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01-001 (6) 710 NORTH FARMS RD BP-2020-0314 GIS#: COMMONWEALTH OF MASSACHUSETTS Map Block: 01 -001 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2020-0314 Project# JS-2020-000528 Est.Cost: $40000.00 Fee:$260.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: BRAMUCCI CONSTRUCTION 110834 Lot Size(sg.ft.): Owner: BRIERLEY-BOWERS KEITH& PENNY Zoning: RR(100)/WSP(49)/WP(14)/SR(7)/ Applicant: BRAMUCCI CONSTRUCTION AT. 710 NORTH FARMS RD Applicant Address: Phone: Insurance: 17 MT WARNER RD (413) 221-3942 WC HADLEYMA01035 ISSUED ON.10/3/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.-TURN EXISTING GARAGE INTO NEW MASTER BEDROOM 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/Chimnc}: 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 sig"nature: Feel',pe: 1)ate Paid: Amount: B u i l d i n g 10/3/2019 0:00:00 $260.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2020-0314 APPLICANT/CONTACT PERSON BRAMUCCI CONSTRUCTION ADDRESS/PHONE 17 MT WARNER RD HADLEY (413)221-3942 PROPERTY LOCATION 710 NORTH FARMS RD MAP 01 PARCEL 001 001 ZONE RR(100)/WSP(49)/WP(14)/SR(7)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST NCL O D REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: TURN EXISTING GARAGE NEW MASTER BEDROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 110834 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 3 ) 7 Si ature of Building Official 10 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. Department use only 1.04' City of Northampton Status of Permit: '. Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability 1� 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 1.1 Property Address: This section to be completed by office /J 0 rJoQTdI -FAV X /Map ( �i ( Lot ��✓ Unit NoR--iI4M?-roK1i MA 010to0 Zone Overlay District Elm St. District CB District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Vr.j-r4 r-3WN/ F3SZtCRLc1J- MT, WAR NC;►2yD . I.IAl7L.1; MA Name(P' Current Mailing Address: �I_� - 2-7 - g2A2 Telephone S gnature 2.2 Authorized Agent: /I 9�Z,AMQCCI CorJS7a0--71OnI/RICk- 13QAmocci 17 M_ vjARNER- R-D. I1A-DLr.y rAA Name(Print) Current Mailing Address: �7 qts - 221 - 3992 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars) to be Official Use Only completed by permit applicant 1. Building $3s ' (000 (a) Building Permit Fee 2. Electrical W Z 9 00 (b) Estimated Total Cost of Construction from 6 3. Plumbing 1 Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 3 S 0 0 6. Total = 0 +2 + 3 +4 + 5) Q O 000 - 00 Check Number p� This Section For Official Use Only Building Permit Number: Date Issued: du Signature: 0 3 Aq Building Commissioner/Inspector of Buildings Date Bk,l rP 1CCI COPJS7X0CT / o AJ @ 6M'I1 L' C(5ky) 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 column to be filled in by Building Department Lot Size 57, 20 Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage 21004 % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DON'T KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DON'T KNOW ® 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 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained Q , 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? YESQ 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 ® 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) ❑ Roofing E] Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[3 Siding [0] Other[0] Brief Description of Proposed \ Work:-ru,zi,l +�xis-rAC-, I CAR (,nRAAc- (ibX2A11070 A n1P-W MAST-E►2 BEDR00✓n. Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family I Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? Yi S /' d. Proposed Square footage of new construction. Dimensions e Number of stories? 3 STn 2Y vl ITIA wAtlr--ou-r f. Method of heating? 0 t L 1O6T OA-re k- Fireplaces or Woodstoves i l k L Ti<k r Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction W on'p i. Is construction within 100 ft. 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 y City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, Y , - Yr�N N`/ 59,1 L.-KL r_y - f3pw ErZS as Owner of the subject property / J hereby authorize ARA YY)U C I o 1J57-X 0 CT t 0 N / 'kirk- Re?11✓ry C C l to act y behalf, in all matters re tive to work authorized b this building permit application. -� - Signature of Owner Date I, R1Z4)Vy)UCC1 e0NS7-"PUC-7 /01/ / feICC 824nruccl 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. <1C 1L RRA ✓(I 0 C C Print Name (�=D Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Q1 C41 Ai2D A"VYI i)C r I C 5 - I I'OR sd License Number 0T. SAP-fJ p= RD. JAI)I-E f M4 01035 9 - 3 - 20zo Address Expiration Date 3 9 4 Z ignature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ bk4lYoic( I C[rA UC-T i01, iso 468 Company Name Registration Number 1-/ M'f'. vj A►Q"E�Q '2D IJA O L-t-4MA 0103-5- S- 17 - 26 Z f Address Expiration Date Telephone 413 -221 -3q 4 2- SECTION 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_ ._. 0 No...... ❑ City of Northampton Massachusetts �Q}'S •c,�t w� fL DEPARTMENT OF BUILDING INSPECTIONS y ' 212 Main Street • Municipal Building Northampton, MA 01060 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 must 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 owner-occupied 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 he registered. Type of Work: F U rn NJG , ' R Y uA L L- , �-L-O o rt i NJ 6 _ Est.Cost: �4 0 006 AddressofWork: .7,o NoR7o F'fzArrs Rp. t�oPur 8ArnPTonl ►.AA 01010 D Date of Permit Application: 9 - (o - q 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-occupied Other(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 DO 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: 9- - 20c416,0 F_-eQ1 WCC/ rso4oR / s-ice-z/ Date Contractor Name HIC Registration No. OR: NotwitAtan4ing 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 f. tics ~ eG ,.t y q DEPARTMENT OF BUILDING INSPECTIONS w 212 Main Street *Municipal Building Q Northampton, MA 01060 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: 710 wakrr4 j.­4;zMs RD. WORTNAMPTAfJ MA (Please print house number and street name) Is to be disposed of at: IIRLLQ I g FGy{' L1NJ6 / 244 EAsT41AmP-roN 22 (Please print name arld location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) l� 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. The Commonwealth of Massachusetts Department of IndustrialAccidenis 0 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Aunlicant Information Please Print Legibly Name(Business/Organization/Individual): R_,i C>aggQ D g RA m u C C 1 Address: %-7 tA-r wAR N Ell Rn, . City/State/Zip: 0Ap i-.EY • r4A o I o.�S Phone #: 913 - z4z- Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 2- employees(full and/or part-time).' 7. [:] New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ®Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance i 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[]Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box#1 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: �A P-1 o R7 o my t p-W R 1 T E a S Policy#or Self-ins.Lic.#: (c 5 b o u$ - 11L-7 0 q 7 4 - 3 - 18 Expiration Date: t l- Job Site Address: -710 Nokl-rd C42ofs IRV. _ City/State/Zip:NoeTdAm PTonl ruA 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. Ido hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Siunature % L —� Date: Phone#• 913- r 2/- 3142 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#: - 68'2A ?,Ac- Breakfast i 13'9 21 14' _ .. _ . 13'2 10' 11 { r � j o Bedroom Kitchen i 07 to l Bedroom Living Room i 60 ... I 1 -ri to 5{1 j I Dining Area i 12' Office LL-4;- tis Bath 1 —�, Wdroo�n 1) First Floor Pla 2165 sq ft ' 448 sq ft garage Garage i Iiz 710 NoR�ra FARMS RU. 68'2 lot IW —___ � eAIJt. It�� _ RSr " m Breakfast i Zo 139 2'3. 14' � 10' — .. 15' 13'2 ..... - _ .. �_ o NaW -r.\/, Roorl) j o Bedroom } Kitchen r to i lVBedroomI Living Room17, �. KOr-OVE DOOR'S a0 I - IN MIT -Up Ln 75'1 Dining Area office C14 - LL . - .._ .. . Bath —1, Mudroom 1 ! First Floor Pla 2165 sq ft 448 sq ft garage _... .. .WE.w w,Noo\n/ c�osE-r Nrvt 5Ej>rZooIrv, I i z NEW 2-21 N%w -- -- sPRA,! FOAM Q-�I s?2AY 710 NOR-rd FAQ Ms RD. 68'2 CA It►► V. Breakfast ► 0 13'9 2'3 14' 13'2 I c Bedroom Kitchen r Living Room 0 1-77— 64 N r1' - / Re rove aoa R-S 60 ov.E y j tN faAfl UP o Dining Area � smp . 12' LO I J { Office r I -.-__ Beth Bgse MINT -�, Mudroom J�i First Floor Plar� 2165 sq ft New `- 446 sq ft garage WFvu wi NpovV [`ri1RgGE� Ro M'' x 57 /,fAULZr=:D -MOL G)-68C- , N1Fv4 B EDRoo Yn _ ... ..:320 26',.--•--.__ :. --- 112