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38B-091 (2)
8 MUNROE ST BP-2016-0951 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B-091 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-2016-0951 Project# JS-2016-001610 Est. Cost: $120000.00 Fee: $720.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MARK LANDY 077431 Lot Size(sq. ft.): 4965.84 Owner: WOFFORD PATRICK W&CATARINA I COSTA-WOFFORD tonin : URB(100)/ Applicant: MARK LANDY AT. 8 MUNROE ST Applicant Address: Phone: Insurance: P O BOX 61 (413) 625-6999-0 ASHFIELDMA01330-0061 ISSUED ON.21412016 0:00:00 TO PERFORM THE FOLLOWING WORK.-RENOVATE ATTIC SPACE TO BEDROOM/BATHROOM 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 Sigpature: FeeType: Date Paid: Amount: Building 2/4/2016 0:00:00 $720.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2016-0951 APPLICANT/CONTACT PERSON MARK LANDY ADDRESS/PHONE P O BOX 61 ASHFIELD01330-0061'(413)625-6999 Q PROPERTY LOCATION 8 MUNROE ST MAP 38B PARCEL 091 001 ZONE URB(100) THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid a Typeof Construction: RENOVATE ATTIC SPACE TO BEDROOM/BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: a Owner/Statement or License 077431 3 sets of Plans/Plot Plan THE 1791.460WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IJWRMATION 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 De oliti Del Signature of Building Of icial 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. }. w,i_ IJP i ' !'p , _ Departmerlt,use only `.I ' r' �kdl — ... City of Northampton Stat`us4ofPermit "< k S'I 'T' 1 ,�Ir�tgZtL i!i 7 '!ti{�i �i •A � I i l I IA'1 I'��r{�-4 + � ! p`_ �i�''�"! -1 "'iJ,^, JAN 2 7 2016 Building Department ;Ct7rb Cil/Dllrtewa`y P81lillt c = 4 �! wl=" 212 Main Street SewerlSeptica H. V! Room 100 4Vater/t!!fal�Auallablhtj� P ~I L r �n v ��!5,�'' DEPT.OF BUILDING INSPECTION$ Nv NORTHAMPTON MA 01060 Northampton, MA 01060 Twa�Sefsot ..1 i�rc° r �� (I�Ti�� tX^4T.",!�."-"_�F!� phone 413-587-1240 Fax 413-587-1272 �P[oflSlte Plans I , , ii„r!rrj^Fy4 [rWtL - !,al:?”-s•-'�11q_;!:�":�!sh'5;,�3J__•.,,:==i =1v�;u'�=i;=.!S�'ya.i.V?;_�;:i I:Other_Speclfy7 r11, __-J�`' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE.OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE.INFORMATION Mai to a c.om le 6411:y'offlc:e_:, 1.1 PropertVAddress. _,,, r,,==�_. - -Ma -- _.._...... -- iqr�7mffg= 2H s__ ._- __..._ri =Zo e�=_�_=-t; ;--' - ;-�,an�-;.Overlay:DisfrLct,�-..: 1 1 Elrit VR-111- `DIStr1 SECTION 2.=PROPERTY OWNERSHIP/AUTHORIZED,AGENT' 2.1 Owner of Record: c a wn -I, 8 'mune . �Ir.IAAm C►)6D Name(Pri 4 Current Mailing Address: 1�VA k* — Telephone Signa 2.2 Authorized Agent: Current Mailing Address: -"Mkz k;;)* h - I -5 144"1 Signature Telephone .SECTIO 3' ESTIMATED CONSTRUCTION COSTS. . Item Estimated Cost(Dollars)to be Official Use Only con leted by permit applicant 1. Building �� `�D� (a).Building Permit Feb 2. Electrical (b) Estimated Total'Cost of 3 co c Construction from 6 `' 3. Plumbingp�OD p BLilding Permit Fee 4. Mechanical(HVAC) Cj L1��/} 5. Fire Protection W v 6. Total=(1 +2+3+4+5) Check Number ThisSection For Official'Use'Onl Date Building Permit Number: Issued: Signature: Building Cammissioner/Inspector`of Buildings:' . Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Informatiah Existing Proposed Required by Zoning This column to be filled in b Building Department Lot Size Frontage —•-- - -----' Setbacks Front 1 Side L:ir_--�--_ f R:< i L:I � '. �.._..t Rear 1 1 Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bldg&pavedparking) #of Parking Spa s Fill: (volume&Location) A. Has a Special Permit/Variance/Findin ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued:1---j IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW } YES 0 IF YES: enter Book —` i Page, and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtainedQ Obtained , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: 1 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 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. f SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacemen�ndows Alteration(s) Roofing El Or Doors r" T' Accessory Bldg. ❑ Demolition New Signs [0] Decks [0 Siding [0] Other Ptd' Brief Description of Pr posed ews��+� "`R1�w it `N No � nYV"5�21 t�`"` Sup Work: si At / Alteration o existing bedroom Yes No Adding new bedroom 1/ Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet / sa. If New house.and or ad.1, ion o existlnq:F ousinq com ete"Elie foilowtnc: 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. Dimens' 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 wit ' 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of b ment or cellar floor below finished grade k. Will ilding conform to the Building and Zoning regulations? Yes No. I. eptic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED .WHEN OWNERS AGENT OR CONTRACTOR APPLIES TOR.B. UILDING PERMIT I, �i l�iSla W10 as Owner of the subject property hereby authorize ' y to act o my be alf, ' I at rs relative to wok authorized by this building pern it a lication. Signature of 0 er Date 1 ( �& , aste r/Authorized Agent hereby declare that the st ements 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. Pri4.11 Signature o dAgent D to SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: f Not Applicable £ Name of License Holder: Sdd� W—0-11 q � � License Number Pb ►d b i 3� �I i 1� Address 1346ExpirJltioDate Slued Telephone h� 9 Re is 'red Home.Improvehient.Contractor _ _... _ ._.___._ ._ Not Applicable £ Company Name Registration Number fbLux UI AS��e I� Aoj-33© b Address w Expir tion Date Telephone /I,Q 6"X 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 Attachd Yes....... No...... £ 11 . .Home 0wnerEgemptio The current exemption for"homeowners"was extended to include Owner-occupied DwellinZs 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 re ' n which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to use and/or farm structures.A person who constructs more than one home in a two-year period shall not considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to�Bu, g Official,that he/she shall be res onsible for all such work erformed under the uildi ermit. As acting Construction Supervisor your prese on ejo to will be requir to time,during and upon completion of the work for which this permit is i s d. Also be advised that with reference to Chapter 1 2 ke 'Co pensation) and Chapter 153 (Liability of Employers to Employees for injuries not resultin h)o e Ma sachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for under this permit. The undersigned"ho er"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Or ' nces,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeow r Signature, The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston,M-4 02111 4 -- www.mass.gov/dia Workers' Compensation Insurance Affidavit: ]Builders/Contractors/Llectriciaus/Plumbers Applicant Information Please ]Print Lezibly Name (Business/Organization/Individual): Mcwk- Sz tm' Address: t)Q3DX b232 City/State/Zip: Jar"t a / 'Pf C> Phone Are you an employer? Check the appropriate bog: 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. VRemodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and'have workers9 ❑Building addition [No workers' comp, insurance comp. insurance.$ required.] 5. We are:a corporation and its 10.X Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11r7l 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 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. tHo meowners 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.Lie. #: 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 under the pains and penalties ofperjury that the information provided above is true and correct. SiMature: Date: 123 116 Phone#: QA 13 )—H Ll Li 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#: City of Northampton f ��r i rl S.•' s�i Massachusetts � DEPARTMENT OF BUSLDING INSPECTIONS 1 � 1 212 Main Street • Municipal Building Northampton, MA 01060 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. 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 t home owner exemption, to act as their own construction supervisor, to be aware that by doing you become responsible for compliance with state building codes and regulations. e inspection process requires that the building department be called to inspect work at various ages, which include foundation/footings before backfill sonotube holes before our a rou building ins inspection (before work is concealed), insulation inspection (if required) and a fin buildinq inspection The building department requires these inspections before the wo is concealed, failure to secure these inspections can result in failure to obtain a certificate o u anc until the work can be inspected. If the homeowner hires other trades to perform work (e e r al, pl mbing & gas) the homeowner will be responsible to make sure that the trades hired secu e t it oper permits in conjunction to the building permit issued, and that they get their require ' spec ions. Failure of the individual trades to secure the permits and inspections as required can LAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's si nature requesting exemption) I will call to schedule all requi d building inspections necessary for the building permit issued tome. Date Mdress of work lo/tion ' I I City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MIGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, 'as defined by MGL c 111, S 150A. Address of the work: Nnrue_ " isila'ta-3 M The debris will be transported by: AdOS C.(.A -LL The debris will be received by: (� Building permit number: Name of Permit Applicant -x dill Date Sign-lure of Permit Applicant i 8-2814MARK LANDY DESIGN/BUILD SERVICES Box,61 Ashfield, MA. 01330 tel: 413-625-6999 /cell 413-531-4440 MA CSL# 77431 HIC 131627 2/1/16 Building Commissioner Louis Hasbrouck Assistant Commissioner Charles Miller Request for Waiver I respectfully request that you grant a modification to waive the requirement for control construction for the Wofford attic conversion project at 8 Munroe Street, Northampton because the scope of work for that project is of a minor nature, will not effect health, accessibility, life and fire safety, or structural requirements and is impractical in that the inherent cost of control construction is considerably disproportionate to the cost of the proposed work itself. All work will be completed within the prescriptive requirements of 780 CMR. Thank you in advance for your consideration of granting relief of construction control for this project. " Mass Amendments, section 107.1 allows for an exclusion from control construction for this project. " Respectfully submitted this l st day of February, 2016 Mark Landy, President Mark Landy Design/Build Services P.O. Box 61 Ashfield, MA. 01330 fYIcork � y - WO�j- 4/p T;. , r i