35-289 (10) 9 SYLVAN LN BP-2017-0028
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 35 -289 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: WINDOW WELLS BUILDING PERMIT
Permit# BP-2017-0028
Project# JS-2017-000044
Est Cost: $9460.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: STEVEN ZUCCHINO 021356
Lot Size(sq. ft.): 32713.56 Owner: FRIEDMAN PERRY
Zoning: Applicant: STEVEN ZUCCHINO
AT: 9 SYLVAN LN
Applicant Address: Phone: Insurance:
70 Gleason Road (413) 584-3878
N ORTHAMPTON MA01060 ISSUED ON.:7/18/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL REDI EXIT WINDOW WELLS WITH
36X36 VINYL CASEMENT WINDOWS
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 ft 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:
FeeType: Date Paid: Amount:
Building 7/18/2016 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File t{BP-2017-0028
APPLICANT/CONTACT PERSON STEVEN ZUCCHINO
ADDRESS/PHONE 70 Gleason Road NORTHAMPTON (413)584.3878
PROPERTY LOCATION 9 SYLVAN LN
MAP 35 PARCEL 289 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILL OUT---yam
Fee Paid �/5' �!G ^7�
Building Permit Filled out
Fee Paid
Tvneof Construction' INSTALL REDI EXIT WINDOW WELLS WITH 36X36 VINYL CASEMEjT
WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement Or License 021356
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
14Approved=Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDERR:§
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 front Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Stonn Water Management
Demolit nt Delay
�f.
7—/yr(1
Sig . . e of Buddin_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.
Deparlmentuse only
City of Northampton Status of RermiB '
Building Department Curb Cdt/DrtvewayPeptnt .
RA/ _: 212 Main StreetSe er/Septic Availabdtty
iIRoom 100 WatsrMetAvMlabilityCNorthampton, MA 01060 Two Sets of SfntCNarai Plane
ae it phone 413-587-1240 Fax 413-587-1272PIottSde Piens Other Specify
Ali .TION TO CONSTRUCT.ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
—_
SECTION 1 -SITE INFORMATION
1.1 Properly Address: This section to be completed by office
�
/ Map Lot Unit
('
C 7 5y Ivo n l--.ci Kr_ Zone Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:r-- p
A-rr)y FrieJ1s IA, q L<,r,e , is<.,f_ AD 3C0
Name(Print Current Mallin.Address:
- - � �, Telephone r
Signature I J�/r-" 71S .__...
2.2 Authorized Anent: /�
_ %tvekn. 2icc.11iAv 9-6O dre c?r, 1�J "' r , ..
Name(Pr-t, Current Mailing Address'.
jr tit 3- c- s-c s5
Sign re Telephone
SECTION 3-E MATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed bypermit applicant
1 Building Cl(165 (a) Building Permit Fee
2. Electrical (b)(b) Estimated Total Cost of
Construction from(8)
3. Plumbing J Building Permit Fee
4. Mechanical (HVAC) ,-
5. Fire Protection rj
6. Total=(1 +2+ 3+4 +5) eLiC- . C3 Check Number 41g fl CQ Zf"
This Section For Official Use Only
Building Permit Number: Date
ssued:
Signature:
Building Commissioner/Inspector of Buildings Date
I Section 4. ZONING AU Information Must Be Completed.Permit Can Be Denied Due To Incomplete information
Existing Proposed Required by Zoning
Thl9 column to he filled in h)
Building Department
I.ttSize .
Frontage
Setbacks Front '—
Side R:.(( I: R:
Rear
Building Height1 ltl�1
Bldg.Square Footage \\ 'A •
Open Space Footage \ 5.
dot ere minus hide&pat ed \,
parbiont
d of Parking Spaces
Fill:
(volume&Location] -
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DONT KNOW O YES O
IF YES, date issued:.
IF YES: Was the permit recorded at the Registry f Deeds?
NO O DON'T KNOW O YES O
IF YES: enter Book Pag and/or Document if
B. Does the site ntain a brook, body of water or i-ttands? O O DON'T KNOW O YES O
IF YES, has a p it been or nee to b obt. •• from the C servation Commission?
Needs to be obtain d 0 al //+ O , ate Issued:
C. Do any signs exist on the p erty? II YES O NO O
IF YES, describe size, type an cation:
D. Are there any proposed changes to or dditions of signs intended for the property ? YES O NO O
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? YEE O NO O
IF YES, then a Northampton Storm Waier Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) X Roofing L l
Or Doors ❑ _
Accessory Bldg. ❑ Demolition ❑ New Signs CO Decks [❑ Siding[C]I Other(Ci
Brief Description.of?romped..ped �L
Work. Shstxi1 to pnab krif f✓irb4L t Lids W' Ai r. Inh y C<`ke+w_I m+ el.rwe
Alteration of existing bedroom Yes `^� Na Adding new bedroom Yes No
Attached Narrative \\\ Renovating unfinished basement Y s No
Plans Attached Roll -Sheet
6a,ff New house and or addition to existing housing.complete the following:
a Use of building:One Family Two :amity Other
b. Number of rooms in each family unit: Number of Bathroo..s ,,,,,, ,
c Is there a garage attached? _
d. Proposed Square footage of new constr tion Dimensions
e. Number of stories? ,WI
f. Method of heating? Fir,.laces or Woodstoves Number of each
g. Energy Conservation Compliant•, asscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of wetlands? Yes Na 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.
(. Septic Tank_ City Sewer Private well—..._ City water Supply
SECTION Te-OWNER AUTHORIZATION-TO SE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Pere/ F(•sl,01a✓\ , as Owner of the subject
property
hereby authorize 5l tktil /''')
acc.it t w0
to act on my behalf,in all matters relative to work authorized by this building permit application. /
/ � 1 � 6
Sgnatu d -r, Date
I. ] e1Ra-.. 7_yc(_1't iyv0 � ..... 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.
_Stet, - 2uCti ( iry
Print Na e c
Sig ._. 7 �.rfralt
Sin re of Dwned
(odic,
Dat
SECTION S-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:^7Not Applicable
0
Name of License Holder *Wean 4.icCi1 0-"O Cc- 1J3i 3)l
License Number
141) aSr. par) Pit OkCD on Address, Y 1 Expire on Da e
Pt
`1f3- 59C
Sign- re Telephone
0,Registered Home Improvement Contractor: Not Applicable ❑
I 99
Number
Name Registration Number
S4
Address Expir to ate
_ Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.o.152,§25C(81)
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 ❑
11. - Home Owner Exemption
The current exemption for"homeowners" was extended to include Owner-occupied Dwellings of one(I) or two(2)famines
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 10833.1.
Definition of Homeowner:Peru(s)who own a parcel of and on which he/she resides or intends to reside,on which there
is.or is intended to he,a one or Iwo family thvelling,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 she will he 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(I.ahIlity 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»ark far you under this permit_
The undersigned`homeowner"certifies and assumes responsibility for compliance with the State Building Code,Cily of
Northampton Ordinances,State and local Zoning Laws and State of Massachusetts General laws Annotated.
Homeowner Signature
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150k
Address of the work: cl 5//114 b `ten c
The debris will be transported by: __.qubb(�_. 24xc11 '�
The debris will be received by: j/c//v y arcyrl 0.6
Building permit number: _.
Name of Permit Applicant 5Livi n Ztxc!t;i�
Ii /r
Date Sign` re of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
'=� Office of Investigations
I 1 Congress Street,Suite 100
� j o Boston,MA 02114-2017
www.mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information �} f Please Print Legibly
Name{Busin7eess/Org�a^nization/Individuu�al): /�'"�p,,//Q%V (,tK4__t{j.it / tl
Address: 13N) (46 5.,�,y.......I sJ^�C .!lllldl l_t__iLl� I I......14 a14 )
City'/State/Zip: - PPhone#: L -- sit' , , 51" _
Are you an employer?Check the appropriate box: Type of project(required);
I.® I am a employer with 4. ® I am a general contractor and I
6 ®New construction
employees(full and/or pan-time).* have hired the sub-contractors
2 i am a sole proprietor or partner- listed on the attached sheet. 7. a,Renodeliog
ship and have no employees `these sub-contractors have 8, ® Demolition
working for me in any capacity. employees and have workers' 90 Building addition
comp. insurance.•
[No workers' comp.insurance P
required.] 5. 0 We area corporation and its - 30.® Electrical repairs or additions
3.0 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 MOL 12.0 Roof repairs
insurance required.] t c. 152.81(4).and we have no
employees. [No workers' 13.®Other
_
comp.insurance required.)
'Any applicant that checks box k I must&so lill out the section below shoving their workers compensation poi icy in rumtation.
t Homeowners who submit this affidavit dicating they are doing all work and then hire outside contractors must submit a new a Ridai itindicating such.
=Comractom that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not(hose entities Nave
employee.. If the sub-contractors lave employees.they aaeri provide their workers'comp.polity 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. Lie. g: Expiration Date:
lob 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 MGI..t 152 can lead to the imposition of criminal penalties of a
fine up to$7,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a SCOP WORK ORDER and a tine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office or
Investigations of the DIA for insurance coverage verification.
I do hereby to othe pal and penalties of perjury that the information provided above is true and correct.
A
Signature; Date: 7/h /�
Phone10 nder
` 5757 ? -S . .. __
_
Of fide!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 J.City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector
6.Other
Contact Person: Phone#:
7/1/2016 Steven Zucchino
70 Gleason Road
Northampton, MA 01060
413-575-2258
Const. Supervisor Lic.#21356
HIC#100199
ste±.e._J CCT Dcomcast.net
Estimate for-
Perry and Jennifer Friedman
9 Sylvan Lane
Northampton, MA 01060
Install two egress windows in basement music room.
Permit- 150.00
Excavating(allotted) - 500.00
Concrete sawing- 500.00
Materials- 175.00
Window- 355.00
Window well and lid- 1450.00
Labor- 1600.00
Total cost per window- $4730.00 x 2=$9460.00
Payment schedule
In advance $3200.00
Start of excavation $3200.00
Project completed c3060.00
$9460.00
k
AAA& ",
Steven ucchino Perry Friedman