37-065 July 26, 2010
Louis Hasbrouck, Building Commissioner
212 Main Street
Northampton, MA 01060
Dear Mr. Hasbrouck,
As Chair of the Design Review Committee of Rocky Hill Cohousing, I am writing in
regard to the proposed building of a bike shed near Unit 128. As is our custom, such
proposed "additions" to units of our condominium must be approved by the Design
Review Committee. As part of the approval process, the entire community is given an
opportunity to comment on proposed projects, and even to object to them entirely. This
process was followed for the bike shed proposal for Unit 128, and the project was
approved. The proposed bike shed will be approximately 10' x 13' in size and located
within a few feet of the exterior side of the house.
We look forward to seeing the bike shed built in the near future and appreciate your
assistance in facilitating the issuance of a building permit.
Sincerely,
Adele Franks
Chair, Design Review Committee
E1 ' u n i
i
v 7 • a�'' ' sy' 011
ROCKY HILL COHOUSING 100 BLACK BIRCH TRAIL FLORENCE, MA 01062
WWW.ROCKYHILLCOHOUSING.ORG
Louis Hasbrouck
From: Adele Franks [adele.franks @gmail.com]
Sent: Tuesday, July 27, 2010 7:26 AM
To: Louis Hasbrouck
Cc: Rosemary McNaughton; Gary Felder
Subject: Bike shed approval at Rocky Hill Cohousing
Attachments: Unit 128 Letter to building inspector.doc; ATT00001.txt
Greetings Mr Hasbrouck -
As Chair of the Design Review Committee of Rocky Hill Cohousing, I am writing in regard to
the proposed building of a bike shed near Unit
128. As is our custom, such proposed "additions" to units of our
condominium must be approved by the Design Review Committee. As part of the approval
process, the entire community is given an opportunity
to comment on proposed projects, and even to object to them entirely.
This process was followed for the bike shed proposal for Unit 128, and the project was
approved. The proposed bike shed will be approximately 10' x 13' in size and located within
a few feet of the exterior side of the house.
We look forward to seeing the bike shed built in the near future and appreciate your
assistance in facilitating the issuance of a building permit.
Sincerely,
Adele Franks
Chair, Design Review Committee
Rocky Hill Cohousing
A copy of this letter is attached
1
Bike Shelter Top View
Rosemary and Gary Felder, 128 Black Birch Trail, Florence, MA 01062
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2x8 White Pine
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Rosemary and Gary Felder, 128 Black Birch Trail, Florence, MA 01062
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Rosemary and Gary Felder, 128 Black Birch Trail, Florence, MA 01062
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Northampton Massachusetts
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HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction supervisor. 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 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 infection (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, T understand the above.
(Home owner /resi ent's signa re requesting exemption)
� q g P )
I will call to schedule all required building inspections necessary for the building permit
issued to
Date 1120/ Zo t O
Address of work
location Z 910 c ' Ira',
Ftore,c.e /Q.IPA D1000
, • ,
. .
. ..
.*\ The Commonwealth opfassachusetts
--7.*=-- Department of Industrial Accidents
Office of Investigations
f ra'1.--..411._.-7 t;
i 600 Washington Street
=::10 #
: z.,Tif— z
Boston, MA 02111
.., — .... f or .
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.A. ■1•1■ ,„z„...,:i ,
wwu'.mass.gov/dia ,.
-Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name pusineseorgaraza tionadivirin.o: 12_e> sc....." .- i\) i■. a t.4.1. t-c, i... +- (Zt.a.v- .-- VR-A. ckg.,...
Address:
City/State/Zip: cl c ,eeA A (.0.- MP. -0 1c) 0 2- Phone #: 'jig— S17 -c7 7f1 1 1/ ) - Sg7 -1?° i t
•
Are you an employer? Check the appropriate box: Type of project (required): /
1.0 I am a employer with 4 . 0 I am a general contractor and I
6. ONew construction
have hired the sub-contractors
employees (full and/or part-time).*
lis-ted on the attached sheet 7. 0 R.emodeling
2. 0 I am a sole proprietor or partner-
These sib-contractors have
ship' and have no c,..loyees 8. 0 Demolition
empoyees and have workers' ..,4
working for me in any capacity l
. 9 ri1,4 Buildmg addifiOn
[N wor comp. insurance _ comp.insin-xnre _f_
10.0 Electrical repairs or additions - 5. 0 We are a corporation and its
3.1,1 I am a homeowner doing all work officers have4xercised their 11.0 Plumbing repairs or additions
myself. [No workers comp. den of exemption per MGL r-i- ...
12.0 R repairs . •
insurance required] t c. 152, §1(4), and we have no
0
errployees. [No workers' 13. Other
comp. insurance required.]
*Any applicant-that checks box #1 must also fill out the section below showing their wodeers' 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 adthtional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees, they must provide their workers' comp. policy number.
Jam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
infonnation.
Insurance Company Name:
Policy # or Self-ins. Lic. #: Expiration Date: -
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page 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 51,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK-ORDER. and a fine
of up to $25000 a day against the violator. Be advised that a copy of this statement may be forwarded to the 0Aeof,_____
EffeitiititionsOf the DIA for 'jai coveraie VerireitiOn.
fito hereby_ ertinz under the pains and penalties of perjurythat the information provitledabove.istrue_and_eorrpri _
/Sittnature: ortki O 1 * Or ....
- 7/Z 6 '
i
Date: ft
0
---
Phone it: HI % -- 5 31 -- 913 - 53 -zlato9 •
Offic.ial use only. Do not write izz this area, to be completed by city or WW1 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 #:
•
• "S
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
.9. Retlis# ted.H
otti�ldib' iadftiieri��tuifra�tor.�.� 2245.2i iM Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M,G.L. c. 152,1 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 ❑
livAlorticOVviie em ton
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 Massachu General Laws Annotated.
Homeowner Signature i " M i. „ ► ,
r'
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition El New Signs [0] Decks [E] Siding [O] Other [0]
Brief Description of Proposed A 11 6414
Brief .-f-it... s1 .2 : (d x t' ' ia: ke sLcc) wok ' o•cst...k w LA. .....o-."
Alteration of existing bedroom Yes _ No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
8a [# iV66Wi i.. tci+r t icl tin'i:Cio s np friaa1` to th oilarl`s1:
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 la - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, , 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, , 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 unde the pains and penalties of perjury.
CHIN/ b,\A r usew - NM4-1..) c...,t F-b-,
Prin Nam L 11,--a, (., . lAjt c i•-•— % _ 7 /26/ ( 0
Signstu of Owner /Agent Date
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 3 i :
Frontage I l
1
Setbacks Front 7 — 1 1 i
Side L: R : - . L: R: ; ._ f
Rear
Building Height d l ?
Bldg. Square Footage FT F — 1 % - 1 I i
Open Space Footage % i
(Lot area minus bldg & paved f.� I I FT
parking)
# of Parking Spaces f
Fill: m� �
(volume & Location) i I I
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO Q DONT KNOW 0 YES 0
IF YES, date issued:l
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book I Pagel l and /or Document ft: _ 0
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0
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 0 NO 0
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 0
IF YES, describe size, type and location:
f
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 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
le'
i City of Northampton , , t -,-
Building Department E ". ;
` $12 Main Street
''t Room 100 a: �. �
, r ortha pton, MA 01060 _ _ �.,� ~
phone 41 -1240 Fax 413- 587 -1272 4 { ; '
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
ECTION 4 -SITE INFORMATION
This section to be completed by office
1.1 Property Address: m � �
I
Lot U
F\ or„, M pr O i O (0 2 Zone 1 . Overlay Distric
Elm St - District' CB: Distric
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
.1 Owner of Record:
11
GZC. F e \oi. t- e.ocew.c.r1 M�NGi.�°1�ita✓i Gc.W ^s coo ��°( �
N e (Print Current M Address
( s3' — �t'�f S
U. �/� Telephone 011'3) 's,51 r 14A O `i
Sign ure
2.2 Authorized Agent:
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ;ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
/ � U completed by permit applicant
1. Building % 3 O (a) Building Permit Fee
�/ 2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection /o -
6. Total = (1 + 2 + 3 + 4 + 5) Check Number . • ii
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2011 -0065
APPLICANT /CONTACT PERSON FELDER GARY & ROSEMARY MCNAUGHTON
ADDRESS/PHONE 128 BLACK BIRCH TRAIL FLORENCE (413) 537 -9755 ()
PROPERTY LOCATION 128 BLACK BIRCH TRL
MAP 37 PARCEL 065 028 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 8913Fee Paid -�
Typeof Construction: CONSTRUCT 10 X 13 ATT SHED
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
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 /
g g
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.
128 BLACK BIRCH TRL BP- 2011 -0065
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 37 - 065 CITY OF NORTHAMPTON
Lot: -028 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2011 -0065
Project # JS- 2011- 000118
Est. Cost: $3600.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): Owner: FELDER GARY & ROSEMARY MCNAUGHTON
Zoning: SR Applicant: FELDER GARY & ROSEMARY MCNAUGHTON
AT: 128 BLACK BIRCH TRL
Applicant Address: Phone: Insurance:
128 BLACK BIRCH TRAIL (413) 537 -9755 ()
FLORENCEMA01062 ISSUED ON :7/27/2010 0 :00 :00
TO PERFORM THE FOLLOWING WORK :CONSTRUCT 10 X 13 ATT SHED
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: House # Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: dk k egflguSi"
? -3d c (eRorce_R. deck - 3 iactiA^
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REG TI ,���
Certificate of Occupanc s*. nature:
FeeType: Date Paid: Amount:
Building 7/27/2010 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner