42-081 (4) BP-022-0762
126GLENDALE RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
42-081-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-0762 PERMISSION IS HEREBY GRANTE TO:
Project# deck Contractor: License:
Est. Cost: 8000 GERDA SWEDOWSKY 067684
Const.Class: Exp.Date:08/10/2023
Use Group: Owner: HOLT BRIGITTE M
Lot Size(sq.ft.)
Zoning: WSP Applicant: GERDA SWEDOWSKY
Applicant Address Phone: Insurance:
34 BULLARD PASTURE RD (413)695-4270
WENDELL, MA 01379
ISSUED ON:06/30/2022
TO PERFORM THE FOLLOWING WORK:
6X20 FREESTANDING DECK
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
:1.),,,jL _52 51)01,i
Fees Paid: $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
Z-OK
File #BP-2022-0762
APPLICANT/CONTACT PERSON:GERDA SWEDOWSKY
34 BULLARD PASTURE RD WENDELL, MA 01379(413)695-4270
PROPERTY LOCATION 126 GLENDALE RD
• MAP:LOT 42-081-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Pe•- • filled out
Fee Paid $50.00
Type of onstru 'in: 6X20 FREESTANDING DECK
New Cons ruction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF MATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR SpecialPermit With Site Plan
MajorProject: 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
y , 5--1. . 6 3a as
Sign:ture 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.
IIlit
I t.0
i , ii. The Commonwealth of Massachu etts � ID
�"
Board of Building Regulations and S an dsR J(� , IF ALITY
Massachusetts State Building Code, N 2
�> 2022 SE
Building Permit Application To Construct, Repair Re Demolish a evise Mar 2011
One- or Two-Family Dwelliiig--.. °T u, Nr,
TVs Section For Official Use Only o ----- "A'''Mq otn,00Ns
Building Permit Number: Pa' 3'3` Date Applied: _______
304N
Building Official(Print Name) Signature
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
12(i 6i0r4 D#t.V Pn , PLDLENCE MPr Oq-2 og1- o I
1.1 a Is this an accepted street?yes V no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions: /�
Zoning District Proposed Use Lot�(sq ft) I
PF onttaagge(ft)�
1.5 Building Setbacks (ft)
Front Yard Side Yards Rear Yard
Required ' Provided Required Provided Required Provided
1.6 Water upply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage�Di posal System:
Public Private 0 Zone: — Outside Flood Zone? Municipal m'On site disposal system le
Check ifyes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
$al 61 TM- Na l..-1 ' 1LoLL4C , N A. o ! Q0..
Name(Print) City,State,ZIP
1210 6(0M DA-r,E 12-U (44 )230-7411
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition ❑ Accessory Bldg. 0 Number of Units Other iirSpecify:rQGV' $ 4Qd& DECK.
Brief Description of Proposed Work2i• (/14./f,Q, rtec-S1 Av biAi& bece., lei Ina. eAtui(d--'
A Plr, -ram ' i 146-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Costa (Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ Total All Fees:
Suppression) a 466Cash Amount:
Check No. � �Check Amount:
6. Total Project Cost: $ gJ 000•pr0 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
.P.pIN ���j)Q <<.- License Number Ex irati 403 n Date
Name of CSL Holder
2� al WAVA9PAS�x IL� List CSL Type(see below)
No.and Street Type Description
� M �� O 1 3 Unrestricted(Buildings up to 35,000 Cu.ft.)
v-A`ri�0- ) Restricted 1&2 Family Dwelling
City/Town, State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
C �p SF Solid Fuel Burning Appliances
i)10/c- 400 SA"la 0V4S e/yA10• COO I Insulation
Telephone Email acKlre ss D Demolition
5.2 Registered Home Improvement Contractor(HIC) t 27 ( •74- Iiradn'
Get S
A '4I)b HIC Registration Number E Datc '
HIC Company Name or HIC Re 'strant Nagle
34 60- 944 v 14Q194,eijob'v• (.ar,
No.and treet
D01„.4.. ti!4 Jot 37T eir)(�15-4J27a
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 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 6i4 SY �j�/J<
i.' :
to act on my behalf, in all matters relative to work authorized by this building permit application.
SRI cr 1 TG- Ho 0 6/g ,4(44
_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.
Cam - SvvJE-')>I7vka aG ��)12072--Pr
int Owner's or Authorized Agent's Name(Electronic S gnature) te
NOTES:
1. An Owner who obtains a building permit to d44figr 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
I
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
•
The Commonwealth of Massachusetts
dr RI Department of Industrial Accidents
s 75 1 Congress Street,Suite 100
f E :„ Boston, ,11A 02114-2017
.,...Y�tt1 ' www tnass.got/dia
1lu,kers'Compensation Insurance Affidavit: Buildersl('ontractors/Electricians/Plumbers.
TO BE FII.BU V.full THE PERMUTING'At'THORfl'1'.
Applicant Information `_' 1�,,•—' Please Print t.ei ibis
Name(i3usittcss-organtsauun lnd►vidualt:__-- ��__�t_�1r�.i_
Address: 3+ liNteLeitieb_ f),1 11.4 ,
City/State/Zip: Woribp.11 ylA4 pi-310I Phone#: 61 d 3..) ii S'—4 V
a,re you an employer!eletrk the appropriate hot: Type of project(required):
LEI I am a engok to with employees(full and'or part-time I.* 7. El New construction
26arafna sole proprietor or partnership and have nu employees working fur me in S. 0 Remodeling
any capacity.[No workers'comp.insurance required.]
i 9. 0 Demolition
I am a humeowncr`doing all work myself.[No workers'comp.unuranc-e requital'
4.0 I am a homeowner and will be hiring ewntraelurs to conduct all work on my property. I will ICI CI Building addition
c-ruure that all contracturs either hate workers'compensation insurance or are sok i ICJ Elet.trital repairs or additions
proprietors with no employee%
. 12.1:1 Plumbwg repairs,or Additions
50 I am a general euntrtetur and I hate hired the sob-contractors listed on the anaehed sheet. 130 Roof repairS
These sob-euntractuta lute employees and have wurkN n'comp.insurance..
We area corporation and its officers hate exenised their right of cxerrptton per 1\1GL c.
14.MOther
6.0
152.t.1141.and we have no employees.l Nu workers'comp.insurance required.]
*Any applicant that cheeks box 01 mutt also fill out the section below showing their workers'compensation policy information.
ilonaown•rs wiw subuul this allidattt indicating they ate doing ail work and Users hue outside contractors must subuut a new affidatit indicating such.
:Contractors that check this but must attached an additional sheet showing the name of the sub-contracirs and state whether or nut those entities hate
employees. lithe sub-contractors have employees,they must provide their weaken'comp.pulley number.
I am an employer that is providing workers'compensation insurance for my employees. Below Is the policy and job site
4ii information.
Insurance Company Name:
Policy tt or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State.'Zip:
Attach a copy of the workers'compensation policy declaration page(showing the police 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 S 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 S250.00 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.
!do hereby certify under the ins and penult' . of perjury that the information provided above is true and correct
Signature: � Date: �D/'2-le i "Zan-
Phone#: (4j2)) 6 r"4•2.-7
Official use only. Do not write in this area.to be completed by city or town ofcial
city or Town: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone It:
_ City of Northampton
YHAMA-
t Massachusetts �4t «.. 'et.
f il VA, w L
\d i �* G DEPARTMENT OF BUILDING INSPECTIONS ;
!� �r�` 212 Main Street • Municipal Building y%) Cb:
,.,. ', Ham. Northampton, MA 01060 ........„ `,.0
•
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, (insert full legal name), born _ (insert month,
.' day, year),hereby depose and state the following:
1. 1 am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the
a► •Massgchusetts 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,
:s does ttbt involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3.
3. I qualifyy 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
It
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 day of , 20_.
(Signature)
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
•
5
mor
24, 61.. 12- iD 4
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE 114 . 5.31
±
�iM
City of Northampton
OC'" MOti SS v.
Massachusetts 4'�{ '<<
DEPARTMENT OF BUILDING INSPECTIONS y �,
212 Main Street • Municipal Building %) a�
Northampton, MA 01060 sy' se)\'\�\C
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.
The debris will be disposed of in:
Location of Facility: Di�
The debris will be transported by:
Name of Hauler:
Signature of Applicant: _ ,� _ Date: _ "2:1
-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO DE CONSTRUED AS AN ACCURATE SURVEY AND 1S NOT TO SE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
L
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Q ' #126
W LAND COURT PLAN #11534E N
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Q �° tz 4_OT #8 co
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7
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330.18't I
I NOTE.
SUBJECT TO EASEMENTS AND
RIGHTS OF WAYS OF RECORD.
TO: NORTHAMPTON CO—OPERATIVE BANK &
LAWYERS TITLE INSURANCE CORPnRATION
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY #250167
..----> —NOTE—
SURVEYOR: �(Y-A•1411 T' J' THIS PLAT FOR MORTGAGE AN PURPOSES
AND DOES NOT CONSTITUTE APROPERTYSURVEY
- --'°. -MORTGAGE LOAN INSPECTION PLAT-
;4,,,�" �-A,, NORTHAMPTON, MASSACHUSETTS
+,gr RANDALL t. . PREPARED FOR
E.
R,ACHAEL NAISMITH
IZER �
\ �35032
` , J SCALE: 1 =60 MAY 12, 2008
�;N' ss e- HAROLD L. EATno AND ASSOCIATES, INC.
SURVt
II REGISTERED PROFESSIONAL LAND SURVEYORS
I235 RUSSELL STREET — HADLEY — MASSACHUSETTS
Freestanding Deck Plans •
6'x20' deck with railing and Trex decking Brigitte Holt
126 Glendale Rd
Florence, MA 01062
Scale: '/2"= 1'0"
Existing enclosed porch
\ A `--H -- — Span 8'9"typical ---- — �
Double 2x8 dropped beam .•_./
v,
2x6 joists 16" O.C.
Footings
with 4x4 posts
Double 2x8 flush beam'`
5' step centered GjjejjwskYa Sw
on porch door 8) 96
carpentry • cabinetwork
general contracting
licensed & insured �1