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24D-259 (3) ti WF3W2412BUTT % W361ri W2112L 1 W3912 hkt B l B12L S 24.DISHWBF 3 EZR33L.WSS 1 ■ [ IF` — " C I a° I ... I Q 4 Iii ° co i BEA R BPPS33 ,... 122496L ;' 4 ' �� � � '- WR3627 � I Ili / WF3.42 W3012 W1512L 1 [I _... ___ .__ _ . .... II rn C) I-- 1- 1-- MSP362496 �-,, . All dimensions size designations w This is an original design and must Designed: 8/28/2009 given are subject to verification on > not be released or copied unless Printed: 8/28/2009 job site and adjustment to fit job + applicable fee has been paid or job conditions. � order placed. 6. 82807f41.kit I All (no dims) Drawing #: 1 r ' k Z g� 1- REMOVE RADIATOR HEAT 2 -CLOSE OFF DOOR -USE WALL FOR CABINETS 168" / 2 3 23 +" 351" 201" 38', 45 a" 1" 46' 28 „' 93 / 12" / 12" 36' .7" 33" 44,V / CD i J N � W3612 I ____ W 3912 . 0.1 � , -- l 2 4.DISHWBF E 0 B 612L N �... --- P� o cbdmkl8 cutting board door rack kit mti ( installed in sink base H_ co N I N tea ` I \ _ -.- _ 1 w I V CD 1 1 0: N � gyp, _F� N I I —¢� ■ ' A r Co • ° ' M Ii' _C5 • Co') -Ql cutlery divide 2 pullout shelves 1 c, co N M M t0 V ut 'Q three drawer pots and pan storage v r 4! L _I PPS33s' M N 3.42 WR3827 42 W3012 1 6 31• , I 30" 15" I 36" - 13- 98" 52:' ; 36 " 24MTEP'4 MTE' MSP36 • . 196 R All dimensions size designations * This is an original design and must Designed: 8/28/2009 given are subject to verification on ` 4 4 44 not be released or copied unless Printed: 8/28/2009 job site and adjustment to fit job ��� , applicable fee has been paid or job conditions. � � '� order placed. 8280c516.kit All Drawing #: 1 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_pToces 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 - - - - -- -- permit-s -in- conjunction,_ to ermit1ssued,_ 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, s 11 _ ��� , _ c , _ understand the above. (: o e o ner /resident's signature requesting exemption) I will •- 1 to schedule all required building inspections necessary for the building permit issued to me. • —mate b' .- �1 0 Address of work location 1 j C 6t� 0 • . .. , The Commonwealth of Massachusetts Department of Industrial Accidents I z.--- - -= ; -,---- Al ---,..u...- Office of Investigations /a; Tairtil - ;, ..... 1 600 Washington Street a 4 -• ..=::1:1=-- ,g‘f • v.-41:7—' 'V 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/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project (required): 11 1.0 I am a employer with 4. El I am a general contractor and I 6. 0 New constru.ction have hired the sub-contractors employees (fall and/or part-time).* 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 ..--ployees 8. 0 Demolition working for me m any capacity. employees and have workers . . . __-- , 9 ET Building addition [No workers' comp. insurance COZ tu I3p. insan,e. required.] 5. fl We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a-hemeowner-doing-all-wor-k _ofacers_haveLexercise_d_teit___ I-1.0 Plumbing repairs or additions right Of exemption per MGL myself. [No workers' comp. 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. IContractors 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. Lf the sub-contractors ha employees, they must provide their workers' comp. policy number. I anz an employer that is providing workers' compensation insurance for my employee& 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 nun3bex and expiration date). Failure to secure coverage . as required under Section of MGL c. 152 can lead to the imposition of crin3inal 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 te advised that a copy of tinq statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. . _ I do her . , certi ; nder the pains and pen. .. 4 of perjury that the in ornzation provided_nbsve_is...tru. sizulcorrect._____ _ & .... _ IN .... ■. _ \ ..`... II. Si • . - ture: Oi■ 9 1APPAMINIll ' OhA li tlig li kVa"MillaillirM161111 '.- ik s .. iii • ____ Phone #: % ‘`1 • 5 % _fraia_q_Ag OffiCial use only. Deo not write in this area, to be conzp -ted by city or town officiaL _ City or Town: Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical 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 3 .Rep stered;Nome impioiternerit refractor ' Not Applicable ❑ _,r1 C 41..)c 9 x■*.t Company Name Registration Number '�t, X_ �- c> se � �o , \N\ O 0125 I (a 03 I n 9 A d ress Z Expiration Date Telephonet{c3• �� l ( 1 Z - � I 0 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 ❑ 4 07 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. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of o ampton irsTrances; a e . I . . ; _' i • - - s- GenerahL-a - -ws- Annotated. Homeowner Signature • t J SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) la Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [[] Siding [0] Other [0] Brief Description of Proposed � ^ �/'� �f,�� � • Work: - _� - 1 / w ' d ale-1-4 i a' ��G w Alteration of existing bedroom V Yes No Adding new bedroom Yes t/" Attached Narrative . Renovating unfinished basement Yes t.,-- Plans Attached Roll - Sheet 6a `1fiNew douse antdofhcldition to "existinti holisikt compete tl a fo1Iouuir g: 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? 3 f. Method of heating? nc� - k., ro S 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, 1 0 \ X S , as Owner of the subject propert hereby authorize 11, - - _ i to act n my behalf, in all ma erS el. ive to work au horized by t is building permit application. ,f.,ik C ;.9:\-) a. y ©off iinatu f Owner Date I, J ^� QVS ��� m �S4� , as Owner /Authorized 9 A ent herby declare that the3tat'ements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed nder the pains and enalties of peKjury. Pri Name • w a Signature of Owner /Agent Date a } 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 _..._..__., ._ .. Setbacks Front =_ Side L: _ . _ R:' ._ L _ _, R: ..,_..._ _.._. Rear Building Height Bldg. Square Footage "'' % 1 "' 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 DONT KNOW 0 YES 0 IF YES, date issued:: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES Q IF YES: enter Book Page' i and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Q , Date Issued C. Do any signs exist on the property? YES Q NO IF YES, describe size, type and location: D - dre tt ere an ro oSed cl es to or ad itlons o. sf ns intendedTor the property YES 0 NO v a p� � g - - p a y? 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 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. City of Northampton 5ta�sf lrrnit Building Department Cu a eitt t 212 Main Street Room 100 Northampton, MA 01060 phone 413 - 587 -1240 Fax 413 - 587 -1272 Pig = s 1 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 1 � 3 5 G r • Map " Lot Unit •r -Ic‘ete,"ft■ Overlay District `CR Q OkObOb Elin StrDistrict CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: ' O t O 1 0 O • v-`ti'n ax. Name (• 'nt) Current Mailing Addres : Telephone 1. ature 2. uthorized Anent: 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 (a) Building `Permit Fee oZ, I b0 � 2. Electrical (b) Estimated Total. Cost of 1/:› 6, ocb Construction from (6) 3. Plumbing Building .Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total (1 + 2 + 3 + 4 + 5) Check Number This Section For Offcial Use Only Date Building Permit Number: Issued: Signature: Building Commissianerllrtspector of Buildings Date File # BP- 2010 -0333 APPLICANT /CONTACT PERSON CHRISTIANSEN JOANN ADDRESS /PHONE 135 CRESCENT ST NORTHAMPTON (413) 586 -6696 Q PROPERTY LOCATION 135 CRESCENT ST MAP 24D PARCEL 259 001 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 04,19______ /5- Fee Paid Typeof Construction: NEW KITCHEN,ALTER BEDRM, ADD 1/2 BATH, OFFICE & WAITING ROOM 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 INF 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 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. 10/14/2009 07 :44 41358789A • 3OANN CHRISTIANSEN PAGE 02/02 File # la- 2010 4 ' APPLICANTtCON `AGT PERSON CH ISTIANSEN JOANN ADDRESS/PHONE 135 CRESCENT ST (413) 586 PROPERTY LOCATION 135 CRESCENT ST MAP .4e Px ... _ 9 i _* 3:, .., ti • FO! t 4 ..a... E O : :Y_r: . . r . ION CITE _I ' = ENCLOSED REQUIRED DA l'E ZO'NINO . s 4..4 ` t i) aC Fee Paid r eeP.i� i OFF!* - Y . * t?z_ .1_4 N w .,, :,�, DOS tt7tcttita l aim- T:44 •v 41 -- c y � ' y , t a�SF�` 1av�t sid 4S 'Ik' e:fiS �,rnr+��.S�`. . J .rr l p` '- a ka J y -y a t ' ACCC''`.st�'r�:S..,. *'1, F l '? . fP.� ,.�., ..4 .w , . 1� 104.:.1.!, - 141 fn..+t t 11. S.: 3 sets of Plans / Plot Plan THE FCfLLO BA WING ACTION PIAS RUN TAKEN ON THIS AM- ICA'11Ol SD ON `�v `I[31� PItR�T� utter (see below) �i.° �,� _Additional p � PLANNING BOARD PERNI1` REQUIREW UNDER • § Site Plan ANDIO1 ,- Special Penult with Site Plan lntexut ]Project Special. permit with Site Kan lul Project: v .�... ZONING NG BOARD 'PERMIT REQUF1it' UNDTR: § Special Permit _ Variance* Pece3ived & Recorded at Registry of feeds Proof Enclosed_____-_ Other Permits Required: k x r �A pprovatlaf - -�-° -- get from CB Arcltitcctot+e Committee Perm, iT�*AS�1k G(!7[kS£Y4ft1L1011. Commission --- --""~'..' ' permit T3I`W E 8 __ permit -Emu Elm Street Co, ".r :~ ice ____ w- -- - Date Signature of Building Official hose app ' with all zoning not relieve a applicant's burden to comply requirements Laurance o[ �'o permit does permits from lPto+�d of Health, Conservation Con on,' ar t t B inibt XDei[i� is and obtain all pli t granting authorities- of public works and other app to t applicants ibo strict standards of rtOL 4OA. Cuadact the Ohre of * VariamC� ate granted <3' Te information. Planning & Development ri,, 0,4 Fe (t 135 CRESCENT ST BP-2010-0333 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24D - 259 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 -0333 Project # JS- 2010 - 000455 Est. Cost: $25000.00 Fee: $150.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 26789.40 Owner: CHRISTIANSEN JOANN Zonin2:UR(1001/ Applicant: CHRISTIANSEN JOANN AT: 135 CRESCENT . ST Applicant Address: Phone: Insurance: 135 CRESCENT ST (413) 586 -6696 0 NORTHAMPTONMA01060 ISSUED ON:10/14/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:NEW KITCHEN,ALTER BEDRM, ADD 1/2 BATH, OFFICE & WAITING ROOM POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: /41/q/1 ,,,, --- Meter: ,-- Footings: 1 i g o> �, r r :r House # Foundation: Rough:/ �' ✓' /' �u h: 1 r //.. lt , in , j .,,,:,,, l Driveway F Final: l .- 1 40 ;' Final: /7 /d Rough Frame• 7.-0 .43 Gas: Fire Department Fireplace /Chimney: Rough: Oii: ...:.�t:�._. Final: f -,:,?,_S �( ‘ moke: Final: O(< 3 in to t i 5 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Ci �'�� Signature: ___ _. _,., /- '''`-'"- - ... .4 FeeType: - " Date Paid: Amount: Building 10/14/2009 0:00:00 $150.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo