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City of Northampton Mail - Re: Porch on North St
( --- . ..2. : , -1 ',*:.': , -- ,---,,,..--
c Louis Hasbrouck <lhasbrouck @northamptonma.gov>
>
Re: Porch on North St
1 message
Carolyn Misch <cmisch @northamptonma.gov> Fri, Aug 17, 2012 at 2:01 PM
To: Louis Hasbrouck <Iasbrouck @northamptonma.gov>
ok, looks fine. Such a nice guy you are.
On Fri, Aug 17, 2012 at 1:47 PM, Louis Hasbrouck <lh aswr ,) rt € r 2 ,: ' o , .goy> wrote:
Carolyn,
I gave conditional approval for this porch at 64 North St; he's got plenty of setback and URC =30% open; not a problem. I told him he's
proceeding at his own risk until Thursday.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
`4 1,' 5k7- :24C office
(413 ) 587 -1272 fax
(City of Northampton E -mail is a public record except when it falls under one of the specific statutory exemptions.)
Carolyn Misch, AICP
Senior Land Use Planner /Permits Manager
City of Northampton Office of Planning & Development
210 Main St, Room 11
Northampton, MA 01060
413 - 587 -1287
cmisch @northamptonma.gov
www.northamptonma.Qov /opd
(City of Northampton E -mail is a public record except when it falls under one of the specific statutory exemptions.)
° The Commonwealth of Massachusetts .,
Department of Industrial Accidents
� 4 - � . Office of Investigations ,
7 ,, r,:', _ 600 Washin Street
= Boston, MA 02111
www.mass .ov/dia
Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers
Applicant Informatiotl Please Print Legibly
Name ( Business /Organization/Individual):
Address:
City /State /Zip: Phone #:
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
6. D New construction
ployees (full and/or part- time).* have hired the sub - contractors
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. 51,1%enolition
working for me in any capacity. employees g Y P h ad have workers' 9. [wilding addition
[No workers' comp. insurance comp. insurance.$
re uired.] 5. ❑ We are a corporation and its 10. lectrical repairs or additions
officers have exercised their 11. Plumbing repairs or additions
3. am a homeowner doing all work ❑
myself. [No workers' comp. right of exemption per MGL 12. ❑ Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13. ❑ 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.
Contractors that check this box must attached an additional sheet showing the narn of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: 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 f• , surance coverage verification. I do hereby certify u , •r •p ins and penalties of perjury that the information provided above is true and correct.
Signature: Date:
,/1/1/ Phone #: ` 3t- 15
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
II . Contact Person: Phone #:
Versionl.7 Commercial Building Permit May 15, 2000
SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required • Yes 0 No 0
SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
1 ._. ._._.
_ _____ __. ,__... ..:.... _ , 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 an 1 na s fperiurX
Print Name /
L 7 J _ .. w _
Signature of Owner /Agent Date .)c.%
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder __
License Number
.r•'r%
' F_ A_ t ' T�4i le^ VTR ..._� � ........
Address Expiration Date
Signature /7 Telephone f t• ?
SECTION 13 ORKERS'';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 0 No
Version1.7 Commercial Building Permit May 15, 2000
SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION-SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENOLOSED •SPACE)
9.1 Registered Architect:
• ____, _ .., _,_.. �.._._ Not Applicable ❑
Name (Registrant):
Registration Number
Address .. __._.,_... _..
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
•
• r
Version1.7 Commercial Building Permit May 15, 2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to filled in by
Building Department
Lot Size
Frontage .
Setbacks Front
Side
Rear '? ._.
Building Height
Bldg. Square Footage g
Open Space Footage
(Lot area minus bldg & paved
parking) paved —__,
# of Parking Spaces , =
Fill:
(volume & Location) _ . _____._........ __....,.__.... - ,._........_.._ .__..__ _ __..___. ,.. _ ...._, _., .....,__
A. Has a Special Permit /Variance /Finding ev been issued for /on the site?
NO 0 DONT KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES
_
IF YES: enter Book ' Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 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 ( NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NOS
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excav 1 , or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
f w
Version1.7 Commercial Building Permit May 15, 2000
0
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 ,
CUBIC FEET OF ENCLOSED SPACE ' '_-
Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Bu (]]S
Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑
Brief Description Enter a brief description here.
Of Proposed Work
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) I CONSTRUCTION TYPE
A Assembly ❑ A -1 ❑ A -2 ❑ A -3 0 1A I 0
A -4 ❑ A -5 ❑
B Business ❑ 2A ❑
E Educational ❑ 2B - r ❑
F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1-3 ❑ 1 3B ❑
M Mercantile ,,❑_,/ 4 El
• Residential LN R -1 ❑ R -2 V R -3 El 5A ❑
S Storage El S -1 ❑ S -2 ❑ 5B
U Utility ❑ Specify
M Mixed Use ❑ Specify.:-_._..._. -._. _ .,�,� __ _ �__ .___ . m._
S Special Use ❑ Specify
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE
Existing Use Group: . _ ___ ....._.. ._ _ .___ ____,._.....___._ .._ Proposed Use Group:
Existing Hazard Index 780 CMR 34): .,_. _. .__ Proposed Hazard Index 780 CMR 34): , ...._._,.m._
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor (sf)
1 sr- c-
2nd _ . _.. .... __,.. ..__.._ .. __, 2nd
3rtl 3rd ..
4 h ..__ . m. __._. 4 cn
Total Area (sf) rci*?) Total Proposed New Construction (sf)_ _
Total Height (ft) ) -
Total Height ft , .,. , . �„
7. Water S,rfpply (M.G.L. c. 40, § 54) 7.1 Flood,Z, one Information: 7.3 Sewage Dis osal System:
Public (� Private ❑ Zone Outside Flood Zone Municipal �/On site disposal system
w �
Version1.7 Commercial Building Permit May 15, 2000
Department :use,only
Ci of Northampton Stitttstaf P(rpt 'q
Bul ding Department curb Crab nrreway,Per ttt."
91 11 2 2 Main Street SeweilSeptfcA�ratlabth
p�G Z Room 100 a biFity a �'
- ha pton, MA 01060 Twof. et's Strattttr Flans
Dec ti 8 1240 Fax 413 587 - 1272 Plof/ Plans
NoR Other Spectfjr
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
This section to be completed by office
1.1 Property Address:
6 if
f fi &T fr Ma Lot Unit
(E� & 7 " t( /? ,l.l I- 1 ,'f t : ,
Zone ,,. e _ Overlay District
E
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
1 \ C. l` ,fl ee l..._ _ _ ... a_It,`_ .'..p" ___ „elm. /2 ei
Name (Print) ' / Current Mailing Address:
+ 1 / _
Signature Telephone
r
2.2 Authorize 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 (a) Building Permit Fee
i
2. Electrical , (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
_..-.._ _
l 64‘C�kl
_•__ ` ._.._ � � �s�>l 'rL' :'4t c, e x /i
5. Fire Protection ty �`
6. Total = (1 + 2 + 3 + 4 + 5) Check! Number /9(a
This Section For Official Use Only
Building Permit Number Date
Issued
Signature: I 2D/1"Z__
Building Commissioner /Inspector of Buildings Date
5
64 NORTH ST BP- 2013 -0187
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24D - 089 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ADDITION BUILDING PERMIT
Permit # BP- 2013 -0187
Project # JS- 2013- 000306
Est. Cost: $7000.00
Fee: $96.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: MICHAEL L HARRINGTON 102948
Lot Size(sq. ft.): 7100.28 Owner: HARRINGTON MICHAEL L
Zoning: URC(100)/ Applicant: MICHAEL L HARRINGTON
AT: 64 NORTH ST
Applicant Address: Phone: Insurance:
P 0 BOX 393 (413) 575 - 8345
NORTHAMPTON ,MAO1061 ISSUED ON:8/21/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 12 X 16 SUNROOM
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 8/21/2012 0:00:00 $96.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner