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18C-141 680 BRIDGE RD-25 CRABAPPLE LANE BP-2018-1275 CIS#: COMMONWEALTH OF MASSACHUSETTS MU.Block: I8- 14110 i5 CITY OF NORTHAMPTON Lot:-OOI PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateeom Porch Enclosure BUILDING PERMIT Permit# BP-2018-1275 Proiect# JS-2018-002274 Esc Cost: $15000.00 Fee, $97.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: MARK BONDE 67758 Lot Size(sp.tl): 1497897.72 Owner: LATHROP COMMUNITY INC zonine: Applicant. MARK BONDE AT: 680 BRIDGE RD - 25 CRABAPPLE LANE ApplicantAddress: Phone: Insurance: 205 PARK ST (413) 535-9529 0 WC EASTHAMPTONMA01027 ISSUED ON:61512018 0:00:00 TO PERFORM THE FOLLOWING WORK:FRAME 3 SEASON PORCH AND INSULATE 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: FeeTvoe: Date Paid: Amount: Building 6/5/2018 0:00:00 $97.50 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2018-1275 APPLICANT/CONTACT PERSON MARK BONDE ADDRESS/PHONE 205 PARK ST EASTHAMPTON (413)535-9529 Q PROPERTY LOCATION 680 BRIDGE RD.25 CRABAPPLE LANE MAP 18C PARCEL 141 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid 1 Building Permit Filled out Fee Paid Typ of Construction FRAME 3 SEASON PORCH AND INSULATE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included, Owner/Statement or License 67758 3 sets of Plans/Plot Plan THE FqLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF99MATION 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 Permi[ 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 e tolition Delay re ofB rld fficial Date No[e: Issuance o a Zoning permit does nol 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. RECEIVED Department use only MAY G�tylof��Qtha pto Status of Permit: 4�' Ph CumCul/Drlveway Fai lSewedSepticAvailabilityWatedWellAvalieblglyTWO Sets of Sltuc ural Plans one 413587-1240 Fax 41&587-1272 Ploym Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address: Th�(�a spew to be completed by office a5 C,ffPg,RpPz.0 �rJ Map l �G Lot 14t Unit zone Ovarlry District Nc 1A MZ>l l Elm SL Disi CB Obtrict SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of�Record: /' Lh\W1zoDG l omLAtTtAonj ion �4S5c1t �clk ZName(prind /��I���I777/�/ n Current Mainlyld"he Sb-, '6bt l Q/4�� / U Lc elsl I Telephone -''JJ Signa 2.2 Authorized Agent, i.IDE Cn�ys07SG"C'yn pg65 Name(Prim) Current Mailing Address' U13 SZj -Z17 �6 Signature I Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permill apphimnat 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 8 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) �� ✓� 5.Fire Protection 8. Total=(1 +2+3-4i5) Check Number This Section For Official Use Only Building Perm' r: Date Issued: SIlure: l Buildin missioner/Inspector of Bwlding, Date EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) e Section 4. ZONiNG7 All Information Must as Completed.Perrot Can M Denied We To Incomplete Information Existing Proposed Requircd by Zoning This W umn to be MW in by Building Depenment Lot Size Prone e Setbacks Flout Side L: R: L: R: Rear • Building Height Bldg.Square Footage Open Space FooUge (let nua minus bldg&paved N of Parking Spaces Fill: vdume&I 'Wn A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0' DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? ^/ NO O DONTKNOW lel YES IF YES: enter Rook Page and/or Document N B. Does the site contain a brook, body of water or wetlands? NO O DONT 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 © , Date Issued: C. Do any signs exist on the property? YES O NOkv 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 IF YES, describe size, type and location: E. VMI the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it pan of a common plan that will disturb over lam? YES © NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION e-DESCRIPTION OF PROPOSED WORK(chock eN sosS btel New House ❑ Additil ❑ Replacement Windows Alterstion(s) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. Demolllion ❑ New Signs [01 Decks [q Siding X31 Other(��� Brief Description of Proposetl work: amr -5 JASON ? N ANA -rT.)�uy�TF � 1-'1£AT�CI-IAU Alteration of emoting bedroom_Ves_No Adding new bedroom Yes No `{17. Attached Narrative Renovating unfinished basement _Yes _No eAg) Plans Attached Roll -Sheet es.N New house and or addhinn to exiatina housing.complete the toliowina �L L7MB. e. Use of builtling:One Family Two Family O[her 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 stores? I, Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Massoheck Energy Compliance form attached? In. Type of construction I. Is construction within 100 e.of wetlands?_Yes —No. Is construction within 100 yr. floodplain_Ves_No j. Depth of basement or cellar floor below finished grade k. Will building conformlo the Building and Zoning regulations? _Yes_No. 1. Septic Tank_ City Sewer_ Private well_ Cay water Supply_ SECTION 7e-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, +��•II�IJ MLK-Lk � � ,as Owner of the subject property hereby aumo' to act on hag, all matters mlati work authorized by this building permit application. 'Zg' IK Signature o``f Omer 1... ^p NINE- Wk as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are two and accurate,to the best of my knowledge and belief. Signed underthe pains and penalties of perjury. 1�nett i�On176 Prot Neme �/1-XJn �G m,.cf..o °i 2`b S5, Signature of Own Agent Date _ City of Northampton Massachusetts 1 212 pain tieet M ipai Huildvn9„ Worth ton, ov, pA 01060 pec Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, 1 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. The debris from construction work being performed at ,25 CAR&TAi VLE LK-). (Please print house number and street name) Is to be disposed of at: VRILrc�( �( �C ( 1A) (t-' (Please print name and oration of facility) Or will be disposed of in a du/m'pster onsite rented or leased from: yotJ',i�E C�OJSri Pt)C�I �'1L) (Company Name and Address) Signature of Permit App�crr Date If,for any reason, the debris will not be disposed of as indicated,the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. ILN The Coaarroaweahh ofMassachusettc Department of/ndmbiialAechkats I Congitm Sheet,Suite 100 Boston,MA 02114-2017 wwatmassgov/dia W11.1sters'Conspensation Insurance Affidavit:Builders/Contrastors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORTTY. A 1' ttf f ?lease Print 1 'bl Name(Busimane ryynbstion/Irdividual : 7T:)0LYV1- Cr11}�<sV. lt•T10� Address: lxi t !- I=' ,hlL,e ST City/State/Zip: ffA5,!Akb!I- rON , to A- Phone#: 4 IS 529 - 21 Are You en employer'!Check tM appmpriv4 box: Type of project(required). 1. employer with__1, employees(fmlmudorPort-timch• 7. ❑New construction 2.❑lemasole ProDriemror parmcmM1ipeM luvememplay«s working formoin 8. �odeling any ownety.[No worken'mm,inam «nrelented) 3❑I am a Iwmeowmrdoi�g ell work myself[Na workers'comp.insurer«rtquired.]1 9. ❑Demolition 4.❑1 a s a homeowner and will he mien mmmcmrs to conduct all work on no,Property. I will 10[]Building addition thodloonhacmra either name re worm.'tort,m.tion htsomcm are sole I1.❑Electrical repairs or additions pere pdmors with no employees. 12.[]Plumbing repairs or additions s❑Ism.general b-onmenimcmraM lhave ldrtd theaeboonirsctomlisledon the anechcd sit«t. 13 Roofre irs Thea aubrontreclors nova employees and have workem'comp.insunrce.l '❑ Im 6 We are a«rpamnon and its olTiners have emmi sed their right of exemption far MGL c. 14.❑Other 152,§I(4),and wa n.ve m employees.[No workers'camp.msmanee regmred.] *Any applicemtnetchcel m box WI most also fill out the moron below showing thor workers'consternation policy infonmlion. r Bameow«rs who submit this trand.il mbed. r they are doing ell wod end then hire amsideoo radr ma must tewhe a new not those Carries g have rConhaoel. that shack This box men eneched en additiarml sit«tslmwing the mon,ofw apoka, minors end state whether or ml nits«entities neve employee. Ifthe mbrontmctors have employees,they must pmvidc heir workers amp.policy numbm. I am as employee that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. �+ C Insurance Company Nm ae: 2A/U�£' 1 .i-IJP • Policy#or Self-ins.Lia Expiration Date' Job Site Address: .a 9S GFQ$QG�F1� L.N' City/State/zip:—ants,Pr►.1 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,§25A is a criminal violation punishable by a 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 fine of up to$250,00 a day against the violation A copy of this statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. I do hereby ceetif�y/�}Q�/d��('thepainsandpenaitieso rjury lhatfhe infoemationprovidedaboveisirueendderarre2 Signature 1 I "Z Dat Phone#: la 1 - 177 �a Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License N Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone N: City of Northampton Massachusetts Iffi12 B n St bP BaZZ Cl IHSPSCTZL�a 212 Hain street .' M 010 HuildiM c aoxC4nmpCon, NA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes.Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("FDC'). M.G.L.Chapter 142A requires that the"reconstruction, afferetion,renovation,repair,modernization, cnnversion, improvement,removal,demolition,or construction of an addition to any preexisting ownerbccupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence orbuilding'be done byregistered contractors. Note:Ijthe komeoowwn7er has compacted wick a corporation or LIC,blind entity masr be registered Type of Work: ej mLirtEL Est. Cost: 15,ey)n__ Address of Work: =rlv '�5 Z-ti Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s)'. _Work excluded by law(explain) _Job under$1,000.00 _Owner obtaining own permit(explain): _Building not owner-occupied _Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: 5. Z'd • I 'A 169lazy Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,l hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supe i.: Not Applicable ❑ cense Number gos }�4rz� �as �IAnIP[t� l t�n Z • Zn I^n AddressFxpinatn Date Signe[ re elephone B.Reotatered Home lnmrovvearrant Contractor. Not Applicable ❑ Company Name Registr tion Number ) g 6�4 �b5 1�2k ST, � • � Address Expiration Date cI FYM 1 r V til ( Telephone 413 629-ZI7C SECTION/0-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.152,1 25C(e)) Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provice Nis affidavit will result in th a denial of th e lssuanceof the bu'Min pe it. Signed Affidavit Attached Ves....... No...... ❑ INSULATE WALLS R-21 EXISTING GARAGE INSULATE CEILING R- RIGED INSULATION ON FLO❑ 8'X12' EXISTING AIR SEAL FLOOR AND CEILING--,,,, LIVING ROOM 2X6 WALL STUDS WINDOWS .28 U FACTO 1/2° SHEETROCK SLIDER .28 U FACTO VAPOR BARRIER 1/2' PLYWOO OUSE WRAP DONDE CONSTUCTION / 25 CRABAPPLE LANE, LATHROP COMMUNITIES 413 535-9529