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24B-003 91 BARRETT ST BP-2016-1403 GIS 4: COMMONWEALTH OF MASSACHUSETTS Map:Block:24B-003 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:ADD BATH BUILDING PERMIT Permitil BP-2016-1403 Project 4 JS-2016-002419 Est.Cost: $8500.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: BELISARIO BURT 165619 Lot Size(sq. ft.): 20124.72 Owner: FOLEY ANITA M Zoning: URB(100)/ Applicant: BELISARIO BURT AT: 91 BARRETT ST Applicant Address: Phone: Insurance: 31 EXETER ST (413) 222-2914 EASTHAM PTO N MA01027 ISSUED ON:5/31/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:CONVERTING CLOSET TO BATHROOM WITH SHOWER 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 5/31/2016 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File 6 BP-2016-1403 APPLICANT/CONTACT PERSON BELISARIO BURT ADDRESS/PHONE 31 EXETER ST EASTHAMPTON (413)222-2914 PROPERTY LOCATION 91 BARRETT ST MAP 24B PARCEL 003 001 ZONE URB(I00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid C k•*- /33 s/ 060 g — Building Permit Filled out Fee Paid TvpeofConstruction: CONVERTING CLOSET TO BATHROOM WITH SHOWER New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 165619 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 D oli ' Sign re of Building OC�G� Date�5=2/Vec 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. R E C w' /T-I J Department use only City of Northampton Status of Permit Building Department Curb Cut/Driveway Permit MAY 2 6 (" . i 212 Main Street Sewer/Septic Availability_,.,__ Room 100 Water/Well Availability DEPT OF BUI@INO w:PECFONa NoRmarmx,nwmcw Northampton, MA 01060 Two Sets of structural Pians phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify i APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION LI property Address: 1 r 63t r tc' ri 5 I This section to be completed by office ��/p 'n�r.F'.�.JIfr Map Lot Unit f� a� �,4 Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: UQt1 tr�Y(J05 A t. dor 1 'Jxi'tt`j'f"f -j l J �ame(Prin Curren(Mai�g�tlyi[es:, P 'if- ,. l/ o 77 ..., Telephone Signature ---- 2.b "' 2. Authorized Agent: 7 J C � ' a r ! J µ v I rIll 731 e,( a„7 e Sl 1a S/'�-r+N iol[ 1 I li or®.'�3 Name( int) (� Current Mailing Address: til - 2Z t — 2�ltu Sig Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Senn Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building ,3 ' J— 0 0 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 6,,, 5. Fire Protection 6. Total=(1 +2+3+4+5) qi r 5- CO Check Number j 173y This Section For Oficial Use Only Building Permit Number: Date tsauad: Signature. Budding Commissionemnspector of Buildings Date Section 4. ZONING Alt 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 Setbacks Front Side I,: R: L: R: Rear Building Height Bldg.Square Footage �. Open Space Footage (lot arra minus bldg&paved parking) S of Parking Spaces Fill: (volume&location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW ©' YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? �+'� NO 0 DONT KNOW el YES 0 IF YES: enter Book Page and/or Document q B. Does the site contain a brook, body of water or wetlands? NO a DONT KNOW YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained Q , 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 O NO Cri IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,ex alien,or filling)over 1 acre or is it pad of a common plan that will disturb over 1 acre? YES NO IF NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION QF PROPOSED WORK fcheck all applicable) New House D Addition ❑ Replacement Windows [ Alteratlon(s) ❑ Rooting ❑ Or Doors D j Accessory Bldg. ❑ Demolition //❑ ,.New Signs/[D],/ Decks fp Siding 1031 Other[f c)o st4 / a._ bong? r (�T. � Brief Description of Proposed 4 [ ( A /y_ ipY /( Work: cid ELT 7rt Ac3ar[Y DOW? Alteration of existing bedroom Yes V-NoAdding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes _v' No Plans Attached Roll -Sheet sa. If New house and or addition to existing housing,complete the following: a. Use of building One Family r 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 a. Number of stones? f, Method of heating? Fireplaces or Woodstoves._, 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 k. Will building conform to the Building and Zoning regulations? Yes No I. Septic Tank_, City Sewer Private well City water Supply SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I. Ua 0 Gtr ) /0 S J,,,,_Sd.i1 jay�', ,as Owner of the subject p ny /��7 7 Vj hereby authorize S7C It SQ V f0 (&ut f to act on ehalf, in •II matters relative to work authorized by this building permit application. * _ x ... Signature of t; . Date .. I, ...&-1/50 YLJ UK ,as Owner/Authorized __Agent hereby declare that the statements and information on ttle.foregoing application are true and accurate,to the best of my knowledge Sbelief. Signed under the pains and penalties of pagury. t kat Lc? Signature weer/A e ���/ ! not Name 4 5/2_3 12- 4, G g 9 nt Date SECTION 8-CONSTRUCTION SERVICES 8,1 Licensed Construction SuQ��Q,rvisor Not Applicable Name of License Holder IJAsa r ID l )j,l1/ r J O. 030 License Number i i e .._> A 00 On 114 0(021 IDA)12a ? Add'--a / Expiration Date L6— 2-2-2 - L '-?(C1 :oat? Telephone S.Rrg,(Stared Home Improvement Contractor: Not Applicable urf 5 ieneraito4 t1Z Cr /65619 m in Na e // Registration Number Add s p¢ation Date 4Sf/1txl/ton ;gni ow Telephone/(15 ZZZ C9j ( • SECTION 10-WORKERS'//JCOMPENSATION INSURANCE AFFIDAVIT(M.O.L.c.152,§25C(M) 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_..,.. r No...._ ❑ 11. - Home Owner Exemption The current exemption for"homeowners" was extended to include Owner-occupied Dwellings of one(I) or two(2)families and to allow such homeowner to engage an individual for him who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 10833.1. 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 ba 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 Superstar your presence on the job site will he 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 assum s esponsibility for compliance with the State Building Code,Ci ty of Northampton Ordinances,State and cal Zoning s and Slate of Massachusetts General Laws Annotated. v Homeowner Signature' 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, asdefinedby MGL c 111 , S 150A. Address of the work: I Dtrre11�/ 91 The debris will be transported by: Giir Qt./of-- The L1 o -The debris will be received by: VA fey re Cy Ail y Building permit number: Name of Permit Applicant 3e-1 I Sa r- ( 4-7 (';Uv r 20/6 Date Signature of Permit Applicant 1 9 PIC. if. , Jf9 _ jay 'j'‘ lir I ,I ,i r < i , , .,e+ ilh1 rr.fopoim L` P c .. r J ^ .. _.._.___ .- Ain2ociy7 s-b ra2a/c/267 ---------,--„.„: j ,� i V Ii fa