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92 Second St. Pittsfield MA 01201
(413) 841 2827
Diplacon'A,amail.com
January 22, 2015
1 request that you grant a modification to waive the requirement for control
construction for the bathroom and Laundry room restoration at 90 Pomeroy Terrace
unit 42 in Northampton because the work is of a minor nature, will not affect health,
accessibility, life and fire safety, or structural requirements and is impractical in that
the cost of control construction is considerable when compared to the cost of the
proposed work. Thank you for your consideration. "Mass Amendments, sections 107.1
allows for an exclusion from control construction for this project"
Respectfully,
Paul Saldana
Diplacon Builders Inc.
92 Second St. Pittsfield, MA 01 201
Diplacon Builders.Paul Saldana.92 Second St Pittsfield MA 01201.(413)841-2827.Diplacon@gmail.com
'01/19/2015 15:28 14135861690 UPS STORE#0325 PAGE 03105
FLOOR PLAN CBP.TMCAUON Exhibit C (page 4 of 4)
This floor plan sbows the omit dctsignation of Unit#2 lower level and Unit#6 lower level,fully and
a=raWy dVlots the layout of the units, the 100Wons,dimensions approximate
amp mMa entranoes and immedisk common areas tc which they aceess
as Wit in Pomeroy ck Coa&mWums at 90 POmImy Terrace,
Nortbamptoa MA. This plan waspr�e formt with the tints and
regalatlons Of the ragiaters Of the wealth of M tr$"I
ME M"
UNIT o6
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ameeM Tmace Neon,MA 01060 As Built 12.1.13
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/12,2 SCALF—, 1/16" z 1'�-t)" ► RIGIOTOR
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01/1912015 15*28 14135861890 UPS STORE00325 PAGE 04105
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UNIT #2,
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1 UNIT #2 - BATHROOgHNOVAT10 DESIGN DRAWTNC
A2.0 7 SCALE: 1/4" 1'-0" VATH: JANUARY 10,2014
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01/19/2015 15:28 14135861890 UPS STORE#0325 PAGE 01/05
. , ate-- 0100
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The Commonwealth of Massachusetts
Department of Industrial Accidents
W Office of Investigations
IA 1 Congress Street,Suite 100
Boston,MA 02114-2017
f�
^M `•y, www.mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Diplacon Builders
Address:92 Second St
City/State/Zip: Pittsfield, MA 01201 Phone #:413 841 2827
Are you an employer? Check the appropriate box: Type of project(required):
1.0 I am a employer with 4 4. ® I am a general contractor and I 6. ®New construction
employees (full and/or part-time).* have hired the sub-contractors
2.® I am a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling
ship and have no employees These sub-contractors have g, ®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.® Electrical repairs or additions
3.® 1 am a homeowner doing all work officers have exercised their 1 l. 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#1 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: Hartford Underwriters Insurance Company
Policy#or Self-ins. Lic. #:6S60UB-4746P71-4-12 Expiration Date:07/07/2015
Job Site Address:
90 Pomeroy Terrace Unit #2 City/State/Zip: Northampton, MA
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 imprisornnent, 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 fox-insurance coverage verification.
I do hereby certify4aperjhep 'ns and penalties of perjury that the information provided above is true and correct.
Si nature•' Date: i ?
Phone 41 4�—
Official uss'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#:
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Donald Davis 017589
License Number
27 Adam St. Pittsfield, MA 01201 03/14/2016
Address Expiration Date
413 822 1349
Signature Telephone
9. Realstered Home Improvement Contractor: Not Applicable ❑
Diplacon Builders 170327
Company Name Registration Number
92 Second St. Pittsfield MA 10/11/15
Address Expiration Date
Telephone 413 841 2827
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....... 21 No...... ❑
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s)who own 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 homeowner.
Such"homeowner" shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in eath)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you and this permit.
The undersigned"homeowner" ce f ies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances, e d Local Zoning ws and State of Massachusetts General Laws Annotated.
r
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing F7
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs M] Decks [Q Siding KJ] Other[gyp
Brief Description of Proposed
Work: Bathroom and Laundry room renovations
Alteration of existing bedroom Yes X No Adding new bedroom Yes X No
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll -Sheet 4
6a. If New house and or addition to existing housing, complete the following:
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 construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
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
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Katte Irwin as Owner of the subject
property
hereby aut orize i lacon Builders INC
to act on y behalf, in all tters relative to work authorized by this building permit application.
rx 1&—
Sig re 06vAner Date
I, Paul Saldana 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 perjury.
Paul Saldana
Print Name
f
Signature of Owner/A,jent Date
Section 4. ZONING Alt 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
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DON'T KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DON'T KNOW O YES O
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
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 O
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? YEE O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
City of ort amp on Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
hs
Orthampton, MA 01060 Two Sets of Structural Plans
on 3-587-1240 Fax 413-587-1272 Plot/Site Plans
taoR' Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION 7
1.1 Property Address: This section to be completed by office
90 Pomeroy Terrace Unit# 2 Map Lot Unit
Nothampton, MA 01060 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Katie Irwin 90 Pomeroy Terrace Unit#2 Northamptom MA 01060
Name(Print) Current Mailing Address:
413 695 2977
Telephone
Signature
2.2 Authorized Agent:
Diplacon Builders INC 92 Second St Pittsfield, MA 01201
Name(Print) Current Mailing Address:
413 841 2827
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 10,500 (a)Building Permit Fee
2. Electrical 2,000 (b) Estimated Total Cost of
Construction from 6
3. Plumbing 3,500 Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 +2 +3+4+ 5) 16,000 Check Number b
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2015-0738
APPLICANT/CONTACT PERSON DIPLACON BUILDERS
ADDRESS/PHONE 92 SECOND ST PITTSFIELD01238(413)841-2827
PROPERTY LOCATION 90 POMEROY TERR-UNIT 2
MAP 32C PARCEL 260 000 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: RENOVATE BATHROOM&LAUNDRY ROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 017589
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9JWATION 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
em itio elay
re of B ing 1al 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.
90 POMEROY TERR-UNIT 2 BP-2015-0738
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C-260 CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2015-0738
Project# JS-2015-001437
Est. Cost: $16000.00
Fee: $96.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: DIPLACON BUILDERS 017589
Lot Size(sq.ft.): Owner: IRWIN KATTE
Zoning: Applicant: DIPLACON BUILDERS
AT.• 90 POMEROY TERR - UNIT 2
Applicant Address: Phone: Insurance:
92 SECOND ST (413) 841-2827 WC
PITTSFIELDMA01238 ISSUED ON:112312015 0:00:00
TO PERFORM THE FOLLOWING WORK:RENOVATE BATHROOM & LAUNDRY ROOM -
unit 2
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 1/23/2015 0:00:00 $96.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner