39A-055 (2) 68 LYMAN RD BP-2017-0388
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 3M-055 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: KITCHEN&BATH RENO BUILDING PERMIT
Permit# BP-2017-0388
Project# JS-2017-000638
Est. Cost:$62760.00
Fee: $408.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ROBERT WALKER 034783
Lot Size(sq. ft.): 11020.68 Owner: BUTLER KYLE
Zoning: URB(100)/ Applicant: ROBERT WALKER
AT: 68 LYMAN RD
Applicant Address: Phone: Insurance:
36 Service Center (413) 584-1224 Workers Compensation
N O RT HA M PTO N M A 01060 ISSUED ON:9/22/2 01 6 0:00:00
TO PERFORM THE FOLLOWING WORK:KITCHEN, 1/2 BATH, LAUNDRY REMODEL,
FIRST FLOOR
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 9/22/20160:00:00 $408.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File ft BP-2017-0388
APPLICANT/CONTACT PERSON ROBERT WALKER
ADDRESS/PHONE 36 Service Center NORTHAMPTON (413)584-1224
PROPERTY LOCATION 68 LYMAN RD
MAP 39A PARCEL 055 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid /702
Building Permit Filled out
Fee Paid
Typeof Construction: KITCHEN 1/2 BATH,LAUNDRY REMODEL,FIRST FLOOR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 034783
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
a-molition Delay
Alla/: • 7—al-FA
lure of Bulls ing Offi ml 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.
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(`v City of Northampton ' tMu t
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c);"' 0�6 Building Department
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i � 212 Main Street - it bll
jo Room 100 W
.N3r c�pe � Northampton, MA 01060 •it of E4 f �'
or""i�°$ phone413-587-1240 Fax413-587-1272
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APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by office
L,1,."a-r-1 tAV Map Lot Unit
✓ -‘ Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
','LC 3U>/4fz 68 (3/4A4N 20 Lcz arGtir M7-
Name(Privi"z Li/ 3 32U aQ Current Mailing Address: C
s 3
///
Telephone
SgnLlure
2.2 Authorized Anent:
12-c 'r tic v a 31D c.E-t u 4 C:/—'0E2 ND }SC RTt4-41.04.. -n,.�� ,,�,rq
Name(Print) Current Mailing Address:
Qwe, . 1zS�_ 4t2-, — Mar - 1724.
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
5 t , (;oma
2. Electrical -z) `u (b)Estimated Total Cost of
Construction from(6)
3. Plumbing C-6(4: W. Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection // /� �j
6. Total=(1 +2+3+4+5) (0Z-- i 7 (aC Check Number lG 0 '�r-'2
This Section For Official Use Only
Building Permit Number: Date
Ded:
Signature:
Building Commissioner/Inspector of Buildings Date
Section 4. ZONING AU Information Must Be Completed. Permit Can Be Dented Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be fill. ' by
Building Depvtno-
Lot Size
Frontage _. . yL /I
Setbacks Front Q. C)
4 n /..
Side L: R: L: C/
je Rear \� �
Building Height �^l�Vv. tiv
Bldg.Square Footage % \ .5
Open Space Footage % --.
(Lot area minus bldg&paved
parking)
#ofParkingS ces --- - -
volume&I .lion) _.. _. _...._. _ i
A. Has a Spe ' l Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO ®'
IF YES, describe size, type and Location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO tCl
IF YES, describe size, type and Location:
E. Will the construction activity disturb(clearing,grading,ex atop, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION S-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [CO Decks ID Siding[Cl Other[c
Brief Description of Proposed
Work: 1< tTzyys r-+) I7 $/VT V. LA--v.-plzL-1 I isn-o'9f\_ c11-yr c-C(X,fk-
Alteration of existing bedroom Yes Vitro Adding new bedroom Yes 1------1NO
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet ✓
sit If New house and or addition.to existing housing, complete the following
j
a. Use of building :One Family_ Two Family Other
`iv`
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
U
d. Proposed Square footage of new construction. Kelp' Dimension
e. Number of stories? r C'
f. Method of heating? r H r.aces 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 --nds? Yes No. Is construction within 100 yr. floodplain Yes_No
j. Depth of basement or. -r floor below finished grade
k. Will buildin. ..nform to the Building and Zoning regulations? _ Yes No.
I. -• icTar*_ City Sewer Private well City water Supply
..-----
...--
SECTION
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, OLE guri__la ,as Owner of the subject
property /
hereby authorize 4' ( W 1 — r
to act on my ehalf in all matters relative to work authorized by this building permit application.
Signature of•T - Date
MIIMIIMIMIMIMMIMIMIII
I, Voc3 QC(W (,^—ND.—i.Irl , 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
(le--I
Signature of Omer/Agent Date
SECTION 8-CONSTRUCTION SERVICES
.1 Licensed Construction Supervisor: L,, {� Not Applicable 0
?Jame of License Holder: I�P)Cr.2-C L AP4_k rtk C S — lJ � 'V7 3
License Nurme_
3(0 ,);� �� Pu Ui(E a 11
Address J) Expiration Date
c6'u 2 Z 4
Signature Telephone
9 Realitgred HorneimerovementContractor. Not Applicable 0
( 1Zc 16,
Company Name Registration Number
Address Expiration ate
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L 0.152,§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 0 No 0
i . -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 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