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05-029 (8) 234.88 99. 15 0S 0'024 104. 19 263,27 os .( 02S 104. 19 175 292.54 8 0 os fft O29 110.64 22 ' 4 117-67 50 51, 73 214.66 X00 82.33 170 , 5 -0-0 26 60 . PL �2 34 03/12/09 9:31:59 AM RESIDENTIAL PROPERTY RECORD CARD CITY OF NORTHAMPTON, MASSACHUSETTS EFFECTIVE DATE OF VALUE: JANUARY 1, 1998 PARCEL ID: 05 -029-001 240 AUDUBON RD PLOT: LIVING UNITS: 1 CLASS: R - 101 CARD #: 1 OF 1 CURRENT OWNER/ADDRESS NEIGHBORHOOD ID: 2.00 FINAL VALUE FLAG: MARKET STOCKWELL BRYCE & SYDNEY FLUM- LAND DATA STOCKWELL - ASSESSMENT INFORMATION - 240 AUDUBON RD TYPE SIZE INFLUENCE FACTORS LAND VALUE PRIME SITE 27290 103,200 PRIOR COST CURRENT LEEDS MA 01053 LAND 93,200 103,200 103 200 BLDG 209,500 197,700 179,600 TOTAL 302,700 300,900 282,200 DEED BOOK: 2672 DEED PAGE: 029 SALES INFORMATION DEED DATE: TOTAL ACREAGE: 0.626 TOTAL LAND VALUE: 103,200 LAST UPDATE/COST: 20050928 DATE TYPE PRICE VALIDITY 19860101 LAND + BLD 127,000 0 LAST UPDATE/COST: 20050928 X DATE: ADDITION DATA Lower Level First Floor Second Floor Third Floor Area DATA COLLECTION INFORMATION A 1sFr 196 ENTRANCE CODE: UNIMPROVED B FrGar 308 INFORMATION SOURCE: C OFP 192 DATA COLLECTOR: MC D DATE: 19991122 E F DWELLING INFORMATION H STYLE: CAPE YEAR BUILT: 1976 STORY HEIGHT: 1.50 ATTIC: NONE Basement: FULL TOTAL ROOMS: 6 TOTAL BEDROOMS: 4 FULL BATHS: 2 ADDITIONAL DWELLING INFORMATION Half Baths: BASEMENT GARAGE(#CARS) ADDITIONAL FIXTURES: EXTERIOR WALLS: FRAME BRICK TRIM: X UNFINISHED AREA: STONE TRIM: X GROUND FLOOR AREA: 884 16 OFP TOTAL LIVING AREA: 1743 REMODELING DATA FINISHED BASEMENT LIVING AREA: X BASEMENT RECREATION AREA: X YEAR REMODELED: MASONARY FIREPLACE STACKS/OPENINGS: 1 / 1 12 METAL FIREPLACES: KITCHEN REMOD(Y/N) HEAT/CENTRAL A/C: BASIC BATH REMODEL Y/N 34 HEATING SYSTEM: SOLAR FUEL TYPE: OIL QUALITY GRADE: B- PHYSICAL CONDITION AVERAGE 14 1 Fr COND/DESIRABILITY/UTILITY GD INTERIOR/EXTERIOR SAME OUTBUILDINGS & YARD ITEMS PERMIT DATA . -TYPE QTY YR SIZE1 SIZE2 GRD COND DATE PURPOSE PRICE 14 26 1 SFr/s RS1 1 1991 1 192 C A NOTES: 11/99-SOLAR PANELS ON ROOF & WET BSMT. 22 FrG 8 14 �2 _ The Commonwealth of Massachusetts ,r.. Department of InduaWdAccidenls =#� Office of Investigadons 600 Washington Street Boston,MA 02111 �:{ t www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Let=_ibly Name (Business/Organization/Individual): A-w Address: pC,,Q 4--b5 ktj2N re-,d 1-i'? City/State/Zip: Phone#: 2C1 37 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 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.b4 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees 'ham sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. 8Wuilding addition [No workers'comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised then 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. t Homeowners 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 thepolicy 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct! Signature: Date: r Phone#: 3 5 Official use only. Do not write in this area,to be complied by city or town orwi d City or Town:. Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/I'own 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: 11 VG7�—�A11V/&-V (,, License Number 2 0 L4 Gas y-pow wit r m--5-6s[L, I/ + r /20 o q Tess Expiration Da e 10137 Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ 6 Ae-,� X04 14.1 (0l Company Name Registration Number 516 Z0) D Address Expiration ate 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....... W' 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 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 and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicablel New House ❑ Addition Replacement Windows Alteration(s) F-1 Roofing Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks 10 Siding[0] Other[CA Brief Work Description of Proposed Awn�� I LY M �J� � X S 2 Alteration of existing bedroom t'C►� Yes�No VA►dding new bedroom Yes �_No Attached Na Renovating unfinished basement Yes __X_No Plans Attach Ro) -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: 1 Number of Bathrooms c. Is there a garage attached? _ d. Proposed Square footage of new construction. —1 Dimensions e. Number of stories? i f. Method of heating? (_zk, Fireplaces or Woodstoves ✓ Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction W L—W 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 L004 k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS A ENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, k6h 6 t „ c �U1 C� If as Owner of the subject property ++ hereby authorize A'J !+A4 A , P'ti to act on my behalf, in a i matters relative to work authlahzed by this building permit application. r Signature olbwner Date E E '!iC r c ka as Owner/Authorized Agent hereb d are 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. wc Print Name Sign 'n:of Owieen 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 `L,7 7.°10 272gd Frontage Setbacks Front (o$` l?t 3C Side L: R: 170 L: '�56 R:30 Rear Building Height ZZ 3S� Bldg.Square Footage 170 % t'g Open Space Footage `r % (Lot area minus bldg&pavedS 8t�� parking) #of Parking Spaces Z 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 Q DON'T KNOW (0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained ® , Date Issued: C. Do any signs exist on the property? YES ® NO JV 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 Mi IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-50-1240 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 2T 0 > v 66i\� "v,, Map Lot Unit Zone Overlay District Elm St-District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ad ? Name(Print) Current Mailing Address: pit ? • TF(- 5'Y'l x Telephone natu�'` 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 rmit applicant 1. Building 1`7 Sao, (a)Building Permit Fee ._- 2. Electrical I G O _ (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) Q Check Number This Section For Official Use Only Building ermit Number: Date g Issued: Signature: Building CommissioneNlnspector of Buildings Date File#BP-2009-0737 APPLICANT/CONTACT PERSON DANIEL HATHAWAY ADDRESS/PHONE 2 OLD GOSHEN RD WILLIAMSBURG (413)268-3135 PROPERTY LOCATION 240 AUDUBON RD MAP 05 PARCEL 029 001 ZONE RR(100)//WSP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiny Permit Filled out Fee Paid Typeof Construction: CONSTRUCT 8 X 12 FRONT ENTRY ROOM New Construction Non Structural interior renovations Addition to Existing Accesso Structure Building Plans Included: Owner/Statement or License 081793 3 sets of Plans/Plot Plan THE FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO AT 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 Street Commission Permit DPW Storm Water Management Demolition Delay Signature of img 0 fficial 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. A fty 6� y 1 t `5 A � 240 AUDUBON RD BP-2009-0737 GIS#: COMMONWEALTH OF MASSACHUSETTS MM:Block: 05-029 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Pennit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2009-0737 Project# JS-2009-001097 Est. Cost: $1:;500.00 Fee: $60.00 PERMISSION.IS H 4%RBY GRANTED TO: Const.Class: Contractor: License: Use Group: DANIEL HATHAWAY 081793 Lot Size(sq. ft.)� ,27268.56 Owner: STOCKWELL BRYCE:& SYDNEY FLUM-STOCKWELL, Zoning: RR(10CC WSP Applicant: DANIEL HATHAWAY AT. 240 AUDUBON RD Applicant Address: Phone: Insurance: 2 OLD GOSH EN RD 413 265-3135 WC WILL-IAMSBURGMA01096 ISSUED ON:313012009 0:00:00 -TO PERFORM THE FOLLOWING WORK.CONSTRUCT 8 X 12 FRONT ENTRY ROOM POS'F THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Undergrpun Service: i<Iet"r: O O fb D Footings. Rough: Rough:S%g�� Howlsc# Fcundation: 1 S /// Lrk-eway Final: Final: Final: / Rough Framer k Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke_ Final: OK O C 12+ 1 q t3 THIS PERMIT MAY BE REVOKED BY THE CI'.rY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of OcC,unancy ;/ � FeeType: Date Paid: Amount: Building 3/30/2009 0:00:00 $60.001164 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Conunissioner-Anthony Patillo