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17C-045 (3)
35 HILLCREST DR BP-2017-0481 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: I 7C-045 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Bath reno BUILDING PERMIT Permit# BP-2017-0481 Project# JS-2017-000796 Est.Cost: $22000.00 Fee:$143.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN D ROSS 079160 Lot Size(so. ft.): 19602.00 Owner: HOGAN KAREN C Zoning: URA(100)/ Applicant: STEPHEN D ROSS AT: 35 HILLCREST DR Applicant Address: Phone: Insurance: 36 SERVICE CENTER RD (413) 584-1224 1) WC N O R T H A M PTO N MA 01060 ISSUED ON:10/13/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:REMODEL BATHROOM 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 10/13/2016 0:00:00 $143.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0481 APPLICANT/CONTACT PERSON STEPHEN D ROSS ADDRESS/PHONE 36 SERVICE CENTER RD NORTHAMPTON (413) 584-1224 0 PROPERTY LOCATION 35 HILLCREST DR MAP 17C PARCEL 045 001 ZONE URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST NCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out t" Fee Paid g/ Typeof Construction: REMODEL B• Ili WM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 079160 3 sets of Plans/Plot Plan THEFOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION 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 3tinDlaYj �pA2Signature of Bu cia 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 40k Contact Office of Planning&Development for more information. tr `nt` , only RECEIVED City of Northampton Sgf tatusPetmit: Building Department Curb Cut/Oliveway Pa) #(t r ; _ •X i iii, . 1 212 Main Street slab variabiiiity ;t J Room 100 W DE - Northampton, MA 01060 T 8 S� pturatPfar ' ,.a �,. c `-- phone 413-587-1240 Fax 413-587-1272 Q.Brer Specify":.: APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: ss�� This section to be completed by office Sg /A/7C Y-/-9 -/ iV ✓ .'' Map Lot Unit Zone Overlay District rl,r�` c _.< yki,y o (e) 4Z Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print Current Mailing Address: ' --d 'ic-L-___— Telephone Signature �//3 �l5 ' 3 / �3 2.2 Authorized/Agent: SI .t C- 1. , Re r Y 3 A S-c ✓r/, ,2.—c Cr 7-Ar 424 )v/G�.._7,4. Name(Print Current Mailing Address: l^ 7/ 3 5-8 7 —( ay ignatyr� Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building / oar,, "- (a)Building Permit Fee , 2. Electrical (j - (b)Estimated Total Cost of Construction from(6) 3. Plumbing °/ d eV �0 Building Permit Foe / 4. Mechanical(HVAC) — U 5. Fire Protection i t 6. Total=(1 +2+3+4+5) IA 27, ciao, Check Number d Ay This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing E Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [DJ Decks [0 Siding[O] Other[CO Brief Description of Proposed 7z`� Cr,/ D 0 4- ✓I raw r` Work: ..Jy l Alteration of existing bedroom Yes 'No Adding new bedroom Yes `� No / Attached Narrative Renovating unfinished basement Yes ✓ No Plans Attached Roll -Sheet 6a.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 Squa•- foot-,e of ne onstruction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each _ g. Energy Conse '-tion Co- pliance. „--. heck Energy Compliance form attached? h. Type of constructio i. Is construction 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 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR/ APPLIES FOR BUILDING PERMIT I, /Ca/Y--1---- /4) c ,as Owner of the subject property / / hereby authorize S r K.."_`--‘ n , Re5-5 to act on rqy behalf,in all afters Motive to work authorized by this building permit application. Sig�a,ure of Owner 1-� Date I 11 ' - f2`s_s as Owner/Authorized Agent hereb de � �� V 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/•-c a Ar.,, P. l2 c I S Print Nam-' - I /� �', /C— C/ 41111*--- l0/ �/ / Signatureo 0 ner/Agent r D]tte Section 4. ZONING AU 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 Lot Size . Frontage _. ... Setbacks Front Side L: R: L: R: Rear .. _. Building Height Bldg. Square Fwtage - % - - Open Space Footage % -- (Lot area minus bldg&paved parking) #of Parking Spaces Fill: ... ._. (volume&Location) __ _ A. Has a Special Permit/Variance/Fin(d�in(ger been issued for/on the site? NO O DONT KNOW V YES IF YES, date issued: IF YES: Was the permit recorded at the Regist of Deeds? NO 0 DONT KNOW 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 O 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 © NO V 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 IF YES, describe size, type and location: E. W II the construction activity disturb(clearing,grading,ex tion,or filling)over 1 acre or is it part of a common plan O that will disturb over 1 acre? YES NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: 1'� Not Applicable 0 Name of License Holder: Si '"— 11-1, 1`f's 5' *•7 (6 G License N mber 34 s-- ,1'• c?c.i-L..r 124_ lv f/�4t .41.4V�Zc5)/l7 Address Expire ion Date �i i S Z2 L/ Telephone 9,Registered Home Improvement Contract : Not Applicable 0 SD. l?e � ti� � CahAV, � � /Sofly '7 Co pane Name Registration/Num bAr 5 'r ie--t CE -.1.1a 2 J /V9% �� s'///7 / Address c� Expire on Date Telephone /� y—/ZZ% SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152, §25C(6)) i 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 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 farm structures.A person who constructs more than one home in a two-war 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 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 111, S 150A. Address of the work: 7 S //fir x-----e- The debris will be transported by: 1/�(/� .-e� /� V�-Q- C - The debris will be received by: 7� / Building permit number: / /j /� Name of Permit Applicant `�-579,0 ''" - P i D DateSignature of Permit Applicant