17C-086 (6) Scope of work at 96 Chestnut Street-
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The barn has a field stone foundation below grade that is in excellent condition. Above
grade the foundation is brick and is deteriorated in some places. The brick is to be
replaced on three sides of the structure with concrete block. The sills will be replaced
with 6x6 PT lumber with the floor joists attached with metal hangers.
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z m DEPARTMENT OP 13UILDr1\'C INSPECTIONS
212 Maui Street ' Municipal Building
Northampton, Mass. 01060
WORICEIR'S COMPENSATION INSURANCE A t tIDAVIT
1 Sow" — UCCI,,I K Q-
(licctLU.e/Pcrrnittcc) - -------
,,vith a principal place of business/residence at:
(stn..t/cltylst tc�r�p)
cio hereby certify, uIlder the pains and penalties of perjury, that -
O I am an employer providing the followint4 v,,orker's compensation coverage for my
employees wor-,ing on this job:
(I-aa=or Compaay) (Policy Number) (Expirtion Date)
O I am a sole proprietor, Keneral contractor or homeowner (circle one) and have dire,
the contractors listed below who have the follo•,v:Pg workers compensation policies:
(Name of Contractor) (Insurance Com,:�an•,/Policy Numbcr) (Ex;imuoa Datc)
(Name of Contractor) (Insurance Comtoany[Pohc, Numb r) (lizpirltion Date)
(Name of Contractor) (lI1suFzuic° Comp:uw/Poicy Nulntxr) Late)
(Name of Contractor) (Insulmicz� Comrmrvty/Policy Number) (Ezpir:tio,Date)
(etiac3t ui!itimal rlscet ifnceeninr;o i'xiu`c;:;I�mi:iec:mtniuinr�t�eli e�<:�dc„-)
I and It OIC prOplletOi aI1Q hCtVC tlo OI1C tot 11le-
I '1111 a home own, OCriCr171I1 vl the �'JOrr: i1iV�ell.
NOTE:plczsc be nwarc ilia;w ilc tx.rro«Zr_ta�Nbo c: ploy rrTO:s to c. ;r_.ulcaincc v r n c cr tcpair. tt, :. «Ll! .:c:
not titcYC 11Ln(limo unity in tv{ dt'x l ,krot Zrs rca:<'_-i cx co tl,. p :.�zpFautcr•^+thereto Lc xt(crxrzlly Yr�:
catployca ua;lcs tlx work&r oc rpr tc m A”(GI.152-!:A 1(5)),r. l:_^.'ic;by a hot:tro%t-.Cr for a liccu
legal ctatur of an aaployor under thn Woikc .Cotnp"r iticn Act.
I understand dui.a copy of thix"at--ai avy bo foe -oniod to tlw Dejxi trend of lr6istrial Ar ide i&OfLoo of In:ur.c>eo for tlm
coverage vcrifieaiioc and that fri=to ecaire coverage ur-, -z sovion 25A of MOM 152 can Icad to tho irmi Tifion of cri nia 1 penal';-
-fisting of a fine of up to S 1,500.00 artl'cx ir.:pri-oantait of up to on-)zar end civil penalties in dx form of n Stcp W-i or& and a
fins of 5100.00 a dsy ig�dnst ttr_
- Foe dcputnrstal uoo ooly
1 can't rittrnbc.r
I ' — --- -----
-�f�, AMIt -------___1
aISTRUCTION SERVICES
SEC•,axe ., a : • _
8.1 Licensed Construction Supervisor, 1 Not Applicable ❑
Name of License Holder : ��e 'r'1 1 V�L'�� �� C� Ca 13��
License Number
Ainwvfg,,, NA
Addre Expiration bate
X79'
Sig ature Telephone
e re me pr uement.Contrac rN Not Applicable ❑
o UO / `7
Company Name q Regi/stration Number lijoq
rin TV ak5an Roelcl VjAcvv\h,Address Expiration Date
Telephone did/_ � 7
SECTION 10-WORKERS',=C.OMPENSATION 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...... ❑
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 buildiny-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
7=777=77=iSECTION�5 D S°"'R TIOOFPROPOSEDVVORKf ctieck�alla ` 'lica�le
i"V L2
New House ❑ Addition Cl Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New 1Signs [ ] Decks [ ] r Siding[ ] Other [ ]
Work:_
__S_!11 Description of Proposed Work: 11 r,��� J "�, r�T,�� ry a 0:1 Xo xa ef4( 't'J 1)"Vn
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet 0
6a�If Ne house a"ri"d o dtli`t-i1n to ezistinR;housing" co V to t lib-1,4611WO g.:
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._ Mascheck 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 OWN'ER AUTHORIZATION' TO"BE COMPLETED WHEN
OWNERS AGENT,'OR CONTRACTOW PRLIES°FOR"B UILDING'PER MIT
as Owner of the subject property
hereby thorize e Ve"1 2 f>CJ1 X110 to act on
my be a , in all m(, ters )ve to wor,' uthorized by this building permit application.
rU
Signature Owner Date
Sh 'N z uC C[k kRO as Owner/Authorized Agent
hereby cYeclare 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.
4e VeAn �J v C(', i lY0
Print e
L03
3 3
Signature of Owner/A e t Date
Section 4.
- ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
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 DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T 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:
;rPity of Northampton
Building Department
212 Main Street
MAY 1 3 20 Room 100
orthampton, MA 01060 a 'et .z c •
phone 418.587.1.'240 Fax 413-587-1272 Poi/ ter
i
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This sectidhi.to be completed by office
Map l tot F s E Unit
1�1 A
1
Zone Overlay District
Urn St. District CB District
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
—0' / O {- S f _
^Cs 11 �C� 1..�1�51 lF'11., 'Q'e.,
Name Pr it) CL:rrent ng Addres
f elephone
XiBatur AkAk
2.2 Auth ized Agent: j / �) q
, u C,CJ'1 I wo _ q0 i �l ci )!3 J t i�(Ci M ��j1/4
Name 'r nt) Current Mailing Address:
Sig ature Telephone
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
2 Electrical (b) -.-timated 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 Numb
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature: ------ -- - -- --
Building Commissioner/inspector of Buildings Date
File#BP-2003-1015
APPLICANT/CONTACT PERSON Steven Zucchino
ADDRESS/PHONE 70 Gleason Road (413)584-3878
PROPERTY LOCATION 96 CHESTNUT ST
MAP 17C PARCEL 086 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinp,Permit Filled out
Fee Paid
Typeof Construction: REPAIR SILL&FOUNDATION ON BARN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 021.356
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOfiMATION PRESENTED:
pproved 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 Stre ommission
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.
96 CHESTNUT ST BP-2003-1015
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C-086 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-1015
Project# IS-2003-1620
Est. Cost: $8680.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Steven Zucchino 021356
Lot Size(sq. ft.): 11107.80 Owner: HART REBECCA F&JONATHAN
Toning:URB Applicant: Steven Zucchino
AT: 96 CHESTNUT ST
Applicant Address: Phone: Insurance:
70 Gleason Road (413) 584-3878
NORTHAMPTON MAO 1060 ISSUED ON.5 115103 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPAIR SILL & FOUNDATION ON BARN
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:o/P
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATIO F
ANY OF ITS RULES AND REGULATIONS.
e z��e
Certificate of Occu anC Signature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 5/15/03 0:00:00 400 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo