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03-028 (18) N E I a — I C? r a I i i 1 _ o t - i _ -- I i I „` - -- - _ - 4 - HILL CONSTRUCTION CUSTOM BUILDERS FINE CRAFTSMANSHIP JOB Re /1 PES! D6 - Eitt - rRy pOse6.14 REMODELING OR NEW CONSTRUCTION GREEN BUILDING ORIENTED SHEET NO. 2— o P 3 OF Ralph Hill 413- 256 -4633 CALCULATED BY ^ # id ' DATE 4/ Mass. License #088673 Over 30 Years Experience CHECKED BY DATE www.RalphHill.com SCALE 1 /4 it -. I' 4ODUCT 227 -1 (Padded 11' EDGE) PRODUCT 227A-1 (Padded 1T EDGE( /A4aNN)a Inc., Groton, Mass 01471 To Order PHONE TOLL FREE 1 -BOO 225.634 - 1 4- / N. 7200g i3 . .______ )1 - n 1 6" O•C (TYP) tAl. moo t$/- F- 2-5 lj GA-KACT r] l 12:1-7 Gol`� G • F '�C . � 0 n / er T' u1. 5 r vy\? 1�1 P, 5. (TYP.) In E► do� p���' vt �A PPS ate. / x 1 I r1 (-rye) El I 1 I 5 y ' j • 1 2 p 1? r° 1 C ___:_b_____I_________/■__ _ _______ IPA coNc F 0, 51 HILL CONSTRUCTION CUSTOM BUILDERS + FINE CRAFTSMANSHIP E LIT )?)N ewe ' g/V TJ� Y POP-4j4 REMODELING OR NEW CONSTRUCTION JOB GREEN BUILDING ORIENTED SHEET NO. 0 0 r { v � OF Ralph Hill 413- 256 -4633 CALCULATED BY r' I r DATE I-//3 0 0 S Mass. License #088673 Over 30 Years Experience CHECKED BY DATE www.RalphHilLcom I H a. i SCALE - ?7 -1 (Padded W EDGE) PRODUCT 227A -1 (Padded 17' EDGE)[Nl:ass]® Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE 1- 800.2256380 1)3,/------ - t..5‘ `'" t , -1- a:iv-5 . - 6 /1N\-, _gJan_g_ela2Apvc-6- --- SQ. FT. 1 Ei 1 R Teat .___ 41/30106" 1 \0\ ' .5.14----.7- I�l� I o F3 — 5 + / J roposed = 1 :.: .- • E house �` -: = -:. ' 4 ° ........ S 68.3 S 66 52 2 " E ' 136.80' -- 160 �� `'•• c � /7,,,,_ - \ ..... ' . - , — .. /,1 1/ 7 . 7/ / .) D Z d pp' S - 2816,034 + /-- . • -- ACRES SQFT , q . , . 4517 + / ,; LI- \\\"\\ ' \ J >: .____„.... / \ V V 1 ft,' ' - , I' G�P OQ , ) 0- N N , o - c p � / � �/ S�� CV C\I ' - Z 0 0, /� cob' iI1� S 32'12'5 W o 33.58' S 19'20'42" E 135.24' N 64'48'20" (pile r saerles to tw�inn oak) 482.96' `t \''• found pile 17.44' 269:49' %\ o f stones 6 6 ■ I a HILL CONSTRUCTION 1 CUSTOM BUILDERS + FINE CRAFTSMANSHIP REMODELING OR NEW CONSTRUCTION GREEN BUILDING ORIENTED Ralph Hill 413- 256 -4633 Mass. License #088673 Over 30 Years Experience www.RalphHill.com i sttAM P �� ��` , ,. (r if of Northampton • ez 1 $P' — A� l y; %9(� # JiIassacilusetts — ` - 5y DEPARTMENT OF BUILDING INSPECTIONS '� _' jW /:' INSPECTOR 212 Main Street • Municipal Building � Northampton, MA 01060 . e HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her construction sups: :i sor. 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 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 . .. • . . ' . / ' ).;' garr 1 45 . GiN of N orth amp ton ..51.3..chugcus. ',Vol**. , • .7- " 1._ . , v ... • , . i ....--....-, ' D EP ARTM ENT 0 P ntilLorr.lc INspac • - _ 212 Main Street • Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION LNSURA.NC.F., AFFIDAVIT . . I -, _ __. - (liccasX/permittee) with a principal placc of businessfresidenc,e at: . (phone) (scrr..... do hereby certify, under the pains and penalties of perjury., thu - • ( ) I am an employer providing the following . compensation coverago for my , employees worinng on this job: ., • ... • -- ■ - (lasur Cocapazy) . (Policy Nu_mix.r) (Expiration Datc) ( ) I am a sole proprietor, general contractor or homeowner (ciscie one) and have hired the conn Listed below who have the followin worker's coalne.nsation policies: • (Nam:: of Contractor) (I ns.urancc. CornpanyiPolic NUMIXT) (11:pirulion IDatc) -- - (Namc of Contractor) (nsurance Company/Policy Ntmc) (Ekpiration D2..tt) . . • - . . (Name of Coturacto) (Insurance Company/Policy Narelx.r) (Expir.acion Date) . . ., (Name of Contractor) (Lnsuran� Company/Policy Numlx_r) (Expiration Date) . (..a...b .-.4-1.k.:.....,i if if acccury to "molls& inforca.-ioo pcuiciag to .11 (,"").' 1 am . a sole proprietor and have no one worldng for me. ( ) I am .a home owner performing all the work myself. NOTE: P bc . Tile. ` bcconowaera wbo =ploy pc to Oa m...i:mcconot, =::- C' nctir work on . chscUjoi: of not niece 1.b.= t.S'e"-• t=itS in which the bor000wncr maid= or oo the crouncis znurtzttzrt tb,- s.. Doc C=•...-1..ty ccOd-- to b' cthPloY ",,,'" -el' the wczkne:: 0 =P=4110 , 2 Ac (G121523=1(5)), -....potion by a boo. -on- far : lic=olsc or permit r-zy cvidoocc tbc lc-gal rt.-au or ...plo under ci. work...-. coo:p..1;o. A.... 1 q.odors2-.act dad x copy of this czatcaleol on...y b. (ec..-...rct...d to tb.. ID-op...-tosoot of 1 Aoa•ztont-Y oz.. or 1 . , ...- - ...... 1-4 ( th- covcrls .not tr.= Li1 =c to s-ozureooy,-1n.,=-4.-; .a.i.o. 25A of MGT_ 152 can Ic-d to the inxpositico of crialioll Poo-thics coasiztioz of & f °fop to S1 „y)0,00 .odor C=pri.i.oacoccn of up La occ ycer and ci•.-i) poodtio io ex form of a Stop Work Ord= lion of .S 100.00 & clly 'vial:1 coo ---._.- For ctopsrtrral ‘,...e oniy . pit Numbc.r ___ • - Af AL....1 _____ / t. 06 .--- Sip:L.141nm t-) i.- •crmi cz ( e -- . • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : H /4/ G C5 0g License Number 1 Q 4 y P 02 LW 1itk 5 T ,9 /ao a_ /4,E Address Expiration D e /11--/ — �� -108 Signatur Telephone CROTteredifoirti rit eaki "mer aitracto"" iS Not Applicable ❑ 4 .2- Company Name Registration � - F ( LL 8t)/ t- r s "1/4/ z:7 7 - Address Expiration Dat 1/5" Q/4 `/ G /� 4774 TTelephone q/3 - 41(7 - 90r0 SECTION 10 WORKERS' COMPENSATION INSURANCE AFFIDAVIT (K at... 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 ❑ . : rrOilleViWlicem f Oil 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 ❑ Or Doors Cgi Accessory Bldg. ❑ Demolition ❑ New Signs [DI Decks [[g' Siding [h] Other [D] Brief Description of Proposed K ` O v ' Work: 601E n cdva c=D Pee - eft AM) 11a51 11a Tte /Al Co) a /41730x' C /3S V w& Alteration of existing bedroom Yes No Adding new bedroom Yes >0 No . Attached Narrative Renovating unfinished basement Yes , , X" No Cans Attache3iRoll 3- Sheet fia CfiNewlio se ail ddtt6 Xistt ai sirrc� O pCeY'6 L u i q: a. Use of budding : 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 1. Is construction within 100 ft. of wetlands? Yes ki No. Is construction within 100 yr. floodplain - Yes )O No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? )Q Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER`AUTHORJZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, �� % Ar k 7 , as Owner of the subject property hereby authorize /tc./0/1 LC. g/ 4 'c. gil /cdeX to act on my behal n al m ers relative to work authorized by this building permit application. ,rte � A .Iifttl/ Q J S ignature Owner Date I, , as Owner /Authorized 9 hereby A ent hereb d tare 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. e4 VM 4 HILL- Print Name '� / 3('O Y J Signature of Owne gen A t Date Section 4. ZONING All Informatibh 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 la . 4/517 t ACeE Sit#1&" Frontage 1 ' - I Setbacks Front - 1' I. 24:0 1, r . 11 Side L:! f ,Sa R: /C°; L /SL^ . R : / 4 Rear i 35v 1 Building Height Bldg. Square Footage .54 e _ - - I % i " i .1509c) Open Space Footage 1-'? `/- % (Lot area minus bldg & paved I ''jG 1 parking) ' # of Parking Spaces 5 , Fill: i E l I (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 er 0 t4 /"'. t.-c),-� IF YES: enter Book Page; and /or Document # B. Does the site contain a brook, body of water or wetlands? NO (5 DON'T KNOW Q YES C IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained Obtained 0 , Date Issued: I i C. Do any signs exist on the property? YES 0 NO co i IF YES, describe size, type and location: 3 D. Are there any proposed changes to or additions of signs intended for the property ? YES l NO 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 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. tepat',1 p1 City of Nortf� a Building Department �`. ` ° u , : • I ! 212 Main Street tee- ` �` Room 100 _ ° .,. 7 r Northampton; MA 01060 �i - Ahd ` -587 -1240 Fax 413- 587 -1272 Ptc St i FpLl AT10N'T .CQNST R UCT T a4LTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1. - SITE INFORMATION Th is ,"s to be i,,7 + feted bX offcc - :' 1.1 Property Address: d 4 rv1 t 5,1/ ales /y -4 o1 cl ►�? �i , Map . . • • _ }. `✓ k ... 'link. Zone OvertayDrsfnc# '4itlit Sf Distract.. _ " _ � B pistr�c# u _ SECTION 2 - PROPERTY OWNERSHIP. /AUTHORIZED AGENT 2.1 Own of Record: Q A Name (Print) ,..e.44.3` Current Mailing Address: Telephone �G, / al 709 Signature 1 7 2.2 Authorized Agent: �MPI4 }litL f L� t t)1� /86AY,B�' 2y ;. If,44 P T /r�v Name (Print) Current Mailing Address: �� /� ��3 -� - 7 - logo Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item - Estimated Cost (Do llars) to be Official Use Only completed b permit applicant 1. Building (a) Building Permit Fee ill )42° 2. Electrical (b }Estimated Total of 3. Plumbing 7 ©d Construction fro Cost (6) s Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection _ 6. Tota (1 + 2 +3 +4 +5) / ��9� Check Number 1- This`Section For Off Use Only ' ` Da te Building Perm Number. Issued: r Signature: 1 Building Commissioner /Inspector of Buildings Date File # BP- 2005 -1080 APPLICANT /CONTACT PERSON RALPH HILL ADDRESS/PHONE 18 BAYBERRY LANE AMHERST (413) 687 -9080 PROPERTY LOCATION 591 COLES MEADOW RD MAP 03 PARCEL 029 001 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out jfjj Fee Paid (J5 Typeof Construction: CONSTRUCT 9 X 9 COVERED PORCH & INSTALL DOOR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 088673 3 sets of Plans / Plot Plan THE FO LOWING 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 Commissio / "" =-�' D5 oar 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. 591 COLES MEADOW RD BP- 2005 -1080 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 03 - 029 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2005 -1080 Project # JS- 2005 -1471 Est. Cost: $11900.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RALPH HILL 088673 Lot Size(sq. ft.): Owner: REITT J PETER & BARBARA B Zoning: RR Applicant: RALPH HILL AT: 591 COLES MEADOW RD Applicant Address: Phone: Insurance: 18 BAYBERRY LANE (413) 687 -9080 AMHERSTMA01002 ISSUED ON:5/6/05 0:00:00 TO PERFORM THE FOLLOWING WORK: CONSTRUCT 9 X 9 COVERED PORCH & INSTALL DOOR 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 5/6/05 0:00:00 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo