24D-272 (4) 3 FRANKLIN CT BP-2017-0075
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24D-272 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-2017-0075
Project# JS-2017-000137
Est.Cost:$4500.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
KUEL MCQUAID 051394
Lot Sae(sa. fl.): 5749.92 Owner: CAREY FRANCIS E&SHEILA G&MICHAEL F CAREY&JOANNE MARIE
CAREY&BRIAN CAREY
Zoning: URB(I00)/ Applicant: KUEL MCQUAID
AT: 3 FRANKLIN CT
Applicant Address: Phone: Insurance:
131 FERRY ST (4131 537-5063 0
EASTHAMPTON MA01027 ISSUED ON:7/29/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT ROOF OVER FRONT DOOR & 9 X
7 REAR 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 ft 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 7/29/2016 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0075 , 1Ic
APPLICANT/CONTACT PERSON KUEL MCQUAID =i- 61" l
ADDRESS/PHONE 131 FERRY ST EASTHAMPTON01027(413)537-5063 Q `
PROPERTY LOCATION 3 FRANKLIN CT b-A/ /11211/4r170
MAP 24D PARCEL 272 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid jk'Iif 1667
Building Permit Filled out
Fee Paid ?K r e beck
Tyoeof Construction: CONSTRUCT ROOF OVER FRONT DOOR eh." /�
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 051394
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
pproved 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
Demolition Delay
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.
Department use only
Fr"-CP/C D City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
JULq 212 Main Street Sewer/Septic Availability
L ' Room 100 Water/Well Availability
orthampton, MA 01060 Two Sets of Structural Plans
o"'°Fn ''^ "_ e 4 3-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
4_ 1.1 Property Address: 7/� This section to be completed by office
Property Address:
F.v'4k /It^ 001.4 - Map Lot Unit
N �// YI rf/,rt Zone Overlay District
/•O/ r4Q/ltQ�Dl1 0/o60 Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Ow er of Record:/� � /� RE
//�1 / I ��^^ /'' /..,
I �C.o AI'-O✓ee C . REdo t. Jr .� Hint. c iM C v /
N1/4:5Pn(r�) Current Mailing Adtlrs^O 3 -r-n6o77
`�j(,lft-f�9't y C. 44.32 4.4 Telephone J
Signature
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 $ (iT/(9_D (a)Building Permd Fee
2. Electrical ✓ (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection // 0/(�
/
6. Total=(1 +2+3+4+5) Check Number aMi^ /7
This Section For Official Use Only (�
Building Permit Number: Date
tIssued:
Signature:
Building Commissioner/Inspector of Buildings Date
Eaia1'/.• K`e 4, 62,0.!,,E 0 c ko 4-.ec . ,VL
Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
Iris column to be filled Walk o
Building Department ail, Mw
Lot Size . . .. . . _ ... . .
Frontage .. ... ... .
Setbacks Front
Side L ...: R.
Rear ---
Building Height
Bldg.Square Footage
Open Space Footage
(Int area minus bldg&paved
parking)
#of Parking Spaces
Filh
(volume&Location)
A. Has a Sp iat Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW Q YES Q
IF YES, date issued:.
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW Q YES Q
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued: ...
C. Do any signs exist on the property? YES Q NO V
IF YES, describe size, type and location
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading, ex \ration,or filling)over 1 acre or is it part of a common plan
that will disturb over I acre? YES NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
a � t. ' .
F. w .
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House n Addition Er Replacement Windows Alteration(s) r Roofing n
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [Cl Decks [' Siding[CI Other[DI
Brief Desc(iption of Proposed /ii/ a f'
work: ,f/✓w_ bCg Se•ru. -G,.,4- �:lecK apt to". (=txoc�ir
co( 3 2o�ac over }co,+.Vc�oac
Alteration of existing bedroom Yes I/ No Adding new bedroom Yes (/ No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
Sa. If New house and or addition to existing housing, complete the following:
a. Use of building One Family V Two Family Other
b. Number of rooms in each family unit. Number of Bathrooms 3
c. Is there a garage attached? Pe
d. Proposed Square footage offnew construction. Dimensions
e. Number of stories? 4,
L 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 V 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 andanZoning regulations? VIYesNo
I. Septic Tank City Sewer 'y/ 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 ,in q QDate
111.1111111
I, VPi( Mc U& t'A ,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.
Kve-t Ac
Print Name A �
ix� ���� 7///q`
/i
Signature of Owner/Agent Date
a -
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: ,t r� /� ,,,t/ Not
CApplicable`e £ �(.
Name of License Holder: kV e.' NAC QV0.1!/\ cc — 0 ✓ 1 39
License Number
131 IC� Eas4tiawtp M 01027 t2/If (2ot6
Address rlt/L`�- Expirati Date
Q,a/% LI-13 - S 37- So 6`�
Signature b Telephone
9.Registered Home Improvement Contractor:/ Not Applicable £
Kue�l A NI( QVa1Gl CQtis rue( c 106700
Company Name Registration Number
X31 ftcc-y Sd— Eq QAn*1 PtA (3t027 '7/2`t /2olg
Address L ! Expir tion Datf
�,r�
Telephone It 3—JC 37-5°63
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(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 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 Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
The Commonwealth of Massachusetts
Department of Industrial Accidents
' Office of Investigations
t, a
raft_ i'i 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
�/
n
Name(Business/OrgflnizationMdividuel): KPi ��qq V � l°lL QNfl.l
Address: 13 ciccv/ S4r—
City/State/Zip: • s •toz7 Phone #: 7{-13 - 3 7 S 060 3
Are you an employer? Check the appropriate box:
I am a general contractor and 1 Type of project(required):
4.
1.❑ I am a employer with ❑
employees (full and/or part-time).* have hired the sub-contractors 6. 12/New construction
2.1%4 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'
[No workers' comp. insurance comp. insurance.t 9. wilding addition
required.] 5. ❑ We are a corporation and its 10.❑ 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 '/ Rag--
employees. [No workers' 13.❑ Other Pad( + Rath
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.
tcontractors 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 certify under he ins and penalties of perjury that the information provided above is true and correct.
Signature: ^, / Date: 7/I 77( &
Phone#: Lt/3 — J 37
— co& 3
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):
I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
City of Northampton
piX 'aTo �t\5
Massachusetts
`- t 1 DEPARITIENT OF BUILDING INSPECTIONS r 1:
212 Main Street • Municipal Building
w Northampton, MA 01060
s n
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 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, L& 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 150k
Address of the work: 3 rcavvkC Coy pciimAgrick4 A
The debris will be transported by: 164 Ac 64.va. 4(
The debris will be received by: pucecw CecycJ ;v2
Building permit number:
Name of Permit Applicant K ,{ c Qv& I
7/ lot 7z SWA
Date Signature of Permit Applicant
home-design.jpg(JPEG Image,500 x 666 pixels) http://st.hzcdn.com/simgs/2c32373t044fa79b_8-640'ibome-design.jpg
1 "I - - fr
111
*Yik,„,,elf
I/.
G.,,aY "
.Ey ... 3'.
9n s<
i
of] 7/14/2016 11:42 AM
Oferave 3S �qa,+(
C ; , (,)/: Mr-
-/7,
- 5 (25
/ D
to,
_________
______________
_____
___ __
rig5L,, , , ,,ezK „, ,,,7
ii 1 1 15-
YoY/R.;M
' xis v,
ca,9t-t, ..5 / a. ceo re Sed Alec V (Z.c1J- cu v cc
-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND 15 NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
FRANKLIN COURT
flit! v •07�C�
' l*
I+L{1 4 1"c
0
r/ip 16.
NOTE:
APROPERTY LINES SHOWN ARE
'*n I -H APPROXIMATE, A FULL FIELD
_„ S 71 to SURVEY IS REQUIRED TO
4gACCURATELY DETERMINE THEIR
9' 165 • LOCATION.
BOOK 10585, PAG: 316
PLAN BOOK 7, PA' 52
LOT4
N e X11
�tSc
62'±
BACK OF GARAGE
EQUALS PROPERTY
T0: LINE ±
FIRST AMERICAN TITLE INSURANCE COMPANY
TO THE BEST OF MY INFORMATION. KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT UNES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY #250167
-NOTE-
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
-MORTGAGE LOAN INSPECTION PLAT-
NORTHAMPTON, MASSACHUSETTS
RANDALL N PREPARED FOR
gR THEODORE C. RIDOUT, J2. & CHRISTINE F. RIDOUT
435032 SCALE: 1-=20' JUNE 18, 2015
HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET - HADLEY - MASSACHUSETTS