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29-359 (7)
BP-2024-1144 243 ACREBROOK DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-359-001 CITY OF NORTHAMPTON Permit: Addition PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-1144 PERMISSION IS HEREBY GRANTED TO: Project# DECK 2024 Contractor: License: Est.Cost: 10000 Const.Class: Exp.Date: Use Group: Owner: STEPHANIE RAFTERY RICHARD& Lot Size (sq.ft.) Zoning: WSP Applicant: STEPHANIE RAFTERY RICHARD& Applicant Address Phone: Insurance: 243 ACREBROOK DR FLORENCE, MA 01062 ISSUED ON: 09/05/2024 TO PERFORM THE FOLLOWING WORK: ADD 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: Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner File #BP-2024-1144 APPLICANT/CONTACT PERSON:RAFTERY RICHARD&STEPHANIE 243 ACREBROOK DR FLORENCE, MA 01062 PROPERTY LOCATION 243 ACREBROOK DR MAP:LOT 29-359-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $75.00 Type of Construction: ADD DECK New Construction Non Structura 1 Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan Driveway Grade% THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESL/ ENDED: Approved Additional permits required(see below) For all projects that need additional reviews Ei++'-„rr,� as checked below,please see the Office of Planning& Susta inability Permit page or scan here -.; PLANNING BOARD PERMIT REQUIRED UNDER:§ 14,42_t,A! 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 Av a ilability 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 q- 5.2v2y 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. wtuit, rea4 ; The Commonwealth of Massachusetts EP — Q Board of Building Regulations and Standards 202Q FOR f MU ICIPALITY Massachusetts State Building e, 780 USE ,•OF?Tf'cm Building Permit Application To Construct,Repair,Re vztfog, '6 R ised Mar 2011 One-or Two-Family Dwelling q o106o°Ns This Section For Official Use Only Building Permit Numbea4/-4 '(//—//yy Date Applied: 1/& Ci- Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 2.'13 ArLooK a2 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 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 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: 1•2.tCHRR-13 17.F*F-7e(Ly FLo2E.1Je /"-A-F1/4/ 6iO4.Z. Name(Print) City,State,ZIP _212Y3 AGCEBRDoI� DR-. K13 377 y g•G.RmFTURY©4MRIL.sQK No.and Street Telephone Email Addr SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other IR Specify: q-bEGk Brief Description of Proposed Work2: '6 u t I.DIAL(G A.N A 7TA GA ED b EGk SECTION 4:ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials) 1.Building $ to ,ADO 1. Building Permit Fee:$ Indicate how fee is determined: Cl 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 Fee,;.A Check No: Check Amount: 6 Cash Amount: 6.Total Project Cost: S 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling yM Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Namc 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 0 No .O 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 7h: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. • 7 IGKAA.D R/V7E/2S/ ° SEP 2D2y Print Owner's or Authorized Agent's'Name(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 r ''' �, Massachusetts ?SI __. y • G "r. 4,, rP: DEPARTMENT OF BUILDING INSPECTIONS \ x-�y�.. 212 Main Street • Municipal Building �vhC�� \ ,..� Northampton, MA 01060 'rsfh, V7N11 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: \IALLE`( ReCyCLftvt The debris will be transported by: Name of Hauler: r It -IR2a ' gy12-Z27 Signature of Applicant: Date: MEP 2cay :ate.\ the Commonwealth ofliassachusetts l s:_ Department of Industrial Accidents 1 �_li»d= . 1 Congress Street,Suite 100 `r —=;4 H-a Boston,I14 02114-201' ,itiwr.mass.goildia 11:iwkers'Compensation Insurance Affidavit:Builder: Contractor:Electrician:Plumber:. TO BE FIND WITH THE PERM'IITIPiC,ALTHORTI7i_ Applicant Information Please Print Legibly Name(Btniuess.OrgamsationIndi:idul): Address: City/State/Zip: Phone Y: -Are you as employer'C heck the appropriate box: T3pc of project(required): 1.0 I ao a omp:oyw with emclosva:tful:and c:pa.-t-t .4)' 7. DNew construction I am.a:c.;propriate:or prtaerasip and:tare no employee:aysking fir ate= $_ D Remo.i 1 iz •copiers•.[Nc wccke:s•cccp.in:mance rocarid] 3.q1I a hcexoaner do na al:work=nee Plc workers'comp.insa-atue rogzirad. ' 9_ El Demolition 10❑Building addttion at,a hataaoanor and will be hiring contactor.to conduct all work oa n•prepare• I will emare that all contactors a thar have worker:.compact:anon inswanco cr ere solo 11.0 Electrical repair:or additions proprietors with no acplcyaes 12.0 Plumbing repair:or additions `a I'=a aenara:contactor and:have h_-ed the sub-ccnaactor.hstod en the aaachad:hoo:. These sub-contractor.have emp:oyee:and have'rocker..coop-msuraace: 13.0Roof iepitt: 6-0 We are a cc:pora:cc and it.officaos have exercised heir rig=cf ezempnco par ti1GL c 14.❑Other :a_.11 j=).and wo ha:v no emp:oyea:.[No wcrkeri'coop.:nsurance:egvrad.l 'Any applicant that check:box>sl must also fin:out the sacnon balow showing:heir workers'cceapeaaaaion policy information 3cm owners who submit this affidavit mdicatnz they are doing all work and than hire ontado contactors muss .:bra.:a new afeda: indicannz such :Contractors that check this box must arched an addition:shoot showing he Dan a of the sub•ccattacsoes and:Ira whether cc not those muse:have eoplcyco: If he sub-ccnn1ctor:have employaei.they must provide their workers co_,-pclic;a•:.mber I am an employer that is providing workers'compensation insurance for nti'employees. Below is the policy and jab sire information. Insurance Company Name: — Policv*or Self-in..Lie._: Expiration iration Date: Job Site Address: CitytState''Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and ezpir,ttiou date). Failure to secure coverage a:required under MGL c 152. 25A is a criminal violation p imishable by a fine up to S I.5C0.00 and'or cane-year impssonment.as well as civil penalties it the form of a STOP WORK ORDER and a fine of up to S250.00 a day againt the violator.A.copy of chi:statement may be forwarded to the Office of Inv-e tigation of the DLL,for insurance coverage verification. I do hereby certify under e ins and penalties o • . ry that the information provided above is true and con etc 1 � � Si mature: —i Date o Sf P 2 0`2_9 ?Corte=- _+ _-�,__—_--- - "113 7 7 ' `1'I 3 Official use only. Do not write in this area. to be completed by city or town official. City or Town: Permit License= Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City'Town Clerk 4.Electrical Inspector c.Plumbing Inspector 6.Other Contact Person: Phone ar: CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: T i2,5f , REAR YARD 15(1 SIDE YARD t � (-0 C SIDE YARD S0 F f 1-) i t DU5E p FRONT SETBACK ikit FT( L, FRONTAGE Di0--,\ N O TO SCALE t LS- 23(0)(1.5 SEe_va.E! Le060- &CI_e ws Y" Do' ZxtoX15 stcvR-et) wsr 5/14, % 311 TIMB5 tetw 2xtoxiS ,T 1. 4-1 30� __� SEcva�v wI I le Q 0 n , t2 o - - - T-- C . ...... S,�v*o 1') S i s 1# t3uP-l-tti Yg" N i 14 15 Fr i 4 0 10 Pr 1 -6- 1 .. 1,....... 619 v I \4.>0 0 - -LEA. zofw.3, 61 _ I i 1 5/4 s y" GRk rolawdea4 j N544-E-w s ' I 17,_________________7---t ____;AFX------ -- .4....___i „a) HO U SE /lb USE- L HOu5� .LaSL. 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