46-058 (16) �dC, , o'er rl-l'/S
Vreeland Design ,associates Sht. of
An integrative approach to design, engineering and site planning `
Re: Mary Glazewski, 503 Mt. Tom Road, Northampton, MA: Pier foundation
details for proposed 12'x 12' Entry Deck and Stair. {3 i
6/21/15
C -
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Notes: ,
=ti� —L 15*gyp'i A C G ecr�i
1. This plan is to certify that the proposed
precast pier foundation for the 12'x 12'
Entry Deck and Stair meets the Flood-
Resistant Construction Requirements of
the current MA State Building Code
section R322.2.
2. This plan is based on a preliminary plan
for the entry deck and stair. The final
dimensions niay be adjusted to e,£lect
the final plans to be prepared by others.
116 River Road, Leyden, MA 01337 Phone: (413) 62+U126
Email: dvreeland @verizon.net Fax: (413) 624-3282
Vreeland esi n Associates Sht. of
An integrative approach to design, engineering and site planning
Re: Mary Glazewski, 503 Mt. Tom Road, Northampton, MA: Pier foundationr, �
details for proposed 12'x 12' Entry Deck and Stair. (
6/21/15
I
Notes:
1. This plan is to certify that the proposed
precast pier foundation for the 12'x 12' r �f � `
Entry Deck and Stair meets the Flood-
Resistant Construction Requirements of
the current MA State Building Code
section R322.2. ' � -
2. This plan is based on a preliminary plan
for the entry deck and stair. The final �
i Tensions may be adjusted to
the final plans to be prepared by others
116 River Road, Leyden, MA 01337 Phone: (413) 62+0126
Email: dvreeland @verizon.net Fax: (413) 624-111282-
V1 „
lit a
J
City of Northampton 212 Main Street, Northampton, MA 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.
J L 0
Address of the wo rk: � u i'
The debris will be transported by:
The debris will be received by: s S
5
Building permit number:
-��t►� is
Name of Permit Applicant
Date Signature of Permit Applicant
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: --
License Number
Address Fxpiration Date
Signature Telephone
9 Registered Home Improvement Contractor: Not Applicable ❑
Company Name Registration Number
Address Expiration Date
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....... ❑ No...... ❑
11. - IIome Owner Exemption
The current exemption for-homeowners"was extended to include Owner-occupied Dwcllin(-js ol'one(I) 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 buildinp- permit.
As acting Construction Supervisor your presence on the job site will be required from time to time.dw-ing 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
I'mplovees for injuries not resulting in Death) ofthe Massachusetts General laws Annotated, you may be liable Ibr person(s)
you hire to perform work for you under this permit.
'I he undersigned'`homeowner-certifies and assumes responsibility for compliance with the State Building Codc_City ol'
Northampton Ordinances, Stat-ai Local /.oning 1 ws and State of Massachusetts General 1_aws Annotated.
Homeowner Signature /,t_
rNew ON 5 DESCRIPTION OF PROPOSED WORK(check all applicable)
ouse ❑ Add ition ❑ Replacement Windows Alterations) ❑ Roofing ❑Or Doors �sory Bldg. ❑ Demolition New Signs [❑] Decks Siding [❑] Other[❑]
Brief Descri tion Proposed m U
Work: GO IPA
Alteration of existing bedroom Yes No Adding new be anI X No
Attached Narrative Renovating unfini
Plans Attached Roll - Sheet eh 71rY �G
6a. If New house and or addition to existing housing, con
a. Use of building : One Family Two Family C
b. Number of rooms in each family unit: Number of E
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. Masscheck Energy Compliance form attached?
Ii 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-OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I , as Owner of the subject
property
hereby authorize — ---
to act on 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 accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print Narne
Signature of Owner/Agent 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 he filled in by
1311ilding I)cpartment
Lot Size
Frontage
Setbacks Front
Side
Rear 0 D
Building Height /I
lX i
Bldg. Square Footage q %
Open Space Footage l %
(Lot Luca minus bldg&paved
narkina)
0 of Parking Spaces
Fill.
(volume& Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DON'T KNOW O YES O
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW O YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained O Date Issued:
C. Do any signs exist on the property? YES O NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO
IF YES, describe size, type and location: y�
E. Will the construction activity disturb (clearing, grading, e cavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO
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
IT Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
i" CV Other Specify
Al 0 ATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
3i61N 1'u E INFORMATION
This section to be completed by office
1A Property Address:
503 J �. f �<
� 4 Map Lot
0 4 Zone Overlay District _
Elm St. District CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name Current Mai Ting Address:
V
- 0AA�d �a.4 IAMI Telephone (, ^e g 0/
Sign ture `� y "�
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone _
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Itern 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. f=ire Protection
6. Total = (1 + 2 + 3 +4 + 5) U.. Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature: ------
I
Building Commissioner/Inspector of Buildings Date _
File#BP-2015-1366
APPLICANT/CONTACT PERSON GLAZEWSKI HELEN S&MARY
ADDRESS/PHONE 503 MOUNT TOM RD NORTHAMPTON01060(413)584-4109 Q
PROPERTY LOCATION 503 MOUNT TOM RD
MAP 46 PARCEL 058 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out lotr
Fee Paid
Typeof Construction: DEMO&REPLACE CANTILEVER ENTRY DECK&STAIRS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory 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
INFORMATION 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
ela
Si re of Building O icial 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.
503 MOUNT TOM RD BP-2015-1366
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:46-058 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-2015-1366
Project# JS-2015-002489
Est.Cost: $20000.00
Fee: $120.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Groin: Homeowner as Contractor
Lot Size(sq. ft.): 117612.00 Owner: GLAZEWSKI HELEN S&MARY
Zoning: Applicant: GLAZEWSKI HELEN S & MARY
AT. 503 MOUNT TOM RD
Applicant Address: Phone: Insurance:
503 MOUNT TOM RD (413) 584-4109 ()
NORTHAMPTONMA01060 ISSUED ON:71212015 0:00:00
TO PERFORM THE FOLLOWING WORK.-DEMO & REPLACE CANTILEVER ENTRY DECK
& STAIRS
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 7/2/2015 0:00:00 $120.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner