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17A-257 (4)
i M f�� x33` 4iw',YYQ* 18/Al , i ' I ; � I I I I � i ' 4 I W: Q I PLOT FAH s. , ,5 3 b T 8a, OA K, ST- E--N— SC.a l e )"- kV c i r M ' - f c-��rEr� doRrfE� vhc 0075 t0 i l j I � I i our1 _ ��yT tof�l. MA, 3J� /ot LYNN POSNER RICE, ARCHITECT 6 Crafts Avenue.- Northampton, MA 01060 • 413 586-4483 to rz_ I , 1 I ; pct?v�E W i t�►t7�W6- I I � � � fi i .4-I't+*Lr SHItJG1.�i 71 A R 9 t• 1=251 <. �s.tZ �1 t EH44A.1I .61PftQ 3 3 -hT� �i o ,6.p�ITIoN 114 T'Il aA,14 1'L0P-E 111G5j Mf6.. LYNN POSNER RICE, ARCHITECT 3 o F �1 6 Crafts Avenue - Northampton, MA 01060 - 413 586-4483 Lo r+T R t t7f Y� NT 3 3N ;� 3~ s / 218 R��TERS Ib D.G. Ea. 3- 53 3-5 s 3 -5 �s 4 t'LY t.l 5 Pttt1 G MO �••_(ZistD iN5 Ut. Wt ! • 3,�.R 2a, VS*4T IUA17tON hPA-C F- h r/ Ffzh.MF- FOV- .FV-rid r- igfP 76" W 3 r21.. .bi N 1 r` C.4 _ 2)T ef E 2,�t c�( . JelST �A.T 6 ftT ONf►ttORAII. cat 4T. SaF1=tT .Q:G. mtreT I-4 tw1:;)o4-4• 5tt_l_S =ExTE1�tD `p tr+SUL. 1 Z � fl-NTt± ti -- I !l.t_t . i�a•, ,b,�v. FIt�. FE_2 c tt I rFEY o -- o �— spar-r,.F _ 2x [t� e ��• v-G• 5u� ��>✓ / O ! � -� 5-X 6_'EAf Dootz r- - 32!r4 15A:Tt•+ TUO i f EX16T ►U 6Tvr>t0 ysEC�La'lit ��G_.ol•1.i7 F�ooiZ �t,.A.N- _ �u11..l�IN� ��G�'.lt� C�l LYNN POSNER RICE, ARCHITECT 2 0� 6 Crafts Avenue • Northampton. MA 01060 • 413 586-4483 r f Z 1<x112T i i 517_LA.Tt= ZN� FLR A 9*OVE t 3 4, 1 . 1 � of —max �sr U ofF1Lc EX�571N bo& ,� _ xi T 'e, VT UPI 0 Ext ' — � r-� 1�T--:lz Ftn-AV PIT 1ot.1 a e�P N 21-PW za o� o zz "' ° CD ► Wz -- 0 3� 5 /oF LYNN POSNER RICE, ARCHITECT DF R rraffc Avenue • Northamaton. MA 01060 • 413 586-4483 y O Oaf Grit� Of Wart4a111pfDtt 9 6 j�aattchnsrtlts' m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORIaR'S COMPENSATION INSURANCE AFFIDAVIT (Ii see/permi"e" with a principal place of business/residence at: (strre,L/city/s atrhip) do hereby certify, under the pains and penalties of perjury, that: (,-�l am an employer providing the following workers compensation coverage for my employees working on this job: (InstlSantx Company) (Policy Number) (Fxpirat!Fod d=) O I am a sole proprietor, general contractor or homeowner(circle one) and have hired the contractors listed below who have the follollving worker's compensation policies: (Name of Contractor) (Insurance Company/Poticy Number) (Expiration Date) r (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contrctor) Gam—m C npa,Yy/Polite NmnFx-r) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional sheet if necessary to inohrde iaforuaatioa pertainuig to all ocatmctots) O I am a sole proprietor and have no one working forme. ( ) I am a home owner performing all the work myself. NOTE:please be aware that while homeowners who employ persons to do ma dCa ace,oonstructioa or repair work on a dwetliag of not more than three units m which the homeowner raider or oa the grounds appurtenant tbarto are not generally ooasidatd to be employers under the workct's compensation Act(GL152—m 1(5)),application by a homeowner for a liecrt3e or permit may evidence the legal etatua of an employer under the Wor$da Compaxution Act I understand that a copy of this rtatcmcat aaay be forwarded to tbo Dcpartaamt of lodauirial Aociden&Offioo of Inacranco for the coverage vaificatioa and that failure to s,==coverage Wxkr scc ioa 25A of MGL 152 can lead to the imposition of criminal pettakiea ooasistiag of a fmc'of up to S1,300.00 anNOC imp ris xt of up to one year and civil penalties in the form of a Stop W orlc Order and a fins of 5100.00 a da ax. For deputn�trso only Permit Number Map#—_ _Lot# Si of Licensee/Permittee Date Y SCION 13 ,P, STRUCTIaN'SI�PP 1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number I o (ohi 1 b 1 Addres Expirati n Da e Signature Telephone Not Applicable ❑ a 1005(A Company Name Registra ion Pumber Address Expirat on late Telephone 3 S,ECT10�1;10-W(.VKERS'Ct,MPENS#1QN (M.G.L.x.152,§2 0)), Workers Compensation Insurance affidavi ust be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance orthe 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 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 t- 3.. New House ❑ Addition K Replacement Windows Alteration(s)% Roofing Or Doors`)-( Accessory Bldg. ` Demolition❑ New Signs [ ] Decks [ ] Siding°bZ] Other [ ] Brief Description of Proposed Work: C /` d�� ftisbaq- I Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ • Sheet❑ a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: a Number of Bathrooms 2l c. Is there a garage attached?� (dekLt,�i ��e'�e—J / d. Proposed Square footage of new construction. $ l f- Dimensions / X33 ' e. Number of stories? f' I f. Method of heating? S r-1 Fireplaces or Woodstoves Number of each r g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? e"11 � Type of construction 44)66 6( r)7� 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 ,r $COG 'iON 7 � Fi At °[ IORI TapN ? NE NIPL � WHEN. O)IVVC�11=N7 4 {#[iOT8 ,3; PLt?RJl�.l [ PI1T, x1 l J V c� ��/Y ✓`► as Owner of the subject property hereby autho o 14 `r 0,"' /1-C x/� �r to act on my behalf ' all ma s elativ to work authorized by this building p rmit annlicatJ 'J S-Tz o a Signature of Owner bate 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. I,Qgned under the pains and penalties of perj*L)ry. ON Print Name / 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 l Building Department Lot Size 2 6 Gets "Q6 0-6(e'!� Frontage 801 s o Setbacks Front 6 7 671 Side L: U< R: 7 L:- R: / !l Rear 0) Building Height Bldg.Square Footage q3 & % / SC) Open Space Footage f % ®/ (Lot area minus bldg&paved FJ,� parking) #of Parking Spaces roll Fill: © O 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 # � I- _Uq 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: Campton ® Buildin artment MAR 2 0 2 R m O reet L on, A 01060 �l 0601240 ax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING S'ECTIt�N,_I DE i1GlRMI 101+1 1.1 Property Address: tip L-oR tEN61(5 out u ts S"ECTICIN 2 Poi E*Oy ERSt11,P1,,.,, IEZECi AGENT 2.1 Owner of Record: Current Mailing Address: Telephone 0113 - ,5-9z/ - 9-� S7 Signature 2.2 Authorized Agent: e C l C�J� Sf Lr� G^�'C M Name TXWT Current Mailing Address: Signature Telephone Item Estimated Cost(Dollars)to be 0fflc al' s 0rtly, completed by ermit applicant 1. Building i' (a)bialding Permit Fee. � 3s saw 2. Electrical (b) Estir Aced TotOI 10 0 ®� Construction froth' 6, 3. Plumbing F1 ® 0 Oult�tittfiertttt �r 4. Mechanical (HVAC) f t a 5. Fire Protection 4 6. Total =(1 + 2 +3+4+ 5) U Q Choi Iker 'Thi?t".Seti,lon Or-Off lcial Use Only Buildin Pe rmit Number '� Date Issued x: Signature >tdng fcoffimiso,t er Ins _ File#BP-2001-0736 APPLICANT/CONTACT PERSON Sackrey Construction -_, ADDRESS/PHONE 288 Chesterfield Rd. (413)527-3465 PROPERTY LOCATION 111 OAK ST MAP 17A PARCEL 257 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out {-Z of ��- Fee Paid Typeof Construction: CONSTRUCT 2ND FLR STORAGE/WORK SPACE TO EXISTING DET GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 040714 3 sets of Plans/Plot Plan M THE LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS 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 Co s ' n Permit from CB Architecture Comm, ee 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. III OAK ST f, BP-2001-0736 G1S#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-257 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:alteration-addition BUILDING PERMIT Permit# BP-2001-0736 Project# JS-2001-1385 Est.Cost: $40000.00 Fee:$175.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Sackrey Construction 040714 Lot Size(sa. ft.): 11499.84 Owner: STENSON JAN Loni+l, : u, .j"^:`irn_rrt: SsckrAV :'^^Str�ICtiC?rl AT: 1 1 1 OAK ST Applicant Address: Phone: Insurance: 288 Chesterfield Rd (413) 527-3465 Workers Comnpensation WESTHAMPTONMA01027 ISSUED ON:3122101 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2ND FLR STORAGE/WORK SPACE TO EXISTING DET GARAGE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: i Footings: Rough:/' Rough: y/ZSla) rz — House# Foundation: Final: Final: 5I-31 1c), w � 14 30 ,01 _�( " Rough Frame: U _a"" G � Fire Department Fireplace/Chimney: Rough: Oil: Insulation: V k '0 Final: Smoke' Final: 0 THIS PERMIT MAY BE REVOKED BY THE C Y OF NORTHAMPTON UPON VIOLAT OF ANY OF ITS RULES AND REGULATIONS. , Certificate of Occu anc Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 3/22/010:00:00 2638 $175.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo