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24D-272 (5) 3 FRANKLIN CT BP-2017-0789 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24D-272 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:CAR PORT BUILDING PERMIT Permit# BP-2017-0789 Protect# JS-2017-001309 Est.Cost:$14000.00 Fee: $14000.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ADAM BELCHER 167231 Lot Size(sq.ft.): 5749.92 Owner: RIDOUT THEODORE C JR Zoning:URB(100)/ Applicant: ADAM BELCHER AT: 3 FRANKLIN CT Applicant Address: Phone: Insurance: P 0 BOX 1354 (413) 539-4937 WC NORTHAMPTONMA01061 ISSUED ON:12/15/2016 0:00:00 TO PERFORM THE FOLLOWING WORK: DEMOLISH EXISTING GARAGE & REBUILD AS CARPORT WITH ATTACHED SHED...ON EXISTING FOUNDATION 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 12/15/2016 0:00:00 $14000.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner • File#BP-2017-0789 S6 D AAI L.- APPLICANT/CONTACT /APPLICANT/CONTACT PERSON ADAM BELCHER ADDRESS/PHONE PO BOX 1354 NORTHAMPTON (433)539-4937 PROPERTY LOCATION 3 FRANKLIN CT MAP 24D PARCEL 272 001 ZONE URB(lOQ)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT PaidFeefj ,t Building Building,Permit Filled out {�5��C(( Fee Paid Typeof Construction: DEMOL :H E " INC,GARAGE&REBUILD AS CARPORT WITH ATTACHED SHED c DN e$4l Stl GAN A'tl0 New Construction Non Structural interior renovations Addition to E3isting Accessory Structure Building Plans Included: Owner/Statement or License 167231 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON 7,k /I.)C '1,-)e am INRMATION PRESENTED: �,, ,,tt¢¢ Approved Additional permits required(see below) nit UT /1'1fi PLANNING BOARD PERMIT REQUIRED UNDER:§ F j • ejL' Intermediate Project: Site Plan AND/OR Special Permit With Site Plan koti:V l ,0.G)q, 1°J 2e Major Project: Site Plan AND/OR Special Permit With Site Plan Q (J 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 Demolition Delay r /2115116 Signature of Building Official Date Note: Issuance Ma 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 ` 11,7. CI o orthampton Status of Permit: IF; 1 : ,win. Department Curb Cut/Driveway Permit lain Street Sewer/Septic Availability 1/2� Room 100 WatwtWefl Awaaabinry 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 Ffiss...k-V`^ LT Map Lot ,Unit kolOrLw se rs..,AA et 04 ID Zone Overlay District Elm St Watrict_. CS District -. SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: -Ti i Aden ..—.... 3 fn.14.0,I. ogweLa tc n Name(Print) Current Mailing Address: sot- 515- X078 r Telephone Signature U 2.2 Authorized Anent: _ Lin f--cLor Qh cr„.y, I�Sri . ittc4inc.m.(1-.., r✓pr (ROC-% Name(P Current Mailing Address: Wi3 535 419 7 sign:/ Telephone 6-Matt Belcher ww l,snkr, SE TION -E TIMATED CO. TR. .TI•N OST. Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a)Building Permit Fee t // 6OP. .._ 2. Electrical (b)Estimated Total Cost of Construction from(6) .. 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection till '.`) 6. Total=(1 +2+3+4+5) l ,n.e Check Number 5(/'t I 9/ This Section For Official Use Only Date Building Permit Number,,,,,, issued Signature: Building Commissioner/Inspector of Buildings Date 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 tilled tr by Building Department Lot Size s,lco SSP+ Frontage 406 Setbacks Front 11 Side L: 11 R: 14 L: R: Rear SS Building Height Bldg.Square Footage /34a o Open Space Footage % (Lot area minus bldg&paved 315, Puking) #of Parking Spaces Fill; (volume&Location) A. Has a Special Permit/Variance/Find�ing ever been issued for/on the site? NO O DON'T KNOW e YES C) IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW O YES IF YES: enter Book Page and/or Document B. Does the site contain a brook, body of water or wetlands? NO a DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , 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 er. IF YES, describe size, type and location: E. Will the construction activity disturb(cieadng,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES © NO sr IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House 0 Addition ❑ Replacement Windows Aiteration(s) [J Roofing ❑ Or Doors ❑ Accessory Bldg. IS Demolition 0 New Signs to) Decks [q Siding IC] Other IC] Brief Description of Proposed _Work: Ot+..e\-.St. C+G'.C4',+.j cwf...v a„)tt nottatIkek taS Cat pa dr t.o/ .310.S.sk 0..td. Alteration of existing bedroom Yes w'r No Adding new bedroom Yes ✓ No Attached Narrative Renovating unfinished basement Yes v No Plans Attached Ron -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 construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces 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 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 f. Septic Tank_ City Sewer Pnvate well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Tut, Qi,a.Qy{ __as Owner of the subject property Mkt,. hereby authorize tempt-.. e \csr.t( to act on my behalf,in all matters relative to work authorized by this building permit application. /za( Z�,<-�-- . /2 /12 /( Signature of Owner Date .111.1111.11.1111.111.11111.11111111.11111.111E— tJ... 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 penury. "T'c$ Pent Name 'J /L rf—" /2(a. t/6 Signature of O.mer/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Nana of License Holder: i��a_«�. .I /0'1 License Number PO ya% SS`'}. t' \ova ,twfk, Ol04i __ id fel In Address Expiration Date 3 Ph9 1-19S1Sig ture Telephone S.Registered Home Improvement Contractor Not Applicable ❑ Ad.r e&LL.J _—_— /G7221 Company Name Registration Number ?n6a14 1351 /1/ tat8 Address / Expiration Date n. Telephone II3 535,1937 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(8)) 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....._ C+f 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 103,3.5.1. 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 he 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 c 111, S 150A. Address of the work: 3 Pre„k\,,, (4- The debris will be transported by: p„,.,nor cnAe,, ,\ The debris will be received by: Building permit number Name of Permit Applicant \AG." (fie\J-,ci Date Signature of Permit Applicant The Commonwealth of Massachusetts r, Department of Industrial Accidents —_'ttr Office of Investigations .� 1 ,j, 1 Congress Street,Suite 100 .:.=',r-', Boston,d14 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganiatioMndividual): a _ Address: Po ('max . 514 .tar . es t.:., otp61 City/State/Zip: Phone#: 1// • 9 93._____ Are you an employer?Check the appropriate box: Type of project(required): I.Eil am a employer with l 4. 0 I am a general contractor and I employees(full and/or part-time).. have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. (Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers' comp. insurance comp.insurance.[ required.] 5. 0 We are a corporation and its 100 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11E Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] f c. 152.§1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] I___ *Any applicant that checks box KI must also fill out section below showing their workers'compensatiim policy information. a Homeowners who submit this affidavit indicating they are doing all work and then hireoutside contractors must submita new affidavit indicating such. tContraams that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide 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: —(MrHkth ..� Policy#or Self-ins. Lie.#: c - F. --t-i to Expiration Date: Ca 315 In Job Site Address:_,3(Srynk\t..-0 • .. .�..... City/State/Zip:�t tkr_._.-,ytet Ola CO 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 e. 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 ceHunder the pains and penalties of perjury that the information provided above is true and correct. Signature: t 1 —.. Date' it)ail 4 ('honeif; In S39 4431 _,.�.. 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 ii: 10'-0" J L 6'-0" / 7 L 16'-0" J L [ i0'69 3/4" E 2'-0" IAS - /van/ily' p.o. Box 1311 CLIENT JOE pes[ No rthampton Wk, 01061 IO p7v Page 1 RI COOT CARPORT FOOTPRINT e AUGUST 19, 2016 nmcnerwwcama 1913com n na SISSISMI m S NMNMS S S CaLier as aidfvcut% y P.O. - 7 BOX 1354 NoGhomplan MA, 01961 _tea DESCRIPTION LATE 1 (513) 539-4937 Page 2 RIDOUT CARPORT ELEVATION NORTH AUGUST 19, 2016 belcheevw@9ma11.com \\ L7//// Lif !i/ -�JGOQIVO/ c P.O. Box 1354 Northampton MA, 01C 61 CLIENTJOB o ., atei f9131 99-9937 Page 3 RIDOUT CARPORT ELEVATION EAST AUGUST 19, 2016 ns;cnerwweget,.I.tom 4"x6" PT 4"x4" PT ' ARCHITECTURAL ASPHALT SHINGLE Ailli GRE RSS 3/B"x0" STRUCTURAL SCREWS / C mma I� i�;;� 1 LAYEAI/2" BEADED PLY 6 1 LAYER 5/8" CDX FULL MORTISE AND TENON L CONNECTION AT TOP OF POST SIMPSON CJT3 CONCEALED HANGER CONNECTION ' SPF STUDS @ 24" OC 6"x6" PT TI-11 SIDING PANEL SIMPSON CPT662 POST BASE ATTACHED TO EXISTING I CONCRETE FOUNDATION W/ 2- 1/2"X3" WEDGE ANCHORS I I WI 2"x8" PT JOIST TO LEDGER @ 16" OC EXISTING GARAGE FOUNDATION New 45x8" POURED CONCRETE PIER a --95C'IRer IS u0121;a/4;f2 ' C7 U.O. Box 1354 C"Te JOE ,.T. DATE Northampton MA, 61O fit 1 (413) 539-4939 Page 4 RIDOUT CARPORT ELEVATION DETAIL AUGUST 19, 2016 belcherww@gmall.com 2 ' 8 ' - I 2 ' I I NEW SHED - -I EXISTING GARAGE 12 ' 19 ' HOUSE 12 ' YJ/006I20<.6Z9 P.O. v1354 Northampton MA, 01CLIENT 061 6EJO DESCRIPTIONDATE f (43) 539-49 v Page RIDOUT CARPORT LOT AUGUST 19, 2016 nahew amai1.rom