18C-141 (43) 39 DOGWOOD LN-680 BRIDGE RD BP-2017-0072
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18C- 141 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-2017-0072
Project# JS-2017-000132
Est.Cost:$17000.00
Fee: $111.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
use Grouo: MARK BONDE 67758
Lot Size(sq.ft.): 1497897.72 Owner: LATHROP COMMUNITY INC
Zonnin ::: Applicant: MARK BONDE
AT: 39 DOGWOOD LN - 680 BRIDGE RD
Applicant Address: Phone: Insurance:
205 PARK ST (413) 535-9529 O WC
EASTHAM PTO N MA01027 ISSUED ON:7/21/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:ENCLOSE REAR PORCH, INSULATE &
REMODEL KITCHEN
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 7/21/2016 0:00:00 $111.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0072
APPLICANT/CONTACT PERSON MARK BONDE
ADDRESS/PHONE 205 PARK ST EASTHAMPTONO1027(413)535-9529 0
PROPERTY LOCATION 39 DOGWOOD LN -680 BRIDGE RD
MAP 18C PARCEL 141 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ,/
Fee Paid /053 tip l�f
Building Permit Filled out
Fee Paid
TypeofConstmction: ENCLOSE REAR PORCH, INSULATE&REMODEL KITCHEN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 67758
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
fr-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
Signa eof Buil.ing • ficial 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 Pemit
REce v8 = " •• Entpartmertorb obeortieweyPeTte
2 2 Main Street sexadseplicAvaambny
a 8 as Room 100 watertWel AYait SfY
•it ampton, MA 01060 Two Sets of Semen'Plans
DE-P . -4 3- : -1240 Fax 413-587-1272 PlotSite Plans
Other
Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE ON TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
This section to be covenlasad byotace
1.12�D' LICE:
4aB B bt&t Map Lot
3'1 5)oc:'.7odnL1�^, zone Overlay MewlNanont�ri 'V , ^ EM,9t DtMnn Ca DWnC
SECTION 2-PROPERTY OWNEI' HW/AUTHOW2ED AGENT
21 Owner of Record:
t-A41%4C.0? OIL/A-) '� • .T[ Ion 1-;- sesserr fnnvk E1a4
Name aCurrant MakigAddress:
4t1 ia34-45-2-9
.,�/( TelePtnme
31Dative
2 Mrtfnnmd AaNt
1,11 A+zk l9T.ID E 2.rs5 '1 A2.k sr .� F-a1ar l-44Aa tri-rt ti
Name(Print) Currant Mai mAddress:
eeJmni3/411/44,.. e i t3 .535--et 521
sigeervz Telephone
AgCTION 3-ESII ATED CONSTRUCTION COSTS
Item Estimated Cost Modem)tc be Official Use Only
completed by pemvt applicant
1. Building (a)Budding Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Medanical(HVAC)
5.Fire Protection
6. Total=(1 +2+3+4+5) ( 7,60(0 Check Number 05 ' //f
This Section For Official Use Only
Dane
Building Permit Number: I Issued:
Signature:
Budding ComaissionerMispector of SS.fl Date
Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To incomplete Information
Existing Proposed Required by Zoning
This coin to be filled in by
Building ilc tnmt
Lot Size
Montage ,
Setbacks ft2g1
Side L:_It L_It
Rear
Building Height
Bldg.Square Footage %
Open Space Footage T 'To
(tnt area minus Ndg&paved
canting)
#of Packing Spaces .
MIL:
1 (vdume&Laaticnl
A. Has a Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES O
IF YES,date issued:
IF YES: Wast recorded at the Registry of Deeds?
NO DONT KNOW O,3/4 rp‘rrni
YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW O YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES 0 NO 1l
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO
IF YES, describe size, type and location:
E. Wia the oontaucrion activity disturb( g.gratfing,ratton,or filling)over 1 acre oris it part of a common plan
that will disturb over 1 acre? YEE NO
IF YES,then a Northampton Storm Water Management Permit from the OPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all walkable)
Now House 0 Addition 0 Replacenenttindows Altaradon(a) rcr Roofing 0
Or Doors
Accessory Bldg. 0 Demolihon 0 New Signe E Decks II Siding Cl] Other(Q
Brief Description of Proposed
Work: EA)CLacct, 2 Ar 1&eal-t ts4t QLArn 1 lSDEc WAITtjs/k'
Alteration of ersting bedroom_Yes_No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
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
r
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR NiCONTRACTOR APPLIES FOR BUILDING PERMIT
I. -DQf'if9z 1' l cm ( f(-a- as Owner of the subject
properly
hereby authorize
to act behalf, in aft��afraff�,�reylattive to work authorized by this building permit application.
Senate 4Owner Date
I, 1‘4a'12--k fn 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.
Ma-o-Ic ASP GT:
Print
.Name
/ylI I -
Si)naba o j I'eilAgent Date
SECTION 8-CONSTRUCTION SERVICES
$.i Licensed Construction Suoervisor: Not Applicable 0
Name calcines Holder: Mack_ ,9.h-0ig. Cs- 66' -NI
License Number
205 PA(x °J5 4s--S-iisri•kc>C7\tu: Ni 1 " 2_- : 9
Ad&ess r Expiration Date
trntla L-413 529-2.17�,
Signature Telephone
9.Reaistered Home Improvement Contractor Not Applicable ❑
R7r)N17 F (L�hl ti'-fztx b►3 I V12-7-8
Comoanv Name Registration Number
.01D � �A2k
Address Expiration Date
tisec; n_ /_14 V.TO Vxi ( M A Telephone L1 13 J 2`j'-Z1 •Jx
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 O--- No...... 0
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwelnas 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 l53(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 I neat Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
The Commonwealth of Massachusetts
Department of Industrial Accidents
lar may,
e=EV= Office oflnvestigations
i ie= y - 600 Washington Street
• = Boston,MA 02111
www.massgovhdia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organiration/lndividual):Bonde Construction
Address: 205 Park Street -
City/State/Zip: Easthampton,MA 01027 Phone#: 413-529-2176
Are you an employer?Check the appropriate box: Type of project(required):
1.❑x I am a employer with 2 4. ❑ lam a general contractor and l
ertployole(fix and/or part-tire).•
have hired the sub-contractors 6. ❑New eonsnuction
2.D I am a sole Phoprietor or partner-
These
on the attached sheet. 7. [l3'ftenpdeling
ship and have no employees These sub-contractors have 8. ❑Demolition
workingforme in anycapacity. employees and have workers'
Pa ty. 9. ❑Building addition
[No workers'comp.insurance comp.insurance)
corporation] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doingall work
officers have exercised their 11.0Plumbing
g repairs or additions
myself(No workers'comp. - right of exemption per MGL 12.0 Roof repars
insurance required]1 c. 152,§I(4),and we have no
employees.No workers' 13.0 Other
comp.insurance required.]
'Any applicant Mat checks box al mut afro fill an the section belowshowing their workers'communion poky information.
t Hombvrurs who submit this affidavit indicating they sty deg all work and then him outside contractors mmaubnit a new affidavit indicating seen.
1Connactors that check this box roue attached an additional sheet dowing the name of the subrmmcbn and stale whether moot those entities have
e plora. lithe mb.cootwas have employes.they men provide their workers'coup.policy number.
I am an employer that is providing workers'compensation insurance for my eneployee& Below is the policy andjob site
information.
Insurance Company Name: Travelers'Insurance •
Policy#or Self-ins.Lic.#: 3B985388UB Expiration Date: 3/13/2011
lob Site Address: tk ra'as t'› 6444 City/Sble/zip: tloa-ranivarrour IAA 016W
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 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fee
of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Imesti:ations of the DIA for insurance covert e verification.
Ido hereby ce . under the pains and penalties.of perjury that the information provided above is true and correct
Signature: ait.0pnrle Date: -]-I Z-I (r, _
Phone#: 413-529-2176
- Official use only. Do not write in anis area,to be completed by city or town offictaL
City or Town: Permit/License#
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
---._.. - .1`7 02 s IvoF —J- 6V id
flY'
_ City of Northampton
r 1 /\ / 1 Building Department
Plan Review
212 Main Street
INSULATE WALLS R-21-. Northampton, MA 01060
EXISTING GARAGE
INSULATE CEILING R-38
RILED INSULATION ON FLOOR
AIR SEAL FLOOR AND CEILING ( 8'X12' LXISNING
LIVING ROOM
2X6 WALL STUDS
ANDERSEN WINDOWS .28 U FACTOR
1/2" SHEETROCK
ANDERSEN SLIDER .28 U FACT[• /
VAPOR BARRIER l
1/2" PLYWOOD-. OUSE WRAP
ADJUST STEP WHEN NEEDED- /
BONDE CONSTUCTION / LAT -ROP COMMUNITIES 413 535 -9529 7
L_