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23D-040 (8) 67 MILTON ST BP-2003-1163 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23D-040 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category:ADDITION BUILDING PERMIT Permit# BP-2003-1163 Project# JS-2003-1824 Est. Cost: $52950.00 Fee: $239.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DENNIS C PITTSINGER 007513 Lot Size(sq. ft.): 15550.92 Owner: HANNIGAN WILLIAM&PAGE STACEY Zoning:URB Applicant: DENNIS C PITTSINGER AT: 67 MILTON ST Applicant Address: Phone: Insurance: 49 BOFAT HILL RD (413) 296-4320 () WILLIAMSBURGMA01096 ISSUED ON:6/27/03 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 18 X 20 BEDRM ADDITION & 5 X 18 PORCH, CONVERT EXISTING BEDRM TO BATH 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: FeeType: Receipt No: Date Paid: Check No: Amount: Building 6/27/03 0:00:00 3734 $239.50 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2003-1163 APPLICANT/CONTACT PERSON DENNIS C PITTSINGER ADDRESS/PHONE 49 BOFAT HILL RD (413)296-4320 0 PROPERTY LOCATION 67 MILTON ST MAP 23D PARCEL 040 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out / Fee Paid c c3("( 2told Typeof Construction: CONSTRUCT 18 X 20 BEDRM ADDITION&5 X 18 PORCH,CONVERT EXISTING BEDRM TO BATH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 007513 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: 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 Co 'ssion Signature of Building icial 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. • c �De` aeSe Y --' a- gfy p City of Northampton Statusofgermtt. �' ' Building Department Curbteut/D eway Ire, '%t . '"212 Main Street Sewer7Septie A atlab - • ,� �. ' Room 100 Water/We[I gv�jab lift' ►, �" Northampton, MA 01060 .= etof SfrtfcturaP arcs : F phone 413-587-1240 Fa• x 413-587-1272, _.. :,_,.„,6:..:,:-4,, , t ... r C 1 1 11 F # ,-- - t 4 APPLICATION TO CONSTRUCT, ALTO"r • •• • • •R D: •JI1I.SH A ONE OR TWO FAMILY DWELLING JUN 1 8 2003 SECTION 1 - SITE INFORMATION IIUp{tdGINSFECTIO"'S DEFT Of 13 This,section to be completed by office 1.1 Property Address:d NORTNA�"10 . ___ j� (� f M l l 10 n Sk- Map c2 V Lot / v Unit-. __ ff!�`�!‘re - c _ MA— Zone __ Overlay District Elm St. District CO District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT • 2.1 Owner of Record: 03 a[(awl tftAhrlt °± C--Yalie ( 7 h-tt l zvt S+ Fio. klA Name in Corr nt ailing Addr Telephone Sgna ure 2.2 Authorized Agent: D, C. Pt• -skyler 63�:1d-e[L-. 44 ct go�..�'�- IA,,IA R.) L d LAyna l� - Mm Wa rne(Print) J Current Mailing Address: of o414 ..____Qpn,e6.6._�-4 — 41 3 Z,RG 4 3 Zo Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS -Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building G c v a , (a) Building Permit Fee 2 Ele'.irical (b) stimated Total Cost of Z. Z o o ` Construction from (6) 3. Plumbing Building Permit-Fee Z Q- oo . 4. Mechanical (HVAC) B►4 1 4 o o , '--, 5. Fire Protection 3 S o . . a ,-- 6. Total =(1 + 2 + 3 + 4 + 5) 1-2_ R Co. a o Check Number ; l 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 Building Department Lot Size /20 X II (1. - /6 6 3 3-. fito - C1 Frontage $ . Setbacks Front 3 3 3 6 a0 Side L: I I R: S 2- L: 3 I R:479 I 5 • • a Rear 3(� o fi — o 0 Building Height � 1 2 Q/ k — as" Bldg. Square Footage I O�5o % 34° 4)4 Open Space Footage 6$n % 9 0 lit/% j' (Lot area minus bldg&paved / /2723o skte�'parking) l j/ #of Parking Spaces Fill: volume&LocationL A. Has a Special Permit/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 YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO v LON'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: 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 V IF YES, describe size, type and location: SECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ® Replacement Windows Alteration(s) ® Roofing 0 Or Doors ❑ Accessory Bldg. ❑ Demolitiontil New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work:/ Ein xt4+; 1edr.0,.. .1-'nt., i'f' /r.' a/3c-lilrs�.. "tA1a'► O''\ a1/ R�aO�L 3 4- porc% Alteration of existing bedroom ✓ Yes No Adding new bedroom ✓ Yes No Attached Narrative 0 Renovating unfinished basement Yes ✓' No Plans Attached Roll 0 - Sheet 6a. If New house:arid .o -'adilitio�to_existing housing, complete the following: a. Use of building : One Family V Two Family Other b. Number of rooms in each family unit: t Number of Bathrooms c. Is there a garage attached? No d. Proposed Square footage of new construction. 34 O 1 ('+9 1v Dimensions I $ X 2 0 k 6 x t g- per.), e. Number of stories? I f. Method of heating? Viet w o..ler (GAO Fireplaces or Woodstoves N 0 Number of each g. Energy Conservation Compliance. ye" Mascheck Energy Compliance form attached? yes h. Type of construction W on d 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 31 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 /l� /aI S jot/ / , as Ow ier of the subject property e�hereby a• hi riz- to act on my be .If, 'jers relative to work authorized by this ildiog permit application. //�, — 64a ci Si; ature of :�1111�� Date tkL41 W y I 6 Ze al/ G'b , as Owner/Authorized Agent hereby declare that the statemennd information on the foregoirtpplication are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. AI: CyPa Print N. gnature op rent Date SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : V evtni s 5(I'►4ey' C S O 07 5/3 J License Number 1-1 g a �} glkt _ it / 3 a/ 0 3 Address Expir ion DIte W111lA►Ast31/ -) rnA 01 oq6 Signature Telephone Li 3 �9 6 Z( 3 2 o 39 Registered H6ft elii provement`Contractor ' ` ',`,, R: .. a Not Applicable 0 6-\• VI-Stnyk- et4d Jen- 10 2- '.19 Company Name Registration Number ti ct i/ Z0 / Address Ex irati n Date s,`1O'Ms A O l 0 Telephone 4/J 2-4/4 4/ 3z,, 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 0 1 Homc O��c�nc1•'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 =0y r A ` Alt Git�,i �rf Nc�i t11a111ptnit 1_ —_*=b t*��f41* SIB ��assarhnsrtls =ram � _=ri— '- • DEPARTMENT OP BUILDING INSPECTIONS -4 _;_T r= - 212 Main Street ' Municipal Building _ - Northampton, Mass. 01060 IMP WORKER'S COMYMTENSATION INSURANCE AFFTDAVIT I, LieInv.;s P.:its c. ln9cy, — - . (liccnscdpermittcc) with a principal place of business/residence at: Ol0'14 y°l Ro$c.fi NtllCz1 @Nei*rkIP INIl��lavA. .y�c.� (phonc ) 1- /3 Z`l6 432v (street/city/state!ap) / do hereby certify, under the pains and penalties of perjury, that: - ( ) I am an employer providing the following worker's compensation coverage for toy employees working on this job: - (Insurance; Company) (Policy Number) - (Expiration Date) V 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: CAlck G>•,CJ Col w ck z4e. 31 3 za a _ (Name of Contractor) (Insurance Company/Policy Number) (Expiry a Date) "`'_`Y)( ( Auto !+ie.#h aoj © a O y 141 _l y 0 �9 3/7/b0 (Name of Contractor) (Insurance Compaay/Policy Number) (Expi ,.non Date) itee %h.')vCol /k Cg_L4L, IN c. 38 7s- 237901 y.1`?/oy _ (Name of Contractor) (Insuranc:. Company/Policy Number) (Expiration Date) C IC 4( La h �.) 111 P �' 7 /(0 YL/ -/re/(Name of ontractor) (Insurance Company/Policy Number) (I:xpir:tion Date) (attach additional slice if necenar:to inclu d&informm:ion pertaining;n all ecc actor.) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please bc aware that wile hcttreo«tr_rs«'So employ peso Vs to(la maintenance,oa:=-zaloo cr icpair work en i dwelling of not more than throe units in which the bozne.o her maid or on the gro;nes zp<irtcnsnt thereto are not generally ocatid rn'.:a be catployaa under the workccs c rr p tcticn Act(GL152rs l(5)),applic.-Ation by a homeowner for a lianx cc peratit may c..i?ence the legal etude of an employer under the Workers Compecaation Ac I understand that a copy of this rtatenmt may be forwarded to the Depertaxed of Industrial Aocidente OfLoe of ln:ursox for the coverage vcrif calioo and that failure to rxttre coverago utdcr section 25A of MOL 152 cam lead to(ho imposition of cri-nia_l per alga consisting of a fine of up to S 1,500.00 andlor ixoprisocmreni of up to one yc r and civil pc altia in the form of a Stop Work Order and a , firm of S 100.00 a day against ter_ - Foe departImmtal uio only permit Number mapti Lot# ., Signature of LICsePe 'ttee to �n • • . ,..,„,,,.„,& �,� ,,,„ '; ;$ Crz# of Paz#lia»i tnii 1: — /. c �ii1 tssachusettb 10 '_ DEPARTMENT OF BUILDING INSPECTIONS , /. INSPECTOR 212 Main Street • Municipal Building '`a,4 _ Northampton, MA 01060 . r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as Lis/her construction super,'isor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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." The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location r . • 780 CMR Appendix J Manual Trade-Off Worksheet (,� ,�s Permit# Builder Name �, (Pi i\-S+n`‘or tau U or- Date L/-,../ Builder Address /-I 9 B 'i)-.A) .11 CO k,+Jfil`►4, h^r Fi►^ i I i' s..) ' t c, Checked By Site Address G-7 rn i I 9' I"73 -01"kr 1111A Zone 012 013 014 Submitted By —I> y,N-. t P, - \x?„ Phone Li I ? 2962 1-I 32 0 Date PROPOSED REQUIRED L. Ceilings, Skylights, and Floors Over Outside Air Required Insulation x Net U-Value Description R-Value U-Value Area = UA (Table J6.2.2) x Area = UA Ceiling ft2 38 , 03 36" IU. 8 c, z .6 '360 9,3L (Table J6.2.2a) Floor Over Outside Air ft2 (Table J6.2.2a) ft2 ft2 Total Area 360 ft2 r Walls. Windows, and Doors Insulation x Net Required Description R-Value U-Value Area = UA U-Value x Area = UA Walls 1 i o I I L/ -� `Li. 3 4/ (Table J6.2.2b,c,d) ,�"' ./ Windows -- ft2 y --- 13, (NFRC or Table J1.5.3a) Doors — FS o ft2 I , Y (NFRC or Table J1.5.3b) Sliding Glass Doors -- f.fft2 (NFRC or Table J1.5.3a) ft2 ft2 Total Area ,_4.: r ft2 Floors and Foundations Insulation Insulation x Area or Required Description Depth R-Value U-Value Perimeter =UA U-Value x Area = UA Flccr Over Unconditioned (Table ft21 Space J6.2.2e) I `1 .C 'l% 7 >i_ ( i( . `j am. , c)c- .3 v I F Basement Wall (Table ft2 J6.2.2f) Unheated Slab ft - (Table J6.2.2g) in. Heated Slab ft (Table J6.2.2g) in. ft2 ft2 Total Proposed UA must be less Total , Total than or equal to Total(or Adjusted) Required UA Proposed UA 7 2 ' E' OR Required UA F I/ 7o Statement of Compliance: The proposed building design represented in --+ Adjusted these documents is consistent with the building plans, specifications, Required UA and other calculations submitted with the permit application. 13,„1,4,),- _ip c ().4.-A--z----,, b, \..,„ ,, `a. lde esigner Company Name D e . DRAFT (for training purposes) 53 1/28/98 "VCEllWET i J U N 1 8 2003 DEPT OF BUILDING INSPECTIONS NORTHAMPTON,MA 01060 Nc:, ,,.,. r _ , i\J (-1) _______._4;/./ e...41: - ... ,r.jr a-1:- Is (.- , ,....,.0 :h. f ..o -------________istcv N -C 5 ' hit . . _ • i• .1 ---------- ------ ---------1-• 4- , / I . : CS) I VI) 1 f...1:. ..\ 'Olaikk i. . \-1-1 . .. ___,..1 I'm . !_ _,_,_'_ _ LI i,IP ., ... .44C...... 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