31A-097 (12) BP-2022-0347
63 VERNON ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31A-097-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2022-0347 PERMISSION IS HEREBY GRANTED TO:
Project# PORCH Contractor: License:
Est. Cost: 60001 JONATHAN TOSCH 116108
Const.Class: Exp.Date: 10/08/2024
Use Group: Owner: BURNHAM SOPHY
Lot Size (sq.ft.)
Zoning: URB/WP Applicant: JONATHAN TOSCH
Applicant Address Phone: Insurance:
312 AMHERST RD (630)902-1627
PELHAM, MA 01002
ISSUED ON:04/07/2022
TO PERFORM THE FOLLOWING WORK:
DEMO DECK AND ADD SCREENED PORCH
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:
Gas: Final: Final: Rough Frame:
Rough: Fire Department Driveway Final: Fireplace/Chimney:
Final: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Cgl •10
Fees Paid: $390.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
-
File #BP-2022-0347 `/�
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APPLICANT/CONTACT PERSON:JONATHAN TOSCH
312 AMHERST RD PELHAM, MA 01002(630)902-1627
PROPERTY LOCATION 63 VERNON ST
MAP:LOT 31A-097-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $390.00
Type of Construction: DEMO DECK AND ADD SCREENED PORCH
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
pproved 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 SpecialPermit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER:
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Perm its 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
sisi2 LI 7 ZOZZ
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.
i I- :---3—E-a-EVIE-----'7 '' IL)
I�0_ APR - he C mmonwealth of Massachusetts
6 20oa d of uilding Regulations and Standards FOR
/'-. 1--PT
Mas achu efts State Building Code, 780 CMR MUNICIPALITY
PT OF Bf�1t,DINT qP T USE
I ._ NOFilu t, _____ pOlica ion To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
—--One- or Two-Family Dwelling
This Section For Official Use Only
Building
Permit Number: 3P e .� 3 Date Applied:
14-uIt--1 420s3 // Z- LI-7-Z.OZ7_,
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 ropert Address: sessors Map& Parcel Numbers
3 V Iu'of sT �+ 09� —odl
1.la Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: • s:
(Ina
Zoning District upai Lot Area(sq ft) Frontage(ft)
ng Setbacks(ft)
I i ont Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
ZO 7OOf4- +
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood 7 me?
Public 5f Private 0 Check if yes Municipal VOn site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
1PNy gvkivii '7 NOr111AA,tp7oty, M/t OIOGO
Name(Print) City,State,ZIP
63 VERNam cT
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition c
Demolition 0 Accessory Bldg. 0 Number of Units_ Other 0 Specify:
Brief Description of Proposed Work': arAtif G171N lam✓ IF riff DELIC Ca/rf7n P e7A'4'
a ' M6w JGn-EEAI/ PoR a . RA/s/M,C #6/t/frfre vE a'thew
., °F .
!JEw RA/1ii etv Ekif7/p ' OEJk Mdvr r AL:L«rE— To F AtrO ff
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ 44 it,U 1. Building Permit Fee: $ Indicate how fee is determined:
0 Standard City/Town Application Fee
2. Electrical $ Z.0 00 0 Total Project Cost' (Item 6)x multiplier x
3. Plumbing $ 2 de 0 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression Total All Fees:_
Check No.1 Check Amount: Cash Amount:
6.Total Project Cost: $ &o d 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) /1 / /0 D o/a f 2 t3
)o /iWIA 1V areII-- Lice(nse Number 6 xp ation ate
Name of CSL Holder I /
3/^ /7 d M c n f r kV List CSL Type(see below)
No.and Street Type Description
Pt/i�tT/�M� M 4 ��� U l Inrestricted(Buildings up to 35.000 Cu. It.)
GI R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
�r
SF Solid Fuel Burning Appliances
�O3o 9oZ 617 J 6NO,?0JC N&4�'A/ 'c I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) n g�, p �/I��A ,
d ONf�-7�A N TD re if- HICCRegistration Number Expiration Date
HIC Vpxy Name or IC Registrant A Nit-Eli7 Na�� Jo AID. Toft II& ('MA/G. Co61
No and Street Email address
p L«.4M M4 cl/oo 90.2 ton
City/Town,State,ZIP Telephone
SECTION 6: 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
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT TT
I,as Owner of the subject property,hereby authorize l f ' Ca 4F 7/2 UGT Cof Lii C
to act on my behalf,in all matters relative to work authorized by this building permit application.
f OPNY eva#HAbl
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
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.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
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
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
CITY 0 THAMPTON
SETBACK PLA
tr
T:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
o , ?i,
4 1 s� �!C
Massachusetts ��. _ !cr
-`virr � $r DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building b
`,"r. � P $
Northampton, MA 01060 le 4— 5
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, 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, S 150A.
The debris will be disposed of in:
Location of Facility:
The debris will be transported by:
Name of Hauler: A ki,ithl ? 7fWGi-iau 4_
Signature of Applicant: Date:
The Commonwealth of Massachusetts
Department of Industrial Accidents
"--"
1 Congress Street,Suite 100
Boston, MA 02114-2017
www.mass.gorldia
11'otkers'Compensation Insurance AMdavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PEItMEITING AUTIHUTV.
Applicant Information Please Print Letibls
Name Hui nesk,Or ganizzuomhusividuisi4. Tdif exi et.f/vd7/14/6-f toe/
Address, ,?(.z,
Citve State/Zip: tt,f/ifi tilif a(002__.Phone #: ieo (02_ / 02.7
Are yorr MR employer?Cheek the apprnpriart boa: Type of project(required):
I C3 1 am a employa with empkoyees(full anikor part-time).* 7. g New construction
t am a auk prumwtor or partnership and have no employees working for me in 8 11 Remodeling
any capacity. (No workers*eortm.insurance respitrol,)
9..cj 1 ant a lionsoowner doing all work myself.[No workers'comp_ansuramv restittrettl [I Demolition
10 0 Building addition
40 I a lanntovi net and will be hiring 4.,Arntraciurs to conchal all work on my property. 1 will
morn:that all contractors either have workers'cionspenarmai insurance VC are sole ii.0 Hectris:al repairs or additions
proprietors with no employees,
12.0 Plumbing repairs or additions
sCi I am a geneaal contractor and I have hired the sub-contraciors listed on the attached sheet
3,0 Roof repairs
Thew itub-etintractors Isiis,e employees and have workers"comp.insurance
14.0 Othei
6.t41 art a eorptwation arid its officers have tam-hood their ngha of ear:moron per Wit.c,
11,2_1 I 4 1,and we ha.,.no employees.(No workers comp.IftliUttillteraCIUITVALI
'Any appl want Mat itheeks hot al must alsonil out the weetion below Auviies then workers'compensation polar. informatton.
*Iltnrionaners who sikinit rho atria:vat ualrealing they arc doing all work and then hire outside emitmetors sonar submit a new Aidesii indwating such
tintractors that cheek this box moat aLIZA:66:11 an additional sheet NhoNing the name of the ASA,<."Dritruler,and,rare ar holier in not those entitle,ha%
'uric-, it hase the‘ niu>4 pro.,ide their workers"veiny.pub.'s outtibei
1 am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy r or Self-ins,Lie.#: Expiration Date:
Job Site Address: _
Attach a copy of the workers'compensation policy declaration page Ishowing the policy number and expiration date).
Failure to secure coverage as required under MGL e. l 52.§25A is a criminal violation punishable by a tine up to SI.500.00
aniVor one-year imprisonment.as well as civil penalties in the Inn 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 Of of Investigations of the DIA for insurance
coverage verification.
I do hereby c under the pains and penalties of perjury that the information provided above true an correct.
Signature: Date,
Phone AI: 0 Pik iC
Official use only. Do not write in this area,to be completed by city or town
City or Town: Permit/license N
Issuing Authorits (circle one):
I.Board of Health 2. Building Department 3.('it 'Town Clerk 4.Ekctrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
City of Northampton
Massachusetts 74",
.:l
.111
DEPARTMENT OF BUILDING INSPECTIONS l � a
212 Main Street • Municipal BuildingJq ..�•'
Northampton, MA 01060 S' 1d1�'
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, (insert full legal name), born _ (insert month,
day, year),hereby depose 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.R5.1.3.1, in connection with a project or work on a
parcel of land to which I hold legal title.
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 buildings constructed in accordance with 780 CMR 110.R3.
3. I qualifij 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
and/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 supervision 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 supervisor for said project or work.
Signed under the pains and penalties of perjury on this day of 20_.
(Signature)
r1 l �
e.! i�e t 'trCa'/<
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
TYpe: lndiviclual
JONATHAN TOSCH# Registration: 202809
312 AMHERST ROADExpiration: 08/1 112023
PELHAM, MA 01002
Update Address and Return Card.
I TS 20M-051177 /�
�'Btre6/6f relfS4St4 t gra &�31ralt "Rsyuf lion
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Individual before the expiration date, If found return to:
Registration Expiration Office of Consumer Affairs and Business Regulation
202809,, 08/11/2023 1000 Washington Street -Suite 710
JONATHAN TOSCH Boston,MA 02118
JONATHAN R,TOSCH
312 AMHERST ROAD
PELHAM,MA 01002 Undersecretary Not valid without signature
•
Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Re uiationsT and Standards
Cons t, r` �Ie/on S visor
CS-116108 spires; 10/08/2024
JONATHAN TOSCH en
312 AMHERST ROAD
AMHERST Mk 01002
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