24C-032 (2) 70 NORTH ELM ST BP-2020-0199
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24C-032 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: ROOF BUILDING PERMIT
Permit# BP-2020-0199
Proiect# JS-2020-000340
Est.Cost:$69000.00
Fee: $483.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor. License:
Use Group: WILLIAM TUROMSHA 000515
Lot Size(sq.ft.): 20386.08 Owner: MURPHY DAVID '
Zoning: URB(100)/ Applicant: WILLIAM TUROMSHA
AT. 70 NORTH ELM ST
Annlicant Address: Phone: Insurance:
P O Box 141 (413) 586-4005
LEEDSMA01053 ISSUED ON.811612019 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF, REPAIRS TO ROOF,
REMOVE CHIMNEY
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 8/16/2019 0:00:00 $483.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2020-0199
APPLICANT/CONTACT PERSON WILLIAM TUROMSHA
ADDRESS/PHONE P O Box 141 LEEDS (413)586-4005
PROPERTY LOCATION 70 NORTH ELM ST
MAP 24C PARCEL 032 001 ZONE URB(100)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
E
OaE,Q REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid
TypeofConstruction: STRIP& SHINGLE ROOF, REPAIR ROOF,REMOVE CHIMNEY
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 000515
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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
7_ O"/(v-Z61?
Signa re 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,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.
Version 1.7 Commercial Building Permit Mav 1 5.2000
Department use only
RECEIVED City of Northampton Status of Permit:
Building Department Curb-Cut/Driveway Permit
AUG 1 62019 212 Main Street Sewer/Septic Availability
Room 100 WaterlWell AvailabiCtty
orthampton, MA 01060 Two Sets of Structural Plans
EPT.of SUI.DING INSPECpbwe 4 3-587-1240 Fax 413-587-1272 Plot(Site Plans
noaTHaMrTON.Ma 0106c Other Specify
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address:
This section to be completed by office
_ . Map �V� Lot � '" Unit
0 N o" tLK S-nez esT'
NO iLT-11 p H P'Tb ro Ih A. Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
i rmtT
Name(Print) I�Ort-r}�ampr0�,
( ) Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
14111141n T. iuQom�NA
1 Name(Print) Current Mailing Address:
_.
Signature Telephone
SECTION 3_ESTIMATEC CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be i Official Use Only
completed by permit applicant I
'. Building 00a. (a)Building Permit Fee -
_�� l
2. Electricali Z eao . o. (b) Estimated Total Cost of
Construction from (6) _
3. Plumbing i -_ - -- - I Building Permit Fee i
4. Mechanical(HVAC)
5. Fire Protection I
. i
6. Total=0 +2+3+4+5) Check Number
This Section For Official Use Only
Building rmit er Date
Issued
I
i Signature:
Building Commissioner/Inspector of Buildings Date (� _ I - L o
Versionl.7 Commercial Building Permit May 15,2000
S. 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 —.--.__.. __.. %
Open Space Footage % --_.-
(Lot area minus bldg&paved
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW Q YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES Q
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
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 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 Q
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? YES0 14Y
NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version 1.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs® Roofing❑ Change of Use❑ Other El
Brief Description Enter a brief description here. _ _
Of Proposed Work: _ 11r'S"TL+I p na ftiaL4 >;1llw pvsf 41^4,e lskmu 14exi 9+lC%,t1.3L j.�. Sk•••'>Jei
SECTION 5-USE GROUP AND CONSTRUCTION TYPE SCS A-Trw'kA ip
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 113
❑
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ 1 F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ I 3A ❑
1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 38 ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility F1 Specify: ,— ..._ _.___ ... ..
M Mixed Use ❑ 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): Y' __ 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(so
_.._ _.... 1 St
ist
2nd
2nd
3rd 3rd
th
Total Area(so Total Proposed New Construction fs��
Total Height(ft) FE JT _
Total Height ft
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood_Zone.Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑
SCOPE OF WORK:
• Set up proper staging around area to be operated on, and move as necessary
around work site for sectional repairs and replacement
• Demolish approximately 4500 square feet of asphalt roofing, and any sub layers of
existing roofing down to original sheathing for new roofing
• Install new 4 ply '/2 inch plywood over existing sheathing for structural integrity
and proper nailing
• Install 8" white drip edge on all exposed eave, rake, and gable edges around
perimeter of roofs
• Install approximately 4500 square feet of Ice &Water shield on all exposed roofs,
hips, and valleys with openings at all peaks for venting
• Install approximately 4500 square feet of new 25 year asphalt roofing shingles
(color TBD) over entire roof area
• Install roof venting material at peak of all gable roofs on home
• Install cap shingle over all hip and gable roof peaks on home
• Install 1 Mitsubishi Hyper Heat 24k heat pump condensing unit with stand
• Install 1 indoor wall unit with integrated control
• Install communication wire between units
• Wire up and put power to all installed HVAC equipment
• Complete start up and diagnostic testing for all installed HVAC equipment
• Remove existing rotted windows out of third floor apartment for replacement
• Install 2 new replacement glider windows with left hand operation and full screen
in third floor apartment
• Install new 6" K style gutters around perimeter of home at eaves
Versionl.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:
Not Applicable ❑
Name(Registrant):
Registration Number
Address
i Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
f
Name M Area of Responsibility
i
Address Registration Number
i
Signature Telephone Expiration Date
Name Area of Responsibility
- t
Address Registration Number
Signature Telephone I Expiration Date
9.3 General Contractor
..._. � ,n...p. Gou�?s��?'�oM Not Applicable
Company Name:
_ .. WL01* S 1 2sinsAA
Responsible In Charge of Construction
AddrA S- -— ------ ------- --- -- - -—
Signature Telephone
Version 1.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No Q
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, A V la N(u�p1►y__ _ as Owner of the subject property
hereby authorize _ i A Sttiif�o o.. h _ _ _ .__ _. to
act on my behalf, in all ma authorized by this ing permit application.
Signature of Owner Date
as&wreaAuthorized
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 penalti.es.of perjury.,
Print Name
Signature of Owner/ gent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder .)�.�/p/ra_7 .-..I.�RAIbB�lxl_.---- _. _.._ 000..S15 _ _.. . .
License Number
a_2-Q
Address Expiration Date
k.,.-►.:�.____ ` � _54-6
Signature Telephone
SECTION 13-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 0
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers'Compensation Insurance Affidavit: General Businesses.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Business/Organization Name: �)Jj T f rco ra<l.ta
Address: T O . Tao x 1 N I
City/State/Zip: n Phone#:_ y/3 Oar,s-
Are you an employer?Check the appropriate box: Business Type(required):
1.❑ I am a employer with employees(full and/ 5. ❑Retail
2.�4 or part-time).* 6. E]Restaurant/Bar/Eating Establishment
I am a sole proprietor or partnership and have no ?. 0 Office and/or Sales(incl.real estate,auto,etc.)
employees working for me in any capacity.
[No workers' comp.insurance required] 8. ❑Non-profit
3.❑ We are a corporation and its officers have exercised 9. 0 Entertainment
their right of exemption per c. 152, §1(4),and we have 10. Manufacturing
no employees. [No workers' comp. insurance required]*
4.❑ We are a non-profit organization,staffed by volunteers, 11.0 Health Care
with no employees. [No workers' comp.insurance req.] 12. Other Cw�f-IEfZtt►L (O Z.��
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
**If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an
organization should check box#1.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information.
Insurance Company Name: `7?ZAV?_L(A 2 t
Insurer's Address:'T2,av El M Lo,,,.,,rA c t •L LI-Its Flo, F-S-V �;4,o0 Z- -..,o CT
City/State/Zip: PA&_ usr_4 GT
Policy#or Self-ins.Lic.# T F _Ti.R -nL X�2Expiration Date: ZO T
Attach a copy of the workers' compensation policy declaration page(showing the policy number and a piration 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
Sienature• Jh h, 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.Licensing Board 5.Selectmen's Office
6.Other
Contact Person: Phone#:
www.mass.gov/dia
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: 10 Nom ELH sr>tc-aT MggTnpmQprm+t
The debris will be transported by: M-B&L.DkW4 P O HOk 9:11 Wilk xnS6u!!3 nva o'
The debris will be received by:
Building permit number:
Name of Permit Applicant
k
Date Signature of Permit Applicant