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24C-055 (3) 61 WOODLAWN AVE BP-2018-1384 GIS#: COMMONWEALTH OF MASSACHUSETTS YM-.Block:24C-055 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categorv: ADDITION BUILDING PERMIT Permit# BP-2018-1384 Proiect# JS-2018-002451 Est.Cosv $140000.00 Fee:$304.00 PERMISSION IS HEREBY GRANTED TO: Const Class: Contractor., License: Use Group: ROGER CLARK 021310 Lot Size(sa.ft.): 13416.48 Owner: ANTONUCCI MARILYN Zoning URA(10UV Applicant. ROGER CLARK AT. 61 WOODLAWN AVE Applicant Address: Phone: Insurance: P O Box 34 (413) 586-14910 LEEDSMA01053 ISSUED ON.71912018 0:00.00 TO PERFORM THE FOLLOWING WORK BEDROOM, BATHROOM & PORCH ADDIT ION 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 i! 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 sienature: FeeType: Date Paid: Amount: Building 7/9/2018 0:00:00 $304.00 212 Main Street,Phone(413)587-1240,Pax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2018-1384 CC APPLICANT/CONTACT PERSON ROGER CLARK tj 1 Fa,u� ADDRESS/PHONE P O Be. 34 LEEDS (413)5861491 U 4t&ot PROPERTY LOCATION 61 WOODLAWN AVECq..�/��.-U MAP 24C PARCEL 055 001 ZONE URA(100)/ Lo R6 THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED Fee Paid Building Permit Filled out Fee Paid Tea IConstruction: BEDROOM BATHROOM&PORCH ADDITION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included' Owner/Statement or License 021310 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF0,MMATION PRESENTED: Approved_Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED LNDER:§ Intermediate ProjecC 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 The Street Commission Permit DPW Storm Water Management Demolition Delay 0 /4-/�`�l/� -71 9116' L Signature of Building Official Date Now 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. r / e? RECEIVE@ry01 qortnampton ildin Department 12 lain Street ,. JUN 2 5 20*6 R oro 100 u . No am ton, MA 01060 7-1 40 Fax 413-587-12726 DEPT OF Beaubre Ncmrw PTON.MAateeO r APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FFAMILY DWELLING SECTION 1 -SITE INFORMATION ko( ROA Q, 14 /.,pL�Property Address: II /1 'J 'T This section to be completed by ice W WOOA I 'l'u ve Map dqC, Lot 0.5- Uril -Zone Overlay District Elm SC-0letrict Ca District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record:h [�'I, / 111,7r;A/ /7hy�7acL/ Ll Name(Print) CWntMailing d s : �. 4ff'- -��� - 9io � Teep ankh e— gnature 2.2 A uthorized Agent / 0.Soy- ec 3 y L e s' /4/.4 616 5 3 I�.OG P.r cl'xv]1 Name(P ) Curet Mailing Address: ", 0011-x_ a. Signatu Telephone E Egg r SECTION 3.ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed bpermit applicant 1. Building / O CC (a)Building Permit Fee 2. Electrical a 0 40 (b)Estimated Total Cost of Construction from 6 3, Plumbing 3UOC Building Permit Fee r Ott 40Tf s6 @ , SJ 4. Mechanical(HVAC) a �BD � 1UU, � 5. Fire Protection RPMOVaCt 10 N S 6, Total=(1 +2+3+4+5) 72612110 Check Number -304,00 This Section For Official Use Only Building Permit Number: DateIssued: Signature: Building Commissioner/Inspector of Buildings Date a Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due T Income eie Idogna4ipri ? - , Existing Proposed Re uired yZoning Thi Colum to bb��.ff��I�in by Bac ing D Lot Size Frontage Setbacks Front Side L :: R:Fj L:,--- R_ Be. .._ _. Building Height ---, Bldg. Square Footage % Open Space Footage ... _I % --- r-ut a a mina Hilt,&PavN sdun #orparkin S aces ----- - ---= -- — Fill: ,.Iron¢&Location 't — A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DONT KNOW Q YES O IF YES, date issued:) IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW Q YES IF YES: enter Book .. Page. and/or Document# B. 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 Q , 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 IF YES, describe size, type and location: E. WII the construction activity disturb(clearing,grading, vation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO ex IF YES,then a Northampton Storm Water Management Penni)from the DPW is required. SECTION S-DESCRIPTION OF PROPOSED WORK(check all applicablel New House ❑ Addition Replacement Windows Alterations) ❑ Roofing ❑ or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [OI Decks [ ] Siding[❑] Other[ED] Brief Descriptionp�fpproposed p l ' Work: ad4l' U('00Y{l i Lis'f4h roam +-S+ilCiirlrPl ' OO Alteration of existing bedroom_Yes ✓ No Adding new bedroom ✓ Yes No Attached Narrative Renovating unfinished basement _Yes JLNe Plans Attached Roll -Sheet / 8a i f4e�fYrhes7ei ��t3 en '" . ns i iei' e1DletBthe'followird a. Use of building:One Family Two Farl Other b. Number of roams in each family unit: Number of Bathrooms c. Is there a garage attached? d Proposed Square footage of new construction. TQC Dimensions L )(1G e. Number of stories? p t f. Method of heating? G.A. I n eX 1 5�111C Fireplaces or Woodsloves Number of each_ g. Energy Conservation Compliance /� Masscheok Energy Compliance form attached? h. Type of construction woo rf -- 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 V Yt' k. Will building conform to the Building and Zoning regulations? LX Yes—No. I. Septic Tank_ City Sewer V Private vrell_ City water Supply SECTION 7a-OWNER AUTHORIZATION.TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I �'7 FiY /f/// � v r 1l ka'l as Owner of the subject property / hereby authorize ra / ge," ( /yG!/'/` to act on my behalf, in all ma ers relative to work authorized by this building perm application. Signature of Own r Dale I, as6@MdAuthonzed Agent Qedare t0th6ecsttements 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. e 04G.0 l�laL-I\ Print Nam 04 Signature of 0 erlAgent Dale y SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor p /1 / Not Applicable t£ Name of License Holder: 12D0 e r 1 L-�d-rlC C5 —DYl 3/O License Number Co R0K 21 geed i / 1/t 0/03 /13f/lao Mdmss Expiration Date � `H3- 30l Signatu Telephone �r�0i �' o er c1arEC • Cd S:Re RoumeF oICNot Applicable £ Gene�s� C6n�rdLJd � Comuan ame Registration Number a3 B N MAplc Sr �� / Address �^/nExpiration Date rhCe-Ce Z`1q 1/�� te :�- Telephone /�(/"3---Vr SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§26C(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 thebuilding permit. Signed Affidavit Attached Ves..L,./£ No-.... £ The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) 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 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 parse.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 mfEmployers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,You may be(fable 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 The Commonwealth of Massachusetts Department of Industrial Accidents s Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information p Please Print Lfeeibly Name (Business/Organizatim � Jlndividual): 4 r 0 • ��Af/� (CSS C r-j lfOn F, A Ibn Address: P0, Boy, 31/ City/State/Zip: L'"&IIJA 610-5-3 Phone #: ��3 —3 6E/—�a✓� Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. P1 New construction employees (full and/or part-time).` have hired the sub-contractors 2.Q I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' camp. insurance comp. insurance.= required.] 5. E] Weare a corporation and its 10.E] Electrical repairs or additions 3.❑ q ] officers have exercised their 11. Plumbing repairs or additions I am a homeowner doing all work ❑ g P myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 131-1 Other comp. insurance required.] *Any applicant that checks box a must also fill out the section below showing their workers'compensation policy information. tHo meowncrs who submit this affidavit indicating they are doing all work and[hen hire outside contractors must submit a new affidavit indicating such. =Contractors Nat check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entitles have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepok'ey andjob site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tinder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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 violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerrdfy under the pains �and penalties of perjury that the information provided above is true and correct. /t/rf Sinatme� r `��1""'� Date �'L#t? Phone#: yf3- 36 /u —(qald, Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2 Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: City of Northampton ' � Massachusetts z 212 Nein street • Municipal Building 9 Northampton, NA 01063 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner' as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants any person(s)who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing &gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location 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: 6/ WA I a w„ Ave - The debris will be transported by: Amk ersf Ttuc 1 ina The debris will be received by: Vdje-j, `N n s'er Building permit number: Name of Permit Applicant aR��o Clam IOvt � Date Signature of Permit Applicant 6/28/2018 City of Northampton Mail-61 Woodlawn Ave cam Of( 1 Louis Hasbrouck<Ihasbrouck@northamptonma.gov> 61 Woodlawn Ave 1 message Louis Hasbrouck<Ihasbrouck@norlhamptonma.gov> Thu, Jun 28, 2018 at 12:19 PM To: rogerpclarkgc@gmail.mm Cc: David Gardner<dgardner@northamptonma.gov> Roger, The zoning is OK for the addition at 61 Woodlawn. The plans are approved except that per Mass amendment AJ102.3.1, the whole house needs current code smoke and CO alarms. Mark up the electronic plans, including existing basement and 2nd floor, send them to us and we will issue the permit. AJ102.3.1 Adding or Creating One or More Sleeping Rooms. 1. Single-family Dwelling. When one or more sleeping rooms are added or created to an existing dwelling, the entire dwelling shall be provided with smoke, heat and carbon monoxide protection. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413) 587-1240 office (413) 587-1272 fax 61 Woodlawn 2818.06.28.pdf 2091K haps.//mail.google.com/maillwlu/0/?ui-2&ik=eo fl9a57e8,jsve,6HPtoh-TLvo.en.&cbl=gmail_fe 180624.14y1&view=pt&search-sent&th=1644730fc... 111 t� 4 LEGEND FOUND IRON PIN IRON PIN TO BE SET UTILITY POLE FOUND STONE BOUND IINMARKED POINT ,. �j ._ r_......,.` � � �;.,d � q -�- �� S�conc�. f lacr I f _L �- � 1 � � � �_1 l t .�5'i_io MCh _ a NK K 12092, PAGE 322 PLAN BOOK 8, PAGE 38 LOT #13 49.09-02 23^ W W 15..47 'IW 3.02!2 9 0�23^ o�W 1 .2' 17.5' h _ o� pP.op�v _ooh p�l'I'lor� ON 2.7' � 1 d '0 ai 00 3 3 ol ^ N . > n 0 I8.3� #.. - 24b' -Z 61 23.8' I -walk] 76.52' 762'5.08' 74.95' 62 -- N '31'45" E N 31'45" E N 62'31'45" E WOODLAWN AVENUE "EXISTING CONDITIONS" PLAN OF LAND IN NORTHAMPTON, MASSACHUSETTS PREPARED FOR �tH � FRANK E. AND MARILYN ANTONUCCI LEGEND RANDA!LLN SCALE: 1"=40' JANUARY 20, 2016 E. HAROLD L. EATON AND ASSOCIATES -1NC. 1503 » REGISTERED PROFESSIONAL LAND SURVEYORS {35032 9 FOUND IRON PIN <'14 235 RUSSELL STREET — HADLEY — MASSACHUSETTS IRON PIN TO BE SET SUR E� 413-584-7599 413-585-5976 (fax) UTILITY POLE emoll — hlectonGool.com 0' 40' 80' 120' FOUND STONE BOUND UNMARKED POINT