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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_...._....._..._.....