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31A-067 (41)
186 ELM ST BP-2017-1263 GIS#: COMMONWEALTH OF MASSACHUSETTS Man:Block: 31 A-067 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: REPAIR BUILDING PERMIT Permit# BP-2017-1263 Project# JS-2017-002110 Est.Cost: $120000.00 Fee:$840.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ZAYAC CONSTRUCTION LLC 074881 Lot Size(sm. ft.): Owner: SMITH COLLEGE OFFICE OF TREASURER Zoning: EU(100)/URC(I00)/ Applicant: ZAYAC CONSTRUCTION LLC AT: 186 ELM ST Applicant Address: Phone: Insurance: 79 HIGHMEADOW DR (413) 737-3872 O WC WEST SPRINGFIELDMA01089 ISSUED ON:5/5/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE IN KIND - FIX ROOF FRAMING, SLATE, MASONARY**materials must match original, including, slate, bricks and mortar** 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 5/5/2017 0:00:00 $840.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck- Building Commissioner Filed BP-2017-1263 ,,! APPLICANT/CONTACT PERSON OW CONSTRUCTION LLC ADDRESS/PHONE 79 HIGHMP.ADOW DR WEST SPRINGFIELD (413)7373872 Q PROPERTY LOCATION 186 ELM ST MAP 31A PARCEL 067 001 ZONE EU(100)/URC(100)/ 561 N61:6 THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST 'INCLOSED REQUIRED DATE ZONING FORM FILLED OUT f N Fee Paid it - WVV. Building Permit Filled out q ' Fee Paid Typeof Construction: REPLACE. IN KIND-FIX ROOF FRAMING,SLATE,MASONARY IC MfI I E; Z_t/ktS tv' MS7 New Construction MATI''N OQ4fyi/sottr'L I Ir.rrl tap!+.2 SSE tp-c(4 mime* Non Structural interior renovations �/ r Addition to Existing rr f( pp"(A Accessory Structure Buildina Plans Included: Owner/Statement or License 074881 3 sets of Plans!Plot Plan THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF MATION 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 J1 di Signatureo 0 'dal Date/ f 7 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 MGC 40& Contact Office of Planning& Development for more information, RECEIVED 51TkxroW(i1r -.T:e City of Northampton t-p r (1,r (t Building Department IC° t rrr iiiiVi D 4>. MAY - 31017 . 212 Main Street �7� �- 7 r rB7tUi x_ = ,, I I Room 100 gYsii 11rAi S°f iiiiil} --- - a Northampton, MA 01060 11 t Y1 t � k,:i fi q�{ rri, it � ^- ," ; - _ phone 413-587-1240 Fax 413-587-1272 1 r�;� APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A SECTION 1 -SITE INFORMATION COM+`k'�tCrC G��� ( pu glen This section to be completed by office 1.1 Property Address:h0.4-54, 14 -" -" � q ! ,L} /,, 7 k`i`� h0.4-5G UajFI m 5- - Map / ` Lot 0(/ Unit. Abfl'woY akW M� Zone Overlay District /"�" Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: --nit 7Rv37CC of -Pic .7A+rnf Cocccc6 /24 War .Sr N VarereAl ofol3 Name(Print) Current Mailing Address: - - - Telephone wre- Signature S .rCenar'i : 7 I oca1 ® SMr'q - edr�— 2.2 Authorized Agent: cl I .)amc 5 LuG aY. /ZG 1.4)es i ST. NF/iPnvmN o/ati Name(Print) / Current Mailing Address: 'kg - SSS - 2 y/z Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 12O (a)Building Permit Fee 2. Electrical I (6) Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee �)7�//�; 4. Mechanical(HVAC) g/ 5 Fire Protection 6. Total=(1 +2+3+q+5) / 9"0 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date 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 tilled in by Building Department Lot Size L _ 1 L_ —. r Frontage fl Setbacks Front (-'i ni _--1 1 Side L: I R: J La R: Rear - Building Height i l Bldg.Square Footage F % i ii 1 Open Space Footage (Lot area minus bldg&paved L_J L i parking) #of Parking Spaces —'1 r---1 (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DONT KNOW 0 YES 0 IF YES, date issued:L IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES IF YES: enter Book I ( Pagel and/or Document#1 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 0 , Date Issued: C. Do any signs exist on the property? YES O NO Q 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 fib? 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 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) i New House IT Addition ❑ Replacement Windows Alteration(s) n Roofing Q Or Doors 0 Accessory Bldg. ❑" Demolition El New Signs [C] Decks [[] Siding [C] Other[C] Brief Description of Proposed Work: Revi.e-R- ,n. Ural- Et Rev(' rfatJ SJakei Atiwnery Alteration of existing bedroom Yes 1 No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa If Newhouse and or addition to existing housing;complete-the following: a. Use of building : One Family Two Family Other Trott- 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 Zfe. Number of stories? ..0_.-- f. . Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction [ria-7 N Dirl- i. Is construction within 100 ft.of wetlands? Yes k 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, -72/c 1895 TEeS of —ME Sint ry Co LL LAS ,as Owner of the subject property �7 hereby authorize OF 1 4 7`,4C- Co 415729 Ln DA) to act on half, in all matters la' to work authorized by this building permit application. 5- .3 - i7 Signatur wrier 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 B-CONSTRUCTION SERVICES 3.1 Licensed Construction�}Supervisor u Not Applicable £1 pet dame of License Holder: 1%GLt I/efet, CS — � 1 U 4 ( FAA/di ��iif License Number .C_ t a/ .r heft ftad �P-06o _ I 1 / seg l l�J Address //,�/ p3 �^-��y(� Expiration Date /i chi Jcf 4 - t1 7DZJ sign ref Telephone mar' A4CL2• pL Cr . yj . Gann 4.Registered H(omelmnruyemenicontraotor ;-- .. _ _ _ ., .. Not Applicable let. Ccw- c-kj -ften Company Name _"" // Registration Number 74 4er✓.'or £1) Leed /n, d/� Address Expiration Date Telephone Ste SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.t„c.152,§25C(69 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. Sisned Affidavit Attached Yes....... 0 No...._ ❑ 11: -°HomeOwner-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 indiadual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 1083.5.1. Definition of Homeowner: Person(s)who own a parcel of land on which betshe 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 fann 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 thispermit is issued. Also be advised that with reference to Chapter 152(Worker?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 de State Building Code,City 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 150A. Address of the work: The debris will be transported by: Wiry /c/ , ns 2114-C Co4-tdia• The debris will be received by: \A,{,Mt y ttG/C(.-.25 Building permit number: Name of Permit Applicant 7_.4/A-c Can 5Ih.cc-f7c'1 5-3, / Date Signaili'e of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents i2 Office of Investigations _ 1 Congress Street,Suite 100 Boston,MA 02114-2017 •V is www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business'Orgganization/Individual): � t. �'4.CJt/a!t LL-Le Address: 2 Aserv'ie/ teP teekis tint H- C ac — City/State/Zip: 1 Phora Are you an employer? Check the appropriate box: Type of project(required): 1.9 I am a employer with 4. Q I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. []New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. Z]Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workingfor me in anycapacity. employees and have workers' P 9. [J Building addition [No workers' comp. insurance comp. insurance? required.] 5. 0 We are a corporation and its 10.0 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 MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp,insurance required.] `Any applicant that checks box NI 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 such. tcontractors 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:,.-fl/ a()t)t/I n5 Co Policy#or Self-ins.Lie. it: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation polity 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 cerShy under the pains and penalties of perjury that the Information provided above is true and correct Si mature: . / Date: 5-3 r 17 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): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 14: CONTRACTOR QUOTE PRINTED ON: 03/20/17 PAGE 1 QUOTE# Q1703253A '<t DATE QUOTED:03/20/17 ` 1 i I.. 181 GOODWIN ST VALID UNTIL: 04/17/17 EHG I •ING PO BOX 51027 COT a,;-' ION Job: ZAYAC P A INDIAN ORCHARD,MA 01151 HIP GARAGE / SLATE ROOF MANUFACTURERS OF ROOF&FLOOR TRUSSES Phone(413)543-1298 Fax(413)543-1847 Toll Free 4100)45G-01r NORTHAMPTON, MA Quote To:Lucia Lumber Company Requested By: ED BOURGEOISE 777 Silver Street P.O. Box 281 Agawam, MA 01001 Quoted By: John Goodrich Attn:ED BOURGEOISE Phone:(413)-786-1636 rROOFTRUSSES LOADING su-rmwauc6 ss"CR- ROOF TRUSS SPACING:I6.DIN.O-G(TYP_1 DN uvD1RJFG 03/20/1703/20/17INFORMATI40.0,900,0.0,100,a 105 PROFILE QTY PITCH TYPE BASE 0/A LUMBER OVRHG/CANT SHIPPING UNIT PLY TOP 160T TRUSS ID SPAN SPAN TCP I GOT LEFT I RIGHT HEIGHT WEIGHT i 1 JACK-CLOSED ,00-11-00 - 16 6.00 0.00 01 05-09-04 105-0904 2 X 4 2 X 4 0306-01 21 JACK-CLOSED 100-11-00 8 6.00 000 02 04-04-034 004-03 2 X 4 2%4 02-11-00 14 JACK-CLOSED 1100.11-00 ' 8 6 00 000 03 03-00-03 03-00-03 2 X 4 2 X 4 02-0308 10 JACK-CLOSED1 06-11-00 ' 8 6.00 000 04 01-0003101-00-03 2 X 4 2 X 4 Ot-07-00 6 DIAGONAL HIP '01-63-09 • • 4 424 0 00 CJ 08-00071 08-0007 2 X 4 2 X 4' 0307-05 29 2 HIP GIRDER 00-11-00 00-11-00 "' 1•-I2Ply 600 000 Cl 21-00-00121-00-00 2X42X61 03-08-01 94 HP '0611-00 0611-00 __� 1 + — I 2 600 0.00 HI 21-00-00 21-00-00 2 X 42 X41 05-0001 BS HIP 100-11-00 00.1100 1 I 2 6 00 21-000O 2%42X4 05-0001 84 MP + 0611-00 00.11-00 (�.._. � 0404-Oi 85 1 I 2 600 0,00 GABLE 21-00-00121-0000 3%42X41 ..--• 2 1342 0.00 LAW 09-03-07 09-03-07 2 X 42X61 05-02-05 42 COMMON 00-11-00 00-114a0 TI 21-000021-00902X42 X41. 06-0607 73 ITEMS CITY REM CATEGORY LENGTH NOTES FTJW1s 12 LUS26 Hanger 4 THJU26 11_,__"Hanger 24 TJ037 1 Hanger . . . . . . 41-00-00 .... . .. , . . .. . . . ----------JL _ I , ... , . • . . , . tie cj n 4 01 csi (-3 ...... 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