38D-029 (2) 292 1/2 SOUTH ST BP-2017-1072
GIS rt: COMMONWEALTH OF MASSACHUSETTS
Mao:Block: 38D-029 CITY OF NORTHAMPTON
Lot:-00t PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit 4 BP-2017-1072
Project# JS-2017-001835
Est.Cost: $12095.00
Fee:$78.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: CARL WOODRUFF 109983
Lot Size(sq. t): 9191.16 Owner: YEARSLEY JOSHUA
Zoning:URB(100V Applicant: CARL WOODRUFF
AT: 292 1/2 SOUTH ST
Applicant Address: Phone: Insurance:
30 PINE ST 2ND FLOOR (315) 854-4024 WC
EASTHAM PTO N MA01027 ISSUED ON:3/28/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:RENOVATE ATIIC ROOM, INSTALL NEW
WINDOW, NEW HARDWOOD FLOOR, NEW STAIR GUARD, REMOVE PARTITION WALL, ADD 2
RECEPTACLES, REMOVE MASONRY COLUMN
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: Date Paid: Amount:
Building 3/28/2017 0:00:00 $78.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1372
Louis Hasbrouck—Building Commissioner
File 4 BP-2017-1072
APPLICANT/CONTACT PERSON CARL WOODRUFF
ADDRESS/PHONE 30 PINE ST 2ND FLOOR EASTHAMPTON (315)854-4024
PROPERTY LOCATION 292 1/2 SOUTH ST
MAP 38D PARCEL 029 001 ZONE URBI100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building W ' I�
Building Permit Filled out
Fee Paid
Typeof Constmctipn: RENOVATE ATIIC ROOM,INSTALL NEW WINDOW,NEW HARDWOOD FLOOR
NEW STAIR GUARD, REMOVE PARTITION WALL,ADD 2 RECEPTACLES,REMOVE MASONRY
COLUMN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildiro Plans Incl.ded:
Owner/Strnemem or License 109983
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORAIATION 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
ti ' otition Delay
-° � 3 -eve i7
Signature of Building "icial Date
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
-,�II 'i
IMpMmwa u.aay
City of Northampton Status of Penni
/� Building Department Cuff QMDdveway Perms
212 Main Street SearedSeplic AvaiabMty
20/1 Room 190 Water/Well AvallaMllly
Northampton, MA 01060 Two Sets of Sbudural Plans
phone 413-587-1240 Fax 413-587-1272 Ptat&SW Mon*
Offer Sped._,_
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION I
...... This section to be completed by office
1.1 Property Address:
212-iii sotAL .64 Map Lot Unit I
Ni iHawawr, 010(0O Zone Overlay District j
ue n l (�
r m{ase.District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT (
IIlIa.lOwner ofRecord. X Pkgst see a{Eackert Con+rACts I
I
I Name(Print) Current Mailing Acores:
1 , ..... Telephone
I Signature
1
^y2 Authorized Agent: I
! t Ar I Wdat�rg l,. ILL-- r n4av1k g
Name(Print) / /j Current Mailing Address: I
1 �( .{/f-.'er 77/77,1, -a7-1000 .. fi
Signature Telephone
1
t,§ECTION 3-ESTIMATED CONSTRUCTION COSTS i
Item Estimated C.oct(Dollars}to be ! Official Use Ong:
completed by permit apdicani
1. Budding I:]Ij / P,A 55- I (a)Building Permit Fee I
.X! t�Ol iJ !! .
2. Electrical rr MJ 1 t-- (b)Estimated Total Cost o/
Y �J. crnrsuuctionfrom(B) ...__
3. Plumbing I ------- Building Permit Fee
4. Mechanical(HVAC) //
5. Fire Protection / a f/
E. Total=(1 +2+3+4+5) lit
/ Mc.
. Check Number /e,?5'
This Section For Official Use Only
Date
Building Permit Number Issued:
iSignature' ..
1 Building Commissioner/Inspector of Buildings Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Informatsw..
Existing f Proposed 1 Required by Zomn
1 1 This cokmm in be ft Ilea u_.
Building Oeoartmerc
Lot Side 0.211 Ac(es 54-le s
Ematzee 1 rt
t F
k
tb
Seacs Front
11111
Side I L: R: L: R:
Rear
Building Height t
Bldg.Square Footage I i
Open Space Footage
ILot arca minus bldg&paved tt
Parking)
of Parking Spaces
I u
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES 0
IF YES: enter Book Page and/or Document ft
3. Does the site contain a brook, body of water or wetlands? NO DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained () Obtained O , Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size. Noe and tocatior
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 0
IF YES,describe size, type and tocano
a. Wil the construction activity disturb idearing,grading,expavation,or filling)over 1 acre or is it part of a common plan
mai will disturb over 1 acre? YES 0 NO
if YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION S-DESCRIPTION OF PROPOSED WORK(cheek all aQp lcabist
New House ❑ Addition t i Replacement_Wj'ndows I Alteration(s) I Roofing f.,
Dr Doors OK
Accessory Bldg. ❑ I Demolition LI New Signs ICI
i Decks [q Siding IO] Other in.
DescriptionpfPr000qsed
:York: Rev,sell rml/ inShlsew diadoiA ctL) I7crd++cODok gooftofu) Sulo& 0.tYPwQP pri
d] warIr
t No add 2 rtrP 4C{Pc,
Alteration of existing bedroom Yes No Adding new bedroom Yes x„ Y{w1ovP t7a5a`Y+i
Attached Narrative Renovatingunfinished basement Yes No
Plans Attached Roll -Sheet
6A If New house and or addition to exist¢hcihousint cess the followino.
I a. Use of budding:One Family Two Famd Otne:
— i
{ b. Number of rooms in each family unit' _I Number of Bathrooms
{
Ic. Is there a garage attached? I
i J. Proposed Square footage of new construction. Dimensions
Number of stories?
i `
Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
1. Type of construction
j i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes Nc
j. Depth of basement or cellar floor below finished grain
1 k. Will building conform to the Building and Zoning regulations? YesM. .
11. Septic Tank City Sewer Private well City water Supptk
I SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN ( t ��(( 4 + +
3WNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I )(Def it'i aCHtpl CDattrge it
I I, ,as Owner of the subject
ocerty
hereby auihoriz=
to act on my behalf,in all matters relative to work authorized by this building permit applicanor..
I Signature of Owner '' Dao
I. 'A✓/ Woodru as Owner/Authorized
t Agent hereby declare Mat the statements and information on the foregoing application are true and accurate,to the best of my knowledge
' snd belief.
i Signed/� under/ the pains and penalties of perjury.
I (—a4l LJoodro - I ..mint
�i
/t , 3Vy,7/1�
I Signa ure of Owner/ get La.
I SECTION 8-CONSTRUCTION SERVICE
18.1 Licontlad Construction Supervisor I Not AAodicatffit
/
I Name of license Helot.. C-Rog00001/f1( t lj-1j/lp3
1fIlicense Numnc'
So P,be Ott /..1) 000r. ]�GC° 14 PLI /M 1* 3/4/zo2e
dm
..wsa 1 Expirations
/ ,6; 3f $5U-ydze
d
I Sbn re c Telephone
I { I
1 I
' >Reandttred Horns MwrawmentGowhsIXor: j Not Applicable 0
I Company Name 1 Registration Numoe
xbow PCB gtA\ck s q/ -o/fg.
Address� t /1` ;le
1 r q (�� 1 Expiration Dat
(22- I" Ch54r'I't `�-'t l l e.....�V t fGrc✓N Telepnont 4/3-527-9txo
� I i
r SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.l.C.152,§25C(6))
:Yorkers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result
I in the denial of the issuance of the building permit.
' Signed Affidavit Attached Yes No 0
11. - Borne Owner Exemntiov
The current exemption for"homeowners"was extended to include Owner-accented Dwellings of one(I) or two(2)famine..
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.e.:
Definition of Homeowner:Person(s)who own a parcel of land on winch he/she resides or intends to reside,on which there
''a.or is intended to be.a one or two family dwelling.attached or detached structures accessory to such use and'or rano
structures.A person who constructs more than one home in a two-year period shall pot be considered a homeowner.
nch"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shall be
responstbie for all such work performed under the building permit
ns acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
.ompienon of the work for which this permit is issued.
,Jso be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to
empioyees 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 perms
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 Caws Annotated
Homeowner Signature
City of Northampton 212 Main Street,Northampton. MA 01066
Solid Waste Disposal Affidav:
I n accordance of the provisions of MGL c 40, S54. I acknowledge mat a:*
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
acensed solid waste disposal facility, 1alIs defined byIIMGL
((c 111, S 150A.
..adressofthe work: Z' Z-'!L £OU LL S} Ihovr�Iatcn NA 0(064
The debris will be transported by: ,4Ilrn'S Rol.O L.ontuitger SPrv!C€
The debris will be received by:
Building permit number oo
Name of Permit Applicant 1:4 rl U000 rig
/23/11- '
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
^ der Department of Industrial Acciaenr�
3mill
f' Office of Investigation-
I Congress Street. Suite In-
,
Boston.MA 02114-20r
'.F., . :rww.mass.gov/tire
Xrorkers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
..pplicant Information (7 Please Print Legibly
ame(Business+oraanizadonsNttividualr Oki Orta C$t6q gliiit}}
ly
.udress 12 f i e Sa �i II r a t?c n r 010 7-
City/State/Zip: Phone=. Y/? 52.7 loft
Are you an employer? Check the appropriate boy: I f Type of project(reouireds. i
1.a I am a employer with S 4. 0 I am a general contractor and t
w have hired the sub-contractors 6. ri New construction•
employees (full and/or pan-time).
listed on the attached sheet. 7. 2 Remodeiina
2.❑ I am a sok proprietor or partner-
ship and have no employees hese sub-contractors have R. ❑ Demolition
working for me in any capacity. employees and have workers'
Com insurance.: 9. ❑ Building addition
[No workers' comp. insurance P
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing an work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp. tight of exemption per MGL l2 ❑ Roof repairs
insurance required] t c. 152, §1(4),and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box isl must also till out the section below showing their workers'compensation policy information.
1 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new afdavit indicating such.
tContmctors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or nor those entities have
employees. If the soh-corm-actors haveempioyec:,they must provide their workers'comp.policy number.
t am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. I
osuranee Company Name: ` 6..
t _,.. . Ca.ee..N
Policy#or Self-ins. Lie. #:(/ (p Sip ,.i)e,- 00 61 VT 47 -b - 1 b "T�— Expiration Date,: 1:1772:7711` n
Job Site Address: 2Il t(L 70r 7lE. City/State/Zip. IVe.4l140119 eniM!( 0100
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date.
Failure to secure coverage as required ander Section 25A of MOL c. 152 can lead to the imposition of criminal penalties of i
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 tine
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 DLA for insurance coverage verineauoc
I.do hereby certify under the s,ins ,n• r enalties of perjury that the information provided above is true and correct
1. attire: III _�:Ara( .% _ Date: 327/II'
fltone#: 9 c. to ...
aOfficial use only. Do not write in this area,to be completed by city or town official I
• f
City or Town: Permit/License# I
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
. ..Other 1
r I
a ! xyl��c43,y � ik'abhg
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OXBOW DESIGN 8ULD,IjC
HON:1y-4242803
C5*.LICENSE CS-1o0183
LICENSE:180013
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4 9
'� `� ' '� o •• Slosh*Yearsley AND KeIim Nurse,desSe to contract with Oxbow
:`.a Stet*the property located at 292 N South Street,Northampton.NU
mnderdrisatpeement wnskfsofthe to0ow'mg.
f. subflmlat.oeossar4 insb8ingrmflnished red oak flooring,
=tom $ •
-'and hlscalOrKbasicAasehaaeh
alredoek*Eng and balustrade alongthe edge ofthe stair opening at the
,�s, ,tp „„ �„ MafMblirlgwSbws with 2$-M se6-8r vinyl double-hung.wmdo ,
' * �_.*.*-team .€s 9 xy"` amimdtfie window;patddrrgof the siding as needed,patinae
r anrleatetortrim bait foam insulation directly around me
"<3 s =am' - ' �. "t'e'kcl back,minor anth adframing repair,Insulating and seams
'2W tl s ' outlets on GableY NI,estimate contingent on being able to fit neW
ThillbeeSdXbdildes°Winedfn dleprovkSummary Molest Other
_ _ s ,2TM ->aep11M4AaaenWTherConbatece.limy changes to tiro FiniaTes
x �" m+� 6n.y(FaomtrALy�J2'fA47-(Estimwted work.daVa eota!$S
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aniac-
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h. i ingoldes about a contractor or sor subcontractor relating
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/ / City of Northampton
6 Building Department
Plan Review
212 Main Street
Northampton, MA 01060
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