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30C-027 99 CLEMENT ST (wrong map block on card)
99 CLEMENT ST BP-2021-1096 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:35-040 CITY OF NORTHAMPTON Lot:- PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING PERMIT Permit# BP-2021-1096 Project# JS-2021-001857 Est.Cost: $7750.00 Fee: $80.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq.ft.): 485415.00 Owner: METRAL CHRISTIANE Zoning: SR/WSPII Applicant: METRAL CHRISTIANE AT: 99 CLEMENT ST Applicant Address: Phone: Insurance: 99 CLEMENT ST FLORENCEMA01062 ISSUED ON:4/5/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:winterize mudroom, add 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. ,,aCertificate of Occupancy Signature:i FeeType: Date Paid: Amount: Building 4/5/2021 0:00:00 $80.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner • CX l ul:o File#BP-2021-1096 L - APPLICANT/CONTACT PERSON METRAL CHRISTIANE ADDRESS/PHONE 99 CLEMENT ST FLORENCE PROPERTY LOCATION 99 CLEMENT ST MAP 35 PARCEL 040 ZONE SR/WSPII THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid `�,�v Typeof Construction:_winterize mudroom,add deck v 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: X 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 65460,A„, „ CP° lilolgd 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. * Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. The Commonwealth of Massachu efts N t C E I V: U W Board of Building Regulations and Sttndar s Massachusetts State Building Code, 7 0 C R 1 IPALITY f F R APR Building Permit Application To Construct, Repair, Rienov to Or [�emo�is�( SE �� R-vise Mar 2011 One-or Two-Family Dwelling Th' Section For Official Use Or& �QTta' {`rnv 9s APE��S Building Permit Number: W—a'. j 6a v Date Applied: _ Building Official(Print Name) Signature ✓ Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 19 C\emsexkF 51; Fla-once. 3©c_- 021- - 01 1.1 a Is this an accepted street?yes no Map Number Parcel Number ...' 1.3 Zoning Information: 1.4 Property Dimensions: c) . 4 Lt Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private 0 Zone: _ Outside Flood Zone9 Municipa^l On site disposal system 0 Check if yes❑ �'!� SECTION 2: PROPERTY OWNERSHIP' 2.1 Owne 'of Record: 1 On c-%s %o.-,A e- I1 f',I ram\ c.L ( Q-Y\ - / M P` B l(7 G 2- Name(Print) City,State,ZIP ,n c Uv Jt e c 13 SV$ IS a-2- c v veerol Sw+t�, es:‘u No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Buildin Owner-Occupied Repairs(s) ❑ Alteration(s)X Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: \,J �r'�. .2 �7c�k-1/4 w.�►-ck,r� , ,a.-a—,r>OW SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ -4- 0op, — 1. Building Permit Fee: $ o. - Indicate how fee is determined: ,Standard City/Town Application Fee 7 2.Electrical $ S ©• `� 0 Total Project Costa (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ ?''J . 4 V Check No. cts Check Amount: 30 Cash Amount: — 6.Total Project Cost: $ 1 .paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) bv-t.-pW License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street . Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name No.and Street Email address City/Town,State,ZIP Telephone SECTION 6: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 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authori to act on my behalf,in all matters relative to work aut rized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains an enalties of perjury that all of the information contained in this application is true and accurate to the best of my owledge and understanding. Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) le-- 14 l , t/o (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) r 1 Lunt Habitable room count & �.�.. Number of fireplaces ( Number of bedrooms ,3 Number of bathrooms 1 Number of half/baths Type of heating system o-s Number of decks/porches Type of cooling system Enclosed Open (V 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: Cjt {� -r,s�o L..-A__ M e�f.�ol- LOT SIZE: 4 tk REAR LOT DIMENSION: REAR YARD D d deaf; " toK ►Z La✓ CI & Q)L ASK+n vo....5"0"ovv% 11la ► I... -v SIDE YARD SIDE YARD V ,row d FRONT SETBACK FRONTAGE City of Northampton Q,i''"PT'i';. < Massachusetts A. • i r. t . t DEPARTMENT OF BUILDING INSPECTIONS y ` 4 ar ; ;�- 212 Main Street • Municipal Building 1Jb, .;ti'b ", Northampton, MA 01060 'Pr - t` CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in::p //9rrin _ - / ok Location of Facility: A — '�oik\ `\e�. 0, % I „ --4,6k4-4:1N--") The debris will be transported by: Name of Hauler: C..\nrtSVto,V.e_ ' _ 1A-Cba- p Signature of Applicant': U Date: OS/ 31 / 24 The Commonwealth of Massachusetts Department of Industrial Accidents , . 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.ntass.gor/dia 11 others'Compensation Insurance Affidavit:Buildertif'ontractorsiElectricians/Plumbers. IO HE HIED WITH THE PERMITtrit:All THORITV, Anolicant Information Please Print Lecibls Name I ilusincss;lkganuation Individual): C\A r.‘ \--'.‘, ch..vt,e_ t`i, e.,\--cc9S)._, Address: A °\ CAeAi•ne-‘k,1/4". City/StateiZip:._ F-- k cpre-J,Ak.R.,.. Phone#: .... An yen as employer!Cheek the appropriate best Type of project(required): i.[]I am a employer wtih ., employees(full and,ot pan-time!" 7, 0 New construCtion 2:1;1,4 I am a sole proprietor of partnership and hacc nu employees wort mg for mr in li. 0 Remodeling in vareienv [No worker.'events infaramy required I 9. 0 Demolition am a homeowner doing all ev&myself (No workers eon/fa,Mikitanat vegan:4)' 10 0 Building addition 4 0 I am a humans nv.-t and will lse hiring omaractors to condoet all work on ins nopeety. I will chain that all csvinfacion either have marker;compensation insurance or am sole I I.0 Electrical repasts Of additions prormmors with no employees 12,0 Plumbing rtrairs or additions I am a teneral contractot and I have hired the sub-contractors listed on the anavhed Meet 13.0 Roof repairs These stilv-vvontnatois have employees and Nor workers'comp.Insurance:, 14.C3Other hip We are a evaporation and ita Orriecn.has,:exercised then right of est motors per Mail_e. _____ , .... 152_§1141.and wr Kane no employees[No workers'everip insurance teiprited,) An applicant that cheeks boa al?matt also fill out the section below skims ow then workers'compensation policy inftwmaintn t Homeowner%who submit this artidaVII=beating they an doing all wort and then hire outside contrives/es mini sulsfmt a new affidav it mdieming such :(unit:a:tom that check this hos mutt attached an additional abed silo%un';She maim of the seh-eintimetatet am)+tate.4 liethe,in not 1Star(mink,lia....' employer,. It'll.:at lb-contraLtm,taro:k'neplo•:o:s.!hr must pil,Mr Ill.1- workem-l‘,1nr printy ilinnbri lam 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.4: Expiration Dale, Job Site Address: City/Statc2ip:______. Attach a copy of the workers'compensation policy declaration page(showing the policy needier and expiration date). Failure to secure coverage as required under MOE c. 152,*25A is a criminal violation punishable by a fine up to S1,500.00 and'or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Ofticv of Investigations of the DIA for insurance coverage verification. — I do hereby certify oder the pain,and penahies ot perjury that the information provided above it true and correct Sigriatumc..:.>V.- ill.: • _ . - Date. — ') / 3 i / 2—t Phone#', Li 1 a 5 C I i?-q 7— . (..-J,_5 i , . Official use only. Do not write in this area.to be completed by city or town official City or Town: Permit/license* Issuing Authority(deck one): 1. Board of Health 2.essildiag Dilemma* 3.Cky/Tows Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other t'ontact Person: City of Northampton °" Massachusetts DEPARTMENT OF BUILDING INSPECTIONSlik 1. ,. 212 Main Street • Municipal Building ,J,, ti Northampton, MA 01060 ssPJY ��,�`''' HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT - • ©6/za/AO I, C`f1 ii 51 t oon e M Lk-( (insert full legal name), born _ (insert month, day,year),hereby depose and state the following: r 1.1 I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s)who owns 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 home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this -11 day of t 1 c..rr\ ,20 2t (Signature) CITY OF NORTHAMPTON .---"4 1vIt\AC ) ilvi i SETBACK PLAN MAP: LOT: LOT SIZE: ' 'I REAR LOT DIIMENSION: ill\ t REAR YARD : I i , (i) 1 \ ...- - , . 0 SIDE YARD 1 PltF,),. M.7 i„ SIDE YARD 1 , k I \ 1 . , r. 4-- )..„,.>‘c_kk 1-,•b\ \-13 \r1-01),,,,, e._ „Ski 1 \\,) \10./ FRONT SETBACK > .<- ----........ FRONTAGEIlisiewim.m.