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BP-20-161-2 File#BP-2020-0161 7� APPLICANT/CONTACT PERSON RENAISSANCE BUILDERS ADDRESS/PHONE P O Box 272 TURNERS FALLS (413)863-8316 PROPERTY LOCATION 78 MAYNARD RD MAP 31A PARCEL 167 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCL ED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ADDITION TO EXISTING BUILDING DECK AND ACCESSORY BUILDING New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included: Owner/Statement or License 013302 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9RMATION 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: 96% 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 0-) Signature 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. .mac not � r t tlr_ ., K ate 0 1 City of Northampton Status of Permit: Department use only Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability ' Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans - -^k phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: 9 p This section to be completed by office r�q' ,' l ( f�l l�(� Map '�-7 Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Pont) Current Mailing Address: e_ "d, n��Aq t L Q' 14���� nS[1� �'fO Signature Telephone 2.2 Authorized Agent: Name(Pd urcent Mailing Addr s: Si nature g Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only _ com leted b permit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee �j ^ 4. Mechanical(HVAC) 5.Fire Protection / 6. Total=(1 +2+3+4+5) 7( ,/ �' Check Number 7 12 This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date r, EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) £ 3 1,71 '-r+ y �P An list W r •. n A�:= 1ti_er; e6 �i< Tx 4 pw kL > v,,.a yE i '•+ ,t- ._ .........y_,t„ 7. Aso,!Rol KMAy- f jQ Al vx� '�`_. •s.�.-'�"aT'.s,a >~ 4":' „��„'a�pt,y_' a: ,� fir`,.�'-� � - � -�, �s` '� c . i 07 �.. Fy r r •.-r. any �:�'!t•3r _. .:'? i`[;�.s �C3 . ,.i'15���i= a.. 'v,:�T4� .!:`��,-`�l.�k �;*-. :Geii�f"s�.' '�°,-! .r 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 filled in by Building Department Lot Size Frontage Setbacks Front (fid . r Side L: R: Lf;tS�R:E-1—f C� Rear Building Height Bldg.Square Footage f��/�I'� "/o Open Space Footage F V % Q � (Lot area minus bldg&paved arkin -� #of Parking Spaces Fill: volume&Location 1 A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DON'T KNOW � YES IF YES,date issued: ], IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW © YES O IF YES: enter Book --j Pagej _� and/or Document#�_� B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW 10 YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained Q Date Issued: C. Do any signs exist on the property? YES O NO 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 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading, cavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES© NO .r IF YES,then a Northampton Storm Water Management Permit from the DPW is required. TWIT boy Kx f t 5 ly! s.: i r f -.t y -�.. fit` -p). ) - •_ ; t - .. r..�,;4t, 17 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition Replacement Windows Alteration(s) j Roofing Or Doors D '""`�� Accessory Bldg. Demolition ❑ New Signs [0] Decks Siding�]d] Other[E7 Brief Description of Proposed �` l Sf,� b,1d+�'�( (2_I <� //fjC�C.lC�! f,Lt to Work: Alteration of existing bedroom—K Yes No Adding new bedroom_ Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Ma l_ '� �Aso tilr� f 6a. If New house and or addition to existing-: 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 rconstruction. lr.�' Dimensions e. Number of stories? /J� q^� f. Method of heating?� �PLVV&(+ CfC KaAS Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction Act KICI— 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 El k. Will building conform to the Building and Zoning regulations? n Yes No. I. Septic Tank City Sewer Private well City water Supply >4:— SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETEDWHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, A V,-�,1306 t AO �h as Owner of the subject property hereby authorize to act on my behalf,in all matters relative two work author ze by this building permit ap lication. �� a� Signature of Owner Date Authorized Agent hereby de tare 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 pedury. Print N e Signature o wner/Agent Date f y •_, ," M S .. sS � � ,F' +g`v6L 7 i}'Lc �, max_�r - �•.< y;,. T t :M-'s n J 4: t• 7-may 1`t 4 F'1 � l�%I'{� ' w'� SEESAW s.iqp d1^t4 M _ m -r t Lait _ E ' i"A ; sly SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Su ervisor: Not Applicable ❑ Name of License Holder Ca' 133d,- License Number (T- 1 .7- t Address Expiration Date Signatur -R I tered H me�mrir"ov"men Contra r= S r x. Not Applicable ❑ "�f���___{l Company Name Registration Number Adrdesj / Expiration l5ate Q elephone v 3 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....... No...... ❑ 7 , t . M e . i} swo owl 36 Ft x. "ia .- Renaissance Builders P.O.Box 272,Turners Falls,MA 01376 (413)863-8316,Fax(413)863-9712 www.renbuild.net Louis Hasbrouck Building Commissioner City of Northampton Building Department 212 Main Street Northampton, MA 01060 I, the undersigned certify that I am the Owner of the property located at 78 Maynard Road, Northampton, MA. I hereby authorize Stephen Greenwald of Renaissance Builders, 390 Main Road, Gill, MA 01354 to submit a building permit application on my behalf for the renovations at Ampersand Sprout, LLC. I agree to conform to all applicable laws of the town and state, and I believe the work proposed to be in compliance with all zoning regulations and the Massachusetts State Building Code 780CMR. Signature of Owner: Printed Name: Date: C) p ( The Commonwealth of Massachusetts viDepartment of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): RENAISSANCE BUILDERS Address: PO BOX 272 City/State/Zip: TURNERS FALLS MA 01376 Phone #: 413-863-8316 Are you an employer?Check the appropriate box: Type of project(required): 1.[ I am a employer with 24 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' insurance.$ 9. ❑ Building addition comp.[No workers' comp. insurance P• 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 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ 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#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors 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. I am 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 CO. Policy#or Self-ins. Lic.#: MCC20020004972019A Expiration Date: 01101/2020 Job Site Address:_ 3 1 � rd City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). b l6(pQ 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert' under the pains and penalties of perjury th the information provided above is true and correct. Si nature: Date: Phone#: 413-863-8316 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: ,?,.� 1i;9:i'�:.a Da to ; t•f^ '�. ._ 4 '. y, -. 2 j ,•. i 5 •.:d•' tF t _ c- a tr "i'w{ .. .. '� ; ' t,,...; ^ s , 1f A 1 .. 2:0 t a a f f r - .�:s i iita�YF 4staijf "i ,m 'ep d Mika cards 1114544c, su ,. ; s,.. .}'SE-,.,. ;y.a, t._.t''EYS. :a..., .. _ i 'Ei..�• .u. ?..° !. , .. !-t u.�c;a�TMl, ,a' . . r !'_.... ,_.Sa....t.;.Y two e - ARM . � ��• r .p t4� .. SS? _y s, ,..Sii t�e 14^ D ., a,,!>'s.. 1i�43=.':p s� .. `!( .^;);e,.... ,. . ... , �� *� .i� Ft� •4 t.,',�3.. �"t ,; x•f_�.h, .`a`;✓� .... t l :`l:..=;'.z.. i � z �E , z ? �I_`•:§ €'&; Y i i�Atit •hl. '.t a ci ;t'D4!. ;3. ;> .r, 3 1 1Z . t t �, ... . .w t`� L.,Ii _ ..ti- ,: t a -s:i� r•.f 3t 1�_ ) a s{ 't"t"F „i2,. 'ilt � _. ,:..Zt aF �'ct' ,� .... , TAW, s Ann*VID? yl :;^_ _ . . ._.-.. __ __ ..� ... _....� 'SRR i{`+-��-i KA•:S.)`^ ;-:: -54'�'�3+�1,. _t ':?it4, „ _ � .. .t .. .: .., .. �� i s; Zz .. know t ij }� ta.51e ,.�:aSat' . ^c ,�:,}'. a. •Ss';� _a... > �', _.. - --..______. ? Office of Consumer Affairs and Business Regulation One Ashburton Place- Suite 1301 Boston, MaUfthusetts 02108 Home Improve - Qtractor Registration Type: Individual RENAISSANCE BUILDERS Registration: 106490 Expiration: 07/22/2020 P.O. BOX 272 TURNERS FALL,MA 01376 e soya yy$�a ger ��e Update Address and Return Card. SCA 1 1'a 2__0MM--05/177 Vfie fpo�rintovzuseac[2 o�VaGG,Edac�C[6e1�6 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TY F E-Individual before the expiration date. If found return to: R istr- f ,\ Expiration Office of Consumer Affairs and Business Regulation _ 07/22/2020 One Ashburton Place-Suite 1301 ;j� Boston,MA 02108 RENAISSANCB1�. �- � � 11" ly 1 STEPHEN J.GR 390 MAIN RD. ° GILL,MA 01354 Not valid without signature Undersecretary < r i a r t�,•. Jyy Ut. J ti ,. 1 -..731 t�� s� ,i<'{i.si'• IS I Al s b :# i �F Y l ',6aF!S.J iR4:l ffih F"? F. ATq`.ax'� f!INf%1'F'- "91.;'••p^ ;t'�,as y h? 16 G, +;,i v tY:�}n rk'.'4Al'Srt:` "!.".r t"'v sSA"•+'t rtL.i.i'"7; -.,` i t+:tsDlt'f�s32(:7 i4'r'E1 id -?'5:' pi vac ul",, ar?}�it gc.i. A rdmlian9 9 fO 6O - cs, 1?h ad * r r x Y' tay.,Yq�,.VI; W ?w :.'leavI't.'� Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-013302 Expires: 08/17/2019 STEPHEN J GREENWALD 1 390 MAIN RD ' GILL MA 01354 f Commissioner AJ to u Cky,O:AM az City of Northampton Massachusetts ��r ,�;,` •.;<< F. ® � ..wi' DEPAR78ENT OF BUILDING INSPECTIONS o}� 212 Main Street • Municipal Building Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes.Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction,alteration,renovation,repair,modemization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note.If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: U►(�(�(QVI D Est.Cost: 75isy. Address of Work: Date of Permit Application: — I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under$1,000.00 _Owner obtaining own permit(explain): _Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: 7 I(0 t 6 aj, asgn lip -Ib a Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature ..s !Wall to to=&= -° Vy c ^ s , t :30 ,�y G'v now v }') kv NY 411 0,113P NOWN"I'mr ! .eyt3x :MWAFT f93w On"On"t tipsy 4Afts; ,.,t t }"' isd '9Hoy, A,..Nvj yvivaAWA("119 MW BEE:;'t,lS.,'A!'" s , , "CUPS Ai Pa {)r: A!MAI" is '4 H t : $Ulm my!RX, r i City of Northampton / Massachusetts .G 1 m? !' DEPARTMENT OF BUILDING INSPECTIONSy?� >�+ 212 Main Street •Municipal Building yX +a Northampton, MA 01060 6ss`• bC Debris 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. The debris from construction work being performed at: ---I �,, 01m tuo j 6 J, (Please print house nuniber and street name) Is to be disposed of at: f4 W- � � A � (Please print name and location of facility) f Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Signature of Permit Applicant or Owner Date If,for any reason, the debris will not be disposed of as indicated,the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. � UP ?.t* r+ lo 6 '%�,. v `, eVi'tsr:' .'._CiCf'� "i•,, t�iir.`fhe_ .. .�._. J -j;.,:.1�v�` -., c`s."3 J'_" i 1 i,;.�f'ry � Ii.P .-•' T'�'.:i�i'�i -d V x �!A w t.:.'• ... '[h S' fl -SIC `. {Z'h rti tid 777777777- REIL NAISSANCE BUDERS 3 6 5 6 (413)863-8316 EZ sE<wEoe. PO BOX 272' TURNERS FALLS,MA 01376 53-7079/2118 Pay to the order of �/1jC�i: f'1� I 5 Greenfield Savings Sams 1-888-324-3191 r For P�7LM/f — f �fh'� fjfJ2(a{-a —,� ----------------------------- — 11'0031 5S Co 1. 2 1 La 707991: 16 00 0 L40 2911' tee- -7 ff ..y. 4y s �` ., .: 5 s�'`asx✓F.,'- as�xy � `` %� h A gx 3 -.`s'�t `�.<' •i, t '.'.-i .g, �' :%,ri3 wy d .- < ,t a r^ "Ql -' .M ' 7y,�r r,..S a 'tom tff 4 Wit, ;-` �#" � :- � .� "� -�,yr'..3Y '� „* .t _ '�f� �...�. ,�,�+'s.' � �ga'4c �. t�f� a- �'� £'_` .W.,,✓ �`"�•�,. r.c� '�'�.-r' •.�:� e+ 0 � ar, tam �. jw' - K ¢� �• r� W, 's�,..� �,� `{",� a`k '€* 1 c ,� a-. ,;"T i �,,3 x s3"'RA -r S «� ta� kz .u L •a, '3 .ris �' S+ .g•-='k 3 '' a 4 �r.'x:.x a x' , b sM- '+ f ;Ni�'.,�. 5 3 �. $' lop t z t _ o � t, Renaissance Builders PO Box 272, Turners Falls, MA 01376 Phone(413)863-8316; Fax(413)863-9712 www.renbuild.net July 26, 2019 Louis Hasbrouck Building Commissioner City of Northampton Building Department 212 Main Street Northampton, MA 01060 Enclosed is the Building Permit application and a check in the amount of $4,875.00 for the permit fee on the property located at 78 Maynard Road, Northampton. Marta Rudolph owns the property. Digital plans with specs have been email to you to accompany this application. Please contact me at 413.863.8316 if you should have any questions in regard to this application. Thank you, /f r Donna Flagg Enclosure a $! Nov° t.i, �L; 5(:`1 .•c eo e _ t 00 tt F .. .. e'- c. . i g �...�. - :� . ...�:�:. �fis�9+w`W�"��M'1gSY.diiTYPi.T•E',���Gu':_.... _ .. �_._. ter._...- ,