31B-028 (4) 51 SUMMER ST BP-2009-0644
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31B-028 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit# BP-2009-0644
Project# JS-2009-000942
Est. Cost: $13450.00
Fee: $78.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: OLIVER ISELIN 039073
Lot Size(sq. ft.): 4007.52 Owner: PARTAN SARAH R
AT: 51 SUMMER ST
Applicant Address: Phone: Insurance:
36 Service Center (413) 584-1224 Workers
Compensation
NORTHAMPTONMA01060 ISSUED ON:1/20/2009 0:00:00
TO PERFORM THE FOLLOWING WORK:FRAME KNEEWALLS,REMOVE
CHIMNEY,INSTALL SKYLIGHT & INSULATE ATTIC
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.F.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: ,._. _ ; House# Foundation:
Driveway Final:
Final: Final: � _��f Ocl
/fir-
n Rough Frame: eV k
(J�it - o -C�9�c
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. dos&L.42tr,
Certificate of Occupancy(/ -•-- � -�` Signature:
FeeType: Date Paid: Amount:
Building 1/20/2009 0:00:00 $78.001878
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo
File#BP-2009-0644
APPLICANT/CONTACT PERSON OLIVER ISELIN
ADDRESS/PHONE 36 Service Center NORTHAMPTON (413) 584-1224
PROPERTY LOCATION 51 SUMMER ST
MAP 31B PARCEL 028 001 ZONE URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out Fee Paid d Op J p+7 ern1>/
Typeof Construction: FRAME KNEEWALLS.REMOVE CHIMNEY.INSTALL SKYLIGHT&INSULATE
ATTIC
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 039073
3 sets of Plans/Plot Plan
THE F 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 Street Commission - Permit DPW Storm Water Management
Demolition Delay
---1/7/"?--
Signature of wilding 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.
•
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
,..•e 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
\� ''' Northampton, MA 01060 Two Sets of Structural Plans i
-\c, phoA:7413-587-1240 Fax 413-587:1272 Plot/Site Plans
Other Specify
1
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
r ' ,'� �„�,�,�./ f 4-. Map Lot Unit
l/
�., r /,� Zone Overlay District
� �f -�-�^•y, Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
(),r 4-e,---- 4-I „,f,...4 11AA.4.04.A•4,..,/ A.
Name Print Current Mailing Address: ;es _ /, Lz__
-
a/ � � Telephone
Sig
2.2 Authorized Agent:
OL-1 ✓t-it-- Z140 ,J 3 6 fe-e1, -c__` et. +-t.,- 7 d.
Name /J Current Mailing Address:
.:2__
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
i Zs-00. 9.0
2. Electrical et (77
(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) / 3Y O • II° Check Number 1f7,- gfI 7,r
This Section For Official Use Only
e
Building Permit Number: Da Issued:
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House n Addition I Replacement Windows Alteration(s) ,--,r- Roofing n
Or Doors D
Accessory Bldg. ❑ Demolition ❑ ` New Signs [El] Decks [E] Siding [0] Other[0]
6ii�w.t {'r4i W 1 '44-1 TLC-..-‘o V[s G ft. .4 4--1 i
Brief Description of Proposed f f�G /) x 6 '� (� ,,.,..f r la-�-�
Work: J/r`� (� ) �•� /.. C� L• 44'`-'-
Alteration of existing bedroom Yes >& No Adding new bedroom ✓ Yes A_ No
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll -Sheet
6a.If New house and or addition to existing housing, complete the following:
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 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
S---t c—k_ 4-4-a"...-
as Owner of the subject
property
H--hereby .. on-
. use /�
to act o, •-half, in al matters tive work authorized by this building permit application.
Si! , ure • • -r Date
1, Oti t JSe it- , 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 he pains and pepalties of perjury.
/ d ,Lse l,r:
Print Name V/ 1
zt,ar
Signatur of Owner/Agent Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
AM_ /.0 % $-t Ow— 00 yt 14- This column to be filled in by
t/d L.! .�"f 6-� ro 6 i f71,,- f(� Building Department
/� � "--1
j
-t r _._ ._.. l
Frontage I
Setbacks Front i
1 i i 3
Side L: _. R: __, ..._ L:L_ 1 R:t ._ •_1 1 r---1
r- r
Rear _____._._.._...�
Building Height 1'
Bldg. Square Footage ] _--1 % "� ". i_ lr-`� ,
Open Space Footage -t % i
(Lot area minus bldg&paved l J —€ _! L. I __
parking)
#of Parking Spaces I J i_. i
Fill: {( -.0
(volume&Location) �.. ..._..._ 1
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book ; Page} • # and/or Document#;
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued: j
C. Do any signs exist on the property? YES O NO er
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 er
IF YES, describe size, type and location: I
E. Will the construction activity disturb(clearing,grading,exc vation, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
•
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: ,/ Not Applicable 0
Name of License Holder: p L 1 L'�" fE c- co29 ��
1 / License Number
36 Ser v►' Tc�
Address Expiration Date
J'y-izzy
Signature Telephone —i,f CS
8.Registered Home Improvement Contractor: Not Applicable 0
t_ /o rL-8
Company Name Registration Number
Address Expiration Date
Telephone ' _.5L / t7
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 N7 No 0
11. — Home Owner 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. 1
Homeowner Signature
2 X6 �" i Amu.,"
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GENERAL CONTRACTOR
36 SERVICE CENTER
NORTHAMPT0N, MA 01060
(413) 584-1224
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2O �3%c.oy
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DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street ' Municipal Building
?Northampton, Mass. 01060 •
WORKER'S COMPENSATION •INSURANCE AFI13)AVIT
1iccuttr/permittcc)
. . %vuh a principal place of business/residence at:
f() fK�"� G�� _
-- - (phone:') S 8V ' I te4
(str..t/city/s-taiehi p)
do hereby certify, under the pains and penalties of perjury, that
(iiI am an employer providing the followint worker's coinnensadon coverage for my
employees worlong on this job.
Gt.-44-ra I £,fi,.'.. wc-383y2fcrIe /' (a►I//
(Insunncc Company) (PoLic— Number) (T:-piration Date) .
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below wbo have the following worker's coonen abon policies:
(Name of Contractor) (Instant: Company/Policy Numb...-.;) (_xpirduor, Date)
(Name of Contractor) (insurance Company/Poticy Number) (L\DLfation Date)
(Name of Connactor) (Lasuranc Company/PoLcy N,tmber)- (Expir000 Date)
(Name of Contractor) (Insurance Compaiy/Policy Numbs) (Expiration Dale)
(m..,.ch s.ddi;iocal sbc if nc tis.ry to o du&inforcu oo pertaining to.11 ooa7•s.c.o:3)
( ) I am a sole proprietor and have no one woridng for use.
( ) I am.a home owner performing all the work myself.
NOTE,plcs;bc a'-yrc tit w•t.^Jo 6Rutvm wbo caploy pc-sons to d.)c•.ir-t.--,.sari c -.:r..1 h c rep it work on.dw&&g of
ON more tb_n tor.tmitr in which the bomoow ncr rciiiim or on the vo-viDetr zpp into:ram them LT ox g )aJiy oeer:d•-cd to bc
carp I o yc-3 nr,r'-the',ydcA's ccaip .nticia Act(GLl52.sa I(5)),applir-lion try a botn000 oa fc c licv v or pcmit rosy evidence the
Icg.l runt of ao coployer under d.o Worker'.C00000dauou Act
I unde"rsaad dirt n copy of this etz®ta¢ a-t tasty be fo -.tad to tbo peputm ¢eo of Icrdus:id Atoets-ct,' -..o OtLoo of b eo for tba
coycraSc ycriG=ioa end th(L•iltat to cocurc coverage tinder ioaion 25 A of MOL 152 an lead to the i. oaitioo of criminal pcostlict
coati-zing of a fiat of up to S I..500.00 andfoc imprisoacoct of up to croc year Lod civil pmahio in 6c form of a Stop Work Order nod a
rim of S 100.00 a thy atpinA CDC
For dqurtrn="-a.1 u.c Drily
.g flu ( , Pt,mil Ntlmtxs------ g . —...„
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