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25C-178 (16)
117 NORTH ST BP-2017-0269 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:25C- 178 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-2017-0269 Project# JS-2017-000459 Est.Cost: $1750.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Gerald A. Joyner 016092 Lot Size(sq.ft.): 9670.32 Owner: BASAL MOHAMMED Zoning; URC(99)/ Applicant: Gerald A. Joyner AT: 117 NORTH ST Applicant Address: Phone: Insurance: 20 College Park Lane (413) 562-5858 WESTFIELDMA01085 ISSUED ON:9/6/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 10X8 FIRST FLOOR DECK EXTENSION FOR STORAGE UNDER EXTERIOR 2ND FLOOR STAIRS 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 $50.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File e BP-2017-0269 4 oWee-- flirt e.ai n: APPLICANT/CONTACT PERSON Gerald A.Joyner I i YIL9 Q� IA ADDRESS/PHONE 20 College Park Lane WESTFIELD (413)562-5858 / A(G�,,,�� PROPERTY LOCATION 117 NORTH ST O W M MAP 25C PARCEL 178 001 ZONE, URC(99)/, THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid c r,{ /b ill.( 4 cn Building Permit Filled out Fee Pa(d Typeof Construction: INSTALL 10X8 FIRST FLOOR DECK EXTENSION FOR STORAGE UNDER EXTERIOR 2ND FLOOR STAIRS New Construction Non Structural interior renovations Addition to Existing Accessory Structure BuildingPlans Included: Owner/Statement or License 016092 3 sets of Plans i Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IMATION PRESENTED: 1proved ,,,,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 ANDt/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER:L 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 _Demolition Delay Oil Signature o wl lding Official Date 9'�z�i 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. GUY of Northampton 67au 'r r • }r Fi ',`t+t3i erl et Building Department 1 232 Mein street y Room 100 x a t ,i i 1 - : r , 'ro \ Northampton, MA 01060 '`1t cu phone 413-587-1240 Fox 413587.1272 i b ' a � 'X C-.111111i TOCON6TRtUCT,ALTER,RP.PMR,RENOVAli ORC41t%ISWA OK OR TWO FAMILY DWELLING ';! � : J .1111111F. . LY /Mt MIT INFOaMAT1oN • 7 Hirth T fT.oYi /4OrO(v0 vri � ' �,S.� X e r ■ • z rbi � ZaSkatiltailia2gt 117 idart‘t. MG/tant ri ed f. ._ < I kloreafluar'prt 11AO(V4O ma" OW' Entre 't 7704 Iff'T• G o• • Gf • r �/� i. jdegn,er phine pieMraa odd, MA ntoe4.1a- y/'�F/� 7 - . . - "t) t. Mat the Ont 1. Bactine O. doP , )9 Paint Fee lialli.111111111111a ✓ P. OG ® }HtlmataQTeWLi I! LILLaj 9 taiiaa.tat sa..re44-J.,i 1 .TjiVAIIIIIIM ottall r Esta% •f g_u . 2-a veriica• net ,_._. .. Section 4. ZONING Alf Information Must Be Completed. Permit Can Be Denied Dye To Incomplete Information , Existing Proposed .I Required by Zoning This column to be filled m by Building Department Lot Size i TIt — Frontage ILT-'—__: ' '" Setbacks Front (—TSideL:?= R:— R:} 1_,_i __�Rezr --• � Building HeightI i _Bldg. Squaze Footage I _JL J I t IOpen Space Footage otarzminus bldg&paved - I I _ —. vl ng) d of Parking Spaces I L--- -- L___ Fill: (volume&Locahoo) � it • 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:' IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW S' YES 0 IF YES: enter Book t Paget and/or Document 11I: .._.WI 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 Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO a IF YES, describe size, type and location: I 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: i E. Will the construction activity disturb(clearing,grading, excavation, or filling)over I acre oris it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ... 1 : . it I v • =E MON a ONtcRIVON OP PROKM:13 WOK least a aaaepygl ' Nw Noun ❑ Addluan Q /II bRCltllaanniatYwrN . M oa j Aftshnpl Q Raatr,O. 0 • Aooa®uryaI4❑ O.naswoo' ❑ I NOV VOa000Lane jQI Osaka 5ftf Siding JO] Othot(CV a�"a°" a "i"910 c B Ifirst'floor eck owete nsi on -For Aor-Otll6aw Y_ Naer "du $Wncog 13X N AWNS!Nimes ' VIMaNd aIM4red aanenI J! Ka PSWI.Alaalaa fid -Thsal • BMWa LW of building:ON Finny Two R at Oust 0. NM VW at morns Inn aNly'un! NMTCetol9eRVaalrV� a 4 man a arselloaban d. FC,. d agora4a1patisccrai tsa OMIMwN a NNnbarof*OM ... I MONS ethe ? Ravin,etVYaear4.ee Number of ectal-_ O. gn■wr<a.nnseea car lkna MWNed( Energy caaf..e ton atad.d? h. Typo am.wallon • L 4 aauVwflvNM WON of wsbtt Ye Ma. Y arratuabn.4V4 160 O. tao$(Mi Yea__No j. OePa ofbaeanenarmee toot aolealadaladtlads k Vmaarlgcombat IS MASH ad 2anVp r z*wu] Yes_ No. I. Ma W'Saaar � Pawls N9'saw EWP4-- MOTION Vs-ORt160ANNIONIGTION•TO K COMP M= me , - OIYMIR MINT OR OONIRIICTOR APPWI I VR a1R.OIMO aunt • @4.eLas Ofld 1%._ca / at OvnNrMthe faint ( !'g aural ifiX• r Ind //1 M�i ' rrdc pnrltecl+adaon. XarTerJL r/23/!G 1 —.1--. Um_-anaaL�edifaterCan1N b *q,,-t n Insalai Want biro best army MNWedSS so bat tan wan 4.1ng/d q`.aNT.t• a y. Paw Naas 41/231/4 • SECTIONS-Cc •S7RUCTiOi SERVICES Lecansad Corestrscflcr �t entiso:-: Not Appiicab e E Name of L1er'a fd /. .4y/nw' CS- D92- ucense Nurser �© Crl�aFe Park 44.16-0es t 4/1,11 407;01 e / 7//9 /7 Aotlress Expiration Date Bice .✓i_ i 3 2 515:' arre Telep.'rone Rehistered Home Improvement Contractor: Not Applicable E o7i2 erg CLis(oni /anus le9S2o5` Co. earn,i arae r Registration Number -- , r e/' ' I 57/7/78 Adores=- i 40// > Expi anon are 413 S62' 573.5-6 Telephone SECTION 111 WORKERS' DOMPENSATiO&INSURANCE AFFIDAVIT(fN.G.L.c 152, §25C(6)) Workers CorneeseiSon Insurance affidavit must be conph:_d and w:.mi"e.,with this application-Failure to provide this affidavit vrcll result in the denial of the iissuance of the building permit. Signed Affidavit Aetached YesE No .D.¢ ®.au ..e..tionl: The-_ ,t '— ent exemption for'sma oeernes"was extended to include Owner-occupied Dwellings of one(1) or mo(2)families and to allow such bomeo'ace:to engage an individual for hire who does not possess a license,provided that the owner acts as sunervisor.CNLR 720. Sixth Edition Section 10835.1. Definition of Homeowner:Person(s)who own a parcel ofla d an 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 mo-gear period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to Eire Bolding 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 ske will be required from time to time,during and upon completion of Me work for whish this permit is issued - Alsobeadvisedthatwithreference to Cnaptes 152(Workers' Compenssat`ion) and Chatter 155 (Irabrit,of Employers to Employees for.-:neuhies not resiting in Death)of:he Massaohusews Gcsry Laws Annotated, von may be liable for person(s) you hire to perform work for you under this permit. The undersigned'hcmeowoer"certifies and assumes responspiiiy 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 ml SE- IOM 5.DE3CRIPTiDei OF Pr<.OPOSED WORN tcheok ail applicable) i New Hair 'a n AdditionI ' el oV atent\Wndows I A r leafs) Li 1 Poo`ncd & Doors r Accessory 3 • H Demolition TT V w Signs fp] Decks [1= Siding [Di Other[CTI `/ Brie Desert on of posed , Work. se b J/1 eao Alteration of . existing bed'. Yes X No Adding new bedroom Yes K. No Attached Narrative Renovating unfinished bassinet Yes p7 Fla l Attached us SFe a. j 'If K4awi Nouse and or a , id'Icn to c I_EISp housi-ai-comDVetc Lhmfeilcwtmq a Use of building i One Family Two Family Other b. Number cf rooms in each family un ' Number of Bathrooms_ c. Is there a garage attached? d. Proposed Square footage of new construct) Dimensions e. Number of stories?_ t Meth f gyfConservn 7 C F - , rr fiance form ttached? of etch Enery of 9 re Ma son V✓og H;n s Number g. Conservation Compliance lv7ass e R n<rg i p h. Type of construction__, _ I i. is construction within 100 ft ofwettiands? Yes No. Is cor:auction within 100 yn. floodplain Yes No J. Depth of basement or cellarfloor below finished grade, k Will building conform to the Building and Zoning regulations? / Yes No I. Septic Tank City Sewer Private well City w-ter Supply SECTION le-OWNER AUTHORIZATION.TO SE COMPLt D WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR EUI '4NG PERMIT 1, .CYt ej ..f 5a- / .as Dwner of the subject ;Fogerty / / /' hereby authorize C �rfrj � t/L1n e r to act on my behalf, in all ma tees relative to wor authorized b)/this building permit application. X- _ B//9//ic, Signature of Owner Fate .._ J ;kn,t. / eik ,u _.,',., E' *YU'Yr` .a, w4A'a ._nN' ,p:'F kk.. . G-,G ..—. a d 4 JrJJr eine as . wnenA,r1`Ic.ized Agent hereby declare that the ate talents andfriformation oh the foregoing popeseon are due and acourme to he be 'of my knowledge and belief Signed under the hams and nenalti-_ f perjl:.'y. Ng e�y PIMA Name _ Te Alr r�I."�1��' it rftLit di / 9// signs i e of Dwner/4gent Cate ane 4.00W1mOfWeaatt OfMassachusetts _ Department ofIndustrial Accidents , ••••=o-s0.•--. Office of Investigations t. yc 600 Washington Street Boston,RIA 02114 -- www.naass.gov/dta • Workers' Compensation Insurance AfIidavit:Guilders/Contractors/Plectrielans/Pluunbers Applicant Information / Please Print Legibly Name(Business/orgmrization/In di vi dual): S.49p a r e s7'long npne49'i _ Address: _ r r l i ',r - . Le 7 ' ' / d I IS r City/State/Zip: • Phone#: si 3-5-2- i r Are you an employer? Check the appropriate box: contractor and I Type of project(required): 1.❑ I am a employer with 4. ®.I am a general employees (full d/or part-tune) • • have- hired the sub-contractors 6. ❑New construction an 2.0 I am a sole proprietor or partner-: listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance? ❑Building addition required.] 5. D We are a corporation and its 10.❑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 - 12.0 Roof repairs insurance required]t - c. 152, §1(4),and we have no 13.�Other �/ ,�� employees.[No workers' Cl cC K. /t?Slll// comp. insurance required.] 'Any applicant that checks box#1 must also IDI out the section below showing their workers'compensation policy information. tflo=owners who submit this affidavit indicating they are doing all wade and then hire outside contractors must submit a new affidavit mdicadng such. iCantractors that check this box must attached an additional sheet showing the name of the subcoutmctors and state whether or not those entities have employees. If the sub-contactors have employees,they mustprovide 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.Lie.#: 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$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 certify under the pains and aof perjury that the brformation provided above is ave and correct Si=.,tire: J /I _� #/ Date: �L�.3��0 Phone#: e413 5? •/ .:S"..: 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#: 7-o ?Aatita - ! - O�- - S U 3vt.ni 9-02 I ' a - o s1 SdS e aUoU - dwo saa9Jom • ) 2dh4 a7 U baatu Gds )9q'ap 'Ma Gil F'Jaa -�o� � v-A ro1" S S1 o 0?2.-1 UCD - f7 S c2J 1P0 O d _494722.-11/ uo—vaacia‘ � ° 1 Jams City of Northampton 21.2 Main Street, Northampton, MA 01.060 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: 7/ 7 A/or t h Sf The debris will be transported by: ‘1, 5ar ent The debris will be received by: (nvn n t !_ (A.0 ft p S'VeY) Building permit number: Name of Permit Applicant - i i i i /,f Date gnature of Permit/t pplicant 5vtsJ : pro ( e,scc-i reetr clack ett 117 Nlort11 3-treet. Gmsfowlex-, (VI- et hetyre4 fa_sal IJOTS`e): I, d.11 Iuvnhe.r u5ec{ is pre`.s5urc +rea.tcdjn.n4Meto..IPLn.PProVad : a. The, gra.cle all arc uh A t1e hose Is' `slat' wkfl-11 i-fIc van i0,tton . 3• 'T e. side of the house s carc.l (el' fo the sielctcr-&(L- -4 streeL ...I-1,4 measured 15t0" frowk. t1-,c rp-vcd s :cke ;ralknleasor•eck icjherc 'Ll-le proposed deck, ct-Claches to the house . 4c Ledges boce.r8, will be_ alincheak concrete �o� n.da for ural\, F:-CI C.71- IU -.'� L�i74F' 1jL f-+pDED LE-PO i5D --- 1 - �. r Cur Per- deck)-i-- Is ____4 Y3 j--, %, °' ci I> >aoC 1 I ti 17 iii °I7.I _ N NI 0 p r rvG '. ! i11 1 IT i • I` �I I N !@J 1i I 1 I 1 _... � tl l; rtt _ L -. ;Si�' wit' G"k6`po5 1 .3- lxer.oxJ" --5 , . G5//eTYr ____,,ii 4o1 _ 1;e 114 (upper ciecic� Je, sv7va Lxi ,rtNG1R%KUa+"= / nppror 3Ca"0.bove 2"-4" r b.'e 9 racre arade. _____ 9'-5 -- - __ City City of Northampton C;.5�2r f rr , " Building Department �_ _.� /-lar _— 4Ora i Plan Review 212 Main Street Northampton, MA 01060 5/4x ti cieck w X '^F1---„,-_--,- tNiote : L`ox -(:)'( 1.+0 < -GrA a j5T 2 -2x8 • be r'esflnq`� on {'or .wa bc Jif I .�.1, 0c 50notzbe Cone. Is possible. use pt /r4-de --7 k t�lvak; to IeDe�l box Ct Ftr_leD I JOrSts Ir necess&_ry. IDnjoNa-r-vkLia I J � �� s CIAWAr