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18C-092 (6) f City of Northampton, Massachusetts ( O 0 Office of Planning and Development i City Hall • 210 Main Street MAY 1 0 2001 z tJ .../1111V.50741 Northampton, MA 01060 • (413) 586 -6950 ry .i .� ►� FAX (413) 586 -3726 * , �'A." ��j te DEPT Of BUILDING INSPECTIONS • Community and Economic Development NORTHAMPTON, MA 01060 � ,�'�' • Conservation • Historic Preservation • Planning Board • Zoning Board of Appeals • Northampton Parking Commission TO: Anthony Patillo, Building Inspector RE: Permit application //r�A / �, 1 f ' C ` FROM: Angela Dion, Board Secretary /OPD DATE: v Would you please review and return the enclosed application before the Planning Board onn Board of g /� 9 ppeals eeting scheduled for /. y/(;/ so that we can advise the Boards of any concerns you may have. f Thank you. 04. ��; � '' c Git Naril l ainpfon � _ * �46`� j s1le �� ��� 6assar ltusctts ' _ 8 • ' � _� '�_ DEPARTMENT OF BUILDING INSPECTIONS • =`_ =j 212 Main Street 'Municipal Building ' Northampton, Mass. 01060 r" WORKER'S COMPENSATION INSURANCE AFFIDAVIT I gl e . lit t riAe.t.r, (li permittee) with a principal place of businne • �- - i-%/b�u✓ kit I t=u2tA (phone #) c - 335 Z- (s trees /city /state /zi p) 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 worming on this job: (Insurance Company) (Policy Number) (Expiration Date) 1 : ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired r the contractors listed below who have the following worker's compensation policies: H , , ': (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) i (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional short ifnecc!wy to include information pertaining to all contractors) QQ 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 persona to do m.i+A'narxY, OXIStrUCti011 or repair work on a dwelling °I- not more than throe unite in which. the homeowner resides or on the grounds appurtenant thereto arc pot generally considered to be employers under the worker's oomprasation Act (GL152fs 1(5)), application by a homeowner for a license or permit may evidence the legal statue of an employer under the Wodccr's Compensation Act I understand that a copy of this statement may be forwarded to the Department of Industrial Accidents' Othoe of Insursooe for the coverage verification and that failure to secure coverage under section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a Eno of 5100.00 • y . :.. me. / i For dial use only � Permit Number Map# Lot # - Si.r • e r of Ltcrosce/Permitt a be e SECTION 8 'CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: /� j . Not Applicable ❑ Name of License Holder : +<.� l : s 1.0 ' j ec t-114 License Number ' , z Address 6 a ("--- 1 Expiration Date Signature Telephone °ire; m rbemenforifractoi .; . ., O �� Not Applicable ❑ Company Name A •,� Registration Number S t _ cv ( JU . 6 1ICJcz Address Expiration Date C1Z Telephone 3 f� 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 ❑ AA ome OWlid Exe pt><o 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 SECTIO DESCR IPTION OF PR ORK'(check all appli y . New House ❑ Addition ❑ Replacement Windows Alteration(s)X Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other [ ] Brief Description of Proposed Work: C • , t. s i Q. I hil. A . I ... . Alteration of existing bedroom Yes X No Adding new bedroom Yes Y No Attached Narrative D Renovating unfinished basement Yes V No Plans Attached Roll D - Sheet t a.1 Ne ai Ta ciditiMtb tt i gititliter `ifi ete h O1.1bWi gg: 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 TOO BE COMP WHEN 3 OWNERS AGENT"OR CONTRACTOR AP PLIES`F'OR BUILDING -PERMIT I, /gJ14 )I , as Owner of the subject property hereby authorize PRA 0 _ 1 (k )-!t' ■to act on my behal , in relat e work a orized by is building permit application. Get — Signa re of Owner Date I, wI C_ Pic- a.)-74141(--6, , 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 a nOs of Print Name al u t a I4 c- CuteLev. tilalo Signature of Owner /Agent 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 3 ZS 1 I e srO Frontage "IS � 25 Setbacks Front 5 3 5-3 2 0 Side L: R: 7 L: I1 R: Z Rear Building Height zU ' t S, Bldg. Square Footage 16Ncst. 14 % 14 7 c. Open Space Footage sc , % (Lot area minus bldg & paved parking) # of Parking Spaces Z Z 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 'X. 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 }( IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location: • r.,:', c U . Northampton � � Q B o g Department _ o )1 l fi� 20011 ain Street _d ,� .5�' APR 2 6 Room 100 �p 1, • am��ton, MA 01060w� f.:d1 DE of B terri %aN 87 - Fax 413- 587 -1272 � pp : . ,'` . . , i APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING i SECTION 1 - SITE. INFORMATION K This sect to • e completed by of fice a 1.1 Property Address: ',,,,,,,1.4',... l A � ',. N E �^ l 1 � - Maps - , of " ,'f � n it A , °, G Aidh Zone Overla D E St " D i str i c t �, "' ` C B D " ,. SECTION 2 - PROPE RTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: /111clvj.; )■1(21k,ti-V12-- .3Z.- GileASOI'N Prt Name (Print / Current Jlailirg Address: / L 0 /17/....d 1 �/ _ -. Telephone S ign.tu - 2.2 Authorized Agent: 1,(t.Qc Act...c=c---t-N v,,,„ a. Name (Prin Current Mailing Address: 4/ Signature Telephone SECTION 3`- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Offic Use Only -' completed by permit applicant 1. Building f . '" Go (a) Building Per mit'Fee L 2. Electrical (b) Estimated Total Lost 4 f . S-CO . C-- ,5 � Constructtor4�frQm „(6), 3. Plumbing Building Permit Fe 4. Mechanical (HVAC) 5. Fire Protection 6 Ct'l . Total = (1 + 2 + 3 + 4 + 5) cCk'j ,off Check Number, d ” This Section For Official Use ; y." Building Permit Number:.. s Date Issued " Signature: Building Comm /Inspector of Buildings Date File # BP- 2001 -0843 APPLICANT /CONTACT PERSON Paul McCutcheon ADDRESS/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 ` g ` Fee Paid — l� O -- Tvpeof Construction:_ RE OVATE COVERED PORCH TO SUNROOM 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § l PLANNING BOARD ZONING BOARD Received & Recorded at Registry of Deeds Proof Enclosed �inding Required under: § ' 3 r 1� 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 Conservatio s • ission Permit from CB Architec e Committee Signature of Building Official Da - 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. , lk . . . A tti l ,E - CEDVErn . L4.. AP F-i _.2 6 zu_ui 11.rdj • McC4terieon uonstrution Full Service GeniTailVECTIONS 87 ChestnUt Stregr ' Ni ' f)1 °G' — 3 qL.E.-470) Florence, MA 01060 (413) 584-3352 — R3 ia.c. A-1- — reek SCAA i iv - ■ -- • -„............_ • 1 li I o .=Z0 c 1 iNtiZT .4 , '''' , ' 1 : ,,,---,., . ,:'.. _ 1 rd 1 i — 1 1 86 ‘ • ( PRoser) i 1 lar=740V4cr ' e.:er.(1,/,',.1 i Z 1 I IC '''•'''.1 I-lcos-- 1 ., 1 ) • rr, 1 i 1 D ZN a ? i ' ! • 6 -y ZONING BOARD OF APPEALS FINDING APPLICATION FOR THE CITY OF NORTHAMPTON (Change of a Pre - Existing Non - Conforming Use or Structure) 1. Applicant's Name: , . Address: 7 � L�/ _ CS rU RC2,_ZLZ Telephone: v� 7` - 6 2. Property Owner's Name: Address: „`71-1.-6 Telephone: £ 3. Status of Applicant: Owner r Contract Purchaser Lessee Other (explain) 4. Parcel Identificat s Via' C Parcel # 9 a Zoning District(s) / / e Street Address :. .,, ; ''`e 7'' ..? 'Jet" Property Recorded at the Registry of Deeds: County:_ _Book: R Page: 5. Finding is being requested under Zoning Ordinance: Section_ 9 r , 5 /,D, Page - 6. Narrative Description of Proposed Work/I4oject: (use additional sheets if necessary) &NO CO Z) l2 1> ©><r�� TCv --sZL aP -SEAS /t-) / (7 N 5 T7E'r.L C- 'e L ,'A r 'A 7. State How Work/Proposal Complies with the following Finding Criteria: (see also Section 9.2 ; for Signs Section 7.0). If the change, extension or alteration conforms to zoning in all respects, no Finding is required. *Explain why the existing building, lot or use is legally pre - existing non - conforming. (Buildings, lots or uses that are in existence at the time new zoning is enacted are protected under grandfathering provisions) n F P0/err H !s ) / 5 hue<� *Dh- -.s the change, extension or alteration create a new violation of the zoning, which would require a variance? Yes No X If Yes, explain how: • *Explain how the change, extension or alteration shall not be substantially more detrimental than the existing nonconforming use to the neighborhood: Al D7-' • L // J o /l9 CJ � //'lF'/¢GT OA) &o 7C ryce', o e�_ 8. Attached Plans: Sketch Plan Site Plan None Required 9. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. I (or the landowner, if I am not the landowner) grant the Zoning Board and Planning Board permission to enter the property to review this permit application. Date: ///ly 3 , c=33 ©d ` Applicant's Si_' : to ' ,i / / 1 Owner's Signature (if different from applicant's):