32C-269 (3) 38 WILLIAMS ST BP-2016-1412
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:32C-269 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-2016-1412
Project# JS-2016-002432
Est. Cost: $17500.00
Fee: $113.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES PHANEUF 108209
Lot Size(sa.ft.): 8799.12 Owner: TROPP LINDA R
Zoning:URC(100)/ Applicant: JAMES PHANEUF
AT: 38 WILLIAMS ST
Applicant Address: Phone: Insurance:
74 Old Stage Rd (413) 247-9993
W HATFIELDMA01088 ISSUED ON:6/6/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:CLOSE IN PORCH &ADD 1/2 BATH
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 6/6/2016 0:00:00 $113.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2016-1412
APPLICANT/CONTACT PERSON JAMES PHANEUF i
ADDRESS/PHONE 74 Old Stage Rd W HATFIELD (413)247-9993
PROPERTY LOCATION 38 WILLIAMS ST
MAP 32C PARCEL 269 001 ZONE URC(1001/
This SECTION FOR OFFICIAL USE C LVLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONINC FORM FILLED OUT q
Fee Paid C a(G ,)Q )
,G l l
Building Permit Filled out
Fee Paid
Tvoeof Construction: CLOSE IN PORCH&ADD 1/2 BATH
New Coustruction
Non Structural interior renovations
Addition to Existing-
Accessory Structure
Building Plans Included:
Owner/Statement or License 108209
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
1NKORMATION 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
P_ of tion Tela
oor
Sign. tre ci 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 MOL 40A. Contact Office of
Planning& Development for more information.
i
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RECEIVED
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MAY 2 7 , City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060 ;_st:skisfaiiivieleettlatanitt.M
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APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
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1.1 Property Address:
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SECTION 2--PROPERTY OWNERSHIFYAUTHOR/ZED AGENT
i -
2.1 Owner of Record: C.
/..,I NiA71‘\ Ig--OFP
Name(Prin Current Mailing Address:
,-/„.— • .^ Telephone
Signature
2.2 Authorized Agent:
jArteS eP-141-4kyt, 75(' Ott) ST46-e-la-a) w' - g 0/0s/
Name(Print) Current Mailing Address:
Signature Telephone
, -
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be _ i : i Official Use Only
_ completed by permit applicant
1. Building
1 (ft trt77-) (a) Building Permit Fee
2. Electrical (b)Estimated Total Cost of
/ , trrt.) - Construction from(6)
3. Plumbing 9rS a -a Building Permit Fee
4. Mechanical ff-NAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) 17 , 5 Cr-t) Check Number
This Section For Official Use Only
Building Permit Number: Issued:
Signature: i
Building Commissioner/Inspector of Buildings . , . . . Date
. .,..
r•
Section 4. ZONING All information Must Be Completed.Permit Can Be Denied Due To Incomptete Information .
? Existing Proposed Required by Zoning
`
1A is cahms to be filled in by
µ
Building Department
Lot Size Ii €i `,
Frontage 1-- 1 i --Li ( ' "J
Setbacks Front I L
Side 7)_....../R: II LL _I x:l
Rear L_..--i I J I I
Building Height ( € l t i
Bldg.Square Footage ' 1 7 % I-1 _ I I -
Open Space Footage
(Lot area minus b!dg Sc paved I 1 L_J L__.J L_.J
parking)
#of Parking Spaces L—L r— 1
Fill: i ,. _ _--.
(robcme&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW !:l YES 0
IF YES, date Sued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW GC YES 0
IF YES: enter Book + f Page . I andtor Document tl`
B. Does the site contain a brook, body of water or wetlands? NO s.!.,+ DONT KNOW Q YES 0
IF YES, has a permit been or need to he obtained from the Conservation Commission?
Needs to be obtained Q . Obtained , Date issued:
C. Do any signs exist on the property? YES Q NO d
IF YES, describe size,-type and location: 1
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO 4a
t
IF YES, describe size, type and location: / j
E. Will the construction activity disturb(clearing,grading, exo ion, or filling)over 1 acre or is it part of a common plan
/ that will disturb over l acre? YES Q NO
IF YES,then a Northampton Sturm Water Management Permit from the DPW is required.
I
3
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ,tel Rooting ❑
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decksc [I] Siding[0] Other[DI
Brief Description of Proposed Ci s 1 . , �- j d 1L �p JZ Fp A-14+
Work: �-W �V ��`_"� /
Alteration of existing bedroom Yes '/ No Adding new bedroom Yes Y No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
ea 1-Nevr house and or additiap fo existing Kousinq, complete fFie following:
a. Use of building: One Family ' Two Family Other
h. Number of rooms in each family uryt: 6 Number of Bathrooms /
c. Is there a garage attached' h// r
d. Proposed Square footage of new construction. T� Lrtf(�-- Dimensions SIX./ Z,
e. Number of stories? Ai'AO^
f Method of.heating? , 1x1.K Fireplaces or Woedstoves 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 i/1 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�/art Zoning regulations? V 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, leu VL -A 0)42 ,as Owner of the subject
property �r
hereby authorize �Jct. ..c ' "^"
to act on my alf,in/all/mev at/terrrss- el
relativeato work autho ized by this building permit application.
IL
Signature of Owner `� v , Date �22-1ll
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 urypsisilde pains and penalties of perjury.
gt
\I Aitf'S�//y�//�Y/�H�/,eW�J
Print Name - V _.
Signature of Owner/Agent Dale
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:up �y /m��ry Not Applicable £
Name of License Holder: V AtAt ) " � £+ Cii63;—
�))� 7 License Numb r
/7 OW �T� RD t�, 14- it a i e i�3 i i8
Address ^ / d / cat', 9ci Expiration o to
Signature 1\I(/y\/ypyt, >V/A Telephone
9-Registered Home'Improvement Contractor _._ - T Not Applicable £
Th4't cLS `► hint J 0 nit.)7
Company Name Reg' trati9^, Number
3o/ib
Address 54-it f-, Ex !ration 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 f No...... £
11.-Home'6tivner Exemptions
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 faun
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 maybe 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 Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature.
The Commonwealth of Massachusetts
Department of Industrial Accidents
area
Office of Investigations
y_� 600 Washington Street
F l® Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Coutractors/Electricians/Plumbers
Applicant Information ^,,,t, �1 Please Print Legibly
Name (Business/Organization/Individual): 'I4ft&S fib11�7')
ettt
Address: 7,7 OW 0-146-t- is t�
City/State/Zip: . • 114 Phone#: d-`I7 '? 73
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. ❑New construction
2. I am a sole proprietor or partner- listed on the attached sheet. 7. ZiRemodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. employees and have workers'
9. ❑Building addition
[No workers' comp. insurance comp. insurance.;
required.] 5. ❑ We are a corporation and its I0.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 1I.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.0 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
=owners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContracmrs 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 ft 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 certify er the pains an aides f rjury that the information provided bonej'�'true and correct.
Signature: �)'7-� Date: �R./��
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#:
City - of Northampton
Massachusetts A� 5 -t rFj •
� � F
br - 1 DEPARTMENT OF SUILD NG INSPECTIONS o
212 Main Street • Municipal Building �
.\,,.. . Northampton, SM 01060 ✓p'W},��a
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
Jbefore 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
understand the above.
(Home owner/resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit issued to me.
Date
Address of work location
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: IAhii
The debris will be transported by: Witte Z4?.Q
The debris will be received by:
Building permit number:
Name of Permit Applicant 1 i'tk4 °P61 st
sitGko
Date Signature of Permit Applicant
From: Jim ohaneuflun iagmail cam 6 Ste_
Subject:
Date: May 25,2016 at 7:12 PM
To: Jim Phaneut pheneuijlm(wgrnaa corn
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Sent from my iPhone
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City of Northampton d,i j
Building Department c y.:
Plan Review
I 212 Main Street
jl+ Northampton, MA 01060
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