24A-226 (4) 43 PILGRIM DR BP-2017-1264
GIS g: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24A-226 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2017-1264
Project# JS-2017-002112
Est. Cost: $12979.00
Fee: $91.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WRIGHT BUILDERS 106505
Lot Size(so. ft.): 11020.68 Owner: CRAWLEY SARA
zoning: URA(100)/ Applicant: WRIGHT BUILDERS
AT: 43 PILGRIM DR
Applicant Address: Phone: Insurance:
48 Bates St (413) 586-8287 (116) Workers Compensation
NORTHAMPTONMA01060 ISSUED ON:5/4/20I 7 0:00:00
TO PERFORM THE FOLLOWING WORK:DEMO AND REPLACE CONCRETE ENTRY
STEPS, REPLACEMENT WINDOWS, NEW KITCHEN FINISHES
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 5/4/2017 0:00:00 $91.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File# BP-2017-1264
APPLICANT/CONTACT PERSON WRIGHT BUILDERS
ADDRESS/PHONE 48 Bates St NORTHAMPTON (413)586-8287(116)
PROPERTY LOCATION 43 PILGRIM DR
MAP 24A PARCEL 226 001 ZONE URA(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tvoeof Construction: DEMO AND REPLACE CONCRETE ENTRY STEP5,REPLACEMENT WINDOWS
NEW KITCHEN FINISHES \ it/O Cli?.'7pi A-cU4cr/'n
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 106505
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
proved 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
Demolitio !-la
Signature of Budding 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.
Department use only
City of Northampton Status of Permit
Building Department Curb Cut/Driveway Permit - -
212 Main Street .Sewer/Septicc Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets ofStructural Plans
phone 413-587-1240 Fax 413-587-1272 PloVSife Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1
II.tProoertv Address: Thisisection to be completed by office
L 3 P I L C k7W Dk . Map �i/'ThnLot d Unit
CkThriltlPTeiti', Graf0 Zone Overlay District
Elm SL District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Ac,A C TvwL,E\-! L PILGRIM )R. NRI-f-iiv PC i , AM
Name(Pant) p Current Mailing Address:
aid Y ( L Telephone ([
nature v4�j� r,) Up
1C — 5" 0�
2.2 Authorized Agent:
\,I, Lfl CCLL 45 BATES ST NOWC\ Rti1PT0:Nl, MA
N me(Priinnttt))��� p _Q ) Current Mailing Address:
I IIlld/Ll[Lid 0 CJ (443) 5SLc - S2C�
gnatura Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS 9b131( i ccc - 11; qI PEE
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building .d 'I ?)05 (a)Building Permit Fee
2. Electrical 1QG ICS 5 (b)Estimated Total Cost of
.IV Construction from(6)
3. Plumbing $ t 5 0 O Building Permit Fee
4. Mechanical(HVAC) a3�
5. Fire Protection �wc ,
6. Total=(1 +2+3+4+5) % 1 GI-Jr Check Number �J;/��% 9/
This Section For Official Use Only
Dale
Building Permit Number: Issued'
Signature:
Building Commissioner/Inspector of Buildings Date
1
}
RLL WORD TU BE DeNE uuiT th P S 1N6 EsL:Dcu €T.PQVA T
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column robe filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R ___ L,_..._ R:L _.._
Rear -
Building Height
Bldg.Square Footage ____ ....
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces ---- --- ----'
Fill: • •
(volume&I %tion)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW ® YES O
IF YES, date issued::
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page - and/or Document#-
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW O YES O
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 O NO
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 e
IF YES, describe size, type and Location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over/ acre or is it part of a common plan
that will disturb over t acre? YES O NO 0
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 ❑ Replacementy7ndows Alteration(s) Roofing ❑
Or Doors - J
Accessory Bldg. D Demolition ❑ New Signs [O] Decks 1g3 Siding[D1 Other[0]
Brief Description of Proposed
Work: MANN RCVXFrCF CCIJ:RFS'E Eln-Y `7,11—i)S riTcHE,J
Alteration of existingbedroom YesPi�'S t1ES
>( No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes x No
Plans Attached Roll -Sheet
ea.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.
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, 7AR,'i LRALl3LN _ _ ,as Owner of the subject
property
hereby authorize AN; LEINN)ELL. / L12
(JO 1,\ALDES
to act onmy
�y behalf, in//allrl matters relative to work authorized by this building permit application.
Sign o Ownerrt lel o. Date —
I, AN,lV lCNA Fl.I iQ110 t B\j DEIZS asOwnerluthodzed
Agennereby declare that the statem nts and information on the foregoing application are true and accurate,to the best of my knowledge
Thrust b lief.
Signed under the pains and penalties of perjury.
A - b 't L.
Prin Name mini
�. .f• er/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not
Applicable ❑
Name of License Holder. ANN ( 1 \CR(. LJ- (Cao5Ci3
License Number
U3S 13R 5(. W6Rz-i) HRArisoN_ MH rn(x0,,r3 / / 1 t
• Expiration Date
6yUl�a�^ X fir;) eco - Za?,
S n lure Telephone
9.Registered Home Improvement Contractor: Not Applicable 0
k) vhr+T -P,AKvCi") S, NC_ '3'. 53
Company Name Registration Number
(-}$ 1;ericS ST, Nb(' 1 -01m) \-1\&,, fkrVROI(- 100 1p / 2 Cc / ( $
AddressCU"i3) Expiration Date
•alit sLii' a Jli.2.1 Telephone 7 1D
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.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 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 fano
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 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: L 5 lc)LGIZLN,\ 11:., 1v0,;
u _N c1 A0 Wonek nwe lli4 t aHickJ'acataead
Si`i Office of Consumer Affairs and Business Regulation
lO Bark Plaza- Suite 5170
Boston, Massac L.setts 02116
Home Improvement ,c: tor Registration
Registration: 101536
A —#YiF=E /'71 Type: Private Corporation
- sm�IJi`rl�
Expiration: 8,262018 Tr 419291
WRIGFIT J4onathan
SST BUILDERS,EINC. t,. m d
�S r�3 . mom d
4 R sr se
Northampton, MA 01060 %3 -W\ .`
M . 0 ° Update Address and return card.Mark reason for change.
sone 4 201.1-05/11 [1:1Address C1 Renewal 1"l Employment E Lost Card
c$28-oa„«e.o„„!G otk.flaa,aJ,d,rs
Ofrke o1Canea nerAflairs&Redness Regulation License or regrstratkn valid for individual ass only
HOME IMPROVFEMENT CONTRACTOR before the expiration date. If found return to:
RogIefratlon:. 1538 Type: Once of Consumer Attain sod Business Regulation
Explratio ` r. . 8 Private Corporation 10 Park P -Suite 5170
o Ewen, i'llb
WRIGHT BUILDERr
Jonathan Wright li
40 BATES STREET coy aitairlif
a
Northampton,MA 01060Undersecretary j �„!}i tare
`�'i�i��
•
Massachusetts Department of Public Safety
Boartl of Building Rer.
gulations aotl Standards
License: CS-108505
Construction Supervisor
•
ANN SURMACEVIZ
106 EAST BUCKLAND ROAD 1 --
SHELBURNE FALLS MA 01370
�/( Expiration:
Commissioner 11/012017
•
Construction Supervisor '.
Restricted to:
Unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet.(991 cubic meters)of
enclosed space.
Failure to possess a current edition of the Massachusetts
State Bulldog Code is cause for revocation of this license.
DPS Licensing information visit: WMW.MASS.GOV/DPS •
•
•
•
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BUILDING DEPARTMENT
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