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25-026 (4) 129 RIVERBANK RD BP-2018-1170 GIS n: COMMONWEALTH OF MASSACHUSETTS MV.Block:25 -026 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:Deck BUILDING PERMIT Permit# BP-2018-1170 Proiect4 JS-2018-002099 Est Cost, $4500.00 Fee, $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor_ Lot Size(so.8.): 5314.32 Owner: WATLING RICHARD H Zoning, Applicant: WATLING RICHARD H AT. 129 RIVERBANK RD ADDlicantAddress: Phone: Insurance: 129 RIVERBANK RD NORTHAMPTON MA01 060 ISSUED ON:5/11/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.•REPLACE 2ND FLOOR BALCONY IN FRONT OF HOUSE- 35X6 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: FeeTyoe: Date Paid: Amount: Building 5/11/20180:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Vito File File 4 BP-2018-1170 r(Ef'`J o0TP�1.1 tJt � �'�, APPLICANT/CONTACT PERSON WATLING RICHARD H 5A'W`, / � ADDRESS/PHONE 129 RIVERBANK RD NORTHAMPTON L 1•LOP,0d£.4�wG( PROPERTY LOCATION 129 RIVERBANK RD �d MAP 25 PARCEL 026 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST CLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tvoeof C nstrucdo w REPLACE 2ND FLOOR BALCONY IN FRONT OF HOUSE-35X6 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INYORMATION 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 Commission Permit DPW Storm Water Management Demolition Delay sivlg Signatureof�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, RECEIVED Depuse only ty,,p(�V o am ton Status ol4eumrc �It"� a ent CurbCUtlOnvewayl emit pi 212 Main tre t Sewer/Septic AjmagabilHy OF 6UI.dN01 0 WaterMleg AY6lability. NORTBA 1060 Sawrot Structural Pians x phone 413-587-1240 Fax 413-587-1272 A-tisige ptme od:. Other Speafy APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address' AA II This section to be completed by ofBca �Znl �Rt.i �k K� Map R.� Lot Unit l l or ,-q .s1 /I..R O( a(o o Zona Overlay District N Elm St.District CB Dislmot SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Recordr: Name(Phro Current MailiW Address: yrs azo-7yY2 Telephone Signature 2.2 Authorized Agent: Name(Pant) Current Mailing Address'. Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completedbypermit a licam 1. Building L/ S-0 O (a) Building Permit Fee r 2. Electrical O (b) Estimated Total Cost of ("O Construction from 6 / 3. Plumbing O Building Permit Fee 4. Mechanical(HVAC) O 5. Fire Protection 2VVV 6. Total=(1 +2+3 +4+5) Check Number 3 This Section For Official Use Only Building Permit Number: DateIssued: Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (1tEQUIRED; EITHER HOMEOWNER OR CONTRACTOR) i Section 4. ZONING 91 Information Must Be Completed. Permit Can Bf Denied Dul"t-viawt mation ! Existing Propose Required by Zoning i This,rrcoluma�n to be fllN in by ' I 2i1, B�lY6"YPa�iaC,i I Lot Size ...._ - - Frontage Setbacks Front i Side L (.0... Rt ZO U R: .._. Rear !......... Building Height30 3 ot.. .. Bldg.Square Footage - - % '- Open Space Footage % (Lot area minus bids&paved !. _... radiant) #of Puking Spaces --' volwne&Location --- A. Has a Special Permit/Variance/Finding ever been issued for/ n the site? NO O DON'T KNOW O YES IF YES, date issued: 'Zo w IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW YES Q.... IF YES: enter Book Page , and/or Document N B. Does the site contain a brook, body of water or wetlands? NO D<1 DONT KNOW O YES o IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © 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 © NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,ELxcavgJPn, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Ste"Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing ❑ 0,Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signa [cal Decks Siding[p] Other[pf Brief Des bon of Pro gyed �ppG -�'lo� i hFs �c-nn�/ Ir. r•�n 'F c7 LJ.�-)-� �j5x Alteration of existing bedroom_Yes No Adding new bedroom Yes No / Attached Narrative Renovating unfinished basement _Yes No Plans Attached Roll -Sheet sa.If New house and or addition to existina 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 Is construction within 100 it 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, 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 I �� , c /l V f1'T �r � , as Owner/Authorized Agent hereby declare that the statements antl infortnali n the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. (- " /- ( c./a+I , ,. e print Name SlgnatorenuMmer/Agent Date SECTION 6-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ No.,of License Holder: License Number Add.... Expiration Date Signature Telephone 9.Reaiatered Home Improvement Contractor: Not Applicable ❑ Company Name Registratlon Number Address Expiration Date Telephone 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 ofthe issuance of the building permit. Signed Affidavit Attached Yes....... ❑ No...... ❑ City of Northampton � Massachusetts � G i ' DLPARI'1II•:NT OF BUILDING INSPECTIONS ' 212 Main St—t • Municipal Building Northampton, !W 01060 �ubh.".3,j1J AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor most be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation,repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owneroccupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: Est. Cost: Address of Work: Date of permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): Job under$1,000.00 _Owner obtaining own permit(explain): Building not owner-occupiedOther(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND 110 NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature _ City of Northampton Massachusetts DEpMB T OF BUILDING INSPECTIONS 7 212 Main 8t—t a Municipal Building xti' CD Northampton, lA 01060 Massachusetts Residential Building Code Section 110.R5.1.2 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. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 1 I O.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. 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. 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: � -Z -? g' The debris will be transported by. The debris will be received by: Building permit number: Name of Permit Applicant -S-- 7 - f Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of7ndustrial Accidents 1 Congress Street,Suite 100 c. Boston,MA 02114-2077 www.mass.gov/dia TNA urkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant If r tin Please Print Leeiblv Name (Business/OrganiutioNlndividual): Address: City/State/Zip: Phone#: Are you m employer?Chemo the appropriate box: Type of project(required): LE]I am a employer with-cantilevers(fun and/or pen-time)^ 7. []New construction 2.❑lamasole proprietor or partnership and M1ave nu employees working formem S. Remodeling afiy capacity.[No workers comp.insurance required.] 3 m a homeowner doingall workm If. No workers'com insurance d 1 Demolition a myself.[ p -n- ereyuirc ]' 4.❑1 am a humcoumcr and will be hiring contractors to conduct all work on my prount, Iwill 10 Building addition ensure that an contractors other have workers compensation insurance a are sole 1 L❑Electrical repairs or additions Pronounces with no cmployocs. 12.❑Plumbing repairs or additions 5 M I am a served contractor and I have hired the sub-omm coos listed on the attached sheet ]j,�ROOf repairs These sub-conteeWrs have employees and have wmkers'comp.mono era. 6.❑Wenrea corpoeuon.ro ds of ecohaveexereisedtM1cir risbtofexemption per MGL a 14.❑Other 152,61(4)and we haven employees.[No workers'compinsurance required] •Any applicant that checks box 41 most also fill out the section below showing their workerscompensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box most attached ea additional sheet showing the reme of the subcontractors and state whether or not those entities have employees. If the sub-conttaaors have employees,they must provide their workers'com,.police numben I am an employer that is providing worker.N compensation insurance far my employees. Below is the policy and job.site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/SmtaZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct Ph #' c'// I 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. pursuant to this statute,an employee is defined as`...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence ofcompliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any ofit,political subdivisions shall enter into any contract for the performance ofpubbc work until acceptable evidence ofcompliance with the insurance requirements ofthis chapter have been presented to the contracting authmiry." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractogs)name(s),address(es)and phone number(a)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the afTidavit. The affidavit should be retuned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/licensc applications in any given year,need only submit one affidavit indicating current policy information(ifnecessary)and under"Job Site Address"the applicant should write"all locations in_(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture Ire, a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number' The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia - ---.._....... . ....... ..... . .... ..�....,...�.,. �u.. � DECK FRAMING PLAN tr (\ Ica •yam �-'--------�-}-� ......... ...<uNme wt............. M Me wm a Pt I+M.r� PmY YI : EvfiW.0 WNmn pyiuul uiuu«� 4iumrr n� rf.eu «.. n,.p. ry, baaa wt/)bHLln ltMD10 t«rl 4 4 n a tw 4:.....__. ._ ,a% ._..�._......_.....__.. _.,.... YyLLM GMY tMItK{LLLNN MHM M ............ ......«. ----------- ._ �- 4ilpn IMsr.eMtlinyJ I.unl MMIM rsr Ytf rYyY tufa J .. Ql- 2 ' \J it `1 i « 4 s i • (_J, ._'1 T' T '—�` �}t oa -?t -_ —.�'—�,-__J7 �� i y • � - � � MY lsR� 6•w 3-s/r LIDowkwo Join my sor otRsa A7gsoN su -J stwlop 05715 mmz(* 2:3 � �p 17111 rk 1 W*M Ino. Elm W NH eG w.0 x.inaa w. PRELIMINARY PLAN, NOT FOR CONSTRUCTION l; DECK FRAMING PLAN 21 3: o: 2' - 2: 8' �' B' N .. 8. 0° �. S.➢t _ Rm R.. acwucc 4rv�. S �1i 411 "LIE S W I I, a, BI .,... .... . ........ I' anmaae axxla xaXaxap xia BLOane DTT1a saeaS01{ Tit HI I H. L; j sr a• Pi xi rk Miles Inc. - wan si.