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23A-287 Northampton, MA Property Detail Page 1 of 2 ,. City of NTorthan-iptol , MA: Commercial Property Record Card New Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map -Block -Lot: 23A- 287 -001 Zoning: Assessment: Location: 3 MAPLE ST Neigborhood: 6 Land: 122,600 #Living Units: 4 Deed Book: 4099 Building: 172,600 Class: A -111 Deed Page: 288 Total: 295,200 Building Information Building Sketch Bldg #: 1 Descriptor /Area Year Built: 1900 4.101018 # of Units: 4 1500 sgft 10 8:1111 Quality Grade: c+ 1R WD1 144 sgft # Efficiencies: 0 7 C 1 r r C:11 126 sgft # 1- Bedroom: 1 50 D:WD1 # 2- Bedroom: 3 WD1 80 sgft # 3- Bedroom: 0 1 ° E. I c sgft Covered Parking: 0 30 101018 Uncovered Parking: 0 1500 Total Unadj RCN: 145,960 Total Unadj RCNLD: 204,810 Grade Factor: 1.08 # Ident Units: 1 7 6 Func/Econ Factor: .8 RNCLD: 163,850 Attached Improvements Type Meas -1 Meas -2 Meas -3 # Units Detail Information: RP5 144 0 1 1 RP5 1261 0 1 1 Levels Use Ext Walls Heat AC % Good Unadj RCN RP7 144 0 1 1 -B1 91 0 17,100 WD1 100 0 1 1 - 01 11 Frame Hot Air 0 61,460 WD1 80 0 1 1 - 02 111 Frame I Hot Air 0 56,690 - Al 86 Frame 01 10,710 Land Data Outbuilding Info Square Foot Type Utilities Type F Feet Value no Primary 31,725 122,600 information Descr Width Length or Quan Yr Phys Func % Value Size Built Cond Util Good RG1 1 380 1 1920 Poor Fair 0 2,700 Acreage Type Street/Road Other Improvements: Total Value: 2,700 Type Acres Value no no information information Sales Info Permit Info http: / /www.northamptonassessor.us/ noho /commdetail.php ?map_no =23A- 287 -001 &pagecard =1 3/16/2011 t , CITY OF NORTHAMPTON Construction Debris Affidavit In accordance with the provisions of MG.L. c. 40 § 54, all debris resulting from any work covered by a Building Permit shall be disposed of in a properly licensed disposal facility, as defined by M.G.L. c. 111 § 150A. Address of Work: ' /1 A, / (1 / The debris will be transported by: /7 �, , (-P,4 % ✓ c r` 4, 6 The debris will be received at: pt. S ue `� Signature of Permit Applicant 1 , Date 3t Building Permit Number: HOME OWNER EXEMPTION A 14 OWLEDGEMENT . The State of assachusetts allows the homeowne the right under 780CMR 108.3.4 to act as his/her onstruction supervisor. The state . - mes "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or • ends to be, a one or two family dwelling, attached or detached structures acres - • ry to such use and/or farm structures. A person who constructs more than one home in . two -year period shall not be considered a home owner." The building department for the City of No 1.... pton wants person(s) who seek to use the home owner exemption, to act as their , -1 construction supervisor, to be aware that by doing so you become responsible for ompliance with state building codes and regulations. The inspection process r- • es that the building department be called to inspect work at various stages, which in lude foundation /footings (before backfill), sonotube holes (before pour), a roue building inspection (before work is concealed), insulation 41spection (if auired) and a final building inspection. The building department req j es these • •.pections before the work is concealed, failure to secure these inspections an resul in failure to obtain a certificate of occupancy until the work can be ins ected. If the homeowner hires oth trad s to perform work (electrical, plumbing & gas) the homeowner will be responsi ■ le t make sure that the trades hired secure their proper •ermits in conjunction to the I ding permit issued, and that they get their required inspections. Failure of the ind ; idual trades to secure the permits and inspections as required can DELAY the pro' - , until such time as the proper permits and inspections are made I, `, %-6. -,;„ t' : understand the above. (Home owner /resid : , is signat re requesting exemption) I will call to schedule al required bui • mg inspections necessary for the building permit issued to me. Date Address of work location / 174 ' S�— .. . . The Commonwealth of Massachusetts Department of Industrial Accidents --a----,2,-- Office of Investigations • 600 Washington Street i, =R.,— ,•• • 7.--...,:y2=. gif Boston, MA 02111 . .4. r i ,,: 0 e , . - ., www.mass.gov/dia • , • -Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers .- Applicant Information Please Print Legibly Name (Business/Organtr' ation/Individual): T, — .e Address: A- 2 L ,r /I/ , 1 2 4.1 - ile c ..‘ C7 City/State/Zip: / e-c -r- ri- (• -r - Phone.#: /23 .2 /e •17 s - C Are you an employer? Check the appropriate box: with 4.. 1 general employees (full and/or part-time).* 7; am a genera contractor and I , • ve hired the sub-contractors IYP °NfePwi.°c°jectistructi(requironed): li" 1.0 1 am a employer wi listed on the attached sheet. 7. 0 Remodeling 2. 0 I am a sole proprietor or partner- These sub-contractors have ship and have no employees These sIDemolition snAiloyees and have workers' working for me in arty capacity. _ . . 9. EIBirlding additiOn [Net workers' comp. insurance " 10.0 Electrical repairs or additions equired-] • • • 5. 0 We are a corporation and its 3. intil_P.A..- a g..).. owner doing all work officers have4xercised their . 11.0 Pltunbbag repairs or additions m T 1 o workers' comp. Heft of exemption per MGL 12.0 Roof repairs . • insurance re. a* 1 t c. 152, §1(4), and we have no . i • 13.0 employees. [No workers' Other • . comp insurance required.1 *My applicant Mat checks box #1 roust also fill out the section below showing then-workers' compensation policy infonnation. — . t Homeowners who submit this affidavit indicating they are doing all work and then lire outside contractors must submit anew affidavit indicating such. Contractars 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-contractorsbave employees, they must provide their workers comp policy nmnber. I am an employer that is providing workers' compensation insurance for my einployees. 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 Secti611 c 152 can lead 'o the imposition olefin:line 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 Offibe of Eiv die DIA foFiriturinTei coverage iierification _ . . ..... ... .... .... , . . , _ „ „.. herehycertifr Under the pains and penalties of p ' 'ruy at th nprovaledabovers_true_aruLcopret - o 1)),_ 1 ' y Sienature: ' =-Lc-"-tc-t- , - , ,, (,),..z...d.„ ( 7 Date: ,..... 4:-; .... i ' • Phone #: . - Official use only. Do not write in this area, to be completed by cityOr townOfficiaL . . • City or Town: .- Permit/License # Issuing Authority (circle one): :1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical, . 5. Plumbing Inspector 6. Other , Contact Person: Phone #: SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : T, ., //.7.- , • - - '' / (3`�� , a ( 0 License Number o ..1 iiikredmilii6OWIT re 1/41A Zc c - x ,j r -7c:, _r -7' Address Expiration Date /'6' .3 yi) ,t(e)s � )1, Signature Telephone 99Rdttlstere .H n#'il(mpio iiipnt:Go`titi ctk , . _ '' Not Applicable ❑ f , /Ix, , 1... ; ' 4 . Company Name Registration Number / Address Expiration Date _r4 " 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 ❑ f ��`�" � ,� i o ;> ; r _ r . 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 ��ict' [ �t iC„ SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition New Signs [0] Decks [❑ Siding [ice] Other [0] Brief Description of Proposed Work: i 0 e 1Y+ d L / J H Ak,5 7 6' n 44- 5' Z° Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet a.Ifetiit ° '�n r ' lln k . f. di t i � x t nti ho s n Q iit fe' a foi o Aifd: 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 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I ill ;4. t 4-44 -( , as Owner of the subject property hereby authorize T. !""` /I ` t '77 to act my behalf, in all matters relative to work authorized by this building permit application. i eb ' Signature of Owner Date 1, / / � G - C G c(.-C T 7/ 14. , as Owner /Authorized Agent hereby declare that the statements a nd 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. /y-) Y Z A ,. / 4- 1 °e d . !" y4 e e, r Print �� �/ /� t , ' G / "' / i �.(,cd. i 1/ -di (�(,J c� / (4 '?- �: // Signature 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 coltnruato be filled in by '''` Building Depa ,= t; = „ j Lot Size _ I w 1 Frontage } 1 Setbacks Front `` i Ell y Side L:' I R:1 - L:? R:7 1 1 { Rear = L1 i i Building Height L_.. __.( i t Bldg. Square Footage [] " - % _ I I Open Space Footage . % t ---- - i (Lot area minus bldg & paved ( ._..J I 1 3 parking) _ # of Parking Spaces i ° (volume & Location) ' I A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued:I 1 IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book 1 I Page I and /or Document # _ } B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES Q 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 0 IF YES, describe size, type and location: I D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO 0 IF YES, describe size, type and location: 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 Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. �C ► �0� k ity • Northampton . ]din , Department Ain Street 0 ,r 0 •y - Room 100 �� �rthampton, MA 01060 , 44 phone 413- 587 -1240 Fax 413- 587 -1272 '� ° t APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 SITE INFORMATION This section to be completed by office 1.1 Property Address: .. /J 1 'r' S `� , map Lot Unit Zone Overlay Distnct Elm St. DIstrict CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) Current Mailing Address: , ) , _ / J /it if "CI- c c 1 . /iv - a.& o Telephone Signature 2.2 Authorized Agent: Name (Pi t) Current Mailing Address: Signat p- 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 Permlt Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total=(1 + 2 +3+4 +5) Check Number This Section For Official .Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2011 -0701 APPLICANT /CONTACT PERSON WADE MICHAEL S ADDRESS /PHONE 426 NORTH FARMS RD FLORENCE (413) 584 -7748 () PROPERTY LOCATION 3 MAPLE ST Al t`4 1 A 6° 1 �/ MAP 23A PARCEL 287 001 ZONE GI(100)/ �I l THIS SECTION FOR OFFICIAL USE ONLY: " AS ( �� PERMIT APPLICATION CHECKLIST N © ENCLOSED REQUIRED DATE (14 ZONING FORM FILLED OUT Fee Paid Building Permit Filled out / /1D9 O Cj i D _ Fee Paid � Typeof Construction: DEMOLISH GARAGE 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 INFORMATION 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 IVA 1`) ---- -' 1( 11 - 1 �i l Signature of Building 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. 3 MAPLE ST BP-2011-0701 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A - 287 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 -0701 Project # JS- 2011- 001152 Est. Cost: Fee: $20.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JAMES HARRITY 052260 Lot Size(sq. ft.): 31711.68 Owner: WADE MICHAEL S Zoning: GI(100)/ Applicant: WADE MICHAEL S AT: 3 MAPLE ST Applicant Address: Phone: Insurance: 426 NORTH FARMS RD (413) 584 -7748 () FLORENCEMA01062 ISSUED ON:3/16/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: DEMOLISH GARAGE 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 3/16/2011 0:00:00 $20.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner