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25C-191 (5) 29-31 HIGHLAND AVE BP-2017-0373 GIS 4: COMMONWEALTH OF MASSACHUSETTS Man:Block: 25C- 191 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING PERMIT Permit BP-2017-0373 Project# JS-2017-000616 Est. Cost: $9000.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN ALBERTSON 81426 Lot Size(sa.ft.): 5706.36 Owner: ALBARELLI DEAN&SARA LONDON Zoning:URC(l00)/ Applicant: STEPHEN ALBERTSON AT: 29 -31 HIGHLAND AVE Applicant Address: Phone: Insurance: P O BOX 971 (413) 522-3158 G R E E N F I E L D M A013 02 ISSUED ON:9/20/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:REBUILD SMALL DECK & STAIRS, SAME FOOT PRINT 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: O1: 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 9/20/2016 0:00:00 $65.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0373 APPLICANT/CONTACT PERSON STEPHEN ALBERTSON ADDRESS/PHONE P O BOX 971 GREENFIELD (413)522-3158 PROPERTY LOCATION 29-31 HIGHLAND AVE MAP 25C PARCEL 191 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid 04. # 1D3 JL� Building Permit Filled out �P Fee Paid Typeof Construction: REBUILD SMALL DECK& STAIRS,SAME FOOT PRINT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 81426 3 sets of Plans/Plot Plan THE F WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF MATION 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 Storni Water Management litio�ay drip // re ofB Idi g O icial 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. • a35c - / V D r in r orgy F, F,r.. Ci'v f Cl rn Upton a c arP r^r I Building De. ac, ent Corn Cu DrNery V - I I I Shr 9 212 /l In Street 'o hcA a iii I i Poore 122 Idaat_rAniei valla_urs _ J elcittnamoo . I2IA 01000Tn Ceso c uccr= ri.Pa 1Ds2 .,, ph - 413-527 2-u Fax e"13-527-`1272 �Plor/Se Plar• - I 0th r_Sc iry Ir ii I APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY CWELLkkG iSECTION 1-SITE INFORMATION _. ._ _ b 11.1 Frooerty Address' TN= -ettm-i to -, rv,-- _- by - j ti/Lss�( H15t'L�/-/") /}'Vl. M p - La. - - I._i• AI OrblW h✓-rezni✓N 41 -Zoce — -OverlayDis.ict - 'E- lm St s tr ct CE D strict i 1 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: /2-4 Lo.Y/7o.✓/DFa-.-J9t&1tte-4 2-4 /694 tr,,--o Aub, N0R-1444- .ih.., ,rt-411Ott ,0 name(02o Curren)Ma;Iln4/3s— Sr/6 - 5-742/ I . Teiepnore I Si ,ture 2.2 Authorized Acenv 5!CAL/Eti ,etter,n_7S o-✓ Ru. R44 97/, (,e£ C7;-(itd- CeYe, None(Print) Current M,ailiing Adores'. al.e !¢/3— 5-2_2_ 573 11 Signature Tei=phooe I SECTION 3-ESTIMATED CONSTRUCTION COSTS 1 item - Estimated Cost(Doha�)to be J OSGsi Use Only completed by cermit e olicant 1- Build)ng r9 avo 1"--=' i (E) Buildina F.01-71t Fee 1 2. Electrical I I (5) Estimated Total Cost of 1 Ni� Conarruarion from (5) 1 3. Plumbing IAl I n I Euilding Permit Fee I I 4- Mechanical(HVAC) 5. Fire ProtectionQ I5 Total=(1 +2+3+4*5) I I check Numoe; /03 I lF I This Section For Official Use Only Builorno Permit Number- Data issued: Signature. 5uiiE.2g Comm lssrone rune pecor of Euildmg a pate I a / , a ///e o.,1 5 0 P; s, .e. , 5eoton 4. .CPNNG ! Al form ion Mue be i tca. 3errit Czn Be :one c InTomplete Mformamme -s.m3 ( r .- sedu .tv sg cola=co be I In by I a-m- ILo.d _. l __ _ '_ , Frontaee �� - - Sr,tbacks �d - - __ SSC:: Zea: Bwi.gfeii , "- I IBldg.suaeForage S ------ II p Space Footage _ - 2 : a:I a '¢& ed pav —1 cereiafi) i Ii - _ I �aofPerlin€Spa :es _�� `-"--- I t -Lova::' A Hasa Special Permit Fin;di^n�g been issued f`o�r�/on the site? V NO 0 DONT KNOW YYES / If YES, date issued:, IF YES: Was the permit�orded at the Registry of Deeds? NO 0 DONT KNOW C) YES IF YES: enter Book Fe3e d/or Dec_-eat B. bo :he site contain a brookbody cf water or wetlands? NO 0 DONT KNOW 0 YES 0 hal YES, has a permit been or need tc be obtained `ro i the Conde—ration Commission? _ F Needs is be obtained 0 Obtained Csr , Date issued: _ C. do any signs exist on the property? YES 0 NO e 'P'1E5, describe ` e, type and location: + m..- ` D Are there any proposed ch n to cr additions of signs intended for the property? YES 0 NO 0 IF YES, describe z , type d Iodation: II E Wiii the eonsra era Ihy dltl (clearing Io caseation, orfilling)evert acre or is it part of a ocri rCn elan that will disabc iane? V „ 0 O e- h:WKS,ten loft apton Storm W :K ar _ _re- ecrit ter zee DPW s rezu;red. Pt SECTICnt 5-DESCRIPTION OF PROPOSED WORK(check all aoolicabfe) il New House Addition 1P.eiofacement'✓tlindows I Akera'tion(s) I Roofing U Or Doors C Accessory BideLI Demolition 7 New Signs (G7 Decks ID Soiling(O7 Other(MT( I Brief Oevc,,' h�on/of Ar ••sed ....._. .... ... Work: fa-Wu, [L '30144 '<=LGA a ^-ci SrAtrs y 50.•-t2' .dcoN r e t_ Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating ur5nshetl asement Yes No Pians Attached Roll -Sheet Gs If New horse End" or addition to cidatrher housine.,CorDP_t_ the fodowinar a Use of buiiding.One Family Two Family Other b. Number of rooms ei each `amily unit: Number of Bathrooms c. Is there a garage attached? 0. Proposed Square footage of new construction Di1T;n5(e95 Number of stories? f. Method of heating? Fireplaces cr Woedetoves Number of each a. Er.eroy Conservation Compil=_nce. Nina:Peck Energy Compliance form attached? h. Type of construction i. Is construction within IOC it, of wetlands? Yes No. Is construction within ICC vi floodplain Yes_.Nc I. Depth of basement or cellar floor below trashed grass k. Will building conform to the Building and Zoning regulations? Yes No . L Septic Tank Cay Sewer Private well _ City water Supply SECTION is -OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, c40,..1-/I4- L-O'"DU.) ,as Owner et the suPtect Property hereby authorize SIGIPRtiTh`Pi E2rgeff3 to act on m Oohed,in a 'a._ -alive to work authayed by this hulloing permit application. big Pyre ofOwner Care / (' 'Tr' Mit R ' iWkv` ; S T —P//( " gyF5d ,:s Owner/Authorized Agent her byDeclare that he statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Signed under the pains a, — aylees of oal}ury �} ( Pont Name Signature of Owner/Agent Date _ _ SE C T TCN as-CONSTRUCTION SERVECES Not Puffin-agile £ E 1 Lic=_used Oons:'u='ic�a Suo=rvi�.. eldecSt"-C°t-le-tiJ 41-0071--1-5 CS ® ( 1-2-4 ee Ne . / b_r I0 o� a ZI e G-Clef,46--,v/t+ lvtA-0i3az o (z7 (u ares p ati �, on D_e //e 527_ — l57) _nature Telephone — — Not applicable ?. ^nems:ered:Home Inprovm aendCprtra ,pr _ _ _. -- � /76rig/� irelp(-{GA-� ATI-4361111r515 Real ation Number Company Name q ti .rc-4sGn> he(d, WU- 01301l,i �p /n'stzo/7 Address e Telephone 4/3-52 -36.g SECTION 10-WORKERS'COMPENSATION INSURANCEAFFIDAVIT(M.G.L.a 152,§25C(6)) Workers Comnsation Insurance affidavit most be completed and su"_m .ed with this appiffiation_Failure to provide This affidavit will result in the Genial of the issuance of the building pemit Signed Affidavit Atached Yes E ��. - Home ®;w-fler Ese-9ntiof The current.exemption for"homeowners"was extended to include Owner-occupied Dweilines 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 980. Sixth Edition Section 1083.51. on wlvchmens Definition of Homeowner_Person(s)who own a parcel of land on which he/she resides or intends to reside, is,or is intended to be,a one ortwo family dwelling,attached or detached=snares accessory to such use and/or farm structures.A person who constructs more than one home in a two-vear period shall not be considered a homeowner_ Such"homeowner"shall submit to the Building Official,or.a foam acceptable to the Building Oficial.that he/she shall be responsible for all such work performed under the buildine permit. As acting Constrnedon Supervisor yoga'presence on the job site will be required from tine 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 Massaciusetts General Laws Annotated,von may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"cerins and assumes responsibilityc,"V responsibility for compliance with the State Building Code,Ciy of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated_ Homeowner Signature The C'c m!mYdeds of/ azac ✓se is Dec' ofsvas, sh'Ar _ s, f 4 i:r" Offlre dj [ ves 6^"oNs . ra51'44P 600 Frasialus ot➢n .)� tee v e ct,, ,pa7rtai Boston, N 07111 wwOt'. ?nasz.aowatn' p� Workers' Cacnoebrsailoa strai e < uButr ! , a✓it. ilideadi .aer3rs/'eect4e9ar /P2unSers AIDDrIcant Inforrnilon Plierse 12r-L t Leffr:bi:v Name(,Busiaesstorganlzriewmndividuat): Qi t Zi (ST-5011111 Address: /&, WOK P7/ City State/Zip:_ Oro't/int6i<j 4- Phone#: 475-5-Z,Z 3/ Are you an employer? Check the appropriate box: Type of p n1 Jt(required): 1 I am a employer with 0 4. ❑ I am a vener l contractor and i - 'Y�' I Fi. n INTT.v.costrucro. employees (fun anDor pari-ripe)* have hired the s b comae ors 2.fl i am a sole proprietor or partner- listed on the attached shut_ 7. ,_ Remodeli.g I ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, employees and have workers' 9. ❑ Building addition comp. insurance[r[No workers' comp, insurance. _ required 5. E We are a corporation and its lap Electrical rete-or additions 3.❑ i am a homeowner doing all work officers have exerct ea their t 7. P' -poli e repairs or additions self [No workers'm ' comp. rightDL of exemption per M , Y1st❑ toof repairs insurance required.] ' c. 152, )1(4), and we have no employees. [No workers' 13 Other comp. insurance required) !Any applicant that checks box$1 must a]so al out the secmn below showing their workers'covbnensahon polity information. tHo meowners who submit this aThdavit indicating they are doing an work and then hire outside contractors mast sttbsut a new affidavit indiwtng such :contractors that check this box must attached an additionaL sheet showing the name of the sub-contractors and state whether or not those en¢ttes have employeesIf the sub-contactors have...a,yloyeer,they mustprovid their workers'comp_pucy 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: Ar F`, (fi��/� t, viAto TU iFL Policy#or Setfins.Lic. ## ,lt*2c Iry - 70309330-zona{ Expiration Date: Pl./ ler( rob Site Address: _ ti .n- • .' City/State/Zip: 0/0 &,t 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 Erse 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 Mr+arded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Sian atur— 2 - Date: ,/,.44.A09, - ...._ Phone#: 41;- CZ2- - 3( JR -. .. II Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# F Issuing Authority(circle one): i I 2, Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical 'inspector S. Plumbing Inspector 11 6. Other_ s 1 Contact Person: Phone: : 1 City of Northampton no '`s ' eS T obt f� i G _ eLolr 0:S60 esereespersks. 21A Street Mtmeeipal L lv�e�y .�' fllS PE TGR Ldus Hasbrouck Chuck Miller C!iiding Commiseoner Assistant Commissioner HONE OWNER EYFIVEITION ACk.NOW7 EDc EN'NrT 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 fwo 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 penod 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 re_porsibt_ for compliance with state building codes and regulations. The inspection process requires that the building department be calked to inspect work at various stages, which include foundation/footings (before backfill). sonctube holes (before tour). a roach 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 occucancv until the work can be inspected. If the homeowner hires other trades ;o perform work(electrical, plumbing & gas) the homeowner will he 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 12 Main Seet, No.rilt D oni 101A 01060 Solid Waste DispoalAffidavit 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: 2`I 54/etodi Jfze7 Kt4ls.J The debris will be transported by: � � qt .73-0,✓ The debris will be received by: cc 2 Building permit number: Name of Permit Applicant .ehGC�✓ Tai✓ Date Signature of Permit Applicant 1,5 (A4'(Anil tiff°/ l >/- , _ 6,--„,- zi" ---; 6 S.B. ALBERTSON City otNonnemnn Professional Carpentry Building papa mart RESIDENTIAL 1 COMMERCIAL _.._ Plan Review- .. . - 212 Main Street NOnha IPttln MAW 060 Stephen B. Albertson -._.. _. ,... _.. CELL ON THE WED (413)522 315$ www sbatb`rtson'`orn EMAIL [.IC(0508142 sbalbertxon©comrastret _._-____. - lit . riot I ; o t 'L 8 I4 I �I lz I I! !t , . ; a —__ ZrsoI 0 4-xi - 4 Iy .I_ \.... S.B. ALBERTSON I Professional Carpentry L RESIDENTIAL / COMMERCIAL Stephen B. Albertson intoner SHEET ON THE WEB CELL belbvLsan.com 352 (413)522 3158 `�AO''° SUBJECT PROJECT NO EMAIL LICE C508142 s bertson@comcascnet BY DATE II 0. ` 0. CI 4ll, .. (2 f 4.e - toe -3 I I a- ---x I N Irs n 1 0$ e--- (O — (o.-y I 1