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38A-052 (3) Northampton, MA Property Detail Page 1 of 2 City of Northampton, MA: Residential Property Record Card [—New Search Property Type Classification Code Reference Card 1 of 2 12 Parcel - Location - Zoning - Assessment Map-Block-Lot: 38A-052-001 Zoning: Assessment: Location: 37 LAUREL ST Neigborhood: 12 Land: B #Living Units: 4 Deed Book: 2967 Building: 2' Class: R-109 Deed Page: 298 Total: 3,' Dwelling Information IBuilding Sketch Style: Col/Gam Year Built: 1900 s Story Height: 2 5 7 5 D 7 OFP 63 Attic: Unfin 30 Basement: Full Total Rooms: 8 Bedrooms: 4 Full Baths: 2 28 UMNUB Half Baths: 0 B0 Exterior Walls: AlumNinyl Unfinished Area: 0 Ground Floor Area: 840 Total Living Area: 1740 oFP Finished Basement Living 0 X 0 2°3 Area: Basement Recreation Area: 0 X 0 Woodburning Fireplace Addition Information: Stacks/Openings: 0/ 0 Lower 1st Story 2nd Story i3rd � Metal Fireplace 0 /0 Basement One Story Frame One Story Framel Unfit Stacks/Openings: Open Frame Porch �C Heat/Central A/C: Basic Frame Utili lone Story Frame]= Heating System: Warm Air lone Story Frame �C Fuel Type: Gas I=Fopen Frame Porch C Quality Grade: C Physical Condition: Poor Interior/Exterior: Same Condition/Desirability/Utility: GD Vacant/Dwell/Oby Status: Dwelling http://www.northamptonassessor.us/noho/propertydetail.php?map_no=3 8A-052-001&page... 8/18/2014 Northampton, MA Property Detail Page 2 of 2 Additional Features: Brick Trim: 0 X 0 Stone Trim: 0 X 0 Remodeling Data: Year Remodeled: 0 Kitchen Remodeled (Y/N): Bath Remodeled (Y/N): Land Data Outbuilding Info Square Foot Type Type FQ t Value Utilities Prime no Site 6,000 101,200 information ear ize n Residual 20,400 7,140 RS 1 1 I910] 360 ©P AD1 1 1 0 1 540 C P Acreage Type Street/Road QM'�- Type Acres Value m 6 no no information information Sales Info Permit Info ate Type rice Validity Date Permit # Price Purpose o informatio d 2,000 17 X 29 FRNT PRC http://www.northamptonassessor.us/noho/propertydetail.php?map_no=3 8A-052-001&page... 8/18/2014 City of Northampton Massachusetts K0�s - s,�fCy DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. 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 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 a d inspections are made ()n understand the above. (Home owner/reside 's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date 911q/I y Address of work location 3 -7 [.ate fkre—J S H A The Commonwealth of Massachusetts Department of Industrial Accidents f Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builder s/Contractor.s/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone M Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.F-1 I 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 for me in any capacity. employees and have workers' g ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3 Y I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHo meowners 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. Waneby certify under the pains and penalties of perjury that the information provided above is true and correct. e: Date: Phone# �� 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 Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: License Number Address Expiration Date Signature Telephone 9 :Re iistered Homeamproyement 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...... F- 1 - Hame Owner Exemption 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 l 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 0 Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [C] Siding [❑] Other[❑] Work escrip' of Prapog�d ��Xlfl d G�/1CC� 101�f& � 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 house and'oc.addfonto existing: . ' Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning TIiis coltunn to be filled in by Building Department Lot Size Frontage Setbacks Front E::71 Rear L--j Building Height Bldg.Square Footage Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces (volume&Location) IL A. Has a Special Permit/Yahanoe/Rnding ever been issued for/on the site? �~\ ~�� NO �� DON7 KNOW «�� YES �~x~� � IF YES, dateissued:| > IF YES: Was the permit recorded at the Registry ofDeeds? NO � J D ~^ IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water nrwetlands? NO 0 DONTKNOW 0 YES 0 IF YES, has permit been or need to be obtained from the Conservation Commission? Needs tobpobtained �~\ Dbtained y~� Date �_� �_� ' . C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changpstooradditionsofsignsintendedforthep,nperty? YES 0 NO 0 IF YES, describe size, type and location: � { E. VViU the construction activity disturb(clearing, gradingexcavation,nr filling)over 1 acre uris it part nfa common plan ' that will disturb over 1 oon? YES ��� } NO ���� IF YES,then a Northampton Storm Water Management Permit from the DPW is required. �� ' u Department use onl�r , ' City of Northampton Building Department G�rrb cuvDnvei�vay�errrst#`r ��'`' 212 Main Street Sewer/Se�ticva�ra7il(�ty f AUG s 18 2014 ' Room 100 water/U1teltAv L a3labihty gal orthampton, MA 01060 Two S2ts ofStruGkural Pfan$' * " crr'c Pty, h ne 13-587-1240 Fax 413-587-1272 P[of/Stte plans 4 No„ r � ( y 1 �)' Ilp` 7 n,IlgaEOtlon3 OtherL'.Sl}eclfy. t ,: �, h 106 -, ... _, .:.. Ld APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING CTION 1 -SITE INFORMATION 1.1 Property Address: This section to be coMP.W. tl by office Map Lot Urnt .1 Lek ure_I ,Strt G ' N or f-h c,L o yon, MA O(Cr G Zone Overlay District :: ... .. Elm St District CB D'istnct SECTION 2. PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Loo rl& RkLI PO -10:2 vX Iq3( nA Qt N me Pr' t Current Mailing Address: �� Y—a!o — 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 ermit a licant Building pa (a)Building Permit Feb 2. Electrical (b)Estimated Total Post of /U/� Construction from 6 3. Plumbing A4 rA Building Permit Fee 4. Mechanical(HVAC) �` 5. Fire Protection l 6. Total=0 +2+3+4+5) Check Number NO JU This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector'of Buildings Date File#BP-2015-0191 ptw� APPLICANT/CONTACT PERSON RAY DONNA ADDRESS/PHONE P O BOX 1431 EASTHAMPTON (413)210-5950 Q PROPERTY LOCATION 37 LAUREL ST MAP 38A PARCEL 052 001 ZONE URB(93)/PV(0)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out q Fee Paid Typeof Construction: DEMOLISH 19 X 18 DET GARAGE / New Construction Non Structural interior renovations Addition to Existing Accesso_ry Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan KEN ON THIS APPLICATION BASED ON THE FO OWING ACTION HAS BEEN TA �el/I INFO ATION PRESENTED: Approved Additional permits required(see below) e 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 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. 37 LAUREL ST BP-2015-0191 GIS#: COMMONWEALTH OF MASSACHUSETTS MU:Block: 38A-052 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: demolition BUILDING PERMIT Permit# BP-2015-0191 Project# JS-2015-000366 Est. Cost: $500.00 Fee: $20.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 26397.36 Owner: RAY DONNA Zoning:URB(93)/PV(o)/ Applicant: RAY DONNA AT. 37 LAUREL ST Applicant Address: Phone: Insurance: P O BOX 1431 (413) 210-595Q () EASTHAMPTONMA01027 ISSUED ON.8/22/2014 0:00:00 TO PERFORM THE FOLLOWING WORK.DEMOLISH 19 X 18 DET GARAGE 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 Dmartment 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 8/22/2014 0:00:00 $20.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner