31B-304 10 TRUMBULL RD BP-2017-0106
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31 B-304 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-2017-0106
Project# JS-2017-000179
Est.Cost:$20900.00
Fee: $136.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WESTERN MASS MASONS 089376
Lot size(sq.1L): 2657.16 Owner: SPONG ELIZABETH
Zoning: URC(100)/GB(0)/ Applicant: WESTERN MASS MASONS
AT: 10 TRUMBULL RD
Applicant Address: Phone: Insurance:
383 COLLEGE HIGHWAY (413) 540-1959 WC
SOUTHAMPTONMA01073 ISSUED ON:
TO PERFORM THE FOLLOWING WORK:REPLACE ONE SIDE OF FOUNDATION
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: OI: 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 7/27/2016 0:00:00 $136.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0106
APPLICANT/CONTACT PERSON WESTERN MASS MASONS
ADDRESS/PHONE 383 COLLEGE HIGHWAY SOUTHAMPTON01073 (413)540-1959
PROPERTY LOCATION 10 TRUMBULL RD
MAP 31B PARCEL 304 001 ZONE URC(100)/GB(0)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT /Ca did20
Fee Paid V
Building Permit Filled out
Fee Paid
Typeof Construction; REPLACE ONE SIDE OF FOUNDATION
New Construction
Non Structural interior renovations
Addition to Existing_
Accessory Structure
Building Plans Included:
Owner/Statement or License 089376
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFQRMATION 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
ii-, o . In Reta
re 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.
CEIVED - Department uo only
• --' City of Northampton Status of Permit _ I
2 2016Building Department Cury,Guterlveway Permt
212 Main Street -SewettSeptic A.arinbtity
Room 100 Wafet/Well Availability'
.Nsrt000Ns No hompton, MA 01060 Two Sets of Struotul el Plans
• t•`t- ' - •87-1240 Fox 413-587-1272 Plot/Cita Plans 2 -
Otheiajc`ecdy
APPLICATION TO CONSTRUCT,ALTER REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DIr'ELLING,
SECTIONS-SITE INFORMATION
4.1 PropeYv Address. -
This section to be.completed by office
/0 T.-4,064///Q Map Lot Umt
Zone Overlay District
Ern St.O str ct _ CB Distoct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: /
5444 l0 7rb.,r /1 p/
Name imp Current Mailing Address'.
Sof Cc ey/ Rct ;elePhone
Signature
2,2 Authorized Auent: I
ttJrs/cry Ale /ttelro ti. j-j 4:L���J�
_ f�f- ✓7p„/�.t ,e/e
NameCurrent
MaurgAckl.e,`s:
i
l 43[UC/
8194741 Telephone
SE ION 3-ESTIMATED CONSTRUCTION COSTS
Earn Estimated Cast IDol ers)to be Oficial Use Only
com•Ieted b •ermita olicant
1. Building (a) Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from{5)
3. Plumbing I Building Permit Fee
4, Mechanical(HVAC)
5. Fire Protection p��} potu n
6, Total=(1+2r 3+4+5) yp?Ct.�1 .c .Cheek Number ad?. I• „
This Section For Official Use Only
Building Permit Number Cate
Issued:
Signature:
F •
Bullring Comrnissysfanerenspector of BuildPateings
Et,na, / • C Lt a/17 e w2-(er v/144,1I A410/ CUM
Section 4. ZONING All Information Must Be Completed. perm_ Can Be Denied Due ToIncomplete Information
e.ry
Existing Proposed scored by Zamn
This mbedin Sy
Building aznment +e-:
y
Lot Sze
Frontage _— __ I
Setbacks Front
Side L- R_ 12 -_
Rear -
Building Hefgat -
Bldg. Square Footage _ .. ..
Open Space Footage --
}
tar a nvsblig&paved _ __ __
par}dnm
#of Parking Spaces - "
Fill:
( olume&Location) I -. --
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:I
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O YES 0
IF YES: enter Book Page I and/or Document r,
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Cate Issued
C. Do any signs exist on the property? YES . NO 0
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 0
IF YES, describe size, type and Location:
E. Will the construction activity disturb(clearing, wading, excavation or filling)over 1 acre oris it part of a common plan
that will disturb over 1 acre? YES 0 NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WOR"R(check all applicable)
New House Li Addition ❑ Replacement Windows I Alteration(s) l Roofing
Or
Or Doors (] LL
Accessory Bldg U Demctmen ❑ New Signs CPI Decks ro Siding{CI Other COI
Brief Description of Proposed nj� G c_ c 1 /Sand/4
el
Work es/
Alteration of existing bedroom Yes No Adding new bedroom Yes _ No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Fell -Sheet --
Ga. If New house and or addition to existIna housing complete the foliowiaraa:
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?
E Method of heating? Fireplaces or Woodstaves Number of each
g. Energy Conservation Compliance, Masscaeck Energy Compliance form attache ?
h. Type of construction
i. Is construction within 100 ft of wetlands? Yes No, Is construction within 100 yr, Floodplain Yes No
(- 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 Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
,as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
e
i rc 4 bYC.
/'�
/y at-Cb
,.yam -. , .x..
0.4 it atCc g ,as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing applcation are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print Nam far
/- '_.......
LII// •
7; 6/K
signature ®awn: l .en/ bate
SECTION @-CONSTRUCTION SERVICES..
SA Licensed Construction Supervisor: Not Applicable E
Nameof License Holder: 0/11.4 C fcci).� ... �-J " op / 326_ —
' -. .
License Number
{�/ --......- �erraarn oar
Address ,/,/
Signa Telephone
9, Home Improvement Contralto r' Not Applicable E
(Nescr, Afi! /r/[>1k a). /77V?
Company Name i Registration Number
/x`/%7,2 _.—
Address Expiration Dae
_.._Telephone
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 _.
Sinned Affidavit Attached e- E No
Y]. -Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwe0ines 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 that
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"shalt submit to the Building Official,on a form acceptable to the Building Official that hetshe shall be
responsible for all such work performed under the bnildine 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 ofEmployersto
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for oersteds)
you hire to perform work for you tinder 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
.26 The C¢r srtrnenrveeft ,ofMas,stn ,erode
.:._i Deparemeeei Thelmstrial Acetylenes
eo–zig+ 6ff G"fjase i fdr res1gQtum:s
i pt ip ,600 Washington Sweet
§,1•K Borten, MA 02111
'Yorkers' Compensateen Emus—mace Ad,1utlav' t >hsallere/Curet esters/Elieeerieke :/Plienndeers
Applicant Information d'Vease Te'ulset ]Leg tnty
Name(Business'Organizatiom ndivniduat): Vk% fi-- I :_ ..1 _
Address: 3F,3 rc,l/q-
•
City;StateZip-.. f `L!f 0(0?-1 Phone#:
lAre yo n ert employer?to er box: Type of project (required):
Cli•ck t e appropriate
am
a
�/ p y ❑ S am a general contractor and I
employees (full and/or part-time),* have hired the sub-contractors6, El New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet, 7. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity, employees and have workers'
t 9. Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. C We are a corporation and its 10._Electrical repairs or additions
3._I I am ahomeowner doing all work officers have exercised their lip Plumbing repairs or additions
myself No workers' coin right of exemption per MOL -
Y [ P 12. Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 1,3.❑ Other
comp.insurance required.]
',Any applicant that checks box kpolicy 1 must also fill out the section below showing ihnir workers'compensation p Iicy hrformaboa
ti3o meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
1C ontracmrs that check this box roust attached an additional sheet showing the name of the sub contractors and state whether or not those entities have
employees. If the sub-consactors have employees,they must provide their workers'comp.policy number.
�1 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information,
Insurance Company Name: �oLn r7e ...1'.--te_ ��
Policy#or Self-ins. Lk. #:, Expiration Date: //
Job Site Address: to //zn eV / City/State/Zip: i(/2. "//r¢. (,[.,�2
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 MOL 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 fbrwarded to the Office of
Investigations of the DIA for insurance cov' age verification.
1 do hereby cer.` der the . a-.penalties ofperjury that the information provided above correct
is true and
•
Si,Cnature: Date: 7-21 .'y�
Phone#: "'EfilG'u
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 #:
City of in7o thanpton
Mass echus to st
c F4
i'� en T3PA- Tc NT or BUIL DING g S'ZCTTCN
t
2122 Me'_- Stnmet o ✓4P 2 Bu_:.d3Pa ' ay
Morthampton, MM01060
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXFMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 78QCfelfit 108.3.9 to act as his/her
construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which
he/she resides or intends 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 per od shall not be considered a home owner."
The building department for the City of Northampton wants any person(s)who seek to use the home
owner exemption, to act as their own construction supervisor, to be aware that by doing so you
become responsible for compliance with state building codes and regulations. The inspection
process requires that the building department be called to inspect work at various stages, which include
foundation/footings (before backfill). sonotube holes (before pour). a rough building inspection
(before work is concealed), insulation inspection (if required) and a final building inspection.
The budding department requires these inspections before the work is concealed, failure to secure
these inspections can result in failure to obtain a certificate of occupancy until the work can be
inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be
responsible to make sure that the trades hired secure their proper pen its in conjunction to the building
permit issued, and that they get their required inspections. Failure of the individual trades to secure
the permits and inspections as required can DELAY the project until such time as the proper permits
and inspections are made
understand the above.
(Home owner/resident's signature requesting exemption) ..
I will call to schedule all required building inspections necessary for the building permit issued to me.
Date
Address of work location
City of Northampton 212 Main Street, Northampton, INIISA. 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: 70 /� ((///,
The debris will be transported by: bi/eJ(cr SF Ateky
The debris will be received by: 73,7( &_/4" C
Building permit number:
Name of Permit Applicant kieder AIfi
Date ature of Permit Applicant
LICENSED REG1SI:ERED }NSURED
WESTERN
i1
383 College Highway, SOUTHAMPTON, MA 01075 • (413) 527-1800
V1tr`r717Vi STERN?i?ASSMASCNS,CQ OM
QUOTE
To: 1 BETH SPONG i Date: I1-20-2016
10 TRUMBULL RD. Qucte# l 674387
NORTHAMPTON MA Project FOUNDATION
Phone: EMAIL _ Other Phone Phone
Description of Work To Be Done:
THE FOUNDATION WAS INSPECTED AND LOOKING FROM THE STREET, THE LEFT SIDE OF
THE FOUNDATION IS STRUCTURALLY UNSOUND. THE WALL HAS PULLED AWAY MORE THAN
2" FROM THE FLOOR JOIST AND IS LEANING OUT. THIS ENTIRE SIDE OF THE BRICK AND
RUBBLE FOUNDATION MUST BE REBUILT.
THERE WILL A 2X6 TEMPORIALLY WALL CONSTRUCTED FROM ONE END OF THE FOUNDATION
TO THE OTHER TO SUPPORT THE FLOOR JOIST THAT ARE SUPPORTED ON THE WALL BEING
REMOVED.
REMOVE EXISTING WOOD FENCE AND 1..64VE ON SITE.
EXCAVATE DOWN TO THE FOOTING OF THE HOME AND DISPOSE OF THE OLD FOUNDATION.
FORM AND POUR A NEW CONCRETE FOOTING\1vnH#4 REBAR X2 RUNNING THE LENGTH OF
THE FOOTING. FOOTING AND WALL WII...L RETURN 2' ON THE FRONT CORNER OF THE HOME.
FORM AND POUR A NEW 8"X5' CONCRETE WALL WITH",#a. REBAR EVERY 6'
TOP 2'OF THE FOUNDATION NHL L BE FILLED IN WITH BLOCK AND BRICK TO SUPPOR" JOIST_
SPRAY ON A POLYMER MODIFIED ASPHALT LIQUID MEN-BRANS ON THE FOUNDATION WALL
60 MILS THICK TO PROVIDE WATERPROOFING
BACKFILL WITH OLD MATERIAL,. IF OLD MATERIAL IS NOT ACCL-Pi 446LE THAN NEW CLEAN
FILL WILL BE USED AND WILL BE ADDITIONAL COST FOR REMOVAL AND SUPPLY.
LOAM AND SEED SIDE AND PITCH AWAY FROM HOME-
i
ANY TEMPORIALL.Y RELOCATION OF PLUMBING OR ELECTRICAL THAT iS NEEDED FOR THE
WORK TO BE DONE CORRECTLY WILL BE THE FINANCIAL RESPONSIABILITY OF THE
HOMEOWNER.
PULL BUILDING PERMIT FOR THE JOB.
T}l._ 54ou For ;'nc Ca'i_j. W.-astern Class Yii son.&
ALL DIG SAFE BEFORE DIGGING.
HOMEOWNER .O SUPPLY WRITTEN AT-P /AL 'N_ „ BO-' FOR EQUIRENIFN IT AN'
MATERIAL TO BE SET ON NP 3HEORS PROPERTY RTY DURING HE CONSTRUCTION
WE HEREBY PROPOSEEOFURNISH MATERIALS THE LUBOR- $ 2090000
IN ACCORDANCE WITH THE ABOVE SPECIFICATIONSFOR
THE SUM OF.
This quote may be withdrawn from us if not accepted within 30 days. 2880xlrut
Quote Prepared By: David Osiecki - .al—
>zl
` '-'.�,':
TERMS:Any alteration or devotion from above spenficatons involving extra costs Rill be executed only upon writlen orders,and-Rill become an
extra charge over and above the estimate,By sg gthis quote you agree and understand all the above terms and conditions thalapply to UM job.
Any changes that are to be made,must be discussed prior o construction and agreed upon by corUedor and may also effect o the final price.
PAYMENT TO BE MADE AS FOLLOWS:One hal:of quoted amount is due whenjob construction has begun.Remaining balance of bit will be paid
in full when job is complete A Finance Charge of 1-1/2(18%annual rate)per month will be added to any unpaid balance overb°days.
ACCEPTANCE OF PROPOSAL:The Above Made As
O fined Above.And Contlf ns Ar Satisfactory And Hamby Accepted.You Are Acthor¢sd in Do '
The Wors As Specified Payment N911 Be Made,Aa Outlined Above.
Signature — Date- Sg ��,1-----= -
TSTA J : f._. v J a nC; '.n st r ,.ra
P-cP(cct L