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362 Kennedy Rd.
Leeds, MA 01053
(413)695-6487
City of Northampton
Building Department
212 Main St.
Room 100
Northampton, MA 01060
(413)587-1240
8 April 2014
To Whom It May Concern:
Jennifer Wasmer, of 61 Crescent St. Unit#5,would like me to build a deck.Given the straightforward
nature of the job, my years of experience performing similar work,and the modest scope of the project,
I am requesting permission to work on Unit#5 without the sign-off of a registered architect.
Kris Thomson
Kris Thomson Carpentry
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362 Kennedy Rd.
Leeds, MA 01053
(413)695-6487
City of Northampton
Building Department
212 Main St.
Room 100
Northampton, MA 01060
(413)587-1240
27 March 2014
To Whom It May Concern:
61 Crescent St. is a condo association with multiple units.We have been granted the opportunity by the
association to build a deck for Unit#5.
Unit 5 is a second-floor unit.The deck will extend over the flat roof of the first-floor unit below.The
existing membrane roof still has at least ten years of life remaining, but to satisfy the association,we will
add an additional layer of 0.060 reinforced EPDM under our new deck,with a footprint of approximately
225 square feet. We will penetrate the existing roof to access the rafters,which are embedded in mortar
in the lower brick wall of the building, in order to mechanically attach the deck at various intervals(see
drawing).Our new membrane will encapsulate the attaching brackets.
All framing and fasteners shall be as specified by RK Miles. Posts,top rails, and bottom rails shall be
mahogany. Mid rails shall be horizontal cable,with spacing to code.All decking shall be composite,face-
fastened to retain maintenance access to roof.
To access the deck,we will modify an existing window(20"wide x 65" high)to become a "door,"and
build the required 3'x 3' landing on each side of the door,with steps on the interior.
Thank you,
Kris Thomson
Kris Thomson Carpentry
The Commonwealth of Massachusetts ,
x Department of Industrial Accidents
Office of Investigations N
-, 600 Washington Street
. .= Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leaiblv
Name(Business/Organization/Individual):
Address: ,121-1 c
City/State/Zip: J 18 Phone#:
F 11re you an employer?Check the appropriate box: Type of project(required):
.❑ I am a employer with 4. El am a general contractor and I
6. New construction
employees (full and/or part-time).* have hired the sub-contractors
- - -
I am a sole proprietor or_partner- listed on the attached sheet. 7: ❑ Remodeling
These sub-contractors'have
'p and have no employees 8. ❑Demolition
working for me in any capacity. employees and have workers' 9. ❑Building addition
[No workers' comp. insurance comp.insurance.$ - -
required.] 5. ❑ We are a corporation and its 10.F-1 Electrical repairs or additions
officers have exercised their I L Plumbing repairs or additions
�.❑ I am a homeowner doing all work ❑
myself. o workers' comp. right of exemption per MGL
y [N p 12.❑Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers'. 13.❑ Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showingtheir 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:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy 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 certify the pains and penalties of perjury that the information provided above is true and correct.
Signature. — Date:
Phone#:
Of use only. Do not write in this area,to be completed by city or town officiaL
_--- —City,-Town: ---- _ - -__._ __ -Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
r
Version 1.7 Commercial Building Permit May 15,2000
]771
g
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR:110 11)
Independent Structural Engin eering Structural Peer Review Required Yes No
SECTION 11 -OWNER:AUTHORIZATION-70:BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property
II i
hereby authorize al. ate- _..___._..m .._._...____-.___.._.._..___u _.... ......__ _....._Ao
act o y behalf ' II matt er relative to work authorized by this building permit application.
Signature Owrpr Apat e
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
Print Na
Signa ure of Owner/Agent Date
SECTION 12-CONSTRhJCTION:SERVICES -
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:'_ � 5 Oti'1r�XwC C S
w_
License Number
Address Expiration Date
Si Telephone
SECTION 13-WORKERS'COMP..ENSATION 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 O
• S
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION.SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
1..
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING.MORE THAN 35,000 C.F.OF EN
LOSED SPACE)
9.1 Registered Architect:
Not Applicable El W - .
Name(Registrant):
J%�a Registration Number �mm
Address _ ``-
Expiration Date
Signature Tel phone _
9.2 Registered Professional Engineer(s):
MA
Name Area of Responsibility
_____.._. _.._..._..
Address Registration Number
s
Signature Telephone Expiration Date
Name Area of Responsibility
:
Address R�qistration Number w
Signature Telephone Expiration Date
Name Area of Responsibility
i
Address Registration Number
F
Signature Telephone Expiration Date
r_ <. ._.W _...._.__.._ _.......- __ ------
............._._..___... ...__,.......__.._ _.... _.__ _._._.. ...______...__. _.__.... ___ .___._.. _... ..._...__.. ___.._. .._.._ .._..._.. _ ............
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
r Ir ✓
<> C cu -E �✓
0._.... Not App
t7� licable ❑
Company Name:
Responsible In Charge of Construction
-Address—_
Signature Telephone
Versionl.7 Commercial Building Permit May 15,2000
8_ NORTHAMPTON ZONING
Existing Proposed Required by Zoning .
This column to fee filled in by
Building Department
Lot Size
Frontage
Setbacks Front __
Side L _ R -- L:L._ - =
Rear
Building Height
Bldg. Square Footage
Open Space Footage ___� % _._,,
--- _
_
-- (Lot area minus bldg&paved -
...y...
parking)
#of Parking Spaces
Fill:
(volume&Location) -- - -
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
- NO 0 DONT KNOW YES 0
IF,YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0 M
IF YES: enter Book Page= and/or Document#! ry
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 0 , 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
_- IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,a avaticn, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
.:
Versionl.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❑
Brief Description :Enter a brief description here.
Of Proposed Work
. _. .-r, _ JAI
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ - - == - 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
PC- R Residential R-1 ❑ R-2 R-3 ❑ 5A
S Storage ❑ S-1 ❑ S-2 ❑ 5B
U Utility El Specify:'
M Mixed Use ❑ Specify ! H
SSpecial Use ❑ Specify. .� ...._..,_ _.,.._.�,-,..�..,..m__H,_,...,,._�.��,....-.w.... .._.._..__,._..�,.,K.....��.._..,..v. ._.��!
COMPLETE THIS SECTION IF EXISTING'BUILDING UNDERGOING.RENOVAm.NS,ADDITIONSAND/OR CHANGE IN USE
Existing Use Group: � _ Proposed Use Group: __.,.._.. ___.. __._._
Existing Hazard Index 780 CMR 34) 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(sf)
St ... _
1 St .... .._........_._,_ - _..-...,............_...... - - -
� � _ w
2nd .
2^d ...._...._._._____._..._____
3rd
3rd
_.__. _ __ _. _ 4u,
4th
Total Area (sf) Total Proposed New Construction(sf) _
Total Height(ft)
---- ---- -._ 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 Zon Municipal On site disposal system E]
Version 1.7 Commercial Buildin .Permit May 15,2000
,Departure t use,,only
2 0 City of Northampton status afi PerEnit h s
L5 � Cur P3SY � 9 b h *C lk
a
Building Department b:Cuf/Dnuewa Permtf F m,
ak
212 Main Street Sewer/SepticAvailabltfy
162014 Room 100 Wate/Wep Auallabiilf
Northampton, MA 01060 Two Sets ofi StructuraE Plans
EN C*i c, Plumbing g Gays l ne 13-587-1240 Fax 413-587-1272 Plat/Srte plans
Northam ton,MA 01� Ofher SpeClfy ,;
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
This section to.be completed by office '
1.1 Property Address:
Map Lot Unit
(� 7 Zone Overlay District
Nock �o rn / G 0 ) d bZ
EIm St:`District. CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT.
2.1 Owner of Record: _
Name(Print) Current Mailing Address:
Signature ��i�--�' Telephone
2.2 Auth iz Agent
Name(Print) Current Mailing Address: _ v G
Signature ! Telephone
SECTION 3 ESTIMATED CONSTRUCTION COSTS'
Item Estimated Cost(Dollars)to be Official Use.Only
completed by ermit applicant
1. Building l (a)Building Permit Fee
1 G
2. Electrical (b)Estimated Total,Cost of
'Construction from-(6)'
3. Plumbing _` Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) I ,rj 00 U Check Number
This Section For.Official Use Only
Building Permit Number Date
Issued
-- _Signature:__ _.
Building Commissioner/Inspector.of Buildings Date
, O,,
File#BP-2014-1064
APPLICANT/CONTACT PERSON KRIS THOMSON w C
ADDRESS/PHONE 362 KENNEDY RD LEEDS (413)549-1027 O r
dls
PROPERTY LOCATION 61 CRESCENT ST 5 0)
MAP 24D PARCEL 243 000 ZONE URC(100)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tyneof Construction: CONSTRUCT 225 SO FT 2ND FLR DECK
New Construction
Non Structural interior renovations
Addition to Existin
Accessory Structure
Building Plans Included:
Owner/Statement or License 084152
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFjORMATION 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 Dela
Z
ture of ilding ficial 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.
61 CRESCENT ST 5 BP-2014-1064
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24D-243 CITY OF NORTHAMPTON
Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Deck BUILDING PERMIT
Permit# BP-2014-1064
Project# JS-2014-001827
Est.Cost: $15000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: KRIS THOMSON 084152
Lot Size(sq. ft.): Owner: WASMER JENNIFER
Zoning. URC(100)/ Applicant: KRIS THOMSON
AT. 61 CRESCENT ST 5
Applicant Address: Phone: Insurance:
362 KENNEDY RD (413) 549-1027 O
LEEDSMA01053 ISSUED ON.51112014 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 225 SQ FT 2ND FLR DECK
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 Si nature:
FeeType• Date Paid: Amount:
Building 5/1/2014 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner