22D-112 (5) i
Jeffrey Bott Contracting
32 Pine Street
Florence, MA 01062
roof pitch: match existing 5112 413 530 6920
cut new porch valley into existing roof
attach porch headers to existing house framing
with metal connectors
hand rail, as required, to be determined
I�
orch Roof Framing
1'-0" overhang I�
8 headers attached to 4x4 posts
6 rafters on 16" centers
3" sheathing
erglass singles to match existing
I
continues 4x4 from pier o header
wrapped with PVC trim
Ilk
0
Co
bolt ledger to rim and joist CID
rl-
existing
T
foundation
0
'orch Floor Framing
Y concrete piers
n 20" big foot footings
' below grade
x8 pt ledger attached to house
-2x8 pt beam attached to 4x4pt posts
x6 p t joists 16" on center
i
x12 pt stair stringers (3 rises)
T Project Name
x3" ipe decking Front Porch
71_1111 Client NamMeiirydMarquardrfrish McGovern
53 Avis Circle
Florence, MA 01062
/ City of Northamptc
80ding Department
s�' V Plan Review
212 Main Street
Northampton, MA 01
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Remove existing concrete steps and sidewalk
Replace in same location with wood IPE deck,
stairs, hand rail(as required) and PVC skirt boards
Build roof over new porch
match roof pitch and trim detail
Bott Contractin g Project Name
treet Front Porch
MA 01062
920 Client NamMelrldMarquardffrish McGovern
53 Avis Circle
Florence, MA 01062
A �� Sheet Number Q_7 Sheet Title Prnnt Floxintinn
r-1
City of Northampton 212 Main Street, Northampton, NLk 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111 , S 150A.
Address of the work: SS AV(-S C-l0,C LF,
The debris will be transported by:
The debris will be received by:
Building permit number:
Name of Permit Applicant
—< —I \V�
Date Sign-ature of Permit Applicant
City of Northampton
r G Massachusetts 4S'' X11
� y s DEPARTMENT OF BUILDING INSPECTIONS : x?
212 Main Street • Municipal Building J''•.. 'b`'
Northampton, MA 01060
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to ac as his/her
construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a pa el on which
he/she resides or intends to be, a one or two family dwelling, attached or detached u-tures
acce ory to such use and/or farm structures. A person who constructs more than o home in a two-
year per d shall not be considered a home owner."
The building d artment for the City of Northampton wants any person(s/thaby k to use the home
owner exemption, ct as their own construction supervisor, to be awardoing so you
become responsible ompliance with state building codes and rs. The inspection
process requires that the bui department be called to inspect work astages, which include
foundation/footin s before ba ill sonotube holes before our uildin inspection
before work is concealed insula ' n ins ection if required) and ifinalbuilding inspection.
The building department requires these%iections before the work is oncealed, failure to secure
these ins ections can result in failurtain a certificate of otcupancy until the work can be
inspected.
If the homeowner hires other trades to perform wo (electrical, umbing & gas) the homeowner will be
responsible to make sure that the trades hired secure eir pr er permits in conjunction to the building
permit issued, and that they get their required inspec . Failure of the individual trades to secure
the permits and inspections as required can DELAY the p t until such time as the proper permits
and inspections are made
1, unders d the above.
(Home owner/resident's signature requesti g exemption)
I will call to schedule all required building inspeQVons necessary for the building it issued to me.
Date
Address of work location
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
x 600 Washington Street
f Boston, MA 02111
x www.niass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): �� U ?c7 CAy1A��`�.�
Address: -:2,7
City/State/Zip: 01A Phone #: 0 �
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. ] I am a sole proprietor or partner- listed on the attached sheet. 7. F-1 Remodeling
ship and have no employees These sub-contractors have g, E] Demolition
working for me in any capacity. employees and have workers' 9 ❑ Building addition
[No workers' comp. insurance comp. msurance.1
required.] 5. ❑ We are a corporation and its 10.F-1 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 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.
tHo meowners who submit this affidavit indicating they are doing all work and then lure 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 the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins. Lic. #: W raV5®A0 J 0 7.Yr,3 Expiration Date: (-ts � {�
Job Site Address: `a 5 Pus z,(k � City/State/Zip: F_L0Z_7?_ L_A,,
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.
Sigriat ure:
Date:
Phone#:
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone#:
t
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable £
Name of License Holder:
License Number
E7- iA
Address Expiration Date
Signature Telephone -
9.IRemstered Home Improvemenf"Contractor �� Not Applicable £
Company Name Registration Number
Address q Expiration Date
Telephone 30
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: - Hame Owrier-Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellin e(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a 1' rovided 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 e resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or deta strictures accessory to such use and/or farm
structures.A person who constructs more than one home in a o- ear eriod shall not be considered a homeowner.
Such er"shall submit to the Building Official,o orm acceptable to the Building Official,that he/she shall be
responsible for 2atnQ work performed under theJr6lding permit.
As acting Construction S't-Ityerwisor your prese5.peon the job site will be required from time to time,during and upon
completion oZStateand for which t i d.
Also be advish reference to pter 152(Workers'Compen and Chapter 153 (Liability of Employers to
Employees foot resulti n Death)of the Massachusetts Gener=1e tated,you may be liable for person(s)
you hire to pe for under this permit.
The undersig er"certifies and a t y or co the State Building Code,City of
Northampton s,State an a Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner
. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks ] Siding[O] Other[0]
Brief Description of Proposed, J `
Work: ��N/4y,I - '� T(nrx C.Oil T _`Fbt'tt� t?S_�e t�11 Q, lam►"i�, �!
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes .-;W No
Plans Attached Roll -Sheet 5
6a.If Newhouse and or addition to existing hou5ing, 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. 46 Dimensions
00
e. Number of stories? 1 "�
f. Method of heating? CN>60J Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. IJ A 7 Masscheck Energy Compliance form attached?
h. Type of construction 1.-CCU 'ul
i. Is construction within 100 ft. of wetlands? Yes 7" No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade_d
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 AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1 V-- � �v- A— as Owner of the subject
property
hereby authorize � ��-+ e
to act y behalf in all rpa ers relative lip work authorized by this building permit application.
Si nature of Owner Date
as Owner/Authorized
Agent hereby declare th4 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.
Print Name
-EDZ�
Si natur wrier/Agent Date /l\�
J
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
(STJ 11 c. IR C4�i\q Building Department
Lot Size
Setbacks Front
Rear
Building Height
Bldg.SquaTe Footage 01/0
Open Space Footage %
(Lot area minus bldg&paved
#of Parking Spaces
(volume&Location)
A. Has a Special Pennit/Vahance/Finding ever been issued for/on the site?
*v�� �~� �~�
NO �S°/ DONTKNOV/ \~_J YE� v~�
|F YES, date issued:
IF YES: Was the permit recorded at the Registry ofDeeds?
��
NO ��/ DONT KMUYY 0 YES `
IF YES: enter Book Page and/or Document#
��
B. Does the site contain a brook, body of water urwetlands? NO ��V 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 si �gn�� ston the pnoperty �� ��� 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 0 NO 0
IF YES, describe size' type and location:
E. Will the construction activity disturb(clearing, gradingexcavation, or filling)over 1 acre orisit part ofa common plan
' that will disturb over 1acre? YES ND K��0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
� � Departmerit,use on y t
p r4 ry
11 ,
Ity of Northampton Status,of Permit � , � k ;
uilding Department Curl?GutlDrirreway Perrrttt ti
2 niF c t
�ols J 212 Main Street SewerlS�ptic kvaifabhtty
a
E i Room 100 WaterlVttel(AVailabllity
Electric PI,.,__°C orthampton, MA 01060 Two Sets of Structural-Plans
Ncr r- .-,t
phgr °$�13-587-1240 Fax 413-587-1272 Plof/Site Paris
E
_. - Other Spect#y ' 1
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed byoffice
1.1 Property Address:
rw i„S
Zone Overla Distinct
Elm St District CB.District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
✓ r- �'t-�� ,rs 5� 1� ?�%fir pktA_' c.--
Name(Print) �' Current Mailing Address:
(s
Telephone
Signature
2.2 Authorized Agent:
y g=-_(a
Name(Print) Current Mailing Address:
igna r Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building (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) ber
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissionerlinspector of Buildings Date
File#BP-2015-1183
APPLICANT/CONTACT PERSON JEFFREY BOTT
ADDRESS/PHONE 32 Pine Street FLORENCE01062(413)530-6920 Q
PROPERTY LOCATION 53 AVIS CIR
MAP 22D PARCEL 112 001 ZONE URA(100)/WSP(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 4
Fee Paid
Typeof Construction: REPLACE CONCRETE STEPS W/WOOD&ROOF
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 053157
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9RMATION 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
to of Ktuilding 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.
53 AVIS CIR BP-2015-1183
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 22D- 112 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2015-1183
Project# JS-2015-002214
Est. Cost: $5000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JEFFREY BOTT 053157
Lot Size(sg.1): 37635.84 Owner' MCGOVERN TRICIA L&MARY J MAROUARD
Zoning: URA(100)/WSP(100)/ Applicant: JEFFREY BOTT
AT: 53 AVIS CIR
Applicant Address: Phone: Insurance:
32 Pine Street (413) 530-6920 () Workers Compensation
FLORENCEMA01062 ISSUED ON:512712015 0:00:00
TO PERFORM THE FOLLOWING WORK:REPLACE CONCRETE STEPS WMOOD &
ROOF
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 Signature:
FeeType• Date Paid: Amount:
Building 5/27/2015 0:00:00 $55.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner