43-148 (10) 111 WHIT"TIER ST BP-2004-0479
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:43 - 148 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:
BUILDING PERMIT
Permit# BP-2004-0479
Project# JS-2004-0682
Est. Cost: $37629.00
Fee: $190.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Wright Builders 045075
Lot Size(so. ft.): 162043.20 Owner: CONSTANTINE RUTH H
Zoning: SR Applicant: Wright Builders
AT: 111 WHITTIER ST
Applicant Address: Phone: Insurance:
48 Bates St (413) 586-8287 Workers Compensation
NORTHAMPTONMA01060 ISSUED ON:10/29/03 0:00:00
TO PERFORM THE FOLLOWING WORK:INTERIOR REMODELING (KITCHEN & BATHS)
INCL PLUMBING & ELEC
POST THIS CARD SO IT IS VISIBLE FROM THE STREET BuildingInspector
Inspector of Plumbing Inspector of Wiring D.P.W. p
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
" '°` Final:
Final: K Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
/,
Final: ��3 eac( °�,i0'
Final: Smoke: i"/
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATIO OF
ANY OF ITS RULES AND REGULATIONS. i
Certificate of Occupancy_- Si nature:
FeeType: Receipt No: Date Paid: Check No: Amount:
Building
10/29/03 0:00:00 16845 $190.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
T
s
File#BP-2004-0479
APPLICANT/CONTACT PERSON Wright Builders
ADDRESS/PHONE 48 Bates St (413)586-8287
PROPERTY LOCATION 111 WHITTIER ST
MAP 43 PARCEL 148 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid
Typeof Construction: INTERIOR REMODELING(KITCHEN&BATHS)1NCL PLUMBING&ELEC
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 045075
3 sets of Plans/Plot Plan
THE F OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION 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 C' '�'ssion
............ r.._ejzi#7„X, e:
An,/2:7/00„...?
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.
•
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G ', r'' ''` °- rt :': 1 J��V M�r*.Wj` y sic
City of Northampton 4 ' saf I,it; 5." }{ � 'r i& '
Building Department b t,D)„ 1 �: •x� • 4, ,;
212 Main Street 'se.g l5en is .,7�` F:,�• s y T
Room 100 a, a lI • a •:Iift&2 ' ;1-"*. 1�,t�r 't -
Northampton, MA 01060 •{ ,.-,.,� r e �� 3 ; .�F{{' ° ..
Phone 413-587.1240 Fax 413-587-1272 a5, e,Pat, r ,� ky1`,4.- .t � �,:K
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
This section to be completed by office
1.1 Property Address: - •
s ' f,x}. -
'`I ram, It).c /� Y ^,,, ., ;4,; N
i W 1.1 1 G SrF-• T Map + fttot� '?i� ,,f .,—Unit ;"
" J nM"�� T Sy J« • "
Zone Overlay D'stnct f ,
N d 9-`t} kM(� N, MA- -_ ,= h
Elm St District _ •„CB District__ _ __..L....,......._
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Ca N s -N''o e (1 I W-th'tt-) sfiy /V o e- -i *(hm r•
Name(P Current Mailing Address: s 'y w . -
ram . Telephone 7 J
2.2 Authorized Agent: 12.1 (*,y l �i�( , /
FLt t' bit /Y�R �' �l l t � cr., �a 1-APTb,j
Name(Print) Current Mailing Address:
>C 2& ct:1341 gt.et,,___, €. - t, - 9
Signature Telephone
SECTION 3 ESTIMATED CONSTRUCTION COSTS S g X *54/Dad,r — # (lo•
Item Estimated Cost(Dollars)to be // Official Use Only
completed by permit applicant
1. Building 2'9 pg1 -r (a) Building Permit Fee __ .
2. Electrical �h (b)Estimated Total Cost of .
�A .. �� a - Construction from (6)
^fj Building Permit Fee
3- Plumbing D Q
4- Mechanical (HVAC)
„ ,,, t-r x
5. Fire Protection ' +
6. Total =(1 + 2 + 3 +4+ 5) - i 3 ? 6 N / "'
J
.Check umbe
._:' ,.a;, This Section For Official Use Only � s •. a.: ., ", :`: _ .,
1( y o Ott
y , � ^..-` 4 -� -''!` . is ,+ �,.sr SY. = t . ,1 ,�' t' +'ti u' �
Building Perc�it Numbers � � Date Issued r,�� 'a k. aY �.. v,,,;•
s i, " 1 ,- xr, r � ''''-'*'*1.1 ":
't+,.q a", - --; '4f 't 01:. '- "�yr� - ti'� 1. ..1'� \Y •4;• ''t r7�iYl5 ;;vv_I.,,,,,,,),,-' ',- & _, Y �`'_1 "
.a� +r r ♦. � �..,, yti ^i ' R d»e .. '. ".< {�.7 Ng$IF.�= 4 °}t �• ,ems e�+ •
r�.. t3,•iµ•-! ,``' t C 'W'''-' �,j1,r.• .4 a4�. ' +tr�. JJ r t'.. e r "i q-,4,1 r S i :. t'7 7 tM1 )
-rl`�. 1'i' �`4 x WNW 4 K 4a,VV tr r l4''1 1'„.,,,T'A,^ ir r3f 1, , S .i.n m a f,,. i ,, i`t,
wt! ri :tt ti t V4+ e� « .."Y•`t ! S'.-- 1 ,'�, „ ti i.. s 'i .a.'�-41^ i�� �.,ty-`C`r y�e y� t:- �, "+'+ ie.,J
Signature ,A, .... .,<. i ,.:e _ . ._
1 x�"Building Commissioner/Inspector ofBuildings ;:'J' ,'. '-.,- `,.tip Date sa,^,,"'•-N, .1woa' "' `.� al `-' '"'
•
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Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
f1,L Way ' g - +9 6E Dt nW W(i hN I Sr rJCf
0.— - m r- o v Existing Proposed Required by Zoning
FF""���� f This column to be He. n by
Ih'VSU\ Building Dep.
Lot Size
Frontage
Setbacks Front
Side L: R: L: :
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spac
Fill:
ume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW x 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 T-
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:
r, % ,
-ACTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition 0 Replacement Windows Alteration(s) Roofing ❑
Or Doors 0
Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: I frtt i.o e- 6t 4'f 5‘" A' ry S� L4 DN . is V , 1," U .
i plNc- PwMa,c - 4 k , x wa4 *
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0- Sheet' .*
6 If'Nev�7i house-and ff arrditlon-to-exlsfinE°h in ;-comp(e a he foitawtn
a. Use of building : One Family Two Family Other
b. Number of roomi 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 *• ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of base . t or cellar floor below finished grade
k. Will bui g conform to the Building and Zoning regulations? Yes No .
I. ptic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN a
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, e-r rI ) Jclit ,I- C , as Owner of the subject property
hereby authorize V'E h-t. kr (Eg- a UJL- to act on
my beh in all matters relative to work authorized by this building permit application. _
- Date
I, 14 ( 1 "T-' e1J1(4)6F-s //q-G/ " 0 M M" W , as OwnerUAuth orized Agent J
hereby declare that the statements and information on the foregoing application are true and accurate, to the besT t'my
knowledge and belief.
Signed under the pains and penalties of perjury. .
v v vl~a p i .
Print Name C i -
/4:2-ae-4-4-tiFatet-4-4---12-- /6 (4)1 i 0.3
Signature of Owner/Agent Date
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SECTION 8 -CONSTRUCTION SERVICES
1, Licensed Construction Supervisor:
L 14 flt. Mt yvi-s Ft Not Applicable ❑
Name of License Holder : (/V 1— l v ►t1 t V I (4' Q s I lNG' 6 y5-7) 75
License Numper
tr" � � sfi� NeV P�(`l, Mfg' 7l160�
Address /
Expiration Date
Signature ^ Telephone
i V m n r• .3, Not Applicable ❑
/ 0 / 3C
Company Name Inffi (( , Registration Number
M T ST = j a rk-Mtti rf i A-
Address n / Expiration Date
� Telephone V-b'od.�"¢2
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.
Signed Affidavit Attached Yes No ❑
11: - Home OWntritExeitiOtion
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.
Homeowner Signature
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