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38B-280 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_oflyorthampton 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 inspectiozipro_cess 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 inspection (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 -- per its-in- conjunction.to the- building.permitissued,_ 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 r; 0.21.4...0$74 T7 r2 understand the above. (Home owner /resident s signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Address of work location The Commonwealth of Massachusetts Department of Industrial Accidents —'?fit — Office of Investig,ations • to 600 Washing on Street _= Boston, MA 02111 www.mass.gov /dia • -Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City /State /Zig: Phone. #: Are you an employer? Check the appropriate box: Type of project (required): / 1. I am a employer er with 4.. 0 I am a general contractor and I 6. 0 New construction employees (full and/or part-time).* have hired the sub- contractors have no .e 2. [] I am a sole proprietor or partner- listed on the attached sheet. 7. [] R ; emodelin Ia roes These sub - contractors have ship and 8. ❑ Demolition d. . : ; for me in a capacity. employees and have workers' working Y P tY- 9. 0 Building addition [No workers' comp. insurance comp..:nsutance.$ required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3. [l 1 -am a- homeo-waer- doing- all- -work o e:s-have - -1.0 Ph Bing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no 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 tContractors that check this box must attached an additional 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. Iam an employer that is providing workers' compensation insurance for my employees. Below Ls the policy and job site information. 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 (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 $1500.00 and/or one -year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER and a ne of up to $250.00 a day against the violator. 15e advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance covera:e verification I do hereby certify under the pains and penrztriPs ofperjury that the information provided above truerritcorrect.__ Si. a.Lure: Date Phone #: Offcial use only. Do not write in this area, to be completed by city or town official City or Town: Pernut/License # : __ • Issuing Authority (circle one): i Board of Health 2. Building Department 3. City/ own Clerk 4. EIeetrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone # SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature Telephone R Hotne =Emproverrtetit£dntret it ,,.. . - ; , .� Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone 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 ❑ The_current_exemption for "homeowners" was extended to include Owner 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. e undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of — - s- General Lawns Annotated. �nrt amptnn •r +mances, a e .: -. • - . • W ,.. � . � /`- Homeowner Signature C" ��� (C��-C� , SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) E] Roofing I I Or Doors 0 Acce sory Bldg. ❑ Demolition ❑ New Signs [D] Decks [p iding ,.] Other [D] _ T i `►= pp _ _ rief Description of Proposed / , Work: (! ?1 yt h g. 1 k�} DV�` 4"'OU _ Alteration of existing bedroom J Yes No Adding new bedroom A Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a: lf,NeVivhoiase afr'dar adclitibitii5 6:1Mte cl l roiliirag complete the- follOWii1CI: 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 Ta - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , 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 I, , 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 Na C P --- c .: 7 10.,4_,1 4 ,.,...,--- ; ; t 74,x/ v 'z ,.-"' --y p,• c- � �' Signature of Owner /Agent ` ' Date -) f ' f , 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._._._w Setbacks Front =„ Side L:',..,„„„--. R M._..,— L:—_,,; R:...._... Rear_ 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 0 DONT KNOW 0 YES IF YES, date issued:: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book Pagel and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: I) - ' ° are tt ere any proposed llianges to or a rtions o signs intended for the property ? YES 0 NO 0 IF YES, describe size, type and location: E. Wlll 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 IF YES, then a Northampton Storm Water Permit from the DPW is required. City of Northampton t tati 4 , 1J Building Department Cu D p ® ov er ttt AI .f 212 Main Street e iAailah+� ' y t �` Room 100 W . ,t � fi��� g ' i3 , - dr4vx gt.: t .. '" s x x ate. Northampton, MA 01060 �vd sew e , 4 M 41 3 phone 413- 587 -1240 Fax 413- 587 -1272 : ` „t 1 f4- .,1 tOtl er pet jr t�� i4 r ,4<t u . r ; APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING • SECTION 1 - SITE INFORMATION .1 Property Address: This section to be completed by office 7 Map Lot Unit .11 G �+ 7 // Z Overlay District f / ( ez 4q P j l ne / PI ce. c:r. /0 l —, 1 aril st. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) Current Mailing Address: 7�ji :'.. f: l / � ` 71/. �Ar��� �11cYI / 0 / &) c ! cJ Cfi/ E-i �/� Telephone ` /- �` 1 j ,� Signature.,l�;,�,� 4e _ C� "� C 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 completed by permit applicant 1. Building ) C›C>4 > �?”` (a) Building Permit'Fee 2. Electrical 3 f:. )- (b) Estimated Total Cost of 5� ��) Construction from (6) 3. Plumbing Building Permit Fee " 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number 9 �� !!!"'lll This Section For Official Use Only Date Building Permit Number: issued: Signature: I Building Commissioner /Inspector of Buildings Date File # BP- 2010 -0254 APPLICANT /CONTACT PERSON TOWLES EDWARD A & JEAN M CIO SUSAN E TOWLES TRUSTEE ADDRESS /PHONE 187 NORTH MAPLE ST FLORENCE (413) 586 -0592 Q PROPERTY LOCATION 242 SOUTH ST MAP 38B PARCEL 269 001 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 /,�� $ -- Fee Paid y� Typeof Construction: SHEETROCK & INSULATE BEDROOM 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: 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 Demolition Delay Signature of Building Of ii . al 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. 242 SOUTH ST BP- 2010 -0254 GIS #: COMMONWEALTH OF MASSACHUSETTS Maio:Block: 38B - 269 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2010 -0254 Project # JS- 2010- 000323 Est. Cost: $8000.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 7056.72 Owner: TOWLES EDWARD A & JEAN M CIO SUSAN E TOWLES TRUSTEE Zoning: URB(100) /' Applicant: TOWLES EDWARD A & JEAN M CIO SUSAN E TOWLES TRUSTEE AT: 242 SOUTH ST Applicant Address: Phone: Insurance: 242 SOUTH ST (413) 586 -0592 () NORTHAMPTONMA01060 ISSUED ON :9/9/2009 0 :00 :00 TO PERFORM THE FOLLOWING WORK :SHEETROCK & INSULATE BEDROOM POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspec � ig D.P.W. Building Inspector Underground: Servibe:� o Meter: ! Footings: Rough: Rough: House # Foundation: Driveway Final: Final: Final: 47,10g J , Rough Frame: oK , / i-g G Gas: Fire Department Fireplace /Chimney: Oil: Insulation: a $ a9 �� r Rou O (�� - Final: Smoke: Z 7c. h1���# Fin al: d THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGUL a TIO• . , Certificate of Occupancy signature: FeeType: Date Paid: Amount: Building 9/9/2009 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo ro,,,..„..,..,,....,, ....,,c),. , .. - -N v\- 1 rm. .,, . k ,,,,‘ ____ rammis ......,. _...., ,, ,, i , ,_ . ,__ ,, f, , . I . l I i � | -- ---'-' ---- --' y / ^- } } / ' | | \ | | | ' } " | � | ' . / ' | ' » | ' ll Q '' e its -fie ' ' i w P'' -' \ ,,,, t tile.... 0.10°,104 , 1 w 16 \ ,,,,,,, , ,....-.....r--- II, - IS t, ‘\, ----0-1 1 ,.. \\,,,,z \ a X11 O a ', \. .r '�lf k I , g . 4 ....1 ,_ , / _► ( , / .L* G� O zi r 3f �'l ujYr n 1 �'� ,r� • • . - 26' --i ., • 6' .. 20' -. : . , 7 l -H T --- —■- . , n ' .---- e ;t. I ! 8"x18" continuous footin 8" wall thickness I I Co Three 2" x 10" spike laminated kl el Beam/Girder Kd. SPF. SASH 6' 6" I cv co 8"x18" continuous footing 2" x 8" joist @ 16" o.c. 6'4" wall height b EN, I Wall height 5'4" I I I I r Drop wall height 12" ir ALL CONCRETE 3000 PSI Minimum - _ 8" wall thickness 8R @ 7 1/2 " cc , 3' 6" opening . • _ , 7 1 T I 1 UP . ce) ' ' NEW BASEMENT AREA so 0 —I 6' 5" SASH cs4 a c4 i ...■..... I 3 1/2 " 2' 6" x 2' 6" x 1' 0" footing pad 1 — " Steel lally col . with plates • Bilco Bulkhead Doori 1 and lags I • Type C 1 & 1/2"x 10" anchor 6'0" Lx 4.7- vv x l'7 1/2" Ht. 1 : i R-19 Fiberglass insulation above"' bolts per code 1 ; I ' b ; . cv 1 1/2"x 10" anchor Compacted sand/gravel base •-• - b : bolts per code I I . 6' 5' 4" concrete slab with I . I 2"x6" PT Sill exp. joints Re-bar/Rod attachment I Beam I . Concrete to existing Brick Fd. I L existing hatchway opening p Z&ZZZZZZZZ1 if 4/ire I li , ; 1088 Re-bar/Rod attachment existing basement area Concrete to existing Brick Fd. . , ',-- 7'4 '1-- 128 . , ! 6' ,,, 20 , ',.. 26' --1 FOUNDATION PLAN GLENN BUILDING ASSOC. INC. Ackerman Residence 32 Winthrop Street N'ton. MA L 20' 7'9 2'3 10' 4'9 _.- 3' 5' 4 5' I 2432 , , 2 _ 1 42 i - 1 I 1 I I 1 - —}- - -- T ... - - - TW2432 I @ TW2842 S48 2" x4" 16 "o.c. R -13 0 I i in I I , a0 g ' o N N Linen CO Ceilin Height 7' 6" A51 � 0 N Sill cock 7 - Tile I 00 - d i M ASTER BATH 1 11- 1/2" drywall - _ d - 36x72 7'3 x 12'6 1 I �� o O O alcove o0 TW2842 N N N pulkhead /Hatch lay whirlpool cotSP Cr) Bilco Type C motor access N - M QFI - - MASTER BDRM CO I I p _.- - - - -- I ... U I 2868 I It so 9'6 x 198 DHP3046 ( O r — o THERMA TRU Carpet ch to #S132 oo ENTRY advantech = ' Co N 9 '6 x 6'10 3/4 dh T +G N Platform T r I and ram TW2842 0 - , - I-- P 2 "x8 "@ 16 "0. c. N CO I O C.J.+ Rafters CO Tile - O I Washer O I Dryer N M Stacked 2868 1 Exi Living Space 5'1 - 2'7 1 y I 7'8 . 1.2'4 - 4 - - - -- 10' i 20' , GLENN BUILDING ASSOC. INC. NEW BEDROOM ADDITION Cleo + Ron Ackerman 400 Sq. Ft. gross living 32 Winthrop Street N'ton, MA g? __ l l ova 3 I 3" 9-// 1 0 1111r ‘A"." • March 29, 2011 Glenn Building Assoc. Inc. 18 Ashley Circle Easthampton, MA 01027 Subject Property: 32 Winthrop Avenue Northampton, MA 01060 Mr. Glenn The plans for the Single Family Residence addition dated 12 -15 -11 have been approved as noted; 1. Structure conforms to 780 CMR 7th addition 1 and 2 family building codes. 2. Energy aspects must comply with 2009 IECC prescriptive and mandatory requirements or an appropriate HERS rating. Northampton has the stretch energy code. (appendix 120AA) 3. Smoke and CO detectors per code throughout the entire structure. 4. There must be an emergency escape from the bedroom (egress window). 5. Please make sure that there is a complete air barrier behind the tub and shower before its installed. 7 Charles Miller Assistant Commissioner of Buildings ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE - AND TWO - FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: Wg / Site Address: c y, 2 2 �i:, pri,tr Town: 0 72/4. 1,r<'Tc� ,p/ Applicant Phone: 7a /2 Applicant Signature: Date of Application: NEW CONSTRUCTION: (choose ONE of the following two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE - AND TWO- FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab II O O tion 1: Basement P Fenestration exposed Wall Floor Perimeter U- factor floors R -Value R -Value Wall R -Value AFUE HSPF SEER R -Value R Value and Depth > - SOO/ROA National Appliance Energy ��� ci R Conservation Act (NAECA) of .35 R-38 R- R -19 R -10 � 1987 as amended, minimums or Y" N' greater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: ' REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck —Web which can be accessed at http: / /www.energvcodes.gov /rescheck/ ADDITIONS OR ALTERATIONS TO EXISTING BUILDINGS OVER 5 YEARS OLD* *Buildings under 5 years old must use option #1 or #2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross. Wall & Ceiling Area equals Formula: (100 x b - a) egei SF 100 x 73 = = 5,,s % of glazing (b) Glazing area equals SF b a If glazing is <_ 40% use the chart below. If glazing is > 40 % proceed', to " SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE. COMPONENT CRITERIA ADDITIONS TO EXISTING LOW -RISE RESIDENTIAL BUILDINGS 7 MAXIMUM MINIMUM Fenestration Ceiling and Wall Floor Basement Wall Slab Perimeter Exposed floors R -Value U- factor R -Value R -value R -Value S A R -Vale and Depth R -3 X a ROC R-36 R -10 R -10, 4 feet a R -30 ceiling insulation may be used in place of R -37 if the insulation achieves the full R -value over the entire ceiling area (i.e. not compressed over exterior walls, and including any access openings). ❑ SUNROOM — An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120.P) 9 • - Massachusetts - Department of Public Safer■ p ,,_� �� _ , Board of Building Rel;ulations and Standards Office�t o m airs 8i i es gu 1' Construction Supervisor License `' HOME IMPROVEMENT CO License: CS 39970 _ 5 Registration: 409823 Type: r . Y e �_ Expiration W�9j2012 Individual t • Bi ".' ". NG UNLIMI,T K 1 . i NORMAN F GLENN ! c. , 18 ASHLEY CIR . # EASTHAMPTON, MA 01027 Ili NORMAN GLENN --' -� 18 ASHLEY CIRCLE • EASTHAMPTON, MA 01D Undersecretary ."--...7-_.-e....- may- ` Expiration: 6/28/2012 ('onunissioner Tr#: 31248 I . f' License or registration valid for individul use only t C before the expiration date. If found return to: Fai to possess a current edition of the Office of Consumer Affairs and Business Regulation Massachusetts State Building Codd is cause for revocation of this license. 10 Park Plaza - Suite 5170 Boston, MA 02116 i Refer to: WWW.Mass.Gov/DPS ? i , No • without signature --- • • - • .7, .i ''..4; b 6: . _._,.. _ —■.••••AM•••••■••••••C:.• Ale ■••■• .....— -- - r. - - - - - - = - - - '"7" • r . - ors; ..e et .p 9 ..t.s. E ; i -. .., --,„_ - ] 11 I i *--■_.,., . ■ la: . -, -. - . , .. . . ----,,, • ' ; .. ...... 11 q.. ..r ii ‘ i S i . IAA ■ .. ....i tA• 1 ...i ' 4: %; - . 1 .. i s ' 4 ---•-, i •-..., *---..... . ; •--,..... : • . i ---4 " - "--e-i l hP 9 I i FS 1 .A,....___......._,, , .......,, „„„ _____ • 1, 76 r p 0%41 i-I ci...f ---__ a/ 7 • - - rr" . ..----------•-.- .. .,•;-• - .. ......■.....,.. ...........v...ir .......,.... •.., .........•■■•7•■■•■•• .g ' ■•••r••■ .e.472r. ? ..., ...i '...• • I 1 ,..... " oc.) ....,. . 6111 I i 1 .......................5s. • . i S. 4) ^...■ 1. r\ b i •,, • At , dp . 4%..4 ..... 7 •••1 Q . "••4 . -4 Alo _.e. • : 11 ; .1 ..7 . .."' 1 1 01 • C3 , . / I I /7.7 , - ... e.i......4; 1 : / : t. I ! l 1 1 .. .. • . — --- . i ......i 4-...-2- .... •• 1 • \ f --- ...... --- - .-". . .: ...... . ----- —...... .........• • - ............1, -........_,_,e.v. ---•-e_. , . v ,.... d I ‘111 1 . , ) 64 •-...: / 7 1 \ ty p.4 IX r i . i i (.. ri. • 4 F•7"• -_, d . . , •li I ... .L .4gi-o -k (....) ,7. L cnit r7 --- .., c> 1 -4Y ,aR,1f • 2 f 7 5' .•::0,1 c r.c. �_ r1 r .. - ... . - r 'City of Northampton, MA: Residential Property Record Card ,1New Search Property Type Classification Code Reference Card l of 1 Parcel - Location - Zoning - Assessment , i Map- Block -Lot: 38B -280 -001 Zoning: , ' - \ Assessment: Location: 32 WINTHROP ST 1 Neigborhood: 12 g b Land: 99,400 #Living Units: 1 1 Deed Book: 1861 N Building: 117,100 Class: R -101 Deed Page: 170 Total: 216,500 Dwelling Information 3uilding Sketch _ _ .1 Style: Conventional , ., Year Built: / 9'Z 1 19111 ✓ /� Story Height: �o ,.�, 1 70 2' j j Ap jih / — / Att I None l / Y g Basement: Full 1 Total Rooms: 6 Bedrooms: Full Baths: 1 20 5 Half Baths: 0 9 o Exterior Walls: Alum/Vinyl 14,;./64,4 16 16 Unfinished Area: 01 4. 5 Ground Floor Area: 528 j 7 Total Living Area: 1117 , 2 2FWB Ts Finished Basement Living ' % Area: 0X0, OFP 20 Basement Recreation 0 X 0 1 fc 13 1 �� Area: 1 r- Woodburning Fireplace 2 Stacks /Openings: 0/ 0 I G 1 .85 l 7 -? Metal Fireplace Stacks /Openings: 0 / 0 Heat /Central A/C: Basic j Heating System: Stream Fuel Type: Oili i Quality Grade: C+ at ,5 s r `fosr c of2C 5 M 3 1 0:39 AA i_ei 'Oct Pa / 44 t 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 inspection (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 jermits 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, understand the above. (Home owner /resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location The Commonwealth of Massachusetts Department of Industrial Accidents ---:71:=—= Office Office of Investigations = _ llel= 600 Washin Street Boston, MA 02111 www.mass gov /dia • - Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business / Organization /Individual): �y s- �i/��ir' ,•�� /b �� Address: / �`'.��� City /State/Zip: % 1 0/ Phone. #: Are you an employer? Check the appropriate box: Type of • oject (required): / 1.0 I am a employer with 4.. 0 I am a general contractor and I employees (full and/or part-time).* have hired the sub- contractors 5. New construction 2. .0 I gar a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling ship and have no employees sub- contractors have 8. Demolition ....Ioyees and have workers' working for me in any capacity. 9 Budding addition [N workers' comp insurance _ 0 _._.. `�" :.. required.] 5. l% We are a corporation and its 10.0 Electrical repairs or additions ffi ocers have exercised their . 11. Plumbing repairs or additions 3. � I am a homeowner doing all work , ❑ � eP - myself [No workers' comp. ri of exemption per MGL 12:0. Roof repairs • insurance required.] t ' c. 152, §1(4), and we have no . [No workers' 13 .0 Other employees. [N comp. insurance required.] *Any applicant-that checks box #1 trust also fill out the section below showing therworkers'- commpensation 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 state whether= 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 information. • 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 (showing the policy number and expiration date). Failure to secure coverage as required under Section`25A ofMGL c 152 can lead to the imposition of crimi ial penalties of a fine up to $1500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a .e of to $250.00 a day against the violator B a dvised that a co of thus statement maybe forwarded to the Office of uP Y g copy Y - -- Investieations of the DIA for isurance coverage verification I do hereby certify under the pains , d p • so perjury that the information provrdedlib.ove Lr true_and.correc Si • • cure: ' / . ; r ate- Xi • . - Phone #: ` >�` rte/ . 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 #: f r t SECTION 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : /f/(iX/Xf g q License Number Address y Expiration a te Signatur Telephone S� {7ectfistei =ETdtiiii lirigi OVem��ent , a.0 . ,,�.. Not Applicable 0 /' Z,s' � /G/� #/i'� e /0 7.Q.,. Company Name Registration Number Address Expiration Date Telephone 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 buildin ermit. Signed Affidavit Attached Yes 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 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House [l Addition Replacement Windows Alteration(s) J Roofing J Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [DJ Decks [[] Siding [O] Other [0] Brief Description of Pro•osed Wr Work: /_' = ice.-! f is i/ „ .✓ �. Alteration of existing bedroom Yes !/ No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa If I OW ` t oils' anct.elr aiddlf i�r . exls %ncr hr i`sina ` oin fete lie: olla flu: 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. �•ifimensions �d cd e. Number of stories? . !' f. Method of heating „ - Fireplaces or Woodstoves Number of each „ Xi g. Energy Conservation Compliance. /.*_‘ Masscheck Energy Compliance form attached? ?� h. Type of construction S;e9 i Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes !' No 1 I/ 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 1' Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I - ���"4::;09 4 , as Owner of the subject property �; hereby authorize /CAe V to n my beha m matters relative to work authorized by this buildin permit application. Signature of Owner Date 0.1/ 61 4A , 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. Aid Print N ame s +� Signature of r Agent Date •J . . • i „. • : . , i ,, Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To In .mpl 'e I ion Existing Proposed Req dred Zoning t et y This co , . to,befilled in by 44.4,X741 Building D .. •.. nt ''''' -. / / Lot Size I Z3 1 . — — ' I / 1 — ______ "s•4 41/4*%, / r KO / 1! ,_57, H Frontage Setbacks Front Side L:j& R:e L:_ R: 1 : 1 Building Height _____ % 1 Bldg. Square Footage nrS la % W ejli 1 i Open Space Footage 2f•'" ° % , (Lot area minus bldg & paved parking) 1---" -----T - ____ # of Parking Spaces Fill: 1 :, (volume & Location) A. Has a Spep1L Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW 0 YES 0 IF YES, date issued:! IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 . --- IF YES: enter Book ; I Pagel I ---1 and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0 (I IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date ued: C. Do any signs exist on the property? YES 0 NO i 7 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: E. Will the construction activity disturb (clearing, grading, ex ation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. .. , of Northampton q .§ , Bu + ing Department e �� � ., �� .. friz ,,,„Lift ,„ ,....: „,, --,,,, , 2 ' Main Street -Room 100 s hampton, MA 01060 c p r� =' e'413- 587 -1240 Fax 413- 587 -1272 ° a: a = ACATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office L_ ! )-2 - -/7,; ' Map Lot - Unit , Zone Overlay Dis ict Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name Print) Current Mailing Address: c� &/ 2i -}tilt- C.- CI-1." Telephone Signature 2.2 Authorized Agent: 4/a ,// ' Cil ,/, / f l Z> � ? I Name (Print) / Current Mailing Address: Name 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 Cos of , t Construction from (6) 3. Plumbing fA .l� _ _ Building Permit Fee 4. Mechanical (HVAC) 4 1C i' J 5. Fire Protection j or 4./e.er---` 6. Total = (1 + 2 + 3 + 4 + 5) Y6� f © Check Number 9 (p 0970 — This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2011 -0743 4 + 0 K et" Rl L' E (7..) APPLICANT /CONTACT PERSON NORMAN GLENN OM F ° .' ADDRESS /PHONE 18 Ashley Circle EASTHAMPTON (413) 527 -4010 GK €. (� N AVjt Cl 0 I 41 PROPERTY LOCATION 32 WINTHROP ST MAP 38B PARCEL 280 001 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 Fee Paid Typeof Construction: CONSTRUCT 20 X 20 BEDRM/BATH ADDITION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 039970 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9RMATION PRESENTED: 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 - molition Delay Aor ..../ Xi, 0e 40 3-;274 Si. re of Building 0 ficial 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. of 32 WINTHROP ST BP -2011 -0743 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B - 280 CITY OF NORTHAMPTON Lot: -001 - PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit # BP- 2011 -0743 Project # JS- 2011- 001236 Est. Cost: $46750.00 Fee: $280.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: NORMAN GLENN 039970 Lot Size(sq. ft.): 5488.56 Owner: GORMAN CLEO A & RONALD D ACKERMAN Zoning: URB(100)/ Applicant: NORMAN GLENN AT: 32 WINTHROP ST Applicant Address: Phone: Insurance: 18 Ashley Circle (413) 527 -4010 EASTHAMPTONMA01027 ISSUED ON :3/29/2011 0 :00 :00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT 20 X 20 BEDRM /BATH ADDITION POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: ,2? Footings: 0 0. 5.41 0 41 . 1 Rough„' Rough:�° / House # Foundation: I — Driveway Final: Final: 6- - - I tt�� � � � Rough Frame: OK 1 // # 4,4 1 Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation:0 - p q^-1( Cttt Final: Smoke: f A l; �� Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. A rt•Cro Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 3/29/20110:00:00 $280.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner