The URL can be used to link to this page

24A-225 (2) / / * i • 4:` 1 STY W fr 1-1bu. E 24 :4i BIT \ CDNC oeNE 59,82_ 1 9.> \ / ? ..,....,..,.......__ , . \;.-- \ . . \ ; , 4 1 ; ■ • , i . . , . , 4 , r 4 . r 1 • . ■ - , ,1 1 : . ,, . 1. 1 • 1 , i . . 1 li_ -, rt . ....... „ 1 . 4 1" I 4 . i . 4 . . , . 4 ' 4 4 i f , 4 I , ; . 1 ; 1 4 _ ..--. 0I-1 I ; . 4 . . . I ' 4 - . 1 - _.......; a Q 1 ,: ---- - / C I-) I 4 i f :1 0 S j°1-• 4.) - , t I 1 . ,,,, :1 9 A y . / LA o r) . A odd fi ." ) 3 c• • ; ■ . , 1 , , 1 ; , . • . , ' • 1 , , . . \ - • , 1 ,. , . ,.., • • , , 1 . . . , . . I • . . , . . . 1 ' . 1 . . . I . I - , -- . • 1 • . i ' , , I . 1. : 11 • . . I I , • _.....1. i , ■., --- •-• . I . t , . L . . i i . 1-.. . . . .. , .:- i I , • • , • , I , . L . 0 . i . . . 1 2. isli • / ac , 71..i (-1, p ?Cgi) 11 f ; 1 0 '.. 1- D i 1, • ; / 7 t - A 0 • 1 5 0 01 ): g - I ; i • . ' 1 1 i i j _ i , I • i I I I .. I / 1 1 I i.._ i � � 9 '.9 --- ilk Cz Id l' 1; °Jp`" °`t — "' -1 i , <2,,,,.. l' I C,,../..ap ,-1,>. 1 t I „ , tri.d E 5 `,1 : art (! k i \, 1. % i i ii " —I—a-7 i ...N Q, ,,\,, i .\ \\ \‘.. \ \ \ ., L� 1 r. , • •,..4..s...- 1 .),p : t..1,u I S � , n •,..4..s...- YIx -......., Ny , afi uo 1 ; U.... p, 5 /Jap p,,.f, tp) i q k .@ • . - . . . .._ . _ - . . . . ...._ ■,.... :. :-- . ■ .- 51 Pi rim (Drive Northampton .NA -■- f - ; 1- r 4- -'- ri • - h - ',-- r -- LL•_i_i: Accessory Apartment (Second Eloor) ,_.1,1,' , ,- 1 ,-- , i i - 1 • - r - ..__ -,---,- I-- -,-- r- --1-1--.+--- i- - - -- 1-1- -- 7 - + -- . 1 , - as -h ' i- ; !. 1 f I , + -1-1-• . . i--± - . r'i I 'l'i I , . , 1 ' • ; 1 1 - f , •i - -' 1 r., -- 1 -, r.,•11 1 -- 1 - + --- F i --- ! , " I . • , . , I - - 1 Es' 4-- t i I • I___ . • 1 ' 11111 i ..,_, i f ..-- .. 7 -- . 1 ' ' { — " ------ 4 , - t I- . .. . . i 1 ' . . 4 _ . . -t._. ... .4 .i_mmo { 1 . -T , — 1 , , si - _4_ i s • ---1 ', • : - • . . 1 . _, 0. . Inl 1 1 1 .. i . . . , . ; • . . --- ' i al.. a • Ella r i i , Hiii , P. 1 I 1 1 ; 1 aammum • • i i_i., , 9 _ , bathroom . g 1_ nom= , • . , . 1 i, _L '• sainu•sammummus - 1 ir , • 4 _ 1 1 ' 11111111111111111111111111111111111111111 i _ .. , . . , _ . ,,, I . .. • ' --'-- --i I . ma . Inuoma _. t _.:_. i 4 - . • - 1 kitchen/livin , g room 1 - r ---4 I-- 1 ---- i 4 . --- i -4 MIMI • g f_ t ? 1 - - -- . . . . I ■ i l .L 1 4. 1 , Mil I . 1 _.: I_ ' , 1 . . . . Illiiiii - 1 L. el • sums. - 1 -- 1 1 r - . . .. . . . ..-,. . . , . . _ . . . . . . . . , _.4. -....... , , 7 1 i 11111 Pro posed 8' x 10' deckf 1 I ' . . . - — . -,. . . . . . . \ , . . 1. •_ . 4 f 1-- i f inium. ,,-- 1 - - - — - 1 INIII and bedroom fire escape 4-1 - - . ," 1 . ii ._ 1 __ t ._ , --,,.. . I- - i HI-4- i t 5.551111111111115111111111111111 1 11111 „ — . . . . , , , , ) . . . . . . , ',„ • . • . . . • , s, - . • . ,...._ -4.-.. .--- .1 ----- ... 2 . -I 4 " i , , _, 4 , i . . . , . , ...4 . -1-- . ---....... . , r . -s. I) MI 1111r1 0 ' ...... 11 111111 :1 ! li t 111 a • 111101211111111111111111111111iniii - . ■ ,--1 , F , • ' i 5555555 1 . 1 ..i. i ... L 1 , : ' am lligglagg ' i ' . i C(14) ' ; ` - -■--. t l - -- 1 1 - - - - -I- --...-....-... I ) ' Tgi II: ' !I I '-' - f 1101 I , mg , :mums , o ___ . , • 1 1 i RE MIMI 7 It ' 1 1.9 , . ., , u. , -- , 1 , .___ ' - • , t - 1--- -: 1 11 . - . ---- 1 - t - 1 - i - ± - 1 --- i - i 1 ' - . ' ' - L 1 tie . 1 Fi ! . . - .• - . . . • • . - i- - t - - i - 1 ---- --- I f .- - --- r - 111 I1 • • - HTT i - I I .1 • ' ' - • -1------- , 1 !-- I i I T ' '--- ' ' i 1 1 i - . ' - - - . ._„__._ ,. . .. 1 . . . 1 _, ...._t _ „ . . , - - -- - - . . . . i _t_l___ 1 -t---1-+-- --i-- ' • LI__L) r ) i_ LI kneewall space : 4 : - T ''-- - - ., r . - . I , • . — ' 1 1 1 I I t • . kneewall space , . ., , -- t --- ,'+f- - . - t 4- ' --- t -- 7 - 1 - . . 1_.+1 .1 • f . - -1-- i---4,--h-i-------/---1-- 1-----t , • . - - - - - , - ,---.. 1- . - td 7 ' — 4 — t -- . 1 -- r -- ir , .ti .t - ------ - - r ---- , - : i , I 7 .. ' . . 4_ . _ ---i-t---i---,-- --I - .-- t t - 1 - 1 - f ' H ' . . ; ' ' - 0 -4 • , -4 , i ; ', ,, t ■ t i T t' rri ' , , 1 • .- j•-■-•-• •••--• 1 111 NMI —, . !- '.. • , - - -r T -- ' - 1 - — - I - r" i 1 ''. ' . . . • ___ r --i-- 4- ; 1 , . ____ . . _ ._ . ._ . .. . . ; . . . . • - • .t-- , I o) . Symbols: Door Window Electrical ._ F--- . . ..... ._,L_I C) -- Outlet . , , : , . - 1 - I ... ,.... . . t .. , t s,„.., . 0-3 , ,--,----,--- - \--c . _ _ . .. Scale: 1 square equals 8" - h .- --- - ' ± -- , 0 .,„ , , I 1 51 PI rim eve Northampton . M)I • f H imary 12esidence (First ghor) • .:. .. . .. .. 1 ....._. 1 ._ ... .. . .. I .. . .. • . .. . i _ . j bedroom r kitchen . cD I 7 t = . t �- 1 II t ` �'`r - -r t t4 , r :l i lI 1 C i_ bedroom l room . . I .! S .... 1 I : ' ' Symbols: Door Window Electrical Stairs _ - Outlet NIL .. . , ©5 kt L -� . • Scale: l square eguals 8 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 /footines (before backfill), sonotube holes (before pour), a rough buildine inspection (before work is cuncealedri ' I I • . I i I 'nsp 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 r T The Commonwealth of Massachusetts _ „ Department of Industrial Accidents i _;� ± t Office ofInvestigations 1. 4 1= y 600 Washington Street Boston, MA 02111 � � www.mass g /dia -Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LegibIv Name ( Business iorgaaization/Individ17at): Nett ti o n a e / 41 Yh: g /C , i,, rie,_. Address: t; 6 C j h. lr S d-- - - C i t y / S t a t e / Z i p : rte 5,c-4 ` M l c G ;r7 Phone. #: '-// 3 - 1 S ' ' 6 , — 3 0 ' 0 _,7 - Are you an employer? Check the appropriate box: Type of project (required): / 1. Q I am a employer with 4. Q I am a general contractor and I employees (full and/or part-time).* have hired the sub- contractors 6. Q New construction 2. � am a sole proprietor or partner- listed on the attached sheet 7.Remodelmg ship and have no employees These sub - contractors have. . 8. Q Demolition working for me in an employees an dl lave workers' Y capacity. 9: Q Builifwe a omp. nsnrance # _ . _ , R+OrkCIS • e ©IDp insurance 5. Q We are a corporation and its 10.L1 Electrical repairs or additions r 3. Q equir ] officers have4xercised their . 11. Plumbing r I am a homeowner doing all work f : Q mg epairs or sdclitions 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 • ■, comp- insurance reg nixed.] *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 state whether or not those entities have employees. If the sub - contractors have employees, they must provide their workers' comp. policy number. I am 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 theniiposition'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 TnvestiQations of the DIA for insurance coverage 'Verification z .. _ ._, . _ I d heb certi under the ni = e i __ -- o er y fy pains penalties ofperjurythafthe informatinn�rovtded.abavP LT �e_anrLcarre�t 1� Signature: / --r -'- Date: (AV /0 Phone #: f / 3_ 2 5 c) . _ 3 dc 7 . . Official use only Do not write in this area, to be completed by city or town icraL City or Town: "• Permit/License #_ __.. Issuing Authority (circle one): - I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical,I 5. Plumbing Inspector 6.Other Contact Person: Phone #: SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Ili Not Applicable ❑ Name of License Holder : M1 4 Ma -L C /1 i,r � l I m� /� +Kt1 pr- ! 0 a O 7 `1 License Number 6 6 C ide lt: 5 - M 01 Q .) g /3//04 to Addre s �* Expira on Da e th3 Signature Telephone : Reaigteredmaiiie- Mrdtii oitt aKW ;M11134. 7rip. .,w_.. Not Applicable ❑ Al e14-lI a444,/ /0 .K Ni 76 Company Name Registration Number e G C trip k Si n 5 +f if c H. tom. !'7!� O t Q ry /!1 4 Address Expiration a e L " t� Telephone l/ " a 50'37 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. n aw a e es V1 1Vo ❑ 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 SECTION 5- DESCRIPTION! OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) [] Roofing ED Or Doors 0 Accessory Bldg. ❑ Demolition El New Signs [D] Decks [[EJ Siding [O] Other [ID] Brief Description of Proposed Work: DECk / rtCCE ssoRy ApT Alteration of existing bedroom Yes _ No Adding new bedroom Yes / No Attached Narrative Renovating unfinished basement Yes Y No Plans Attached Roll - Sheet $ ` IN.' . - 4, . . iiii.ii-: s " " ` ' "' iv rm^, #, '+6. :?2: °r Ems] ��:B7C�C'It�,�tSrlp 11T��fw. ��e`��#lt]]�/�t1[�: 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 I, a v , e. t i.., /�t a a . - °C I 1' , as Owner of the subject property hereby authorize A/ N' ' It a et o e / 4 b41 e k N d e,- to act oy behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, Nc141i, .i,,c / /4/14“ k •h dob , 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. I40 4(na,nnn l Minch,' de, Print Name , / 2 -- ------ ( 3Li►u -'g, l v ! 0 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 column to be filled in by Building Department ' Lot Size 1 / f i et e 1- e j f lca ; Frontage L 1 Li 1 I 1 1 ¥ 1 I 1 7 , Setbacks Front I 3r € , Side L:i g ` R:I Z i L: Rd 2 4 / s i Rear Fi 1 I Building Height s - ' i Bldg. Square Footage IC 2 % 1 i Ln GI iu{: n , 5�4rat 15.`9 `� o Open Space fo otage G % a I (Lot area minus bldg &paved X 08+ i 774 Z$; �D ,_ parking) # of Parking Spaces F - 3 ` -^ ..v Fill: 1 hOhe_ holle_ i (volume & Location) '_ ' i A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DONT KNOW 0 YES 0 IF YES, date issued:I IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page x and /or Document # B. Does the site contain a brook, body of water or wetlands? NO tjf 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 (3 NO C 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 ip� IF YES, describe size, type and location: I 1 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 Cf IF YES, then a Northampton Storm Water Management Permit from the DPW is required. f City of Northampton `'B h A DO Build Department M q0 212 Main Department Street ' ' om 100 :,,','"-''f'7'•'''''',.::',1‘ 1.:4,7,1,77.,f-,,,,,,,,,,,,..,,.- W , 0 g � Y,:,---:,=,, . No� ampton MA 01060 � �, ' ;a phone 413- 587 -1240 Fax 413- 587 -1272 - _ - e 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 be completed by office `7 h 1 1 t- i rri 0 i--- VC_ . Map Lat IJiait K 0 I A_ h a in h , I ,t 0I0 O b ane Overlay District Elm St District CB District SECTION 2,- PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: /' rn1 DA.I^etlt A - ( _7'C- t-'C4dt '-t- 5 1 Pi' /�L,rrz. ni-IL. , �0. d�faa Name (Print) / / Curr (i�I g g , 7 , 7 GZA 4 C & • - � W ` v 't Telephone 1 2.2 Authorized Agent: Nri fArtnoe/ QIY (G C /or S4 E.Sbt , N"1A 0/v37 Name (Print) lC 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 (a) Building Permit Fee 2. Electrical . (b) Estimated truction Total fr o Cost m (6) of 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 4 5. Fire Protection 6. Total= (1 +2 +3 +4 +5) (O b' '1$ Check Number 7` iro This Sectio For Official Use Only Date Building Permit Number: Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2010 -1208 APPLICANT /CONTACT PERSON NATHANAEL ALMEKINDER ADDRESS/PHONE 66 CLARK ST EASTHAMPTON (413) 250 -3007 PROPERTY LOCI t RIM DR t 2A; gyp 2 , "; 7/ NE URA(100)/ — — — I THIS SECTION FOR OFFICIAL USE 0 0///e/ II ,A, PERMIT APPLICATION CHECKLI; / ENCLOSED � I ZONING FO • F L _ CJ �/ 9 Fee Paid 1MIIIMIMNI157 Tv Building Permit Fi b d out 411111V 4r Fee Paid , 11121% • i t Typeof Constructio . •'i' STR T ACCESSORY APT & 8 X 10 DECK New Construction Non S u al interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 102079 3 sets of Plans / Plot Plan 31 ) .l\A: VI t G'9r21d THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLIC INFORMATION PRESENTED: It 5) A "}L1 S (139 N % Approved Additional permits required (see below) 1■+), 'Jt 1 - 1 )15 PLANNING BOARD PERMIT REQUIRED UNDER:§ 1 - ) 111. ` X9114 Intermediate Project: Site Plan AND /OR Speci Major Project: Site Plan AND /OR Speci Q) - 01 .57):9A OJ ZONING BOARD PERMIT REQUIRED UNDER: § CV/Li Finding Special Permit Vari: ..,St' 'V)d 0 N Received & Recorded at Registry of Deeds Proof E n c l o s e Other Permits Required: Curb Cut from DPW Water Availability l Septic Approval Board of Health Well Water P. J `' • Permit from Conservation Commission Permit from , X ;,° -Ze , N 'Z LC e � C7 1 Permit from Elm Street Commission _ Permit DPI/ t'' "�� "` � J d Demolition Delay T / ' I G' Al 2)1 1 pci) 5 i - 4 Signature of Building Official 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.