06-023 (5) 56 LEONARD ST BP-2004-0543
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 06-023 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0543
Project# JS-2004-0767
Est.Cost:$400.00
Fee: S15.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 40815.72 Owner: RYAN JAMES M&BRENDA M
Zoning: URA Applicant: RYAN JAMES M & BRENDA M
AT: 56 LEONARD ST
Applicant Address: Phone: Insurance:
56 LEONARD ST (413) 586-8285 ()
LEEDSMA01053 ISSUED ON:11/10/03 0:00:00
TO PERFORM THE FOLLOWING WORK:DEMOLISH DET GARAGE (NO UTILITIES)
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: aa
Final: Smoke: Final: 0 K f 9.-�.3-(3 3 -I,
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLA OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Sienature:
FeeTvpe: Receipt No: Date Paid: Check No: Amount:
Building 11!10;03 0:00:00 MO $15.00
212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2004-0543
APPLICANT/CONTACT PERSON RYAN JAMES M&BRENDA M
ADDRESS/PHONE 56 LEONARD ST (413) 586-8285 Q
PROPERTY LOCATION 56 LEONARD ST
MAP 06 PARCEL 023 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid /VO 4.41--
Typeof Construction: DEMOLISH DET GARAGE(NO UTILITIES)
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION 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 Co•/'ssion
// f/003
Signature of Building Official 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.
a
._` —nS
City of Northampton
Building Department
- -212 Main Street L , 'sat-,
Room 100 yir
- -!Northampton, MA 01060
r��nv _ :ph,Qne 413=587.1240 Fax 413-587-1272 T"L;r�'T aa,x
brit +^,_ _ __- _ .
APPLICnN IO.CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1—SITE INFORMATION
1.1 Property Address r'.*' his 4i a LII1 i5;-ff e.y,
IEEUS m 9 O/d$ 3 uZIS :i:1-: 32:—..1 ® r:,..;,`":,--i,ElmSt- alnct _ �i�sry� At;„4,:t.ii,
, :
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
TAr1E0- �1 Al. / Ye%^.1 56 LEe..x}g0 Si LfEU5
Name(Print) Current Mai bn Address
s 4 —eat,
nature
i..------------
� Telephone
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone __
SECTION 3 - ESTIMATED CONSTRUCTION COSTS.-
Item Estimated Cost (Dollars)to be Official Use Only
completed by permit applicant _
...,//1. Building /t00 ov (a) Building Permit Fee
2 Electrical (b) Estimated Total Cost.of
Construction from (6)
3. Plumbing Building Permit Fee
4 Mechanical (HVAC)
5. Fire Protection ,7I C
6. Total = (1 + 2 + 3 + 4 + 5) H Check Number Mb 1216
This Section.For Official Use.Only
Building Permit Number 4'/DO4” 59'3 Date Issued: .
Signature:
Building Commissioner/Inspector of Buildings Date
•
Section 4.
- ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF 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 Footage
Open Space Footage
(I.ot
area minus bldg&paved
parking)
q of Parking Spaces
Fill
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property?YES
No
IF'YES, describe size, type and location:
;SEay�o.ia7&ti�le .e P e105nA O d' tr :9e fm.� ' I
New House ❑ Addition 0 Replacement Windows Alteration(s) ❑ Roofing 0
Or Doors 0
Accessory Bldg. 0 Demolitio7;t New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: 4NOUE iYS/,5)`/f �`/sOxBA611 4 0 r/7r/2-1-405�
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes _ No
Plans Attached Rolle. Sheet U
6a'. 33 t .. :"d . ailit~i& t "ezigtii gii •: n-. =sc a ,.•+ng<
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. Mascheck 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`Ne
i. 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__,
s3ip, IZA,TiON `«(0 Bt'CaMPG ED WHEN
'tome a s O TRACTO APFLtES FOR'BUILD G PERMIT
as Owner of the subject property
hereby authorize to acs a!
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
!, , as OwnerfAuthortzed 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.
Print Name
Signature ,f Ownef ''nt ,'� J Date
, -
•
s€ dAN ,x CONsieuetION SERVICES _
B.1 licensed Construction Supervisor: Not Applicable 0
same of License Holder
License Number
Address Expiration Date
Signature Telephone
2k':i-Y_ cd« LSth 113i11 Ianitat:flide.:a- -1;:c. . .n..:::..;,-1R5:-_-... .. 'p'It r4m Not Applicable C
Company Name Registration Number
Address v Expiration Date
Telephone
76E/Talleati KERSTCOMPENSATION INSURANCE-AFFIDAVIT(M G le ca 152, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with to is application. Failure to provide this affidavit
will result in the denial of the issuance of the building permit.
Signed Affidavit AttachecT Yes 0 No 0
tifj. —:BECH ti.-i@Kt rt:(:sIiaAt 1-11t:
The current exemption for"homeowners"was extended to include Owner-occupied if Wellings 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 deb site will be required from time to time,during and upon
completion of the work fry 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 ZoninggLL iws and State nssachusetts. General Laws Annotated.
\jHomeowner Signature ( 7 � ..........
• OFY1UNl')•p �
IA E o U,itlr n} artllumpfnn
M Ph.•e. if�6 Fiuecofl„z111e 1 1
ky E.
'” DEPI iT1.fEJT OF BUILDING INSPECTIONS • /
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S CONTENSA I ION INSURANCE AFFIDAVIT
Qlr^tc."permit^^)
with 2 principal place of btisinessiresidenee .=.r
(phonefi)
do hereby cenifi'. taatet the ;dins and penalties of 7Jjury, t iirii -
() I am an employer providing the follot':inc :.oikcrLs col npensauon coverage for my
employees working on this job-
(lnsvrznce Comp itet) cPc5cr Narrnbcr) (e?-xF'rnon Date)
( ) I an a sole prop:e_er, general ocnscor er borteo'.vner(circle one) sed :rave hired
the contractors listed below, who hav,11. the I m. worker's s co-p nsaT for polic:es
(Name of Contncmr) .___z-co Como:To:Polio Number) thioadro.tece Date)
(Name of Con-nes T) (1.Ls,2.ranct Corn—so/Police'Nammod Ulcers lion Date)
(Name of Coatraclar) ( mu cncz I s :,Qoi cy it.m1_:1 r':r - Date)
.
(Name (Ia of Con:mctor) pram Com7,anyT+ofi_ryy,Numt^s) _. deSetostice Daft)
( ) I mil a sole picatirda: and ;enooda .. r{ far me_
5( I din a how =i! [ ea:
NOTE:?loch awarr that..rerli e-.. - _ -: ,
cplcy= r cth vy co n Coc ill k,.c•
rr
legal Warns of en cel ) . wa e' 7.m,..vo.. vx
1 un&cntmd th x a copy o!Ilu n..c-s vvy to td,—,,,,i m,in 1r-Iwe.--1 or LM,...nd M bar, cin-a oadux for 1!n
covraas:vcificioaF.:4tiut f_ihcc to:c_:vottrmr,taikr f.C.flitr.2LA
inin ofae ofup to S lia).CO v+ . -.-._a JI "idl l 1.�1b11 1 e Jpc-'_tr4
6rco - .._ .:.1 1'.-_vL�loe van cern. , .-:ry., aro,
LSI W.W.CY:gena r...
-a ) I
tlNic � _. _.. Pcrmi Menthe ._
11(7
tr of Lto 1 to .r r
eb
Crfp
�y.. DEPARTMENT OF BUILDING INSPECTIONS ):
INSPECTOR 212 Main Street • Municipal Building a,,==
Northampton,MA 01060 �
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction supe: i sot, The state defines"Homeowner" as, "Person(s)
who owns a parcel on which he/she resides or intends 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
home owner."
The building department for the City of Northampton wants any person(s) who seek to
use the home owner exemption, to act as their own construction supervisor,to be aware
that by doing so you become responsible for compliance with state building codes
and regulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation/footings (before backfill),
sonotube holes (before pour), a rough building inspection(before work is
concealed), insulation inspection (if required) and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work(electrical, plumbing& gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
ski, iii 4 „6 understand the above.
ome own..✓'esident's signature requesting exemption)
I /111 call to schedule all required building inspections necessary for the building permit
issued to me.
Date
Address of work
location