38-072 141 GROVE ST BP-2005-0372
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38-072 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildiinci DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
category: BUILDING PERMIT
Permit# BP-2005-0372
Project# 35-2005-0492
Est.Cost: $24800.00
Fee: $168.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sa. ft.): 17380.44 Owner: DIAMOND WILLIAM D&HARRIET R
Zoning Applicant. DIAMOND WILLIAM D & HARRIET R
AT. 141 GROVE ST
Applicant Address: Phone: Insurance:
141 GROVE ST () 584-1412 O
NORTHAMPTON MAO 1060 ISSUED ON:10/8/04 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 28 X 12 FAMILY ROOM ADDITION
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: Receipt No: Date Paid: Check No: Amount:
Building 10/8/04 0:00:00 2081 $168.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2005-0372
APPLICANT/CONTACT PERSON DIAMOND WILLIAM D&HARRIET R
ADDRESS/PHONE 141 GROVE ST NORTHAMPTON ()584-1412 Q
PROPERTY LOCATION 141 GROVE ST
MAP 38 PARCEL 072 001 ZONE URB
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: CONSTRUCT 28 X 12 FAMILY ROOM ADDITION
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
INFOPIATION 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 Co ssion
/p L tib
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.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
i y of Nortf ampton t .
t Iding Department fur ftwreuva F>
12 Main Street ewe t,
�.
Room 100 �ertlltfel uatiax
Q,,��,•,.,�Nppton; MA vi`�lorth m 0 t
F 14
240 Fax 4136587-1272
�16VSit i'Acf�ia�
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 c mpteted byoffice
!.� &rove
lJo r f iI fit.p7l ne Overlay District
0 0
m m S�Distrrct CB DstFIct
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
/ r
�{Qrrt'.ef k.! /avno�� �'1l1avrt 6-�t`am8iJ ��� L7roJe�
N (Print Current Mailing Address:
Teleph -594 — 1 Itl
Aiature
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 permit 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) 1 _
5. Fire Protection
6. Total=(1 +2+3+4+5) Check Number
This Section For OffFiciaf(Use Only
Date
Building Permit Number. Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
1 i
Section 4. ZONING All Informati6n 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
Setbacks Front
Side L. 3 R: L: R:
Rear Z0
Building Height --
Bldg.Square Footage % M .
Open Space Footage %
(Lot area minus bldg&paved
azkin j
#of Parking Spaces
Fill: LL
(volume&Location) `'
iJ
A. Has a Special Permit/Variance/Finding ever been issued for/on the site? d rt'G�Gf
NO DONT KNOW Q YES 0
IF YES, date issued:,
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
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 Date Issued:
C. Do any signs exist on the property? YES Q 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
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? YESr NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check'all aaolica w
New House ❑ Addition [ ] Replacement Windows Alteration(s) Q Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [o] Decks [M Siding[D] Other[0]
Brief Description of Proposed
Work:
Alteration of existing bedroom Yes N_No Adding new bedroom Yes x No
Attached Narrative Renovating unfinished basement Yes _2�_No
Plans Attached Roll -Sheet
sa_{f New rOgseandar a dR16
n-
a. Use of building:One Family 1.1� Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
t
c. Is there a garage attached? f L 0
d. Proposed Square footage of new construction. 5 J �, Dimensions
e. Number of stories?
f. Method of heating? la Fireplaces or Woodstoves 0 Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. 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 Cf'A�o &OAS C_
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.PER1IIIT
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
-D f me 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. '
Prin
12 ,
Skature of Owner/Agent Date
SECTION 8-CONSTRUCTIOUSERYICES f
8.1 Licensed Construction Supervisor; Not Applicable ❑
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
-.kw. ec^?�Ms u.-r• -
t2eciise Moine tii�sra�venteir CoitatoriggmNot Applicable ❑
Company Name Registration um er --
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...... ❑
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 1083.5.1.
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-vear 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 J4ocaI Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
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DEPARTMENT OP ➢UILDrNC INSPECTION'S -
212 Main Strcet Municipal Building
Northampton, Mass. 01060
WORKER'S CO'iEPENSATTON MSURA..NCE AI'I'ID:i,VI-1-
I, -
(li�vs.�-cJperm)ttcc)
,,I,rlth a pt incipal place of business residence at:
— (phoney')
(scrt/ci ty/Sta.Lcra p)
do hereby certify, under the.pa-int and penalties of perjury, :hat
( ) I am an employer providing the followine'worlcer-5 comocasaLlon covemS-e 'or my
etnplovecs worl�ng on tltis job:
Omsu -n=Conprmy) (Pclic: (r:pircior.Dzte)
( ) I am a sole proprietor, general contractor or homeow70er(c c;e one) a.9d have hired
t_he C000-actgrs listed below wbo have the folJowiog worker's Campen_sation policies:
(L+^II1C Oi C0Z,!Mci0r) (InR!ranc: Cot parlyipoucy Dntc)
(N me of Councior) (I.nsuznec. Comoaa}1?0'jc- \LMm-Zr) (Lx-DU'-"6on Date)
(Name of Conuacio,-) (Inaurajac Comte}•/Polio• Numb j) (Exipir-.:
¢'Ct1Aa1P�.
Y
- Ili H3SAChiiSttf9 -
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s DEPARTMENT OF BUILDDN1G INSPECTIONS /=
INSPECTOR '212 Main Street • Municipal Building
Northampton,MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 78OCMR 108.3.4 to
act as hds/her construction sup,,:-�' sor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be,"a one or two fame
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 inspections are
made
I, Gc understand the above.
(H me owner/resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date 0 0
Address of work
location `�'` r-0✓�` S� ' __
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7
VEQ, 2 (-1
ENERGY CONSERVATION APPLICATIONFORM FOO, J � t
LOW-RISE RESIDENTIAL NEW CONSTRUCTION AND ADDITIONS
780 SMR Appendix J-{-effective 3/1/90
Applicint Mame: �j _ Site Address: —
Appf,crrnt f ddrns5: -- C,ty/Towm
Use Group:
' Date of A,ppirczithon:
Ari nitt•ffilt Ptvw.f; � _ %+v y,i i:.u'iiv i Ji�r,piiil-t'�:���� '
Corn.p{daroce f wtk (check artetX
Ej- Prascriptive Package (!_imiteo to 1- or 2- family wood frzmE t)uildingt, treated Witt, fossil fue!s only)
Package (A throup`t KK from Table .15.2. ib) ____ Heating Degree IJays (HDD65)from Table J5.2 la:
(For items d. throug'`t i., fall in :ell values tfnat apply from Table J5.2)
a. Gross Wr0i ,area sq. h f. Well R-Yafuc g
b. GI azi ng Ar" Floor R
g �-
c. Glazing g,(100 x b+a) h. Pbsement wall
d, Cla Zino t I-yhl v -;;ab Perimeter
t_
e. Chilling R-value S. Heating AFUE
❑ Performance- "Manual Trade O'f' (Limited to wood or metal framed buildings only)
Gimate-Zorre(tram Figure J6.2.2) Zone 12 ❑ Zone ;S 0 Zone 14
Attach trade O`f t4)' k-sher, f;om Apperidi',: J,[and HVAC Traoe-(D ivbtksheei, it applicable)
Cj MASch&ck Softwarr
Attach Cornpltance Pap--4 and.inspeclipn Checklist printouts.
❑ Sysitms Analysis O-R ❑ Renewable FnerF-y Sources
Attach Mass. %-gistered Archited or Engin,--,r Analysis
ALTERNATIVE FOR ADDITITYNS Orifi Y_
a- Gross Wall + ( (,U" ti.Sy � `�`5
C-�ittnV A,f� . �'. G1aZin^firFa` �� t a
� q.Y. C. l,sl.,Zrrnj3 Imo (I60 x b-r a)
❑ ADDMON with Glazing % (c.)up to 4•0%may use 780 CMR Table JI 1.2.3.1 below:
MAXIM.L111 U-value Minimurn R YalUcz
Fenestration Ceiling Miall Floor Basement Wall ; Stab Perimeter, Dept
0.3s R-37 R13 R 19 R•10 t R.IO, 4 ft.
❑ -S1J'NP 01l` addition (greeter than 40% gialing•to wail and ceiling gro:s area)
Aftach -Consumer Inforn-ation Corrin' from 780 Cf4P Apperidix B.
vmciai'S Na me: Official's Signature.
Ap-Pticatron Approved ❑ Denied Ivl Date of App2r=al;
pvvSi,�q`S)vi Denial:
(ProyidC addiiional details as needed on back silo)
Axta==y be okho r PM01{3P'mmig cc Unit D mcn-uons.
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THIS PLAT NOT FOR RECORDING PURPOSES-Ar
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,ALL,DISTANCES BY DEED.
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TRACT I TRACT II �.
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BOOK 2261, AGE 3
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GROVE STREET (PUBLIC)
TO: THE NORTHAMPTON INSTITUTION FOR SAVINGS &
THE FIRST AMERICAN TITLE INSURANCE COMPANY.
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 TETE BUILDINGS ARE ENTIRELY WITHIN THE LOT
LINES. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED IN A FLOOD PRONE
AREA AS SHORN ON FEDERAL INSURANCE MAPS FOR COMMUNITY NUMBER 250167
DATED: October 15, 1985
SURVUORI;9!��
-NOTE-
THIS PLAT FOR MORTHWELOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
OF
HAROL �� -MORTGAGE LOAN INSPECTION PLAT-
EATON NORTHAMPTON, MASSACHUSETTS
o No.g301i PREPARED FOR
rstERIC W. & DIANE K. JENSEN
s�t,LA SCALE:SCALE: 1"=50 t OCTOBER 15, 1955
HAROLD L. EATON, PROFESSIONAL LAND SURVEYOR
9 SUNRISE DRIVE �- HADLEY - MASSACHUSETTS