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31A-278 (2) 82 WASHINGTON AVE BP-2016-1095 GIs #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A-278 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categ ry: renovation BUILDING PERMIT Permit# BP-2016-1095 Project# JS-2016-001876 Est.Cost: $12800.00 Fee: $83.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: OLIVER ISELIN 039073 Lot Size(sq. ft.): 9801 .00 Owner: SHERER STANLEY E&SENECHAL MARJORIE L Zoning: URA(100)/ Applicant: OLIVER ISELIN AT. 82 WASHINGTON AVE Applicant Address: Phone: Insurance: 36 Service Center (413) 584-1224 Workers Compensation NORTHAMPTON MAO 1060 ISSUED ON.3/17/2016 0:00:00 TO PERFORM THE FOLLOWING WORK.REMODEL 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 Signature: FeeTyue: Date Paid: Amount: Building 3/17/2016 0:00:00 $83.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2016-1095 APPLICANT/CONTACT PERSON OLIVER ISELIN ADDRESS/PHONE 36 Service Center NORTHAMPTON01060(413)584-1224 PROPERTY LOCATION 82 WASHINGTON AVE MAP 31A PARCEL 278 001 ZONE URA(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 Typeof Construction: REMODEL BATHROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Buildine Plans Included: Owner/Statement or License 039073 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: proved 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 el ?A6101"A6_1110, S r uildi tcial 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. City of Northampton I 0 216 ( Building Department MAR 212 Main Street Room 100 DEFT.OF 3U.Lr;1" '' F' 'S N rthamptoni MA 01060 NOM HA T'l C.N.fd1C,� �r-6—r��ne -587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING { 1.1 Property Address: 37 2.1 Owner of Record: 17 Name(Ekipt) Current Mailin Addr s• Telephone oignature 2.2 Auth rized Agent Name(P n Current Mailing Address: LZ Signature Telephone CC Item Estimated Cost(Dollars)to b flctal: se Ortt}e completed by permit applicant 1. Building 2. Electrical �-�o _ _ b F� dd 3. Plumbing 4. Mechanical (HVAC) 5. Fire Protection 6. Tota l =(1 +2 + 3 +4+ 5) / [� ' IftdIrT1beTate,.fssued .�l�Tti�F1�e Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning '�� �� This column filled in by J�1 ���lC.i' V -Building Department ent . Lot SizeFrontage 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 ✓ DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO j DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES 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: -4115 <r New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors ❑' Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: Alteration of existing bedroom Yes '�No Adding new bedroom Yes ✓No Attached Narrative 0Renovating unfinished basement Yes -- NoPlans Attached Roll 0 . Sheet ff 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. Mascheck Energy Compliance form attached? 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 . 1. Septic Tank City Sewer Private well__ City water Supply 2.3 IN r5 � �' �lf�.l7 rc a� � �' ' �``e C CC_ as Owner of the subject property hereby authorize if SQ( '` to act on ehalf, in all tters r tive to work authorized by this building permit application. /1Iq ure 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. 0 Print N e Signature of Owner/Agent Date I Licensed Construction Su ep 9visor: Not Applicable ❑ Name of License Holder: © License Number Address Expiration Date Signature Telephone Not Applicable ❑r /? y ..I 7-T Company Name Registration Nu ,F Yer /6 Address Expiration 6ate Telephone �* � $°C111 ��@l � 1fiC> E1} '{lel 1 ,15r � x � 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...... ❑ 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 F E (r-�ii-�] Of �-Tcirf11alliptoil ; ,fi�c�atscfFcssctta DEPARTME?/T OP BUILDD\?G INSPeCTlot,S 212 Main Strcet ' Municipal Building Northampton, Mass. 01060 NV ORIC;R'S CO)VENSAIION MSUIZA_NCE A _ , T �NrI / Te 01 omscclj um),ttcc) with a piZncipal place of businesslresidencc at: �honC' ' J � `' ���/ (stx-�v�lyinazLlz�p> do hereby ccl , under the pains and penalties oL perjury, :hal dt: ( ) I am an employer providing the following worker's coinocns�,uon cove--c for Illy etuplovecs worlang on alis job. k. oasu.n. c-- COED=-,,) (Polis: Nurni cr) (r,pica ion Datc) ( } I a.m a sole proprietor, general ccaotnaor or homeow-oer (clicie one) and have hired the contractors Iistc�d below wbo have the foUoVvin ,vorker's comoensadon pol!cies: (Name Of Contmcwr) Comp3 ;y/-,)cU�i Nurn't---.) C'_\)ialuon D'Itc) _ (Name of Cootraclor) -- Cinsuranc.c CompaayfPo!im, \urucr) (La•pirulon Date) (Name of Coaraclor) (nsurancc. CompanyfPolicy Numbu) (Fspirz000 Date) (name of Coatmctor) (Insurance Comran [Pobcy Numbs) CL-xpirdtioo Date) (tmAzb ad i oc�l rtxc dnc^--..y to¢sc ud inform-zioc a'n.to.0«crr_co 7} ( } I am F sole proprietor and have no oile worLiog for me. { } I am a home owner performing all the work Myself. NOTE: barruuvcca wbo s=play p, secs w o.� .,orx M.d..� -Z or a4t rxocc i t'.=eo L-i''a in u'3 ca the botnoavMC rrs da err oa the P-a 06:,"Pune -tbe'-'o t:�C oo=:d:cd a be yioycs ua,c Cbc u1X f1'z ::ioo Act(GLI 52=t(5)} mpplicatien try a bomeoa'xr fes:l;cv or permit may c-v&xc tltic Icg.l r-nU of c.n axptoyo uadcr drn Wor4.olr Coczrp,, L},M hcL t uodcrYL&;od taa a oopy of Usu rA.=oc =my y bo foc-w.,j d to 01.Qcpart neat of k"huxri.J Amd.&Office or Lr_for tha coven=s mil eaioo aid th t f z3 c to arzurc oO mase under suction 2 5 A cd}.SQL 152 caa lad to the L-pac.6oc of cri aiwJ pcaa.Wa 8 of a fin,of up so S 1,504.00 UnNor ssxStt of up to orx yry tDd ci�ti1 pcntt'�a is tx form of a Stop Work Ordcr tad. fim of S 100.00 i dsy tp-uzp¢x - - -- Jf f FNZ tw NumberSignaturtof LicxnscclPcrniiucc � �eP;'— Lot City of Northampton 212 Main Street, Northampton, Na 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL 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: The debris will be transported by: The debris will be received by: I`°`jt VO %7" Building permit number: Name of Permit Applicant 0 Date Signature of Permit Applicant