38B-006 (107) 126 WEST ST BP-2017-0558
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man:Block: 38B-006 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv: renovation BUILDING PERMIT
Permit BP-2017-0558
Project# JS-2017-000906
Est. Cost: S89350.00
Fee: S623.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SCAPES BUILDERS & EXCAVATION LLC 021087
Lot Size(sq. ft.): 9365.40 Owner: SMITH COLLEGE OFFICE OF TREASURER
ZoninE: SI(100)/WP(6)/ Applicant: SCAPES BUILDERS & EXCAVATION LLC
AT: 126 WEST ST
Applicant Address: Phone: Insurance:
P O BOX 469 (413) 665-0185 O Liability
DEERFIELDMA01373 ISSUED ON:10/25/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:REMODEL 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 VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 10/25/2016 0:00:00 $623.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File_`BP-2017-0558
A PPLICANTICONTACT PERSON SCAPES BUILDERS& EXCAVATION LLC
ADDRESS/PHONE P O BOX 469 DEER.FIELD (413)665-0185 ()
PROPERTY LOCATION 126 WEST ST
NEAPS PARCEL 006 001 ZONE SI(100)1WYF(6)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION c HECK LI ST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Fitted out1111
Fee Paid G
TvieP ofCppstruction: REMODEL 2 ROOMS
New Construction
Non Structural interior renovations
Addition to Existing.
Accessory Structure
BBuil ina ans Icluded:
Owner/Statement or License 021087 ,Mr / Mr /'�
..... 3 sets of Plans t Plot Plan J~. n( r4C- ,(��Jityir
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
proved 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
p,..aliti• • e Iry
• /a YY/o
Signature of Building effcial 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.
0k Ts Lei IA( i0-2V, ct.......
--" � .7 Commercial Building Permit May I5,2000
.,_ Department use only
I 3ity of Northampton Status of Permit
..,I 2 Q 3uilding Department Curb Cut/Driveway Permit -
212 Main Street Sewer/Septic Availabiaty
nsa CFmnL➢,a's NSF C11ONS Roan, 100 Water/Well Availability
NO Th AMPFON,MA omoA Nc rthampton, MA 01060 Two Sets of Sbuctural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN(,(�JN
AONEE OR TWO FAMILY DWELLING
SECTION 1 .SITE INFORMATION , t V t�:e/dt5
1.1 Property Address: This section to be completed by office
126 West St,Northampton,MA 01060 Map Lot Unit
Zone Overlay District
Elm St.DNmct CB Metric*
SECTION 2•PROPERTY OWNERSHIPNAUTHOR17-E0 AGENT
2.1 Owner of Record:
The Trustees o Smith College 126 West St
Name(Pnm)C! Facilities Management Charles ConantCurrwltMINngMkesa
/Lid l/,/{) (413)585-2424
Signature ! � Telephone
j.2 Authorized Agent.
Name(Print) Conant Malang Address!
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTO
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building $69,753.00 (a)Budding Permit Fee
2, Electrical $18,597.00 (b)Fslimaletl Tomei Cost of
�,,,,, CgnaEuction frau(6}
3. Plumbing $1,000.00 Building Permit Fee
4. Mechanical(HVAC) 1<
gl
5.Fire Protection
6. Totem=(1 +2+3+4+5) 77 3c 6 Check Number �(
This Section For Official Use Only
Building Permit Number Date
Issued
Signature: i
Building Commnalonemrrepector of Buildings Date
Version1.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS I FCS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wail Signs ❑ Demolition❑ Repairs('J( Additions 0 Accessory Building 0
Exterior Alteration 0 Existing Ground Sign❑ New Signs 0 Roofing Change of Use❑ Other 0
Brief Description Enter a brief de Orion here.
Of Proposes work: C�t v�o c)C I G {.. )t /s 1�, (.5y,,124 1kSc
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 0 A-2 0 A-3 0 1A r ❑
A-4 0 A-5 ❑ 113 ❑
B Business 0 2A ❑
E Educational 0 2B ❑
F Factory 0 F-1 0 F-2 0 2C J ❑
H High Hazard 0 3A 0
I Institutional 0 I-1 0 I-2 0 I-3 0 3B 0
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 0 R-2 0 R-3 ❑ 5A ❑
S Storage 0 S-1 0 S-2 0 58 0
U Utility ❑ Specify:
M Mixed Use 0 Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
1m
151
2n°
2m
3rd 3rd
4in
4th
Total Area(sf) Total Proposed New Construction(sf)
Total Height(ft)
Total Height ft
7.Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public 0 Private 0 Zone Outside Rood Zone❑ Municipal 0 On site disposal system
Version 1.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage ^/o
Open Space Footage
(Lol area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DON'T KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES
IF YES: enter Book Page and/or Document
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions 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? YES O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version1.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
R.E. Dinneen Architects and Planners INC Not Applicable ID
Name(Registrant):
R.E. Dinneen Architects and Planners INC Registration Number
Address
123 North Washington St, Boston, MA 02114 Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
RDK Engineers
Name Area of Responsibility
200 Brickstone Sq, Andover,MA 01810-1448
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Scapes Builders & Excavation LLC Not Applicable ❑
Company Name:
Douglas A Blowers
Responsible In Charge of Construction
110 North Hillside Rd, South Deerfield, MA 01373
Address
Peuy/asAB&urom, 7sfasa,iksq-7flerndu//C (413) 665-0185
Signature Telephone
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW( 110 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No O
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTORR /} APPUES FOR BUILDINGN^ PERMIT
9 /,
1, 12/044e, ( 2✓7/(v(t—/ff�/' �lell i I Jj Nene- ,as Owner of the subject property
hereby authorize Douglas A Blowers J m
act on my behalf a matters relative own uthorized by this building permit application. p
Signature of Dale �'7
I, ,as Owner/Authorized
Agent hereby declare that the statements and information an the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perlu
U /
Print N/�fJJ^ ///� �/' �J9
s rhgi8fru�ea of UmarrTAgeM Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Severvlso(: Not Applicable 0
Name of License Holder: Douglas A Blowers 021087
License Number
110 North Hillside Rd, South Deerfield,MA 01373 04/05/2017
Address Espirason Dale
Peu914 A fi&wcu, ?eat,/ /Le (413)665-0185
SIgnalum Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,e.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted vAth 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 0
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 150A.
Address of the work: 126 West St, Northampton, MA 01060
The debris will be transported by: Dave Wickles Trucking
The debris will be received by:
Building permit number:
Name of Permit Applicant Scapes Builders & Excavation LLC
10/18/2016 P„y`. al,o.A4, Jeasienpleatem. iC
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
- ' gri 1�= Office of Investigations
. els
7 Congress Street, Suite 100
Boston,MA 02114-2017
•• www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Baan s organi a on naivia ap: Scapes Builders & Excavation, LLC
Address: 110 North Hillside Rd
City/State/Zip:S. Deerfield, MA 01373 Phone#:413-665-0185
Are you an employer?Check the appropriate box: Type of project(required):
If} I am a employer with 18 4. ❑ I am a general contractor and 1
a have hired the sub-contractors 6. El New construction
employees(full and/ort part-time).
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.% 9. ❑ Building addition
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions
myself [No workers' comp. right of exemption per MGL
12.E Roof repairs
insurance required.] c. 152,§1(4),and we have no
employees. [No workers' 13.❑ Other
comp. insurance required.]
'Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information.
f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suck
Contractors that check this box must attached an additional sheet showing the name ofthe sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comppolicy number.
tam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:AIM Mutual Insurance
Policy 4 or Self-ins. Lic. #:WMZ-800-8005664-2016A Expiration Date:6/25/2017
126 West St Northampton, MA 01060
Job Site Address: City/State/Zip:
/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.
1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct
Signature: Douiria.4-A 94,4#04,., 74le aaraq-7/1amIu./ /C Date:
Phone#:
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#:
SCAPES BUILDERS Data October 24,2016
&EXCAVATION,LLC.
Commissioner Hasbrouck,
Subject:Request for Waiver
I Request that you grant a modification and waive the requirement for control construction for the work at 126 West St in
Northampton per plans dated B/31/16 by RE Dinneen Architects and Planners because the work is of a minor nature,will not
affect health,accessibility,life and fire safety,or structural requirements and is impractical that the cost of control construction
is considerable compared to the cost at the proposed work.All the work will be completed within the prescriptive requirements
of 780 CMR.Thank you for your consideration.
"Mass Amendments,sections 107.1 allows for an exclusion from control construction for this project'_
Respectfullyy,," 4 /� -��,/" -��,/ � [ /J
Z7B( U�&&o tz-, /iiaaQ[IfL,� Neatp&v 2.-Le
Douglas A Blowers,Managing member LLC // �/
Scopes Builders&Excavation,LLC
110 North Hillside Rd
South Deerfield,MA
01373
110 North Hillside Road P.O Box 469 South Deerfield,MA 01393
Phone!(413)666-0185 Facsimile:(4131-665-0186