11C-001 92 FLORENCE aT, ,� BP- 2010 -0218
GIS #: COMMONWEALTH OF MASSACHUSETTS
Ma: � ; CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -0218
Project # JS- 2010- 000272
Est. Cost: $33200.00
Fee: $177.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 410770.80 Owner: GABLE VIKI J
Zoning: URA(100)/ Applicant: GABLE VIKI J
AT. 92 FLORENCE ST
Applicant Address: Phone: Insurance:
92 FLORENCE ST (413) 586 -9198 (�
LEEDSMA01053 ISSUED ON :813112009 0:00:00
TO PERFORM THE FOLLOWING WORK.-ADD 8 X 20 GREENHOUSE & 8 X 16 DECK TO
EXISTING GARAGE,AMENDED 10/22/10 ADD INSULATION, REPLACEMENT WINDOW,$;A''
`ftVff d /EP,ANT MUST BE FILED PRIOR TO FINAL INSPECTION
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.
Certificate of Occupancy Signature
FeeType: Date Paid: Amount:
Building 8/31/2009 0:00:00 $177.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner
File # BP- 2010 -0218
APPLICANT /CONTACT PERSON GABLE VIKI J
ADDRESS/PHONE 92 FLORENCE ST LEEDS (413) 586 -9198 ()
PROPERTY LOCATION 92 FLORENCE ST
MAP 11C PARCEL 001 001 ZONE URA000)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: ADD 8 X 20 GREENHOUSE & 8 X 16 DECK TO EXISTING GARAGE,AMENDED
10 A ON REPLACE VEN T
NLVV` bris E ction
Non Structural interior renovations
Addition to Existin
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
INF RMATION 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 Commission Permit DPW Storm Water Management
Demolition Delay
/d a 6
Signature of Building Official Date
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning & Development for more information.
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer /Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413- 587 -1240 Fax 413- 587 -1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE Oy DEM ISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: _
This section to be completed by office
a rl o r ce Map Lot Unit
�e / W. 0 /05 3 Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record
Name (Print) Current Mailing Address: n
4Z F /Or- , encic SW.
11'f4. Alkl
Telephone
Signature
2.2 Authorized Aaent:
Lka- & S
Name (Print) Current Mailing Address:
L-X" Q I T —
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
1. Building D O and (a) Building Permit Fee
2. Electrical 00 (b) Estimated Total Cost of
w Construction from 6
3. Plumbing �/# Building Permit Fee
4. Mechanical (HVAC) /V/)f
5. Fire Protection N1#
6. Total = 0 +2+3+4+5) 60 Check Number
This Section For Official Use Onl
Building Permit Number: Date Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage 20
Setbacks Front
Side L: pp R: L: R:
Rear n 7 �f
�e�' 6 0 15 /' ay
Building Height Ll Gl ` l
Bldg. Square Footage BDIJ % G4 J �
Open Space Footage •C v %
(Lot area minus bldg & paved S
parking)
# of Parking Spaces �n
Fill:
volume &Location) /
A. Has a Special Permit /Variance /Finding a er been issued for /on the site?
NO 0 DON'T KNOW YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DON'T KNOW 0 YES Q
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued: `I✓�
C. Do any signs exist on the property? YES Q NO (3
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO 0'
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO (
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Wi ws Alteration(a) Roofing ❑
Or Doors
Accessory Bldg. W Demolition ❑ New Signs [0) Decks [ Siding [ En ' Other [p]
Brief Descnp ' f Proposed ' � —M/ ,'kl or �jp c T''c .
Work: on / a c 7< K�� .G(i "lit q c� i "�t i5 yla.A'6 n • 6 c ArtN,
i
Alter i sting bedroom Yes No Adding new bedroom Yes No
tta ed Narrativ Renovating unfinished basement Yes No
Plans Attac oil - Sheet
6a. If New house and or addition to existing housing, complete the following: II
a. Use of building: One Family Two Family Other 5 '}yc 10 G.cr.e + a v-9.3
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. /(/ ��`i Dimensions
e. Number of stories? 2 J
f. Method of heating? _ CofS' l ��e_e_ r G Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. 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 tl Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Vill kf' /'YGj !l' l� as Owner of the subject
property
hereby authorize L /` 4rle5 '
to act on my behalf, in all matters repative to work authorized by this building permit application.
VA_�4_
D
Signatu a of Owner Date
a hA as Owner /Authorized
Agent heteby declare at the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
C ha - le s R.
Print Name
aA-Alf
Signature of Owner /Agent Date
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor Not Applicable
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
9. Reaistered Home Improvement Contractor: Not Applicable
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.
Signed Affidavit Attached Yes....... ❑ No...... ❑
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 an "I Zoning La and State of Massachusetts General Laws Annotated.
Homeowner Signature - V4 "
Re: Building Permit # BP- 2010 -0218
Project # JS -2010- 000272
Date Issued: 8.31.2009
I would like to amend this existing permit to include replacement of
insulation and siding on the existing building this work is being performed
on. There is also. a minor amount of electrical work (a few receptacles and
light fixtures, some re- routing of existing wiring).
All of the information supplied in the previous application is still correct,
this just adds the siding, insulation and electrical to the scope of work.