23A-003 (3) 27 MEADOW ST BP-2005-0147
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map: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: BUILDING PERMIT
Permit# BP-2005-0147_
Project# JS-2005-0161
Est.Cost: $I0500.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Robert Reckman 009498
Lot Size(sq.ft.): 10802.88 Owner: GUNTHER JOHN F&DANAE MARR
Zoning;URB Applicant; Robert Reckman
ii T: 27 i'iiLl-v..,C.;"' .7i"
Applicant Address: Phone: Insurance_
36 Service Center - Unit 2 (413) 584-1224 Workers
Compensation
NORTHAMPTONMA01060 ISSUED ON:8/16/04 0:00:00
TO PERFORM THE FOLLOWING WORK:REPAIR 2ND FLR SYSTEM
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: 1-/'--0A ?�ugh: Houe#
Foundation:
Driveway Final:
Final: Final: ��
Rough Frame:')/< q.,15 , i'b=� , il
Gas: Fire Department Fireplace/Chimney:
Ilcugii: _! Insulation:
Final: Smoke: Final: lg k a-7.o 3 .-k
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy_ Signature:
FeeType: Receipt No: Date Paid: Check No: Amount:
Building 8/16/04 0:00:00 10912 $50.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Building Commissioner-Anthony Patillo
111=I=L
27 MEADOW ST BP-2005-0147
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map: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: BUILDING PERMIT
Permit# BP-2005-0147
Project# JS-2005-0161
Est.Cost: $10500.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Robert Reckman 009498
Lot Size(sq. ft.): 10802.88 Owner: GUNTHER JOHN F&DANAE MARK
Zoning:URB Applicant: Robert Reckman
AT: 27 MEADOW ST
Applicant Address: Phone: Insurance:
36 Service Center -Unit 2 (413) 584-1224 Workers
Compensation
NORTHAMPTONMA01060 ISSUED ON:8/16/04 0:00:00
TO PERFORM THE FOLLOWING WORK:REPAIR 2ND FLR SYSTEM
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: Receipt No: Date Paid: Check No: Amount:
Building 8/16/04 0:00:00 10912 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2005-0147
APPLICANT/CONTACT PERSON Robert Rachman
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 QNLY:
PERMIT APPLICATION CHECKIESTT
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 99/ #�
Fee Paid ie
f1/47-
Construction: REPAIR 2ND FLR SYSTEM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owned Statement or License 009498
3 sets of Plans/Plot Plan
THE FO OWING ACTION HAS BEEN TAKEN ON TINS APPLICATION BASED ON
INF ATION PRESENTED:
ApprovedAdditional 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 Co n _
84%y 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 Sr Development for more information.
Department use only
City of Northampton !Status of Permit
Building Department Curb Cut/Driveway Permit212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability—__--
Northampton, MA 01060 Two Sets of Structural Plans_
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans__ --
Ober
APPLICATION TO CONSTRUCT,ALTER,l REEPAIlc.`TN vec“' L'OYevEKWi.ar A. ONE OR TWO FAMILY DWELLING
cct
SECTION 1 -SITE INFORMATION I I:J 1 AUG 3 - 2004 1•+J
1.1 Property Address: i t This section to be completed by office
Ol
Al /Ykadtw &re�p� DEP OF BaumGdRSfEC bNS
01330' Unit
—_
A� q ryrR+, uavi6t5..MA
Flarene€ /'IPT Zone--__ _ verlaYDistrict_______ ___
Elm St.Distract__ _...__- CB District_ ____ ____
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print Current Mailing Address
rT--o- -- - `' 709 -- ----------
_ Telephone
Signature
2.2 Au prized Agent:
Reekir n 'te-Is tweiti "Cx_,_Altam pian-
Name(PrintCurrent MailingAddress.
SBl 1 ,
----- ------------------- - h — -- ------
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
cam.ietedb -rmita.•irvnt 4
1. Building {t
iv,QUO (a)Building Permit Fee
2. Electrical dCca (b)Estimated Total Cost of
6 Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) sjtjr.yCQ(} 0 Check Number l0 Wr2.- ),Ca--
,(�['7 This Section For Official Use Only
Building Permit Numbeg6_( Z F Date
— __
Signature:
Building Commissioner/inspector of Buildings Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column pa be filled in hs
t }, Building Denartmom
lot Size Nb Piot. 773 f/'5F7{(�,7 4C
Frontage ✓
Setbacks Front
Side L: I2:_......_ L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage %
(Lot area minus bldg&paved
Barking) __ .._....
ffi of Parking SVates
Filk
(wlume&Inwiam .. _
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 ✓_ DONT 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 k"---
IF
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:_,,,,_,,,_
•
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House n Addition ❑ Replacement Windows Alteration(s) Rooting n
Or Doors ❑
Accessory Bldg. n Demolition ❑ New Signs [(0) Decks [E3 Siding[CO Other[CO
Brief Description of Proposed (�ji �+
Work: Il' TIOhr f 1 rJgsteem
Alteration of existing bedroom—__—Yes ✓_No Adding new bedroom Yes "No
Attached Narrative Renovating unfinished basement Yes _✓....No
Plans Attached Roll Cate°
ea.If New house and or addition to existing housing, complete the following:
a. Use of building: One FamilyTwo 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 Woodstoves_ Number of each
g. Energy Conservation Compliance. ... ...._Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 B.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 Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR�jAPPLIES FOR BUILDING PERMIT
I, duo(Je - _ , as Owner of the subject
property ���(.
hereb authorize .J=..LL�riinl7
to act it• mr<lehalf '. - ••_. --- . . '•--to work authorized by this building per ' application.
as 4
Signa of Owyneerr,,+j,,,.�,. Date
& n
_jj oA ` C},_—___— _ _ .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.
Print Name
Signature of Owner/Agent Bate
SECTION S-CONSTRUCTION SERVICES
8.1 Licensed Construction
Sup
ervisor: Not Applicable
Name of License Holder: 0L _pL -fedifimn. Sy71❑46_
License Number
die o/61Q0
Address Expiration Date
Signature retepbone
9.Registered Home Improvement Contractor: Not Applicable C
40frek. L-- /055
Company Name Registration Number
045.1121,2
Atldross • �1f /Ltt? Nele one- Expiration Dale
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MAI.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 0 No ❑ i r /'t' d p 7 j1C+
IL - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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 en 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"homeowneffi 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(Worker&Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,yon 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_...._....._..._.....