10B-074 (3) 32 WATER ST BP-2002-0452
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 10B-074 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: Deck Addition BUILDING PERMIT
Permit# BP-2002-0452
Project# JS-2002-0682
Est. Cost: $29476.00
Fee: $145.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: STEVEN MIZULA 024706
Lot Size(sq. ft.): 15333.12 Owner: LARSON DONNA M
Zoning:URB/WP Applicant: STEVEN MIZULA
AT: 32 WATER ST
Applicant Address: Phone: Insurance:
127 PLAIN RD (413) 665-7027
SOUTH DEERFIELDMA01373 ISSUED ON:10/25/01 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 16 X 8 DECK & REMODEL
KITCHEN
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:/vh Rough: 74 ki:falpli House# Foundation:
414�L 1i0/0/ /4 Driveway Final:
Final: OJ/li- 7 �"!ma :3C/� Oi--1�1/s tiA4 2L01'OZ
lf Rough Frame:Qk i_.7
C2Gi 9-7.644
Gas: "' 37 ire Department
Fireplace/Chimney:
Rough: Oil: Insulation: �� 'A
aK i-z-oa
Final: Smoke: Final:
K 3 ' ao7 9pg ..
THIS PERMIT MAY BE REVOKED BY THE CITY F NORTHAMPTON UPON VIOLATI N OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/25/01 0:00:00 7302 $145.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
fser
2 WATER ST BP-2002-0452
GIS#: COMMONWEALTH OF MASSACHUSETTS
Malock: 10B-074 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: Deck Addition BUILDING PERMIT
Permit# BP-2002-0452
Project# JS-2002-0682
Est. Cost: $29476.00
Fee: $145.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: STEVEN MIZULA 024706
Lot Size(sq. ft.): 15333.12 Owner: LARSON DONNA M
Zoning: URB/WP Applicant: STEVEN MIZULA
AT: 32 WATER ST
Applicant Address: Phone: Insurance:
127 PLAIN RD (413) 665-7027
SOUTH DEERFIELDMA01373 ISSUED ON:10/25/01 0:00:00
TO PERFORM THE FOLLOWING WORK:CO N STR U CT 16 X 8 DECK & REMODEL
KITCHEN
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 Occupancy Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/25/01 0:00:00 7302 $145.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2002-0452
APPLICANT/CONTACT PERSON STEVEN MIZULA
ADDRESS/PHONE 127 PLAIN RD (413)665-7027
PROPERTY LOCATION 32 WATER ST
MAP 10B PARCEL 074 001 ZONE URB/WP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 7� O�e 1 / 3_
Typeof Construction: CONSTRUCT 16 X 8 DECK&REMODEL KITCHEN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 024706
3 sets of Plans/Plot Plan
THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
Approved Denied
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan OR Special Permit and Site Plan
Major Project: Site Plan OR Special Permit and 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 Co ission
/r:
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.
8-:f-5 - `/3 el
.._ • ,kii.,5,(2_ g =.00 his frz.r- ,.
. .
f 1 -r_,_ Department use only 1
1 ,,�, , City rthampton Status of Permit:
D v', OCT 25 2� Juil epartment Curb Cut/Driveway Permit
21 Ma n Street SevveriSeptic Availability �.
NGINSPECfIONS o0 100 Water/Weil Availability__ l
NeRIHA� ON, 6 MA 01060 Two Sets of Structural Plans
OEPTOfBUIl01
one 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
3 2 �q,`�'e r 5-f Map /o Lot Unit _
LAed S /NlA Zone erlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
.IOenJIJ LAR$oN' .3 LJiG ' .S? .�Qe�s " . o'ro_s'3
Name(Print) Current Mailing Address:
r. it/3 - Ls8,5-^S>S8
E i J Telephone
Signature
2.2 Authorized Agent:
.STTtJ t./U A - ill i Zu 14 p7 ;ni Scl. So:bEe 'Rita( 11Ji4,0l3>3
Name(Print) a n Current Mailing Address:
yl 3 6,6:s-->0�7 t lx 66S-051-15-
Signature Telephone
SECTION 3 ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building/la/ 3(e82, ',2.O (a) Building Permit Fee
2. Electrical/
i 80 (b) Estimated Total Cost of
Construction from(6)
3. Plumbing 3 3v)_� Building Permit Fee
4. Mechanical (HVAC) —
5. Fire Protectio4 /c c'.
6. Total =(1 + 2 + 3 + 4 + 5) 02 9) Check`Number `jf,D 0 /
This Section For Official Use Only
Building Permit Number: -, 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
Buildi0 /5-3'
g Department
Lot Size :�3 / -S A
Frontage 11--)
Setbacks :::t
I / WI/ ��
L: N R: 3 o2- L:
sC Rear
aQ-c�
(; Building Height q i'(/ / ✓
Bldg. Square Footage /aU� % 3 O
Open Space Footage PS�7 %
(Lot area minus bldg&paved /A; S
parking) �j f
#of Parking Spaces /674 v
Fill: /( V A-
/ 4 /
(volume&Location) t/
A. Has a Special Perm t/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW ✓! YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW v YES
IF YES: enter Book Page and/or Document #
B. 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 -Z-' 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 z—
IF YES, describe size, type and location: ----
SECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition 0 Replacement Windows Alteration(s) 0 Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks � j Siding[ ] Other [ ]
'Brief Description of Proposed Work: _� � d':'mf,�--.00� ,._. 4 A 6Lifs toe beck
Alteration of existing bedroom Yes ' No Adding new bedroom Yes ` No
Attached Narrative 0 Renovating unfinished basement Yes `' No
Plans Attached Roll 0- Sheet r
. :O `e,: .ToMiff xi ifi i sln rt irr pp e he foil in
a. Use of building : One Family Two Family Other 7V
XI
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
I I, /Okl/dA L.tRSdal , as Owner of the subject property
l
hereby authorize S IIE iJ a J A . vzl I Zu ``° to act on
my behalf, in all matters relative to work authorized by this building permit application.
►V )4" la)a y io I
Signature of caner Date
I, 4 . Yirrfzudia
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.
.5*--7-12_V F_1ti /`a _ YYt i z LA I r44
Print Name
_,...... .-(0- ,,e-,-, 6_ /o% 0 (
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder: _ST?veti A , Ml zu /4 Q .2'J 7 0
License Number
I�? �� �., �.�. So�c 17�f�v� ���� )/lr� 0�373 ///2s/c
Address Expiration Date
l
Signature Telephone
•'� =g mA=gin] ` 'e' ; :_" . Not Applicable ❑
.. eu&N 114 r Z u (/.a -7 Id os", ,
Company Name Registration Number
/.27 .cJ• D(3>3 J/ 3 O Z
Address Expiration Date
Telephone 9/ /G '�c)a7
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 ICY" No El
. - Home Owner Exemption
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
4 tAMP2.
A'�IA`!4 '1$
BY4.a, 4 SI-
Lri al North-amp f an
asaxc[Tnsrtld' =o
+__fille
`�"' :�_ DEPARTMENT OF BUILDING INSPECTIONS ilk =_t`r
212 Main Street ' Municipal Building .=
Northampton, Mass. 01060 r s
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, l— L)aku A _ `?/l 12 u IA
(Li censeelpermittee)
with a principal place of business/residence at: •
r ml3>3 •
7 PLAA-v AL SoKAD6erI ,(/1M (phone#) 913 ' toe 7Q2 '7
(hticeticity/stafeJap)
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:
` ��Piev�
t rr!sT SrA1�4tve_e 0044 wf�3'4'-DO /off 0 f 0 i
(Insurance Company) (Policy Number) (Expratior Date)
�'. ( ) I am a sole proprieto , general cones or homeowner(circle one) and have hired
F the contractors listed below wh-ii- lave the following worker's compensation policies:
as-3089 f ci,i i<� � �/ /� +` X l-I U �3 33�/`�a�Z�o
r- ELc. %r�aUElg►�f�rrrolaw 7'. C,osct Pat. ,
.` ' (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
L(�NO3. ill al elc + Rey,,,-.,,iJ, kav�.leised/ou, 0isua / £c,�(333 i1 45 Ol
(Name of Contractor) of (Insurance Company/Policy Number) (Expiration Date) Cca f
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
- (attach additional shoot ifnre,-e<.ry to include information pertaining to all 000fractoes)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while homeowners who employ persons to do m•horns o,,-,construction or repair work on a dwelling of
not wore than three units in which the homeowner resides or na the grounds appurtenant thereto are not generally oomidered to be
employers under the worker's oompenssiion Act(GL152,n 1(5)),application by a homeowner for a license or permit may evidence the
legal status of an employer under the Worker's Compensation Act.
I understand that a Dopy of this statement may be forwarded to the Department of Industrial Accidents'OfSoe of Imur anoe for the
coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties
oom.istrng of a fine of up to S1,S00.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of S100.00 a day against me.
For dial we Doty
Cc//�. Permit Number
e �%�/ I Map# Lot it
; ,-,..-- Signature of ermitiee Late
STEVEN MIZULA, BUILDER
127 Plain Road
— 15'11 - SOUTH DEERFIELD, MA 01373
(413) 665-7027
1 ,
-- -- 9'10 - 6'1 fey/ 7/° Sfrirl•i
Fo
'----- o"/NA &A e"So"il
- - - -- J 3-X. L....atev 3 T
Leeds r��c olof3
s&en
-S'7SF3
_E
i ll ,
8'
[ 7
f/tose,,, ex)i,,,,,,,•-t-s , 1'9/`\k _
, — v''' \i..)
° IU r S.." o
b
® L r
c
I O Xs
co (Q - _
N -1 KITCHV , io
I,' 4 —
' I
c ar,9 I I
' • �`►+
I IN ) 1 %< .
h I 1 o �'�
M \\ --1 1 c.
.t.
a _
s
lia,---- N
--- -9'10 --- ---- ----6'1 ----------
a
15'11 — -- -y
"ka, LIVING AREA
443 sq ft
STEVEN MIZULA, BUILDER
127 Plain Road
SOUTH DEERFIELD, MA 01373
(413) 665-7027
r✓.< t-, 1,4.40 v-i
tie,rcrrl S T
5 rKCa
f1-711-
A Go /Go
- •
ci
,2 x
I fly OC ,
..t..„4,..cr
V.0 nvitrAtf J. BACHAND
BOOK 1435, .PAGE 235 BOOK 893, PAGE 432
SEE: PLAN BOOK 21. PAGE 80
• ,.1:7 4, / .
CA
1 stb .•44)14,1
c.) ;
1:I
tz.
•Ia •4 ‘V
CO
43 63
t4Z Qa 4\
,- --"'-IV.- -7---'-' ---- 210.43.-- FOUND LP. TO •FOUND LP. 18.20'
____
229.26' (DEED AND 'LAID OUT) ;
, .
0)
TNT t3
44 .,
I SEE: BOOK 920 /
, PAGE 274
1 •
• 1
0? • I
tr) 1
? 6Z
tA
,._
N 11.1
,
.7._•c-17:-'-•-•Tepir, -
a p
tn cc
8179'21"w , ,-. -•
N
- .r.v., 68.37• -
gt•I 0) ,_
-CD C7
t\I
..""2t,"—• .-V .
M - 83:5 0 '
VI
*** S.'
Ct) 7
N
UN
......k.
Cb
CA
ED LINE 205.50' (DEED AND LAID OU7'
(.4
A,C/
CAD
1 0Z)me
[V
C4 Ci4:
•
1 AY
I'll
,....-Ni
--`2 :'2
1 KN7
i+
IV IV
/Z4Z
0
g
I. MI I NCi / g
k
190.00' (nrryn , tr" ' • —