23A-126 (2) 30 MIDDLE ST BP-2017-0187
GIs k: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23A- 126 CITY OF NORTHAMPTON
TEE-001
Permit: Building
Category:demolition BUILDING 1 ■ R1VIIT
Permit# BP-2017-0187
Project# JS-2017-000307
Est.Cost:$5000.00
Fee: $30.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor_
Lot Size(sq.ft.): 15463.80 Owner: DOPPMAN JAMES P&PATRICIA A
Zoning: URB(1001/ Applicant: DOPPMAN JAMES P & PATRICIA A
AT: 30 MIDDLE ST
Applicant Address: Phone: Insurance:
30 MIDDLE ST (413) 586-3244(8)
FLORENCEMA01062 ISSUED ON:8/23/2016 0:00:00
TO PERFORM THE FOLLOWING WORK: DEMOLISH BARN: PHOTOGRAPH AND
DOCUMENT PRIOR TO DEMOLITION
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:
Cas: 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 8/22/2016 0:00:00 $30.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis I lasbrouck-Building Commissioner
File#BP-2017-0187 ' I obil q� t'„p
APPLICANT/CONTACT PERSON DOPPMAN JAMES P&PATRICIA A 5 Y `i��t
ADDRESS/PHONE 30 MIDDLE ST FLORENCE01062(413)586-3244(8) �s565 1)EVs J
PROPERTY LOCATION 30 MIDDLE ST f' �i `)
T
MAP 23A PARCEL 126 001 ZONE URB(100)/ �p.�/f4 ori
THIS SECTION FOR OFFICIAL USE ONLY: 01 L'—' Q- F(-
PERMIT APPLICATION CHECKLIST OP
ENCLOSED REQUIRED DATE ',.r�wGr`
ZONING FORM FILLED OUT tyxY
Fee Paid d99e' 0<3U %CSC
Building Permit Filled out CO VV.t�
Fee Paid / Ply"'
Typeof Construction:_DEMOLISH BARN Cee
EN`
New Construction A
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOj.LOWING CTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION P ESENTED:
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 Commislion Permit DPW Storm Water Management
Pe
Demolition Delay /P41.-/LI-v4 U jc FILL( i 6
8/2,z116
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.
. Ilk�L� i1f�=� CiDepartment 5se only
v of hlor hamton Statin of Fermn
AUG 1 ( Z0�6 Sin
ding Departmpen
t ewe
SCurb cut/Dnceway permit = _
212 ain Sh?et r/SepbcAvadabrllt�
RoomM100 ewe NV Pi AverObiliry
DEPrOFaUtil wsrcnort ,,,,n
MA 0102-087_1272
1060 Two Sefs of Srrltaural Plans
utwrrianrerory MA of wa =
p;Itune-319-3�7-1240 Fax4'13-58717 2 Ot shee Plops 7.
Other Speeny
APPLICAi IGH TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OF.TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATIONI
_.
1.1 Prcoertr Addre�srysy: � //^^ this�ecnon}o be com plered - once
Jo Mn/ 4 t 037 Map La[ Unit
f(oi((a C$ mG4 0/06 04
zone Ov rl Y Grs.nc¢
Elm St'G st ct CB District
sr Fe-ccucc
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record.1) Day/Villeci:
raa
Name(Print) Cunent lllnc Address:
y/3MaE6 :i,tY 8
a1C' n r: �et r Telephone
Sig,ahem
2.2 Authorized Auent:
Name(Pont) Current Mailing Address:
Signature Telephone
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
co
plated by permit applicant
1. Building �C,Cpl) ��I (a) Building Permit Fee
2 Electrical (b) Estimated Total Cost of
Construction from(6)
3. Plumbing I Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3 +4+5) , check Number I 036
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Comrnissioonenlnspeclor nt Buildings Dale
e �� t r -/Pt 0 tt'2"76 /5f /...7
/
Section 4. ZONING AL!Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Hosting Proposed Required by Zoning
This cobmm to be filled in by
Building Deportment '
Lot Size
Frontage — — -
Setbacks Front
Side L R:-- L R _ , _
Rear -HB
Building Height -- I
Bldg. Square Footage i1m 7 % __ iY.,.
Open Space Footage _ _ ___ % ___ ---
(La area minus bidg&paved
(Laareamnusbidg&paved t__ .... - —'
parbng)
#of Parking Spaces __ "" , ,
Fill: 1
11 __..
(volume&Location) .> .--.� __ -. ..... _ .
A. Has a Special Permit/Vas-la nce/F,nding ever been issued for/on the site?
NO Cr DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book ' Page( l and/or Document#'
B. Does the site contain a brook, body of water or wettards? NO Of DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
x
Needs to be obtained Obtained 0 , Date Issued: _
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and Iecatton _ _. _ __
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO C
IF YES, describe size, type and location
E Will the construction activity disturb(clearing,gradin, exc vadon, or flling)over I 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 DEW is required.
1
SECTION S-ESSCRIPT/OH OF PROPOSED WORM.(chock all aoolicab(e)
Now Nouse I J Addition U Replacement Windows Aheratfor{s) Roofing
Or Doors ❑
Accessory Bidg n Demolition V. New Signs CI Decks (❑ Siding [UI Other(❑I
Beet DescripHop,gt otrifi�e
Work: ,o# lk • /,%
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating umfiniehed basement Yes No
Plans Attached Roe -Sheet
ea If Hew house and or addition to ettisting housing, corm fete the following:
a. Use ofbuilding :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. Masscheek Energy Compliance form attached?
h. Type of construction
1s construction within 100 ftof wetlands, Yes No. Is construction within '100 yr_ floodplain Yes No
j. Depth of basement or cellar Scar betow finished grade
k. Will building conform to the Building and Zoning regulations? Yes No
L 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
Cate
Ala Vt{ttatt (gitte{yNalAx4iVitt
as Owner/Authorized
Agent hereby declare that the statements and information an the foregoing app./cation are true and accurate,to the best of my knowledge
and belief.
Signed under the peons and penalties of perjury.
Point ht ,e
/
�11:/k
afore ofOwner/Asset Da
SECTION 8-CONSTRUCTION SERVICES
5.9 Licensed Construction Supervisor: Not Applicable £
Name of Licanse Horde,:
License Number
Address Erpvatlon Date
Signature Telephone
9;Realstered Horne 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 bulking permit
Signed Affidavit Attached Yes E Mo___ £
11. -Home ®ager Earl wilon--
The current exemption for"homeowners"was extended to include Owner-occuoied 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 buildin¢permit.
As acting Construction Supervisor your presence on the job site will be required from tune 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 ofEmployers 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 }'yri,.,� Inni
��fO" ,LA,lir-
�',. The 61: a$,v nvem"dh cj.'Ylats.sasc/nzsells
i —— .D
3 epcw6xee66 off IS sstreat1 Accidenes
14� d.l Office ®,:ICraveeSaa esta®nay
1E6 r-61600 War.ha grc. .`Stheee
F.? /B
eane , MA 02111
)O6-1fir ynch6mass.gov/dia
Workers' Compensation ][Enwramce Attidersit: 1Fluaa➢dens/CantractonSElec Crvuouans/IPiattabers
Appklca®t Inforrmatiem Neese Prh t LeathPy
Name (Business/Organizxtiom'Jndividualn j4, t S 71"- ( e p ng,
Address: 3t tLhbLL
City/State/Zip: Fur/zee-Ake" M4, thOt') Phone #: y1? " } 3t7 - ja y
Are you an employer? Check the appropriate box: Type of project(required):
1.n I am a employer with 4. Li 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. 1 Remodeling
ship and have no employees These sub-contractors have 8. v[ 'Demolition
working for me in any capacity. employees and have workers'
comp. insurance.] 9. ❑Building addition
[No workers' comp. insurance
required.] 5. We are a corporation and its l o.❑ Electrical repairs or additions
3. if I am a homeowner doing all work officers have exercised their ILI 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' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box Al 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 subcontractors have employees,they must provide their workers'camp.policy number.
Iam 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 cart 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.
lZ do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: �,fnq...._.�-- Date: Iib/f(o
Phone#: `113 -- 7GL >j9*.
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#:
I
City of Northampton _
MassachusettsIrA6M ��CE � ��
All
l � r ( DEZ42.T N Ot. BUILDING =SECTIONS f 1
212 Ma¢n street amp o Municipal Bclld�n5
Northampton, MA 010fi^. 'Y r'r ,"
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 I
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 reauired) and a final buildina 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
J 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 006
Address of work location Li -3
/3C rith) T
G 6u Ce /NF1, co 04',.2
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: 30 ALDOLS ,57. fe.c, 14 1%#. Not
The debris will be transported by: /94'wt:fJT ieeie -nic t .
The debris will be received by: /fluty KesiytciNE
Building permit number:
Name of Permit Applicant �A✓k73- P ,deWX4%f
✓ /OALd,fi /1)
Date Signature of Permit Applicant
8/11/2016 City of Northampton Mal-30 Midde Street
4r Northampton
Louis Hasbrouck <Ihasbrouck@northamptonma.gov>
30 Middle Street
1 message
Louis Hasbrouck <Ihasbrouck@northamptonma.gov> Thu, Aug 11, 2016 at 3:59 PM
To: Sarah LaValley <slavalley@northamptonma.gov>
Sarah,
I received a demolition permit for a barn at 30 Middle Street.
The barn is in poor condition. There was a fire in another outbuilding and the owners realized that the barn is a
firetrap and would burn down their house. It is also at risk of falling on the neighbor's property. No date is listed
on the property card but I think it's safe to say it dates to the 1880's
I don't think it can be rebuilt for anything approaching a reasonable price (see pictures). I do think the owners
should document it before they take it down.
Let me know what you think.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413) 587-1240 office
(413) 587-1272 fax
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