10-011 (3) 14'
X 4 CEDAR TOP RAIL
X 4 CEDAR POSTS
5 -8Y 2
N 1 S
�
'TREX SELECT DECKING 33/4 d 2 X 8 OR 2 X 10 JOIST
TYP, RAILING DETAIL
Qc(US(tees 56 16 .l'_
SOUTH ELEVATION
ARAI/FIRST DECK
523 KENNEDY ROAD
LEEDS
SCALE:
1/4"=1'
AUGUST 2015
�' 3 3
Pmm—eGm—2
2 6'
dining window
asen o5ri I itch. window
SIM S❑ TR NG E ❑I HINNURS ON ALL JOIST AT LE GE
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5'-119 6"
1 '
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ARAI/FIRST DECK
523 KENNEDY ROAD
5'-1116" LEEDS
SCALE:
PLAN VIEW 1/4"=1'
AUGUST 2015
AZ
City of Northampton
Building Department
Plan Review
212 Main Street
Northampton, MA 01060
MAIN DECK;
® 3 - 6 X 6 PT POSTS
3 - PRE-CAST C❑NC, PEIRS
-8" '-8"
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2'-91 2,-11 2N
ARAI/FIRST DECK
523 KENNEDY ROAD
LEEDS
SCALE:
STAIR SYSTEM: PLAN VIEW 1/4"=1'
8 - 4 X 4 PT POSTS AUGUST 2015
6 - PRE-CAST CONC. PEIRS
(2 POSTS DIRECT BURY) a 3
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I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES,AND BASED ON EXISTING MONUMENTATION, ALL EASEMENTS, ENCROACHMENTS
AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES. I FURTHER
REPORT THAT THE PROPERTY IS NOT LOCATED IN A FLOOD PRONE AREA AS SHOWN ON FEDERAL INSURANCE MAPS FOR COMMUNITY
NUMBER ZSO1G-T
DATED: 9 - IS - 9-7 NOTE
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES
SURVEYOR: NOT CONSTITUTE A PROPERTY SURVEY.
MORTGAGE LOAN INSPECTION PLAT
114 OF Ar
RICHA4iD D NOR--I N ,4M PTON, MASS.
J. owNCR
LQARGE SR
#34605 Q L•l C E R . CL.EMEµT S
S�c''-''�4 SCALE: ( I 57r I
Richard J. LaBarge,Sr., Registered Professional Land Surveyor
110 IGng Street, Northampton, Massachusetts 01060
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.
Address of the work:
The debris will be transported by: �� �� � C
The debris will be received by: dV IN
Building permit number:
Name of Permit Applicant
9
Date Signature of Permit Applicant
City of Northampton
Massachusettsf{y
- + DEPARTMENT OF BUILDING INSPECTIONS
x,
212 Main Street • Municipal Building �vt
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 act as his/her
construction supervisor. 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 inspe & made
understand the above.
'(Home owner/resid t' signature requesting exemption)
i t call to schedule all required building inspections necessary for the building permit issued to me.
Date
Address of work location
T
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): � f7, i� '
Address:
7 Phone #:City/State/Zip: >7 � 41 C
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 I
employees (full and/or part-time).* have hired the sub-contractors 6. E] New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working for me in any capacity. employees and have workers'
9. ❑ Building addition
[No workers' comp. insurance comp. insurance.
4
quired.] 5. r_1 We are a corporation and its 10.E] 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 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 the policy 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 cerd under the Prins and penalties ofperjury that the information provided above is true and correct.
Sign ature°` f C 414 C Date:
Phone#: `0/ 9 " 37 "� %' _7
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#°
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
License Number
Address Expiration 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. 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 a"Zoni, State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors E]
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[Z] Siding [O] Other[a
Brief Description Proposed e
Work: REPLACE EXISTING DECK DESTROYED BY FALLING ICE AND SNOW WITH NEW DECK. -"1
Alteration of existing bedroom Yes x No Adding new bedroom Yes x No
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll -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: 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. Masscheck Energy Compliance form attached?
h. Type of construction
L 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
1, Azl— ,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
1, 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 Name
I
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 be filled in by
Building Department
Lot Size
Frontage 1.13 113
Setbacks Front 47 47
Side L: 58 R:'26 L: 5$ R:',25
Rear 109 96
Building Height 28+6 28+6
Bldg. Square Footage 1625' 6 % 2005 7
Open Space Footage %
(Lot area minus bldg&paved 2536 92 2494 90_ ..
parking) 3" "
#of Parking Spaces 3 3
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW G) YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW Q YES
IF YES: enter Book ; Page' and/or Document #'
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO 0
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, grading, excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
E Department use only
} �7 K'7 " - Cit� of Northampton Status of Permit:
Building Department Curb Cut/bliv6way-pelrmit
I' AUG 14 2015 212 Main Street Sewertseptk4Avatl biflr
Room 100 Water fell:Availabili
Northampton, MA 01060 Two Sets of Structural Purls
Eh�t�
I' -phone 413-587-1240 Fax 413-587-1272 PlotlSite 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
523 KENNEDY ROAD Map Lot Unit
LEEDS, MA 01053 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: '03
NATHANIEL ARAI & KATHERINE FIRST 253 KENNEDY ROAD, LEEDS, MA 01053
Name(Print) Current Mailing Address: 413-335-6477
Telephone
Si ure
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 ermit applicant
1. Building 15,000 (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 = 0 +2+3+4+ 5) 15,000 Check Number
This Section For Official Use Only
Building ermit Number: Date
g Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2016-0187
APPLICANT/CONTACT PERSON ARAI NATHANIAL Y&KATHERINE A FIRST
ADDRESS/PHONE 523 KENNEDY RD LEEDS01053 (413)586-3144 Q
PROPERTY LOCATION 523 KENNEDY RD
MAP 10 PARCEL 011 001 ZONE RR(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
Fee Paid
Typeof Construction: DEMO EXISTING&CONSTRUCT 380 SQ FT DECK
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
1 flO AMATION 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
la
S ure o 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.
523 KENNEDY RD BP-2016-0187
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 10-011 CITY OF NORTHAMPTON
Lot: -001
Permit: Buildlnq
Category: Deck BUILDING PERMIT
Permit# BP-2016-0187
Project# JS-2016-000316
Est. Cost: $15000.00
Fee: $76.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 27704.16 Owner: ARAI NATHANIAL Y&KATHERINE A FIRST
Zoning: RR(100)//WSP(100)/ Applicant: ARAI NATHANIAL Y & KATHERINE A FIRST
AT: 523 KENNEDY RD
Applicant Address: Phone: Insurance:
523 KENNEDY RD (413) 586-3144 O
LEEDSMA01053 ISSUED ON.812112015 0:00:00
TO PERFORM THE FOLLOWING WORK.DEMO EXISTING & CONSTRUCT 380 SQ FT
DECK
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:
I �
Building $76.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck-Building Commissioner