35-137 (2) 34 WESTWOODTER BP-2017-0952
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 35 - 137 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Pennit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit 4 BP-2017-0952
Project# JS-2017-001635
Est. Cost: $46283.00
Fee: $300.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THAYER STREET ASSOC INC 045159
Lot Size(sq.R): 10323.72 Owner: MALLEY RUTH C&JAMES H
Zoning: Applicant: THAYER STREET ASSOC INC
AT: 34 WESTWOOD TER
Applicant Address: Phone: Insurance:
8A COATES AVE (416) 665-4018 Workers Compensation
SOUTH DEERFI ELDMA01373ISSUED ON:2/21/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:RENO KITCHEN AND FAMILY ROOM, REPLACE
HEATING SYSTEM, UPGRADE ELECTRIC
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: OI: 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 2/212017 0:00:00 $300.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File# BP-2017-0952
APPLICANT/CONTACT PERSON THAYER STREET ASSOC INC
ADDRESS/PHONE 8A COATES AVE SOUTH DEERFIELD (416)6654018
PROPERTY LOCATION 34 WESTWOOD TER
MAP 15 PARCEL I37 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
'NCLOSED REQUIRED DATE
ZONIN FORM FILLED OUT
Fee Paid
Building Permit Filed out
Fee Paid
Typeof Construction: RENO KITCHEN ANDLY ROOM.REPLACE HEATING SYSTEM, UPGRADE
ELECTRIC
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Sttncture
Building Plans Included:
Owners Statement or License 045159
3 sets of Plans 1 Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFt),IiMAT1ON 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
Permit from Elm Street Commission Permit DPW Storm Water Management
ay
rMa
- '% 02 In
Signature of Hui ding s��ctal 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 Permit
Building Department Curti Cut/Driveway Peoria
��\ 212 Main Street Sewer/Septic Availability
�p. \6 Room 100 Water/Weil Availability
ACT's' Northampton: MA 01060 Two Sets of Structure Plans
phone 413-5874240 Fax 413-587-1272 Piot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.7 Property Address: This section to be completed by office
.14 (A/c54-w a Da Tetyate_ Map Lot Unit
Florence_ MA. 0 /644, Zone Overlay District
Elm St.Dlstrtct CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT - !"na l)` /9// /7,5
9// /7 J
C
2.1 Owner of Record: C• // (•�
.4hatutam Sq., 'Jo 3etcs 4s it. t4c!ts:4 A. S i)r0.-hcIJ4A 0137}
Name(Print) �441P Current Mailing Address:
4 OO R41- Ylu-bgkl
_ }0.4111 yl Telephone
Signature
2.2 AuthorizedfrAlent:
Vern. Diiiiik' -ON I Coa/cs %Ve. S. Deer F;eld/L/.¢0t>77
Name '`p� /G Current Mailing Address:
��'l� � ��5 ` WS "44. 5-rfoi9
Signature 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
0 el, 000
2. Electrical 4 (b)Estimated Total Cost of
Ai 1700 Construction from(6)
3. Plumbing E �,r O OC Building Permit Fee
4. Mechanical(HVAC) ,a /./. i 175
5. Fire Protection d O 1
&. Totai=(1 +2+3+4+5) '�Lf,� d, `�} Check Number „.35.0
This Section For Official Use Only
Building Permit Number:_ Date
Issued:
Signature:
Bultana Commissioner/inspector of Buikiings Date
,SECTION 5-DESCRIPTION OF PROPOSED WORK tcheck all applicable)
New House ❑ Addition ❑ Replacemenj Windows Alteration(s) ® Roofing 0
Or Doors I&I
Accessory Bldg. ❑ Demolition ❑ New Signs E❑] Decks [0 Siding 1] Other[M
Brief Description of Proposed m,
Work: is A . - ii L - . i .A C. . e A • s s aestddeelec.
Alteration of existing bedroom Yes V No Adding new bedroom Yes V No
Attached Narrative Renovating unfinished basement Yes //l_-
No
Plans Attached Roll -Sheet
ea.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 Ts-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Shahn.on S4nf8nle/D _,as Owner of the subject
property
hereby authorize Vern ON 140f e t NA io0
to act on my behalf, in all matters relative to Wdrk authorized by this building permit application.
,9AYld r>vt/Stc .eG � j�)C — Gr'^/7
Sign!lento rrature of Owner // / Date
I, I/eo h i air r n4 JO d .as Owner/Authorized
Agent hereby decllliare that the tatements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under th4 •ains and penalties of
perjury.
er ,a,, Ear, ;.v, . 4asi,
Print NZr /� P
��G/ , I .
A' f a
Signature otaigesM.gent as
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:Mar
Not Applicable
J ❑
Name of License Holder: UCr 110x1 MarrrhA Ado 6 S O45 / S9
p Ave_ (' JJ / A,� License Number
D Cetafes AS. [ Jrrrim: de �r 'A. 09- 03 -/ 8
Address Expiration Date
.i%3� ‘‘ S-4/c/7
Signat�7 ale e
/ / /vS
9.R-.'stored Home lm• ent Contra •r: Not Applicable 0
/ 8/035-
Company Name ,n/ Registration Number
Tliay9 SiffoI"A35 cG:a{c s 0d - I7 - / 7
Address ��// Expiration Date
A`f
8 Co a it lt. 5-. D ger F:el®/1A d S73 Telephone 9/3 -A6S-Vd IQ
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 MldNo 0
11. - 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 1083.5.1.
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 153(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 Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
Section 4. ZONING AU 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 Size
Frontage
Setbacks Front
Side L: R: 11 R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage 90
(tot area minus bldg&paved
Parking)
#of Parking Spaces
Fill:
(volume&Location) -
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW 0 YES a
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW ® YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO ® DON'T KNOW O YES O
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 O NO
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 12)
IF YES, describe size, type and location:
E. WII 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.
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: 3y Wes4c,aood Tc trace F1ore4cS/''R. oroGa
The debris will be transported by: Role,3Ff s
The debris will be received by: O/IJI11 ft 0/di s S S6 htatn Sftet+ I4oEyck NAologo
Building permit number:
Name of Permit Applicant entcs L4arrih97oti tkayer S4«e ¢ASsoc`ales
24/7 SRe
Date Signature of Permit Applicant
_1:::‘_ The Commonwealth ofMassachuseus
' --T W—!l Department of Industrial Accidents
—
�,: 7,, .. -, ICongressStreet,Sulte100
'— ' Boston,MA 02114-2017
E1/4„_ It'Ivdwmass.goddla
{Torten'Compensation Insurance Affidavit Bdldert/Cootracton/Elecfrldsm/Plumbert.
TO BE FILED WITH TEE PERMITTING AUTHOBTTY.
Applicanttaformadoo Please Print Legibly
Name(Bmiarardraannnaivawq:Thntie t Skre4 RSSmclatzS -Inc_
Address: 8 ( r-n1PC f;1/4)42
city/statd7ap:GeAkhesce MR Phone#: x-113- ( 4:•S 4013
Norm m espryM tied the appropdclebr: Type of project(required):
1.ffem canny::with 20 employees(h0 anaor p1.te).' 7. 0 New construction
v❑lBata sole pmpieanpntners*sod Pace no employees mottos forme in 8. ElRemodeling
my cap*.(Na.alum•comp.Immo:required.)
3.01ama beemowmrdoing all work myna[No wanes'camp.imam chard)' 9. ❑Demondon
4.0 Ism ahomcowana veil be hhem
a mc Go cen to=duct all.askan ptwwens Iwn 10❑Building addition
m
cone Am mmaamnakhehveworkers'co pemr non r:mmaa<crosole 11.0 Electrical repairs or additions
pepeyms with re employes. 12.0Plumbing repairs or additions
S.01 am a peal 13.❑Roof repairs
Thor mbueamcbn 5,.esybyas aid have*ohm'camp nmreal
k❑Wem•mporrdm edbomm,Panmmdmdtkeeryhcofe:actionI MGLc. l4.❑Olha
151,f1(4).rd wane m empioyca[No weans'amp.®mora nonthed)
'Any spWtmel thirteen hen in ort abs an out the maim below crow:ten watlma'oaf po&y Ifomnioe.
t Iiouanwrm Mx:stink this amdwb iodiroaat Pecy in dont all work era dm hire onside oaem mom me mbeet•ocw amSvin iedltffia ash
Naanmese am check the hos norm a erred an dmtisanl Meet Warns de®e ofase mksW YCM and more whether or ea these entities have
employed intim anbcesmmga km employte,Sy torn provide their workers'comp.policy comber.
1 am mu employer dear providing mnrkns'compensation insurance for my employees. Below b the policy andJob she
htformaaon
Insurance CompanyNamc CINI`v fa t‘t te rS
Policy a or Salt-ins.Lie.1r. ¶'V A?X -&-jAt-te. Expiration Date: Ib-'8-(1
lob Site Address: 3 'l bJC}'hwrInG Tcfra f.e City/Stater/AP: Fib rencc,M4. elO6oa
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c.152,WA is a criminal violation punishable by 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 fine of up to$250.00 a
day against the violcri..Acopy of this may forwmded to the Office of Investigations of the DIA for insurance
twvenge 46, z
eI do rehneky��aadn and fpnJ the btfornaaonprovldedabove btrue and correct
Signature: UfiJ Z I . 1 f S . Due: a - S'_l7
Phone 11: 5'/3- G 6 S- 4/ 1 S
Official use only. Do not write In this arts,to be compietedby city or town official
City or Town: Permit/License 0
Issuing Authority(e4de one):
1.Board of Health 2.Banding Department 3.City/Tuna Clerk 4.EleetrIcal Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone 0:
FLOORPLAN SKETCH 'd id " .
BIXNwar: Snanrron StigrlaltbieW - Fie 110116437* " "`� '
P,OPenT Address:3:4Westw354 Terrace
Cnv: Florence .
tender P...esBaRK
Stale:AM - Zia 01062
,�,j/
T4 der }rer /�SSO t (o v cps. Cl.
gt3 �� 5•Ya18 } i7
1
.-0 I, r4chlress
I 3K Cvcskwoed retro to
is f-forc-, cG .:pooG
\I\ b tir i
Bedroom Bath x-
Kitchen
ibic
LO
*ii\
G w
k`,- .1 ¢t� t
,A,simil 4-02° UJB} CV
4fp1$4. 16
Bedroom II Bedroom Living Room
1
36.0'
First Floor
900.0 sf
t
City of P
lOni
BuildingDepartment .
Plan
II
Review
212 Main Street
;aorthampton,MA 01060
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Otai. AfKPbq :r, l.q 90q q 1210;.` fl(Yi i 75.0 :` 210 a Wa.. I
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