? y Yes No. I. Septic Tank City Sewer,7 Private well City water Supply y SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize v�'®``ice to act on my behalf, in all matters relative to work authorized by this building permit application. '3 /,)A(0 Signature of Owner Date I, lqkT/ � A �_� 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 Name 6� Signature of OwnerlAgent Date Section 4. ZONING All Information Must Be Completed.Permit taaBe Denied Due To Incomplete Information Existing !"_ 'Proposed Required by Zoning / This column to be filled in by n Building Department Lot Size `% '{6 \ S 014 6 Frontage ° 6 0 Setbacks Front Side L: I L: t Rear z Z y k 7 V Building Height 15 "cs t la ` Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces 5 3 Fill: volume&Location A. Has a Special. Permit/Variance/Finding/ever been issued for/on the site? NO © DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW (3V YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ( DONT KNOW ® YES 0 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 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excayfition,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/Drlveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/well Availability V tt 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: "� �„�ry This section to be completed by office '�/�czz t�lX� C)��, y v(06 Map Lot Unit (�' Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: WIT- ' Name{Print) Current Mailing Address: _ /� Telephone d Z J 3 6 S 0 Signature —t 1( 2.2 Authorized Agent: P ,6^k TO-.7 Name(Print) Current Mailing Address- /Aok "l W-� 666 2Y 76 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by rmit applicant 1. Building } 0 00.pC:, (a)Building Permit Fee 2. Electrical �9 (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) Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/inspector of Buildings Date File#BP-2007-0896 APPLICANT/CONTACT PERSON LAMPIASI MATTHEW T&LISA A ADDRESS/PHONE 86 FLORENCE RD FLORENCE (413)303-0377 Q PROPERTY LOCATION 86 FLORENCE RD MAP 22D PARCEL 070 001 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REBUILD EXISTING STAIRS&ADD ROOF OVER New Construction Non Structural interior renovations Addition to Existing - Accessou Structure Building Plans Included: Owner/Statement or License 063492 3 sets of Plans/Plot Plan THE ,OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON RMATION 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 Co ion 0001, 001, Z Zpo� 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. BP-2007-0896 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: BUILDING PERMIT Permit# BP-2007-0896 Project# JS-2007-001460 Est. Cost: $4000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GEORGE KOEBER 063492 Lot Size(sg. ft.): 15246.00 Owner: LAMPIASI MATTHEW T&LISA A Zoning URA Applicant: LAMPIASI MATTHEW T & LISA A AT. 86 FLORENCE RD Applicant Address: Phone: Insurance: 86 FLORENCE RD (413) 303-0377 O FLORENCEMA01062 ISSUED ON.•313012007 0:00:00 TO PERFORM THE FOLLOWING WORK.-REBUILD EXISTING STAIRS & ADD ROOF OVER 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 3/30/2007 0:00:00 $50.001357 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 86 FLORENCE RD BP-2007-0896 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 22D-070 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-2007-0896 Project# JS-2007-001460 Est.Cost: $4000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GEORGE KOEBER 063492 Lot Size(sq. ft.): 15246.00 Owner: LAMPIASI MATTHEW T&LISA A Zoning• URA Applicant: LAMPIASI MATTHEW T & LISA A Applicant Address: Phone: Insurance: E6 FLORENCE RD (413) 303-0377 FLORENCEMA01062 ISSUED ON:313012007 0:00:00 TO PERFORM THE FOLLOWING WORK.-REBUILD EXISTING STAIRS & ADD ROOF OVER 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: Insulation: Final: Smoke: Final:0k 'I` �3'0 7 - V-' THIS PERMIT MAY BE REVOKED BY THPCITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGUL IO Certificate of Occu anc Signature: FeeType• Date Paid: Amount: Building 3/30/2007 0:00:00 $50.001357 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo