Loading...
42-095 (7) 220 GLENDALE RD BP-2000-0899 GIs#: COMMONWEALTH OF MASSACHUSETTS Zap:Block:42-095 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: Deck Addition BUILDING PERMIT Permit# BP-2000-0899 Project# JS-2000-1667 Est.Cost: $2500.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Lot Size(sq. ft.): 52272.00 Owner: BRESNAHAN WILLIAM M&BLANCHE Zoning: SR Applicant: BRESNAHAN WILLIAM M & BLANCHE AT. 220 GLENDALE RD Applicant Address: Phone: Insurance: 220 GLENDALE RD (413) 586-5473 () FLORENCEMA01062 ISSUED ON:4/21/00 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 10 X 12 DECK POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Jnderground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: Fee Type• Receipt No: Date Paid: Check No: Amount: Building 4/21/00 0:00:00 1207 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2000-0899 APPLICANT/CONTACT PERSON BRESNAHAN WILLIAM M&BLANCHE ADDRESS/PHONE 220 GLENDALE RD (413)586-5473 Q PROPERTY LOCATION 220 GLENDALE RD MAP 42 PARCEL 095 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building,Permit Filled out Fee Paid 1l Typeof Construction: CONSTRUCT 10 X 12 DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § —w/ZONING BOARD OF APPEALS 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 Co 'ssion Permit from CB Architecture Committee La Z OO� Signature of Building OfTicial 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. Department use only City of Northam Status of Permit: Building Departme t APR 18 2C �urbCut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sots of Structural Plans phone 413-587-1240 Fax 413-587.1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING i SECTION 1 - SITE INFORMATION This section to be completed by office 1.1 Property Address: -kd Map _ Lot _Unit Zone :5A Overlay District-- Elm istrict _Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: A) Sao & IQ N O�-le Pri t) Current Mailing Address: Telephone �S' 3 Signkture 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building c c,/- (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number This Section For Official Use Only 9uilding Permit Number: Date Issued: Signature: Zd Low Building Commissioner/Inspector of Buildings 4ate Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front 5O 0 Side L: R: L: �d R: 15-0 a© Rear Building Height Bldg. Square Footage a/ % /O��i 0110 Open Space Footage l0 % O (Lot area minus bldg&paved D parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Findi ng ever been issued for/on the site? NO DON'T KNOW ✓ YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location: ;CTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing El Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks Siding [ ] Other [ ] Brief Description of Proposed Work: / 'V l Alteration of existing bedroom Yes No Adding new bedroom_Yes No Attached Narrative El Renovating unfinished baement Yes No Plans Attached Roll ❑ • Sheet 6a. 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 there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? 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 or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT i, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date as Owner/Authorized Agent here declare tha the s atements and informa ion on the foregoing application are true and accu(afe, to the best of my knowledge and belief. '-igned under the pains and penalties of perjury. Pra e Sign re of Owner/Age Date QFCTION 8-CONSTRUCTION SERVICES L Licensed Construction Supervisor: Not Applicable 0 Name of License Holder License Number Address Expiration Date Signature Telephone Not Applicable 0 Company Name Registration Number Address Expiration Date Telephone — SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152, §25C(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 the building permit. gned Affidavit Attached Yes....... 0 No...... 0 11. - Home Owner Exemption 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 person 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 of Employers to Employees 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 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. eowner Signature_0A.Z11 "Ju- O�'C 11A�t p�0 g� � °g (C.x�J iT� �QZ�I�I�111�7�QIZ V Bails achusetta DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 y `PYORIER'S COMPENSATION INSURANCE AFFIDAVIT (lic=Sw/permittee) with a principal place of business/residence at: / (phone#) l/ (street/city/stairJrip) do hereby certify, under the pains and penalties of perjury, that: O I am an employer providing the following worker's compensation coverage for my employees working on this job: (In_sU=ac Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors fisted below who have the following worker's compensation policies: (Name of Contractor) (Insurance Conq my/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) mP � (Name of Contractor) insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (E)piration Date) (attach additiomi sheet ifna«ssuy to include information pertaining to all ooh adore) ( ) I am a sole proprietor and have no one working for me. (�-I am a home owner performing all the work myself. NOTE:please be aware that while homeowners who employ perwm to do m i t_�,nee cons ructioo or repair work on a dwelling of not motor than three units is which the homeowner r=dcs or oo the gtvunhs appurtenant thereto arc ooh gooeraily considered to be employ,=under the week='s comp=satioa Act(GL152,n 1(5)�applicatiou by a homeowner for a license or pelma may evidence the legal status of an employer under the Wo&,cea Compomation Act I understand that a copy of thin eut®ent may be forwarded to tho Deparomeea of Indatstfid Mddw&Ofoo of 112SUR000 for the ooverage verification sad that failure to soc ue coverage under Semon 25A of MOL 152 can lead to the imposition of Mminal penalties coasisting of a fine of up to S 1,500.00 and/or imprison of up to one year and civil pc o&Wc'in the form of a Slop Work Order and a firm of S 100.00 a day against tae. /r For dcpatnacotal use only l / Permit Number ktR M ap# �t# �i of LicensedPetmittce e 4ThAM O O Crztg of Northampton z $ � �lassachnsetts S DEPARTMENT OF BUILDING INSPECTIONS r INSPECTOR 212 Main Street • Municipal Building Northampton, MA 01060 5 MUST INCLUDE: Site Plan/Plot Plan - Showing all buildings with square footage and distance to property lines : aming Plan if applicable . Riling deadline is Wednesdays by noon Reviewed every Thursday 60' ZV lei A/, ppb - �o as G p� / ' v -o 1 I o :o MI-F c� oQ 0 1'01 x 9 loxft i1/e,we 4 S 10.T. U � a P.T s Ts T. f