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31A-059 (3)
274 CRESCENT ST BP-2017-0385 GIS#: COMMONWEALTH OF MASSACHUSETTS Mao:Block: 31A-059 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:ADDITION&RENOVATION BUILDING PERMIT Permit ft BP-2017-0385 Project ft JS-2017-000392 Est.Cost: $200000.00 Fee: $675.80 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: TEAGNO CONSTRUCTION INC 108109 Lot Size(sq.ft.): 6490.44 Owner: BERGER DAN H&LAURA A Zoning: URB(100)/ Applicant: TEAGNO CONSTRUCTION INC AT: 274 CRESCENT ST Applicant Address: Phone: Insurance: 228 TRIANGLE ST (413)549-0803 Workers Compensation AMHERSTMA01002 ISSUED ON:9/23/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:peck and enclosed three season porch on the rt side and an open porch, foyer, and bedrm on the nide 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 9/23/2016 0:00:00 $675.80 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0385 APPLICANT/CONTACT PERSON TEAGNO CONSTRUCTION INC ADDRESS/PHONE 228 TRIANGLE ST AMHERST (413)549-0803 PROPERTY LOCATION 274 CRESCENT ST MAP 3IA PARCEL 059 001 ZONE URBIl00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST O /_ ENCLOSEDqREQ IRED DATE ZONING FORM FILLED OUT 47./ - � Fee Paid C�•r� /Q Building Permit Filled out Fee Paid Typeof Construction: Deck and enclosed three season porch on the rt side and an open porch, foyer,and bedrm on the It side New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 108109 / /Z / , 3 sets of Plans/Plot Plan O( pV Cl,Pp,yf-r THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INI,'CifrIVIATION 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 4,7W 6' Si• . ure of Build gO ictal 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 City of Northampton Status of Permit: RECEIVED Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability SEP 202016 Room 100 Water/Well Availability N. hampton, MA 01060 Two Sets of Structural Plans DEPT.or ops os�w�o .-6x113 587-1240 Fax 413-587-1272 Plot/Site Plans NOKN Other Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE EOR(/DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION r2U 1( 0 r (on 1.1 Property Address: This section to be completed by office o21`f 022/ Sctxfr ST Map Lot Unit tJ el:ent-P4z LPTa7Ll. Wt 1`F Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 ner of Record: / c1 4.1.1V A,AY.f Pl Y L.ti, rc— it•a.''�" t O.0 vein,..� J I; 4/..,41-....)071-., m'! Na -nt) V Current Mailing Address: Telephone Sign ure 2.2 Authorized Anent: Trcca>`to Q-O". ,5Tn.kt-rlTo rte( ( ' C_ 228 TR cern) G Lr_ ST (21101tMsr °tool- Nam rint) / Current Mailing Address: 6/441/01—(QhL at zf(3—Stt 4—0 8-03 Signature V Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completedyy permit applicant 1. Building t' 41r7'6&I COO.0--D (a) Building Permit Fee tom; o'TL u 2. Electrical (b)Estimated Total Cost of t Sr PGD - at Construction from(6) 3. Plumbing Building Permit Fee tO,C71-rj ,tro • 4. Mechanical(HVAC) 5.Fire Protection cLr00-/p 6. Total=(1 +2+3+4+5) 2WO,(7zJb -0Y7 Check Number / d 5-5" 67679 This Section For Official Use Only Building Permit Number: Date Issued: Signature:Signature: Building Commissioner/Inspector of Buildings Date P511.00t _�37Y '.2 .7 $ At0I 1LOA — 1 t2vb �,�_ /24 . ID-arc-ht. P-C7V2W'rt r rE4rCat x ( . 'E5t 4 (07SSt SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House In Addition ® Replacement Windows Alteration(s) Xi Roofing ❑ 0r Doors O Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [UZ} Siding[Cl Other[O] Brief Description of Proposed Pk) re -L°12—PcShpo✓*-rtMO DF ( IB r7 47 G t4Dtk6C f71-11>work: Wilt of I"1/to:0kt rrtpgcr* Qt-kr2- Porto,(,& 1 'Zen S)cC41._ Alteration -enS)cc.h- Alteration of existing bedroom Il Yes Yes X No Adding new bedroom x Yes No Attached Narrative Renovating unfinished basement Yes x No Plans Attached Roll -Sheet Ba.If New house and or addition to existing housing. complete the following: a. Use of building : One Family \ Two Family Other 2-4.15.1__/I T , b. Number of rooms in each family unit: Number of Bathrooms 2 3�y, 6r v.v.terxe(,t{r(Mp c. Is there a garage attached? y (FXI$rlrt4) /, I ( 0 706 that— d. Proposed Square footage of new construction. di t./, Dimensions SOvTGt3 e. Number of stories? 2 I Method of heating? OIL. Fireplaces or Woodstoves IS/ Number of each g. Energy Conservation Compliance. Y- Masscheck Energy Compliance form attached? h. Type of construction wOc➢ Vtt,APtE i. Is construction within 100 ft. of wetlands? Yes X No. Is construction within 100 yr. floodplain Yes X No j. Depth of basement or cellar floor below finished grade iI k. Will building conform to the Building and Zoning regulations? X Yes No. I. Septic Tank City Sewer X Private well City water Supply X SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, V os._ pf , as Owner of the subject property hereby authorize 'MA-es Ata ctrios ru,LcAL5 'x) iMa_ to act on my behalf, in III matters relative to work authorized by this building permit application. I 's Signatures(Owner Date IIMIIIIIIMIII I, I CAt 0 6 GM Si-1 c AC212 a n.a / A] Z. , as Owaer/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 un he pains and penalties of perjury. GU __ft 1Zn,j,n-o % 4FLO( P/LGS/Bt&JT Pun am (J q/7,e Signature of or/Agent Dateate Section 4. ZONING ALL Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning [ This column to be filled in by � Building Department Sae P Lot Size (�'9S/tc Gt/`'Y14 Frontage kyr ti/G Setbacks Front 2O.S I lG Qk Side L:ISbZ R: Art L: ISOv R: NIG Rear 37.7r 2a7' Building Height 2( t t Bldg. Square Footage 3 ?� r f H 3'7 //330 t Open area Spin Footage e7 'l3 % tiff 7 N�y Park iga minus bldg&paved —I parking) #of Parking Spaces 304 / 3f0. I Fill: NM. N/A (volume&Location) _ A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW e) YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW O YES O IF YES: enter Book Page and/or Document ft B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES Q 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 e 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 e 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 O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑(� Name of License Holder'. I'0w/at rEeta N0 as -6syc7fco License Number PO 8 o'j /1M LttNS T HC V1"' CI OC1 t /CO /IS" Address Expiration Date rf13-36,4 -8'1(of Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 in? /Q Company Name Registration Number l thtr*vu g/ eoal rnJc lofty Addres(s}, .' Expiration Date fl 1Je,qXICI-L ST Mr 3N l it Telephone Seib SY9 0103 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 buildi 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 fano 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 isk )fie ffyifg of Northampton !" ; ria DEPARTMENT OP Dr)IID➢`'G rNSPECPIaNS __.- 2I2 Main Street ' Municipal 01 Euitciag Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT L T ketieo „r S 'CtOak l ?QC- (liceos epr[pvtes) with a principal phoe of bi isin-thesidence at'. • YZ�j j jet ikrit GCE O PiYttfietZST-Ot007{obonee)483 ^S'fa-01'03 (eatuticity/statdrip) do hereby certify,under the p-ics and penalties ofpeijury, that �..' (tfl zm az employer providing the following won_ces tempt-cation coverage for my employees working on this job: A-rw1.Mum,eh- wfruz Foo 'PPo foxl3 2D16R 'lb 117 Rine Company) (Policy Nut) Ceexpira6oa Davi) () I am a sole proprietor,general contractor or homeowner(click one)and boot hired the contactor,listed below who have the following worker's compeensa€on policies: (None of Contactor) Ona-an=CompanyxPolicy Number) (Expiration Date) (Name of Contactor;; (Iaru_aaw CreetyrPolicf Nutter) (ExpLalionDate) (Name of Cunrsaccr) (Inca anx Coaparni:oU.y Nwnirt) (EExpiradon Dat) (Name of Conaaaor) (Io$wan•t Cora/nay/Policy Number) (F.Rputtot Dem) (neat¢a*nasi mod/meanieym'meavl.'uaam.vm'metres 1441 mn..aa) ( ) I am a sole proprietor and have no one working for me. 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