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35-242 (2) __ __ __ __ __ __ __ __ __ __ __ __ _ 10, 01 jp ITION OFFICE ROUGHOUT NEW DOO 1�7— R OFFICE RADON, door to remain UP INDIREDTW,H, install new oil line to boiler. UTILITY SCHROEDER BASEMENT REMODEL :WASTE LINE � PUMP../FILL ! | `E / - | - - - - - - - - - - I II II II II II BULKHEAD TO BE RELOCATED II I , I II I II II II II II II I ! access panel to crawl space L APROX LOCATION OF NEW I C REC, REMOVE PART BULKHEAD I i NE HI LITE STORM THI DOOR x � i J I _READY FOR OWNERS CARPET J i 1 add microlam and sheetrocklbeam/ SEP ZONE FHW HEAT remove one lolly . V�'o;�f L�11ly �oCry-7�i•� !- - - - - - - - - - - - - - - - -_ - -- - - - - - - - - - - - - - - - - - - - - - - - - - - �-- FRAME FOR FUTURE BATH ceramc REUSE DOUBLE DOORS CUT FLOOR;'0 I verify AND EJECTOR WITH PEA ST01 - - - - - - - - - - - ELECT PANEL I I I OIL TANK WASTE LINE - --- - - - - - - - - - - - - - - - - - - - - - i L i I i i I �I 1 !.II:cI (BIZ 11-811 i N !I I I i T- I � i i I i� Ll I I "'2,T?' E!, i?"SPECTION,S 212 Mnj 0 r n:11 01060 C K --1c7: 63 (c- 11 7, 113 211s 5— 'C; -:3 e7 tCl Opt) p-:ir-' S't SECTION 8-CONSTRUCTION SERVICES If] 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: �- 1 f L lt4r,0--) License Number G 1 f't Addre Expiration Date � l gnatur Telephone au ,.^r.,as_.nr— --:i' "'2,n dr"' v-.:v "' ,,'y" ,- 9 Rea�sfered Homemprovement Contracar_ �; °; Not Applicable ❑ Company Name r Registration Rum ✓rr - -" -" 17 Address Expiration Date YJA Telephone ti/.7i SECTION 10-WORKERS'COMPENSATION INSURANCEAFFIDAVIT(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...... ❑ IT �'�- 11 r :Homer Owsne>r emption 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-vear 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 pen-nit. 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 r.. SECTION 5 DESCRIPTION OF PROPOSED WORK(check-all applicable) New House [] Addition [] Replacement Windows Alterations) Roofing Or boors � Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding[O] Other[0] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. If-New houseandorad"dition.toexisfing houslng,:complete.theoficiwlng: 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- as Owner of the subject property hereby autho ze Q to ik myl ha matters relative to work authorized by this building permit application. -7- Sign ture of O n Date �1_?4' (4n J1p f 7 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. Pri ame —: gnature of O gent Date . . . ` ' Section 4. ZONING All Informati6h 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 r Rear . Building Height . Bldg. Square Footage Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces (voluniel&Location) A. Has a Special Permit/Variance/Finding ever been issued for/nnthe site? y_� �� NO �~�~� \^�� DON7 KNOW v�s ^~� IF YES, date issued: IF YES: Was the permit recorded at the Registry u[Deeds? NO �� D0NTKNOVV YES�� z�_ | '--------- IF YES: enter Book Page� and/or Document#L� —— �� �� B. Does the site contain u brook, body ufxvaterorwetlands? NO ^���� DON7KNOVV \_� YE3 �_� IF YES, has permit been or need toba obtained from the Conservation Commission? - Needs tobaobtained x�\ Obtoined /—� Date � | �~� \~� ' C. Du any signs exist on the pruport �� ��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 /-� NO 0 IF YES, describe size, type and location: ' E. Will the construction activity disturb(clearing,gradingexcavation,or filling)over 1 acre orinh part o[o common plan that will disturb over 1 acre? YES ��� ) , NO < } / `_� IF YES,then a Northampton Storm Water Management Permit from the DPW is required. J r ;e City of Northampton Building Department 212 Main Street S Room 100 Northamp on; MA 01060 -W r, ara. ta ,�A phone 41.3-5 7-12}0 Fax 413-587-1272 Pao f an OFte pect x � .. -APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: wJ a This section,tobe completed by office Map Lot Llntt /� Zone'-, i '" � + ?=Overlay`D►str�cf. SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record_: Nam Current Mail'n Addre s: Telephone Sign ure 2.2 Authorized Agent: me(Print Current Mailing Address: LJr ` �r r7 — nature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit 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) QJ� Check Number This'Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2009-0210 APPLICANT/CONTACT PERSON KEITH HAMILTON ADDRESS/PHONE 17 ORCHARD ST EASTHAMPTON (413) 587-0763 Q PROPERTY LOCATION 39 LADYSLIPPER LANE MAP 35 PARCEL 242 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCT BASEMENT FULL BATH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 074129 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Demolition Delay Signature of Building Official /Me 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. BP-2009-0210 GIS# I44 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: BUILDING PERMIT Permit# BP-2009-0210 Project# JS-2009-000277 Est. Cost: $10000.00 Fee: $60.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Groin KEITH HAMILTON 074129 Lot Size(sq.ft.): 60984.00 Owner: SCHROEDER ROBERT&CAROL Zoning-: SR Applicant: KEITH HAMILTON AT: 39 LADYSLIPPER LANE Applicant Address: Phone: Insurance: 17 ORCHARD ST (413) 587-0763 O WC EASTHAMPTONMA01027 ISSUED ON:812912008 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT BASEMENT FULL BATH 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 8/29/2008 0:00:00 $60.007489 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo