1. Completed BP App. 6 Beaver Brook LoopDepartment use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION I
1.1 Pro~ertv Address: This section to be completed by office
6 Beaver Brook Loop Map Lot Unit
Leeds Zone Overlay District
Elm St. District CB District
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT I
2.1 Owner of Record:
Steve McDonough 73 Barrett ST, Apt. 3109, Northampton, MA
Name (Print) Current Mailing Address:
Telephone 413-209-1608 Signature
2.2 Authorized Agent:
Steve Ferrari 103 Ryan RD , Florence, MA
Name (Print) Current Mailing Address:
413-588-8975
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS I
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building $275,000 (a) Building Permit Fee
2. Electrical $12,500 (b) Estimated Total Cost of
Construction from (6)
3. Plumbing $18,300 Building Permit Fee
4. Mechanical (HVAC) $12,000
5. Fire Protection $9,500
6. Total = (1 + 2 + 3 + 4 + 5) $327,300 Check Number
This Section For Official Use Only
Building Permit Number: Date
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 tilled in by
Building Department
Lot Size 27,385 SF 27,385 SF
Frontage 83.2' 83.2'
Setbacks Front 30'
Side L: R: L: 33.7' R: 23.5' --- ------ ---
Rear 95' +-
Building Height 30'
Bldg. Square Footage % 1570sf 6%
Open Space Footage %
(Lot area minus bldg & paved 25,035sf 91%
parking)
# of Parking Spaces 3
Fill:
(volume & Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW ~X ) YES 0
IF YES, date issued:
IF YES : Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO (~) DON'T KNOW Q YES Q
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 (X)
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES 0
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 Q NO (~)
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) D
Or Doors D
Roofing D
Accessory Bldg. 0 Demolition
D
D New Signs [D) Decks [0 Siding [D] Other [D]
Brief Description of Proposed Construct new single family two story house with attached garage Work: _____________________________________ _
Alteration of existing bedroom ___ Yes ___ No Adding new bedroom Yes -~-No
Renovating unfinished basement Yes ____ No Attached Narrative
Plans Attached Roll -Sheet
sa. If New house and or addition to existing housing, complete the following:
X Use of building : One Family ___ _ a. Two Family ____ Other ___ _
b. Number of rooms in each family unit: ___ 7 ____ Number of Bathrooms. __ 3 ___ _
C. Yes Is there a garage attached? ___ _ House 1888sf
d. 60'-4" x 31.-8" oa Proposed Square footage of new construction. __ G_a_r_a_q_e_5_4_3_s_f ___ Dimensions---------------
e. Number of stories? __ 2____________ Gas
Nat. Gas Warm Air F1'replace f. Method of heating? --------------Fireplaces or Woodstoves Number of each
Prelim HERC attached g. Energy Conservation Compliance. _________ Masscheck Energy Compliance form attached? ______ _
h. Type of construction Wood Frame unprotected
i. Is construction within 100ft. of wetlands? ___ Yes __ X_ No. Is construction within 100 yr. floodplain ___ Yes _X_No
0' to 6'-1 0" j. Depth of basement or cellar floor below finished grade __________ _
k. Will building conform to the Building and Zoning regulations? ____ Yes _X __ No .
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
Steve Ferrari
by this building permit application .
-1 ~ -l.s-
5 Tt--vc= F --Q .a K) !) ...,-1, '--(:;: Q I) fT '' ..)._, , 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.
Steve Ferrari
Print Name
SECTION 8 -CONSTRUCTION SERVICES I
8.1 Licensed Construction Su12ervisor: Not Applicable 0
Name of License Holder : Steve Ferrari CS-098877
License Number
103 Ryan RD, Florence, MA 5/23/2017
Ad~ Expiration Date
413-588-8975 ·. _F~
Signatu Telephone
9. Registered Home lm12rovement Contractor: Not Applicable ~
Comj2anl£ Name Registration Number
Address Expiration Date
Telephone
SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) I
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 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 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--------------------------