23D-119 (5) 188 FEDERAL ST bliP
BP-2001-0303
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23D- 119 CITY OF NORTHAMPTON
Lot:-001
Permit: Building •
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2001-0303
Project# JS-2001-0491
Est.Cost: $22000.00
Fee: $70.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Edwin Olander 049348
Lot Size(sq. ft.): 20691 ..00 Owner: KAHN HELEN&DORRIE BROOKS
Zoning: IIRB Applicant: Edwin Olander
AT: 188 FEDERAL ST
Applicant Address_ Phone: Insurance: 0
44 Willow St (413) 58 -6364
FLORENCEMA01062 ISSUED ON:9/22/00 0:00:00
TO PERFORM THE FOLLOWING WORK:ENCLOSE EXISTING PORCH & REMODEL BATH
& KITCHEN
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Euildings
Underground: Service: Meter:
Pi"— Footings:
Rough:ak'II//3/ c r(M43 Rough: 1I,Ivc House# Foundation: & (1_K--q'p�LilYrlin
cK ! 0 -3.00�
Final: / „„ Filial:1 101 01)
"/ ' }��r/ Rough Frame:
0 K 6i--CZ-66
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation: 0`( I I" a 7 oo-
&-;,
Final: Smoke: Final: ok /- 30„D/ �.�
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION ATION OF \
ANY OF ITS RULES AND REGULATION
Certificate of Occupancy Signature:
Fee Type: Rece pt No: Date Paid: Check No: Amount:
Building 9/22/00 0:00:00 1500 $70.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2001-0303
APPLICANT/CONTACT PERSON Edwin Olander
ADDRESS/PHONE 44 Willow St (413)584-6364
PROPERTY LOCATION 188 FEDERAL ST
MAP 23D PARCEL 119 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 /(f-CCI Ctt 70 "
Typeof Construction: ENCLOSE EXISTING PORCH&REMODEL BATH&KITCHEN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 049348
3 sets of Plans/Plot Plan
THI.....53tErOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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
Y14/4 q—c22 -00
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.
IF Ali
Department use only
--o, -il of Northampton Status of Permit:
ding Department Curb Cut/Driveway Permit
% Main Street Sewer/Septic Availability___
'. v\ 2 oom 100 Water/Well Availability_
,�S a pton, MA 01060 Two Sets of Structural Plans
B 7-1240 Fax 413-587-1272 Plot/Site Plans
OVI ;tH 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
f '00 rev - - 7 - Map Lot Unit
/ Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
f- e /21ZZ6 v,rzonKS 1BB Fep e -c sT"
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
FtV LIB+ C a PZ y-14- to t W 9 T Fa)
Name(Print Current Maili Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building /L//000 (a) Building Permit Fee
2. Electrical 000 (b) Estimated Total Cost of
Construction from (6)
3. Plumbing C�-�0 D Building Permit Fee
4. Mechanical (HVAC) �✓
5. Fire Protection
6. Total =(1 + 2 + 3 +4 + 5) 24/000 Check Number U C) —
2 This Section For Official Use Only
Building Permit Number: VC/ _ 56 3 Date Issued:
Signature:
l 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 ZZ/5720 510 C)
Frontage 1 ZO i 2-0
Setbacks Front [..f('
Side L: I R: W L:15__R: 6 0
Rear l..r S
Building Height •Z51 /
Bldg. Square Footage t3. 6 %
Open Space Footage I % �,
(Lot area minus bldg&paved 201000 ea �1000
parking)
#of Parking Spaces 4- 4-
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO (ON'T KNOW 2 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 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:
C. Do any signs exist on the property? YES CI-O
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:
"CTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition X Replacement Windows Alteration(s) 0 Roofing ❑
Or Doors 0
Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks
[ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: FA7CLO5E E u2 5 FlAG/+1 411-thgni , 1Agl-. lrt,k t L
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement - No)
Plans Attached Roll ❑ • Sheet❑
eaill.rftwAlotitelitutkoltiadditiOluto,eXititigliousing. cOmplat the tOl.lO+i►i :
a. Use of buildi : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached? CDv p w4L. /vr co, i'ec ja
d. Proposed Square footage of new construction. /T Z Dimensions V37-f!(�,
e. Number of stories? 2.
f. Method of heating? i A(IDLit Fireplace)Woodstoves Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?
Type of construction WOOL f"at
i. Is construction within 100 ft. of wetlands? Yes Nos construction within 100 yr. floodplain Yes No
1
j. Depth of basement or cellar floor below finished grader
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 V!' i Cooks
as Owner of the subject property
hereby autho ' e eu, tP LJ p to act on
my b:•alf,.in :II ma ter re tive to work . horized b his ilding permit application.
, 9 /.,49/60
Signature of Owner, Date
4110
I, ��!�1 :" 0 EW t./ n E , as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing application true and accurate, to the best of my
knowledge and belief.
Qigned under the pains and penalties of perjury.
Print 0414106
I
iktli,• *Fe'2_,A41 91,0/DO
Signature o Owner/Agent Date /
•
SECTION 8-CONSTRUCTION SERVICES
Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: �
License Number
it-1-0 1/3 FIo 1 (\
Address Expiration Date
Signature Telephone
-*1:1LiNS Not Applicable 0
t,o 6- �io)
Company Name Registration Number
LLk vituotio ST, FLtrtL6C
Address / j ( � Expiration Date
U`1 am6
Telephone 36
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 X No ❑
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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
r
s 4,
•
•
1ttn1f pT�o�`�o rri of Northampton E 1r EA�w }tasaarhncrlla/
z� DEPARTMENT OP BUILDING INSPECTIONS — ,
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANC:b, AFFIDAVIT
IJ)AVIT
• 1-, _____2IX)314 .1_041 -r.r)____Eze__ ,
(li ccnsce/permi ttcc)
with a principal place of business/residence at:
__� , . �L T J��____ _ __(phone.,,) `{-6%U
(st7t/city/staic1z3 p)
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:
(Ins-urn Cocic,:_nv-) (Polk:Number) (rti-pintion Date)
( ) I am a sole proprieto , general contractor r homeowner (circle one) and have hired
the contractors listed below who-have the following worker's compensation policies: .
(:-.-- 16-12-
(Name of Cot +etor) (In uranc: Compan •ii'ciic; N'umlYr) (Fx;>irnuon Date)
CIlt(.Cov _ __
(Name of Contractor) (Insurance Company/Pohcv Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Poticy Nmb) (Expimoon Date)
•
(Name of Contractor) (Lasurance Company/Policy Number) (Expiration Datt;).
(attach.rWio¢al cbcct if ncccsary to incu&inforsnaao)pc:naininz to.11 oner .rocs)
'k?
I am a sole proprietor and have no one working for me.
) I am.a home owner performing all the work myself.
NOTE:plea be aware du!w•l:Jo hemco..vcn' o employ pccons to ea a-.iri,--a,ce-.- co~r,:cioo c repair stork on a d..c1L g of
not most th n ibroc traits in winch the homoowver rrsid.c or oo the p000d.,zpputtc n1 thc-ro e.•c oat Cally oocnd.^cd to be
employes undo-the s cxkrfs occpeosatioo Act(GLIS2,sslOD,applir-rioo by a homoowocr fort lice.or 1>`nuit n_y cvidmoe the
legal ctaau of an a:nployor uodcr tho Workoc Coo pcecutioa A.0
1 I uode.tcnd that a Dopy of all.mscmay may bo foc-wwrded to the Depanmm¢of lr.4,-ricl Aractca f OfLoo of Lor ua000 for tho
coverage vrrir esiioo and that L•iiu c to soauc coverage modes sostioo 2 S A of Mal.152 an Iced to the iwositioo of criminal p wlbct
ca o rrn;of a tint of up to S 1.00.00 and/or icapri3oatocrit of up to Doc year and civil p panto in the form of a Stop Work Ordcr and e
frnn of 5100.00 a day apiiroa
For dop.rt --.t u.c only
�!�
Permit Number
"Q�,�"'AlO Map': Lot "
Signahirr of LiocnsceJPcrtu tote
-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
SEP20
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TO: SOURCE ONE MORTGAGE CORPORATION &
FIRST AMERICAN 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 THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
cN OF M,S —MORTGAGE LOAN INSPECTION PLAT—
icy, NORTIIAMPTON, MASSACHUSETTS
(RRANDALL � PREPARED FOR
31 IZER RICHARD F. & ELSIE M. NEWMAN
#35032 SCALE: 1 "=30 ' SEPTEMBER 30 , 1999 •
<'�� HAROLD L. EATON AND ASSOCIATES, INC.
SURVEY
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
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