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24D-125 (2)
BP-2021-2352 23 HOOKER AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-125-00I CITY OF NORTHAMPTON Permit: Demo PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2021-2352 PERMISSIONIS HEREBY GRANTED TO: Project# DEMO Contractor: License: Est. Cost: 40000 DECONSTRUCTION WORKS 108554 Const.Class: Exp.Date:01/10/2023 Use Group: Owner: NOYITT, ADAM & PRISCILLA Lot Size (sq.ft.) Zoning: URC Applicant: DECONSTRUCTION WORKS Applicant Address Phone: Insurance: PO BOX 10 (802)380-9333 WEST DUMMERSTON, VT 05357 ISSUED ON:01/04/2022 TO PERFORM THE FOLLOWING WORK: DEMO BUILDING 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. Signature: istrw-erL / Fees Paid: $300.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 2`l31� File #BP-202 I-2352 APPLICANT/CONTACT PERSON:DECONSTRUCTION WORKS PO BOX 10 WEST DUMMERSTON, VT 05357(802)380-9333 PROPERTY LOCATION 23 HOOKER AVE • MAP:LOT 24D-125-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $300.00 Type of Construction: DEMO BUILDING New Construction Non Structural 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 INFjORMATION PRESENTED: V/ Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Penn it With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Specia I Perm it Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability SewerAvailability 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 jII I /1/ W Sib' ature of Building Official Date l 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. -NOTE- THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED. BUILDING LOCATION ACCURACY IS NOT GUARANTEED. CURRENT SNOW COVER NEGATES THE ABILITY TO ASCERTAIN ENCROACHMENTS UNDER SAID SNOW. NOTE: PROPERTY LINES SHOWN ARE APPROXIMATE, A FULL FIELD SURVEY IS REQUIRED TO ACCURATELY DETERMINE THEIR LOCATION. 90.7'± cn approximate location of abutter's shed �2f G BOOK 12652, PAGE 219 21'f IRON PIPE N" FOUND 53't HOOKER AVENUE TO: CONNECTICUT ATTORNEYS TITLE INSURANCE COMPANY TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY #250167 —NOTE-- SURVEYOR: �Z . t THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY �N � —MORTGAGE LOAN INSPECTION PLAT— "' S�yG\ NORTHAMPTON, MASSACHUSETTS o RANDALL s� PREPARED FOR IZER NI ADAM & PRISCILLA NOVITT #35032 ` SCALE: 1"=30' MARCH 5, 2021 RvO od HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET HADLEY — MASSACHUSETTS BUILDING DEPARTMENT DEMOLITION PERMIT SIGN-OFF SHEET Date: f o./ �co Address: g3 14C0/C(2—i / � Building Use: Owner: a. /Uk / )Q 0 it / Phone: 14( : 1 ) \17� Owner's Address: 1.7 60 l /3 ve- UTILITY CUT OFF (Signature of Authorized Representative of Utility Department required) As required by the Massachusetts State Building Code (780 CMR), a permit to demolish shall not be issued until a release from the utilities is obtained, stating that their respective service connections and appurtenant equipment have been removed or sealed and plugged in a safe manner. /� I Eversource (Gas) Signature Title National Grid (Electric) Signature Title DPW (Water) Signature Title DPW (Sewer) Signature Title DPW (Storm water) Signature Title DPW (Tree Warden) Signature Title DPW Director Signature Title Historic Comm. Review Signature Title The Commonwealth of Massachusetts Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number Be-2,i Date Applied: Building Official: SECTION 1:LOCATION G'sL ry rY— `(?b 0 No.ar}El Stre t City ,Town ��' Zip Code Name of Building(if applicable) Assessors ap# Block#and/or Lot SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair❑ Alteration 0 Addition 0 Demolition'(Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No\R" Is an Independent Structural Engineering eer Review required? Yes 0 Noi' Brief Descripti n of Pro se Work: • 1 i G SECTION 3:COMPLI I L THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)8z Area Per Floor(sq.ft) Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional 1-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2❑ R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA ❑ IIB ❑ IIIAO TIIB ❑ IV 0 VA 0 VB SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Trench Permit: Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Public r Check if outside Flood Zone❑ Indicate municipal A trench will not be Licensed Disposal Site41T Private 0 or indentify Zone: or on site system 0 required 0 or trench or specify: permit is enclosed 0 Railroad right-of-way:_,_ Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable!Y Is Structure within airport app ch area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No Yes 0 No 1------ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: fIle) Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of P;operty Owner Name(Print) No.and Street City/Town f Zip Pro�erty Owner Contact Information: ,t,4.)frv(2- - - yi'3 7)772 ? -10 64 i y C7C'�e ,-Q Tie Telephone No.(business) Telephone No. (cell) e-mail adeiiress If applicable,the property owner hereby authorizes: Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor �E-r ;,,i3T, ��Tiic l &r ham .. ._ ---- _ Company Name 4_7-4c:1-f 14226 L /14{1 Li(,* CS- iO8W-Lj •i'KA 111(718B LI,Si Name of Person Responsi1le for Construction License No. and Type if Applicable l) 0 6o1( /O u) )CM,(SOt r--Sia V v(- 0573 c----t- Street Address City/Town State Zip it'd-3if- C(?,-33 ��'_3. .3 c _q 3 .-: gi c .L rat lSr c-rrO(-‘l„tx ,KS. cc ".7 Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes O No ❑ SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ Building Permit Fee=To . "onstru =•n Cost x (Insert here 2.Electrical $ appropriat- unicipal factor) $ . 3.Plumbing $ 4.Mechanical (HVAC) ti Note:Minim , fee=$ (co •ct municipality) 5.Mechanical Other $ close check payable to 6.Total Cost $ y 1 QG( . contact municipality)and write check number here J6/e) SECTION 13:SIGNA E OF BUILDING PERMIT APPLICANT By entering my name belo I hereb a and penalties of perjury that all of the information contained in this application is true and accurate to the est of my knowledge and understanding. /49/1 i Ll A loV/7T 973-�x� 7 7� t�zg z Please print and sign name Titl Telephone No. Date 11 OC(Uo-it i4-t1C �'�(j�/r It}�(I p�z�t i ✓L1 cy-1 MO -rA,aNia V © 4 Kt As_. co-7 Street Address City/Town State Zip Email Address AMunicipal Inspector to fill out this section upon application approval: ('',`"cam,``' � ? U U l -_ �� Name D e City of Northampton `' r Massachusettsw` 't_ �: sL k ;, DEPARTMENT OF BUILDING INSPECTIONS 7 ° 212 Main Street • Municipal Building auk ;'q�' Northampton, MA 01060 6 '36� 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: Location of Facility: 6 C6 to lq Cc €\,\ I T7 , e_ Oh) l C The debris will be transported by: Name of Hauler: �k)C- kC yc:(. c (l4 AJ Signature of Applicant: Date: I Z 2i • Z-1 The Commonwealth.ofMassachusetts 172222 ® Department of IndustrialAccidents lip I Congress Street,Smite 100 �" Boston,MA 02114-2017 www.mass.govldin Workers'Compensation Insurance Affidavit:BuildersiContrrctorsIElectrieirns/Plumhers. TO SE FILED WITH THE PEIMITTINCADTIIORITv. Applicant Infprmatiofq Please Print Leeibly Name(BusmnsOrrran Uo_wlndiaidupl): I)Lk i( / Address: /7 /Ti O b-1 e_ CityfStateiZip: j0C-N I t r;, f U'J 141 Phone#: 9,1 Ma yaw ter otrplmett awl time appropriate Type of project(required): t p t am a employs:with e.npl.».e,troll amine-pert•tirwe►_• 7. ❑New con.vtruciion 20 t on a wk prupnetta ut pmma>.itrp and leave nu eniployesa aurkieg tut me In -a.a Remodeling any eap►c's).[No sorkt&c.inp,phut-Dal reunnetl.J Dettwlititm �-7 301 am a laaotnin doing all wo,4.myself_[No winters'wimp.insurance mimed_ ' . 'to Q Budding addition 4.02 1 am a farrr:uwncr and Mill tic tarring crntradoc to cundttd all work on my petrperty.I Mai ctuure that ill c b amoom either lint workers'compensation insurance or Are Auk I70.Electrical repairs or additions pmupnel rs with no employees" 12.0 plumbing repairs or additions 50 1 ant a gcai^rad contras yr and 1 6a%c hued the wb•iunua.Wn hated.m the attached abort These sob contractors hart eittploytmi.and base workers'rump.assurance I3.DRoeaf repairs 14.(1Other 6.0 We are a c.rptartitn and its diners tame exercised their right of esempotm pet Mtrt.c. 152.')it 4 t,and we tease no esopluyaa..[No r ur4 rs tuinp-rosiaaatc te.fuuwl} •�ir,y aprk.mia that cheeks bus al matt Ala fill out dt`trowel below ahwwmg thou works'cunQc ant un pulley information_ '11.11be w ors who submit Loki set tdarit indicating they arc do os all work and thin hut ouu&eantrsciera mini submit a or*atfaia4rt ttahcatng fuck it",mtr:wi:m heal check this but ruck t munch ll err ael.iii,onij sheet firrwtng the mune of der sedt-.o,tm:tnn and atak whetisir ornot those entities have i npk,crs. If Inc nub-ctninitit.m' cc}.d.:.nnc+7 pet•,i ie shear 'workers'loan N.'rcy number. I am an employer that Is providing►vorhers'contptnsation insurance for m_►'employees. Below is the policy and jab site information. Insutaztte Company Name: Policy g or Self-ins.Lie.#; Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy decl*ratioa page(sleeting the polity etsatber and expiration date). Failure to secure cure coverage as required under MGL c.I52,,¢25A is a criminal violation patnisltable.by a fine up to 51,500.00 and'or one-year imprisonment,as well an civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the OtTioe of Investigations of the DTA for insurance coverage venlicatian. I do hereby .y under e pains and penalties of perjury than the information prat ided above is true and correct Silmature: f 1 Dale: 2- Phone tt: Official use only. Do not write in this arta.to be completed by city or town official City or Tow n: Permit/License# issuing Authority(circle one): • 1.Board of Health 2.Building Department 3.City'ffown Clerk 4.Electrical Inspector 5-Plumbing Inspector 6.Other Contact Person: Phone#: