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43-107 a 63 PARK HILL RD BP-2011-0273 GIs #: COMMONWEALTH OF MASSACHUSETTS Map.- 43 -107 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-2011-0273 Project # JS- 2011- 000455 Est. Cost: $1800.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DONALD PELLETIER 101876 Lot Size(sq. ft.): 34586.64 Owner: COGAN JOHN & MARIANNE Zoning: SR(100) //WSP II Applicant. DONALD PELLETIER AT. 63 PARK HILL RD Applicant Address: Phone: Insurance: 1107 MAIN ST (413) 538 -6002 WC HOLYOKEMA01040 ISSUED ON. 9/27/2010 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL OPEN ATTIC 6" CELLULOSE INSULATION 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 9/27/2010 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner File # BP- 2011 -0273 APPLICANT /CONTACT PERSON DONALD PELLETIER ADDRESS/PHONE 1107 MAIN ST HOLYOKE (413) 538 -6002 PROPERTY LOCATION 63 PARK HILL RD MAP 43 PARCEL 107 001 ZONE SRO 00) //WSP II 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: INSTALL OPEN ATTIC 6" CELLULOSE INSULATION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 101876 3 sets of Plans / Plot Plan THE F OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF THE 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 De i ' Delay afore of Building Qlftcial 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. City of Northam 1� Depa rtment 212 -Main Street koom • 0 Northam 0:i phone 413-587,-1240 Fax 4 APPLICATION T CO NSTRUCT, S $ ' � r �4'�l. ±�r�'W�.�„fi` r '+'�"fi�' j � ` v ,� �i r�'"<Z ,r'�ix.Y+:' r � A t sk``�. tF x ,,•- �. -��� J/r ♦ia .c � r �. • mot/ r , � I Namegnt) Current Mulling Addre": - - Estima Cost to be t completed ♦ �c4r$ y a ?1" ii �e QK� i F v • ®��� � ��'� � � -d D irt ei e*-r�i ✓' }� C F 2 !(faY 4'�i<�� 1 �W '1­111 IM Mech 5. Fire Protect Jon `� k � {w z f^.y f, c �T`a . G+u1 's7 .s sS +�!,�7 s<��'..s : dw Slti '�` �i �?� �Y n � tam f ><•; �' i"'XR Y'.t -.. 3 +y , r�•�'^ry �'�i ° .;.L�*'` > � F A'K: Yw :> � "� .r � h`u�ts. rk ?t3N s,!� � t�"!�f r r s r k ',. rt �<ss r.2 ^ :' t �v� a''��,`a?<y �>�+%r�L$ se `'G � f�. 3d r..f �'��; ?t x'� r -. ,R a� �. � x Y.ti x ✓'� z v r�^�r,> i3fi°t"��.^°t �,. S � r �� '� r � s a �: s �� ;k x '� x "��kp fx .r$ *�.y ` ^`E�„ t.Th ^�.; v`�`rC�°,_:.v�<ra r.Zyy���r�.y�e�c '�.�s,�.x �y,, v. .n +'�ziy,(;,"„t''�� SJe� �'vz- „3.<���•'���z""�2JR'r �,''C,z� <� 4 r f ???� t,<' - �5. , � ,�� '� r '6 r "+ y ' c ��, > Y' � rr..z.'�✓ �” �. s f � ��v ,,� a � 3' � p' r„C x .. z � >e ;. �'s"� < t<+S � { 5 � - ^ N ,sy + Xs. �e�+. ., rx p ✓ - 5 ;� _ t ; s �, �� t -fit ,> r<« { .. i � xn,t r, 5:+i `�,F?S './i....`�ir�}f� 09/17/2010 FRI 9:59 FAX --+- Pelletier 2003/016 j. Section 4. .ZONING All Information Must Be Completed. Permit Can Be Denied Due:To Incomplete Infonvation j Existing Proposed Required by Zoning i. This column to be filled in by I Tiuilding Dopainment . Lot Size i Frontage Setbacks Fron L J i i j, Side L: R L: FL= Rear 1 = 1 4 Building Height Bldg. Square Footage % Open Space Footage �-- °} i {Lot area minus bldg & paved park 1 ! # of Parkin g I. Fill: ' volume &Location. j A. Has a Special Permit /Variance /Finding ever been issued for /on the site? , NO a DONT KNOW _ © YES Q IF YES, date Issued:L_ IF. YES: Was the permit recorded at the ttegistry of Deeds? NO 0 DONT KNOW O YES iF YES: enter Book � Page and /or Document, '# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES .O tF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained © , pate Issued: ( " C Do any signs exist on the property? YES. Q NO . IF YES, describe size,.type and location: D. Are there any proposed changes to or additions of .signs intended - for the property ? .YES N0 ' IF YES, describe size, type and location: E. Wilt the construction activity disturb (clearing; grading, excavation, or filling) over 1 acre or is it part of a comnlcti plan that will disturb over 1 acre? YES NO IF YES, then a Northampton Storin Water. Management Permit'from the DPW is required., 09/17/2010 FRI 10:00 FAX --•- Pelletier 2004/016 7T i i i I New House ❑ Addition [] fieplacement YYindows Alteration(s). ❑ Roofing Or Doors f. Accessory 81dg. ❑ Demolltton ❑ New $Ions (CI] Decks JE3 Sid ing per] other Brief Description of Proposed Work: Dpe > Tl i�: l O11 Aftelatlon of existing bedroom ,_Yes No Adding now bedroom yes No Attached Narrative Renovating unfinished basement Yes No RansAttached Roll -Sheet i L a. Use of building: One Family Two Family. Other b. Number of room$ in each family unit: Number of Bathrooms I' c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions j e. Number of stories? f. Method of heating? Fireplaces or Woodatoves_ _ Number of each ! g. Energy Conservation Compliance. Mesecheck Energy Compliance form attached? f h. Type of construction L Is construction within 100 fi of wetlands? Yes No: Is construction within 100 yr; floodplain Yes No j. . Depth of basement or dollar floor below finished grade k. Will building oonform to the Building and Zoning regulations? Yee No. t. Septic Tank Co Sewer - Private well City water Supply i prone , as Owner of the subject ]. henebY authorize . �fJ l9i /l''i P /Z p. J l �/L '�'[w l� �LIJ i ti to a ' my behalf all matte alive to work authorized y ,is building permit application. a les ; r /Authorized Agent hereby declsre that the and information on the forogoing true find accurate, to the best of my knowledge and belief. Signed under the pains and penalties of penury. aj PArtt Nn ENO= naturo of QwnerfA ent Det4 . 09/17/2010 FRI 10:01 FAX --- Pelletier 19005 1016 J 8.1 Lksnsed Constructlom SURN32or "Applicable : Q ' .AIcQ I�c�1�1�ie �0�9 ( i � -N f'L- L O e br M M St� I Mai. a O o /' 0 _ Address Date I �1i3 -Sig �oaa Signature Telephone i Not Applicable . E3 ! Company Name Registration Nurn r Address Fxplratlon DaW ' Telephone Workers Compensation - Insurance affidavit most 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.... , O The current exemption far "homeowners" was oxtended to include Owner-oceuplied2= of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possbss a license, Drevided tbat the owner sea as suoerviser. CMR 750. Sbdb Edifice Section 188.3.5.1. Def loon Ul Homeowner Person'(s) who own. a parcel of land on which he/she resides'gr intends to reside, on which.there is,.or is intended W be, a one or two-family dwelling, attached or detached structures accesmory to such use and/ or farm structures. A person who Metructs more lbs one hose in a two -Year nerlod MR not be couNleted a homeowner Such "homeowner" shall submit to the WIding.Official, on a form acceptable to the Building Official that h a sbafl be responsible for aid such Mgh oedormed under the bnW jrm perffiit Asacting Constructi"Sillggri ft 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 Beath) ofthe Massachusetts General Laws Annotated, In may be Habk 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. 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AFFIDAVIT Home Improvement Contractor Law Supplest to Permit Application soggedeaAfdwkFor Ham hap nneonaaccodiaeWPamicA on ?' Name of City / Town For Office Use Only Pittsfield Permit No.. j Date: E A, requires that the Areconstruction, alteration, renovation, repair, nnodernization conversion, e removal or demolition or the constructional of an addition to any pre- existing owner occupied ontaining at least one but no more than four dwelling unit, or to structures which are adjacent to such orbuildinga3be done byregistered contracts, with calm exceptions, along with other requirements. Type of Work <z S U KU Est. Cost Address of Work: GwL ¢ 9 C a4 1 Owners Name: Date of Permit / Application: I I hereby certify that f s Registration is not required for the following reason (s): Work excluded by law j Job under $ 500.00 Building not owner occupied Owner pulling own permit Other (specify) Notice is hereby given that f OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREG ISTERE ) CONTRACTORS ! FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARAN'T'Y FUND UNDER MGL C. 142A. j Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner•. Date: 9 /a ©/, Con - R eg. J i sa 3 i S 1 OR Not withstanding the above notice. I hereby apply for a permit as the owner of the property. ! Date. Owner: TeL #