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22B-030 9 CORTICELLI ST BP-2019-0935 GIS s: COMMONWEALTH OF MASSACHUSETTS Map:Block:22B-030 CITY OF NORTHAMPTON Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateeorv: demolition BUILDING PERMIT Permits BP-2019-0935 Project JS-2019-001568 Est Cost $1000.00 Fee: $30.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use croup: Homeowner as Contractor_ Lot Size(so. ft.): 7840.80 Owner: LINNELL JOSEPH zoninw URB(100)/ Applicant. LINNELL JOSEPH AT. 9 CORTICELLI ST Applicant Address: Phone: Insurance: 3 WESTVIEW TER (413) 695-2606 O EASTHAMPTONMA01027 ISSUED ON.3111/2019 0:00:00 TO PERFORM THE FOLLOWING WORK:DEMO SHED 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 Occuoancv sienature: FeeTvpe: Date Paid: Amount: Building 3/11/20190:00:00 $30.00 212 Main Street.Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File NBP-2019-0935 Oitl D F0 (Z' APPLICANT/CONTACT PERSON LINNELL JOSEPH ADDRESS/PHONE3 WESTVIEW TER EASTHAMPTON (413)695-26060 PROPERTY LOCATION 9 CORTICELLI ST QED\ MAP 22B PARCEL 030 001 ZONE URBO00V THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid 41 Building Permit Filled out Fee Paid TvyeofConstrution: DEMO SHED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owned Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN RMATION 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 Demolition Delay 371 ll 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&Development for more information. SS u Department use only City of Northampton Status of Permit: f Building Department Curb Cur/Drtveway Permit 212 Main Street Sewer/Septic Availability Room 100 WatertWell Availability Northampton, MA 01060 Two Sets of Structural Plans y phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR, ENO+'ECCCE4N*®NE C R TWO FAMILY DWELLING SECTION I -SITE INFORMATION This sect t completed by office 1.1 PronerN Address: 0 Lot (J 3 d Unh 9 CorticeHi Street, Florence, MA 01062 NORTNAMpTON.MA01p60 Zone riay District Elm SL Dlahic Ca Dlchlct SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Joseph L innell 3 Westview Terrace Name(trim) Cum nt Mailing Address: 413-695-2606 Telephone Signature 2.2 Authorized Agent: n � Name(Prim) Curtent MaiFng Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS hem Estimated Cost(Dollars)to be Official Use Only —completed by perrmt applicant 1. Building $9,000.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building PermH Fee ?� 0 D 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) $9,000.00 1 Check Number (O This Section For Official Use Only Building Pemrfi Number: Date ed: Signatum: Building Commissbrredlnspector of Buildings Data linnelljl@gmaii.com EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) AL to /2eMAlA fuCt a ED Section 4. ZONING All Information Must ee Completed.Permit Can Be Denied Due To Incomptete Information Usting Proposed Required by Zoning 'Ibis Mumu to be filled in by Building De annum Lot Size 7,840 7.840 Frontage Setbacks Front Side L R: L: R:_ Rear Building Height 2 stv 2 sty Bldg.Square Footage 1735 100 11 1735 Open Space Footage % (tat area minus bldg&Paved #of Parking Spaces 2 FII: A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document# 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 O , Date Issued: C. Do any signs exist on the property? YES O NO O 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 O IF YES, describe size, type and location: E. Will the consbuc ion activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb wer 1 ase? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION S-DESCRIPTION OF PROPOSED WORK(check all anallcabtel NOW House ❑ Addition ] Replacement Windows Afieratlori(s) E3 Roofing ❑ Or Doors 0 Accessory Bldg. E3Demolition ❑ New Signs [D] Decks [q Siding r-3] Other[O] Brief Description of Proposed 1)f nonaoo of gmgds ,2i Work: Alteration of tensing bedroom_Yes X No Adding new,bedroom Yes X No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet ga.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 Mere a garage attachadl d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of hea0ng? Fireplaces or Woodstoves Number of each g. Energy Conservation Compka os 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 a cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Sepfic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMDLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 .as Owner of the subject property n1a hereby authorize to act on my lr: iBygToan o work authorized by this building permit apdin�tiort. �y/ Signature of Date 1, J-. L;h^ ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to Me best of my knowledge and belief. Signed under the pains and penalties of perjury. fsepk [,;nnc 1/ Print Name 2 28 1 Signature of Owner/ Date SECTION 8-CONSTRUCTION SERVICES 8.1 Lid CoMnxUw Supervisor: Not Applicable ❑ Name of License NoW . n/a- Homeowner to complete described work. License Number 3 Westview Terrace, Easthampton, MA 01027 n/a Atltlress��� n/ anon Dale n/a Signa Telephone 413-695-2606 9.Repiskued Home Improvement Contractor, Not Applicable ❑ company Mame Registration Number n a n/a AddressExpirstion Date Telephone n/a SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,;25C(S)) 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 Af klaW Attached Yes....... or, No...... ❑ City of Northampton V ek Massachusetts j) I�PdR1aET1T OF lreZLDZAO INSPECTIONS Pv min street . ami' p r Buira:nv ��'.�� Northsvpton, !A 01060 f 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 he registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the`reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demoldion, orconstruction of an addition to any preexisting owner- cupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or buildimf be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered TypeofWork: Demo N"61 Aer IaroM<nf (+bird^wS Oec)( Es[.Cost 9 Oar 00 p {' —/ AddressofWork: / Co/ fi//e � �r Street F1err,1 ,e Miq 01061 ' 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): A 11 W=-� c�er�rr bt � +� dt d" S y _,,_Building not owner-occupied o w ncr _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 ag nt of the owner: Date Contractoame HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: 2/Zb/iI � J--5c,,4 Date I Owner Name ngnatu� City of Northampton WiiTaSDIICji Massachusetts9OILDING AoP Ws212 Nein St t .Municipal a Idin North mp ., M 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, 554, 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. The debris from construction work being performed at: `f co' f ecll( S1. 6 e F/o�enee (Please print house number and street name) Is to be disposed of at: V23`I Ea3�ti4Mpfea� Ed, 5 Ile, geC.YG �,�S •- /,/o�jLe< rop fen, MN o1060 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: /S M, Nrn (zit O6ogZ (Company Name and Address) 2128,9 .T. s,t- Signatufe of Permit Applicant or Owner 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. The Commonweahh ofMassachuseas Department oflndustrim/Accidents l Congress Street,Suite 100 - Boston,r►DA 021/4-2077 www-mass gov/dia porkers'Compemsatios Insuraace Affidavit:Beiklers/Contmetors/E[ectricions/Plumben. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (BusimsaOrgwinfioNmdividual):Joseph Linnell Address: 3 Westview Terrace City/State/Zip:Easthampton, MA 01027 Phone#:413-6952606 Are you an employer?Cheek no,appropriate Dox: Type of project(required): r_❑1 am sertpoya wiN m�ployces(fldl am/or pm-6rm).• 7. []New construction 2.[]lamawieproprie patnvshipadhnenoemplomswoddng formeit $. E]Remodeling ary cgiaciN,Mo workers mm2,-insurance .,uired.l 3.Q1 am a honmwrcrdoiogall work myself[No workers'cunW.irnumnm requiredl' 9. Q Demolition 4f-1 1 con a ho rmwncr m1d will be ruing coram ton to conduct all work on my Property. 1 will 10❑Building addition ensure first all contractors eiNer have workers'comperamion imunamor are sole I LE]Electrical repairs or additions pnpnolon with a,elmloyms. 12.0 Plumbing repairs or additions 5.E31 an a genal contractor and I have haW ase subcarina ton lived on the madled shra, 'flare subcootraYors have employees and have workers'.,insuraooct 13.E]Rwf repairs b WemamrWtnion adi6 oaxas haveexemiscdthearightofeman ion pr MGL c. 14-QOtherwindows,deck repairs 152,1I(4),adwehavenumn to os.lNoworkers'carp.iruurmcerequiredl 'Any applicant arra checks box MI ormt also fill am the motbn below showing theirworkm'mmperamon policy information. t Hommwners wMwu itthisa dwititdimmgdaymdomgallworkand Nenbucouuidecomatorsmustsubmitamwaflid itkdimt sucb. mnployctorsahacheck this bozmh m plow , tiomishmtshowing Nename oflhe spdionectors and stare whethmwnot Nose entities have elrwloyees. If th subcomactors haveemployees,NeY must provide the'v workers mmP.PWicY number. I am an employer that is providing w rken'rnmpemation inuroncefor my enwi0yem Below is the policy andjob she information Insurance Company Name: n/a Policy#or Self-ins.Lic.#: n/a Expiration Date: n1a Job Site Address: 9 Corticelli City/State/Zip:Florence, MA 01062 Attach a copy of the workers'compensation policy declaration page(showiag 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 forth of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.Acopy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pain artdnakies of perjurythan the information provided e iroue and correct Si ature: � � Date' 7; 111 Phone 4:413-695 OJfwW we a*. Do not write in this area,to be completed by city or town oljiciaL City or Town: PermittLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Perms: Phone#-.