45-040 322 OLD SPRINGFIELD RD BP-2021-1419
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:45-040 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: shed BUILDING PERMIT
Permit# BP-2021-1419
Project# JS-2021-002357
Est.Cost:
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 38942.64 Owner: FLORIO CHARLES J
Zoning: Applicant: FLORIO CHARLES J
AT: 322 OLD SPRINGFIELD RD
Applicant Address: Phone: Insurance:
3 STRAIGHTS RD (413) 247-5094 O
HATFIELDMA01038 ISSUED ON:5/28/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:14X20 SHED
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. f
r
Certificate of Occupancy Signature: i. * ' 9 '1
FeeType: Date Paid: Amount:
Building 5/28/20210:00:00 $35.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2021-1419
C4.44,6014‘ vie
APPLICANT/CONTACT PERSON FLORIO CHARLES J
ADDRESS/PHONE 3 STRAIGHTS RD HATFIELD (413)247-5094 Q
PROPERTY LOCATION 322 OLD SPRINGFIELD RD
MAP 45 PARCEL 040 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: I4X20 SHED
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:
VApproved 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
5yas/ai
Signs re 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.
City of Northampton
i••" Massachusetts
' DEPARTMENT OF BUILDING INSPECTIONS y. `
\ - 212 Main Street • Municipal Building
Northampton, MA 01060 pVw ,r0
OVA l✓<<\
40
'l +so
ACCESSORY STRUCTURE PERMIT APPLICATION Vei.
(For freestandingstructures less than 200 s . f at least 5 feet from anyother structure)
q � � )
Check# 4'
Lis-D
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: C/fv,174 LDS J '✓+' c-''
Address: ..3 S7 P,t)JS /i'Dj 41.4 /Ees, l44relephone:
N 1 (C+='LL
Z�- )
2. Owner of Property: A 4dZ e'S \J La/ b
Address: 3 6Gc .5/1P/N6 Fl i-ct /t Telephone: Yl3 ,79 .S a9?
3. Status of Applicant: _Owner Contractor
4. Structure Location: -SA".r S>7 c° Of FIX)3TIM116 S 1l'eQ
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family: Multifamily: Commercial:__
6. Description of Proposed Structure: ✓< Lf� 61-02"4,-e__S
One Story Shed under 200 sq.ft.: _ Freestanding Deck under 290 sq.ft., less than 30"above grade:
SIZE OF STRUCTURE: J4`,/ A o2
Other(describe): /C2'6)/= i j SRO'?'/-G e —a24'rh 6VC yc 2J�/14 t)
7. Attached Plans: Sketch Plan Site Plan Plot Plan
8. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES: Has a permit been, or need to be, obtained from the Conservation Commission?
Needs to be obtained _Obtained , Date issued Ve/c t 9 etc 2I 4-5S)010 Afi9 /j /
CONTINUED ON NEXT PAGE
9. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
This column to be filled in by
the Building Department
Existing Proposed Required by Zoning
Lot size
Frontage N/A N/A N/A
Front:
Setbacks: Side:
Rear:
Height
% Open space:
(Lot area minus bldg and
paved parking)
10.Certification: I hereby certify that the information contained herein is true and accurate to
the best of my knowledge. /
DATE: / 4//>7/�f APPLICANT'S SIGNATURE ( �-s iC�tt�
NOTE: Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities
File#BP-2003-0376 0 ii/Q '<RCA/f Q US L-/
APPLICANT/CONTACT PERSON FLORIO CHARLES J No ?l Nt e 7 o ,�A r7c1D J J
ADDRESS/PHONE 3 STRAIGHTS RD (413)247-5094()
PROPERTY LOCATION 322 OLD SPRINGFIELD RD /- Yj
MAP 45 PARCEL 040 001 ZONE SC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid c7 ' 5 —
Typeof Construction: REPLACE 18 X 14 SHED
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:
Approved V 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
tic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street C mmission
do,
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.
f
0w( het
Y V of Northampton - Sta usof If i ktX
L
, 3 ,t.N'a
t:l '�`r ' a•c. `�tvJlMD . <
ing Department �Curb�Gut/fiD s.��veway per_ tt� �� �
2 2 Main Street Sewer/Septic A ailabt►'ty
OCT - 9 2002 Room 100 wa er/we ,Ava t'y;
.
N rtharhpton, MA 01060 Two Sets of3Str c ur,,a ans. f,.
DEPT OF BUIL NG tCT
587 1240 Fax 413-587.1272 Plot/Site Plans ..
I
NORTHAMPTOr MA 01060 Other bpectfy' �+ u > "`ter
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
oze �,� Map_ ._ Lot Unit
�eii?_,//� 17-6/IJ � Zone � Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
7
2.1 Owner of Record:
C/ iIRLeS Cr G�oic) 3 STRa .PD //./37-, -//a. > %
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized 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 ^od 0- (a) Building Permit Fee
2. Electrical (b) Estimated TotaltCost of
Construction from (6)
3. Plumbing Building Perme
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check Number 1,83—
a�
This Section For Official Use Only 0
Building Permit Number: d 3- 037e, Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
•
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size rL' 3 vl/l UUV
Frontage �� 11
Setbacks Front a zS' /o0
Side 6,5/ L: 93 R: L: R: 5D
Rear li/
Building Height /3 •
Bldg. Square Footage
Open Space Footage _
(Lot area minus bldg&paved c ._ r
2
parking) _ `� ci
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW L/ YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW J YES
IF YES: enter Book Page and/or Document #
B. Does t e site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or eed 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
No
IF YES, desOribe size, type and location:
SECTION 5=DESCRIPTION OF-PROPOSED WORK(check all applicable)
New House 0 Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolitions New Signs [ ] Decks [ ] Siding[ ] Other[ ]
Brief Description of Proposed Work: /r e/sid /e• i4^i!9 oeCfZ- ,Si ,2114 e S//ed /
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ Sheet❑
5a:`'1fiNe"'w honed and :or` additionlo existing housing, complet Tthe 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. Mascheck, 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
C •lf1, 7 e S ZObte, , 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.
Si ure of Owner Date
/� -00L e c_7 . 2-e,a'Ie , 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.
C27/4741I e_.< ._J - . am>��, -
Print Name
Signature of Owner/Ag�K • Date aaC-T7/2f/e
SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: �- Not Applicable ElName of License Holder : C/14#?ZBS . X /— LaV� C 5 0 y 7/c2
License Number
3 STD 4,r s d?/9 6 9/i1/V 0D 3
Address Expiratio Date
Signature Telephone
1_ .., -> Not A licable ❑
�9 Registered "ofnelmprovemenfContractor:��6 �, �,� PP •
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 [B' No 0
ome OwI e EXCI11pfto
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner:Person(s)who own 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 homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
oq- oy
a ,,gl _,''Alt
(rztpr of Northampton _*=L
9 � � ��1•
6 asserlinertta' _ _
't SIt ist"" WOW
'�'W DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060 Iles.,`
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, ('//4-#24 e1' 7 , LD,,f-rle9
(licensee/permittee)
with a principal place of business/residence at:
•
/`2 e A 2 C WeZ ebl/G .V3 1/61.3T sT l� ilFL� (phone#) .30,2 S/5-02
(street/city/state/ap) eve' 7
do hereby certify, under the pains and penalties of perjury, that.
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (E pirntion Date)
i r.
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional Mott if necessary to include information pertaining to all 000tractor)
(t•YI ama sole proprietor and have no one working for me.
a home owner performing all the work myself
NOTE:please be aware that while homcotivm who employ pc ras to do maintenance,ooasn:dioo or repair work on a dwelling of
not more than throe units in which the homeowner resides or on the grounds appurtenant thereto are not Gun,..,ally considered to be
employers under the worker's compensation Act(GL152,ss 1(5)),application by a homeowner r fora license or permit may cvidraoe the
legal rtatrra of an employer under the Wotir.or's Compamation Act.
I understand that a copy of this rt•t.-m..t may be foew coded to the Department of Industrial Aocidrnt>'Offioo of Insurance for the
coverage verification and that failure to secure coverage under section 25A of MGL 152 can lad to the imposition of criminal penalla
oomisting of a fine of up to S 1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of S 100.00 a day against mc. •
For depart» ai erne°My
L ��. •/� Permit Number
� (/�% 07 Mapol Lot#
: �_�.:...., signature o ctmittcc
OLD SP•INGFIELD ROAD
110'
63'
----\--
\-
WELL
/
171'-3.09"
350'
ri----- i) I
_ Icc, 352'
CD
N a DISTRIBUTION
BOX
a7`- G
—g I _J f
F- mil
/
CJ y-F--
O
MA z 6'-6.00" c 53'
T
81' EXISTING
18' X 14'
SHED
1 i'""------_„ 120'
• OXBOW LAKE _'--/