17A-184 (3) 10/18/13 Northampton,MA Property Detail
Kitchen Remodeled (YIN): Yes
Bath Remodeled (Y/N): Yes
Land Data Outbuilding Info
[Square Foot Type
SQ Utilities
YPe Feet Value no
Prime information
Site
7,200 117,400' [
Type Qty Year Size 1 Size2 IGrd Cond
RG1 [fl 1929 11
Acreage Type
trYPe Acres,Value no
no information
information
Sales Info Permit Info
Date Type Price Validity
06/24/2010[Land+Bldg1389,50010 Date Permit It'Price'Purpose
08/19/2002[Land+Bldg 305,000 0 (no information
102/01/1984[Land+Bldg[82,500
10/18/13 Northampton,MA Property Detail
City of Northampton, MA: Residential Property Record Card
New Search Property Type Classification Code Reference Card 1 of 1
Parcel - Location - Zoning - Assessment
Map-Block-Lot: 17A-184-001 Zoning: Assessment:
Location: 181 NORTH MAPLE ST Neigborhood: 5 Land: 117,400
#Living Units: 2 Deed Book: 10213 Building: 245,200
Class: R-104 Deed Page: 261 Total: 362,600
Dwelling Information Building Sketch
Style: Conventional!,
12 Descriptor/Area
Year Built: 1928 A:UA/2Fr/B
14 E 14 1276 sgft
Story Height: 2 12 B 2s0 FP
Attic: Unfin 27 200 sqft
2Fr/B C:2s0 FP
Basement: Full 14 37$ 14 104 sgft
Total Rooms: 12 2 9 D:37� 8 � 378 8 s gft
Bedrooms: 4 2sOFP E Wood Deck
104 168 sgft
Full Baths: 2
Half Baths: 0 44 UA//2FFr/B 44
Exterior Walls: Frame 1276
Unfinished Area: 0
Ground Floor Area: 1276
Total Living Area: 3308 29
.;) ebFinished Basement Living 0 X 0 8 t_2b[ I a n o
Area: °
Basement Recreation Area: 0 X 0 Addition Information: Pr'I f ra et CIL_ S A:r g
Woodburning Fireplace 0/0' Mir
Stacks/Openings:
Metal Fireplace 0/0
Stacks/Openings:
Heat/Central A/C: Basic
Heating System: Stream
Fuel Type: Gas
Quality Grade: C+% Lower 1st Story 2nd Story 3rd Story Area
Physical Condition: Average Basement lone Story Frame lOne Story Frame Unfinished Attic; 1276,
Interior/Exterior: Same Open Frame Porch Open Frame Porch 200
Open Frame Porch Open Frame Porch! 104
Condition/Desirability/Utility: GD
Vacant/Dwell/Oby Status: Dwellin Basement lone Story Frame 'One Story Frame 378
g
'Wood Deck l 1 168
Additional Features:
Brick Trim: 0 X 0
Stone Trim: 0 X 0
Remodeling Data:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
L
=D = 1 Congress Street,Suite 100
—�•- Boston,MA 02114-2017
www.mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information // Please Print Legibly
Name (Business/Organization/Individual): `k 4N7in
C�leg It .L.
Address: r c J
� CG a/��•t �
City/State/Zip: Eqs/h are, f r /flit- 01027- Phone #:
Are you an employer? Check thtppropriate 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. ❑New construction
listed on the attached sheet. 7. ❑ Remodeling
2.1k,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'
g Y P tY 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.:
required.] 5. ❑ We are a corporation and its 10.0 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 D pp
employees. [No workers' 13 Other roil h /7:7 f'
comp. insurance required.] 5*12 114".
*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 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 for insurance coverage verification.
I do hereby certify under t 'inns and penalties of perjury that the information provided above is true and correct.
Si a ature: ��- Date: /0//i6 7 0( 3
Phone#: 14(3 371/ — (v i L
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
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: / Not Appppliliicablee 0
Name of License Holder: 1/�I 6�en//) Vle2✓1 e. 6
/- License Number
47-AA/OM S}- G tStkri..i//�iar.? IWO a/o a -7, /Zo/y!
Addres / Expiration Date
y/3 -379 -7x2 .4
Sign ture Telephone
9.Registered Home Improvement Contractor: Not Applicable ❑
ge�gen Gie'✓re /5383 3
Compan Name Registration Number
117--C 4 67t ■ S / �s .,,.�.,/o%ti M/-- eta Sy/072e.
Address Expiration Date
Telephone 11/3/�-3719Y26
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 f No ❑
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellines of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm
structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [CI Siding[p] Other •.1' .
0,--- • � ' • 4
// 'w- rI , Ir .' ice-
Brief Dekcripg on of Prpp s d ,t,,,�
Work: Ifepa[G lien 1% DR Col•,-c! O�j 04 (Of �r do.' /O pS0""VIVAP-, 1"1.$9,4- ' 7
/r "� rehs ,,36as 5.
Alteration of existing bedroom Yes No Adding new bedroom Yes No 4/ P t Z/ /2
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet "/9 r' l,4
6
7
a. 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
Ar OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, G[4-1t(20 A. ainIG{ oil ,as Owner of the subject
property ■
hereby authorize 5e0
nom/n �L Gevi
to act on my behalf,in all matterirelative to work authorized by this building permit application.
07. 31' 13
Signature of Owner Date I�7 r n
I, -b/gyp � C_
en, ��� /� ��n ,as Owner/Authorized
Agent hereby*tare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
f3P Pi 'ten 6[-e-e
Print Nam
Oct 46, 20, 3
Signatur of Ow 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
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage
Open Space Footage
(Lot area minus bldg&paved
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 Q YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW Q YES Q
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO Q 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 Q
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 Q
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.
•
— ��ri Department use only
- - ,,-.-- �-y'-t -i�-- \\V City of Northampton Status of Permit:
��` ; , -ullding Department Curb Cut/Driveway Permit
OC► 18 2013 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
--' Northampton, MA 01060 Two Sets of Structural Plans
Electra F.. =
N ''__._ r_ pfitone 4.1.3-587-1240 Fax 413-587-1272 Plot/Site Plans
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
f13/ /, /176, (L S 74(ezy Map Lot Unit
/-707eft� Aa Zone Overlay District
ex, co, 2
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
V-ikA'hrp A . T2-00 -1-11---5 N i tj I N. nA-A7 t-iE sr 'F-[�NLta Am- o I P 6z.-
Name(Print) Current Mailing Address:
A LI-I-3 -381-52-1`i
• Telephone
Signature
2.2 Authorized Agent:
Na _ Current Mailing Address:
if
ig .ture Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 3000 DD (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) '$ 0O , e9 C7 Check Number 9 41:5-
This Section For Official Use Only
Date
BuildinggPermit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2014-0486
APPLICANT/CONTACT PERSON BENJAMIN GREENE
ADDRESS/PHONE 47 Chapin Street EASTHAMPTON (413)374-9826 0
PROPERTY LOCATION 181 NORTH MAPLE ST
MAP 17A PARCEL 184 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building ding \'J2 J
Building Permit Filled out 1:k5q �/(C
Fee Paid O�`j(� -l
Typeof Construction: REPAIR FRONT PORCH(SAME FOOTPRINT) S
New Construction /�p� }• V
Non Structural interior renovations P".€1 d 1 r
Addition to Existing a S
Accessory Structure
Building Plans Included:
Owner/Statement or License 96066
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission _ Permit DPW Storm Water Management
%•lition Delay ' '
/O-/(71/ 3
ignature of B ilding 0 icial 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.
181 NORTH MAPLE ST BP-2014-0486
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A- 184 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-2014-0486
Project# JS-2014-000831
Est. Cost: $3000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BENJAMIN GREENE 96066
Lot Size(sq. ft.): 7187.40 Owner: ROUGHTON RICHARD A&ANNE E
Zoning:URB(100)/ Applicant: BENJAMIN GREENE
AT: 181 NORTH MAPLE ST
Applicant Address: Phone: Insurance:
47 Chapin Street (413) 374-9826 0
EASTHAMPTONMAO1027 ISSUED ON:10/21/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:REPAIR FRONT PORCH (SAME FOOTPRINT) -
post requires 1 sq ft bearing
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 10/21/2013 0:00:00 $55.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner