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31A-032 (2) 21 FRANKLIN ST BP- 2009 -1059 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A - 032 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- 2009 -1059 Project # JS- 2009 - 001539 Est. Cost: $140000.00 - Fee: $840.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LOUIS TONELLI 65242 Lot Size(sq. ft.): 37592.28 Owner: SILBERSTEIN HARVEY & JULIE Zoning: URB(100 Applicant: LOUIS TONELLI AT: 21 F RA■IKLIN ST Applicant Address: Phone: Insurance: 35 FLETCHER AVE (413) 323 -5074 BELCHERTOWNMA01007 ISSUED ON: 6/23/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT NEW WINDOW IN LIVING RM,PARTITION CLOSET & MUDROOM 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: I i „ 4:4/2"° - House # Foundation: Driveway Final: - 't 11,;0 Final:/ *Final: i / 3 l / 0 w ;'A. Rough Frame :M S`'`pey -f99 *14 Gas: Fire Department Fireplace /Chimney: Rough: -; / Vi i%;: ia.su.atio► ::g iC Q^ 9-- (J r --.'"(-- D t Final: ! � ^ `' / v�� moke: 1 iti lJ Final: O(< I [ 2;9 )1O (rel,4i THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. d' / Certificate of Occupancy l Signature: FeeType: Date Paid: Amount: Building 6/23/2009 0:00:00 $840.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo 21 FRANKLIN ST BP- 2010 -1169 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A - 032 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 -1169 Project # JS- 2010 - 001705 Est. Cost: $5000.00 Fee: $28.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOMETOWN STRUCTURES 98186 Lot Size(sq. ft.): 37592.28 Owner: SILBERSTEIN HARVEY & JULIE Zoning: URB(100)/ Applicant: SILBERSTEIN HARVEY & JULIE AT: 21 'FRANKLIN ST Applicant Address: Phone: Insurance: 21 FRANKLIN ST (413) 441 - 0880 0 WC NORTHAMPTONMA01060 ISSUED ON :6/28/2010 0 :00 :00 TO PERFORM THE FOLLOWING WORK: ERECT 10 X 14 SHED 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: ' ! —4 "t' fs C l ✓j`� THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND RE - = j /` A o Certificate of Occupanc : ignature: FeeType: Date Paid: Amount: Building 6/28/2010 0:00:00 $28.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo / i / {_., r!! ? b / (` -- 4 . -,(1s 6 /" ;--07 - , V- -- — S 4.--2cf". ("/"9 Cdgei'fidf - / l ' 9 j - V ii iv ey b C P I A c) f ,>/y /A i C7 d rAV9 '2191f (1,2 l ilif , s pit _iip/// 21 FRANKLIN ST BP -2010 -0098 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A - 032 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 -0098 Project # JS- 2010 - 000114 Est. Cost: $34000.00 _ Fee: $204.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LOUIS TONELLI 65242 Lot Size(so. ft.): 37592.28 Owner: SILBERSTEIN HARVEY & JULIE Zoning: URB(100)/ Applicant: LOUIS TONELLI AT: 21 FRANKLIN ST Applicant Address: Phone: Insurance: 35 FLETCHER AVE (413) 323 -5074 BELCHERTOWNMA01007 ISSUED ON:7/31/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:ADDITION TO GARAGE & CONVERT SCREEN PORCH TO 3 SEASON POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: >.. ... ^, ;, . ,Meter: , ,s_. - :,.+ Footings: Rough: Rough: Mouse # Foundation: . 9, " rLp Driveway Final: : ok , s .Y Final: Final: - T/d I. Rough Frame: j o< / � Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: © i ( /G ' .e• O Final: Smoke: 7 Final: 0K t i i /l� /f l J� ` I mac/ S THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLA, ON OF ANY OF ITS RULES AND REGULATIONS. `` Certificate of Occupanc ) Signature: FeeType: Date Paid: Amount: Building 7/31/2009 0:00:00 $204.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo Boilard 9- 8 -09 Key Beam a attn : Rich - 5 / 4 3 12:59pm job: Tonelli joists Pd • 1 of 1 KcyBcam® 4.504a kmBeamEnginc 4.505c Materials Database 956 Member Data Description: Member Type: Joist Application: Floor Lateral Bracing: Continuous Both Standard Load: Moisture Condition: Dry Building Code: IBC / IRC Dead Load: 25 PSF Deflection Criteria: L/480 live, L/240 total Live Load: 40 PSF Deck Connection: Glued & Nailed Filename: KYB2 T T / / 14 0 0 Q 14 0 0 Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall N/A 1.750" 613# -- 2 14' 1.750" Wall N/A 1.750" 613# -- Maximum Load Case Reactions Used for applying point loads (or line loads) to carrying members Dead Live 1 236#(177p1f) 377 #(283p1f) 2 236#(177p1f) 377 #(283p1f) Design spans 14' 1.750" Product: IB 400 91/2" 16.0" O.C. Component Member Design has Passed Design Checks. ** Minimum 1.75" bearing required at bearing # 1 Minimum 1.75" bearing required at bearing # 2 Allowable Stress Design Actual Allowable Capacity Location Loading Moment 2168.'# 2800.'# 77% 7.07' Total load D +L Shear 613.# 1185.# 51% 14.15' Total load D +L TL Deflection 0.3595" 0.7073" L/472 7.07' Total load D +L LL Deflection 0.2213" 0.3536" L/767 7.07' Total load L Control: Moment DOLs: Live=100% Snow=115% Roof =125 % Wind =133 All product names are trademarks of their respective owners , Ott " >" Copyright (C(1989 -2005 by Keymark Enterprises, LLC. ALL RIGHTS RESERVED. ni i iii- ttf'afiii�. 1 EB. "Passing is defined as when the member, floor joist, beam or girder, shown on this drawing meets applicable design criteria for Loads, Loading Conditions, and Spans listed on the sheet. The design must be reviewed by a quaffed designer or design professional as required for approval. This design assumes product installation according to the manufacturer's specifications. Boilard 9- 8 -09 - eyBea attn : Rich / — 3� 12:57pm J job: Tonelli porch l of 1 • Kcyscam0 4.504a kmBeamEngine 4.505c Materials Database 956 Member Data Description: Member Type: Beam Application: Roof Lateral Bracing: Continuous Top Slope: 0.00 / 12 Standard Load: Moisture Condition: Dry Building Code: IBC / IRC Dead Load: 15 PLF Deflection Criteria: L/240 live, U180 total Snow Load: 30 PLF Deck Connection: Nailed Member Weight: 10.4 PLF Filename: KYB1 Other Loads Type Trib. Dead Other (Description) Begin End Width Start End Start End Category Replacement Uniform (PSF) 0' 0.00" 16' 5.00" 7' 0.00" 20 40 Snow T T / / 16 5 0 / 16 5 0 Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall N/A 1.500" 3564# -- 2 16' 6.750" Wall N/A 1.500" 3564# -- Maximum Load Case Reactions Used for applying point loads (or line loads) to carrying members Dead Snow 1 1245# 2319# 2 1245# 2319# Design spans 16' 6.750" Product: 2.0 RigidLam LVL 1 -3/4 x 11 -7/8 2 ply Component Member Design has Passed Design Checks." Minimum 1.50" bearing required at bearing # 1 Minimum 1.50" beating required at bearing # 2 Design assumes continuous lateral bracing along the top chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 14758.'# 22891.'# 64% 8.28' Total load D +S Shear 3138.# 9081.# 34% 16.55' Total load D +S TL Deflection 0.7460" 1.1042" L/266 8.28' Total load D +S LL Deflection 0.4853" 0.8281" LJ409 8.28' Total load S Control: TL Deflection DOLs: Live=100% Snow=115% Roof=125% Wind =133 % Manufacturer's installation guide MUST be consulted for multi -ply connection details and alternatives All product names are trademarks of their respective owners _��� .' Copyright (C)1989 -2005 by Keymark Enterprises. LLC. ALL RIGHTS RESERVED. "Passing is defined as when the member, floor joist, beam or girder, shown on this drawing meets applicable design criteria for Loads, Loading Conditions, and Spans listed on this sheet. The design must be reviewed by a qualified designer or design professional as required for approval. This design assumes product installation according to the manufacturer's specifications. JJ Rich W @ Boilard Lumber 8 -25 -09 , e a --, 10:07am KeyBeamo 4.504a tI kroBeatrEiginne 4.505e MdetiaraDatabase 982 Member Data Description: Beam 1 Member Type: Beam Application: Floor Lateral Bracing: Continuous Top Standard Load: Moisture Condition: Dry Building Code: IBC / IRC Dead Load: 15 PLF Deflection Criteria: L/360 live, L/240 total Live Load: 40 PLF Deck Connection: Nailed Member Weight: 23.6 PLF Filename: Beam 1 Other Loads Type Trib. Dead Other (Description) Begin End Width Start End Start End Category Additional Uniform (PSF) 0' 0.00" 22' 0.00" 12' 0.00" 10 0 Live Additional Uniform (PSF) 0' 0.00" 22' 0.00" 12' 0.00" 15 35 Snow It. 1 . / / 2200 9 2200 • Bearings and Reactions Location Type Input Length Min Required Gravity Reaction Gravity Uplift 1 0' 0.000" Wall 3.500" 2.077" 8179# — 2 21' 6.750" Wall 3.500" 2.077" 8179# - Maximum Load Case Reactions Used for appyirg port loads (or line loads) to carrying members Dead Live Snow 1 3651# 431# 4528# 2 3651# 431# 4528# Design spans 21' 6.750" Product: 2.0 FIgid Lam LVL 1 -3/4 x18 3 ply Component Member Design has Passed Design Checks.** Design assumes continuous lateral braang along the top chord. A llowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 44088.'# 77891.'# 56% 10.78' Total load D +S Shear 7041.# 20648.# 34% 21.55' Total load D +S Max. Reaction 8179.# 13781.# 59% 0' Total load D +S TL Deflection 0.7230" 1.0781" L/357 10.78' Total load D +S LL Deflection 0.4003" 0.7188" U646 10.78' Total load S Control: TL Deflection DO Ls: Live = 100"/ Snow---‘115% Roof =125% Wind =133"/ Design assumes a repetitive member use increase in bending stress: 4 % Manufacturer's installation guide MUST be consulted for multi -ply connection details and alternatives AI product names are trademadcu of ther respective owners Adam Tredo 7D Wholesale 1206 Eat Seat South i [ill a _ Copynght (C)19 89-2005 by Keymark Erterpses, LLC. ALL RIGHTS RESERVED. Sdiield CT 06078 "Passing is definedas When the member, floor joist, bean or g rder, drown an this drawirg meets applcdle design criteria for Loads, Loading Conditions, and Spans listed on the sheet. The desgi must be reviewed bya qualified designer or design p ofessiond as requredf or atprwal. This desgn assumes product instalatim according to the maul acturer s speed icatbns. ■ —NOTE — THIS PLA IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED. BUILDING LOCATION ACCURACY IS NOT GUARANTEED NOTE: PROPERTY LINES SHOWN ARE APPROXIMATE, A FULL FIELD SURVEY IS REQUIRED TO I �1 = :,�-> • ACCURATELY DETERMINE THEIR LOCATION 17 9,4' \ _ - 7 \�71- ..1C'' ) • 1 I - BOOK 5535, PAGE 237 ' I SEE: PLAN BOOK ',;'PAGE 8 1 shed ( ' - - t A ec) f ! ��j \-1, • C �?(�� ! 21 _ � I-ri - / • , 4- , \ ! 41.110 L ( kr � r> I 1 oD' " FRANKLIN STREET 1, 0 (7 ,.:2`4 11. X TO: CONNECTICLT ATTORNEYS TITLE INSURANCE COMPANY TO THE BEST 0 MY INFORMATION, KNOWLEDGE AND BELIEF I HEREBY REPOT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING MONUMENTATIO I ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND A'. SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, EXCEPT AS NO ED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRON; AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY #2'0167 PO —NOTE — SURVEYOR: THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY ,�N — MORTGAGE LOAN INSPECTION PLAT —, NORTHAMPTON, MASSACHUSETTS / . BANE ALL j ai P REPARED FOR IZER y , i HARVEY AND JULIE SILBERSTEIN \ ��p, SCALE: 1 " =40' MAY 8, 2009 \ \ ' q sa"•,� i HAROLD L. EATON AND ASSOCIATES, INC. \ suavE/ • REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET — HADLEY — MASSACHUSETTS , , , • • , ' • • • ' O4 Cis �� ►�� Tt p 0 \• - Ito►J)4 7 Nrg0 -Atom 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 /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 i , The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations '1 ;, �r� "- 600 Washington Street ' Boston, MA 02111 =� WwW. mass.aov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/lndividual): 1 - 01(3 1 1J ( M-k) cl Q1Z. j Address: C1.14<6 ,& - / V. • 0.0V_ *01 City /State /Zip: GiJi JAA Ot6/71_, Phone #: � `' !y ' 2 1 ' Are you an employer? Check the appropriate box: Type of project (required): 1. I am a employer with 1 4. 0 I am a general contractor and I employees (full and/or part-time).* have hired the sub contractors 6. 0 New construction 2. VI I am a sole proprietor or partner listed on the attached sheet. 7. ❑Remodeling These sub - contractors have ship and have no employes 8. 0 Demolition working for me in any capacity. employees aud have workers' [No workers' comp. insurance comp. insurance. $ 9. 0 Building addition required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing ll work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' co right of exemption per MGL I2. ❑ Roof repairs insurance required.] t c. 152, § 1(4), and we have no e mployees. [No workers' 13. Other 1 comp. insurance required.] *Any applicant that checks box #1 must al o fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit i dicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ( Contractors that check this box must atta ed an additional sheet showing the nano of the sub - contractors and state whether or not those entities have employees. If the sub - contractors have loyees, they must provide their workers' comp. policy number. I am an employer that isprovidin 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 of MGL, c. 152 can lead to the imposition 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 .$750 00 a clay against the 'iolator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification.- I do hereby tify under the painss / and penalties of perjury that the information provided above is true and correct. Signature: Date: 40 < }!�� 1 `� Phone #: AA* ' C71 (All",.) ( — S'0 Official use only. Do not write 4n this arca, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): j 1. 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 ❑ 1'0)11'0)1 i Name of License Holder : / /(. License Number ki�� % t _ S C , 4•AD. 0 SIOI �,00e) Address Expiration Date � (-h Signat elephone 9. Registered Home Improvement Contractor Not Applicable ❑ \ Lea uTr--)Je is e- x'2\1 IGe /1.<;9‘59,1J a43 1fo 6 Company Name Registration Number Address / �, � �, Expiration Date 1 M& " / Telephone (� t � lk SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (MG.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 ❑ 11 = othe © £ten pt 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 Chap_tur152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Lows Annotated, you may be liable fui peisuu(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 It'ROPOSED WORK (check all applicable) j New House ❑ Additlion J Replacement Windows Alteration(s) I I Roofing n Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [El Siding [O] Other [Cl] Brief Description of Proposed Work: kl 1 ' rc 0 .Ac( .ie .4 Ni 11-]S / 3 %dS -1 -' "007-6-01 (7 ] Alteration of existing bedroom I Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet , I 6a. if New house and or ad iition to existing housing, complete the following: a. Use of building : One Family I I )�- Two Family Other b. Number of rooms in each family unit: Number of Bathrooms C. Is there a garage attached? i7 ni d. Proposed Square footage of new construction. 4 4' 9t Dimensions 2 '.. (Z e. Number of stories? � f. Method of heating? a./ A Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. {.s /A Masscheck Energy Compliance form attached? h. Type of construction W000 i. Is construction within 100 ft. ofjwetlands? Yes No. Is construction within 100 yr. floodplain Yes I No j. Depth of basement or cellar flo below finished grade � A k. Will building conform to the Budding and Zoning regulations? V 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 1, SOU l✓,OrYa -A as Owner of the subject property ' �1 ` hereby authorize ,e ' 1^ �3 ized � ,,1 ke. (�� to act on my behalf, in all matters re ative to work auth by this building permit application. Signatur Owner Date I, ■17 efoti v o 1 k La1S .)t-Oc J 2 J\ S , as Owner /Authorized Agent hereby declare that the sta ents and information on the foregoing application are true and accurate, to the best of my knowledge and belief. I Signed under the pains and penalties; of perjury. 0 1S 1 Print Nam 11 1‘ I 2.P/ Signature of Own k75 .... D i � Section 4. ZONING AR 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 e'7 Frontage Setbacks Front e 2 U Side L:._1 _.... R: Rear 20 Building Height Bldg. Square Footage Open Space Footage � (Lot area minus bldg & paved %ilt do W` �lq'I parking)_ # of Parking Spaces Fill: .. m .. _....._ .._._. __ (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO CD DONT KNOW ►3 YES 0 IF YES, date issued:'1 IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW or r YES 0 IF YES: enter Book Page' and /or Document # B. Does the site contain a brook, body of water or wetlands? NO O 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 0 , Date Issued C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO 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 (3 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • N. Department use " ortlr City of Northampton Statua'e ft Building Department , Cut ua errrnt 212 Main Street Availe4itit y Room 100 r/WelllvailaliiltCy. IfJorthampton, MA 01060 Two Sets �ructu ,I Plans= phone 413 -587 -1240 Fax 413- 5-ipz Plo#tiV! Plans 3 �+ \ ef Specify 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 21 f1�'LS Map Lot Unit p( ��'? *u > ¶A 1 1 Zone Overlay District Elm St District " " CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: t'QrV '( J U e - At,? - - etO e)(k 4' • 'iZT7. Name (Print) Current Mailing ( 4v2D ess: � 012,V1 Telephone �� Signature 2.2 Authorized Agent: /ck(4-1 161,{..P.4a2+2,3$11 l'°(Print) (c 1. S C it I A - M4 , Name (Print) Current Mailing Address: (A1 ? - * Signature Telephone - SECTION 3 - ESTIMATED CONSTRUCTION COSTS', Item Estimated Cost (Dollars) to be r Official Use Only completed by permit applicant 1. Building !z , 04-19 G30 (a) Building Permit Fee 2 Electrical (b) Estimated Total Cost of (p 0(10 - (20 (b) from (6) 3. Plumbing �� 1 (A Building Permit Fee 4. Mechanical (HVAC) — O 5. Fire Protection Q 6. Total = (1 + 2 + 3 + 4 + 5) cz29 2Q Check Number t cTO This Section For Official Use Only Date Building Permit Number: Issued. Signature: Building Commissioner/Inspector g of Buildings Date Ii File # BP- 2010 -0098 APPLICANT /CONTACT PERSON LOUIS TONELLI ADDRESS/PHONE 35 FLETCHER AVE BELCHERTOWN (413) 323 -5074 PROPERTY LOCATION 21 FRANKLIN ST MAP 31A PARCEL 032 001 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 i �' ` Fee Paid ,66 3 xi./ Typeof Construction: ADDITION TO GARAGE & CONVERT SCREEN PORCH TO 3 SEASON New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 65242 3 sets of Plans / Plot Plan T F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION PRESENTED: A pproved _ 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. i r BP- 2010 -0098 GIS #: COMMONWEALTH OF MASSACHUSETTS 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 -0098 Project # JS- 2010- 000114 Est. Cost: $34000.00 Fee: $204.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LOUIS TONELLI 65242 Lot Size(sq ft.): 37592.28 Owner: SILBERSTEIN HARVEY & JULIE Zoning: URB(100)/ Applicant: LOUIS TONELLI AT: 21 FRANKLIN ST Applicant Address: Phone: Insurance: 35 FLETCHER AVE (413) 323 -5074 BELCHERTOWNMA01007 ISSUED ON: 7/31/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:ADDITION TO GARAGE & CONVERT SCREEN PORCH TO 3 SEASON 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 Sig iature: FeeType: Date Paid: Amount: Building 7/31/2009 0:00:00 $204.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo ' • � • \\\ ~�* �//�� ___----- \ S ■ ' ��` 0 \ \ �� . v /\ \ � / \ -_~~�~ \ \\\ \ , S% \-'~-~ 0\ \ ~ /} . \ \ -~ + , „- - ,--.------ 7z-p,(‘,- „4" , 7- ■ f i f. , _j_____... ) ("4-1--A - c ‘0t0C742v,,Yz7 (:)r) -- — , ( ' FAO C ,-,1..) i I. tlig-- 0 - (Hk* td 4 :,..i,., 6 2/----c - 1 1/ ■ 0 v /.,--c.7"i 0 • i tA —Xk P4--V t 1 1 \____----., '------"-- -------- , ,------ , , t i 1 1 i , - 0 - - CIS 1 1C yr .a-00 f Cz11j mac' �z1?�i '� O c') 1'1 V Dno6c00\ ( . -V•vo97) oy -�'► rM c1�9) ( \-) )'062\(-\ - 1 - z A ()'l f tkU-\ \ �� ✓!ae arrt mancoea' o/ zi zaaac %cre Board of Building Regulations and Standards License or registration valid for individul use only Et'' HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: yy6� Board of Building Regulations and Standards =I Registration: 156978 Expiration: One Ashburton Place Rm 1301 p 8/21/2009 Tr# 258428 Type: Individual Boston, Ma. 02108 LOUIS TONELLI LOUIS TONELLI 35 FLETCHER AVE. _ 4 BELCHERTOWN, MA 01007 Administrator Not valid without signat • ccii7L ado in ras _ _ Construction Supervisor License License: CS 65242 Birthdate: 8/10/1970 Expiration. 8/10/2009 Tr# 4982 Restriction: 00 LOUIS A TONELLI 35 FLETCHER AVE BELT' IERTOWN, MA 01007 Commissioner \ The Commonwealth of Massachusetts _, ,a0. "� Department of Industrial Accidents 4. 4 Office of Investigations I , 600 Washington Street t '" ? - A Boston, MA 02111 www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information t Please Print Legibly Name ( Business /Organization/Individual): c rg-I1 . 2.211 /..01-1911Z-0/.1 v (Ge j/ -ouv' i - - _-' Address: . "6 4 CL.4-tR Acll6 - / ?. o - 1:5c)X- 4 1 City /State /Zip: &t -1, 4At O1G27I Phone #: (-4 ' 4-o1k 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. El New construction 2. [ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in aci employees and have workers' g any capacity. 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.0 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 comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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. Lie. #: 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 of MGL c. 152 can lead to the imposition 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 Investigations of the DIA for insurance coverage verification. I do hereby ce 'e under the pains and penalties of perjury that the information provided above is true and correct. Si_nature: �. \ze, . Date: 1l Q' Phone #: C4' ' ) .523 X 0--1 • / L.CL -lam (41 3) (12-1 — 32 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 #: SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ I � Name of License Holder : �0 ( Tv 1,4,- l License Number y -E - fr aiJ 1J 1 vA a 0001 b (i c' ;.� 7 Address Expiration Date -t; (AA 3) Signa e Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ L G(a Company Name Registration Number F o . K 17 zi We. €2 � 2-1 2cX>, Address Expiration ate 1: 2k�1�)LS VA■6- 0(001 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 ❑ 11. - Home Owner Exemption 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_jl1 indows Alteration(s) E4 Roofing n Or Doors %1 Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [❑ Siding [0] Other [0] Brief Work: Description of Proposed L A„ "li 1 63, , 11 1-1-6c 1< 11)1 Alteration of existing bedroom _ Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll - Sheet /Q I Z.ta -tV 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each fa , ily unit: Numb- of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new const . ion. Dimensions e. Number of stories? f. Method of heating? A411111116, Fireplaces or Woodstoves Number of each g. Energy Conservation Complian - . k asscheck Energy Compliance form attached? h. Type of construction i. Is construction withi 00 ft. of wetlands? Yes No. Is co ruction 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, &j U t 1. 2L 2 7(' / 011 , as Owner of the subject property , 1 -- \ hereby authorize �k701 Gj ' %J t-1.-1 ���� K G�\CtJ c- to act on my behalf, in all matters relative to work autho ized by this building permit application. Signature of r D to I, t'L . 1 - 621 --ie V1A ‘ J G �7 OL t�5 , as Owner /Authorized Agent hereby declare that the statements 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. L61) 1 L j` i-4/l/1 /f - -" - (/ ( Signature o • er /Agent D:te , 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 �e. Setbacks Front .) Side L:_ R: "'- , L: R: (s, Rear Building Height ~ Bldg. Square Footage % -,...,, Open Space Footage % w� (Lot area minus bldg & paved parking) '''''N'''''''''''NN''.N c # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO ® DON'T KNOW �1 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DON'T KNOW ►4, YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO C4 DON'T KNOW Q YES 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 ® NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES ® NO tli 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 ® NO 112) IF YES, then a Northampton Storm Water Management Permit from the DPW is required. F' ' Department use only �` city of Northampton Status of Permit r! Building Department Curb Cut/Driveway Permit 1 12 Main Street Sewer /Septic Availability ' r' F '10 Room 100 Water/Well Availability N *tharrpton, MA 01060 Two Sets of Structural Plans ph: 411 -P40 Fax 413 - 587 -1272 Plot/Site Plans Y r.• ! Other Specify APpL^i4f1 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 Zt .46c014.-uLI t C9 G( Map Lot Unit Zone Overlay District Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) Current Mailing Address: 6717-46717-4:1 11 (41 — 3 5P , 1 - Telephone Signature 2.2 Authorized Agent: L hs /- ' C. A3 - t t� — p.kl.1 . y Name (Print Current Mailing Address: (a Oil 6 Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building i 17-0, COO - 00 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of t Construction from (6) 3. Plumbing 1 UvO � Building Permit Fee 4. Mechanical (HVAC) ZJ 5. Fire Protection 2 1 o9o• OCR 6. Total = (1 + 2 + 3 + 4 + 5) 4 114, 00 Check Number /3 igve9 This Section For Official Use Only Permit Number: Date Building Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2009 -1059 APPLICANT /CONTACT PERSON LOUIS TONELLI ADDRESS/PHONE 35 FLETCHER AVE BELCHERTOWN (413) 323 -5074 PROPERTY LOCATION 21 FRANKLIN ST MAP 31A PARCEL 032 001 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 /5 �0 Typeof Construction: CONSTRUCT NEW WINDOW IN LIVING RM,PARTITION CLOSET & MUDROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 65242 3 sets of Plans / Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved 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 , 2 . ›/Z 7 a 9 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. z BP-2009-1059 GIS #: COMMONWEALTH OF MASSACHUSETTS k �gr 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- 2009 -1059 Proiect # JS- 2009 - 001539 Est. Cost: $140000.00 Fee: $840.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LOUIS TONELLI 65242 Lot Size(sq. ft.): 37592.28 Owner: SILBERSTEIN HARVEY & JULIE Zoning: URB(100)/ Applicant: LOUIS TONELLI AT: 21 FRANKLIN ST Applicant Address: Phone: Insurance: 35 FLETCHER AVE (413) 323 -5074 BELCHERTOWNMA01007 ISSUED ON: 6/23/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT NEW WINDOW IN LIVING RM,PARTITION CLOSET & MUDROOM 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 6/23/2009 0:00:00 $840.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo 30 -year architectural 2 x 6 rafters 16" on shingles over 1/2" CDX center with collar plywood roof sheeting 4 . Tti ties 4' on center . ' *- - ''''''''''' -411 1*',„ , i . ridge vent excl ive detailing, us ��� � �� 1 0 1 with large roof overhang '''.,,,,,,,,, \ ';'' '''''''- i-%, , - h N - Ni4 <- , )1L# g .. ' 1 b A ,, ,, ‘ vp , , ,, , k‘ - .,„ ' y , , , t, , , ,,, ,, , ..„,„--4000. '*4 - , * 1 '''''' _ 3 ' i $ Y double 2 x 6 header over windows and doors pressure treated floor �_ system, 4 x 4 rails, joists 12" on center, 5/8" plywood vinyl over 1/2 CDX plywood -H BOOK 5535, PAGE 237 SEE: PLAN BOOK 1, PAGE 8 ly i (ANEW 10r$HEA 75'± S' 5€T B Act< (S 5 Per F2w`1 -H PROP *r / tWNt= .. co 00 r � M #21 100'± FRAJVkL ST_ -NOTE THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND 1S NOT TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED. BUILDING LOCATION ACCURACY IS NOT GUARANTEED NOTE: PROPERTY LINES SHOWN ARE APPROXIMATE, A FULL FIELD SURVEY IS REQUIRED TO ACCURATELY DETERMINE THEIR LOCATION. - H 17ga� BOOK 5535, PAGE 237 SEE: PLAN BOOK 1, PAGE 8 shed 75'± -H Cx ST /NG• SA/66 �o N T �E^� $E RE�°L�4�� (AJ I L4et,E'2 $ 4 . 56- o A LARGE? V A M 1i✓. / 100'± FRANKLIN STREET TO: CONNECTICUT ATTORNEYS TITLE INSURANCE COMPANY TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY #250167 _ -NOTE - SURVEYOR: � I - ` THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY �N ms - MORTGAGE LOAN INSPECTION PLAT /4" v NORTHAMPTON, MASSACHUSETTS RA E ALL ;\ PREPARED FOR r IZER y HARVEY AND JULIE SILBERSTEIN O SCALE: 1"= 40' MAY 8, 2009 N O solve , HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET - HADLEY - MASSACHUSETTS NtJTICE - �-�- -: ¢�' = NOTICE TO NJ:40771i.- { -" E, TO EMPLOYEES = ;_ EMPLOYEES • The Commdnwealth f � Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617 - 72174900 - bttp:/ /www.mass.gov /dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above - mentioned chapter by insuring with: I CSI , y NAME OF INSURANCE COMPANY •'• Box 409, P: N107054 ADDRESS OF INSURANCE COMPANY WC 648 -45 -02 05/27/2010 - 05/27/2011 POLICY NUMBER Ek'x".ECTIWE DATES Berkshire Insurance j 31 Court St., (413)562 -3659 Group Inc. ' Westfield, MA 01085 NAM OF INSURANCE AGENT ADDRESS PHONE # Hometown Structure 627 Southampton Rd, I Westfield, MA 01085 (413)562 -7171 EMPLOYER. Ai DRESS EMPLOYER'S WORKERS' COMPE*SA.TION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in i s of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospitald medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First 4-port of Injury must be given to the injured employee. The employee may select his or her owtl physician. The reasrable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is Faeces and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby that the insurer has arranged for such attention at the NAME OF HOSPITAL i ADDRESS TO B POSTED BY EMPLOYER 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/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 a AIR The Commonwealth of Massachusetts Department of Industrial Accidents ? Office of Investigations _= 600 Washington Street 1 = _ Boston, MA 02111 www.mass.gov /dia - Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/PIumbers Applicant Information Please Print Legibly Name ( Business /Organization/Indivirinal): /,^rye �,�, r� S fi c f v r-e r Address: ( 7 Se th „ City /State/Zip: de . f-1 A mg O /OYS Phone. #: S(od /7/ Are you an employer? Check the appropriate box: Type of project (required): / 1. ►= I am a employer with 4. 0 I am a general contractor and I 6. 0 New construction employees (full and/or part- time).* have hired the sub- contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no a loyees These sub - contractors have . 8. 0 Demolition working for me in any ca aci employees and have workers' • . or ' Y P tY• $ 9. 0 Building addition [No workers' comp: insurance ed 5. We are a corporation and its 10.0 Electrical repairs or additions required.] ] officers have i sed their 1 1. Plumbin repairs h ❑ g epairs or additions 3.0 I am a homeowner doing all work myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no 7 ) employees. [No workers' 13. ®Other a t� s s v �� comp. insurance requited ] . *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 subcontractors and state whether or not those entities have employees. If the sub - contractors have employees, they must provide their workers' comp. policy number. lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: CH / 5 fS ()roil Co Policy # or Self-ins. Lic. #: Li L (,Y p ( if .— ` 0 2— Expiration Date: S . 2 7 ` ? ()J / • Job Site Address: / f'rc'/1 k f /1 S City /State/Zip :' /0orf itw• io',/ P2A ()Ai fo 0 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 of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1500.00 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 Investigations of the Da for insurance coverage verification I do hereby certify under the pains and penalties ofperjury 'thatthe frrfonmatdon provided istrue_ar�carrec _ __. yy� ' Signature: _�' 1 p.• ., .� Date: 1/ /0 Phone #: Y/ 3 5 (o • J "/ _ - 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 y Contact Person: Phone #: — c SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: jjJJ 1 Not Applicable p ❑ - Name of License Holder : A n ) u r/ Z CS 9 0 7 8 License Number 295 QNrn la_ RJ . Hv�h� �,, ✓hA o loss 5-- 3- 11 Address Expiration Date y / 3L9 -7/7/ Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ 3 f r --hd r ,e s 1 59 - 27D Company Name i_ Registration Number { J A Address Expiration Date MA )OBS Telephone St)' 7/ 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 VI No ❑ 11. — Home Owner. Exemption 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 posse's's 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 4 .� SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. Et Demolition ❑ New Signs [O] Decks [Q Siding [O] Other [D] Brief Description of Proposed Work: $[t/t.,� A /0 /AI VA Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a. if New house and or addition to existing 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 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, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date A/q/r (icy 5 t-got ST- Imo! , 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. 1/44i/ay Sl4.302 STEIN Print Name 4i/) �j lii fM l.Ill / /�G /D Signature of Owne gent 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 33 (000 „ -_ta Cr„„ _ 3 ,,.(• So* Frontage Setbacks Front Side L. SST; R. . (Ft „' L Sir R . i'fr Rear S i,r Sir Building Height 9 'p (8 f /�Mk Bldg. Square Footage ° / g• q g � o.�d, � � SiO 9y..0 Open Space Footage ' � /o a (Lot area minus bldg & paved !Ob ( 0,000 8. 3 ` 0 parking) .__._..........__.... # of Parking Spaces _ Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW • YES 0 IF YES, date issued:. — 1FYES:. Was the permiL_recorded-at the- Registry -of Deeds? — — NO 0 DONT KNOW YES 0 IF YES: enter Book Page and /or Document # 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 Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO 40 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO 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 Q NO Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit' Bu Department Curb‘Cut/DrrvewayyPermit 2't Main Street a werl$�Aaabty Zoom 100 t Later l�Au rfa alit Northampton, MA 01060 wo et fStru Ural Plans phone 413- 587 -1240 Fax 413- 587 -1272 < �srtealn s Other Specify 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 Z I FRA Nk L I?! Sro - Map Lot Unit A/012)/AM P ?d1\1 Al A 010 &O Zone Overlay District i Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Z! F24Nki.. /14 1/4/Q1/Ey Acv! '3 StL$eRsrEin/ NoRrt/AA1pi J /HA O'0(00 Nam (Print) Current Mailing Address: 10 4� 4 4 1 0880 Telephon Signature 2.2 Authorized Agent: 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 r 00 (a) Building Permit Fee 2. Electrical N/A (b) Estimated Total Cost of Construction from (6) 3. Plumbing N/ Building Permit Fee 4. Mechanical (HVAC) Az 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 5000 Check Number d54 0d-8 - - This Section For Official Use Only Building Permit Number:, D Issu ed: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2010 -1169 APPLICANT /CONTACT PERSON SILBERSTEIN HARVEY & JULIE ADDRESS/PHONE 21 FRANKLIN ST NORTHAMPTON (413) 441 -0880 Q PROPERTY LOCATION 21 FRANKLIN ST MAP 31A PARCEL 032 001 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 Q/l! 0.0 Fee Paid 54Y f Typeof Construction: ERECT 10 X 14 SHED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 98186 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION PRESENTED: pproved 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 6/ Sign e 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. 2I ..t"- BP- 2010 -1169 GIS #: COMMONWEALTH OF MASSACHUSETTS _ ; is 3IA 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 -1169 Project # JS- 2010 - 001705 Est. Cost: $5000.00 Fee: $28.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOMETOWN STRUCTURES 98186 Lot Size(sq. ft.): 37592.28 Owner: SILBERSTEIN HARVEY & JULIE Zoning: URB(100)/ Applicant: SILBERSTEIN HARVEY & JULIE AT: 21 FRANKLIN ST Applicant Address: Phone: Insurance: 21 FRANKLIN ST (413) 441 -0880 0 WC NORTHAMPTONMA01060 ISSUED ON: 6/28/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: ERECT 10 X 14 SHED 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 6/28/2010 0:00:00 $28.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo