11A-005 (3) THIS INSTRUMENT SHOULD BE FILED AT ONCE FOR RECORD OR REGISTRATION.
STATE FORM 441 INSTRUMENT OF REDEMPTIO:
TITLE IN MUNICIPALIT
Ili. ;; : ;t „t, , k , I , ik TAX TITLE NUMBER : 95u01
THE COMMONWEALTH OF MASSACHUSETTS
.a;; I OF NORTHAMPTON
�1 C TY
Bk: 8832Pg: 91 Page: 1 of 1
Recorded: o8/oe/2008 01 :30 PM OFFICE OF THE TREASURER
- - The CITY OF NORTHAMPTON , holder of a tax title under a
taking for non - payment of the 1996 taxes assessed to
GEORGE ADRIENNE B
46 CHESTNUT AVE
on land described in the instrument of taking conveying said title, dated
June 30, 1997 and recorded with
HAMPSHIRE COUNTY REGISTRY OF DEEDS , Book /Page 5148 0268
Document No. , Certificate of Title No , does hereby pursuan!
to General Laws, Chapter 60, Section 62, acknowledge satisfaction of the tax
title account secured by such instrument of taking.
DESCRIPTION OF LAND
PROPERTY: LAND do BUILDINL:i CVNl'AININU: .500 AC (more or less,
LOCATION: 46 CHESTNUT AVE
ASSESSORS: 11A- 005 -001
REGISTRY: M/S ' 011/
LAND COURT: -
RECORDED AT: HAMPSHIRE COUNTY REGISTRY OF DEEDS
REDEEMER: Adrienne B. George
Witness the execution of this instrument this O day of , 4000
CITY OF NORTHAMPTON
By ±!. L , / ' . ,,,;4 ..m._„u���. , Treasure]
THE COMMONWEALTH OF MASSACHUS TTS
HAMPSHIRE , ss . 1 . .0 . s i
Then personally appeared the above named GEORGE R. ZIMMERMAN
Treasurer of the CITY OF NORTHAMPTON , and acknowledged
the foregoing instrument to be the free act and deed of said town.
Before me,
My commission expires , c () /A /
N ary P r c
1 .rc WENDY MAllA o
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ATTEST: HAMPSHIRE ---- REGIS
MARIAN L. DONORrne
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AMENDED DESCRIPTION OF WORK TO BE DONE
AT 46 CHESTNUT AVENUE, LEEDS, MASSACHUSETTS
The following work is what is proposed to be done at 46 Chestnut
Avene, Leeds, Massachusetts:
I. The front and rear porch are going to be reconstructed as they
were. 2
2. A bathroom will be placed on the second floor where there was no
bathroom previously and it will be as it has been detailed in the
submitted plans.
3. The kitchen will be enlarged four feet into where the porch used to
be. J
4. The first floor wall where the stairs come out will be removed.
5. Plumbing will be redone.
6. The electric work will be completely redone.
7. A first floor bathroom will be placed in the side closet as indicated
on the plan.
8. The walls will be insulated and the dry wall will be replaced.
chestnutave(j)
4 StiAMp l ,
4 (Cit. of 3artlia 1 pt -* . _.
*1:11 �� -
'", DEPARTMENT OF BUILDING INSPECTIONS
=__:=14F___=-. _ /_
INSPECTOR 212 Main Street • Municipal Building � '
Northampton, MA 01060 o 5 ■
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as Lis /her construction supc:..:sor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he /she resides or intends 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."
The building department for the City of Northampton wants any person(s) who seek to
use the home owner exemption, to act as their own construction supervisor, to be aware
that by doing so you become responsible for compliance with state building codes
and regulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation /footings (before backfiIl)
sonotube holes (before pour), a rough building inspection (before work is
concealed). insulation inspection (if required) and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
I, 7- 1`744. 4 t-4 understand the above.
(Home owner /resident's signature requestin exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date VIVO 1 / 0o
Address of work //II
location VG 64 el* c, j 44 -e__-
L.Jf /L74 6/os
fio p7.0 ��� (i ±� of ' .�t�z-fl�a1)tpfolt ='t 3 =
A �
+ 11(3artrl)nrtia.
r im
li d!. --_ _
n — DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street. Municipal Buildin
1 Mass. 01050
WoRran COfrICPENSA AITIIDA
.
(li ccns."x /pertni tree )
With 2 principal place of business/residence at:
(phone=') •
(svrt/ci ty /ssauda p)
do hereby certify, under the pains and penalties of perjury, :hat
( ) I am an employer providing the following worker's cotnpenszoo:: cover c For Illy
employees worlOng on this job:
(Incur oc Cone•) (Policy Nu b r) ( : Dzi.)
( ) I am a sole proprietor, general contractor or homeowner (ob one) and have hired
the contractors listed below tvbo have the following worker's COD en_sanon pel ties:
•
(Neme of Conan c or) (In urancc Cornpa,•]y /Poi.ic Numcc:) (E:ptFJUon Datc)
(Name of Contractor) (Insrancz Companyi?o!ic Nu.aiocr) (Expiration Date)
C•:me of Conffaelo;) (Insirran Company/Policy Numhu) (Expiration Date)
(Name of Contractor) (Insurancr Comparzy/Poticy Numbs) Date)
( eIIath :d1tic 1 rhea,tT aerc•'1 tc ncK tarortac�oc P £ to .Il ooCS'_GO ^)
,I
an a sole proprietor and have no one wodang for me
I arn home owner performing all the work myself.
NOTE: plcsr be ea-zre r +• kt 1c be verz bo rmploy pesenz to do r --. r.;nr work cc d•• <t1: ^q: of
not more tbz t`, -a_- ‘mitt the bomoowoc raid-= or oo the roc ca3 zpp: nett.= tbeco c--r D ( —.!}y xcc:d -c° to be
ciployc-z une.= the wui;rt (GL152.= t(5)). op,lir r o by n bomeoa-cc fc _ Gee or pc-mail r-y n /dmre
Icssl n or en ep loyor under ttzo W ork.sec Coazpemctioa A ..
1 a ts4. a copy or 'hi, czzco<cs ta.y bo f« - ,-..e to tb t =om 011, , , ;u Ao6' otvoo or Ico..moot nor t�
cove>b eaioo w
+L�d (h C i1t�c u amat eovera t 3^ eii 25A of Mai_ n
152 a Irk to the i uioa of ciaiozl pea LiC1
oam sag of c f iat of
IT to s 13 . or °C up to ooe year cad to form Stop Work Or end e •
I= or S100.00 t thy a ^a irx� --"-
1
e. -- For w-� , ‘J only
Pcrtait NuG1bCI
�_ is D Map: __ Lot
t« tun ��� .s�JPc nn.iu cc e - - 1
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
J. egisteredomelrriprovement `Contratr for_ ,_ Not Applicable .❑
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10 WORKERS' COMPENSATION INSURANCEAFFIDAVIT(M.G. 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 ❑
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 -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 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 . d Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signat _
•
1
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House (J Addition IT Replacement Windows Alteration(s) n Roofing
Or Doors 0
Accessory Bldg. n Demolition ❑ New Signs [0] Decks [Q Siding ID] Other [d]
Brief Des ription of Pr pose / re ^ J & '
Work: I ,p / s! �O _ �7 1�i •` . c arJ Z ` t � 1 y 1 " IKcout is S.
Alteration of existing bedroom `' Y N o Adding new bedroom Yes N o r / S ee.
Attached Narrative Renovating unfinished basement No
Plans Attached Roll - Sheet
6 f:A1eliouseka idor additiOrrPttoa Stinct ozsiriq cnmpfieteIL ollaw
a. Use of building : One Family Two Family Other
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? 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 Private well City water Supply
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED VHEN
OWNERSAGENTOO CONTRACTOR-A FOR B.U[LDiNG�P._ERMIT
I , fa 7 ----
,r. 7 74.G `Z • t , 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.
Signature of Owner Date
I, , 7- /,-✓G 4 7 . I. L4 /ti. L , :s Owner,' uthorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to t - • - of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print Name
Ade
API L-----
3----/574/ Si nature a te e
7'/"2--4
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 2,2 d vi
Frontage i6 1
Setbacks Front
Side ?we' V . R: I!7 R: - - --
/
Rear l' : )t-
Building Height
Bldg. Square Footage %
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location) ' ' I
A. Has a Special Permit/Variance /Finding ever been issued for /on the site?
NO DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES
IF YES: enter Book Page; ' and /or Document #
B. Does the site contain a brook, body of water or wetlands? N�j DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NOC'
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 Q NO/
IF YES, then a Northampton Storm Water Management Permit PPe from the DPW is required.
-"l -- // CA, ( $ c1
> `' ��_� s Dparfineri use cznt i
t r
City of Northampton Statusofpermitk
�'° Building Departm r u t reway 4 ` - r
f ; . s� 212 Main -Slreet % v Se ueriS @ " . atla tits r
Y
Room 1=0
0 : )3 W d U 1 at „
r,,.r,, �lorthampton, MA 0106� e s ba
e'.,, \�. 9 ^�. '4 � a�.o
ph one 413-587-1240 Fax 413-587-1272 &JSif Pia -»4 . � r � .
APPLICATION TOPDNSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
'SECTION 1 - SITE1NEORMATION
1.1 Property. Address:
This section to 1be: complefed 4byoffice
L �/
Li 6 lii.e f A' .1--- 4-L Ma„ t "Unit
Zone - O verj ay Distract ; -
Etf+St 3is � C - — ct
SECTION 2 = PROPERTY OWNERSHIP/AUTHORIZED-AGENT [
2.1 Owner of Record: _
/ fi 7 ,1 ‹ r A f,:, L ✓ // 0 Lf� 14- ��'- N� a,1►'o
Name (Print
�� ent aili Ac r g e
y m
�� "s ✓4e� �� /,_ ��phone
Signa e
2. Authorized Agent:
Name (Print) Current Mailing Address:
Signature Telephone
SECTION =3 -- E
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building t �� (a) Building Rerrn t:Fee
2. Electrical 13 !tea (bj Estimated;Total Cost of
- Construction tfrom:(6)
3. Plumbing , ,2_,. O LT?, Building Permit "Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) 1 / s / "." , Check Number 3 g6:0
/ This.Section -For O- fficial lJse -Only
Building Permit Number. Issu
Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2007 -0196
APPLICANT /CONTACT PERSON MELNIK PATRICK J
ADDRESS /PHONE 110 KING ST NORTHAMPTON (413) 584 -6750 0
PROPERTY LOCATION 46 CHESTNUT AVE
MAP 11A PARCEL 005 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out s J �
Fee Paid
Typeof Construction:_ REBUILD FRONT /REAR PORCH(SAME FOOTPRINT), ADD BATHROOM EXISTING
2ND FLR, ENLARGE KITCHEN 4' INTO PORCH AREA, ADD 1ST FLR 1/2 BATH
New Construction
Non Structural interior renovations
Addition to Existing
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
INFOFNIATION 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
1/ / t /
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.
Qro 9 n 2C D7 MELNIK LAW OFFICES
Attorneys At Law
110 King Street
Northampton, Ma. 01060
Telephone (413) 584 -6750
Fax (413)584 -6789
Patrick J. Melnik, Esq. email: pmelnik@verizon.net
verizon.net
Patrick J. Melnik .Jr., Esq. patmelnikjr@verizon.net
September 20, 2007
Building Commission of the
City of Northampton
210 Main Street
Northampton, Ma 01060
Re: 46 Chestnut Avenue, Leeds
Dear Sirs:
Please be advised that as I had agreed to provide you with an updated
estimated cost of the total of work to be performed on 46 Chestnut Avenue in
relation to the renovations of the home, the cost of renovation of the home was
approximately $60,000.00 including all plumbing, electric work, materials and
labor.
Sincerely,
at ' elnik, Jr.
09071et(100)
, 0 6 :_ i ° ziz,v
Patrick J. Melnick, Jr
110 King Street
Northampton, MA 01060
November 22, 2006
11A-005
Dear Mr. Melnick,
I have issued the building permit to renovate your house at 46 Chestnut Avenue.
I think, however, that your estimate of costs involved is much lower than the job will cost.
Since building permit fees are based on construction costs, we ask that you submit
updated construction cost estimates before we issue the certificate of occupancy.
Feel free to call if you have any questions. The telephone number is 587 -1240
and our office hours are Monday through Friday, 8:30 am to 4:30 pm, excepting that we
close at 12:00 noon on Wednesdays. I am in the office daily from 8:30 to 9:30 am and
from 1:00 to 1:30 pm. My email address is: Ihasbrouck c(r7city.northampton.ma.us.
Thank you for your cooperation in this matter.
Louis Hasbrouck
City of Northampton
Local Inspector and Zoning Enforcement
Ihasbrouck (ccity.northampton.ma.us
•
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�� C�iz # fez #l��nt#�rr_� _
� _ � :� i y`: ,• I 1 Nassac u ett5 n ___ _�
`�"� DEPARTMENT OF BUILDING INSPECTIONS ' � ` - —
INSPECTOR 212 Main Street • Municipal Building
Northampton, MA 01060 5 .`
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his /her construction super ..:sor. The state defines "Homeowner" as, " Person(s) •
who owns a parcel on which he/she resides or intends to be, a one or two family
dwelling, attached or detached structures accessory to such use and/or farm struct A
person who constructs more than one home in a two -year period shall not be considered a
home owner."
The building department for the City of Northampton wants any person(s) who seek to
use the home owner exemption, to act as their own construction supervisor, to be aware
that by doing so you become responsible for compliance with state building codes
and regulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation /footings (before backfill),
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
I, 7. /4741a. 4 �""4 understand the above.
( owner /resident's signature requestin exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date Vf5/ I
Address of work
location VG CtQr - f 44-4_
to a
fiOK 4 �tv 1 rnT y
� (! iI -i of ;c tl
F E
.
�`• .1
t�`� DEPARTMENT OP DUILDt)G INSPECTIONS . , . .
212 Main Street - Municipal Building
No
rthampton, orthampton, Mass. 01060
r' - �
WW'ORICEIZ'S COMTENSATION F_NSURANCE AFF )A\TIT
(li ccvsxlper ni ttec )
with a principal place of business residence at:
(phone:') •
(saer. tJeiij /sta dr p)
do hereby certify, under the pains and penalties of perjury; t_112,1
( ) I am an employer providing the. followine worker's compensation cove ale for in1'
employees vor>dng on this job:
(Lsnu - -nc Coor-mw) u
(Policy N_ cr) (r :pirr on Dale)
( ) I am a sole proprietor, general contractor or homeowner (ci cie one) and have hired
the conis listed below who have the following worker's compensation policies:
(Name of Conir c (In urano^- Company/Policy N' c; ) (Ex lyduon Dntc)
(Name of Contractor) (Insurance Company/Policy Nunccr) (Ext Lra ion Date)
(Name of Conrrdelor) (Insurance Company/Polley Number) (Expiration Date)
(Name of CAntraaor) (Inslran Company/Policy Number) (Ex Dale) .
(naac� - d'± - or31 bc.a.ifacca.. - to mcut� iafotm,.5oa pcssaiaias t di cocrt�:a)
•
I am a sole proprietor and have no one woriang for me.
I am,a home owner performing all the work myself -
•
NOTE: plea be "'"Art tt.,. ' Jc 6o�cocoµ oeen .�bo on:pla c--
y ptuto to do c..nm + .:c, oo c repxa work J oa a dwt. of
room roo then t...... .7
tfJ in whi the bo 000wo rid or Co the p -ou(yJ z7purtmty -r1 S11C"CD LT DO( C^m.T.11Y OC6 -d... 1 to be
=captor= ”ne'r- the ttxk � =22 , - Act (GL152.,:=1(5)), o.pplimaioo by a bonanotvocr far _ lick or pataa rty c-vidmcx the
levt.l runs. of ao esrloyor under duo Workore Com:pemalioa Act
1 atodcratkott dui a copy of tbia mtccooa may loo fora ordud to tbo Dori rrmcoa of !. Ae■dcat! O Xioo of Ira+r+nce roc tb■
oove>gc vc if cslioa and th_t L to scout'covcros coder s.octioo 25A of NCH_ 152 m led to the i,mposiLioa 0(eimia i pcailtic
000sisi alt of a floe of up to S1_,100.00 artdlor o oacxat of up to ooc yev end civil pemhie in the form of Stop Work Orcie tad a
(im o(5109.00 1 dry IFp,iaA tnc
For dWcur vac only
+ PCTQUI NUILIbC7
/� � 7_ ( }t4.11):: -- Lot "
tun �
=- a. • c t7ni ucc S- _ _ - ¢: e
SECTION 8 - CONSTRUCTION. SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
9 e "gis re i.Dame lmprovemenfConttact r r . %`$, .; a f„ ,a Not Applicable .❑
Company Name Registration Number
•
Address Expiration Date
Telephone
SECTION 10- WORKERS' COMPENSATION INSURANCEAFFIDAVIT (M.GL. 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 ❑
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 . d Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signat •
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing
Or Doors El
Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [E] Siding [L7] Other [0]
Brief Dess tion of Prppose // JJ
Work: 1- 7`, , ,,p / s! te , r C "�7 �i� � ' f � 4 �� M Ht Jr_ / ti S.�
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement 5 ' o
Plans Attached Roll - Sheet
sal t ew:: oose!anc or atl"dttiow onexistincrhorisinq mp ewe 'e I nid
•
a. Use of building : One Family "' Two Family Other
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? 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 Private well City water Supply
SECTION 7a- OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR'CONTRAC -TOR• APPLIES. FOR: BUILDING PERMIT
�.�. � .a t , 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.
Signature of Owner Date
1, a.(-/i(G 7 k , :s Owner,•uthorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to t - • - of my knowledge
and belief.
Signed under the pains and penalties of perjury.
/A, y
Print Name
Signature a te
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 -- a vl _ _
Frontage
Setbacks Front 1 0
Side L:- R:lt/ee LL______, R:
Rear l S '
Building Height 5m
Bldg. Square Footage
Open Space Footage � % ;
(Lot area minus bldg & paved Z 'y�' +i' i , I i
parking)
# of Parking Spaces '
Fill: I; i
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DONT KNOW 0 YES 0
IF YES, date issued::
IF YES: Was the permit recorded at the. Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book Pagel and /or Document #
B. Does the site contain a brook, body of water or wetlands? NIKO DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained Date Issued:
C. Do any signs exist on the property? YES t NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO?
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 0 NO/
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
1' lh") s d
7 _ e�a>�dse I ,
City of Northampton Statt;s
n Building Department �� "; a�� °� ��
?'I � ^ 212 Main Street - �,
C.- � i Room 1 00 _e e p t'''," y a , sue`
n, rthampton, MA 01060 e - �. x
} ' ' phone 413- 587 -1240 Fax 413 - 587 -1272 s .� f- ,
c „ 4 . _. . ...�4v1'��'�;'�`,� .
��
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
'SECTION 1 - SITE INFORMATION
1.1 Property Address: This #secticjrt to beyc o m pleted byuff
f6
6-1 .c f f nr d--- /dam. M ai .� ;, �o � s U rut
. L ce 117A p/0.5 3
one F ' , O0 t;ct
ifit;'St.Distrtct.,r: - CB=DistncL
SECTION 2 PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of 7/I( n
f � / - ) t7'. /, G / L ✓ 1 // 0 1-(/ Li `C-77--- /1V�P7 ��, a, ro
Name (Print 2Ph2 i aili Adc1re Signa
2. Authorized Agent:
Name (Print) Current Mailing Address:
Signature Telephone
SECTION = ESTIMATED - CONSTRUCTION -COSTS --
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building t ” PO'' (a) Building Permit Fee
2. Electrical 2 id
.,j " (b) Est Construction mateTotal from Cost : (6of
)
3. Plumbing D !TZ, "Building, Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 +2+3+4+5 5" , Check Number .2 3 ( 679
This Section For Official Use Only
;pate
Building Permit Number. Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2007 -0196
APPLICANT /CONTACT PERSON MELNIK PATRICK J
ADDRESS/PHONE 110 KING ST NORTHAMPTON (413) 584 -6750 ()
PROPERTY LOCATION 46 CHESTNUT AVE
MAP 11A PARCEL 005 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid alai 1g5D
Tieof Construction: INTERIOR DEMOLITION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans / Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
A 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 Co sion
8 2
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.
46UJF''\iU eP-2007-019C
ffiflr T
CO1\IA . - - Ctfl JsE: 1 FS
M4jJIock 11A oo
Lot: 001 PERSONS CONTRACTING \k ' CO fItA( 1 ORS
iLnut - Building DO NOT HAVE ACCESS TO T 0 MGL c 142A)
Cate oi
1.T
BP-2007-0 196 . .: •.
Project 4 JS2n1010032)4
Est. Cost: $15000.00 .•• 7 .
Fee: $ 50 .00 PERM[SS'L/ IS HLRJ'
Cont. Class:
Contractor- . . ., . .: •.•.. .
Hcmeowner dS ontiactor_
L SiztqJij:22O41.36 Owner: MELNEKPATRLCKJ ... . .' ...
r
- - -
AT: 46 CHEStr'.:UT AVE . ..
1pe'tcant ,1 ddr s.s PJwn 1,, snran
110 K(NG ST (413 584-c7 -
NORT HAM PTO N MAO IO6O ISSUED ON 1J'22iOO6 0 00
VIR
TO PERFORM JIIFFOLLOWING V0RK flEBUILD r RPOC"(S E
FOOTPRINT), ADD BATHROOM -XI TING 'D FLR ENL N 4 INTO PORCH
AR EA, ADD 1 S FLR 1/2 E31\1FI NEED UPDATED ESTIMA ISISSUED
POST d!S CAIU) SO IT Y3 VP FROM THE STREE
InetoF of Plumbing hispcctor of VViriig D.P.W. ..... 1n. . ector. .
1 Tq(1( Service: Meter:
4 Rough House# F
FLu g
inal:
Gas: Fire teit
Rough -. . .. :
Filial:
1, Smoke: -
AT
THIS PERMI)' MAYBE REVOKED BY THE '1 Y OF M Lk110 01
ANY OF ITS ULES AND REGUL TIONS/ . .. . . . . ..
.............................
Certificateo(;u:nc
Fee 1 ye Date Paid: A iiottnt
Building 11/22/20060:00:00 $O.00238
212 Main Street, Phdllc (413) 587-l20. I'tx: ) 1272
Buikling Commissiontr -Adh:.:: Pati O