32A-260 (4) City of Northampton Mail-Re: Porch Removal at Historic Northampton https://mail.google.com/mail/u/0/?ui=2&ik=3921lafc3d&view=pt&se...
Charles Miller<cmiller @northamptonma.gov>
Re: Porch Removal at Historic Northampton
1 message
Louis Hasbrouck <Iasbrouck @northamptonma.gov> Mon, May 4, 2015 at 1:46 PM
To: Sarah LaValley <slavalley @northamptonma.gov>
Cc: Charles Miller<cmiller @northamptonma.gov>
No problem
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413) 587-1240 office
(413) 587-1272 fax
On Fri, May 1, 2015 at 10:50 AM, Sarah LaValley <slavalley @northamptonma.gov>wrote:
Hi Louis-
The Historical Commission reviewed the porch removal and basement window closings at Historic
Northampton and granted permission for both pursuant to the Preservation Restriction the City holds on
the buildings.
Thanks very much for flagging that one!
-Sarah
Sarah I. LaValley
Conservation, Preservation and Land Use Planner
City of Northampton
Office of Planning and Sustainability
210 Main Street,Room 11
Northampton MA,01060
413-587-1263
1 of 1 5/4/2015 1:50 PM
Tlae Commonwealth of Massacliusetts
Department of Industrial Accidents
Office of Investigations
a y,_
r- 600 Washington Street
.-
Boston, MA 02111
www.mass.gov/dia
Workers'.Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le6ibly
Name (Business/Organization/Individual): 4r'J S g?rYt,S6'�
Address: S LZ C . %A%4-ecAYn (Ltk �, g S
City/State/Zip: Phone#: �o
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. F-1 New construction
2_. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
These sub-contractors have
�ip and have no employees 8.—K Demolition
working for me m any capacity. employees and have workers'
[No workers' comp.insurance comp. insurance.1
9. Building addition
required.] 5. ❑ We are a corporation and its 10.E]Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 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.
hnsurance 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 certr u th ins and penalties ofpeijury that the information provided above is true and correct.
Signature: / Date: 2 g
Phone#: �� • 64�s
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#:
Version 1.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780;CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes No
SECTION 11 OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
NQ ' as Ow er
f the sub o
ject property
hereby authorize
act on my be , in all matt ers elaZ1;777777:1�.�O[Dat Sign re of Owner 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.underthe pains.and of perlury -
Print Name
Signature of OwWnerint Date
SECTION 12-CONSTRUCTION:SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
mss• e� i52.
Name of License Holder: r� ►cs.�n_._ �....
License Number
Address Expiration ate
Signature Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MG.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 0
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL.PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF fhbtOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Registrant)--_.
Registration Number
...:.......
Address
_. _.._. Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
;Na me
Area of Responsibility
_ress Registration Number
Signature Telephone Expiration Date _ ...,,__..._._.,.
Name Area of Responsibility
_.._.
Address Registration Number
t
Signature Telephone Expiration Date
Name Area of Responsibility
t
Address Registration Number
__
Signature Telephone Expiration Date
...... . . ._..._._ _. _...,._,. . .. _ .,..
Name
Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Ir
Company Name: Not Applicable ❑
Responsible In Charge of Construction
.......
CAD5 3.
Ad_dres_
Signature Telephone
Versionl.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to 5e filled in by
Building Department
Lot Size
Frontage _ _..
Setbacks Front
Side L _.._-_._ R:'
Rear
Building Height "
Bldg. Square Footage
Open Space Footage °
(Lot area minus bldg&paved
#of Parking Spaces
Fill:
(volume&Location) L _. .......:.. _.._..._,:,. .... _. :__.. _ :.... .,.. _. _...
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q 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 :...."...,
IF YES: enter Book Page, Document#
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 Obtained 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,excavation, 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.
Version 1.7 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 ❑ DemolitiouX 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 JDQx t S„�! Y eY �YC.1/�
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 ❑ 1 B
El
Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ - 3A ❑
I Institutional ❑ 1-1 p I-2 ❑ 1-3 ❑ 36 ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use ❑ Specify ,
m. .,
S Special Use ❑ i S ec
p fY
COMPLETETHIS SECTION IF EXISTING'BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group w_...__.. _..,.,
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)
2nd ..._....,... .....,.,_..,..,. ...,....:_ ...._,... .,..__.. 2nd
3 rd 3rd _........ _..__.___ _......_. .�....,
th ---------._..._-_
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 E] Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system[:]
FL
Version l.7 Commercial Building Permit May 15,2000
Departme t useonly,
City of Northampton Status of Permit:Building Department Curb Cut/Dnveway Permit 1 2015 212 Main Street Sewer/SepticAvallabtlrty
Room 100 Water0ell AVaifabI ity:pections orthampton, MA 01060 Two"Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plat/Site"-Plans"'
,Other Specify
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:
.. ...._.__...__. __...... -____ -
VIeG n� , Map Lot Unit
I
se, S Zone Overlay District
s'n "
-- Elm St.District CS District
SECTION 2-PROPERTY OWN ERSHIP/AUTH'ORIZED AGENT
2.1 Owner of Record:
Name(Print) !! /� Current Mailing Address
ice
/�
l /
Signature C,61 Telephone
2.2 Authorized Agent:
KY i 5`TM_ .lin_5 a+a....__._ 2 �hY � k�1W►
Name(Print) Current Mailing Address
`.. ._.__..- L_.?
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official:Use Only
completed by ermit applicant
1. Building �o�, a (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from- 6 _..... .._
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) _. .__._... _.... -
5. Fire Protection
6. Total=0 +2+3+4+5) Check Number
This Section:For'Official Use Only
Building Permit Number Date
Issued
Signature:_
Building Commissioner/Inspector of Buildings Date
File# BP-2015-1040
APPLICANT/CONTACT PERSON KRIS THOMSON
ADDRESS/PHONE 362 KENNEDY RD LEEDS01053 (413)549-1027 Q
PROPERTY LOCATION 58 BRIDGE ST
MAP 32A PARCEL 260 001 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: DEMO REAR PORCH
New Construction
Non Structural interior renovations
Addition to Existing
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
INFOIJMATION 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 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
el
Sig re o Bu di g Offic al 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.
58 BRIDGE ST BP-2015-1040
GIS#: COMMONWEALTH OF MASSACHUSETTS
MapBlock: 32A-260 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: demolition BUILDING PERMIT
Permit# BP-2015-1040
Project# JS-2015-001976
Est. Cost: $2000.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: KRIS THOMSON 084152
Lot Size(sq. ft.): 21344.40 Owner: NORTHAMPTON HISTORICAL SOCIETY
Zoning. URC(100)/ Applicant: KRIS THOMSON
AT. 58 BRIDGE ST
Applicant Address: Phone: Insurance:
362 KENNEDY RD (413) 549-1027 O
LEEDSMA01053 ISSUED ON.51512015 0:00:00
TO PERFORM THE FOLLOWING WORK:DEMO REAR 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:
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:
FeeTylpe• Date Paid: Amount:
Building 5/5/2015 0:00:00 $35.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner