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25C-172 (3) 129 NORTH ST BP-2020-0614 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:25C- 172 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-2020-0614 Project# JS-2020-001038 Est.Cost: $10000.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sa.ft.): 10541.52 Owner: FISHER MICHAEL&BARBARA Zoning. URC(100) Applicant: FISHER MICHAEL & BARBARA AT: 129 NORTH ST Applicant Address: Phone: Insurance: 3 MARILYN DR (413) 949-1333 O WILBRAHAMMA01096 ISSUED ON:11/13/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.-RENO 2 KITCHENS, 2 BATHS AND FRAMING IN STAIRWELL AREA 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: I 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: FeeTyue: Date Paid: Amount: Building 11/13/2019 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Department use only _-- City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit t 212 Main Street Sewer/Septic Availability i 1, 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 INFORMATIOIN REIDEIVED 1.1 Property Address. This section to be completed by office NOV 7 ?019 Ma e715--c-— Lot / 7d Unit 129 North Street Zo Overlay District DEPT.OF BUILDING INSPECTIONS NORTHAMPTON,MA 01060 Elm t.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Michael and Barbara Fisher 3 Marilyn Drive, Wilbraham MA 01095 Name(Prin Current Mailing Address: 413-949-1333 Telephone Si ur 2.2 uthorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 10,000 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee o 0 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 +4+5) 10,000 Check Number (� This Section For Official Use Only Building Permit Number: Date Issued: Signature: 1 13 Building Commissioner/Inspector of Buildings Date v-X erYZ— 1-10 @ Yrl ci t 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 10,650 sf 10,560sf Frontage 60' 60' Setbacks Front Side L: R: L: R:Q Rear L� Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces 4 4 Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DON'T 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 DON'T KNOW © YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 0 , Date Issued: C. Do any signs exist on the property? YES O NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO Q 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 O NO Q 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 ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [p Siding[O] Other[0] Brief Description of Proposed of(2)kitchens,(2)baths,also framing of 2 walls in stairwell area Work: Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other 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? f. 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 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 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. Signature of Owner Date I, iida- r eA 491, ( is , 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. Print Name oe ';Plo�� �� AajbaAa Via&A- Sign er/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder. License Number Address Expiration Date Signature Telephone 9, Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone 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....... ❑ No...... ❑ City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 1 x 212 Main Street • Municipal Building yJ� ca 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 be registered Type of Work: cepnnkli 4 12 L-1Zw�_ .? Est. Cost op Address of Work: Date of Permit Application: 111-h9 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: Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: v Gtr Datel Owner Name and e City of Northampton `r Massachusetts w � ( DEPARTMENT OF BUILDING INSPECTIONS �. 212 Main Street •Municipal Building y�y.•. _C�� f_._. s 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: 12y )114t (Ple esa print house number and street name) Is to be disposed of at: (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: hj�e r+ ��1 rAA 0 14Y0 (Company Name and A ess) 01l i ur ermit 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 IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Avylicant Information Please Print Legibly Name (Business/Organization/Individual): Address: —2) City/State/Zip: #: Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with 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 354I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.[]l 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 1 I.Q Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13QROOf repairs These sub-contractors have employees and have workers'comp.insurance. 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 thepolicy 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 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. I do hereby certify u ins d penalties of perjury that the information provided abovXv;ue and correct. Si ature: Date: 1//;;F, Phone#: I Official use only. Do not write in this area,to he completed bh 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#: Fisher Residence 129 North Street Northampton 1st Floor Renovations Kitchen • Remove/replace cabinets • Paint walls • Replace flooring y Bathroom • Remove replace tub, toilet, sink • Remove tiles on walls and floor • Replace with bead board and new flooring t 2nd Floor Renovations Kitchen • Remove/replace cabinets • Paint walls • Replace flooring U, ............................................ ........ W...._ ......... Bathroom • Remove/ replace tub,toilet, sink • Install bath fan w/exterior vent • New flooring New walls in stairwell Install new walls around top of stairwell install entry door for apartment unit 2 ! _............... Jonathan Flagg<jflagg@northamptonma gov> city of ........._....................... Building permit application, 129 North Street 1 message Sun,Nov 10,2019 at 9:31 PM Michael Fisher<mike.fisher140@gmail.cOm> To:jflagg@northamptonma.gov,kross@northamptonma.gov Dear Kevin&Jonathon, This email is intended to accompany a building permit application submitted on Friday,11/8. My wife and I recently purchased the property at 129 North Street.This is a 2 family house(1st floor/2nd floor) ;� MWasHy And,,OcCYVY 00 2nd NoorfPSMWt The renovations under which the building permit application has been submitted will include: • Kitchens:replacement of cabinets and flooring • Bathrooms:replacement of fixtures and flooring • 2nd floor stairwell: install new walls on 2nd floor around existing stairwell to provide for a bedroom closet and lockable entry into 2nd floor apartment. 1 have attached details on sketches of each affected area.Please contact me if you have any questions:413-949-1333 Sincerely, Michael Fisher Mailing address: Michael and Barbara Fisher 3 Marilyn Drive Wilbraham,MA 01095 -------------- ,*1 scan006i.pdf 1563K I