38B-183 (2) DEMOLITION REVIEW APPLICATION Activity Tracking Sheet T
Property: ai eck. Ce-f2 ' 69(ASe-- .
Map n ig Parcel I S Year Built 1616°
Address: 0 /1 F &
Received in Building Department: daitUe(A( .yj.. ab(f
Referred from Building Department: C(Ottit.ltj 31, a6 (
Action Taken/ Northampton Historical Commission
Action Taken By: v Entire Commission
Sub- Committee of the Commission
Commission Designee/ Staff .
Date Action Taken: 1XRa ki I'-( aoti Initial Determination
Public Meeting held
Ceib l f't `b ao n Public Hearing Held
Determination Made:
Property has been determined not to be
Significant according to Ordinance definition.
No further action will be taken. Demolition
Permit may be issued.
Property has been determined to be Significant
according to the Ordinance definition and a
Public Hearing has been /will be scheduled.
Demolition Permit may not be
issued at this time
Public Hearing has been held, Property was
determined Significant but not Preferably
Preserved. No further action will be taken/
Demolition Permit may be issued.
Photo documentation may be required.
Public Hearing has been held. Property has
been deemed to be Preferably Preserved. The
• demolition review period has been initiated. No
demolition permit may be issued until the
Historic Commission approves an alternative plan or the
twelve month period concludes.
Alternate plan has been approved/ delay terminated.
Demolition may or may not be approved as part of plan.
Twelve month time period has expired, demolition
permit may be issued. . Q q Referred by: 35`- (I CJC(11 Date MrAt( A. -1 a 2 O (
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PLANNING AND DEVELOPMENT' • CITY OF NORTHAMPTON -
i - � planning • conservation • zoning • northampton CIS • historic • community preservation • central business architecture
\ �� �r:l� � / Sarah I. LaValley, Conservation, Preservation, & Land Use Planner • slavalley @NorthamptonMA.gov • 413 - 587 -1263
- i ' r =,�/
March 9 2011
Louis Hasbrouck
Northampton Building Commissioner
Puchalski Municipal Building
212 Main Street
Northampton, MA 01060
RE: Historical Commission demolition review, 27 Fort Street
Louis:
In accordance with Chapter 161 of the Northampton Ordinance, "Demolition," the Historical
Commission held a public hearing February 28 to determine whether the house at 27 Fort Street
is "Preferably Preserved." The Commission voted that, while significant, the house should not
meet the criteria of the Ordinance to be determined Preferably Preserved. No demolition delay
has been imposed, and a demolition permit may be issued at any time.
Thank you-
Sar LaValley
Conservation, Preservation & Land Use Planner
•
Enclosures: Demolition Review Application Activity Tracking Sheet
•
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ti54'il o f pn� #1�a111�Jfnll 1 *_ t �E �I csexchncc t(
DEPARTMENT OP BUILDING INSPECTIONS
wl
212 Main Street ' Municipal Building
Northampton, Mass. 01060 r
WORKER'S COMTENSATION INSURANCE AFT IDA.VIT
pc,I✓& jSE -►
(li cons ttce )
with a principal place of business/residence at:
NI/444t ,lam ol0 6 v
(sue t/ tL7 y /statcfzip)
do hereby certify, under the pains and penalties of perjury, that
an employer providing the following workers coinpcnsauon coverage for Inv
employees worlang on this job
C c ) 5'v5-tt WC /(3g i 87.'11 - 7 - -t
(lusur:� Cocapan -) (Policy Nt! r) i Datc)
() I am a sole proprietor, general contractor or homeowner (cucie one) zn have hired
the contractors listed below who }lave the following worker's compen d policies
(NQIDc of Co feint) (IriR!ranc-. Coinpanyi?oUci Nurnbz.i) C_\)Ird : :on DatC)
(Name of Contractor) (lnsirancc Comoauv Polk ' NuGlcor) (ExDirtion Date)
(Name of Contractor) (Insuiancc. Company/Pol;cy Number ) (Expir000 Date)
(Namc of Contractor) (Lcsurano Comcaay/Policy Numbs) (ExPirauoo Dato)
(a Hier addi ecr.l c'xci if n<ax. to c>Gu& infor oa pert y iag to .11 ocar.-r_o:5
( ) I a s a sole proprietor and have no one wor4dng for me
( ) 1 am a home owner performing all the work myself
NOTE: plus be ea-xr th *t wt 1c 6eaxxrw�r� who employ pcsoci to 63 r - ccv.-dc-t t cork ad c dsocti.oz of
0.01 ant th•c t Toe u Jt5 to which the bacmccuver rondo oc oo the crado t T nx C rc - J1y o:rs :die 1 to be
es ploye 3 uaCi- the wcc c iioo Art (GLI52.o1(5))., tt.pplitcdion by a bou coo.rer fat c __ oc permit ray ct-idvx rite
I csil ctaa.cc of ea e-r:loy., under d,o W ockoet Cocopocuutioa
1 unda-tittod [hod a copy of thi, m ca:t of m.ay bo foa-wnniad to tho Deportaxas of iodaizrid ,.odcatt' OOLoo of 1 no for the
covertsc vm6C2ioo and that Eiknr to ecauc coverage undtr sccvoa 25A of MGL 152 can Iced to't& . t.oc , ittirxli of crmaun>1 pc tin
oaasu:ing of a finc of up to S 1,500.00 and/or utap idooa)aat of up to on( year civil pozuh n in trc form of a Stop Work Orttcr and a
fiat) of 5100.00 l thy LEn,iaA me
For dcwtrun =:a1 u.c only
Z ' Pcrutit Ntimbcr
Map':
Si gnature of Lit iscc/PcrtniUcc Date
Lot
, tet4 fS*rRUcrtoN SERV CES
1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : ()Lt �'&'` �LS� 35(3.3
License Number
36 ,r ✓Icc• ctr►n*'• Rd. �� - S /S" I )
Address r Expiration Date
.5e4
Signature Telephone
p _ :,.. WE, Not Appl icable ❑
a3 ,ct
Company Name Registration Number
Address Expiration Date
Telephone
S E C T I Q N RKERS' COMPENSATION I.N ". EMVIDAVITIM.G4i , 152 , )
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 Di 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 and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
(" x 1 P11 @ N�,0 a SDI, a s s le
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Derri�y onl7 New Signs [ ] Decks [ ] Siding [ ] Other [ ]
Brief Description of Proposed Work: 3014 )`•\" tle • fig_ S " '" 4o C Kw Ik 40• u 4., P�•�1
r1
•-c)
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative ❑ Renovating unfinished basement Yes �No
Plans Attached Roll ❑ • Sheet o
1 *t�.v s a 3 ^% ss & 6 w,
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?
. 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
SEC' N7 O1 NEILAUTT I {�?N MPLE1 �, °, WHEN
OWNERS AGENT QR CON I� APPU 0 BUR DI a " ?ERM!T ._r
4 ti -1tv s
Y , as Owner of the subject property
,/hereby authorize Q1,1 v' L) J to act on
my behalf, in all matters relative to work authorized by this building permit application.
• re of wner Date
p l.1 ✓,(- -- ,f�,( t ! ,J
1 , as Owner uthorized Agent
hereby declare that the statements and information on the foregoing application are true and accurate, to t e est oT my
knowledge and belief.
Signed under the pains and penalties of perjury.
OL/vtr- Ell
Print
Z/ I
ignature 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 , 2 Z ®c t.va
Frontage
Setbacks Front /6'
Side L: £ I O R: � L: 7 /,S R:
Rear > j 4
Building Height <.
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO I/ 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 ✓ 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:
File # BP -2011 -0667
APPLICANT /CONTACT PERSON OLIVER ISELIN
ADDRESS/PHONE 36 Service Center NORTHAMPTON (413) 584 -1224
PROPERTY LOCATION 27 FORT ST
MAP 38B PARCEL 183 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid )/
Building Permit Filled out ��3 ��
Fee Paid
Typeof Construction: DEMOLISH PRINCIPAL STRUCTURE
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 P)ENTED: 414111
pp roved ,,,/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
P ermit from Elm Street Commission Permit DPW Storm Water Management
I/ Demolition Delay / V''- 'P-`' D ( "" k j A T
- 2/10 /
Sign a of Buildmg 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.
•
27 FORT ST BP- 2011 -0667
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38B - 183 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: demolition BUILDING PERMIT
Permit # BP- 2011 -0667
Project # JS- 2011- 001065
Est. Cost: $12000.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: OLIVER ISELIN
Lot Size(sq. ft.): 14069.88 Owner: COHN CHARLES & SMITH CATHERINE H
Zoning: URB(100)/ Applicant: OLIVER ISELIN
AT: 27 FORT ST
Applicant Address: Phone: Insurance:
36 Service Center (413) 584 -1224
NORTHAMPTONMA01060 ISSUED ON:4/6/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: DEMOLISH PRINCIPAL STRUCTURE
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:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 4/6/2011 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner