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16C-031 (2) 383 SPRING ST BP-2017-0279 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 16C-031 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-2017-0279 Project# JS-2017-000474 Est. Cost:$18900.00 Fee:$123.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 31319.64 Owner: BOSCO JOHN Zoning: URA(57)/WSP(57)/ Applicant: BOSCO JOHN AT: 383 SPRING ST Applicant Address: Phone: Insurance: 383 SPRING ST (413) 262-5243 () FLORENCE ,MA01062 ISSUED ON:9/6/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:RENOVATE UNFINISHED ATTIC 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 9/6/2016 0:00:00 S123.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0279 APPLICANT/CONTACT PERSON BOSCO JOHN ADDRESS/PHONE 383 SPRING ST FLORENCE , (413)262-5243 0 PROPERTY LOCATION 383 SPRING ST MAP 16C PARCEL 031 001 ZONE URA(57)/WSP(57)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Crg a3 f) Building Permit Filled out Fee Paid Typeof Construction: RENOVATE UNFINISHED ATTIC 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 INFO ATION 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 lition Del d, 7-01-/Z Si of Building 0 ficial 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. RECEIVED ttis Department use only 3 � 2016 City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit DEFT OF BU:Ln'NG}N'Y-C-''".q i 212 Main Street Sewer/Septic Availability r~oR_VAMFTC , �� co _ Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 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 This section to be completed by office 1.1 Property Address: 383 Spring St. Map Lot Unit Florence, MA 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: John Bosco and Valerie Vignaux 383 Spring St., Florence MA 01062 Name(Print) Current Mailing Address: 413-262-5243 Telephone Signature 2.2 Authorized Agent: (same) 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 S18.000 (a)Building Permit Fee 2. Electrical $900 (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) $18,900 Check Number c '3. i/83 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Z,oning This column to be filled in by Building Department Lot Size 1.4 acres 1.4 acres Frontage 232 ft. 232 ft. Setbacks Front 70 70 SideL: 148 R: 36 L:_148 R: 36 Rear 161 161 Building Height ^'35 �3S' Bldg.Square footage 2640 t % 3500 t Open Space Footage (Lot arca minus bldg&paved 95 95 parking) #of Parking Spaces 4 4 Fill: none none (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW Q YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW O YES g< IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained ® , Date Issued: Nor NEEDED C. Do any signs exist on the property? YES Q NO n IF YES, describe size,type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO 0 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? YES 0 NO -1440 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing El Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [Q Siding [0] Other[0] � I Brief Description of Proposed Work: Renovating unfinished attic Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet 6a. If New house and or addition to existing 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 e. Number of stories? 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.onstruction 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 la-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 Date 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 under the pains and penalties of perjury. Print Name Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable X Name of License Holder: License Number Adcress Expiration Date Sicnature Telephone 9.Registered Home Improvement Contractor: Not Applicable Company Name Registration Number 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 CX No 0 11. - Home Owner Exemption 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 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 he 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 Yt41 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: 3 33 5rR)N4 ST. f e-wce, ,q,4 01062 The debris will be transported by: Jt{-11V ADSL o The debris will be received by: VALLEY iREcyct4 tJ G Building permit number: Name of Permit Applicant J°{-f iV go SC 0 b7307/ 6 ?,,ety Date Signature of Permit Applicant City of Northampton Massachusetts ,t • , `,' DEPARTMENT OF BUILDING INSPECTIONS y 'v 212 Main Street • Municipal Building Northampton, MA 01060 s'"--• '‘`�� 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 f• ..ti•n f. • in• • -f• • . kfill •n• .1- • •f•r• . • r . r. .h • _•I•in• i .- i•n (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 thg 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 o er/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date / 4:11 Address of work location 3 83 Sf.Iii G St. Ftoigi lcl-/Ce, MA- 01062- 'gL, The Commonwealth of Massachusetts i"=`=> t�f/ Department of Industrial Accidents t —.•, ;ill_= , 1 Congress Street,Suite 100 -,7.--...4._=-. 5 Boston,MA 02114-2017 Y�;:� ..X' www.mass.gov/dia gm Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTPVG AUTHORITY. Applicant Information / Please Print Legibly Name (Business/Organbztion-Individual): ��2- ) �14tryyi�.. P'r-{rj'?VZ -wc,c l( •G Address: (tiCi t-'(e‹.,s a,-t &\-- City/State/Zip: .�p ,1/(/� 06, Phone #: L/!2 J ct ` G.+1• G' Are you an employer?Check the appropriate box: Type of project(required): ta.am a employer with employees cfull andlar pan-time).• • 7. 0 New construction 201 am a sole proprietor or partnership and have no employees working for me in 8. DB Remodeling any capacity.[No workers'comp.insurance required.] 301 am a homeowner doing all work myself.[No workers'comp.insurance required] 9. Demolition 4.Elt am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 El Building addition ensure that all coruracxors either have workers'compensation insurance or arc sole 1 1.0 Electrical repairs or additions proprietors with no employees. 12.a Plumbing repairs or additions 5.0I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0Roof repairs These sub-contractors have employees and have workers'comp.insurancx 6.(We are a corporation and its officers have exercised their right of exemption per MGL c. 14. [Other i/L�i AA C C 152.tt 1(41.and we have no employees.[No workers'comp.insurance required.] 's I 'Any applicant that checks box NI must also fill out the section below showing their workers'compensation policy information. c Homeowners 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 stale 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: ;_�C e6.e.v'` �ct l-i ��er- 5eA.ci SLLer, ,1c.s.(`'?".-{) Policy#or Self-ins.Lic.#: l — L�5 3 3 -tel —Ci 7/- Expiration Date: /1 / ' // Job Site Address: 5' S S 7i' ST - City/StateiZip `-f.c\CL rr J 1 tot las. Attach a copy of the workers' compen ation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152.§25A is a criminal violation punishable by a fine up to Sl.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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. J do hereby c rrr under the pains and enallies of perjury that the informal"provided above is true and correct. Signature: 'tL�.�-{� ; b left--- Date: 3.-)) ) ‘ J1. Phone if: 4/t3 ,5".. 9 v . 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#: The Commonwealth of Massachusetts Department of Industrial Accidents =moi= t Office of Investigations ,_ 1 Congress Street, Suite 100 tit= r— Boston, MA 02114-2017 •'�.:t� www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �1111).._. Gctof Address: (13k ( .QAL tuti.A45 4c Ufi WAY (-)12ca, City/State/Zip: Phone #:– 4`'3b r 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.M I am a sole proprietor or partner- listed on the attached sheet. 7. (I Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' comp. insurance.: 9. p Building addition [No workers' comp. insurance required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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 13.0 Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowner;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 S250.00 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 certi under the pains and penalties of perjury that the information provided above is ue and correct. C Signature: 1 Date: t,� Co • Phone#: 413- -6c145 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#: 1).1/. 60,0( a s NOS � �' Side view of kneewall slope insulation / ' / ' , 4 2 x 10 rafter City of Northampton Building Department Plan Review (R30) 212 Main Street Northampton, MA 01060 b'rl,S e_ Ce ( (U °S e 16" Cellulose dense-pack 2" Rigid insulation (R13) (R56) 11411141111111\ Knee wall Sealed Soffit blocked with / / closed-cell / spray foam ��� aN H~ Top plate sealed Open floor joists blocked NOTE: In areas where there is no heating duct, Exterior wall the 2" rigid insulation board will cover the entire open slope. J.,-, q 4/\ CDA/t45-: cik i/s tr/ d'eiv .e --12c (c iv live � / es 46-7-7v6v- q