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#-.