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23D-119 (6) 188 FEDERAL ST BP-2002-0955 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D- 119 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2002-0955 Project ft JS-2002-1548 Est. Cost: $3000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group Edwin Olander 049348 Lot Size(sq.ft.): 20691.00 Owner: BROOKS DORCAS A&HELEN KAHN onira ?JP.E Applicant:Edwin Olander AT: 188 FEDERAL ST Applicant Address: Phone: Insurance: 44 Willow St (413) 584-6364 FLORENCEMA01062 ISSUED ON:5/7/02 0:00:00 TO PERFORM THE FOLLOWING WORK:REMOVE & REPLACE EXISTING FRONT PORCH DECK SAME FOOTPRINT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspe Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: (-104-5- 0 If Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil insulation: Final: Smoke: Final:®lV 5-27-®off - --n THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: P Y Fee Type: Receipt No: Date Paid: Check No: ' Amount: Building 5/7/02 0:00:00 1699 $50.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo .... sc:7 3 D t -1...-' . . . _ ,_ .....,..,... . ..., ,.,7,-- ••-• • ,,, . , _„ •,. _, .., /i- 1 --.----. -* - ,t• MAY 2 8 200 • ......• i 1 _ , - II II 6 .,,._.),. .,.: A_......_ . . . .. _______ _ 4.- . _...,...__.., . . . __ Is • L . . • 47 /, . .1 4 _ II -4 I il .. • Ai. .4- - ... s-:-.. .:-....0. . , . ,...,„... _ . • , . ,_....,,,, ,. • ._.. ,....„ ,, .... ___ „ f,... .---- . , ,.. -.* . 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' '• ,,,a, V -. _ ''' . , .2. ... .. • ,, , File#BP-2002-0955 APPLICANT/CONTACT PERSON Edwin Olander ADDRESS/PHONE 44 Willow St (413)584-6364 PROPERTY LOCATION 188 FEDERAL ST MAP 23D PARCEL 119 001 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 A 7 p / O� _ Typeof Construction: REMOVE& PLACE EXISTING FRONT PORCH DECK SAME FOOTPRINT 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 THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF 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 t Commission 2- -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. • .De•a t i-"R~' Cif of Northampton Status of Permit tii- g Department Curb Cut/Driveway Permit Main Street Sewer/Septic Availability- �a ' - !Room 100 Water/Well Availability _ ! MAY 2O02Northarr pton, MA 01060 Two Sets of Structural Plans phone 413-587-¢240 Fax 413-587.1272 Plot/Site Plans Other Specify- a; APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION This section to be completed by office 1.1 Property Address: I Map d3 O Lot t 1,q — Unit R012-1At rt Zone af2 " Overlay District " Elm St. District CB District__ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: N rint) Current Mailing Address: Telephone Si nature 2.2 Authorized Agent: ED ©L Litt kioi L L& Name(Print) Current Mailing Address: - j- Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars) to be Official Use Only completed by permit applicant 1. Building 4---Z,/^t (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2 + 3 +4 + 5) Check Number /by9J L� p This Section For Official Use Only Building Permit Number: 1 6a " `5'S 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 r� Building Department Lot Size if L— ` +4, Frontage C> j 1 1 Setbacks Front ') Side L: 15 R: LC.7 L: R: Rear 3 0 Building Height Bldg.Square Footage WOO I ID Open Space Footage % % (Lot area minus bldg&paved I 000 n parking) 1 #of Parking Spaces _3 Fill: (volume&Location) e. 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 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 ONO 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 0 Addition 0 Replacement Win ows Alteration(s)) Roofing 0 Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: eM rt e • • Wl • rct Alteration of existing bedroom Yes No Adding new bedroom Yes ef" 4 Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll 0 • Sheet 0 raNittNeWdrolleforta dditi�n to'errs it g g r ours c irp e"te h f611=ing: 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? 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, 4_JC3 �- '`-��� � ,as Owner of the subject property — hereby authorize EV 0 ('0,S iz'J -T C)1\ to act on my alf, in all matters relative to work authorized by this building permit application. Sign ture of Owner Date I, , 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. Print Name Signature of Owner/Agent Date / • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor:' }� � Not Applicable ❑ Name of License Holder : 0 cr <</L1 S ep OL"r �� )blo ` l 3 L1tense Number 144 w 1 1,\0 Z S'T, Vo(eAtce Z- 3 0 4- Address Expiration Date A I 10 9 et 5g4 6-t,i,f__ Signature Telephone eg a.e m , m ovement -ont ac or 'r„:; , ,.,; '4 -, , .,,.A, ', ry '.,; rih !' Not Applicable ❑ . PC rD -r1z r-rr o I I o 1 n Company Name Registration Number Lig W) 1 I603 .st, 2 - 3 -- U 4- Address Expiration Date Telephone 5S-Lf- -3/ y 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 0 111 ome owner'Exem s 1 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.otMfp . a erV2i90 qt. �� E e Gitg �a# Northampton hampiim _*=1� 9. ~4� m6 Alassacfittaetts' 1111i` •"�y_'� DEPARTMENT OF BUILDITNG INSPECTIONS • =_I i= 212 Main Street ' Municipal Building Northampton, Mass. 01060 r",. WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, D FJ (licensccipermittee) with a principal pl ce of, 11'.business/residence at:(1 '"� W 1j OZ (phone#) " "l ^ b3 t.) ({ streei/ci /stair/zi ( tY 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: - (Insurance Company) (Policy Number) (Expiration 11\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: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) r. (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional sheet if ne,r,t.. y to include information pertaining to all contractors) to I am a sole proprietor and have no one workdng for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that while homeowners who employ persona to do rnarttt n,rxr construction or repair work on a dwelling of not more than throe tmiti in which the homeowner resides or on the grounds appurtenant thereto arc not generally ooasidc cd to be employers under the worker's ration Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the legal ctatua of an employer under the Worker's.Compensation Ad. I understand that a copy of this wtcmcnt may be forwarded to the Department of Industrial Accideati Offioo of Inauwoo for the coverage verification and that.failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S 00.00 and/or iniprisoemseat of up to one year and civil penalties in the form of a Stop Work Order and a fins ofS100.00aday .. r� , I For departmentaltrso only Permit Number �. � r Map'# Lot