16C-038 370 SPRING ST BP- 2010 -0413
G1S #: COMMONWEALTH OF MASSACHUSETTS
Map:Bloc 16C - 038 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 -0413
Project # JS- 2010 - 000560
Est, Cost: $25574,00
Fee: $132.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WRIGHT BUILDERS 045075
L Size(sg, A.): 291764.88 Owner: HAXBY ROBERT G & ELIZABETH GRAMS HAXBY
Z oning: URA(100) //WSP Applicant WRIGHT BUILDERS
Applicant Address: Phone: Insurance:
48 Bates St (413) 586 -8287 Workers Compensation
NORTHAMPTONMA01060 ISSUED ON. 1011912009 0 :00 :00
TO PERFORM THE FOLLOWING WORK :REMODEL EXISTING BASEMENT BEDROOM &
BATH
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: lloil� SO House # Foundation:
Driveway Final:
Final: ;Z '1 -07 (inal:
70 Rough Frame:
11 1121
Gas: Fire Department Fireplace /Chimney:
Rough: 0i:: In-vNtion:
Final: Smoke: Final: ® df' 1,;7
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Z- signature:
FeeType: Date Paid: Amount:
Building 10/19/2009 0:00:00 $132.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
s
File # BP- 2010 -0413
APPLICANT /CONTACT PERSON WRIGHT BUILDERS
ADDRESS /PHONE 48 Bates St NORTHAMPTON (413) 586 -8287
PROPERTY LOCATION 370 SPRING ST
MAP 16C PARCEL 038 001 ZONE URA000) / /WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
T_ypeof Construction: REMODEL EXISTING BASEMENT BEDROOM & BATH
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 FOI OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
pproved 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
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.
..., Departm@nt.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
4 Northampton, MA 01060 Two of Structural Plans . *' u
phone 413 - Fax 413 -587 -1272 Plot/Site Plans ' ! v
Other Specify
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
- 5 - 0 t rl ( r Map Lot Unit
ph Zone Overlay District
Elm St. District C8 District,
SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
r i ' s &- Q �blxr�— 3 �o sng-,'N ST.. - f-tvce
Na rint) q o Current Mailing Address:
Telephone JQ d
Signature
2.2 Authorized Agent: '
►�bl�o BAS S'r� No�P�N, Mfg
Name (Print) Current Mailing Address:
Sign re Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS It kk )C 6
Item Estimated Cost (Dollars) to be Official Use Only
comillete8 by ermit aoolicant
1. Building ' a, I IS[.-- (a) Building Permit Fee
2. Electrical �'�,�.$ (b) Estimated Total Cost of
. Construction from 6
3. Plumbing • ��� l Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check Number
This Section For Official Use Only
Permit Number: Date
Building Issued:
Signature: "
Building Commissionerilnspector of Buildings Date
SEP 2009
i
t14- W 1 b - h str "frol INt�h�rN C�cts�N� t
&VW
Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by ;b� ng
This column to by
Building Depa
Lot Size
Frontage
Setbacks Front
Side L: _ _ __ R: .. _..._.; L: `
Rear
Building Height
Bldg. Square Footage _ % _
Open Space Footage _ _ %
(Lot area minus bldg & paved '
p arking) _._.
#. of Parkin, aces
. a
F' .
volume & Location)
A. Has a Special Permit/ Variance/ Findin ever been issued for /on the site?
NO. 0 DONT KNOW YES
IF YES, date issued: ,
IF YES: Was the permit recorded at the Registry of Deeds?
• . y0 O, DONT KNOW O YES O
IF YES:' enter Book . age and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW O YES O
e
IF YES, has a permit been or need to be obtained from the Conservatidn Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of sighs intehded * for the property ? YES O NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading,_exi;,xvation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO JjCx
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 Windows Alterations) . , 'Roofing ED
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [t:� Decks
'(p. ' ,' Siding (pZ ,Other [a)
Brief Description of Proposed ��� —sh �� Jj ��
Work: ��j� 1' r F'�(J '(
Alteration of existing bedroom Yes No Adding new bedroom Yes_ No
Attached Narrative Renovating unfinished basement Yes _�_ < No
Plans Attached Roll - sheet 6
6a. If New house and or addition to existing housing. Complete the followinq: '
a. Use of building � "One Family Two Family _ Othel..
b. Number of rooms 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? Fir ces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. etlands? Yes No. Is'construction within 100 yr. floodplain Yes No
j. Depth of basemen cellar floor be!ow finished grade
k. Will buil ' 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
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Sa" �tL pb &_ tl as Owner of the subject
property 4 � V
hereby authorize �" P (L+ Aws
to act on y behalf, in all atter�re!ative to work a t orized by this building permit I' t' n.
Sig ure f Owner QJ Date
tA o as Owner uthorized
ereby declare that the statements and information on the foregoing application are true and accurate, to the best o m e ge
and belief.
Signed under the pains and penalties of perjury.
dui 10 f f' M A r__CR'"
Prin* tame
Signature of wne gent bate
SECTION 8 - CONSTRUCTION SERVICES '
a '
8.1 Licensed Construction Supervisor Not Applicable ❑
Name of Llcense Holder
Up License Number
AIMS
AddteSs Expiration Date
a
Signature Telephohe
i - r
9. Re ' istered Home Imp rovement Contract : ; e - Not Applicable ❑
Company Name Registration Mimber
W Mk � L &4
gdd�ss 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 allo�c such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CNIR 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 -vear 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 wort: for which this permit is issued. -
Also be ad% ised that w ith 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 undersi_;ned "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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