17A-259 (2) i
POUT
0
, , ,,,,,/ ,// DESIGN B BUILD
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/ � ' x 3' walk m r
showe 1
/ / with custom bench/ / I 104 Elm Street
�// j� / //' / Northampton, MA 01060
' / ' / / \, / � '� - s , � i (413) 587 -3050
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/ / / / __ Bath A Godin/ Petruccelli
// 11.44 ' 4 f / �/ /
97 Oak Street
�7 / / , //� / Florence, MA
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2nd Floor Proposed
12' 9 / Al 02c
Scale 3/16" = 1' -O"
rim 2nd floor p ose r ro p d
1 -0 — — — VI __ Project number Project Number --
3/16" -J - " Date issue Date
Drawn by_____ Author
Checked by Checker
__— ______
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ROUT
I DESIGN B BUILD
, ://// / // / // //// //
/ / � / / / �� /�/
�/ /// / 1 O4 El / � � / i m Street
/� / ////// 4 /�� / . Northampton, MA 01060
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/ / radiator to be moved // /// (413) 587 -3050
/
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Existing door an adjacent /
i / wall to be removed /��/
/ / / ' / /// / Godin/ Petruccelli
/ / / � / , /
//
//// // ✓ � / 6 97 Oak Street
/ ///' //' / / , / j / / , Florence, MA
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/// ✓ / / / /
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/ r rim / / __---- -- Existing brick chimney
/ / �® / to be removed down to
/ / ///
, /// / / basement floor
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/j / 2nd Floor Demo
- - -- - - - - -- - - I A102
17.9"
/ / I Scale 3/16" = 1' -0"
I
--� 2nd floor Demo `-
�J 3/16" = 1' -0" - - -- - - - - -- - - --
Project number Number _
l Date -__ Issue Date-
Drawn by Author
Checked by
1 RO UT
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1 DESIGN 6 BUILD
// // /// / //// y / / / / /// /// //
//, �� //, / // , / , / / 1 // //// // //
/ // / // /
/ / / / /// ///////// �j ;/, 104 Elm Street
I� / / / / j / Northam ton, MA 01060
/ / /� / �j / /� (413) 587 -3050
/ / /// / ' / / / / / i/
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/ / ,/ Godin/ Petruccelli
/ / /, / Office
/ / / / / / / j //7 / ; / / , /// 97 Oak Street
/ / �/ / / —, / /// / / Florence, MA
/ / /, / / / / / / / / / / // _ / //// '7 /� /
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' l Storage' '
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///// / //1 / 7/ / /��% �� ' 2nd Floor Existing
1
12 ,_ 9 .,
A102
Scale 3/16" =t-0"
2nd floor Existing Mr
U 3/16" = 1' -0"
Project number Project Number_
;-Date____ Issue Date
— _Drawn by Author__
Checked by Checker___
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"` "� ' $2 At*. - I DESIGN B BUILD
■
Project Scope:
I I
A second floor office space will be converted into , "
p �` ` AI" '
a full bathroom with a walk in shower. The 104 Elm Street
I Northampton, MA 01060
existing brick chimney will be removed down to ,,
the basement floor. There will be no alterations to (413) 587 -3050
the exterior walls or structure.
1
Godin/ Petruccelli
—NOTE— ^
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND I5 NOT TO BE RECORDED. 97 Oak Street
BUILDING LOCATION ACCURACY IS NOT GUARANTEED Street View - Existing Florence, MA
82.5'±
NOTE:
SUBJECT TO EASEMENTS AND chimney to be removed
RIGHTS OF WAYS OF RECORD• r -- -,
down to basement floor
,.._ n ,
wpm/ LOT #6 �,• - r i . •
I FV M,
a 1 f
Bit. /" j v
- ' ,- ,:i.'
ri s
REFERENCE: ; .,,-^' - _ 'Tf .:X �" 4' - a
BOOK 1663, PAGE 91 $ ; / w r _,t 4
BOOK 320, PAGE 30 R , 1 i ;
` & ?1-
Bit. Conc. Driveway Extends I
over Property Line. 1`'
82.5'±
1. 5' ±-1 -
OAK STREET
I
TO: BERKSHIRE BANK & '
COMMONWEALTH LAND TITLE INSURANCE COMPANY
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF 4ir I 97 Oak Street
r I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING �,-
MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON ��" -la . .u, Wig- +a 1
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, r ,: * — - - - --
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN w ,
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR O 0
1 Al
COMMUNITY #250167 .. Ar kp , ' '
-NOTE-
SURVEYOR: 02./n t Q Q
T -1-.23,-, THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
- MORTGAGE LOAN
1N INSPECTION PLAT- 1 Scale
NORTHAMPTON, MASSACHUSETTS Rear View - Existing
RANDA PREPARED FOR
IZER P RUTH M. LaFRANCE
135032 SCALE: 1"=30' JULY 18, 2011
e.
4» aue HAROLD L. EATON AND ASSOCIATES, INC. P roject number -_- _Project NUIT1ber___ -._
REGISTERED PROFESSIONAL LAND SURVEYORS H _ Date _ Issue Date - -___ _
235 RUSSELL STREET - HADLEY - MASSACHUSETTS
Drawn by Author _
Checked by _ Checker
Mar 30 10 10:38a p.3
The Commonwealth of Massachusetts
Department of Industrial Accidents
"" ° .-. i Office of Investigations
x411— 1 600 Washington Street
• ; LM„
(- MEP '+ Boston, MA 02111
�., www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers
Applicant Information Please Print Le
�
Name ( Business /Organization/Individual): de 9 2 n,,,�� W jti■ 1 I &
Address: /U /JOrh\ S 54 fee f /Vo; / /lb - Dfe6O
City /State /Zip: Phone #: Tl3 - 5 ' - OSO
Are you an employer? Check the appropriate box:
Type of project (required):
1.I am a employer with r 4. ❑ I am a general contractor and I 6. ❑ New construction
employees (full and/or part- time). * have hired the sub - contractors
listed on the attached sheet. 7. ❑ Remodeling
2. El I am a sole proprietor or partner-
ship and have no employees These sub contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
comp. insurance.+ 9. ❑ Building addition
[No workers' comp. insurance p
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
1 ❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.E 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
etnployees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information. ,/
Insurance Company Name: / A lPr e , „p( G -4cX
Policy # or Self -ins. Lie. #: /50e.,J (• ¥ // Ta Expiration Date: £ /'i 2
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.
1 do hereby certify under the Rains and penalties of perjury that the information provided above is true and correct.
Signature: 7 Date: Z � 7 /
Phone #: `i i — 58 /6 / 3e
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 ❑
Name of License Holder : � � Y C 5 - i J 3 Y 5c)
License Number
Address u Expiration Date /01,/901V
Y -9SRP
Signat 4. 7 Telephone
e m , n
... o . z . mow., ` �� KH�
ai "s ered"j�io`rnet mar'ouemet�Gntractor. � <<,° _ Not Applicable ❑
& 9� Pp4, - . Q, d tairO3
Company Name Registration Number
Ma I74 27 )7
-- Address Expiration Dat
/./0.--JL G 54 / Telephone 1 /3 a0/�gliO
SECTION 10 WORKER COMPENSAT1ON 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 ❑
come- dv , ner xempti
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- DESCRIPT4 t OPO'SSE all �catsie
New House ❑ Addition ,J Replacement Windows Alteration(s) ED Roofing ICJ
Or Doors ❑
Accessory Bldg. 1.=.1 Demolition 2ST New Signs [0] Decks 441 Siding %] Other [0]
Brief Descrin +inn of Prn''rw"1
Work
�. a 2.4 L� ct - � a�ev� cl�: ,, ��e y
Alteration of existing bedroom Yes K No Adding new bedroom Yes ) No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
r� .,t.+ s.s.•�. rr &a�,c [ . =t4 Ea, ., �.«. ..W.°,...v `�u �.e `�- `�...�,�..��... . .
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? VD
d. Proposed Square footage of new construction. ,6. Dimensions 13 � , !I X / 1 >�
e. Number of stories? 2e
7
f. Method of heating? !11,03 A /v#. p 1 fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Ma -. check Energy Compliance form attached?
h. Type of construction w 00 D cYAMe•
i. Is construction within 100 ft of wetlands? Yes No No. Is con ruction within 100 yr. floodplain Yes No 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 Supp
SECTION "7st S NE . s� : � � ®• � � Al k r:„ v ' b, S
OWNERS AGEi�tS?OR a r R' e _ d
I, / k t 66I' V` k le C h 1 T t (T a i t.L. , as Owner of the subject
property a
hereby .uthorize _ Z K d.0 y
to act • my be .If, i - relative to work autp(orized by this building permit application.
/. Z
Si • - of • ,x Date
I, J D L l DkvtOmr , as Owner /Authorized
Agent hereby declare that the state mi ts and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under a I
the pains and penalties of perjury.
/ILA, ttmotrt/
Print Name
•.4 .- -' T -/
Signature of • r /Agen Date
- •••`,„)
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U�1 72012
C of Northampton ' -
Bui ding Department
- ?C -
212 Main �
, Roo 100
DE' . d A 01080 _ _._ . � v
RTHAMF . _.�-
�— No rthamp
NO 3 - 587 -1240 Fax 4 ton, MA 01060 Street
■
phone 4113 - 587 -1272
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A LING
SEC TtON.1 - SITE
- a OR M N te r "
1.1
property Address:
x
�? Oak ONE OR TWO FAMILY DWELLING
z
SECTION 2 P1;'ERT YC3'r`I
2.1 Owner of Record:
�1 (�� � ,. �-�cv�c 417 0 A (.ovtN[:>� MA- mJ t��z
Na (Print) Current Mailing Address
!. y/ 3 -$ — 8690
. , r , 4 , At r. . . Telephone
2.2 Authori * Agent:
-- 37,1"• t .( r ■ /ay ��� IL Z/14% tidy
Name (Print) / Mailing Addre
¶fl — 587— 3 cSo
Signature Telephone
SECTION 8 - E&[ATE#T
Item Estimated Cost (Dollars) to be , � � « i e - ,
completed by permit applicant r ,c * ,. ; . " . • ,.
1. Building J + �! _ � r� —
s .sew z r x1�S4' s ,�„
mtk
2. Electrical Q � � �) � , .� / � ` „� <
�✓ Corlstorfrx
3. Plumbing d#L .S�ng Permit: - � :
BOLT �a�
4. Mechanical (HVAC)
Protection
5. Fire - „-,,,,,,,,,,,,,s .-,-,,,....,-,,,,,, ,,,,-, -
Numbe 6. Total = (1 + 2 + 3 + 4 + 5) sLl�l1 i • Checkr i , . ,--
'rt Se er on Fc rfli: r Check efse . <, .,
Building Perm Nun ber- bate
tssued
Signature.
Bu+fd#1gCs rz?cress�on ![nsPectoro€Su dings •
File # BP- 2013 -0067 (� r
APPLICANT /CONTACT PERSON JOHN LANDRY 1 t7 (�)
ADDRESS /PHONE 104 NORTH ELM ST NORTHAMPTON (413) 204 -9880 S
PROPERTY LOCATION 97 OAK ST
MAP 17A 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
Fee Paid 3
ICE 'a''
Typeof Construction: ADD 2ND FLR BATHROOM & OFFICE & REMOVE CHIMNEY :: i4 A t `11-6' - v
New Construction 1 F niter' t-( P j,7 „ ,60
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 093450
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN1 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
17/ 9i 2_
Signatur f 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.
97 OAK ST BP- 2013 -0067
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A - 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: renovation BUILDING PERMIT
Permit # BP- 2013 -0067
Project # JS- 2013- 000097
Est. Cost: $7800.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN LANDRY 093450
Lot Size(sq. ft.): 12719.52 Owner: LAFRANCE RUTH M C/O MICHAEL A GODIN
Zoning: URB(100)/ Applicant: JOHN LANDRY
AT: 97 OAK ST
Applicant Address: Phone: Insurance:
104 NORTH ELM ST (413) 204 -9880 WC
N0RTHAMPTONMAO1060 ISSUED ON: 7/23/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:ADD 2ND FLR BATHROOM & OFFICE &
REMOVE CHIMNEY - HARDWIRED SMOKE /CO
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 7/23/2012 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner