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07-012 (19) 408 NORTH FARMS RD BP-2007-0407 GIS#: COMMONWEALTH OF MASSACHUSETTS Maoltock:07-011 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit BP-2007-0407 Project# JS-2007-000598 Est.Cost:$80000.00 Fee: $465.30 PERMISSION IS HEREBY GRANTED TO: Const. Class: 5B Contractor: License: Use Group: R4 Homeowner as Contractor Lot Size(sq.ft): 54014.40 Owner: HOMSTEAD KERRY M&NEIL P Zoning: RR Applicant HOMSTEAD KERRY M & NEIL P AT: 408 NORTH FARMS RD Applicant Address: Phone: Insurance: 408 NORTH FARMS RD (413) 584-0458 0 FLORENCEMA01062 ISSUED ON:10/20/2006 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT DET GARAGE W/ACCESSORY APARTMENT 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 Sienature: FeeType: Date Paid: Amount: Building 10/20/2006 0:00:00 $465.30474 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo • File#BP-2007-0407 APPLICANT/CONTACT PERSON HOMSTEAD KERRY M&NEIL P ADDRESS/PHONE 408 NORTH FARMS RD FLORENCE (413)584-0458 0 PROPERTY LOCATION 408 NORTH FARMS RD MAP 07 PARCEL 011 001 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Pin¢Permit Filled out /',r,� i// So Fee Paid `��J `ff4l`7 Typeof Construction: CONSTRUCT DET GARAGE W/ACCESSORY APARTMENT 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 FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Pemdt 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 ion 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. .t �T;WW •' City of Northampton , kms ,z1' Budding• Department i 212 Main Street 20 --�-' -- '" ";' A •- x v6 Room 100 'Northampton, MA 01060 phone"413-587-1240 Fax 413-587-1272 'E ��,�,, � _. ..$.. ... .., 5t APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION.t-•SITEINFORMATION. 1.1 Property Address: _ ThigsectrarrtabecornPtetodbyafce _ 408 QostTV F./keen ja7>. L eot Stirc . Flo 2E7uCa 044. :tuns overtajeorstcitt- fiEm•St es t t- CaDIs vier SECTION:'2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ' 1 Uric_ € 1reRPY TICIitcreat -4'OS room FAIOrS Name(Print) Current Mailing Address: FtnrzI )Cts (i A/U4 /r 0106Z. Sign- re • �- Telephone (4131 s O-'t - 0 T Se 2.2 Authorized Agent: SA.uir . Name(Print) Current Mailing Address: Signature Telephone SECTIONt3-ESTIMATED CONSTRUCTION COSTS _ Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building If6l co — =(a)BuiFing.Permit Fee 2. Electrical7S oO -" (b);EsfimatedTotarCostof Canstructiori from(6)' 3. Plumbing o 000 - Building Permit Fee 4. Mechanical(HVAC) 71 O0 o — 5.Fire Protection Sao - /G � j����� 6. Total=(1 +2+3*4+5) ' 0� OOO — Check Number 7 a_ _ This.Section For Official Use Only Building Permit Number. Issue_ 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 titled in by Building Department Lot Size 40 htetS: e}ttNh G ._ _ _ Frontage —....... — Setbacks Front - too ' ; rr Side L -la) R:_ L: !=h R:'2GQ -y,„ Rear If[-g , / Building Height I ---t...10. r : ✓ Bldg.Square Footage Vit. 2.t, % d91 2.5 % Open SpaceFootage % (Wt area mnsbldg&paved Alcoa) '' (��t(� . / Ie1 jrara 974 VL ',midge) #of Parking Spaces Hit ,i (volume&Location) '— A. Has a Special Pemdt/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES IF YES, date Issued: 7/2,6,10C- V/l'J/0(e 1F YES: Was the permit recorded at the Registry of Deeds? �/ NO DONT KNOW O YES C' IF YES: enter Book 4f $(e Sc Page: IS I ' and/or Document#:be0"25.2SS S18W sr (s4 oce-T3asc. B, Does the site contain a brook. body of water or wetlands? NO O DONT KNOW O YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained V Obtained © , Date Issued: And U1tt�v 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 0 NO e IF YES, describe size, type and location: E. Win the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part ot a common plan that wilt disturb over l acre? YES © NO er 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 ❑ Addition ❑ Replacement Windows Alteration(s) C Roofing n Or Doors El Accessory Bldg.14 Demolition ❑ New Signs [0] Decks (p Siding[C] Other[C! Brief Description of Proposed Work: oe TA CII ET ACCe550L'Y INLJELL- QA Alteration of existing bedroom Yes 1/ Na Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Ire $ ca::If e to rsrigt t litWU sfiitcfrc`tsl"° .: ;; D t'`r``-":"'. i=NViliq: a. Use of building:One Family N[ Two Family Other b. Number of rooms in each family unit: Number of Bathrooms / 7 c. Is there a garage attached? CO i d. Proposed Square footage of new construction. 5 9 SQ Fr Dimensions 29 i G9 Y 30 e. Number of stories? 1 ji- b 9f. Method of heating? tier L1xr&)a/-Cif Aiv /Cj AS Fireplaces or Woodstoves 'Ye S Number of each ] g. Energy CoThervation Compliance.hMasscheck Energy Compliance form attached? h. Type of construction WWWOcn Parka+(; i. Is construction within 100 ft.of wetlands? Yes S No. Is construction within 100 yr. floodplain Yes )t No j. Depth of basement or cellar floor below finished grade C RA COL S PAC 1 k. Will building conform to the Building and Zoning regulations? )C Yes No. I. Septic Tank )C City Sewer Private well 'A City water Supply SEC ION7a-OWNERAUTHORIZA7101E-TOBECOMPLETED WHEN OWNERSAGENTOR CONTR'AC'CORAPPLIESFOR BFIILDRl6PERMIT 1. AJFft Ho or GTrlf'N ,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 , 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. Print Name Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of'Renee Holder - f.,. a • .. Was 031). 49 _ License Number I ' • �_ • 9 30 Address �t • Expiration pate _ ,.moi 41 C; 4 - 04C Sr Signs ure Teiep one fts ire`. .. igHibictiYblirif r :`f''?':'` Hdi•N .- ,Caw"laity ,,,,,W,t<,;fl Not Applicable 132-24 t Germain Name Registration Number i/EfL _ 1r.u -S fl 1 2- or(7 Address Expiration Date S 1 I L1 t Telephone SECTION 10-WORKERS'COMPENSATION INSURANCEAFFIDAVIT(fd[O:L.c..152 f 25C(8)) Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result in the demist of the issuance of the building permit. _— Signed Affidavit Attached Yes C No t1'17 j s`ttrulaYil '1rr. '1at"t ,,.. The current exemption for"homeowners"was extended to include Owner-Knitted 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 hetshe 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 venom 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 bpildine permit. As acting Construction Supervisor your presence on the job site will be required fromtime 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 010 f 0e (Gr h ofM.orf()aflt}Ifoll ►_ _ • ti filaythiehrtthrla- IR" D EPAATM ENT OP PMLDIW INSPECTIONS 27.2 Maio Street - Municipal Building Northampton, A1ass- 01060 WORSC1rIt'S COI` PENSATLON INSURANCE AlIp)A VI"r (bccvs;ri{ ntnttc) with a principal place of business/residence zt. ice Mit IUk FAo.et s l 4D r (phonekin ) .S-8-4-Ott $� (sm fcityiewurap) do hereby certify, under thc.pains and penalties of perjury; Mil • ( ) E zm an employer providing the following worker's comocnsauon coverase for my empiovices Ivor ng on this job. aerie=Coetnnv) • (Policy N.^,mr) �... (--ointion Dae) ( I am a sole proprie or, general Gaon-actor or homeow-ter(circle one) and have hired the conuacors listed below who have the followlne wor'ker's compensation policies' (Name of Con nctorl (ltvmranc.Comoanya?obcy Nucix ) (harm ce._Date) (Name of Coaozaur) (Insurance. Compaav/Pour.; Nuotarl (Expirzoon Daae) (Name or Coanacer)) (Insurance CompanyePalicy N',mtu) (Eaqu:ues Dam) (Name of Coalractor) {Lnmaanc Company/Policy Nuotr-r) (Expiradoo Dare) (ufrh vNrxJ=00 i(uufothcv to'0c'ud iprc•n.:i C peryti nc u.L msvcois) I am a sole proprietor and have no one working for me. ( ) I am.a home owner performing all the work myself. • NOTE:Pleaea'•rtlth W:t Eanthwth+=W emPlw path=ea.6-.;e" ryuu . .d. .r.of oth moth thth l:,v.•itu m uteth to b' C+9d{y cc m the cnc4a.t iovw a u'cco c,00 L•_..Jh cc�G:'mul.: c-,ploycr 'oCc yx wtdo 0-.yam.:m Na(GLIS2a I(5)) :?pl000 try.bemmmv fa•Yes,:ce resin=ay c`R++*"h It J conn a.ea aglenc 400.1.e the Wu4a.r .. Arm I'u.S uua dw gimpy NWu cam.m mny 4y(cc,vd.4.n tb p.,yvmy ar L>mu'nJ Acct d GGw or thu.w the W. arcs ecvoc4ioaUva I rzc to save 0,00mr _one=tmrw]SA af MCJL Wbn'o4to W. mmMatS_Slpr .4o mv"•g or.Ga:trap los t coon=mar mpuwy,'eao(u0 bau,r--rW cVJ paWvd cc(cc=a(.top Vic.* 0.dc raxof 310o.oe•n.y•o me fv dY�o=d ut W). }'1umacr' Lot: m Si ..uc of L.' /Feur . ^_...'U3ce . .J K • 44 k Lith of Xorthompfon • I tV ,t 4 ; aguexckunette j i Y � a t: DEPARTMENT pEPARTM@NT OP EU[LD0�0 tN<PECTIONS tr 212 Malt/ uee St • Municipal Building INSPECTOR 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 supc:icor. 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 (, ,p f funderstand the above. (Ho owner fr ident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date /D- 11 — O6, Address of work t location fiord IJc not FA12t is k>7> ra chic EIA . 0 / 06$2. Page l oft Ernie Mathieu From: Anthony Patillo Sent: Tuesday, July 12, 2005 6:51 AM To: Ernie Mathieu Subject: RE: Septic System Permit and Well Test Results received thanks! Original Message From: Ernie Mathieu Sent: Monday, July 11, 2005 4:42 PM To: kchomstead@comcast.net Cc: Anthony Patina Subject: Septic System Permit and Well Test Results July 11, 2005 Re: 408 North Farms Road -Septic System Permit and Welt Test Results Dear Neil, I have signed off on your Septic System Permit for 408 North Farms Road. As we discussed last week, this permit is being issued with a condition. The condition is that when the house construction is completed that the well must be flushed for about one half hour and the a water sample must be taken and tested for ph, iron, and color, since these were very slightly elevated in the first test results collected on 6/15/05. If they do not decrease after retesting, then you will be required to install a water filter that treats and lowers these items. I trust in your cooperation in this matter. Please let me when you will be picking up your permit. Thank you. Sincerely, Ernest Mathieu Health Director • • 7/12/2005 �I THE COrMMONWEA TH OF MASSACHUSETTS I. end 3 1 4 DR ki se .MASSACHUSt i I S 7t T- Tii'tcnie of tompiinna ¢( 4 "T I IS 12 CERTIFY,, M the Onsite .ewag• Disposal System installed ben repaired/replaced( ) on by _ • I. �a 0aah� for. w,, W AIe Are i at P . e a3�y+s{ '� _._. �....has been constructed in accordance with th rovisions of Title 5 and the for Disposal System Construction Permit No. _ ��" JI¢.._ dated / .?"-?"" . Use of this system is conditioned on compliance with the provisions set forth below. LL The issuance of(his certifpate sh II nqt he construed as a guarantee that the system will function as designed. This Certificate expires on ,nom G3/.a) .��/y-ry7-- . DATE ��'3��d _._... Inspector /-4.14.1 . . I/-- `F _ HELEN T. Nir .30Or-I .1. i / VOL LINGER\ 2fkcE F, VoLLff.L.rc .6r"? -p8ar-e,,sveo-a ®nota-caobOBb,4“.wixle>empf7o.aoaofX9oca4 " °'x` `0.040P0060-0o PDPQ.V. . ra-ora-a"D�^s�_, NA' Po tC.A4A6L 4 MARION WA1)6 -- AI i __-.-----------�— JN74°2'1„w ow V w. "� >..il� !73.00 P' % 44.- ‘5 Q yJ; ' -`� ---%� 9p rr \ Note 1479^3g F O "7Z>' u W ^ 0 ilk G � /}, y __. .__. .......\.'�...�-"'� / ,- a 3't ' 09 °n' O IKERR e 7) k?'; 11- W `Z, � l0'� - --- _.. ..- - r 5 7B w y' HohAS ,�Y ,.ilii, y\ ,\ti 36 fUraFZEY WRti� t \ S 814°Q I' `� 47Z• z • 29' vd ___--- IP- rn v l,\ I' --J i� ' 7 5 78"47 t o ! o`til0�+i'0 G 4 1L M \ a K -o4t-e o z. Nc rite tfi \ N /I Pks� ,ALC . - . WE rm.. moA l '" LA LA l aj I; a Cq,zY M �,e3AizNE'Z,. \-- `t 1" �---- — — S r #' i I tr fe Qprf $R,y i to SFE T..7 150 `\ --- .�--� Q UJE IP f'RoMslf 1ll..ii."� a i , qfG. STKvru' 0 50 X00 70P 400 Fr ` -,0' Y 2%{ `o '+± 'O tea..err • , , „ Col �--- $27,9 3 Neil Hansind P cc 3 t 5 $!° p4 V' 408 Nat Forms Rd aim 1018 MOM 'ft 6- t -oc