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31B-027 (5) 1 ALDRICH ST BP- 007-1266 COMMONWEALTH OF MASSACHU ETTS Map:Block: 31B-027 iT CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.14 A) Category: BUILDING PE IT Permit# BP-2007-1266 Project# JS-2007-002019 Est. Cost: $2000.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DAVID RIOPELLE 077609 Lot Size(sq. ft.): 5575.68 Owner: WIJNHOVEN ROBERT A Zoning:URC Applicant: DAVID RIOPELLE AT: 1 ALDRICH ST Applicant Address: Phone: Insurance: 15 BRIERWOOD DR (413) 586-6199 () FLORENCEMA01062 ISSUED ON:6/29/2007 0:00:00 TO PERFORM THE FOLLOWING WORK:ENCLOSE EXISTING PORCH TO 3 SEASON ROOM & REPLACE WALLI3OARD IN 2 ROOMS 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 VIOL• TION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu Banc si.nature: FeeType: Date Paid: Amount: Building 6/29/2007 0:00:00 $50.003030 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 4 File#BP-2007-1266 APPLICANT/CONTACT PERSON DAVID RIOPELLE ADDRESS/PHONE 15 BRIERWOOD DR FLORENCE (413)586-6199() PROPERTY LOCATION 1 ALDRICH ST MAP 31B PARCEL 027 001 ZONE URC THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � rr�� Fee Paid `�D O 4.6-6 Typeof Construction: ENCLOSE EXISTING PORCH TO 3 SEASON ROOM&REPLACE WALLDOARD IN 2 ROOMS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 077609 3 sets of Plans/Plot Plan THE FO OWING 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 Commissio ,/-9/20,3 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,Departm•nt 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. k , Department use only � ;City of Northampton Status of Permit: E (�; [� t ,'Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability 2007 Room 100 Water/Well Availability r JUN 2Northampton, MA 01060 Two Sets of Structural Plans phone 41 -587'1240 Fax 413-587-1272 Plot/Site Plans Other Specify �_ A�'PLICATIAN T0"C6A�S CT,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 �` t ; cAkr � Map Lot Unit 1•t„ ktry , f tAIN ow[.0w Zone Overlay District N Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: -Qc1k,tf\ ki•YStA01/4Y41\1 vssiAtAr.c. --\vis2,k- , Na Current Mailing A dress: �-� (kk3ISeS• 12 Telephone Signature 2.2 Authorized Anent: 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 2000 (a)Building Permit Fee 2. Electrical n( (b)Estimated Total Cost of Construction from(6) 3. Plumbing /7( Building Permit Fee 4. Mechanical(HVAC) „( 5. Fire Protection 6. Total=(1 +2+3+4+5) �yyO Check Number '2)036 156 /`"" This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date er . Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning ,` This column to be filled in by 1_ P Nk.fS., Building Department Lot Size 5 S iO • Frontage — rbI-- — Setbacks Front j _ Side L:_ .__ R: L:' -'; R:i__ - ,Jl Rear I — ` 2.0 Building Height : **A- -46 Bldg.Square Footage % Open Space Footage (Lot area minus bldg&paved 4010 parking) #of Parking Spaces Z 1 Fill: N (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO �►�ur DONT KNOW 0 YES 0 — - IF YES, date issued:! IF YES: Was the permit recorded at the Registry of Deeds? NO 11$'"'1.1 DON'T KNOW 0 YES 0 IF YES: enter Book Page' and/or Document# B. Does the site contain a brook, body of water or wetlands? NOig , DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained Q Obtained Q , 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 0 NO IF YES, describe size, type and location: - E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES IQ NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. r . ' 1 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) cgt, Roofing n Or Doors CI Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [I= Siding [0] Other[0] Brief Description of Proposed _ Work: Cc:>tw1SE. Z" �' 5' itJc 'OFirhji1 Pt 3Scr..l1501.� �t�=�p�cK Orr' "mt nw _.RE1 ),,vyr Ca.) t ( 1 it0=v, �k 2 4out{S Alteration of existing be roo Yes No _.Adding new bedroom Yes xNo Attached Narrative Renovating unfinished basement Y s k No Plans Attached Roll -Sheet / sa_If-NeW--house-and o"r addition to existtnq`hou Shirr cobra teaheIitit owing: (4 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. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 10Q ft.of wetlands? Yes No. Is construction within 100 yr. floodplein- 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 V V\ 0\4,0 V.14\) , as Owner of the subject property hh hereby authorize Tht^i,JitiV_- to act on my behalf,in all matters relative to work authorized by this building permit application. 6 )10 (2001— Signature of Owner-1 Date ,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 er e pains and penalties of perjury. Print Na is Signature of Owner/Agent Date 1 • Jr SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: ?eAtc., CS 7?b 0 9 V (�a, a i i i License Number � TI R R� 444 .feCiCp/ f Ule f 6 4/I 7/C ' Aauress ,/ Expiration Date ev, 1101/-- &''3 s2o S�6 Signature Telephone 9 :Recatered Home.lmbrovement Contractor ffi _. .� ', Not Applicable 0 poop-e lle gat es'S /b/f0i3 Compahv Name Registration Number ei./ie/6 hill Ri7 qt/ 4/lp 7 Addresss J /j/J Exp. ation date �elltan S64 �"i 00? Telephone '- i3 32© SIFj 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 0 No lr2! 11. Home Owner Exeniptiori 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 buildine 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 • The Commonwealth of Massachusetts Department of Industrial Accidents ri Office of Investigations 600 Washington Street Boston, MA 02111 � www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r._.. Please Print Legibly Name (Business/Organization/Individual): �00►N2, 531)-Vt,1A3L Address: C\ V i\Vul \k• 17,4S City/State/Zip: k�1'alai,% . , _ 1 i OVA) Phone#: kr3 '32u '$6c Are you an employer?Check the appropriate box: Type of project(required): 1.El I am a employer with 4. 0 I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp.insurance comp.insurance. t required] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.0 Other employees. [No workers' comp.insurance required.] ---'Ariy applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: — Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: - Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: <'l Date: fj�°?/70 7 Phone#: y/3_ 3qC- .Str6 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: scstlAMp2O 1 • ;ft..� 1..a!4 sacl�usciis 77_, _ ---7.2 ' DEPARTMENT OF BUILDING INSPECTIONS =':�=— /,i INSPECTOR 212 Main Street • Municipal Building '-o y`, 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:: . sor. 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 blig/01-- Address of work location INor[nampton,,l\}'A rropeny lietaii rage i or z City of Northampton, MA: Residential. Property Record C New Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map-Block-Lot: 31B-027-001 Zoning: Assessr Location: 1 ALDRICH ST Neigborhood: 10 Land: #Living Units: 1 Deed Book: 6647 Buildi Class: R-101 Deed Page: 67 Total: Dwelling Information Building Ske ch Style: Conventional Year Built: 1870 Story Height: 2 Attic: Unfin Basement: Full 16 5 E 5 Total Rooms: 9 Bedrooms: 4 202sOFP < 1r_i Full Baths: 3 11010 Half Baths: 0 5 Exterior Walls: Frame 5 _'? Unfinished Area: 0 50 UAl2Fr/B 1 Ground Floor Area: 950 '- 1e�� � Total Living Area: 1940 a Finished Basement Living 0 X 0 a Area: o FP_ Basement Recreation Area: 0 X 0 so Woodburning zi Fireplace 0/0 21 6 Stacks/Openings: Metal Fireplace 0/0 Stacks/Openings: Heat/Central A/C: Basic Heating System: Stream40-66U-3A-- )t,_____ Fuel Type: Oil Addition Information: Quality Grade: C+ Physical Condition: Average Interior/Exterior: Same Lower 1st Story 2nd Story Condition/Desirability/Utility: GD One Story C Vacant/Dwell/Oby Status: Dwelling Basement One Story Frame Frame Additional Features: http://www.northamptonassessor.us/noho/propertydetail.php?map_no=31 B-027-00 1&page... 6/26/2007