24D-003 (4) rt
I
ii
Side Elevation
P17 -
oil
f
f
� I
I ,
I; I
Rear Elevation
�" �
i
�W —
n
�U
0
� �
as 'y
Hancock Signature Decks& Remodeling, LLC
18 Rolling Meadow Lane
East Longmeadow, MA 01028
413-525-3556
MA HIC License: 151976, CSL: 105419
Job Name &Address:
Lisa Bezo
231 Prospect St.
Northanpton, MA 01060
413-348-3070
Deck Notes:
1. All lumber shall be pressure treated.
2. Approx. 208 s.f. deck addition.
3. 10" concrete piers 48"below grade
4. All deck hardware/fasteners shall be hot dipped galvanized or stainless
5. All joists shall be 2 x 10, 16" on center.
6. One Triple Beams shall be 2" x 10".
7. Decking shall be IPE fastened with Stainless fasteners Deck Nails
8. Railing will be Feeney Cable Rail System
9. Deck Level at Stair landing is 49". Deck Level at outside rail is 63"
10. Ledger flashed with copper and attached with LedgerLok bolts.
�J j
� r
i 24D-001
, �_ ; r 7
24D-002
385.08
100
r �
254.88 i
20.64 !
_ 50 26
4C:-@15 - / r 32
So`
r
l V
, P
/ Rp
1 Sp t/'
/
/120
/ 133 ��r3r / A� 12 . 4
�.i �4C
�� 75.7 I�� v �
/24b-24 , 24 1 55-- v s3.34�24D-6
135 ��24 2 75
o �� �ss;�
50 r123.5 \.
<3 `° The Commonwealth of Massachusetts
r„ Department of Industrial Accidents
Office of Investigations
600 Washington Street
Fy i
r' Boston,MA 02111
www.masxgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Ap_Rlicant Information Please Print Leeibly
i C r1
Name(Business/Organizationlfndividual): r1�` t-C_t� ��t t wri ic.;, 1}uCt`5 r wt . L L L.
Address:
City/State/Zip: E, L-t�c-t,t T:1-,NL 1`-1 pA phone#: > j 2 S S
Are you an employer?Check the appropriate box: Type of project(required):
1. 1 am a employer with t 4. ❑ 1 am a general contractor and I
6. ❑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. ❑Remodeling
ship and have no employees These sub-contractors have 8. [❑DemoIition
working for me in any capacity. workers'comp.insurance. g. ❑Building addition
[No workers'comp.insurance 5. ❑ We are a corporation and its
required.] officers have exercised their !0.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself.[No workers' comp. c. 152,§1(4),and we have no 12.FJ Roof repairs
insurance required.]* employees. [No workers' t aLe K
comp. insurance required.] I3.�Other 1
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
7 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating stick.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
- z
I am an employer that Is providing workers'compensation insurance far my employees Below is the policy and job site
information.
r—
Insurance Company Name:
Policy#or Self-ins. Lie.#: 2.U Q _7 VII (L2,45 Expiration Date: 9 1 l
Job Site Address: i-2c)S 7. City/State/Zip: Ny.2.; 6V't jz7 Mq U(o U
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. I52 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 nd penalties of perjury that the information provided above is true and correct
Signature: �ZL-2 c Date:
Phone#: ` `� ?5 5�?
Official use only. Do not write in this area,to be completed by city or town ofjiciaL
City or Town: Permit/License#
Issuing Authority(circle one):
I.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 Su ervv�i Isor: Not Applicable ❑
Name of License Holder: w&cf( _ ' �/1
In q r AA License Number
VJ L4J L.Lo��,--M A��cV of ozgg 7-25--ZO1 j
Addr ss Expiration Date
L4�� Ll
Signature Telephone
9.Registered Home improvement Contractor: Not Applicable ❑
I L►1/nP 1/StG—N �1.2>v C IGS ¢ �F�NloO>vG/Nc� 1 S 17k'
CG'ompanv Name `` Registration Number
Address / Expiration Date
6A5 ��r3c-i^'� �� M� 0I()ZZS Telephone q/3 �z5-
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 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
resoonsible 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 ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ED
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks Siding[E:3] Other[dJ
Brief D?�cription of Proposed
Work: FFMave-
Alteration of existing bedroom Yes vl' No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes _�No
Plans Attached Roll -Sheet
6a. 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 f 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 V'_ Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I 1_) 5.1k- 6r ZU as Owner of the subject
property J�
hereby aut rize K�'lit k `e,-t" AtJ 6 0 G PL_
to act on behalf, in al matters relative to work authorized by this building permit application.
Igo
SignaZTof Owner Date
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.
KE4(sirf—T 14
Print N me
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 /oi 0 eP
Frontage q �' I
Setbacks Front `
Side L: R: 35 L: z.5 R: 35
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO ® DONT KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DONT KNOW YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO a DONT KNOW ® YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained ® Obtained ® , Date Issued:
C. Do any signs exist on the property? 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
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 ® NO Or
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
[EC L
!' City of Northampton Status of Permit:
2 B 204 J Building Department Curb Cut/Driveway Permit
AW 1 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
ectric,Plumbing&Gas Inspections Northampton, MA 01060 Two Sets of Structural Plans
Northampton,MA 010 413-587-1240 Fax 413-587-1272 Plot/Site Plans
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
23 {�a oSPFC s i, Map Lot Unit
RTf I vL1 �Ta D(e b
Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
3 t
Name(Print) Current Mailing Address:
- y r3 3`t�S-3a-70
Telephone
Signatur
2.2 Authorized Aaent:
l� �o S�I N� c•N-Dd�LN. �, �o ti(:-��P,q�� N_rN it� Z b
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building y r l4' 6 0� o 6 (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) 0 6d . D U Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Comm issionedlnspector of Buildings Date
File#BP-2015-0238
APPLICANT/CONTACT PERSON KENNETH HANCOCK vj`�
ADDRESS/PHONE 18 ROLLING MEADOW LANE EAST LONGMEADOW (413)525-3556 k
PROPERTY LOCATION 231 PROSPECT ST
MAP 24D PARCEL 003 001 ZONE URB000)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid
Typeof Construction: REPLACE W/208 SQ FT DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 105419
3 sets of Plans/Plot Plan
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 Permit DPW Storm Water Management
Demolition Delay
yi
Aigaaftffe'of—Buifding Of icial 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.
231 PROSPECT ST BP-2015-0238
GIS#: COMMONWEALTH OF MASSACHUSETTS
MC.-Block:24D-003 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Deck BUILDING PERMIT
Permit# BP-2015-0238
Project# JS-2015-000444
Est. Cost: $14000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: KENNETH HANCOCK 105419
Lot Size(sa. ft.): 9583.20 Owner: OHLENBUSCH HENNING W&LISA BEZO
Zoning: Ug RB(10o)/ Applicant. KENNETH HANCOCK
AT. 231 PROSPECT ST
Applicant Address: Phone: Insurance:
18 ROLLING MEADOW LANE (413) 525-3556 WC
EAST LONGMEADOWMA01028 ISSUED ON.91512014 0:00:00
TO PERFORM THE FOLLOWING WORK.REPLACE W/208 SQ FT DECK
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 Siznature:
FeeType• Date Paid: Amount:
Building 9/5/2014 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner