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18-021 (2)
154 COOKE AVE BP-2017-0590 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18-021 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-2017-0590 Project# JS-2017-000955 Est.Cost: $14300.00 Fee: $93.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: STEPHEN D ROSS 079160 Lot Size(sq. ft.): 22128.48 Owner: CIACH SANDRA Zoning: Applicant: STEPHEN D ROSS AT: 154 COOKE AVE Applicant Address: Phone: Insurance: 36 SERVICE CENTER RD (413) 584-1224 p WC NORTHAMPTONMA01060 ISSUED ON:10/28/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:CHANGE WINDOWS &WALLS AT EXISTING SUNROOM, ADD GAS FIREPLACE 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 f! 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 10/28/2016 0:00:00 $93.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0590 APPLICANT/CONTACT PERSON STEPHEN D ROSS ADDRESS/PHONE 36 SERVICE CENTER RD NORTHAMPTON (413)584-1224 Q PROPERTY LOCATION 154 COOKE AVE MAP 18 PARCEL 021 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid TvpeofConstruction: CHANGE WINDOWS&WALLS AT [NG SUNROOM,ADD GAS FIREPLACE New Construction Non Structural interior renovations 1❑ L/ Addition to Existing. IY Accessory Structure Building Plans Included: Owner/Statement or License 079160 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFCIANTATION 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—olWEion Delay 'ray ire i 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: Building Department Curb CuUDriveway Permit 212 Main Street Sewer/Septic Availability Room 100 WaterPNeR 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 1.1 Property Address: This section to be completed by office 4- cc-Dye AMap Lot Unit PoeTN-4chArt.CDIJ Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 31 Owner of Record: • S /t1) 14 Gt# - N t '74- Goo Av�tJtiE Name(Prin� Current Mailing Address: jt11ltil . LILUXn , Telephone 12- 1 - 8 00 Signature 22 Authorized Anent Ros.9 36 aft cc-. c6N't`>v..R- eo so Name(Print) — Current Mailing Address: .. �. 42'> . 23`1-' (224 �gnature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1, Building / 2./ USG, u" (a) Building Permit Fee 2. Electrical // 'IJ (b)Estimated Total Cost of // f!iConstruction from(6) 3. Plumbing ^ e,0Building Permit Fee 4. Mechanical(HVAC) 1- 5,Fire Protection C.) — 6. Total=(1 +2+3+4+5) /y 3a0 •-"' Check Number Z�" This‘ection For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due Ta Incomplete Information Existing Proposed Required by Zoning This column to he filled in by Building Department Lot Size irkte c,&ke Frontage IJO CFS AA/G E Setbacks Front Nd C4 kA1t E fide L. R:.... L: Riar Building Height :.10 Loth .X. Bldg.Square Footage % NO 4irr..1/424C. Open Space Footage (Lot area minus bldg&paved NO Cf{Ac NCC. parking) #of Parking Spaces Fill: ksiCklt. (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW 0 YES 0 IF YES, date issued: • IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ® DON'T KNOW CJ YES CJ IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained O , Date Issued: C. Do any signs exist on the property? YES © NO 0 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 lJ 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 a 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 El Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [I= Siding[I7] Other[ ] Brief Description of Proposed Work: C.WM wtx.d 4&'ta wA4J-4. AT E-Ktosiv3A '7v,-aCOM . .&bb Ccs eiiQGPtAc . Alteration of existing bedroom Yes )C No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet sa.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 nstruction. Dimensions e. Number of a - d I. Methoe of heating? Fireplaces or Woodstoves Number of each r g. Energy Conservation •mplian : Masscheck Energy Compliance form attached? h. Typof construct I, Is con rust 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 Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, S06‘1,.) (2-46r CA A C -* ,as Owner of the subject property hereby authorize ' p H GAJ b. t"+.CO S'i to act onbehalf,in all matters relative to work authorized by this building permit application, 44i ditn. Of/a/I- ><v a S 11rP Si nature or Owner Date I, STS P+k (U b a Ta-UV.a7 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. S i aPIAG--+.I D. -OSS Print Name i'Aatrel -22c ( gnat J of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 licensed Construction Supervisor: Not Applicable 0 Name of License Holder: ST%P Potty b• x'05 ' c&S*1 A1v C'k"' • 7 g/c 0 License Nu r 36,. Ct,v-rEe eo,�a / 2 `ter//l7 Address Expiration Date 413- 'c,&' s{'-. 1224- Signature _ Telephone �� q/y C el-re. z 9.RReaissteered Home Improvement Contractor: ^ Not Applicable ❑ Kocr lic O l Com any Name Registration N ober 24 S. vie G-f 172 M44e /. ' O7GtCce) 61( /0j Address Expir Iron to Telephone 5-73,1-1L''-// SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G,I.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 )8,• 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 1083.5.1. 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 he 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 i-------------- C x ' '..'.M •a t*d 4 0 A f Y1Rk- t Kp C xs t AI '� • s • ... u, . 1y •• Fk ': Q z S\V b�F . . �" 'i'.x. +� N a ' Q R defo- tSION. 04.11.16.4 ', - T" `�RtF ` , ,.,...b Z °?i • . .. ":. .'.:- '.. syr ;4 w:f ,� s 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: /t> CoJar---- ,U ti / The debris will be transported by: /771-"'"-30-1 it '✓-A- ��yr).` The debris will be received by: 1/4v/47 1/ -E'ey� Building permit number: C/ Name of Permit Applicant - / eri /9734/7k jr- , ,,..-cca.._ Date Signature of Permit Applicant