18C-092 (3) i'-' rp'
. ,
zl • ,,. NOV I 5
i
McCutcheon Construction - -
\
Full Service General Contractors \
87 Chestnut Street ,.
Florence, MA 01060
(413) 584-3352 .
\
//
y \
i ,:„...2
\ ..
\-...
; i
. I
'
i I ,
,
-- ' --
i 1
1 t 1 i
1 i 1 i 1 I
1 1 I 1 ;rf
'
I 1
' . ! i
0
- ,
i 1 I
°\.
1
, _ ..... . „,.. , . . .... . . ..,.„..._ ...... .. .._:_. ,I. - .._ _... ,_ i „„_77,1----
- - - ---- - -
Et...e...\/A —
-- SIPE. ...t,EY06.-71.01‘x ....._--.
- 1207-ti t- cx±--
M.Pcu
1°A eit.cul291(7 6 , ), 6 ,
- So•to – icke.,--
_ P7,
z ,,,, 16 ' c.) I C-.' ■
.-.-
- 2%/ L\ S-ICAT (6 0 , C., •
ect-
- PLNAl'uor!„_, tt-lc). 17c)ors:
_ s , p F-- \I ALL
()Ly Goer0
— 1)1,
GO 11 1 1\ C' 01,4 - ncip
_ E – I 3
F-triDe
......".
S2 - "30 ,
____
11
q 1
ai iS NOV 5 2000
7PT T31;i;
McCutcheon Construction
Full Service General Contractors
87 Chestnut Street
Florence, MA 01060
(413) 584-3352
Itar ?tA"
- 52, EA24 ?ALI)
sc e zn % A
a
I I
•
1 0 fl
3()
o
4 .7.
— 0
PP 0 Pose
D
z!)'
\)/
7 I
120%-17)
��tiAMp �.,
#6,„„k_..., e fQ it , s , 0
��� trt cif NartilanipthI1 _'♦ -L
am eoz- ;i 6 lasaachnsctta —Willi.
tJV rye'
�.Y:..__ _ I=
212 Main Street • Municipal Building f
— DEPARTMENT OF BUILDING INSPECTIONS
_
Northampton, Mass. 01060 r'
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, RtLi 0,, 'il C- Co-c-eLt 4-\
(licenserilermittee)
with a principal place of business/residence at:
•
0 --) Sdc,, t . -i-- (phone#) S -'7,e
(street/city /state/zip)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date) , : < >;,.
( ) I am a sole proprietor, general Contr actor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
, r
(Name of Contractor) (Insurance Company /Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet if necessary to include information pertaining to all contractors)
I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE: please be aware that while homeowners who employ persons to do ma iut.* +nn, c o n struction or repair work on a dwelling of
not more than three units in which the homeowner resides or on the grounds appurtemun thereto arc not generally considered to be
employers under the worker's oration Act (GL152,ss 1(5)), application by a homeowner for a license a permit may evidence the
legal statue of an employer under the World:et Compensation Ad..
I understand that a copy of this statcme:a may be for warded to the Depute cnt of Industrial Aocidmfs' Ofhoo of Insurance for the
coverage verification and that failure to ecatre coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to S1,500.00 and/or of up to one year and civil penalties in the form of a Stop Work Order and a
fine 0( 5100.00 a day against tee. •
iie(../&___-- For dqurtma aai7
eleiCe Permit Number
Map# Lot # Signature of Licensee/Permittce o
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : TAACJA ef6 2
License Number
JZ7f
Address Expiration Date
Signature Telephone
liteiidtWolfit4061imiiitrtentlitto E l l Al E ,, Not Applicable ❑
/ C6 „ l rzc.AS'. . r2w 1 co2 1s
Company Name Registration Number
P7 c ,>`ssilA - r. L 6 (rz
Address Expiration Date
Telephone -4 — 3 S
SECTION 10 WORKERS' COMPENSATION INSURANCE AFFIDAVIT (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 JY No ❑
Jaw-arainwutwiteXmlivin DUO
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 and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other ['j
Brief Description of Proposed Work: i�Cj A .j 4- QI-Aci II vet,,
Alteration of existing bedroom - Yes `y(' No Adding new bedroom Yes '` No
Attached Narrative ❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet
0 lNeweh ? K., ri "o +dd "iti r iMit c u trtg.acarrnplet4`the.:folI»vqin
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. Mascheck 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 CONTRACTOR APPLIES FOR BUILDING PERMIT
\ANV I L,L , as Owner of the subject property
hereby authorize fG - Yi E' � to act on
my behalf, i all matters relative work aut rized by is building permit application.
S ature of Owner D to
, as Owner /Authorized Agent
hereby declare that 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.
Print Name
C '[U
Signature of Owner/ gen Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size 11 3ZC
Frontage 75 �5
Setbacks Front 2�‘ Z C ' d 2
Side L: 35 R: L: R: 45-
Rear
t( 1
Building Height Zt Zt
Bldg. Square Footage %
Open Space Footage t �
(Lot area minus bldg & paved CM 4 ! � &7 5O
parking)
# of Parking Spaces 2 2
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO V DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued
C. Do any signs exist on the property? YES NO �c
IF YES, describe size, type and location:
D. Ar there any proposed changes to or additions of signs intended for the property ?YES
No A
IF YES, describe size, type and location:
.. . . '
City of Northampton P s: '...its!,‘,.,:lk:::: ,di:',' 4',1: :34 G4' , It!?-lks: ,:t:It: l' '''.;,,N
PY,= ' ,... 11;!iieS `' 4ik3/4- : i. ;; 2. :.: . ' ,4 1.1 , i; , ii,t;,:‘,14,i1.1i:':*Ifi .:',:tt•,- "''-f,,,,414-,4,,,',f-',-4•,,,,:i.'•:,,
Department
------ i
a n Street
'
I '
,f 1 NOV I 5 2000 I om 100
...4,,,,...p,./.7,__,,, .....,,A,,,.,... ..,„,.... a.: „.„,..., Ak , , "Vikliz.% "t:'• '• !AI.", „V '",;,<...,' ,.,.. - ',... 'A
, _ 413 5817.124o Fax 413-5
Northampton, MA 01060
't,e, i ,, °%k,,,:::„is.,,t,,,,,;:i„,-;44,4fikt,,,,,,No.,;4::..),1:-. ,...1.4v
• F i f "o - F - 141 - 1511 . 0- ir ,,---, -,.., , 87-1272 .,
DWELLING
CONSTRUCT, ALTER, REPAIR, RENOVATE OR DE
t!.*:(4,1i,...0":`,—,, .....;0 FAMILY D . .,,,...... I
DEMOLISH A ONE OR
APPLICATION TO CONSTR
SECTION 1- SITE INFORMATION
itoted,by uttk#.e,;
T his tojp ypmP , #
':, A / ,,,,,,,i.,'
. it
1.1 Property Address:
,, , P otrioV ;,‘ - r/i Z , I
/4 1,4 , °!;4,# , .„,, 2 ,,,--45-
' ' ' rft PI ..At
Elm St pistrjct
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
5Z- Llisi..„- g LI
1 Lvi:
pi.,,
Name (Print) /
, Current Maili c:
Telephone
( -'..("i7"-/
Signature
2.2 Authorize A ent: c..6k, 1 el i
,tip c io,,
t,/ (1- A
Current Mailing Address:
Name (Print)
.)--1 —
L
Telephone
elephone
SECTION 3- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (DpIlars)tobe (a)
1. Building . F Official Use Only
completed by permi t applicant
Building Permit. ee
* oc , aC.)
2. Electrical ( b ) Et c s o n i m t a r t u e c d t i o T n b t from a l Co ( s 6 t ) 0 of
3. Plumbing B Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
tt ...., ..--7„,, 1
.,....--
thrt
3 + 5) Check Number 9-oir"
se-I-, ' Ct)
6. Total = ( + 2 + 3 + 4 This Section For Official Use Only
6 BuildIng Permit Number: Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File # BP- 2001 -0504
APPLICANT /CONTACT PERSON Paul McCutcheon
A,DDRESS/PHONE 87 Chestnut St (413) 584 -3352
PROPERTY LOCATION 32 GLEASON RD
MAP 18C PARCEL 092 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
4g71., Fee Paid
Typeof Construction: REPLACE 6 X 6 WITH 4 X 6 FRONT PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 062544
3 sets of Plans / Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
e ek, Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received & Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w /ZONING BOARD OF APPEALS
Received & Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w /ZONING BOARD OF APPEALS
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 Co on Permit from CB Architecture a omm', ee
it ! 2006
Signature of Building (+dial 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
r m. of public works and other applicable permit granting authorities.
32 GLEASON RD BP- 2001 -0504
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18C - 092 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Citegory: alteration- addition BUILDING PERMIT
Pormit # BP- 2001 -0504
Project # JS- 2001 -0862
Est. Cost: $2500.00
Fle: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Paul McCutcheon 062544
Lot Size(sq. ft.): 11238.48 Owner: NEWKIRK MARTI
Zoning: URB Applicant: Paul McCutcheon
AT: 32 GLEASON RD
Applicant Address: Phone: Insurance:
87 Chestnut St (413) 584 -3352
F LORENCEMA01062 ISSUED ON:11 /17/00 0:00:00
TO PERFORM THE FOLLOWING WORK: REPLACE 6 X 6 WITH 4 X 6 FRONT PORCH
CUT FIREPLACE OPENING
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter: 00
Footings: V
Rough: Rough: House # Foundation: a vt. `fir
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 11/17/00 0:00:00 4692 $50.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
'Ming Conun.& °sion'r - Anthony Patillo