29-408 (13) 89 SANDY HILL RD BP-2021-0037
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29-408 CITY OF, NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE.GUARANTY FUND (MGL c.142A)
Category:Deck .-BUILDING PERMIT .
Permit# BP-2021-0037
Proiect# JS-2021-000052
Est.Cost: $5000.00
Fee:$13.60 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 17206.20 Owner: ST ONGE ALBERT J
Zoning: Applicant: ST ONGE ALBERT J
AT: 89 SANDY HILL RD
Applicant Address: Phone: Insurance:
89 SANDY HILL RD (413) 584-4198 O
FLORENCEMA01062 ISSUED ON.711012020 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL 8'6"X 8' DECK TO REPLACE STEPS
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
ina1: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 7/10/2020 0:00:00
$X10 1`�
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212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
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" The Commonwealth of Massachusetts
o Board of Building Regulations and Standards FOR
z M Massachusetts State Building Code,780 CMR MUNI�E ITY
° � Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar-201.1
D c '— One-or Two-Family Duelling
C)° "t' This Section For Official Use Only
zG) o
7` N Buil"d"ing Permit Number: .• Date Applied:
a� oMD
4
SCM)
z �cial(Print Name) Signature Date
N ! SECTION 1:SITE INFORMATION
peg, �dfess14 : /1 Q ].2 A,ss�r�Map&Parcel Numbers'D R
I.1 a Is this an accep d'street?yes no "Map Number Parcel Number
1.3. Zoning Information: 1.4 Property Dimensions:
7/
Zoning
F
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
I
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone?
Public 19 Private El — Check if yesM Municipal 91-On site disposal system El
SECTION 2: PROPERTY OWNERSHIPI
2.1 O er'of Record• //
Name(Print) City,State,ZIP I
�q "�o 114 l C( Rep y15 6Tq ql9 g Tc.s! s'�/ Z Co K c,e s4 ne.
No.and Street Telephone I Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORKI(check all that apply)
New Construction❑ Existing Building'13 Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ I Addition ❑
Demolition ❑ Accessory Bldg.❑ Number ofUnits Other JK Specify
Brief Description of Proposed Rrork-2: _T1L s4Fc( mac,e- a 017 f 0 & , k Ss ltc'Xl to CeVV
rdr j" S�e,>rl
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Offci�ai Use Only
(Labor and Materials)
I.Building $ 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical ❑Standard CitylTown Application Fee
❑Total Project Costa(Item 6)x mnitiplier x
3.Plumbing $ 2. Other Fees: S
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire S
Suppression) Total All Fees:$
Check No.111q..:Check Amou Cash Amount:
6.Total Project Cost: $ 5,Oad ❑Paid in FuIl 0 Outstanding Balance Due:
SECTION 5: CONSTRUCITON SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildin s up to 35,000 cu.ft.)
R Restricted 18,:2 Family Dwelling
City/Town.State,ZIP M Masonry '
RC Roofing Covering
WS Window and Siding
SP Solid Fuel Burning Appliances
I Insulation',
Telephone Email address D Demolition
5.2 Registered home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company l�Tame or HIC Registrant Name
No.and Street Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS':COMPENSATION INSURANCE AFFIDAVIT(NLG.L.c.152.y 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...........0
SECTION 7a: OVVWER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties ofpetjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
& r f. OIL q,--
Plint Owner's or Authorized Agent's Name tronic Signature) ate
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who Hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have'access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.massmov/oca Information on the Construction Supervisor License can be found at www.mass.sov/dns
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
1 .3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
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Proposed addition of deck to front of house
' i +' dee
Deck size 8 "6 wide X 8 p
89 Sandy Hill Road Florence, MA. 01060
Drawing not to scale
Drawings by homeowner.
Project material cost $5,000 Deck construction by homeowner.
22'
J
/main House
4'
Garage
-'!2'approx.
Proposed area
8'
Driveway o
�— 8'06
Sandy Hill Road
Framing Specifics Ledger & Flashing
�*--�--Bernt aluminum flashing under siding
Copper film flashing Membrane like zip tape to
-7against house IN, protect aluminum from P.T.
2"x8"P.T. ledger
Joist
Ledger loks into
Footing and post house rim joists 2"x8"joist hanger
�J bolt with washer and
grade nut.
8"sonotube
Two footings and
Beam
sono tubes poured
approximately 7'
from the house and
6'apart.Top of tube 2"x8" P.T.Joists 2"x8"
will have a J bolt to Installed 1'O.C. box/rim
hold an approved "poured footing at - Joist
4"x4"bracket. bottom of the hole.A
piece of rebar will go
from ground through
4"x6"p.t.beam
footing into sonotube
4"x4"post with
approved connect-
or to beam and
sono tube
J bolt
8" ono be
Deck view
DOOR to house
Azec or a another synthetic
type decking material/black
line is picture frame border
S
Orange line is Westbury vertica-
ble railing 36"high
8plus to allow for full deck board
2"x8"pt joists 12"O.C.
f 4"x6" PT beam tied to 4"x4"with
Stairs approximately 4'
wide
5 rises at approx.5 5/8" 1
4 treads approx. 10.24" 8P6"
Total rise approximately
28"
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The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Streets Suite 100
Boston,MA 02114-2017
T www mass gov1d is
I orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Aimlicant Information Please Print Leaibl
Name(Business/Or,anization/Individual): Ile
Address:
r-J- 1) ,V/3/�City/Stztc/Zzr: �'i C rlar�ic 7 3
Are you an employer?Check the appropriate box:
Type of project(required):
1.17 1 am a=player with employees(full and/or part time).• 7. F1 New construction
2.❑I am a sole proprietor or partnership and have no employees working forme in $. []Remodeling
any capacity.[No workers'camp.insurance required.]
9. []i Demolition
30 am a homeowner doing all work myself.[No workers'comp.insurance required.]f i
10 0 Building addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.❑I Electrical repairs or additions
proprietors with no employees.
12.Q Plumbing repairs or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet.
'These sub-contractors have employees and have workers'comp.insuraneet 13.7Roof repairs
6.❑We are a corporation and its officers have exercised their right of exemption per MGL e. 14.g Other aC X
152,§1(4),and we have no employees.[No workers'comp.insurance required.)
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
I Homeowners who submit this affidavit indicating they are doing all work and then lore outside contractors must submit a new affidavit indicating such.
tContraciors that check this box must attached an additional sheet showing the name of the sub-counactors and stare whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. j
lam an employer that is providing workers'compensation insurance far my employees Below is the policy and job site
information.
Insurance Company Name:
� r i
Policy#or Self-ins.Lie,#: Expiration Date:
Job Site Address: . City/State/Zip:l
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL e. 152,§25A is a criminal violation punishable by 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.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 thepains and penalties of perjury that the information provided ab' a 7sueand correct
Signature: Date: 7--b
Phone#: V1 - Y13 7 Gel
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#:
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1 � The City of Northampton
W �
Building Department
�r aY �h 212 Main Street
Northampton, Massachusetts 01060
Phone(413) 587-1240
Fax (413) 587-1272
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CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVAT ION PROJECTS)
In accordance with the provisions of MGL c40, s54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility as defined by MGL c 111, sl 50A.
The debris will be disposed of in:- h , r
Location of Facility j{io
�b 111A
The debris will be transported by:
Name bf Hauler 41141 VVd .c
,
Signature of Applicant: Date:
City of Northamptoft
Massachusetts
DEP R2HE tem OF BUJMDTNG 2NSPECITONS. i r
212 Main Street • Municipal Building a
Northampton, MA 01060 .yy, �'t
III
HOMEOWNERS EXEMPTION ELIGiBILn Y AFFIDAVIT /
f, f (insert fulllegal name), born! sett
month, day,year), hereby Obse and state the following:
1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.85.1.3.1, to connection urith a project or .
work on a parcel of land to which I hold legal title.
II
2. I am not engaged in, and the project or work for which I am seeking the' aforementioned homeowners'
exemption, does not involve the field erection of manufactured buildingscpns-hucted in accordance with
780 CMR 110.83.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2:
Person(s) who owns a parcel of land on which he/she 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 aiid/or farm structures. A person who constructs more than one home in
a two-year period shall not be considered a home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I
qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of
the project or work on my parcel, I am not engaged in construction super Ivision in connection with any
project or work involving construction, reconstruction, alteration, repair, removal or demolition
involving any activity regulated by any provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on
my parcel,I acknowledge that I am required to and will act as the supervisorfor said,project or work.
Signed under the pains and penalties of perjury on this_7 of 4320_.—
Signature)'
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