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{UL i AUG 10 2005
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DEPT Cr-
Attn: Building Commissioner
From: Mike Badorini
Attached please find foundation and framing details to be inclu&d with the building
permit application submitted for
109 Cardinal Way
Florence, Mn
16' x 24' poolhouse/shed
thank you,
MAe$adorini
413-563-4720
TO 39va ANVdWOO QNd-30H
86ZT-EbL-ELb bb:OI 500Z/0T/80
MORTGAGE LOAN INSPECTION
P
AMP
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1 c)(3 dab et c !e a ,..
LOCUS REFERENCE.
Book 6790 Page 0106 (Portion)
Plan Book 192 Page 84
TO:
National. City Mort a e Co - ---- --°
.First Americana Title Insurance Co OWNER: David. M. Lepine
AND
1 hereby report that the premises shmm on this plan are LOCATION
-
not located witin a Flood Hazard Area as shown on the Cardinal Way, Lot 4
Federal Emergency Management A.geney°s Flood Northam ton Massachusetts
insurance Rate Map,
Community No. 2,50167-0001A __ � E. B. TIOLMBERG & Associates
Effective Date April 3, 1978 LAND SURVEYORS
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7 ThTTOIXT C+IM V7."r =A Q'rT-T A 1LA1M+'TA %,T A.4 A n 1 n')'7 nnA C
� � �i'ilassacltusetts -
sr. DEPARTMENT OF BUILDINTG INSPECTIONS
INSPECTOR '212 Main Street • Municipal Building 'a
Northampton,MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as l:is/her construction sups: , i so r. The state defines "Homeowner" as, "Person(s)
who owns a parcel on which he/she resides or intends to be, a one or two fanu -
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 fegulations. 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 sour), 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 individ 1 trades to secure the permits and inspections as
required can DELAY t c til such time as the proper permits and inspections are
made
I, understand the above.
(Home owner/rest ent's signature requestin a on)
I will call to schedule all required building inspections necessary for the building permit
issued to
Date VCS ' ' C/�
Address of work
location
r
Grim of �'Ta tljalliptoi) - _-
P J E 'qtc3aAc4nrcIIs' _
DEPARTNIE14T OP BUiLDD\IG INSPECTIONS
212 Main Strcct Nfunicipal Duilding
Northampton, Mass. 010G0
«'O RIC:-R'S CO NIT EN S A-M N MS URA.-N CE A 17FM
Ivith a principal place of business residence at: - -----
Car- (! hone;') i3 - S2SIC�
(strtxtl6 ty Isla tcfa P)
do hereby certify, under d)e.p trts and penalties of perlt�j-l�2I �
( ) I am an employer providing dic following!%vorkces comocnsado, coverage for my
emplovccs worloag on Nils job:
i
(Insurmc Cocz=v) (Pt lip:Nu-mir_r) -- C-:-piration D2i--)
O I am a sole proprietor, general contractor or homeowner (clicie one) and have hired
the contractors listed below wbo have the follo'ViOpz worke>'s comoensaiion pokies,
(Namc Oi Con=aoi) Gnsuranc:. Coinparl)-Pi NumII CT) (ExulFJuon D.Itc) -
(Name of Coamctor) CLastu-a.ncz Comoan`i?o6cv Nttncrr) (Lxpir.6on Date)
(Name of Coaa-acl ) Jnsuranc:. Compa=)•/PoUcy Numbu) (Expimooa Date)
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(Name of Contractor) (Losuranc—c Comoazy/Policy Number) (Expiration Darr).
(&M—h:.ddi-�ocal rx-a,ifacc '-to c�etu�saformi'ioa pertaiai.as w.1!acs-_eo:s) -
{ ) I a.m a sole proprietor and bave no one wonting for me-
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I am-a home owner performing all the Nvork myself.
NOTE:pl,-,^be ztvart:tl—vet Ie bcmcr vm -bo e¢tplay pcLo=LO d� cs.:cjuo r n.pair work m a d.•ell_C of
aot ante tb:a ttzex tcsia is--bich tlx boaw�vncr rt mdo or ca the rjt=43>a�tbec r. Oot C=)=Uy cersd--ad w t+c
—Vlcra—11 c the..ui c'z oa2{>�oa Arw(GLt 32.s 1(5)),=,pti,naon try a bomco.va far=!c .a Pmt zy c idc tb<
lcS%I n--+,•of as— loyw uodr din WockzeL Compoo3alioc Au.
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[yad---d tha a copy orth6 mtcm m may be foco vd.d to the Dcp.t of Indurrid Aced ty Office or t�-ror t6. _
cov=ra vcit mlioa--id th:s L-um to"o=covcraye undo auction 23A of MOL 151 Qa ltd to the i=POSaioa oral=aal Pca%Wli
eoaiis of a fiat Orup to S 1,500.00 andfor i:=pr6o® ortt to trot - =d c.i1 .io io t c roan ora Stop work Ord-aad a
P � l� -
fun of 5100.00 a day Lpjati Or-
. �` ✓ For 6oyuta+=mil u,e only
Jf Permit Number
r A�p°i Lot 11
S acre of ermitrec -
J .
SECTION 8-CONSTRUCTION SERVICES 71
8.1 Licensed Construction Supervisor: Not Applicable
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
9�7egise"'red`linefimoEa emeCaitfra Not Applicable 0
Company Name Registration mum er
Address Expiration Date
Telephone
SECTION 10 WORKERS'COMPENSATION iNSURAN"CE*F'FI 64 Vir,o I.G:L.c:'152,425C(6}j
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"certifNis and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State cZlmng La and S ass setts General Laws Annotated.
Homeowner Signature
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SECTION 5--DESCRIPTION OF'PROPOSED WORK(check-alF-aoplicableY
New House 0 Addition Replacement Windows Alteration(s) Q Roofing
Or Doors C]
Accessory Bldg. Demolition 0 New Signs [0] Decks [p Siding[o] Other[E]
Brief DeWiption of Proposed '/
Work: GowsrR(AcT /L x�� Poo L. //OuSi SHED W/TN 6 $-�JC457- 4441s
Alteration of existing bedroom Yes V No Adding new bedroom Yes No ./
Attached Narrative / Renovating unfinished basement Yes V No
Plans Attached Roll Sheet Y
6a_�fNevu--hoc>�s��na�ddt#ian 7ons 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. Dim
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conser ration Complian Masscheck Energy Compliance form attached?
IV
h. Type of con r i
i. Is constru I n i f 00 ft.o etlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of a ent liar floor below finished grade
k. Will buildi nform to the Building and Zoning regulations? Yes No.
I. S is Tank City Sewer Private well City water Supply
SECTION 7a-OWNERAUTHORIZATIC�N-TO-BE COMPLETED WHEN` ,
OWNER �4PPLIES:FOITBUICAINGC PP-RMIT-
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
ast�=uthorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the b€f of my knowledge
and belief.
Signed under th s and penalties of perjury. '
Print Name
Signat er/A a Da
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 i
Opp Side L: R: L: R: =/J {� -3 Sibob
s
Building Height
Bldg.Square Footage Q f,t I % I
:J
Open Space Footage
Lot area minus bldg& sued
parking)
#of Parking Spaces /4p71'
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO (g DONT KNOW 0 YES Q
IF YES, date issued::'
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book Page! and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Date Issued:
C. Do any signs exist on the property? YES Q NO
IF YES, describe size, type and location: j
D. Are there any proposed changes to or additions of signs intended for the property? YES NO
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 r NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
(— pJer ampton
r�
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u i partment
fi2� in Street
R o .100 m
(j Ir JUN 2 9 ha • MA 01060
40 o°_sue
Ll� 2 Fax 413-587-1272
phone 413-58T I �tofS�f
"X
E Der'?OF P!!!!nflk!r,
rti
`APP=ATION-T0 I" R,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 SITE-,INFORMATION:
1 Thrs seetron to be cornptetedbXoffice
1 Property Address: '
A9 / 4!: /yep/^1 r1/ �/�y I a Lot [i�trfi
/41A Q / �p z Zpr Y OveriayDistirc�
�ElrnaSt.Dratrtet .. n CB�7�s�ct 'x
SECTION -PROPERTY OWNERSHIP/AUTHORIZED AGENT.'.
2.1 Owner of Record: MA'
v��i9�'G ,c�i9tJn� D0 IAI .t�lti�✓�9y o r o(0.2,
Name Current Mailing Address:
y�3 -
Sy-57-9 0 0 1
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
com leted by ermit applicant
1. Building rypOo . °° (a)Building Permit Fee
2. Electrical (bT Estimated Total.Costof
7 Construction from 6
3. Plumbing 0 Building;Permit Fee_
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) .Z S�• °° Check Number r
This.Section FOB Officlal-Use:Onl
Date,.,
Building Permit Number. Issued:
Signature:
i
Building Commissioner/Inspector of Buildings Date
e'exlll l T 4,5—D Of
AI'Kfc.Q(4v
File#BP-2005-1314
APPLICANT/CONTACT PERSON BADORINI MICHAEL J&DAWN M
ADDRESS/PHONE 109 CARDINAL WAY FLORENCE
PROPERTY LOCATION 109 CARDINAL WAY
MAP 36 PARCEL 308 001 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 16 X 24 POOL SHED
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 FqkLOWING 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 Streemrnission
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.
109 CARDINAL WAY BP-2005-1314
GIS#: COMMONWEALTH OF MASSACHUSETTS
MaRBlock:36-308 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2005-1314
Project# IS-2005-1764
Est. Cost: $5250.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor. License:
Use Group: Homeowner as Contractor
Lot Size(sg.ft.): Owner: BADORINI MICHAEL J&DAWN M
Zoning: SR Applicant: BADORINI MICHAEL I & DAWN M
AT. 109 CARDINAL WAY
Applicant Address: Phone: Insurance:
109 CARDINAL WAY (413) 585-9001 O
FLORENCEMA01062 ISSUED ON:8117105 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 16 X 24 POOL SHED
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 8/17/05 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo