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17A-149 (7) Expand opening, leave minimal Peninsula to fit wall at right,5' two stools. passage from left C to counter. o Dishes& glasses Trash& recycling bins Baseboard heat 1,1 p Kitchen U Need dishwasher 11'4"x 11'4" dimensions &standards Oo° o Gas Range=28- Need fridge 'W'D x 30"W dimensions& Pots&pans Hood&Micro= standards storage 15"D x 30"W Kitchen Renovations 28 Fox Farms Road Florence, MA 01062 March 05, 2004 City of Northampton Building Department 212 Main Street Northampton,MA 01060 Re: Application for Permit Kitchen Renovation at 28 Fox Farms Road,Florence To Whom It May Concern: Attached please find my application for a building permit. I plan to renovate an existing 132 square foot kitchen at 28 Fox Farms Road in Florence. The project will include new flooring, cabinets, countertop, replacing an existing window, and enlarging the opening in a non-bearing partition. I plan to contract with a licensed electrician for the electrical work(outlets, switches and lighting) and a licensed plumber for the water, sink, baseboard heating, and gas connections. For your reference, I have also attached a floor plan for the new kitchen. Please contact me during the day at(413) 531-5668 or in the evening at(413) 584-8944 if you have questions or need additional information. Thank you. Sincerely, I bglurw' Patrick J. Mahoney 28 Fox Farms Road Florence, MA 01062 4��p7p tiff Crzty of Nart4autptan z � �lassac}�usrffs {p DEPARTMENT OF BUILDINIG INSPECTIONS INSPECTOR 212 Main Street • Municipal Building S 'r Northampton, MA 01060 , HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as Isis/her construction sup,-.,S'sor. 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 and inspections are made \ I, I understand the above. (Home owner/resident's ignature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date `? d Address of work 5 �tw location D9 Fox 0"/ o�.�tt/.N•PT� �- � L1f117� �licilll�Jf(1]1 $ 6 fiiassxcE)asctls' S m llEPARTMEtrr OF LUILI)MG INSPECTIONS 212 ATnin Street Municipal 73uilcling Northampton, Mass. 01060 WORKER'S COMTENSA7nON INSURANCE A FFMAVIT It(L T MA-HOVE cpa place of bessr : delc^ t.,v th a prini c ir ;i (SLTC_-UCit 'I:--=?_'/r jt�--- do hereby ccr-Lif), ujvlcl tl1C p<t!i]5 2i110 pCil lil S Oi petjury, .Imt. O I am an employer providing tlic Follo%%,H)c_ '..-orr,er'-s compensation coverage For my employees working on this job: (Ins =c.- Company) olc;Mmnber) - (rte pir den Date) l ) I an a sole proul-ietor, _ventral c.�D- or IIOIIit 0�'Tlt r (crcle onei and 'gave 'autcl t-lle contractors 1]ste�, beiow,vho ii ill'.' `Oil .i;F workt-s ;oi r. S: (1:t1I➢C Of(_'OILI3Ci0:) ( nsu=ic„ COIP.^"::i1:Po(lc Nitmh.:r) Date) (Name of ContT cto:) -- (111S.1rdnCC Coa 1p 121 v/Poiie,' N um,b--r) : it Lion Daie) (name of Contractor) c. Numb--r) ate) - (Name of Contrnctcr) - - (Insuranc-_- Comrr_.y Policr Ntl.ml;�*) Date) (^IL1C}1 Vdj��c[:'a]c•:'�t:-.._-_.. 'n:..--..�.� .-..'t:::a":��:�--._.... � -+li:.:�.-'_...,..') ( 1 illTl it -,;Ole propr]etJl hill i]ilt' no OI:C ,. ; 1 ri ' for -M I �iil i? horllc r f. NO IT.:plcasc tc a,1 c Ls:.,l:i]c lxc-c:�"ir c ply, n t: .• -ainc�a:.r n r m cr:c;;au zLi c: not uKcc th.n(hroo uni!s i�t,t;dt he 1; �.;:1 r rte: x o;'` .::i z r•� cr_r1 Lhcd e c n{(txtallY c•_r.:`t?`_ t cznploye3 u--ti:,cs tIv tvc i;�s ar z=:_tics i•G (GL!52- !{51!,-y: ._ :ic:t+y hnt:tmu-icr`or e licesc c<p-r::i:: :r c leg']nztus of an a:uployx under tLm Workc1■Co,2,.or_-ikon!.ci I unde-rtand th,c a co?y of th_etat_-_ai my bo forvrnrci j to ti»J),_I-L,, !of Indiizrin!M616-:3'Crr-of!::sr.,ra--,-o 9-tS>e oovaagc vaif-G1ioo and that failure to to r:mv_r_, 75A of?dGL 152 can lc--d to tlx imPasitiDn o(cr .r_I pc ah: romutingof a fur_ofup to.11-500.00 an1'c<ir_:nr,_r.�ti._of::p to cn:),r e.-.j civil prsutl a in de(c nn c(a S!r,,`:Jni Ord sr1 ftln of 5100.00 a dsy a ain:t ttr For `ly 3/5/ Ycrmtt 1lutnlr r — - - - :. _: 5irnaturc cif i.iccrx:JI'crm .tc; - _ T- --- F �. N15 Vias 7 8 1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone e m We En-C�rac'to Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone '�EC� Q '���YO KERS',COMPENSA�IQN INSI�RANCEx.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 acccptable 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, Stat�,and ocal 7,onina Laws and State of Massachusetts General Laws Annotated. Homeowner Signature PG SE a�a III e . New House ❑ Addition O Replacement Windows Alteration(s) Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ) Decks Siding[ ] Other[ ] Brief Description of Proposed Work: '�Zl�l'� Alteration of existing bedroom Yes--X No Adding new bedroom Yes No Attached Narrativeb,0'- Renovating unfinished basement Yes No Plans Attached Roll D• Sheettp/ 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 Nc 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 EC �l �RfZATON TO BE COMPLETED WHEN L1 ES FOR BUl'L'[S�N4G'PERI II �� I, as Owner of the subject property hereby authorize _to ac; or my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, as Owner/.Authorized Agent hereby declare that the statements and information on the foregoing application are true and accur�`a7eo the best of my knowledge and belief. Signed under the pains and penalties of per'ury. j /�}-T121C.�K T. MX 1 '0rVC;y Print Name rll� Signature of Owner/Agent 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 arkin ) #of Parking Spaces Fill: (volume'&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW X 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 1` 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 X _ 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: City of Northampton Building Department .�12 Main Street _ l Room 100 Northampton, MA 01060 M,AR 413=5'87-1240 Fax 413-587-1272 APPLICATIOKITOZIONSTRU q ,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING .SECTION 1 SITE 1IFOW IATION 1.1 ProRgfty Address: e IN k SECTION 2-='Pk DUTY OINNERSHIP,IA ORIZEU GENT 2.1 Owner of Record: ame(Print) Current Mailing Address: l 4i+ Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SEi:TION 3 fSTIMATWZQNST 1 �UC'iION`OOSTS" Item Estimated Cost(Dollars)to be 6ffficial Use Only completed by emit applica nt 1. Building �?� Via)Bwld�ny Permit Fee b Estimated Total cost-of 2. Electrical it t Cp structi'o_n from''�5 3. Plumbing ��/� . Bwldh "Permit Fee; 4. Mechanical(HVAC) W 5. Fire Protection 6. Total = (1+ 2+ 3 +4+ (T C eckaNumber �� TIM,s Sechoni:For Official Use°Onl Building Permit Numibert ����d`�Y Date Tssued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2004-0854 APPLICANT/CONTACT PERSON MAHONEY PATRICK J&CYNTHIA M ADDRESS/PHONE 28 FOX FARMS RD FLORENCE (413)584-8944 Q PROPERTY LOCATION 28 FOX FARMS RD MAP 17A PARCEL 149 001 ZONE URA 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: RENOVATE KITCHEN&ENLARGE OPENING IN NON-BEARING WALL New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included• Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING 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 Street Commission 4/�L Lam 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. BP-2004-0854 28 FOX FARMS RD GIs#: COMMONWEALTH OF MASSACHUSETTS � ,,Map:Block: 17A- 149 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-2004-0854 Project# IS-2004-1265 Est. Cost: $26070.00 Fee: $115.00 PERMISSION IS HEREB Y GRANTED TO: Const. Class: Contractor: License: Use Group; Homeowner as Contractor Lot Size(sq. ft.): 14810.40 Owner: MAHONEY PATRICK J&CYNTHIA M Zonin¢:UPA Applicant: MAHONEY PATRICK 3 & CYNTHIA M A1: 26 FOX rl`1K63 E,D Applicant Address: Phone: Insurance: 28 FOX FARMS RD (413) 584-8944 FLORENCEMA01062 ISSUED ON:3110104 0:00:00 TO PERFORM THE FOLLOWING WORK.-RENOVATE KITCHEN & ENLARGE OPENING IN NON-BEARING WALL 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:-5 Q� House# Foundation: Final: Final: Driveway Final: , /V Rough Frame:0K hvo2y-0y Gas: Fire Department Fireplace/Chimney: Insulation: k y—I& Kitite�:: Final: -J1 F ' (4 *Smoke: Final: ©4 ; THIS PERMIT MAY BE REVOKED Y THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGU TIONS. / Certificate of Occu anc si nature: Feel e: Receipt No: Date Paid: Check No: Amount: /k Building 3/10/04 0:00:00 1809 $115.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo