06-035 (4) 244 HAYDENVILLE RD BP-2005-0272
GIS#: - COMMONWEALTH OF MASSACHUSETTS
Mao:Block:06-035 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.342A)
Catepor BUILDING PERMIT
Permit# BP-2005-0272
Project# JS-2005-0354
Est.Cost:$2000.00
Fee:12-$.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grouts: Homeowner as Contractor
Lot Size(sa.ft.): 23435.28 Owner: GINGRAS LOUIS I
Zoning:URA Applicant: GINGRAS LOUIS J
AT: 244 HAYDENVILLE RD
Applicant Address: Phone: Insurance:
- 246 HAYDENVILLE RD (413) 586-7420 O
LEEDSMA01053 ISSUED QN:-9/9/04 0:00:00
TO PERFORM THE FOLLOWING WORK:ERECT 16 X 20 SHED
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: ak,
Rough: Rough: House if Foundation: rt �7i
Driveway Final: /0 S—o y(/I/
io sI Final: the/id 7 O/( 7 f�
!;y yVe RoughFrame f
Fire Department Fireplace/Chimney:
Ron;"• Oils Insulation: / /
Final: Smoke: Final: OK 6➢/2 01 �A UIs
THIS PE:,6':. N;AY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
•
OF ITS 2 Ut..:S AND REGGUULATION
•
E P� YlCdte D .i_'CSi¢pature;
Receipt No: Date Paid: Check No: Amount:
Buildl. 4
9/9/04 0:00:00 608 $2500
217 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
1
File#BP-2005-0272
APPLICANT/CONTACT PERSON GINGRAS LOUIS 1
ADDRESS/PHONE 246 HAYDENVILLE RD LEEDS (413)586-74200
PROPERTY LOCATION 244 HAYDENVILLE RD
MAP 06 PARCEL 035 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out dot stoic _
Fee Paid
Typeof Construction: ERECT 16 X 20 SHED ,,,
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�ALLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFQAMATION 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 ElmStreet
CC9R�fission
Signature of Building Official �1� 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.
— -:.7 City of Northampton =
5
-" E \ ` IBuilding Department Lam-
212 Main Street
Room 100
7 'L004 hampton, MA 01060 __„_W
phoo 413 587-1240 Fax 413-587-1272
4
APPLICAIIO1I TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE-INFORMATION
71116'EPmorr ntfletB . fy-o face
1.1 Property Address: x� �.e -r:.
L L- ECJS M4 0/O3-.3
SECTION 2-PROPERTY OWNERSHIP/AUTHORnED AGENT
2.1 Owner of Record:
LOd, 5 j 6,NGAt,/l5 }YY N11YO6NVri.t,E 20 l,6Ep5 nq,0/6;9
Name(Print) �n7 0 Current Mailing Address:
efLer-- Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be OffidalUse-Olay
completed by permit applicant
1. Building .� �) o nD .(a)'Building Permit Fee
2. Electrical (b)Estimated Tolal Cost of
Coustrudion from:(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection � �t
6. Total = (1 + 2+3 +4+ 5) Check Number 46t ,
3 T'
n This Section:For Official Use Only Y�
Building Permit Number: t 5 ^) 7cL— 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
Lott Size AG
Frontage 1//4.8 I
Setbacks Front zed 30
Side L: 151 R: tC L: S g R: 8 0 r
Rear
Building Height 0'1
a/2/
Bldg. Square Footage . % 3 J-o
Open apace Footage ap
(Lot area minus bldg&paved
parking)
#of Parking Spaces -/
Fill:
(volume&Location) Na Ark
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW X YES
IF YES, date issued:
• IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW X YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO X- 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 X
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property?YES_
No X
IF YES, describe size, type and location:
iG : ar7 oa4E so EaSW aR h "Il 1.-:'R3`
-:•a:.. .. .ter_.. . .aaas:, r..-,� —.
New House 0 Addition 0 Replacement Windows Alteration(s) ❑ Roofing 0
- Or Doors 0
Accessory Bldg. , Demotition❑ New Signs [ j Decks [ j Siding[ j Other [ ]
Brief Description of Proposed Work: CJ5tit.0 cS.7 rX y5H60
Alteration of existing bedroom Yes No Adding new bedroom Yes -SC- No
Attached Narrative❑ Renovating unfinished basement _ Yes x No
Plans Attached Roll D- Sheet 0
Mgg. anion o xa'stine'<�i irWr i' . "- .j
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. bimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g Energy Conservation Compliance. Mastheck 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 .
I. Septic Tank City Sewer _ Private well City water Supply
a . MI
;174 a PTAAPPL:IsORU1t0 NG PER
as Owner of the subject property
hereby authorize - to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date ^-
5 r. E. t-16- .1445 , 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.
Lec,'s :;. G. 4/6 445
Print Name
044
Signature of Owner/Agent i Date
-5,87C00 .ssCONS{f13L70'f110N SERVICES
8.1 Licensed Construction Supervisor: Not Applicable OE
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
May WIRESABESSINa Not Applicable
Company Ngpte Registration Number
_._
Address Expiration Date
Telephone
netglEat«
- 1; + ofyy1lag$'tpfvlpElJ5Atl01JaN$DPANCE-.AFFIpAV1T(Irt:G;L,..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 O Na...... 6.
rt eviaa,'tv�+,y', r7;e['am%Ugt ;.en CS P'
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-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 he 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 SW/Akers'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 " 074 t- -�
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DEPARTMENT OF BUILDING INSPECTIONS sIF
INSPECTOR 212 Main Street • Municipal Building ,A'
Northampton,MA 01060
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR I08.3.4 to
act as his/her construction supe: sor. 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).
ponotube holes(before pour),a rough building inspection(before work is
concealed),insulation inspection (if required) and a final building in;pection. 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
1, understand the above.
(Home owner/resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date
Address of work
location
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LdwS 'RESEW/L/-1-
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limn 28£15 Bc F Z37
tIAer?evdc. 27 PAC.L: iZ