31A-039 (6) r planning.ctm ten aann•tniflxtg.north tmpinn GIS•historic•cnmmunitt preservation.central huhinew architecture
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Sarah 1AValley,Consereation,Prese atlon.&Land 4se Planner•slwalley(i�northatnptonnw.gnti°•4 t3-58"tafi3
March 9,2015
Heidi Schiller and Fletcher Blanchard
197 Elm Street
Northampton MA 01060
RE: Elm Street Historic District Certificate of Nonapplicability
197 Elm Street Window Replacement
Dear Ms.Schiller:
Thank you for submitting an application for a Certificate of Nonapplicability for window
replacement within the Elm Street Local Historic District,as shown in the plans submitted on
March 5. In accordance with§195-5 B(11),the work proposed is a'duplication or rehabilitation of
existing windows,provided that the new windows are identical in size to the old windows,have the same
style and details and are consistent with the Design Standards.,'and is exempt from Historic District
Review.
This Certificate is issued by staff to the Northampton Historical Commission,acting on behalf of
the Director of Planning and Sustainability. No further Local Historic District Review,is
required for this project.
Thank you,
�tl 1)
Sarah I. LaValley
City hall••_no Main Street•Northampton,MA oi.o6o•w»,vv.northampt(inm.t.gov/OPI'.)
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 177961
Type: LLC
Expiration: 2/28/2016 Tr# 249507
TRITON CONSTRCTION SERVICES, LLC.
LOUIS TONELLI IV
P.O. BOX 497
BELCHERTOWN, MA 01007 -- --- —
Update Address and return card.Mark reason for change.
20M-OS/11
SCA 1 it
Address Renewal E] Employment Lost Card
n�i?P. C('CIyl l9?Cz�7fCeQ'f,�17 CL>>n�ZfXJJl7f'itif.Jl.'�3
_ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
egistration: 177961 Type: Office of Consumer Affairs and Business Regulations
- xpiration: 2/28/2016 LLC 10 Park Plaza-Suite 5170
Boston,MA 02116
TRITON CONSTRCTION SERVICES, LLC.
LOUIS TONELLI IV
35 FLETCHER AVE.
BELCHERTOWN, MA 01007 Undersecretary valid without signature
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Super-isor
License: CS-065242
LOUIS A TONEL"
35 FLETCHER AVE ;
BELCHERTOWN MA
v'
Expiration
Commissioner 08/10/2015
�1�(t��N� Otn" � 1�A�W �f�kl�i � �2 ` 1�
Y-tCX'�uV��� f ��vv+v
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste 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.
Address of the work: I11�)'1 I tW
The debris will be transported by: M , Vb OyF- -I 1 ��
The debris will be received by:
Building permit number:
Name of Permit Applicant �15'ro�G�w1
:!7 2.o4A,s
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
d 1 Congress Street, Suite 100
Boston, MA 02114-2017
1M 5� www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): IS'�GLV1
Address: 'v 'I.i'_C W . A)C--
City/State/Zip: iGG '�U►Jt-� 4A a Phone #: Ak3 X2'1 -'7-'5<:?
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. New construction
2.[� 1 am a sole proprietor or partner- listed on the attached sheet. 7. MRemodeling
ship and have no employees These sub-contractors have 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.❑ 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.❑ 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:
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 under the pains and penalties of perjury that the information provided above is true and correct.
Si ature: Date: J
Phone#:
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#:
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Swervi 1sorLL: f Not Applicable ❑
If If
Name of License Holder: 2
— OCOS s1'2—
( License Number
Address Expiration Date
�1
Sig-nafure Telephone
9.ReaisteredfHome Improvement Contractor: Not Applicable ❑
Company Name Registration Number
F-D - ?,;K2< A�-' zp t v
Address ! 1 Expiration Date
1 L , kx Telephone ,b
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....... d 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,provide I 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 Death)of the Massachusetts General Laws Annotated,you mad be liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement endows Alteration(s) ❑ Roofing F-1 r Or Doors _
Accessory Bldg. El 1=! New Signs [�] _ Decks [� Siding[0] Other[p]
Brief Description of Proposed
Work: A_Vf-;!gA LVJ X eA(JAJCiilir Aja,040 k'4og- 500-- /N-10 ao-'o" ' - A1QQ 1%�cJ�DRY
Alteration of existing bedroom Yes No Adding new bedroom Yes _J No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa.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, Ai� ] a7j,, t�� r — as Owner of the subject
property ,(
hereby authorize �� ' t �a' t64�� �
to act on my behalf,in all matters relative to work autho ized by this building permit application.
Signature of Owner Date
I )tL✓ '`� � as OwnerlAuthorized
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.
I�Qk t�TQA& t
Print e
Signat Owner/Agent Date
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
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 Sp cial Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW ® YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DONT KNOW ® YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 10 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained ® Obtained ® , Date Issued:
C. Do any signs exist on the property? YES 0 NO d
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading, a avation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES ® NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
Dp ity of Northampton Status of Permit:
--- i uilding Department Curb Cut/Driveway Permit
I 212 Main Street Sewer/Septic Availability
—
2 5 ®{ �' Room 100 Water/Well Availability
__._ ' lV rthampton, MA 01060 Two Sets of Structural Plans
ElectriNop,h rnnr c,& -1272 S
�- .: ;Q -587-1240 Fax 413-587 Plot/Site Plans
Other Specify..
APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address:
Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Own=oecord:
Name(zz Current Mailing Address:
Telephone
Signat e
2.2 Authorized Agent:
kw(
2 IaAj%. , � R�zjll-.y,
Na Print) Current Mailing Address: G=a ��QIFJ1 Mpr 01Gt�
("ham) G;7 1 - �D
Sign& r Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 1 5 X50 , 00 (a)Building Permit Fee
2. Electrical I Sao_ oo (b)Estimated Total Cost of
t Construction from 6
3. Plumbing SC�O. 00 Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total =(1 +2+3+4+5) 24�j �j�' - L�� Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2015-0881
APPLICANT/CONTACT PERSON LOUIS TONELLI
ADDRESS/PHONE 35 FLETCHER AVE BELCHERTOWN01007(413)627-3250 Q
PROPERTY LOCATION 197 ELM ST
MAP 31A PARCEL 039 001 ZONE URB(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
Typeof Construction: RENOVATE 2ND FLR BATH,ADD LAUNDRY&INSTALL WINDOW
REPLACEMENT(WEST SIDE GABLE WINDOW)
New Construction
Non Structural interior renovations
Addition to Existin
Accessory Structure
Buildine Plans Included: ,
Owner/Statement or License 65242
3 sets of Plans/Plot Plan
1
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF RMATION 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 Delay
ell- a
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.
197 ELM ST BP-2015-0881
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 3 1 A-039 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2015-0881
Project# JS-2015-001719
Est.Cost: $25530.00
Fee: $153.00 PERMISSION IS HEREBY GRANTED TO
Const.Class: Contractor: License:
Use Group: LOUIS TONELLI 65242
Lot Size(sg. ft.): 16247.88 Owner: BLANCHARD FLETCHER A III&HEIDI A SCHILLER_
zoning. URB(100) Applicant: LOUIS TONELLI
AT: 197 ELM ST
Applicant Address: Phone: Insurance:
35 FLETCHER AVE (413) 627-3250 (�
BELCHERTOWNMA01007 ISSUED ON.41612015 0:00.00
TO PERFORM THE FOLLOWING WORK.-RENOVATE 2ND FLR BATH, ADD LAUNDRY &
INSTALL WINDOW REPLACEMENT (WEST SIDE GABLE WINDOW)
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 Sisnature:
FeeTyne: Date Paid: Amount:
Building 4/6/2015 0:00:00 $153.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner