Loading...
31A-006 (2) 9 MASSASOIT ST BP-2017-0162 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:3I A-006 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-2017-0162 Project# JS-2017-000258 Est. Cost:$40500.00 Fee:$263.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: THOMAS DOLAN 039281 Lot Size(sq. ft.): 6011.28 Owner: JOHNSON NANCY NASH TRUSTEE&KENNETH D NASH&PEGGY NASH Zonino: URB(100)/ Applicant: THOMAS DOLAN AT: 9 MASSASOIT ST Applicant Address: Phone: Insurance: P O BOX 297 (413) 585-0612 0 Workers Compensation CHESTERFIELDMA01012 ISSUED ON:8/8/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:REMOVE RAISED SECTION OF FLOOR STRUCTURE, LOWER APPROX 12' & INSTALL NEW FLOOR SYS 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: FeeTvpe: Date Paid: Amount: Building 8/8/2016 0:00:00 $263.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File# BP-2017-0162 APPLICANT/CONTACT PERSON THOMAS DOLAN ADDRESS/PHONE P 0 BOX 297 CHESTERFIELD0I012(413)585-0612 0 PROPERTY LOCATION 9 MASSASOIT ST MAP 3IA PARCEL 006 001 ZONE URB(100)! THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FII LED OUT /� `yr Fee Paid p!J T 3 Building Permit Filled out Fee Paid T e pnstmction: REMOVE RAISED SECTION OF FLOOR STRUCTURE, LOWER APPROX12'& INSTALL NEW FLOOR SYS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: # vner/Statett of or Lice._ 039281 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOTION 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/ORSpecial 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 AvailabilitySeptic 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 Aleemollitioonn/Delay [` t;t6))))) o:n - " g #ffi alie 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 Manning&Development for more information. "''.. 3:.ee �p N a s ea: � J"1 City of Northampton ' ; t s ``' ,,y * "l, e r rst 1 Building Department "+tom ,.a e7rt r `" , ALS 292 Main Street E �et� 1.7rtr;r- `_. c. 4 zJlo Room 100 ..A• tgwrA. kg ty e't' Northampton, MA 01060 010607- 272h ne413-587-1240 Fax 413-58 p .ttgefo€§ caa»v sx$` ' ViSi 'elans , ,� rteC � a 1114:8 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION IA Prop�ejrtY Address: r 'ThisysecGptXt(ttm campiStedq office 7 //,R.S.S'4Jo��' sr Map L,aL r - Uqd /1/'w'/64M.,J w Il . 0106© FZane ,'" vetlaybrstrt t „ �EIm S�}1L;fy(#C ,,,,, CB DIatficY _,-,� SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 23 Ow er of Record: kE at-1 ("-.1 q ktassesaf 4r ah4ah6leis• d P Gunent Mailing Address: - esy i.1 vis -ss 1T _/ Telephonee Signature ap 2.2 Authorized Agent: 7i bobs/Jo/ugh1 t ahsvdds l?D+ 001 d 47 l�iin/n owls Name(Print) Current Mailing Address: w..« - -( '1/3-at,—sib Se 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 3/.9ou 2. Electrical {b}Estimated TotalCost of /��yj, «� ConstrUCtion from(S) 3. Plumbing yarxv. Building Permit Fee 4. Mechanical(HVAC) S. Fire Protection �) ! I6. Total=(1 +2+3 +4+5) � /Q T$O, ry Check Number / 2 . 1 This r Offi Section For Use Only Building Permit Number Date aed: Signature: euflding Commissmnernnspector of B�ildings Date Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Required by Zoning This corwmtoby filth in by Building Department ... u ENIIIIIIalaMM= 4 Setbacks Front EEl 1 Side L:_! R:ET1 1.1 ___!_R:L_ CI Open Space Footage Iffalillilla (Lot area minus bldg&paved .arkin; _ -.W Fill: votwc&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES 0 • ' IF YES, date issued: I ' IF YES: Was the perthit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book i^ Pagel 1 and/or Document#1 I B. Does the site contain a brook, body of water or wetlands? NO (3 DONT KNOW W YES Q IF YES, has a permit been or need to be obtained froth the Conservation Commission? Needs to be obtained Obtained lJ , Date issued;f • • C. Do any signs exist on the property? YES ® NO leg 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: j 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 © NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 1/�Je,vtovgqe par-ice).Sectc v! e6' 2 cve s' euctue n e <awe QPb< IOIf RMT�sI /( /VCLJ 4706R SYS�'/i/� SECTION -DESCRIPTION OF PROPOSED WORK(check all applicable) New House fl Addition Replacement Windows Alteration(s) Roofing E Or Doors 0 Accessory Bldg. Demolition E New Signs [C] Decks [p Siding [C] Other[I7] Brief Description of Proposed Rent. Co tJ chop /AIY�. "twin refit AIY.ew- velli Nes* AVL roar Work: Neu ill eau/to PANe...7 t/re✓Aiwa ago isle,.- Mora her lq E/coir eta Alteration of existing bedroom Yes ✓ No Adding new bedroom Yes ✓ No Attached Narrative Renovating unfinished basement Yes ✓ No Plans Attached Roll -Sheet as.If New house and or addition to ixistinq 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 a Number of stories? Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction 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 ..A(GENT OR C ONTRACTOR APPLIES FOR BUILDING PERMIT rCN J0F1\15 ,as Owner of the subject prope rrMM ,(ry/ hereby \ on - TY- ` DCO-1 ^ to -.' all,in all matters relative to work authorized by this building permit apph tion. Signatu Date I, pin f7!//I✓ dWAC�Q� attiast ,as Owner/Authorized Agent he by 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. du /I/n A�oLn, Print Name Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 licensed Construction Supervisor: Not Applicable £ Name of License Hold&: 7 r! A?DL X✓.__.__—_— License Number Address / Expiration Date COI a97-SA1V Signature Telephone 9,Reaistered Home Improvement Contractor; Not Applicable £ Company Name Re *dation Number 1.j-4-- Address i Expiration Date " ... Telephone yI t99%576N 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 - Hume Owner Exemption The current exemption for'homeowners"was extended to include Owner-occupied Dwellings ofone(t) 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 7$0, 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 strucewes.A person who constructs more than one home in a two-year period shall pot be considgreed 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 far 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 oflndustrialAccidents _-1u �t Office of Investigations in _r a_ _p 600 Washington Street =14:19 Boston, MA 02111 %rt i www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): /OA/ 20a#10) hensfita L L b/tiaINv/ _ _ Address: Pa, A'ue fl Al City/State/Zip: , , i r , Phone#: A -p7g7- Are you an employer? Check the appropriate box: Type of project(required): 1.R'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. ❑ N w construction 2.El 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.' 9. ❑ Building 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 11.4lumbing 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' 13.0 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. / N� y ' Insurance Company Name: At ler*4' e'L'.'� .4 1 Atj, Policy#or Self-ins. Lic. #: Expiration Date: 1-/6 - 96 Job Site Address: /!r(A 54 tifSIif 1 r dal IIlitr/Llik City/State/Zip: Q/O/g Attach a copy of the workers' compensation policy declaration page(shoeing 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 cerfiffyy under the pains and penalssoo perjury that the information provided above is true and correct. Signature: e��� .� /L��t(�. Date: y.z0id Phone#: 4///1- 00,- $76 4/ 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 l' o Massachusetts .�� '4, w: s AF�4 DEPARTMENT OPBUILDING INSPECTIONSn. 4 ys�f>-:w 212 Main Street a Municipal Building JF ,�L eer Northampton. MA 0100 Ph •1•.` 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 mare 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 foundationlfootings (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, - - 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 ,1111, S 150A. Address of the work: 9 dlaisGsoft eT �{t�,cf ..rpJam The debris will be transported by: %n+ 7)7)„,2/ 46,.../ The debris will be received by: U4/ky �otyt/i , Building permit number: d Name of Permit Applicant ,.f U&J4At/ 4 '/ 2f/A Date Signature of Permit Applicant ,J-41 ea&cc,(4204( 1_________.____t..., —v"' qM 354 So it Si' 0 , , ./ / 4 I 11 0.) 1 IN e<I 5'h,uey 'FLo„ - To 3e I_oLoane.Q / I II i I \\ I bl i 0('s1,rJ �V a Ebco — .\ l,Eo x L N I 1 YI -. F)YLC D/.AI'. 71--.?>v 1 I ' ' i 6;k4 T*n&� k„ i` o ii ii ,, exist*u0c 4F le H ' I ----cid)cc. IAJ4 ( 1 I II ax,a Sour I I c a' rz r cl' 41 1 I I i t i I y tit fi 1i ! i ; 1 w , 1 s, I ( { 1 I I I i 1 '• i I � I I9___ i I I ex,s+ ---- —� hoe 6\4 71skyovoCAo id'' PJC 1"p{ansoN 41 Mt,S1ttor I" sr t( ?LN7corin sobF=cot d/arhsvtis /Yfar oioo° 3' OAK Rats?? c'i,00n_ 4 �R D014-,J Gtcne*c 440‘44,1-41A, tgg�e 2 6�3 r:o, aox & vPi# 47 Ghost / t/Oa 64/1 4)13-o997-T2n `YI MI 2,144(iti-carz_ Gvuf/ I n 151 J/4�/� -Pow,I Al A/a?Q/'. V/A,v/in fr M. OL ~r aQl{,c'42t,Inlet.- 2€ ev,., c - k Atm .Artlotity( °tactt- 1 I -,.> 1 'K- 1_, i. >Jt3E / 1Cu7 flewMew Lvl_ p (-)v ?Yu, 1 VI-100 /, 0“ PI 7o1S1' �K,C w/tga.t Arr5 Si(to lid"- ✓"" 'V" 1'P 5T i { ,£3/4-e/// N7" -\ 1 Psrs7/n¢ 1 Geeta'[ et e5iirttJ I f,okg-Itw&eniNcea71vr) 1 ((7fkr) 1' Canieta C pAlert yy.....