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24C-112 07/27/11 12:31:05 PM RESIDENTIAL PROPERTY RECORD CARD CITY OF NORTHAMPTON, MASSACHUSETTS EFFECTIVE DATE OF VALUE: JANUARY 1, 1998 PARCEL ID: 24C- 112 -001 15 FIFTH AVE PLOT: LIVING UNITS: 1 CLASS: R - 101 CARD #: 1 OF 1 CURRENT OWNER /ADDRESS NEIGHBORHOOD ID: 9.00 FINAL VALUE FLAG: MARKET STEIN MAXINE J LAND DATA - ASSESSMENT INFORMATION - 15 FIFTH AVE TYPE SIZE INFLUENCE FACTORS LAND VALUE PRIME SITE 5765 151,530 PRIOR COST CURRENT NORTHAMPTON MA 01060 LAND 151,500 151,500 151,500 BLDG 237,100 245,200 237,100. TOTAL 388,600 396,700 388,600 DEED BOOK: 8672 DEED PAGE: 28 SALES INFORMATION DEED DATE: 20060404 TOTAL ACREAGE: 0.132 TOTAL LAND VALUE: 151,500 LAST UPDATE /COST: 20080306 DATE TYPE PRICE VALIDITY LAST UPDATE /COST: 20080306 20060404 LAND + BLD 420,000 0 X DATE: ADDITION DATA Lower Level First Floor Second Floor Third Floor Area DATA COLLECTION INFORMATION A Bsmnt 1sFr 1 /2sFr 400 ENTRANCE CODE: UNOCCUPIED B OFP 144 INFORMATION SOURCE: C OFP 24 DATA COLLECTOR: MC D Wddk 128 DATE: 19991030 E 1 F DWELLING INFORMATION G H STYLE: CONVENTIONAL YEAR BUILT: 1914 STORY HEIGHT: 2.00 ATTIC: UNFIN k Basement: FULL TOTAL ROOMS: 9 _ ®x (13 TOTAL BEDROOMS: 4 _ — — ')� QaSCd b ? G FULL BATHS: 3 ADDITIONAL DWELLING INFORMATION 6 Half Baths: �� n � f G BASEMENT GARAGE( #CARS) ADDITIONAL FIXTURES: 8 WD ek X' � EXTERIOR WALLS: FRAME BRICK TRIM: X UNFINISHED AREA: STONE TRIM: X GROUND FLOOR AREA: 728 20 TOTAL LIVING AREA: 2156 REMODELING DATA FINISHED BASEMENT LIVING AREA: X BASEMENT RECREATION AREA: X YEAR REMODELED: MASONARY FIREPLACE STACKS /OPENINGS: 1 / 1 METAL FIREPLACES: KITCHEN REMOD(Y/N) YES 20 1.5Fr /2 HEAT /CENTRAL A /C: BASIC BATH REMODEL (Y /N) YES — HEATING SYSTEM: WARM AIR JFF FUEL TYPE: GAS 8 QUALITY VG PHYSICAL NTERIOR /EXXTEERIORN EXCELLENT 3 BETTER 26 OUTBUILDINGS & YARD ITEMS PERMIT DATA Zo s TYPE QTY YR SIZE1 SIZE2 GRD COND DATE PURPOSE PRICE G.-- Z b ----- RG2 1 1917 11 18 C A 19960722 95 ADD 2S 28 A /2Fr /B NOTES: 9 -9 -05. currently listed for sale by owner at $465,000. 24 OFP 6 • City of Northampton Rx w r t x;1 S ? ' Massachusetts �°;` ° e �? ,c e DEPARTMENT OF BUILDING INSPECTIONS r � ; bti 212 Main Street • Municipal Building vy Northampton, MA 01060 ss INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner 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 any 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 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 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 Depa rtment of Industrial Accidents 4 =7, , -4 Office of Investigations =arrow 600 Washington Street or ""7 =1 Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name (Business /Organization/Individual): � s y , l I' Address: Ti CL ' City /State /Zip: j f' , Phone #: -{(3 2(00 Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub - contractors 6. Et New construction 2. Mt I am a sole proprietor or partner - listed on the attached sheet. 7. ❑ Remodeling These sub - contractors have ship and have no employees 8. 111 Demolition working for me in capacity. employees and have workers' g any ca ac P Y 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑ Plumbing 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 1? (_� 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. 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: " ten City/State /Zip: Attach a copy of the workers' compensation y declaration page (showing the policy number and expiration date). Failure to secure coverage as required un ection 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one - 1"mprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day aga e violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of th for insurance coverage verification. I do hereby cer ' a u , ai and penalties of perjury that the information provided above is true and correct. Signature: F = Date: Phone #: .555 — 2(0O 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 #: r 1 SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: 3 Not Applicable ❑ t /IAA (� Name of License Holder : �117� ii .v Vv ` 1j l 1 _J l g License Number 1 015-6.4A S} . c veAtu 2- 3 12 Address A Expiration Date % �y�i_ 1) L� 2(00 Signature J Telephone ' ikiirt fe ed me mpTOVemen 'Contractor ' Not Applicable Geloa ttA L . Otect,d- ie- Liq 25 Company Name Registration Number Address Expiration Date Telephone 7oq-ltoo 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 de No ❑ ll: Wom ker axeinpto 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 Su ervisor "r presence on the job site will be required from time to time, during and upon completion of the work for w this permit is issued. Also be advised that with erence 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 • f -.. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable): , r , New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [0] - ecks [ Siding [D] Other [D] Brief Description of Proposed v X l k----- Work: C i I KOMI fCV kid e- ItWtf.le i Vl�'[ d eck_ Alteration of existing bedroom Yes No Adding new bedroom �� Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa..:If sNeikSOuse and;orFaddition .tore #housing, complete the.. following: 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 Complia Masscheck Energy Compliance form attached? h. Type of construction / i. Is construction witllili 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of bament or cellar floor below finished grade k. Will bu dill ng conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply 7.!SECtION 7a OWNER.AUTHORIZATION TO BE COMPLETED WHEN ".OWNERS AGENT OR CONTRACTOR: APPLIES F OR BUILDING PERMIT ,,, I, Al A-' I &1 f S4 € l In , as Owner of the subject f - property hereby authorize 0 C {r to a t on alf, in all m�ttte relative to work authorized by this building permit application. Signature of Owner Date I, ed 0 av1'ei - , 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. FawkV. 01 (AV e ,• . Print Nam- A.. I...Ai k tt i - - . 74 /.- 2-i -. I( Signature of Owner /Agent Date 1 ., M S .y Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Inco plet, - +n#ormation Existing Proposed Require• by' oni This col .. to .. fill 0 it Building ' .a . ent 5 7 5 i{ 5742c i ti�a?. Lot Size j P' E Frontage : Setbacks Front i 2o i 124: i Side L:' w ` R: 20 i L: Zo i R: 7D i ! �- E Rear ? 7.0 I Building Height 3 F Bldg. Square Footage R },ti;; %W 7 Open Space Footage � (Lot area minus bldg & paved X f _ '.. = ! l9 7 1 i i parking) # of Parking Spaces = 1 3 1 1 Fill: i I (volume & Location) I % ` i I A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW I�� YES 0 IF YES, date issued:: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW OD YES 0 IF YES: enter Book Page and /or Document # 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 0 Obtained , Date Issued: C. Do any signs exist on the property? YES 0 NO I F YES, describe size, type and location: l D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO VD IF YES, describe size, type and location: I I 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 I) NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. t .. D a rtmea �-u e on y � E�v ity o f Northampton Status o Permi( ' : ��� r , : uilding D epartmen t C • b. IDrr eway P er nl . , � , w al 2/9/1i 212 Main Street Se la • a`C � � �� �' � '� _ Room 100 Wa erc(Wett A ' ilabil '' G IVO �r ya k 4 t ` Yom' �' -�"'tizi - ' �' • hampton, MA 0 4 1 1 0 3 6 -5 0 87- 1 vo e b K. ct � - • '177 ` �. l - •87 -1240 Fax 1272 Po sa s � 3$ n �..u. _ a .. tax �; t Other S p eci fjr , w: ., 5 : f APPLICATION TO CpNSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 SITE .INFORMATION This section to be compl office } 1.1 Proaert Addres Ave ✓ ' 1 A Y` Y m p a .'° ` s 1 "w '� ,..14,..-.,,,,:..1;: TMw x x r Lot. a . . s. ,. Ma Unit b : . a xr 4 7 �. _ �:-- ^.. .. S t `a te `- ,a1. ; Zo Overl Distract * ` 5 r `r .;:Elm ,St. D i s t rac t CB'Distnct . SECTION 2 PROPERTY OWNERSHIP /A UTHORIZED AGEN 2.1 Owner of Record: )k) a,)„e. LA/Le- 5 r o 5 GN Ave Name (Prin(} ^ . 3(1---- Current iling Address: 4f — 37 - Telephone nature 2.2 Authorized Agent: �iCt. er� 91 C,tAes S` . �( vev+Ce Name (Prin Curre M a il i n g Ad dress: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be O ffi c i a l Us completed by permit applicant 1. Building 5��� (a) Building Permit F ee 2. Electrical ( E s timated Total Cost o f Cons truction fro (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection ,�5 ., 6. Total = 1 +2 +3 +4 +5 C heck Number J r ✓�"" " This Sect For Official Use On - `B u ilding P Number: IIssued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0124 ' APPLICANT /CONTACT PERSON EDWIN OLANDER ADDRESS /PHONE 97 CHESTNUT ST FLORENCE (413) 584 -2100 0 PROPERTY LOCATION 15 FIFTH AVE MAP 24C PARCEL 112 001 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 L3 7)- Typeof Construction:_REPLACE DECK W /10 X 18 DECK New Construction Non Structural interior renovations Addition to Existing_ Accessory Structure Building Plans Included: Owner/ Statement or License 049348 3 sets of Plans / Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN y 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 i 'molit'• Delay - ,to Y /K Sit . re 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. is 15 FIFTH AVE ' - BP- 2012 -0124 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24C -112 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING PERMIT Permit # BP- 2012 -0124 Project # JS- 2012- 000181 Est. Cost: $5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: EDWIN OLANDER 049348 Lot Size(sq. ft.): 5749.92 Owner: STEIN MAXINE J Zoning: URB(100)/ Applicant: EDWIN OLANDER AT: 15FiFTHAvE Applicant Address: Phone: Insurance: 97 CHESTNUT ST (413) 584 -2100 0 FLORENCEMA01062 ISSUED ON: 8/4/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: REPLACE DECK W /10 X 18 DECK 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: Cik q - a -k Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: r I< 7_ 2 4 THIS PERMIT MAY BE REVOKED BY HE CITY OF RTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND RE. • / " ° •►.1 /4, j f ' Certificate of Occupan gnature: FeeType: Date Paid: Amount: Building 8/4/2011 0:00:00 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner