32C-306 (7) 48 HOCKANUM RD BP-2019-0641
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map-Block:32C-306 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: SUNROOM BUILDING PERMIT
Permit# BP-2019-0641
Project# JS-2019-001044
Est.Cost: $110000.00
Fee:$715.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ERIK VAN NATTA 104203
Lot Size(sq. ft.): 5662.80 Owner: NORMANLY JENNIFER
Zoning:URC(100)/ Applicant: ERIK VAN NATTA
AT. 48 HOCKANUM RD
Applicant Address: Phone: Insurance:
175 PARMENTER (413)834-0054 SOLE PROPRIETOR
BERNARDSTONMA01337 ISSUED ON.12/18/2018 0.00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT A 10X18 SUNROOM ADDITION ON
SIDE OF HOUSE
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 12/18/2018 0:00:00 $715.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2019-0641
APPLICANT/CONTACT PERSON ERIK VAN NATTA
ADDRESS/PHONE 175 PARMENTER BERNARDSTON (413)834-0054
PROPERTY LOCATION 48 HOCKANUM RD
MAP 32C PARCEL 306 001 ZONE URC(100)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
REQUIRED DATE
ZONING FORM FILLED OUT E
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT A 10X18 SUNROOMAODITION ON SIDE OF HOUSE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 104203
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATIOSENTED:
Approved 74ZAdditional 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 REUIRED UNDER: §
Finding L V' 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
o . o Delay
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. S
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City of Northampton Sta iso ' ry.
Building Department CutCa
212 Main Street
Room 100 WateriWell Avallabiarfy
Northampton, MA 01060 Two Segs of Structural'Plaris :,
phone 413-587-12 -587-1272 Plot/SwtePlans '
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APPLICATION TO CONSTRUCT,Ai TER,FEPAIR,RENOVATE OR MO SH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION NOV 2 8 2018 60,/4—&V/
1.1 Property Address:
Tt is section to be completed by office
8 Hockanum DEPT OF BUILDINGN�TIONS 30(P
NORTHAMf TON, "'t Unit
Northampton MA
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
Jennifq~anly 48 Hockanum Rd
Current Mailing Address
i
Telephone
Si natur
2.2 ith ized Agent:
Erik Van Natta 75 Parmenter rd,Bernardston MA 01337
Name(Print) Current Mailing Address:
413-834-0054
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building $110,000 (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
6. Total=0 +2+3+4+5) $110 00 Check Number �^
This Section For Official Use Only
Building Permit Number: IIsssued:
Signature: f ot / 1Z
Building Commissioner/Inspector of Buildings Date
ir-r 1 h- na ✓t�'t /�a r'T-ate b u d kS .
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This col umn to be filled in by
Building Department
'5650 Same
Lot Size
146' same
Frontage
Setbacks Front 14 Same
Side L:26 R: 16 Lj6 R:Same
Rear 16 Same
Building Height 30 same
Bldg. Square Footage 2484 2662
Open Space Footage
(Lot area minus bldg&paved 3166 56% 2998 53%
parking)
#of Parking Spaces 2
Fill: none
volume&Location) _ _. I I I _
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO xDONT KNOW YES O
IF YES, date issued:;
IF YES: Was the permit recorded at the Registryof Deeds?
NO DONT KNOW 0 YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 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
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NOG
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 Q Replacement Windows Alteration(s) Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks[ ❑ Siding[O] Other[El
Brief Description of Proposed
Work:Construct a sunroom addition on the side of 48 hockanum road.Sunroom will be 10x18'Misc interior renovations to copnnect the addition to the home and
Alteration of existing bedroom Yes x No Adding new bedroom Yes Y No
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll -Sheet
sa. If New house and or addition to existing housing, complete the following_
a. Use of building:One Family Two Family X Other
b. Number of rooms in each family unit:6 Number of Bathrooms
c. Is there a garage attached? no
d. Proposed Square footage of new construction. 180' Dimensions 10'X17'
e. Number of stories? 1
f. Method of heating?Mini Split heat pump 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 X No. Is construction within 100 yr. floodplain Yes X No
j. Depth of basement or cellar floor below finished grade 6'exsiting (addition to be built on pre-cast piers)
k. Will building conform to the Building and Zoning regulations? Yes yes No.
I. Septic Tank City Sewer X Private well City water Supply X
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,Jennifer Normanly as Owner of the subject
property
hereby authorize Erik Van Natta
to act o ehalf, i afters relative to work authorized by this building permit application.
Signature o w er Date
I, Erik Van Natta 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.
Erik Van Natta
Print Name
Si nature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable Q
Name of License Holder:Erik Van Natta 104203
License Number
175 Parmenter Rd Bernardston MA 12/11/19
Address Expiration Date
413-834-0054
Signature Telephone
9.Registered Home Improvement Contractor: Not Applicable Q
Van Natta Co LLC 132102
Company Name Registration Number
175 Parmenter Rd Bernardston MA 01337 11/12/19
Address Expiration Date
Telephone 413-834-0054
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....... Q No...... 4
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 deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the
owner of a 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 of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)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 affidavit. The affidavit should
be returned 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/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)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 proof that 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
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax# 617-727-7749
Revised 5-26-05
www.mass.gov/dia
City of Northampton
Massachusetts
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DEPARTMENT OF BUILDING INSPECTIONS a
212 Main Street •Municipal Building �<<,y
Northampton, MA 01060 r Yyq �ai.�as
Debris 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.
The debris from construction work being performed at:
48 Hockanum RD
(Please print house number and street name)
Is to be disposed of at:
Valley Recycling
(Please print name and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Zt�� � t �A�
Signature of Permit Applicant or Owner Date
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
Aft
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Van Natta Co LLC
Address: 175 Parmenter Rd.
City/State/Zip:Bernardston MA 01337 Phone #: 413-834-0054
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 3 employees 4. ❑ I am a general contractor and I 6. ❑ New construction
(full and/or part-time).* I am a have hired the sub-contractors
2.Q sole proprietor or partner-ship and listed on the attached sheet. $ 7. ® Remodeling
have no employees working for These sub-contractors have 8. ❑ Demolition
me in any capacity. [No workers' workers' comp. insurance. 9. ® Building addition
comp. insurance required.] 5. ❑ We are a corporation and its
I am a homeowner doing all work officers have exercised their 10.El Electrical repairs or additions
3.❑ myself. [No workers' comp. right of exemption per MGL 11.0 Plumbing repairs or additions
insurance required.]t c. 152, §1(4),and we have no 12.0 Roof repairs
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation 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 must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic. Expiration Date:
Job Site Address:48 HOCkanum Rd City/State/Zip:Northampton MAO 1060
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a fine
of up to$250.00 a day against the violator.Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certi under the pai enalties of perjury that the information provided above is true and correct.
Signature: Date: l
Phone#: — 3K —®o 5
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#:
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Sunroom Van Natta Builds Erik Van Natta
Jennifer Normanly 175 Parmenter Rd. CSL: 104203
48 Hockanum Rd, Bernardston, MA 01337
HIC: 132102
Northampton MA erik@vannattabuilds.com
413-834-0054 November 28,
2018
Windows and Doors
Marvin Ultimate Double hung windows
Lower sash tempered on all units due to low sill height.
Units adjacent doors will be fully tempered
3'0'x7'0"Marvin Ultimate French door
r
Sunroom Van Natta Builds Erik Van Natta
Jennifer Normanly 175 Parmenter Rd. CIC: 104203
32102
48 Hockanum Rd, Bernardston, MA 01337
Northampton MA erik@vannattabuilds.com
413-834-0054 November 28,
2018
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2 PLY 2X12 CONTINOUS HEADER
4 PLY 2X12 PT BEAM
2X6 WALL STUDS WITH
ROCKWOOL INSULATION LOW SLOPE ROOF
6X6 PT POST 2X12 RAFTERS WITH WITH EPDM
CELLULOSE INSULATION MEMBRANE
2X10 JOISTS AND LEDGER
Bottom of joist bay enclosed
by 1/2 plywood. Insulated with
cellulose insulation
November 28, 2018 Jennifer Normanly 48 Hockanum Rd, Northampton MA Sunroom 01
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November 28, 2018 7ennifer Normanly 48 Hockanum Rd, Northampton MA Sunroom 03
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