35-269 (21) 78 TURKEY HILL RD BP-2021-1428
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:35-269 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: shed BUILDING PERMIT
Permit# BP-2021-1428
Project# JS-2021-002369
Est. Cost: $23756.00
Fee: $156.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 186828.84 Owner: PELLEGRINO CHARLENE
Zoning: Applicant: PELLEGRINO CHARLENE
AT: 78 TURKEY HILL RD
Applicant Address: Phone: Insurance:
78 TURKEY HILL RD
FLORENCEMA01062 ISSUED ON:6/1/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:14x24 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.
• . .1 '• .
Certificate of Occupancy Signatur i•
FeeType: fate Paid: Amount:
Building 6/1/2021 0:00:00 $156.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File# BP-2021-1428
APPLICANT/CONTACT PERSON PELLEGRINO JAMES R&CHARLENE
ADDRESS/PHONE 78 TURKEY HILL RD FLORENCE
PROPERTY LOCATION 78 TURKEY HILL RD
MAP 35 PARCEL 269 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out Fee PaidTypeof Construction:_14x24 shed New Construction
Non Structural interior renovations6\6)
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
X 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
' Oi 69,Na
Sign ture of Building Official 11 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.
' 1
,e2C,....,
The Commonwealth of Massachus ✓e& d
Board of Building Regulations and S ds1 FOR
I
Massachusetts State Building Code, 780 �Q�� IQIPALITY
��P ,(,� USE
Building Permit Application To Construct,Repair,Renov' �_ ''p lish a Revised Mar 2011
One-or Two-Family Dwelling '-� ^q p<cT
This Section For Official Use Only ,°soo'tis
,,�� r
Building Permit Number: 6f'',I—�y,Zeei Date Applied: _
: 11 b% -61.5)-)A41
Building Official(Print Name) Signature uu�� -I e
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
7$Tvt-key 140iRd IL 35 035'-249-GO1
1.1 a Is this an accepted street?yes ✓ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
2r2. jleb /868z1_ isy b.(03
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1g0Pr \32Fr 100 Fr
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private Zone: _ Outside Floodne? Municipal 0 On site disposal system Gier
Check if yes
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: _
Char/en e i ll e5,-/ a o Flo r.en c- - 1 MA O/o 6,Z
Name(Print) City,State,ZIP
Ig 71trk.e,y Nr// Rol y/a-cis-663r my,0 g6,9mac'i. oan
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 12 Number of Units Other 0 Specify:
Brief Description of Proposed Work': vs4-4-ij /u X Z4/ 3Ii 1 c i 3/y i &_
,„,..1.. ,
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 0?3 ,7�-6 Jo I. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All F�
Check No.2. i Check Amount: IG V''
Cash Amount:
6.Total Project Cost: $ a23, 75G /U 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
�O-�Ea �,A.ev k) �K.'( �5 }�) c 2-7530 1 l��I a
Licennsese Number Expirationn Date
Name of CSL Holder
List CSL Type(see below)
2-i ieCetr
No.r and Street Type Description
C' �N CT '�(pO Z y U Unrestricted(Buildings up to 35,000 Cu.ft.)
i w / L R Restricted 1&2 Family Dwelling
City/TowiY,State,ZIP M Masonry __
RC Roofing Covering
WS Window and Siding
p SF Solid Fuel Burning Appliances
E' o- Sit - Io4O I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(H IC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
City/Town,State,ZIP Telephone
SECTION 6: 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.
Signed Affidavit Attached? Yes 121 No .0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S 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.
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
71/164)
Print Owner's or Authorized gent's Plaine(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE: ` ,-z B '9 4'
REAR LOT DIMENSION:
REAR YARD No Fld
p
v
ti--
i i 2 Fr obi 16. .
/ 6 "
IlltSIDE YARD t 2✓2 FT i SIDE YARD
4.
O
FRONT SETBACK LOFT
FRONTAGE ly O, 3
City of Northampton
4• Massachusetts '<<
4
11 DEPARTMENT OF BUILDING INSPECTIONS
a
rv` eit
212 Main Street • Municipal Building CDC
Northampton, MA 01060 JjfriN `^��
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
5/,)eb //y ),4-5sern (k1
The debris will be disposed of in: /
Location of Facility:
The debris will be transported by:
Name of Hauler:
Signature of Applicant: Date:
The Commonwealth of Massachusetts
►* Department of Industrial Accidents
—_» (� I Congress Street,Suite 100
`-__ — Boston. _1LA 0?114-201 7
wwis masxgov/dia
11 urkers'('omprnsation Insurance Affidas it:Builders/Contractors/Elect ricians Plumbers.
10 HE FILED%1 1111 1 lIE Ptr R'.111.1-f1M:AI'THORfI s.
Antillean,Information /����� Please Print I_ri:ibls
Name IHus Oiness rti.i ioaldividual): (_/' a i-/et-7.P Re/J jr/ n
Address: ` ' Thr-ife,ey this gel
City'StateZip: Pare -7c2-, till o/04'2- Phone#: h1/3 S7S '4)<0��
err you an imployef'!(bri the appropriate bit:
Type of project(required):
la 1 am a envies cY with rtte4luyees(full and or pat-time.• 7. 0 New construction
20 l am a sok props-Kim or pcutamhif adbase nu empknes-s VIorkifti: for me is 8. D Remodeling
ants carmen.,No Isorkers.cony.iaelaaoix nywnd_d
9. p Danolition
RC 1 am a homeowner dome all work myself_No wrwkcr;wags insurance n.-ywnd_l"
10 0 Building addition
4.�am a ISmcow net and will be hump sentraa ors to conduct all wiw►on my prup►Yty. I*in
ensure that all lYMliraeWrs either hay e'warrla1) corr4;Yl's:h a insurance 1,f Me MAC 11.(J Electrical repairs or additions
proprietors wlih no employees.
12.0 Plumbing repairs or additions
!ID tam a o neral contractor and I has c hired the subcufftraeturs listed un the attached sheet 13 Roof repairs
These subcontractor lute employeesand have"uulters comp.arafaate."
11.0 We a a corporation and its utfeers base ctim ised then null,..I c Ucn4itna1 per SI(:I_c_ 14. ()dui 6 �
sue
152.f l(4►.and we hays no employees.(Nu workers.comp.*nun au cc sequinvf.(
':any applieaatlhttcheeks box al must also fill out die unarm b►luw slxo.,fag their workers'compensation pulley information_
I loincownera whir submit dui aft-mini'man:ming they arc"hinny all work and then hoc outside contractor*111111111i mama a ni:w Oliva iaiaiahantl
t .miracton that check this tees must attached an additional sleet shou fit.the name of the sal'—aina..turaadlM!whrthei ur not don antifinshave
irfiplowes. It the sub-contractors lase.-m,luyer s.thes must provide their workers'corgi.pulley number.
I am an employer that is proridinx worLers'compensation insurance for ally employees. Below is the policy and job site
information.
Insurance Company Name:_ —
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: City/StateiZip:
Attach a copy of the workers'compensation policy declaration page(showing the policy aawther awl expiration date).
Failure to secure coverage as required under MGL e. 152.*25A is a criminal siolation 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 violator_A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby terrify under the pains Penalties of perjarr that the information provided,at bore is true and correct_
Signature: � `— DDatc_ /T/// /-2/
Phone#: `// -c7S=l
Official use unit Do not write in this area,to be completed by city or town official
Ciq or Tow n: Permit/license#
Issuing.tuthorih (circle one):
I. Board of Ilealth 2. Building Department 3.(It'll-own Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
( untact Person: Phone#:
City of Northampton
0,0
OaMS,C
rMassachusetts $ • '• ._
( w _ DEPARTMENT OF BUILDING INSPECTIONS y,
212 Main Street • Municipal Building v`., CDC
' ~r/ Northampton, MA 01060
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
S/2 067
I, —//ar/-e7P- / e/k ri tiC) (insert full legal name), born (insert month,
day, year),hereby depose and state thefollowing:
1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a
parcel of land to which I hold legal title.
2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption,
does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2:
Person(s)who owns 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 home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for
and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work
on my parcel, I am not engaged in construction supervision in connection with any project or work involving
construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any
provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my
parcel,I acknowledge that I am required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this /le day of 20L.
eizataii
(Signature)
/
141 WIDE ELITE SEKIE5 WI o . N . DOOR
13'-8 I/2"
VARIES /
/ r r /
/ / r / 7 r /
/ / / 7- r 7 / 30 YR.
j / / /r T r r z �CHITECTURAL
/ r 7 /
/ / / / r / / / 7. ASPHALT SHINGLES
r / I r / 7 / I /
/ / r /
/ / / / / r / /
X 7 / / / r / / 1 END VENT
/ 7 r 7
/ / / / / / / / EACH SIDE
1 SINGLE
----= HUNG 1
-4 4 L. 7 A
ALUMINUM ����/J
� � WINDOW //l. ___
j I I I
...--- ----- \ 1 _
FONT 52"CDX PLYWOOD SHEATHING SIDE
W/VINYL SIDING
'SHOWN WITH STANDARD DOUBLE DOOR OR LP LAP SIDING
AND STANDARD WINDOWS 2 X 4 STUD WALL @ 16'O.C.
TYPICAL ROOF CONSTRUCTION
CONTINUOUS RIDGE VENT OPTIONAL
MIN. 30 YR.ARCHITECTURAL ASPHALT SHINGLES
OVER 15#ROOFING FELT
I/2'CDX PLYWOOD ROOF SHEATHING
12 PLYWOOD GUSSET EACH SIDE OF RAFTER OR
12 7 2 X 8 SPF#2 RIDGE PLATE
2 X 6 SFr#2 RAFTERS @ 16"O.C.
2 X 4 SPF#2 COLLAR TIES @ 32'O.C.
RT3A HURRICANE TIES
@ EA. RAFTER l•
TYPICAL ROOF EAVE
I O"O.H.LV/SOFFIT .00 \
I X 6 PTD FASCIA
DOUBLE TOP PATE
+9
5/8'DURA-TEMP OR
1/2"CDX PLYWOOD SHEATHING IC TYPICAL FLOOR CONSTRUCTION
3/4"T4G P.T.PLYWOOD SUBFLOOR
W/VINYL SIDING 2 X 6 P.T.FLOOR JOIST Q i 2'O.G.
Qij LP LAP SIDING OVER 4 X 4 P.T. BASE
2 X 4 STUD WALL @ I G'O.G. MAX.SPACING @ 4'-0'O.C.
4 5"CRUSHED STONE
APPROX. GRADE APPROX. GRADE
SECTION
BUILDER: NOTES:
DESIGN LOAD:
KLOTER FARMS DRAFTING CONCEPTS LLC
2,'6 WEST ROAD Building Code conforms to -SNOW LIVE = 50 P5F ARCHITECTURAL DRAFTING
ELINGTON,CT 06029 201 5 International Residential .WIND = 100 MPH
PHONE:860-87 I-1048 Code table R30 1 .5 - FLOOR LOAD = GO P5F JCh-N es1+ 111-442-5053