23D-077 (12) viiisyARNER ST BP-2009-0527
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23D-077 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2009-0527
Project# JS-2009-000739
Est. Cost: $7000.00
Fee:$55.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: STEVEN PISTRICH 048770
Lot Size(sg.ft.): 35501.40 Owner: ECK JUSTIN R&CHRISTINE D
Zoning:URB(100)/ Applicant: STEVEN PISTRICH
AT: 117 WARNER ST
Applicant Address: Phone: I nsu rau ce:
7 RIVER RD (413) 665-2303
SOUTH DEERFIELDMA01373ISSUED ON:12/8/2008 0:00:00
TO PERFORM THE FOLLOWING WORK:CONVERT BARN INTO STUDIO
(W I N DOW S,FLRS,STAI RS)
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:
FeeTvpe: Date Paid: Amount:
Building 12/8/2008 0:00:00 $55.002975
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2009-0527
APPLICANT/CONTACT PERSON STEVEN PISTRICH
ADDRESS/PHONE 7 RIVER RD SOUTH DEERFIELD (413) 665-2303
PROPERTY LOCATION 117 WARNER ST
MAP 23D PARCEL 077 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid
Typeof Construction: CONVERT BARN INTO STUDIO(WINDOWS,FLRS,STAIRS)
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 048770
3 sets of Plans/Plot Plan
THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INNF9P.MATION 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 Commission Permit DPW Storm Water Management
Demolition Delay
Z/6' 0 '.
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.
w yr
Department use-only
_ n City of Northampton Status of Permit:
� . Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
8 2008 Room 100 Water/Well Availability
��� Northampton, MA 01060 Two Sets of Structural Plans
phone-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
Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Cti r i 5-(-i v> sz • j st I I`z a r►ti e r y/ . F l oc olds.
Name(Print) Current Mailing Address: �*
PA Cl Telephone
Signature
2.2 Authorized Agent:
,��,,r _�',st 7 �;ue7-- / c D� tray
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 6GI°o (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
1 OO ) Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 7�'OC� — Check Number dJft/6' J
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
a� •
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
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height l 2'
�, 1 2 642 ii
Bldg.Square Footage %
7cro' 4.. 7yo`F4-
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOWS YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO ‹ DONT 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
IF YES, describe size, type and location:
SECTION'5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition 0 Replacement Windows Alteration(s) Roofing 0
Or Doors it
Accessory Bldg. X Demolition❑ New Signs [ ) Decks [ Siding [ ) Other [ )
Brief Description of Proposed Work: I?es 'T_ ex 1r , j Ic;Y v7 %H�y ,5f7/Ji O — Froors AA,-
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll❑• Sheet � /Q &Ai/.//g 61G41& VT F 4f//L.d//(/r---- —
S 1f New house and;or"adaition to:..:61T Ingwhousinir comp. d tti' followln:
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
1, ti 04-kr c 4)a Z CQ,K , as Owner of the subject property
hereby authorize P t 1,1 to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Dat
I S o'Y /"rj/y12 L, , 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.
S 'vtv1 / l r'rc`/
Print Name
Signature of Owner/Agent Date
SECTION 8-.CONSTRUCTION SERVICES
8.1 Licensed Construction `�'e Supervisor: Not Applicable ❑
Name of License Holder : Ste f) J- ( `I 0 CI 7 2 e
License Number
Address Expiration Dhte
� vJ PA:./1 66 23c%3
Signature Telephone
Ale"-s e e ,y Om e 'ma ovem on tract Not Applicable ❑
_Sc iv I f ). 3 if
Company Name Registration Number
I/0f/Oq
Address Expiration ate
Telephone
SECTION1;0 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 0 No 0
OIll" 0vonDTI'
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
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,,of
m = DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE A i U)AV1.T
(licensee/pet-mince)
with a principal place of business/residence at: •-
7 A'Air-t- R 1 P _et;‘, /t M-( — 663 z303
(strectIcity'.''aat l7Jp)
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 follov.-a-Ig worker's compensaton po! cies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
•
(Name of Contractor) (Jastlrancc Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Cou j.anyiPolicy Number) (Ex;,:r tioa Date)
•
(Name of Contractor) (Insurance Company/Policy Numbs) (Expi-:tian Date)
(s(L%ch aelditional sh..-ct if necenn,.-.o arc!• `e scr:-u:hex:,:_._.a:r:;,t:ell c:c:-s moo:•.)
•
, -i1111 a Solt: proprietor zutu have no one workine, for me.
( ) I am a home owner performing ail the wo.., myself.
NOTE:*zee be atrare the wile bettx:JK1Y_•re ckas employ ice:.-:In It)�.as tenance,oar..n:r~m Cr trpai w.,t;:e^i cc•tl!i:g cr
not utoce than throe units in wLiett the li.:eneowo-s rc:w or-co the g:rArn.i.3 c:tter tat thctto ere rust coxtally ar.:i:i:::�:o be
employ=under the woci.e>'s eot:p=stim Act(GLI52,ss 1(5)),:4T1:cation by a homeowner for a liccu cc p-rmi::: • _ '<r,`e t r:
legal etatus of an employe(under rho Worker's t ompor_,.ation Act
I unel=stend that a co,y of this statay.Q i clay bo forwarded to the Desiettarttt of Ir,.6,etrial Aoaderr?Ofeoo of I::::urenoo for the
°overage vcriftctioo and that failure a to se.ue covcr_r.ur,3;r section 25A of MOL 152 can Iced to the imposition of Cr.. ir-1 per-skies
consisting of a fine'dun to$1 S00.00 ar_i'or ins. risrx.:r a=of tip to Cr.'yt.r e:d civil pernttice in 3e tocrn of a Ste-0 Wcn.On=a.d a
. firam of S t 00.00 a day sgun:t rot. . •
For dgn,uvmsal nee only
I
permit Nt��-��iH / 1
_
Si nature if i.tcct:eJf'ernititr:_ 17 I F l
( • 1 Q xf of Northampton • 17 =*=" /.
3,4.� : i i 8 �4lassa*tor tts 7. ---1=
iik
_-
' DEPARTMENT OF BUILDING INSPECTIONS =s I.
/_
INSPECTOR 212 Main Street • Municipal Building a
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 his/her construction sups:,Hsor. 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
1 I 7 r,, - K
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December 5, 2008 v� ?,3
To Whom it May Concern at the Building Dept.of Northampton, MA:
As the homeowner, I,Christine Devlin Eck,and on behalf of Justin Eck,am writing
this letter to confirm that we will not be using our renovated barn,located at 117
Warner St. in Florence,as an illegal apartment to collect monthly rent.
Sincerely,
Citz,<),tor,c4K.:(,‘ AD' C;i4A.4d
Christine Devlin Eck
4-( (3 —34( —%C2.—rL It • M Mo
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