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37-022 (10) • 1 0S DEPT. OF BUILDING INsP Kohl Construction ■ ■ ■ ■ ■ ■ ■ www.KohlConstruction.com 31 Campus Plaza Road, Hadley, MA 01035 ph (413) 256 -0321 fx (413) 256 -0130 Dear Mr. Miller, The following is the amended plan for the building permit application to construct a 14'x14' screen porch at 1 Mountain Laurel Path. Enclosed please find (2) sets of revised plans with floor joists changed to 2 x 10 nominal dimensions and the floor beams revised to a triple 2x10. Please call me with any questions. Sincerely, Fred Meyer 256 0321 ext. 109 New Treeline. Typ. ,, ; • i SET yMxE t: s° I I E =AK ` [i,EY .. 297 5G TBgI ' 7 t SET SPKE W ,t CY g i =v e • ......^... rte' / 1 iiillik , lor e es ,- t..,,. / s ' ' I. \ 1 c .''''•■•.,'''',..,-,_ i---- ----4.--1Cecti \ o r . 1 \ . r 1 Pavett.Emerge y /I l .�� i - - --- ' Access ^, r Common _., \ � Area ' �� VI ' v it i t, , * WW , g 1 \ fillio ii . 0 ' . .. 4 ;11 ...\,\ etrand. � ' 1 1 A , { Patio \ .... \ 4 . ;° g t 4 \ � r' .# R.esidential �� # s 1 Unit (Typ.) �\�. i 1 ) Pa ved Wal .. ;'' / / �`�\ i � * # 1 �. I T H M S j , 1 _ r \ 1 �ervs ,,, , ( i) .... ....\ A \ . - — ..y. i i �l t 1 \ t 1 t t : 1 -77Y-1 ►' iI S£7 SPK£N Y 1 1 ' • { .— ____..�._______._.— " LILY :g7 90 1 y t .44 • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervgqisor: ` /�. y�, Not pplicable ❑ Name of License Holder : / / � �ie /1 ec� 6'639 License Number 3/ C,GMAus -Az4 //x cy NA 5 26 - /2 Address / Expiration Date Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ KOHL— tO,v ie / N d ivC.. Company Name Registration Number 3 r CAmAus »243 A [ Address Expiration Date /�// / /1'AL L.i «� s ' ! Q 0/e)3" / � Telephone 2 56 ' 2 / 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 la" No ❑ Home Owner Exempti©n 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 The Commonwealth of Massachusetts Department of Industrial Accidents IV= r Office of Investigations G "MUM 600 Washington Street =oh= Boston, MA 02111 www. mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): Kohl Construction, Inc. Address: 31 Campus Plaza Road, Suite 3 City /State /Zip: Hadley, MA 01035 Phone #: 256 -0321 Are you an employer? Check the appropriate box: Type of project (required): 1. 0 I am a employer with 14 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part- time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7 • ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. 0 Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11. ❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12. ❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIM Mutual Insurance Company Policy # or Self -ins. Lic. #: WMZ 800287201 2010 Expiration Date: 02/10/12 Job Site Address: 1 Mountain Laurel Path, Northampton, MA City /State /Zip: 01060 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi y under the p' 'ns and penalties of perjury that the information provided above is true and correct. Si ature: /. .s Ie /� ✓rf Date: April 15, 2011 Phone #: 256 -0321 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: 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 Frontage b Cn f Setbacks Front 3co '; 30c Side a R: 007 L:e!' R: 0L7 ....... Rear Building Height Bldg. Square Footage 'Hoe Open Space Footage (Lot area minus bldg & paved ?, s parking) # of Parking Spaces N/A - -' N 4 -,- Fill: (volume & Location) ! l! /(/ ..._ A. Has a Special Permit /Variance /Findin ever been issued for /on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Re istry of Deeds? NO 0 DON'T KNOW YES IF YES: enter Book Page: and /or Document # 1 B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW ef YES i 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 V IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES ® NO e IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, exc vation, 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 from the DPW is required. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [q Siding [0] Other [0] Brief Description of Proposed ) Work: CON I 1? _)CT &,/ CE. PO kc;H AN iTlb/J Alteration of existing bedroom Yes X No Adding new bedroom Yes X. No Attached Narrative Renovating unfinished basement Yes >c No Plans Attached Roll C 6a If New house and or addition -to existing housing, complete the following: a. Use of building : One Family ■ Two Family Other b. Number of rooms in each family unit: C Number of Bathrooms ∎� c. Is there a garage attached? A/0 �1 d. Proposed Square footage of new construction. / q p 6 Dimensions /q X/ 7 e. Number of stories? 1 f. Method of heating? No /lam T Fireplaces or Woodstoves NO Number of each g. Energy Conservation Compliance. /V/ A Masscheck Energy Compliance form attached? J(/ /A h. Type of construction i. Is construction within 100 ft. of wetlands? Yes V No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade /V �A k. Will building conform to the Building and Zoning regulations? I✓' 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 I, "t `� \. "-- Lc `t t () , as Owner of the subject property C �j hereby authorize l /'E b may E / -.- to act on my behalf, in all matters relative to • authorized yy this buil • •ermit application. l _ � 1 Signature of Owner varr' #r Date 1, / ,c A! f'� t , 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. r/ e.A. ..1cK e, I1 ':y Print ame 9 i /tt /`-- ( c'c'/ 4//•,7 -// Signature of Owner /Agent Date V Department use onty R EGE N City of Northampton Building Status of Permit Curb C Pe veway Pe y r 212 Main Street Department Sewe .tic Availablii +,t$ ` /P z `� Room 100 iter1ve ait putty ` 41:,,1 . rthampton, MA 01060 Two et € 4 Ptans \ .4� __ - fie 41 -587 -1240 Fax 413 -587 -1272 P1otJ t � 3y,� Other Specit,W - , APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address This section to bec by office ' ��OV:1iiN ��a =� i E, ? Map Lot L � ! Un it + � � 1 ��� � � M q 01060 Zone Overlay District I Y EIm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT l 2.1 Owner of Record: 4 p� p r: 1 N Current Mailing Address: '' ignatur 2.2 Authorized Agent: F,E-3, M t -YE- _ 31 CAM P)S OL-A2 A 1 HIPILy //A Name (Print) Current Mailing Address: L/J 26 0 3,2 / ' i O Signature Telephone SECTION 3- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire on � 6. Total l = = (1 (1 + + 2 + 3 + 4 + 5) - - Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2011 -0895 NA APPLICANT /CONTACT PERSON KOHL CONSTRUCTION A r - ��,� ADDRESS/PHONE 31 Campus Plaza Rd HADLEY (413) 256 -0321 i �' PROPERTY LOCATION 1 MT LAUREL PATH - 600 FLORENCE RD MAP 37 PARCEL 022 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � 05n - Fee Paid Tvpeof Construction: CONSTRUCT 14 X 14 DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 064539 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF, IRMATION PRESENTED: V 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 D - molitio ) elay tture of Build ng * fficial 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. 1 MT LAUREL PATH - 600 FLORENCE RD BP- 2011 -0895 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37 - 022 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING PERMIT Permit # BP- 2011 -0895 Protect # JS -2011- 001453 Est. Cost: $21000.00_ Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KOHL CONSTRUCTION 064539 Lot Size(sq. ft.): Owner: FEINLAND JERALD B & JULIE B Zoning: SR Applicant: KOHL CONSTRUCTION AT: 1 MT LAUREL PATH - 600 FLORENCE RD Applicant Address: Phone: Insurance: 31 Campus Plaza Rd (413) 256 - 0321 HADLEYMA01035 ISSUED ON:5/11/2011 0:00:00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT 14 X 14 DECK POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: l J - 2'6 / Footings: Rough: Rough: House # Foundation: Driveway Final: Final: Final: Rough Frame : 6- 34cn(Pt' Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: Otor THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND RE -' • : %' At * reAc Certificate of Occupan • ( nature: FeeTvue: Date Paid: Amount: Building 5/11/2011 0:00:00 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner