23A-215 36 BEACON ST BP-2016-1450
GIS x: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23A-215 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 n BP-2016-1450
Project 4 JS-2016-002491
Est. Cost: $21500.00
Fee: 5140.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
use croup: Homeowner as Contractor
Lot Size(sq. ft.): 23870.88 Owner: ADLEMANN DANIEL
Zoning: URB(l00)/ Applicant: ADLEMANN DANIEL
AT: 36 BEACON ST
Applicant Address: Phone: Insurance:
36 BEACON ST (413) 658-5356 O
FLOREN CEMA01062 ISSUED ON:6/14/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:MAKE 2 BEDROOMS IN TO 4 ROOMS, ADD
TOILET, NEW WINDOWS, ELECTRIC TO CODE, BASEMENT WORK DUE TO WATER DAMAGE
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:
FeeTvpe: Date Paid: Amount:
Building 6/1420160:00:00 $140.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File 4 BP-2016-1450
APPLICANT/CONTACT PERSON ADLEMANN DANIEL
ADDRESS/PHONE 36 BEACON ST FLOREN CE (413)658-5356 Q
PROPERTY LOCATION 36 BEACON ST
MAP 23A PARCEL 215 001 ZONE URBi100V
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
pp,
Fee Paid CLI'' C 7 T '! qt)
Building Permit Filled out
Fee Paid
Typeof Construction: MAKE 2 BEDROOMS IN TO 4 ROOMS.ADD TOILET,NEW WINDOWS, ELECTRIC
TO CODE BASEMENT WORK DUE TO WATER DAMAGE
New Constmction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
prov€d- 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
'n. selay
�� Y/(
ure of: ding (tidal 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.
r flails ,-em</ (i, o
�\ ` ) Department use only
� r
E,G Cihj itf Northampton Statusof Permit
'Z., Buddha Department Curb Cui/Dnveway Permit
�� 212 Main Street
Room 100
Sewer/Septic Avededniry
Water/Well Availability
Northampton, MA 01060 Twc Secs of Structural Plans
ti --- phone Fax 413-Sd7-1272 Plot/Site Plans =
Other Specify
APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY Ell/YELLING
SECTION 1 -SITE INFORMATION
�.1 PropertyAddress: This section to be completed,by office
3Co BQ.Qc cL reeJ11— Map Lot Unit
(e'r nic „ ar Al � Q 10/ri Zone Overlay District-
C_,(✓ /t�1 /(- l b Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
.2.1 Owner of Record: % �Gv� C/
l/A, 'el Adet.,h G..A �.�-c.. Gu-sLt,cu
Na e ?nn;) Current Mailing Andress. Flame A.f/) Q/O/..2-
Zn'`��i� Telephone 1a_csr s.?,5- , r
gnature
2.2 Aut�rized Aaent: /
pU �4 L-%
Name(Pnntt) Current Mailing Address'
973.—S192— 77
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Oficial Use Only
completed by permit applicant
1 Building (a) Building Permit Fee
416, oso
2. Electrical (b) Estimated Total Cost of
Construction from(6)
3. Plumbing ,/W 15-40-DO Building Permit Fee
4. Mechanical(HVAC) -is j ca.CO
5. Fire Protection
6. Total=(1 +2+3+4+5) 421, 51b0, 01) ,Check Number/0 2 7 I "r/ge)
This Section For Official Use Only
Date
Building Permit Number Issued:
Signature:
Building Commissioner/Inspectar of Buildings Date 1
Section 4. ZONINIG Ag Information Must Be Completed. permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled to by
Building Depm msnt
Lot Size
Frontage
__
Setbacks Front .
Side Li R---- L ., R'_
Rear
Building Height - -- __
Bldg Square Footage — % '—
Open Space Footage
(Lot area minus bldg&paved _ r _...
oarbing)
of Parking Spaces -- --
Fill:
(volume&Location) — —. _ ___ ..., ..-_
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW YES 0
IF YES, date issued:)..
IF YES: Was the permit recorded at the Re istry of Deeds?
NO 0 DONT KNOW YES 0
IF YES: enter Book Page, and/or Document k
B. Does the site contain a brook, body of water or wetlands? NO d DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued:
C. Do any signs exist on the property? YES 0 NO CJ
IF YES, describe size, type and Location:
D. Are there any proposed changes to or additions of signs intended for the property? YES 3 NO d
IF YES, describe size, type and location
E Wil'.the construction activity disturb(clearing,grading ex avation, or filling)over 1 acre or is it pad of a common plan
that will disturb over 1 acre? YES 3 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 V' ndows Alteration(s) Roofing n
,—/ Or Doors
Accessory Bldg. ❑ Demolition L New Signs [D] Decks I[] Siding [p] Other[D]
rief Description of Proposed 7<i OL't.% C7..} d i•45 1 4- kn +4..tet 4 D-00 At S.
Work: a,ly A-. '(cl .w?-e +.4�w (l-s a_i/ Neta y,a..dewc ciccAre LD L,;ctr 3csc.nc.} c.i tc '
Alteration of existing bedroom V.-Yes No Adding new bedroom
V Yes No t S cc o,if.ta.J (AAA
Attached Narrative Renovating unfinished basement • Yes ✓ No _
Plans Attached Roll e—e
Ga. 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?
L Method of heating? Fireplaces or Woodsteves 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
, as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, ae elk/
/1ej.e, % -W/ T�'//arz-rx LR.r�w�f (fL_ .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 un,7der the pain an penaltiesgof perjury. C,, `
Pri
am;
rAoetClPteiJ----Qfr/02di�
t-----Signature o(Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable £
Name of License Holder
License Number
A-ddress Expiration Date
S-ignature Telephone
9.Registered 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 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 198.3.5.1.
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 font 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,von 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 .8 Local oning Laws and State ofMassach e- hipGeneral Laws Annotated.
1 I,,%
Homeowner Signature � — :01,
a i The Commonwealth of Massachusetts
Department of IndustrialAccidenls
Office of Investigations
-aEs'.-- 600 Washington Street
Boston, MA 02111
sr
-`r— rrovw.arass.gov/iiia
Workers' Compensation Insurance Affidavit: ]Bihlders/Cvmtsactors/Electrnebans/PS nbers
Anolicant Information Pease Print Le¢ibiv
Name (Business/Organization/Individual):
Address:
City/State/Zip: Phone#:
Are you an employer? Check the appropriate box: Type of project(required):
1.H 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
listed on the attached sheet. 7. ❑ Remodeling
2.❑ I am a sole proprietor or partner-
ship and have no employees These sub-contractors have g_ ❑ Demolition
workin for me in anycapacity. employees and have workers'
g P ty. t 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.
_frequired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
-->3. I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself [No workers' comp. right of exemption per MOL 12.❑ Roof repairs
insurance required.] t C. 152, §1(4), and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
•Any applicant that checks box I must also fill out the section below showing their workers'compensation policy information.
'Ho 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. Lic. n: 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 MOL 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 ear • untie a ains and penalties ofperju. that the information provided above is tr and correct.
mature:171/ a'571
c / (,���¢n7�� e: p XP4
Phone#: 3 TSO 1535
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
J ' .iii
Mass achcsetts e
tt
DEPIRTDY£NT OF BUILDING INSPECTIONS
}
212 Main Street s Municipal Building Y
• �e.egh, Northampton, [nA 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 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 rough 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 in ctlons re made
f fin!/ _ ,,n/
JI, V✓�' O Oga 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 6 t ( 6
Address of work location ' 6 ?D e 5 CO ./.
S i .
ototz
City of Northampton 212 Main Street, Northampton, MA 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: U aU e5 (lecsci 45
The debris will be received by: V 6(C e S tel: U 5
Building permit number:
Name of Permit Applicant 1-)Gvt;e,l A Jel a IZa w Gwa L,e, t I
/iF/�l� �
Date Signature of Permit Applicant
36 Beacon St
Aleman /Carswell
Additional work to add to drawings
Basement:
Remove water damaged ceiling tiles and 1 non load bearing wall
Update electrical switches and add lighting
Replace existing toilet and vanity
Sheetrock ceiling
Estimated costs added to phase 1 permit
General Notes - _ _-_ _ - _- - __. ..
1. Construction shall be in accordance with all applicable codes and regulations having ( -
Jurisdiction. Provide products of acceptable manufacturers which have been in satisfactory use ��I
in similar service for three years. Use experienced installers. Deliver, handle, store, and install LxcO
materials in accordance with manufacturer's specifications. The Contractor shall provide all EXT'G SHWR
permits and arrange for all inspections. ---- BATHi 'CRAGF� d
2. The Contractor shall take reasonable precautions to protect all employees on the work site,all •,
NO CHANGE IC BL REMOVED u o
materials and equipment incorporated therein,as well as other property at the site. Any FT
IN PHASE 2 T- o
I- E E
damage or loss to any of the above caused in whole or in part by the Contractor or any of CAB. ABV (a,
w sEVE New ' PP
o
q A
his/her Subcontractors shall be remedied the x
4 Ifwithin toneyear after the
ik has been ttheO Documents,, Cof thew work is
sMs-Sxrc cocw, cc `
3. by /�\
nsurance to protect him/her from claims which may arise
BDRM4
of or result from the Contractor's operations under the Contract OOD -- - '®' PATCH WD FLR as
Fl
acceptedby anyin AS REQ / o §
be defective, or not in conformancex �0' / -o o PWD'�LNDRY Zo
it promptly and at his own expense after written notice. IHALL2 _, WOAD s O � E
3
W X 0 > w
5. On-site verification of dimensions and conditions shall be the responsibility of the Contractor. E 30 8 WOOD cc
i 1 [CLO w
Noted dimensions take precedence over scale. The Contractor shall compare and coordinate U # ..,., I ® .°., ri vz TO BE REMOViD > �^ m
drawings and site conditions and report discrepancies to the Architect for adjustments before o o m I NEW30%80 SM2 3 — SMI o 3 IN PHASE 2� a x tn
proceeding with the work. Dimensions are from rough framing unless noted otherwise. "0 o o. EXT G OPEN I T� �s I- m II — Q i ,^„
6. The Contractor shall promptly correct work rejected as defective or not conforming to tw xa w >� ' a
Contract Documents and bear costs of architectural services thereby made necessary. ow = �_ - 15Wx2a0 wiv w � m a
Z ��- 90H CAB z iv 0 4' 4,, z ENTRY ■ ~
7. The Contractor shall be responsible for the removal of rubbish from the site. Final clean up is 3 o w A. ��
broom clean with windows washed. ��SMI - -- __
8. Building materials and components shall be protected from rain,snow,and other moisture z v�i a W0003 v 4 4` / 4 M1 x70
W 88
o
sources during storage on site and construction. NE roc
y
9. Construction shall be in accordance with the requirements of the EnergyStar program to the Ls o. (NI —05-1:12---- NE FXTR O
fullest extent possible including framing, air sealing and HVAC detailing. = • IIII •SM2 SM2 WOOD frig O z f
10. Local,sustainable and non toxic materials are preferred. o HEADER AS REO. Z g
11. DEMOLITION-Remove building components and appliances as noted on drawings. =ca w m ITTLam. > ��� -2 do i- a w
o D. X3.1. - EXT'G WNDW -2.5 do Z
I
I> m EX ' - F- C LIJ H
-I �fsH. z � w �R �rI I MI DN PROPOSED FIRST FLOOR PLAN Q
NO CHARGE � � > STAIRHALL (2)
D
_TO BE z a WOOD .n 1/q = 1�_D„ F J
Ini-
BEDRM ---- PL„,o MOVED c�ac:^ svAmcs,,., tea:,. Q 0
,rlEW30 80 • MrA t/) R
�'i 7 3 ' 3 -9 / xi n+ Lighting/Flet, HVAC&Plumbing Notes CC w
CLOS '- / I :,:..- Q n
o �� oordinate all new and existing Fixtures, U
z i receptacles,and switches as necessar
w C-- - 1 Jr OExrc I I
SM-1 IKEA Calypso w/LED bulbs(by owner) m
P I CLOS LIGHTING/ ELEC. KEY3 BDRM1 SM-2 LED "downlight" (by contractor) Z cc Z W
T�i __ WALLSCONCE :�LWOOD Gg n Wall Light(by owner) _ F_f1 L___.__ 'I -1di � 0 RECESSED DOWNBDRM2
1:).
v g Verifypower location. 2aO
wsWS-1 LED Godmoe o
o -ss a. R RECESSED WALL WOOD 5M2 P-1 Eglo Rondo 11.75''D(by owner) Oce Z
I DN .el WASHER
on _ s i _ F-1 Panasonicifyibathroom ehhatstfto, no light w O y
PENDANT 6 "' 2. Modify existing basebard heating to 0 U
Q accomodate all modified and new roams. p W
z� 0 SURFACE MOUNTED DING P x 3- Modify exisitng ductwork and add supply Z O W
sM
LIVING ® ExH•V5r FIN _ registers as required in each room. Q Ul C7
E EO EQ 4. New Toilet by owner Z O Z
LINEAR FLUORESCENT 5. Bathroom sink faucets by owner d
F0 =
® ® Ism xd -J
' $ DUPLEX RECETAA£ (/� II,,,,
4. QUAD. RECEPTACLE sin SM1
54A eke Q.J� " Q AtJSQ.LZ W -J
I TO BE DEMOLISHED ♦ GROUND FAULT Il DATE DRAWN:
OR REMOVED $ VETCH NEW WNDW. (2)DH NEW WNDW: (2)011 v� Te Cu 22eA G eo�e5 aree4 ! 06-07-16
TELEPHONE / � U REVISED:
EXT'G SILL & HEAD , - EXT'G SILL & HEAD i{e- S hAJCITJ,e.e
REMOVE TRIM
5- �-I EXISTING/DEMO FIRST FLR PLAN f iii r --=_H
TO BE REPLACED PERMIT SET Al
1 1/8" = 1'-0" "XT G M.O./P.O.