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32C-111 (10) fie eomvmonzu ea/,C! ol.. aoac%ivael4a Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to Board of Building Regulations and Standards r` Registration: 140264 \Zsof Expiration: 9125/2009 Tr# 133505 One Ashburton Place Rm 1301 Type: DBA Boston,Ma.02108 DAVE BRUSCO SIDING DAVID BRUSCO I.) •12 KINGSLEY AVE: � 1141/ _..- HAYDENVILLE,MA 01039 -,_.. — Administrator Not valid without signature WORKERS COMPENSATION AND EMPLOYERS'LIABILITY INSURANCE POLICY—INFORMATION PAGE INSURER: POLICY NO: WCT79279 NGM INSURANCE COMPANY 4601 TOUCHTON ROAD EAST SUITE 3400 RENEWAL OF: WCT79279 JACKSONVILLE, FL 32245-6000 NCCI Company No: 16322 Account No: CACT7 9 2 7 9 ITEM 1.NAMED INSURED AND MAILING ADDRESS: AGENCY NAME AND ADDRESS: DAVID BRUSCO FINCK & PERRAS INS AGCY INC#2 DBA DAVE BRUSCO SIDING 12 KINGSLEY AVE 6 CAMPUS LANE HAYDENVILLE MA 01039-9708 EASTHAMPTON, MA 01027 AGENCY PHONE NO.: (413) 527-5520 AGENCY NO.: 200294 LEGAL ENTITY: INDIVIDUAL OTHER WORKPLACES NOT SHOWN ABOVE: (See Workers Compensation Location Schedule) ITEM 2. POLICY PERIOD: From: 04-19-2008 To: 04-19-2009 Effective 12:01 A.M. Standard Time at the Insured's mailing address. ITEM 3. COVERAGE: A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers' Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident: $ 100, 000 each accident Bodily Injury by Disease: $ 500,000 policy limit Bodily Injury by Disease: $ 100, 000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: all states except: ND, OH, WA, WV, WY and states designated in ITEM 3A of the information page. D. This Policy includes these Endorsements and Schedules: See Schedule of Forms and Endorsements. ITEM 4. PREMIUM: The premium for this Policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required on the Workers Compensation Classification Schedule is subject to verification and change by audit. Please see Classification Schedule. Total Estimated Minimum Premium: $ 500 Annual Premium: $ 3, 878 Audit Period: ANNUAL Date: 04-07-08 Countersigned by WC 00 00 01 A Copyright 1987 National Council on Compensation Insurance Pane 9 of d SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: (� Not Applicable ❑ Name of License Holder: p fit) 1.® R r i ' (d ( 1 o z License Number t2 KtuS � .� A•)e1 It,R}Il .o1 PA 119s9 1IzS. I LOCI . Address Expiration Date Signature Telephone 9.Registered Home Improvement Contractor_ Not Applicable ❑ Company Name Registration Number Address Expiration Date 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 Exempti©n. The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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 he 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 Ayith the State Building Code,City of Northampton Ordinances,State and ,ocal Zoning I,aws an State of Massachusetts General Laws Annotated. Homeowner Signature / 1.1 r SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing n Or Doors E Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [p Siding] Other[D] Brief Description of Proposed Work: V 041( Sit 'L Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet ea.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, l(?-` " V C ('I VL.e. , as Owner of the subject property hereby authorize 17AJ B R I)Stc to act on my behalf, in all matters relati':3 to work authorized by this building permit application. Signature of r Date l 1 4-1-1 au(Cote , as Owner/Authorized Agent hereby declare at 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. I I.-I- Print Name il. - f , Signature of Own- 'gent Date De) artmen.#:use onEy City of Northampton Status of I'srtnt: JUN 2 6 2008 Building Department curb Cutroriveway Permit 212 Main Street SewertSepticAvaEEabil4y --1 room 100 Water/itjteii Avaiiability L' fJortham ton, MA 01060 Two Sets of Structural Plans • phone 4'r3=58''-1240 Fax 413-587-1272 i5iot/Site Plafts 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 c2 3 5 6.1(l t4. S--f1��Z�1, Map Lot Unit b t 1 /J a M1 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHrr'/AUTHORIZED AGENT 2.1 Owner of Record: L7 Te+- 1 G u f f 1vt V‘16 O" ( J �l G�e r 14- A � ot, Re, v e 1-tR Name(Print) Current Mailing Address: 01'S 1Y Ai;:k '14 —1— cr.114 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 _ 610itllioz 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) Check Number I 0 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date BP-2009-0015 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: vinyl siding BUILDING PERMIT Permit# BP-2009-0015 Project# JS-2009-000014 Est. Cost: $10000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DAVE BRUSCO SIDING 140264 Lot Size(sq. ft.): 8842.68 Owner: GORFINE TETTY Zoning: SI Applicant: GORFINE TETTY AT: 23 SMITH ST Applicant Address: Phone: Insurance: 146 OLD SUNDERLAND RD (413) 367-9874 0 WC MONTAGUEMA01351-9510 ISSUED ON:7/2/2008 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING 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 7/2/2008 0:00:00 $25.00302 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo FJ r 141# 'T�P �6 f� Cj/ 61( 111111111*% y1/ �1 � /� N l.I°w. INN 5 i,/ ,e/1-7' tea.S 7 NL� �"°I ''��' f i S r }( i p/tE5v/_z.r1 E 514-;/16g/1- 9- X /,2- 7'4 e/'-rk,e, C L LA/ 9-X P '- z..)./ 4-vs T ems 1 611 ;F t-r �� �5 fU T/IVES PV51'YC. 'S T "c /0/f Se'/v,..r w/ ;6 Ile o-r Foo-r;' I Northampton,MA Property Detail Page 1 of 2 City of Northampton, A: Residential Property Record Ca New Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map-Block-Lot: 32C-111-001 Zoning: Assessmen Location: 23 SMITH ST Neigborhood: 16 Land: #Living Units: 2 Deed Book: 6794 Building: Class: R-104 Deed Page: 184 Total: Dwelling Information Building Sketch Style: Col/Gam Year Built: 1900 Story Height: 2 Attic: None Basement: Full Total Rooms: 8 Bedrooms: 4 14 Full Baths: 2 Half Baths: 0 2Fr Exterior Walls: Frame 20 20 Unfinished Area: 0 Ground Floor Area: 567 14 Total Living Area: 1694 21 Finished Basement Livin g h/toX Area: 0 X 0 Basement Recreation Area: 0 X 0 27 2Fr/13 27 OFP_ Woodburning Fireplace + Stacks/Openings: 0/0 (� 1144,i y Metal Fireplace 0 /0 L,ni r Stacks/Openings: 21 6 Heat/Central A/C: Basic Heating System: Warm Air Fuel Type: Oil Quality Grade: C Physical Condition: Average Interior/Exterior: Same Condition/Desirability/Utility: AV Addition Information: Vacant/Dwell/Oby Status: Dwelling http://www.northamptonassessor.us/noho/propertydetail.php?map_no=32C-111-001&page... 6/25/2008 . - 7/9 LL .ev, Fa,r ;4/6 5) c “ -. l Z /" -19 - 'j"f�'' , J E � � 61/L ,e)CO 71_5- 3. it J"I v" T L V o t"c& F ire$y F Lee*4_ AND 6.w.fv3lx4 '.'-7 ,"-'i v a /toe vt� � ��"� � I1.4 f1,194 y. � „ � LgSc 711/ X 61 00l ,. / At- ;Lo ,F47;7 + 4,04 PoseP L. 2,7v6 ;.0E Ft"` e' FF iC C _50L E . 'y Ave (. )--149' ' 4, e•v L,AA6i c/o 'elite:K s �o zassacfpcscfs 1 ` •- c _-- DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building \'a-,y= Northampton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction sups: ,- sor. 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 any 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 ins•ection if reauired and.a_final_buil• •a ins section. 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 ran he 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 The Commonwealth of Massachusetts --i Department of Industrial Accidents 7.1 _tlj..�. Office of Investigations - l 600 Washington Street - Boston,MA 02111 s°• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): L D V;.S ` Ga i 4/6 4 AS Address: ,?-1-1 4 I-Jil Y,0 N 1/,L L f no, 1.... 4491" :MA. o/e S',3 City/State/Zip: 4.l&46S "IA. 010 5 3 Phone.;: '-I i 3 - S 2 4 -7'1 2-e Are you an employer?Check the appropriate box: Type of project(required): 4. I am a general contractor and I 1.0 I am a employer with 6. Q 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. ®Remodeling ship and have no Ailey ees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' g Y $ 9. ❑Building addition [No workers'comp.insurance comp.insurance' 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ eP 3.Q I am a homeowner doing all work officers have exercised their 11.Q Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.Q Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.Q Other comp.insurance required.] --"---'any applicant that checks oox#1 must also all-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 the pains and penalties of perjury that the information provided above is true and correct ih°fo -• gi�tatire� Date: [•° P-la _ Phone#: Li 13 6'2'4 "" "7 q A'AC) d I Of iciai use oniv. Do run'.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 CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone T: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: �+td V i S ✓ G i Ab l/I S C S 31 4-'7 License Number y H/9y�Giv ��c� !��. /.kfas ,/VIA, ores 3 ) .1111 Address _ Expiration Date - •-elios 0.— 413•- 6-P4--7Y c2•1 Signature Telephone 9r-Re4�stered Home'ImP�ovem`ent Contracfor e _„, _ Not Applicable ❑ Law7►4 rr, 6,w6/10S / :33 111 Company Name Registr tion umber �t 1-MVIJc.v1/0 L4.6 nil, t...4 64.s Mi9. c /cs:3 41 *7 Address Expiration ate 40"^7a • Telephone 9l3' 76'-7 y:$0 SECTION 10-WORKERS'COMPENSATION INSURANCEAFFIDAVIT(M.G.L.c 1'52,§-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 X No ❑ I1.� 1J `m t-, e ptro 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 n Addition ❑ Replacement Windows Alteration(s) n Roofing El Or Doors IX. _ Accessory Bldg. ❑ De olition IX New Signs [D] Dec [Q S'aiegiSaa Other j is J/ /k...i+I Brief Descripti of. , ed ' N r / 'Ul°1 Work L t .,C C -7/)4-4-14-7/)4-4-7/)4-4-14;. I-T Alteration of existing bedroom Yes x No Adding new-bedroom Yes No Attached Narrative Renovating unfinished basement Yes X No ;rue- ,,,/��1�, . Plans Attached Roll -Sheet C.rCC `��(/l_ sa_if isl'6 Ftauseand araddltioi to-existm hOLIS01 x -C plete^the lafiO*111 : 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 lo. s cons ru ion i ++ I . ••••• 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, 7e 44 b G '%( % ,as Owner of the subject property J hereby authorize L e i's' S 3` 6;~6 R o s to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of O r Date j 1 1,0 i,,;S j 6. 4!6.1 A S ,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 paiiis and penalties of perjury. Print Name ,.....--A,,,.....,..../. .4.....„, 4,b.ti;I e I Signature of Owner/Agent 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 g 1 l 2 $a FTC Frontage Setbacks Front Side L: - R- - L: R` Rear • Building Height Bldg.Square Footage . .% i , Open Space Footage % (Lot area minus bldg&paved ' parkina) I I I ' #of Parking Spaces Fill: ! (volume&Location) i ' A. Has a Special Permit/Variance/Finding ever 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 Q DONT KNOW +:4 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ►4 DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES © NO (R, IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO rte. 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 0 NO g IF YES,then a Northampton Storm Water Management Permit from the DPW is required. .. .__ . .- ,,,„ „„tt.:,-,. .;:i..„-- _,__--▪ -• -..:T=„,,,,. ,==i, - City of Northampton ,,,..,§ ii i--.ztif _bit77.r1.75,4- f:-.I7-ii'p7-3W-..;,- 7=;;;;-:=-4-7 - ....=,[17 -:• at.,,,,,cevite.77.720-02R_feelarp_ 1 ,::„,_,,, 6,7.I.-;;::ciii-4-,--;;;715-5.-rwli ,--- .-(7..54/r1.-'5-----„,r--4---teerrrilta-L--,z,----,.,----- 7.---7.----....,,--77-- ,-.7--=' -e4 ----- 1 63dilang Department ' 1 :7---7 ,--,-,---- ---wiz.;?_3,---,--,--,74,--,,,,,,,‹:.-.- ---. ..-,7ter.„:,-..-ir---1;_:,„,,,,,_. 1,-;-• ', -' '=----' -- 212\Main Street 'Room 100 ---- = * ' m 7 20i■Irthaptioton, MA 01060 . , VA pticine 413-58T-124: Fax 413-587-1272 , \ AF,ptisiAtibil'.76,6ctt' ,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING f-SECTIONA-SITE INFORMATION ,,...:a--,:-.,-- . -7.77-7; illf:s.i41;ft'7.7717::-7:-.12::1;--'.:2;:.:271-11::: RsHIplAuTHoRizEry AGENT I:4-1:::7Zn ',..-F-,- . ,-7::::-.. ,-;,-"_-:1-,7,:-:-- :':-E;E'g-SL::.7772,-,77,=:.-:::::: 1 1 Property Address: ...),.. 3 s Aot i 714 5 r• „, A. vip fie A■pil-rI-1 A•migr‘it' '-''' SECTION 7-PROPERTY OWNE 2.1 Owner of Record: : :-_.„: ::,:t---':,!:::,.:;1-::;_-.:-'...::::':;:toti- Avrariv-----i• --7.7.'_ "_---:_,---4,,,,------:.I :-s-t-:•-_-mr,zt. :_-:f-2v-L,-=y- E-7,::::::'_- - _,---' ,-;1 -1;:::;:..,Sr'-''', -*:::: ,::=":7-..-,g7-,::: ::--k':-7:-E,i_-;; :4:-.,-4-3.:,-E-g: _... .....Z...-.,''-a,- ^ovidaTDtstrict ''''''''''Z''''''5';'''';'J:=5.4: ..."-::::-.•''T,..--',^-,"---,-,-.:-L., ''''':,',5-1;112, ,j":22.::;,F,...2,.:1,i4:,,,..s.„..,:.,_,_._, ._ ,_ ...--"" t4 6 01 d ( 1 ,, , m....fritki .,,A t 4‘. %.1 I 0,1 14t AlAtiv(i ki k 01%9 I e,+-4-,/ Go Iktk AA Name(Print) Current Mailing Address:(tit 3 1 361_1 al ../ Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature - Telephone SECTION 3-ESTIMATEO CONSTRUCTION COSTS 1 Item , Estimated Cost(Dollars)to be Official Use Only., . completed by;permit applicant 1. Building '--(a).-Building Permit Fee - ) 2. Electrical ;(1.7):Estimated Total"Cost of - -Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) .-. 5. Fire Protection - 6. Total =(1 +2+3+4+6) ' Check Number -, -- This Section For OftCiaTUSe Only ---2- 4-"-- - — ----7- '--.- Dare - Building Permit Number 'issued: Signature: . . . Bt,ildingCommissioner/Inspector of Buildings - Date ...'. ... '.... - , . .....,. - ... : File#BP-2009-0014 APPLICANT/CONTACT PERSON LOUIS J GINGRA.S ADDRESS/PHONE 244 HAYDENVILLE RD LEEDS (413) 586-7420 PROPERTY LOCATION 23 SMITH ST MAP 32C PARCEL 111 001 ZONE tt -C_- THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid /7 Typeof Construction: REBUILD 2ND FLR EGRESS,REPLACEMENT DOORS,ROOF OVER 1ST FLRENTRY,CONSTRUCT LR WALL TO CREATE OFFICE SPACE&HANDRAIL ON SIDE PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 087279 3 sets of Plans/Plot Plan L(sc O1 ,;F# pep))D we; z,,,,,,z,,,,,, 1 ¢aJ) 60 M?4i 5 Wc_thu PP`(-F'' it- / THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION 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 Peanut DPW Storm Water Management Demolition Delay X-LA---i. ifilL4-1.--T erj.—e—as__ CV/4)t 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. • Zoning Board of Appeals - Decision City of Northampton Hearing No.: ZBA-2008-0021 Date: July 25, 2008 FILING DEADLINE: MAILING DATE HEARING CONTINUED DATE: DECISION DRAFT BY: APPEAL DATE: 6/24/2008 7/19/2008 7/31/2008 REFERRALS IN DATE: HEARING DEADLINE DATE: HEARING CLOSE DATE: FINAL SIGNING BY: APPEAL DEADLINE: 7/12/2008 8/30/2008 7/24/2008 8/7/2008 8/14/2008 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE: DECISION DATE: 7/10/2008 7/24/2008 7/24/2008 7/25/2008 SECOND ADVERTISING DATE: HEARING TIME: VOTING DEADLINE: DECISION DEADLINE: 7/17/2008 5:30 PM 10/22/2008 11/26/2008 MEMBERS PRESENT: VOTE: Malcolm B.E.Smith votes to Grant David Bloomberg votes to Grant Sara Northrup votes to Grant MOTION MADE BY: SECONDED BY: VOTE COUNT: DECISION: Sara Northrup Malcolm B.E.Smith 3 _Granted w/Conditions MINUTES OF MEETING: Available in the Office of Planning&Development. I, Carolyn Misch, as agent to the Zoning Board of Appeals,certify that this is a true and accurate decision made by the Zoning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk on July 25,2008. DI „v/l I certify that a copy of this decision has been mailed to the Owner and Applicant. C4V1611 1111/4-161 - JUL 2 5 2008 R CITY CLERKS OFriCF NORTHAMPTON, MA 01060 NOTICE OF APPEAL An appeal from the decision of the Zoning Board maybe made by any person aggrieved and pursuant to MGL Chapt 40A,Section 17 as amended,within(20)days[30 days for a residential Finding]after the date of the filing of this decision with the City Clerk. The date of filing is listed above. Such appeal maybe made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of Northampton. August 15, 2008 I, Wendy Mazza, City Clerk of Northampton, hereby certify that the above decision of the Northampton Zoning Board of Appeals was filed in the office of the City Clerk on J.uIy^25, 2008, that twenty days have elapsed since such filing and that no appeal has been filed in this matter. Attest: /r „, City Clerk-City of Northampton • GeoTMS®2008 Des Lauriers Municipal Solutions,Inc. � � REGISTER A T. EST: HAMPSSIRE,✓r M9RIP,NNE wn� L. DO$OiiUE 11 11 111 11 11 11 11 I II II 111111 Zoning Board of Appeals - Decision City of Northampton 2008 00018370 Bk:9573Pg: 346 Page: 1 of 2 Hearing No.: ZBA-2008-0021 Date: July 25, 2008 Recorded: 08/18/2008 02:54 PM APPLICATION TYPE: SUBMISSION DATE: Special Permit 6/26/2008 Applicant's Name: Owner's Name: NAME: NAME: Tetty Gorfine Tetty Gorfine ADDRESS: ADDRESS: \ °r 146 Old Sunderland Rd. 146 Old Sunderland Rd. r --,� li'' ,' TOWN: STATE: ZIP CODE: TOWN: STATE: ZIP CODE: r MONTAGUE 7i9A 01351 MONTAGUE MA 01351 PHONE NO FAX NO PHONE NO FAX NO.: A,,4G 1 g 2008 EMAIL ADDRESS: EMAIL ADDRESS: r C.',1!iS : ' Site Information: Surveyor's Name: STREET NO.: SITE ZONING: COMPANY NAME: 23 SMITH ST URC TOWN: ACTION TAKEN: ADDRESS: NORTHAMPTON MA 01060 Approved w/Conditions MAP: BLOCK: LOT: MAP DATE: SECTION OF BYLAW: 32C 111 001 Chpt.350-10.12:Home Occupation Special TOWN: STATE: ZIP CODE: Book: Page: Permit Criteria 6794 184 PHONE NO.: FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK: HOME OFF/OCC REG-PSYCHOTHERAPIST HARDSHIP: CONDITION OF APPROVAL: 1) Clients may only be seen weekdays with no more than 15 clients per week. FINDINGS: The Zoning Board granted the approval based on the information submitted in the application and the Board found that: A. The requested use protects adjoining premises against seriously detrimental uses. The use of the property will continue as a two- family house. B. The requested use will have no effect on the convenience and safety of vehicular and pedestrian movement within the site and on adjacent streets, because C. The requested use will promote a harmonious relationship of structures and open spaces to the natural landscape,existing buildings and other community assets in the area. No changes on site will take place. D.The requested use will not have an effect on city resources as the two family uses will remain the same. There is ample parking and the site is walkable from downtown and surrounding neighborhoods. E. The requested use meets special regulations set forth in the Zoning Ordinance under section 10.12 as specified in the application. F. The requested use bears a positive relationship to the public convenience or welfare. The use will not unduly impair the integrity of character of the district or adjoining zones,nor be detrimental to the health,morals,or general welfare. The use will be in harmony with the general purpose and intent of the Ordinance. G. The Sustainable Northampton Plan calls for greater mixed use and inflll within this portion of the city that is walkable to and between neighborhoods and city services. COULD NOT DEROGATE BECAUSE: ® E C E v q E v JUL 2 5 2008 CITY CLERKS OFFICE NnDTUnr;ntr-nro nna Mc?' GeoTMS®2008 Des Lauriers Municipal Solutions,Inc. �, ' V File#MP-2008-0080 APPLICANT/CONTACT PERSON GORFINE TETTY ADDRESS/PHONE 146 OLD SUNDERLAND RD (413)367-9874 O THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out /s_ Fee Paid t/0719 Typeof Construction: HOME OFF/OCC REG-PSYCHOTHERAPIST New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 C ssion Permit DPW Storm Water Management 2/4 e 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 the Office of Planning&Development for more information. 23 SMITH ST BP-2009-0014 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:32C- 111 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-2009-0014 Project# JS-2009-000014 Est.Cost: $6000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LOUIS J GINGRAS 087279 Lot Size(sq. ft.): 8842.68 Owner: GORFINE TETTY Zoning: URC Applicant: LOUIS J GINGRAS AT: 23 SMITH ST Applicant Address: Phone: Insurance: 244 HAYDENVILLE RD (413) 586-7420 LEEDSMA01053 ISSUED ON:7/14/2008 0:00:00 TO PERFORM THE FOLLOWING WORK:REBUILD 2ND FLR EGRESS,REPLACEMENT DOORS,ROOF OVER 1ST FLR ENTRY,CONSTRUCT LR WALL TO CREATE OFFICE SPACE & HANDRAIL ON SIDE PORCH *USE OF SPACE PENDING ZBA/SP POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: 6 l` 7/L %/d� 1/xis Footings: III Rough: Rough: House# Foundation: 11 Driveway Final: y Final: - )'` i Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: 4 Final: 1 `,' Smoke: Final: o K O:;(l 5(0 t.-01A4 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. e.4gr° 747 Certificate of Occupancy 1.4" Signature: ^ s FeeType: Date Paid: Amount: Building 7/14/2008 0:00:00 $50.001420 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo