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City of Northampton Mail - Re: Porch on North St
Re: Porch on North St
1 message
Carolyn Misch <cmisch@northamptonma.gov>
To: Louis Hasbrouck <Ihasbrouck@northamptonma.gov>
ok, looks fine. Such a nice guy you are.
Louis Hasbrouck <Ihasbrouck@northamptonma.gov>
Fri, Aug 17, 2012 at 2:01 PM
On Fri, Aug 17, 2012 at 1:47 PM, Louis Hasbrouck wrote:
Carolyn,
I gave conditional approval for this porch at 64 North St; he's got plenty of setback and URC=30% open; not a problem. I told him he's
proceeding at his own risk until Thursday.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
f 5.8,- =�' office
,4126;= 587-1272 fax
(Ci --y of Northampton E-mail is a public record except when it falls under one of the specific statutory exemptions.)
Carolyn Misch, AICP
Senior Land Use Planner/Permits Manager
City of Northampton Office of Planning & Development
210 Main St, Room 11
Northampton, MA 01060
413-587-1287
cmisch@northamptonma.gov
www.northamatonma.gov/opd
(City of Northampton E-mail is a public record except when it fails under one of the specific statutory exemptions.)
Name (Business/Organization/Individual):
Address:
tate/Zip:
Phone #:
Are you an employer? Check the appropriate box:
1. ❑ I am a employer with 4. 0 I am a general contractor and I
employees (full and/or part-time).* have hired the sub -contractors
2. (VI am a sole proprietor or partner- listed on the attached sheet.
ship and have no employees These sub -contractors have
working for me in any capacity.
[No workers' comp. insurance
required.]
LW a homeowner doing all work
myself. [No workers' comp.
insurance required.] t
employees and have workers'
comp. insurance.$
We are a corporation and its
officers have exercised their
right of exemption per MGL
c. 152, § 1(4), and we have no
employees. [No workers'
comp. insurance required.]
Type of project (required):
6_ ❑ New construction
7. ❑ Remodeling
8. emolition
9. [wilding addition
10.lectrical repairs or additions
11.0 Plumbing repairs or additions
12. ❑ Roof repairs
13. ❑ Other
*Any applicant that checks box 11 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 state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers' comp. policy number.
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: City/State/Zip:
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 a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA fyqnsurance coverage verification.
I do hereby certify urod�er 111pdins and penalties of perjury that the information provided above is true and correct.
Of use onlh. Do not write in this area, to be completed by city or town officiaL
City or Town:
Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector
6. Other
Contact Person: Phone #:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations ,
_
.
600 Washington Street
Boston, MA 02111
www. mass.g ov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Informatiotl
Please Print Legibly
Name (Business/Organization/Individual):
Address:
tate/Zip:
Phone #:
Are you an employer? Check the appropriate box:
1. ❑ I am a employer with 4. 0 I am a general contractor and I
employees (full and/or part-time).* have hired the sub -contractors
2. (VI am a sole proprietor or partner- listed on the attached sheet.
ship and have no employees These sub -contractors have
working for me in any capacity.
[No workers' comp. insurance
required.]
LW a homeowner doing all work
myself. [No workers' comp.
insurance required.] t
employees and have workers'
comp. insurance.$
We are a corporation and its
officers have exercised their
right of exemption per MGL
c. 152, § 1(4), and we have no
employees. [No workers'
comp. insurance required.]
Type of project (required):
6_ ❑ New construction
7. ❑ Remodeling
8. emolition
9. [wilding addition
10.lectrical repairs or additions
11.0 Plumbing repairs or additions
12. ❑ Roof repairs
13. ❑ Other
*Any applicant that checks box 11 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 state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers' comp. policy number.
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: City/State/Zip:
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 a 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 fyqnsurance coverage verification.
I do hereby certify urod�er 111pdins and penalties of perjury that the information provided above is true and correct.
Of use onlh. 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 S. Plumbing Inspector
6. Other
Contact Person: Phone #:
Versionl.7 Commercial Building Permit May 15, 2000
SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No 0
SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIESFOR BUILDING PERMIT
........... . ..
w......... ..... .._ ...... as Owner of the subject property
hereby authorize . _ ____ . _ ...
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 anAdna s If perjury. -_ _ ____ ._ --- 1--1--,-.,--. __.._...... ..,_ .. _.
Print Name
Signature of Owner/Agent Date
SECTION 12 -CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor Not Applicable ❑
Name of License Holder tY
License Number
�.. ..r•'r% !_K._.._�...t._� _.._� _���'�T�c�>�^.�T��.� ..._G�`.�� � rte' �-� � 1 `�
Address Expiration Date
Signature Telephone f
41
SECTION' 13 ORKERS.' 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 () No
Version 1.7 Commercial Building Permit May 15, 2000
SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION. SERVICES -FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name (Registrant).
___.. __..... __..,. _._.....
_..._
........_,. .. q„
Registration Number
Address
Expiration Date
Signature
Telephone
9.2 Registered Professional Engineer(s):
Area of Responsibility
Name
Registration Number
Address
Telephone
Expiration Date
Signature
Area of Responsibility
Name
Re�istrahon Number
Address
Telephone
Expiration Date
Signature
3
Area of Responsibility
Name
Registration Number
Address
Telephone
Expiration Date
Signature
_. ..... , . _. _ ._.. _._..____..
_. ......... _......, _ ... ... ...... ... ...
Area of Responsibility
Name
Registration Number
Address
...w ......._a
Telephone
��_... _. ............ a. ...... _... M ....
Expiration Date
Signature
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address
Telephone
Signature
Version 1.7 Commercial Building Permit May 15, 2000
S. NORTHAMPTON ZONING '
Existing
Proposed
Required by Zoning
This column tofilled in by
Building Department
Lot Size
Frontage..
Setbacks Front
j t
I✓y��/Yj
Side
L. R...._ _, _.
L .._._...,.__. R
Rear
Building Height
tj
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
_ %
m..
# of Parking Spaces
= —`
Fill:
(volume & Location)
_ . _____._.. .. _ ,.__.... -,._
__..__ _ __..___. ,.. _ _. __
._. .. _ .
A. Has a Special Permit/Variance/Finding evpp been issued for/on the site?
NO 0 DONT KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
- NO 0 -- - --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 DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
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
IF YES, describe size, type and location:
E. Will the construction activity disturb (cling, grading, ex cav 1 or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
w
Version 1.7 Commercial Building Permit May 15, 2000
0
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
,
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Bug% (}]�
Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑
Other ❑
Brief Description 'Enter a brief description here.
Of Proposed Work:'
SECTION 5- USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable)
CONSTRUCTION TYPE
A Assembly ❑
A-1 ❑ A-2 ❑ A-3 ❑
1A
A-4 ElA-5El
M
B Business ❑
2A
❑
E Educational ❑
2B
❑
F Factory ❑
F-1 ❑ F-2 ❑
2C
❑
H High Hazard ❑
--- -:
3A
3B
❑
❑
I Institutional ❑
I-1 ❑ 1-2 ❑ 1-3 ❑
M Mercantile ❑
4
❑
R Residential
R-1 ❑ R-2 R-3 ❑
5A
58
S Storage ❑
S-1 ❑ S-2 ❑
U Utility ❑
Specify
Specify
M Mixed Use ❑
S Special Use ❑
Specify
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: ___ _. ____
Proposed Use Group:
Existing Hazard Index 780 CMR 34) _,. _w .,_._,__.___,
Proposed Hazard Index 780 CMR 34): , ...._.__ m._
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING
PROPOSED NEW CONSTRUCTION
OFFICE USE ONLY
Floor Area per Floor (sf)
15t .
...
2nd _ . . _... ..,.. __,.. ..__.._ .. ,
i
2nd
a _ ,_._., _,_ :.... ... ................._ ,,.,,
rd
..
3rd
___ _._,_._., :. __ _
4 th
4m
Total Area (sf)
Total Proposed New .,Construction (sf)
y
Total Height (ft) -
Total Height ft �„ _..., .. .....� ._ ..
7. Water S,eipply (M.G.L. c. 40, § 54)
7.1 Flood Zone Information:
7.3 Sewage Di osal System:
On
Public jZ Private ❑
Zone Outside Flood Zone
Municipal
site disposal system
w
Version 1.7 Commercial Building Permit May 15, 2000
_ Ci of Northampton s'ttaf PeE:
Bul ding Department curbCraf,L�nyev✓aysPE
!t 2 2 Main Street 5eweilSelattcAratta6
p�G Z Room 100 Wae�7llUel.�yallabl�f
ECT ha ; pton, MA 01060 Two SesoS ri�tirra.
P, 0, 87=1240 Fax 413-587-1272 's
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
This
1.1 Property Address:
17 � Map
/L.7 /q / , l I / , ,� C1 Zone
------ Elm St. District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name (Print) ?
Signature
Name (Print)
Signature
-'ESTIMATED CONSTI
Item
1. Building
2. Electrical
3. Plumbing
4. Mechanical (HVAC)
5. Fire Protection
6. Total=(1+2+3+4+5)
Building Permit Number
_
Signature:
�
Buildina Commissioner/Inspector of
action to be completed by office
Lot Unit
Overlay District
CS District
Current Mailing Address:
T eleohone
Current Mailing Address
Telephone
RUCTION COSTS
Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
(a) Building Permit Fee
(b) EstimatedTotal Cost of
Construction from- 6'
Building Permit Fee
Check Number
This Section For Official Use Only
Date
Issued
Date
64 NORTH ST BP -2013-0187
GIs #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24D - 089 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ADDITION BUILDING PERMIT
Permit # BP -2013-0187
Project # JS -2013-000306
Est. Cost: $7000.00
Fee: $96.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: MICHAEL L HARRINGTON 102948
Lot Size(sq. ft.): 7100.28 Owner: HARRINGTON MICHAEL L
Zoning: URC(100)/ Applicant: MICHAEL L HARRINGTON
AT. 64 NORTH ST
Applicant Address: Phone: Insurance:
P O BOX 393 (413) 575-8345
NORTHAMPTON ,MA01061 ISSUED ON:8/21/2012 0:00:00
TO PERFORM THE FOLLOWING WORK. -CONSTRUCT 12 X 16 SUNROOM
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 8/21/2012 0:00:00 $96.00
212 Main Street, Phone (413) 587-1240, Fax: (413) 587-1272
Louis Hasbrouck — Building Commissioner