29-107 (2) CHAPTER 281 OF THE ACTS OF 2006 Page 1 of 1
PCIT
Chapter 281 of the Acts of 2006
AN ACT PROTECTING CERTAIN REAL PROPERTY IN
THE CITY OF NORTHAMPTON.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the
authority of the same as follows:
SECTION 1. Notwithstanding section 6 of chapter 40A of the General Laws or any other general or
special law or ordinance to the contrary, the property located at 540 Ryan road in the city of
Northampton shown on city map 29 as lots 105 and 106 shall be considered 2 separate lots and shall be
subject to all protections that would have applied if the lots had never been held in common ownership.
SECTION 2. This act shall take effect upon its passage.
Approved August 30, 2006.
Return to:
List of�L.aws passed in 2006 Session
General Court-home page..,or
Commonwealth of Massachusetts_home page.
http://www.mass.gov/legis/laws/seslaw06/s1060281.htm 10/11/2006
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V5" DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building
Northwripton, MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as has/her construction supr.,,- .°;or. Tlie 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 inspection (if required) and a final building inspection. 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 can be 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
Department of Industrial Accidents
Office of Investigations
d 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
-Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information 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. E] I am a general contractor and I
6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working or me in an capacity. employees and have workers'
g Y P h'• 9. F1 Building addition
[No workers' comp.insurance comp.insurance.$
required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions
myself. [No workers'comp. right of exemption per MGL 12.r_1 Roof repairs
insurance required.]t c. 152,§1(4),and we have no
employees. [No workers' 131J 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.
tContractors 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
Investieations of the DIA for insurance coverage verification.
Zdrehy certify under the pains and penalties of erjury that the information provided above is true and correct re: °�� -Date: 1— 7
Phone#: q l -3 6 '1 -7— gIJL G
Of
fcial 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#:
N ,r
ECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: I o l eo j d r - Ly Lv k)
License Number
Address Expiration Date
Signature Telephone
9.Re 0merE Conta r Not Applicable ❑e f
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCEAFFIDAVIT(M.G.L.c.152,§2SC(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
N r
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicablei
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [C] Siding [O] Other[0]
rief Description of Proposed
Work: (iC•fi�
Alteration of existing bedroom Yes_v,,' No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement ,/` Yes No
Plans Attached Roll -Sheet
. �ezfstlncr'fors nm com tloccfitiotYts Nw ioe ar of flr folCoia�inz:
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.11
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING-PERMIT
1 as Owner of the subject
property
hereby authorize
to 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 and penalties of perjury-
'-1-.T{�e6 6 re. i ou1 Z I ,
Pr' t Name
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
Frontage
Setbacks Frnnt
Rear
Building Height
Bldg.Square Footage
Open Space Footage %
(Lot area minus bldg&paved
#of Parking Spaces
(volume&Location)
A. Has a Special Permit/Vorionoe/Findi ever been issued for/on the site?
�� ��
NO ����/ DON'T VV v��KNOW YES �~�
IF YES, data issued:
IF YES: Was the permit recorded at the Registry nfDeeds?
NO � } DDN7 VV KNO YES
��
IF YES: enter Book | Puge and/or Ducumont# �
�� ��
B. Does the site contain abrook, body ofm/atarurwetlands? NO v���� DON7KNOVV x�� YES �_�
IF YES, has permit been or need tu be obtained from the Conservation Commission?
Needs tobeobtained ^���-\ Obtained , �~«��� Datm �ssum��..
C. Do any signs exist un the propert �� ��y? 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 NO 0
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre oris it part ofo common plan
that will disturb over 1 omn? YES [ ) NO � )
�� ��
IF YES,then a Northampton Storm Water Management,Permit from the DPW is required.
Department use onto
City of Northampton status o1 Petrnit
49yotl
Building Department Gurl�CufEDRewaPeumt _
212 Main Streeteuver ;epttc�ivatFablit � ,
Room 100 VaerllNeil Aya�fabrtit ` �" _
Northampton, MA 01060 1 wa Sets of StruetriraF 'lans .
phone 413-587-1240 Fax 413-587-1272 sans r `
pthecSpectfym nit.f;
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE.INFORMATION `
1.1 Property Address:
Th"s!section to-becompUted byoff,
JI x
Nd tOt �nit
'O verlay Drstrrct
E1frr St Distrrct t� C�D�stt7ct _• .--. r
SECTION 2-PROPERTY OWN ERSHIPIAUTHORIZEDr AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address:
� o� h to-lhGn,:�7c�� 111 l7
�;Z=Z�Itk_. v �, one
Signa re /3 —C�
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
com feted by ermit applicant
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) Check Number
This Section For Official Use Only
Building;Permit Number. Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2007-0679
APPLICANT/CONTACT PERSON THEODORE D TOWNE
ADDRESS/PHONE 26 CHURCH ST EASTHAMPTON (413)527-9060
PROPERTY LOCA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tvveof Cons= n: CONSTRUCT SFH W/ATT GARAGE/PORC
VPRTMstiuction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 000724
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFQ MATION 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 ission
2 Q�
Signature of Building Official Dat
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.