23A-003 (2) 27 MEADOW ST BP-2005-0662
GIS 4: COMMONWEALTH OF MASSACHUSETTS
Man:Block:23A-003 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit; Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:Non structural interior renovations BUILDING PERMIT
Permit It BP-2005-0662
Project if 75-2005-0161
Est.Cost:$24500.00
Fee:$80.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Robert Reckman 009498
Lot Size(so. ft): 10$02.$8 Owner: GUNTHER JOHN F&.DANAE MARK
Zoning:ORB Applicant: Robert Reckman
AT: 27 MEADOW ST
Applicant Address: Phone: Insurance:
36 Service Center-Unit 2 (413) 584-1224 Workers
Compensation
NORTHAMPTONMA01060 ISSUED ON:12/9/04 0:00:00
TO PERFORM THE FOLLOWING WORK:FINISH BATHROOM/LAUNDRY/STAIR HALL & 2ND
FLR CLOSET
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: O_t: 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: Receipt No: Date Paid: Check No: Amount:
Building 12(9/040:00:00 11099 $80.00
212 Main Street,Phone(413)587-1240,Fax;(413)587-1272
Building Commissioner-Anthony Patillo
File N BP-2005-0662
APPI.dCANT/CONTACT PERSON Robert Reekman
ADDRESS/PHONE 36 Service Center-Unit 2 NORTHAMPTON (413)584-1224
PROPERTY LOCATION 27 MEADOW ST
MAP 23A PARCEL 003 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out /1199
Fee Paid IJ
Tvpepf Construction: FINISH BATHROOM/LAUNDRY/S/AIR HALT &2ND FLR CLOSET
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 009498
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO TION 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
o� Permit from Elm Street Commission
Signature of Building fficial 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 appiieable 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.
2 'A Department use only
, City of Northampton Status of Permit:
S
ljp ^ , Building Department Curb Cut/Driveway Permit
' t 212 Main Street Sewer/Septic Availability
jl Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
1
APPLICATION TO CONSTRUCT,ALTER, REPAIR_LENOVA �tA H A ONE OR TWO FAMILY DWELLING
D LO
�- r, IM1 1, Ii � , �,
- I S
SECTION 1 -SITE INFORMATION
1.1 Property Address: ..,�. � - �3 Q T41 section to be completed by office
Qy�� 4v I
-7 rn ac1OW `Jt I'Ger 4 Map I Lot Unit
i,VS
FIbrence. 1 (nA CIO?a� pn'Ot ;.1-r7 t)! n• •r_ Overlay District
.1.----
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Nama(PrintUnAi t Cuurn Erg c2gmf/IDOu) 3� a
r; FlueitucEM
ress:
— 6 ,1-I —IT a-o9
' Telephone
Signature //
2.2 Au'" ...ii-zed Agent:
I fel iRE 'V MAO . _. _ . 1. • Mtgiro 44/4
Name(Print) Current Mailing Address:
.-----2,...---------r— 5f3N- I�-44-
Slgnature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
16000'OL)
2. Electrical (b)Estimated Total Cost of
(.5C0 OD Construction from(6)
3. Plumbing Building Permit Fee
-3500 •DO
4. Mechanical(HVAC)
5. Fire Protection 9 I OW00
6. Total=(1 +2+3+4+5) at (4, a Do .00 Check Number /logy —
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Sae
Frontage X10 CFYANC-tt TD Fa' TfpQjNT Otzu
Setbacks Front
Side L: R L: R:
Rear
Building Height
Bldg_Square Footage
Open Space Footage
(Tot urea minus bldg&paved
pa king)
#of Parking Spaces
Fill:
Flume&Location)
A. Has a Special Permit/Variance/Fin(dirn�g ever been issued for/on the site?
NO 0 DONT KNOW (1 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW cio YES (9
IF YES: enter Book Page and/or Document ft
B. Does the site contain a brook, body of water or wetlands? NO a DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO 0
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES (9 NO 0
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 O 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 n Addition ❑ Replacement Windows Alteration(s) Roofing in
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [❑ Siding[❑] Other[0]
Brief Description of Proposed
Work: �IN15tt }3An]Ropy1.4 LquNOry 51-/9 HAi( e onlg Closer e;
Alteration of existing bedroom A Yes No Adding new bedroom Yes X No -2ND Axe
Attached Narrative Renovating unfinished basement Yes )( No
Plans Attached Roll Che?
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?
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
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, .J DHN UUMT)7 Et ,as Owner of the subject
property
hereby authorize E?r,OF EL-iL-ft'1A n-)
to act on my f, in al a tern relative to work authorized by this building permit application.
Signature of er Date
.30t3 RE( k MAN/ , 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.
`tea IRF(v ti(>a-ti
Print Name
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: ,'}�" .. \ Not Applicable ❑ (>
Name of License Holder: "f�OP]E ytT g avIA-r + _— o _I-± f1 p
License Number
32(P C t(np NAmoreN 144 Qio(oO (4 il /oto
Address Expiration Date
Sea - taay
Signature Telephone
9.Registered Home Improvement Contractor: Not Applicable O
C . get rr4nr3 1051109-
Company Name Registration Number
34, 5E1E4itE 1 i2. ) R(lt 4Ma to /t*
Address /f'',, ++ Expiration D
...... Telephone 50-1 1ZZ4
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MAL.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. (ICH_ Signed Affidavi^.Attached Yes ❑ No ❑ (It2ri ricAra ott( Ei(e
11. - Home Owner Exemption
The current exemption for"homeowners'was extended to include Owner occupied Dwellings of one(Il 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 )08.3.5.1.
Definition of Homeowner,Person(s)who own a parcel of and 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 fort acceptable to the Building Official that he/she shall be
responsible for all such work performed under the buildine 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 persons)
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