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' ' _ _ __ 1 ' . . , ' _.1 I . vo ` ,," —4---- 91 +_ __- `�-- ` n | _25" _ _ = __ —'I | __ _ ~m - 1 N /r' N/r N\F RONALD R. & JANET D. COTE i ARNE T. & INGER A.M. RENGSTEDT FREDERICK & DALE BUSS BOOK 2921, PAGE 208 BOOK 3155 PAGE 60 BOOK 2841, PAGE 65 - -...im -- SEE PLAN BOOK 136, PAGE 96 f I i .� N 24'36 "E N46'46 42 E c --{a— _. 267.52' �.-- 32.61' 84.91' 150.00' 44.12' \ ck, .1 4- N .O N. CHAIN :1 ` TO BE 36.51, 40, 446 SQ. Q. FT. ± �� 3' 48 ' p 1 „ w 7• ci v% 1 839 "'' i POOL ■ 21q 90 , 0 1. , N/F WILLIAM V. & 3ARBARA A. RAKASKA `' t 300K 1749, PAGE 181 N/F `` _ _, 300K 3533, PAGE 342 a\ HAROLD D. HALLETT, JR. i551 \-~ 300K 3533, PAGE 344 BOOK 1166, PAGE 324 �, _ _ .... \ 'LAN BOOK 136, •' PAGE 96 ` ' r' 1._ 'LAN BOOK 162, PAGE 32 N. o S W N 3 �, G" 2� 5 .,1,1 X56 0 0 q.1' s� , !> 1 a\NO ..- b2 0 gE P X62 . \ "-- - . - - - - - -- PLAN BOOK ! PAGE 54 — ________ --- - __ _�,_ 0N 4k----;\ \AC. t p • "� Gat of Northampton • +i � B Jilcsaachasrtta • 3 "' DEPARTMENT OF BUILDING INSPECTIONS _ 212 Main Street • Municipal Building • Northampton, Mass. 01060 OW s ' s WORKERS COMPENSATION INSURANCE AFFI)AVTT (liccnscdPerrnittec) with a principal place of business/residence at: S JUAr `i'J /f/- tn4 /' j4 -.sr of L(phone;.-') 57 Pe (st r deity /statcJap) do hereby certify, under the pains and penalties of perjury, that ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (Ias nano Company) (Polio Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below vcho have the following worker's compensation policies: (Name of Contractor) (Insurance Company /Policy Number) (Expirdtioa Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Poticy Nu bes) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional shed if neccuary to include infonnatioa pertaining to all ood'radnrs) am a sole proprietor and have no one worI ng for me. ( ") I am a home owner performing all the work myself. NOTE: plr. -ae be aware that while homeowners who employ pawn to do m *fnten,00-, couurtutioo or repair work on a dwelling of not more than three units in tchich the homeowner resides or oo the grounds appurtenant thcc(o arc no. gcocrally considered to be employers under the worker's oempesatim Act (GL152.3n 1(5)), application by a homeowner for a liecase or permit may cvidcooc the legal rtar u of an amployor under tie Wocirdr Compere .iioa Act_ I uodaztaod that a copy of this ctatcmrot may be forward.od to the DcpartmmG of 1n4. Aoadmc,' Ofiioo of Incuraoce for the coverage verification and that failure to secure coverage under *n ion 25A of MOL 152 can laid to the imposition of criminal pc-mains cocaisimg of a fine of up to S1,500.00 and/or snprisoc>mcril of up to one year and civil penalties in the form of a Stop Work Order and a Imo 0(5 100.00 a thy against an For dcputrocce.ii use only Permit Number lvi 1 p4 Lot g Signature of LiccusccJPctmittce e r N • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : ✓fi e..4 ) P i 'mi. Ce'�i R 5' License Number S 3 `/ /C4.Z)^0ii c i - '704i 0 d er lO /2G /0---? Address Expiration Date �.�.,r,cs. -- 'c'Ps 2 - C.,. / / 3' f - 4 9( 7 Signature Telephone v.. ,,x' Not Applicable ❑ ��g e��f�oti'tern� p, .ernent��Co�fac`or ,� �� r _ �_Y. _�....aV».� ....x. PP f(1 7?2 4 it 0 /Zo d6 e Company Name / J Registration Number 5717 5717 'Z ✓i e— 77,/ ..z/ate /04 Address Expiration Date /V ')y Telephone .125 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 ❑ 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 _.■ ■' _ i .d`,. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. Demolition New Signs [ ] Decks [ ] Siding [ ] Other [ ] Brief Description of Proposed Work: 4 z t r.7 , � ° / ��� a 9 Z e GQr9t Z /vi�:" 4 0 4 6 , 9 t��c /a 51,E �a ? t ct oin �c' ✓��a I Alteration of existing bedroom Yes No Adding new bedroom Yes > No Attached Narrative 0 Renovating unfinished basement Yes "bc No Plans Attached Roll 0 - Sheet 0 6a: if Ne. _ td o adult' i tb7elrit ng o slag, torriplete #h "ef l.IaWing: 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. Mascheck 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 / /2/i e , as Owner of the subject property hereby authorize A2�r� St,/ to act on my behalf, in all matters relative to work authorized by this building permit application. - Ole Signature of Owner balte I, 111,6 , as Owner,CBi. t 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. C � .1 - Print Name Signatu e of OwnerAllgeat Dat- • • Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by (�/� (�(�� Building Department Lot Size Ye/ g-4) / v) % i 3 6 ) T r Frontage /5 //'& / d Setbacks Front .S dr.e 30 Side L: R: « ,24. 3 L R:c"®, c2 O Rear 8 p "2 9 �G Building Height • 15 — Bldg. Square Footage / l r� D Open Space Footage (Lot area minus bldg & paved 6 parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO N. DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO --X" DON'T KNOW 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 IF YES, describe size, type and location: • - City of Northampton <:�': cifi : uilding Department i �# . � .. : � 2 F O U� 2�p2 ji Street � V 100 Northa �,MA01062 . is �� � , , � . . nee l � 87 ' ►► Fax 413-587-1272 .may v �� � APPLIC l' A ER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLIN SECTION 1 SITE INFORMATION liThts section 1# 4 16"1:0 y4ffrGe ': '. 1.1 Property Address: ,�� v 0 � N / s ,/r /, c - hr/ Ma ' p �,. A.Lot , h i p z ��/ �i� e C h e -t cal .' 4 1 a W e .� r �Y f�- /4c7 Q� , i -- rwo#4� Zone �O ? rl OxstrE t Elm St Di CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: ' G /G , ' — De 11 4 A 3 %�Z he +l. r,.... .,/ Name (Print) Current Mailing Address: s 0 8S _. ../`. �_ Telephone 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 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) G ,2 e!, Q ad �— Check Number �� j +'� 4 This Section For Official Use Only Building Permit Number: J 5 Date Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2003 -0153 APPLICANT /CONTACT PERSON RICHARD DENNO ADDRESS/PHONE 551 FLORENCE RD (413) 584 -0852 PROPERTY LOCATION 551 FLORENCE RD MAP 37 PARCEL 001 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 1 Fee Paid V l(5 )2 97 Typeof Construction: REBUILD GARAGE 26 X 29, ENLARGE BREEZEWAY & ATTACH SHED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 066189 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION 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 Commiss' /I' 8 /S z © o - Signature of Building Offi 'al 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. 551 FLORENCE RD BP-2003-0153 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37 - 001 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2003 -0153 Project# JS- 2003 -0288 Est. Cost: $20000.00 Fee: $75.40 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: . Use Group: RICHARD DENNO 066189 Lot Size(sq. ft.): 40467.24 Owner: DENNO KAREN H Zoning: SR Applicant: RICHARD D E N N O AT: 551 FLORENCE RD Applicant Address: Phone: Insurance: 551 FLORENCE RD (413) 584 -0852 FLORENCEMA01062 ISSUED ON:8/20/02 0:00:00 TO PERFORM THE FOLLOWING WORK:REBUILD GARAGE 26 X 29, ENLARGE BREEZEWAY & ATTACH SHED POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector 101,7.407., Underground: Service: -- -- Meter: V0 7 ootings: Rough: Rough:/ /rt PIouse # Foundation: !` ��' Driveway Final: i6 M.0 G ' 16 - a i - A °-22 mK q -a4 .OP ; • Final: Final: / ,` f ea t t \ J Rough Frame: et. rg t t.- r-' Gas: Fire Department Fireplace /Chimney: n IV Rough: Oil: Insulation: Final: Smoke: Final: OK , 7 7 3 -- ' a - THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTH 2 PTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Si. nature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 8/20/02 0:00:00 345 $75.40 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo