24D-272 (7) 3 FRANKLIN CT BP-2019-1052
GIS#, COMMONWEALTH OF MASSACHUSETTS
Map:Block:24D-272 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cateaorv:Deck BUILDING PERMIT
Permit BP-2019-1052
Project# JS-2019-001716
Est,Cost$4000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor. License:
Use croup: Homeowner as Contractor_
Lot Size(so. ft.): 5749.92 Owner. RIDOUT THEODORE C 1R
Zoning:URB(10o1/ Applicant. RIDOUT THEODORE C JR
AT.- 3 FRANKLIN CT
Applicant Address: Phone: Insurance:
14{Al9=kN01Qbk6t77 fl ISSUED ON.312812019 0:00:00
TO PERFORM THE FOLLOWING WORIL•ADD 1 OX 10 DECK ONTO EXISTING DECK
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 Occuoancv signature:
FeeTvpe: Date Paid: Amount:
Building 32820190:00:00 $55.00
212 Main Street,Phone(413)587.1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2019-1032
APPLICANT/CONTACT PERSON RIDOUT THEODORE C IR
ADDRESS/PHONE 10 SHERMAN BRIDGE RD WAYLAND
PROPERTY LOCATION 3 FRANKLIN CT 0 L
MAP 24D PARCEL 272 001 ZONE URBfl00U
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
CLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tyneof C nstru ton, ADD 10X10 DECK OXTO JWTINGDECK
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 F)DILLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9MATION 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 m 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
3 Zg-Zo�4
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.
e 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/Septic Availability
! Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
�..,.:• phone 413-587-1240 Plans
R E C E I V E titer pecify
APPLICATION TO CONSTRUCT,ALT4R,Ri RENOVATE ORD 111101.ISH A ONE OR TWO FAMILY DWELLING
2 2019
SECTIONI -SITE INFORMATION
1.1 Property Address:
DFPT of null nor,INSPFCT10NsTt sotlon seto be complal by office
Nonr�asmrroN.inacrocn D
3 FrtHK�!^ Oli/ � . a7� Unit
01060 zone Overlay District
Elm St.District CB DMlrict
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
21 Owner of Reeord: ��/
�Qpne C. �Q4*4 Sr. dM Chrr,60'fe �Rrdea 3 Fnur/r���au r l lrirP+aa
Name(Print) Current Melling Address:
C. K,�d.� Address,_,,
SignatureTelephone
2.2 Authorized Anent:
Name(Print) Currant Melling Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Oficial Use Only
completed by permit applicant
1. Building 2''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=(1 +2+3+4+5) a0 Check Number I a 14
-
This Section For Official Use Only
Building Permit Number. Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
fL / I
edr/QOu � @ /lO�Mnr � • � oM
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicablel
New Nouse ❑ AddMon ❑ Replacement Windows Alterations) Roofing ❑
Or Doons
Accessory Bldg. ElDerrtoutlon E3 New signs [ol Decks PC Siding Iol Other ICU
BriW"oekDescrip0on of Proposed fiih /0' x 1 o ' geek 6e yax, oy,'i iAl 7,;4,x yr a r c(e-4
Alteration of existing bedroom_Yes_No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yea 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 Omer
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?
I. 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
I. 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.
Siynature of ow
ner (� ./. Deta
I, SLP O d 0 re C R l d0 wl ✓. ,a�/Authorized
Agent here y declare that the statements antl info tion on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under thepainsand penalties of perjury.. yy T
�{ 0,1 C(0 rE. �• /�rdOrall Ute•
Print Name
(C �ir�i cc. Ca. .r/"
Signatured Owner/Agent Date
. .. �
•. � _ \ I
-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
FRANKLIN COURT
62't
NOTE:
deck PROPERTY LINES SHOWN ARE
APPROXIMATE, A FULL FIELD
SURVEY IS REQUIRED TO
m �R ;`+" ACCURATELY DETERMINE THEIR
y LOCATION.
K �
Soo otwbe
gar.
62't
BACK OF GARAGE
TO
EQUALS PROPERTY
t
FIRST AMERICAN TITLE INSURANCE COMPANY LINE
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT 1 HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE EASEMENTS. ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY /250167
—NOTE—
SURVEYOR, 1� F. '=' THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
aM a �Lr -MORTGAGE LOAN INSPECTION PLAT—
NORTHAMPTON, MASSACHUSETTS
RAN .ALL �, PREPARED FOR
rzER THEODORE C. RIDOUT, J2. k CHRISTINE F. RIDOUT
/35032 SCALE: 1"=20' JUNE 18, 2015
URV HAROLD L EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
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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 filled in by
Building 4par meet
Lot Size
Frontage
Setbacks Front
Side L R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage n/
(la urea minus bldg&paved
q o(Parking Spaces
Fill:
vdlmK&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O 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 O 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 O
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 O
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 YAII disturb over 1 acre? YES O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
� 7retn�Its�r.rertl�t�rs
Departnteltt of7ndushMAccMenfs
I Congress Street,Smile 100
Boston,MA 02114-2017
www.tnass.gov/dia
qF11'rkerg'Compensation Insurance Affidavit:Bullders/Contmetors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Informati n / Pleas Print L ibl
Name(Business/Organirstionnnlividual): Q ts�0 'T—
Address: 3 F zL t lr/r'„ C Ola r l
City/State/Zip: o 'fo Phone#: So$ 3?S 6O 118
Art yn n employer'Check the apprepriam loos:
Type of project(required):
1.[3 1 sun a employer with employees(full md/m put-hone).* 7. ❑New construction
2.❑[am a sole pmprluor or pmmership and have on employees working torment B. ❑Remodeling
any capacity.Mo workers'comp.Imuramc required]
J❑ k m
I am a homeowner doing Ml work fNo workersro
' mp.maurmwe required.]' 1 Demolition
4 1 am a home roan,and will be hiring connectors to surd.,all work on my property. I will
x10 Building addition
ensure Mal all wnaectors either have workus'congsensetion insurance or are rale 11.❑Electrical repairs or additions
Mrsictors with no employees. 12,❑Plumbing repairs or additions
5.01 am a general manclmaod I lave hired the subcummmrs hand on the anachad shcet 13.❑Rwf repairs
These subcannctors have employees and have workers'comp.msurmee.1
6.❑We are a emporulan and in officers have exercised their right ofexemgim per MGL c. 14.(ZOdter
152,§1(41,and we have m employees.pJo enders'comp.insurance required.]
•Any a rtment Mat cheeks box affidavit
mum Mso out the smio i below showing their him outside
e rimm neums policy bait anew
a Hammwners who submit Iris most attached
indicatingheaa they are doing all work end then hire outside conummrs must submit n new on thost indicating have such.
$lontnclorsMat check this hnx must anached en additional sheer showing the name of the suM:ontmaors end stele whether or mi those entities M1ave
employees. Ifthe subcontncmrs have employees.They sumo provide their winders comppolity number.
!am an employer that is providing workers'compensation insurance for my employees Below is the poaryand job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.M Expiration Date:
Job Site Address: City/Stme/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 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.
do hereby certify under the pains and pen ,(desnofperjuury thalt the Information provided above is true and correct
Si more d.o->[u—A�- xa-.. +.Y ' R Date ala o-z ad/9
Phone#, J Og 3 ? r ' 0 /
Olfleial use only. Do not writ in this area,to be completed by city or town ofciat
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2. Building Department 3.Cityfrown Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phoue#:
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, 554, 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: 3 Franklin Court Northampton MA
The debris will be transported by: Theodore Ridout, homeowner
The debris will be received by: Valley Recycling Northampton
Building permit number:
Name of Permit Applicant Theodore Ri(d�out, homeowner
� p
March 26, 2019 � Z'O'C ci-1 - R'.'�J
Date Signature of Permit Applicant
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