31B-243 (7) 138 ELM ST BP-2017-0228
GIS9: COMMONWEALTH OF MASSACHUSETTS
Mao-Block: 31B-243 CITY OF NORTHAMPTON
Lot:-00I
Permit: Building
Category: REPAIR BUILDING PERMIT
Permit# BP-2017-0228
Project# JS-2017-000386
Est.Cost:$15000.00
Fee:$100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ZAYAC CONSTRUCTION LLC 074881
Lot Size(sq. R.): 11194.92 Owner: SMITH COLLEGE
Zonino: URC(100YEU(57)i Applicant: ZAYAC CONSTRUCTION LLC
AT: 138 ELM ST
Applicant Address: Phone: Insurance:
79 HIGHMEADOW DR (413) 737-3872 O
WEST SPRINGFIELDMA01089 ISSUED ON:8/29/2016 0:00:00
TO PERFORM THE FOLLOWING WORK: Rot repair on front porch to match existing
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: FeeTvpe:
Date Paid: Amount:
Building 8/29/2016 0:00:00 SI00.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck-Building Commissioner
File k BP-2017-0228
APPLICANT/CONTACT PERSON ZAYAC CONSTRUCTION LLC
ADDRESS/PHONE 79 HIGHMEADOW DR (413)737-3872 Q
PROPERTY LOCATION 138 ELM ST
MAP 3IB PARCEL 243 001 ZONE URC(100)/EU(57)/
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: Rot repair on front porch to match existing
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 074881
3 sets of Plans/Plot Plan
THE FOL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED: (yPI4{ (ANbllleNS No EhANG6 Of
Approved Additional permits required(see below)
AQP6ArcAtve6 eR.. NATER-IA-(,S -�
PLANNING BOARD PERMIT REQUIRED UNDER: § N66.1) Pf10To6 RA Pis OF at"
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan £NQ(TIONS
Major Project: Site Plan AND/OR Special Permit with Site Plan
&- / �/I le
ZONING BOARD PERMIT REQUIRED UNDER: § 0 I/l/tel/_l, Q✓LL7
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
/l Q
Signature of Building Official Date ' I
•
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 the Office of
Planning& Development for more information.
Star rie=o
Department use only
t ivy of Northampton Status oPPermtt
9I a ] :.wilding Department Curb CGUDnvewsy Permit
4 212 Ulain Street Sewe 'Septic Avallabtlity
q r�snv
t Room 100 WatcrrN Il Availability
GBIU3QBU No hampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 ?Plot/Site Plan=
ICJther Specify
I( APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATIONI
This section to be completedorrice
1A P2rooenr Address': /' - - -
p--
by
13i; fI.-I... JT fk7C'}4,eta 21240 n in Map Loc _ U
S' ' q Cu 112 Zone Overlay District
JJ ErnSt District CB Dstrct , .
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
—i-O Ice5 oG Hi, Smarm Co/l t
Name(Print) Current Marling Address:
u Te,'ePhon q13 ‘91(
30°&
2.2 Authorized Agent:
1 E-X Lo(gVJ///�
koro (Print)�t / Curren".Mailing Address
Siete Telephone
•ECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building1( (a) Building Permit Fee
0602 Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing I Building Permit Fee ))))
4. Mechanical(HVAC) / e
5. Fire Protection /(r/
I
6. Total=(1 +2+3+q+b) icLa\ 0 ,Check Number l UNN
This Section For Official Use Only
Building Permit Number Date
Issued
Signature'.
et
�i •
BuildingCon• pcsmmisioner/InspedorofBuildings Date
f� nai 1 ' l I lllii— zA i-ic a) 6-v+'Ici, i, c,3✓✓°
Section 4. ZONING All Information Must Be Completed_Permit Can Be Dented Due To Incomplete Information i4
Exist:eg Proposed Required by Zoning
This column to be tilled in by
Building Deoarment
Lot Size
Frontage
Setbacks Front
Side LL R• L R _
Rear
Buil
Bldg ar dS g Height
Square Footage
Open Space Footage(Lotareamnusl dg&paved _.. ...._
parking)
4 of Parking Spaces
A. Has a Special Permit/Variance/Finding ever been issued for/on the she?
NO 0 DON KNOW 0 YES 0
IF YES, date issued,
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 1 YES 0
IF YES: enter Book Pae and/or Document
B. Does the site contain a brook, body of water or wet ands? NO 0 DONT KNOW 0 YES 0
IF YES, has a permit beer or need to be obtained from the Conservation Comm scion?
Needs to be obtained Q Obtained Q , Date Issued
C. Do any signs exist on the property? YES Q 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 Iocaton
fof Will the construction activity disturb(clearing,grading excavation,or Ming)over l acre or is it part of a common plan
thatwill disturb over I acres YES 0 NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Y
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all atoneable)
New House ❑ Addition I I Replacement Windows Alteration(s) Roofing n
Or Doors O
Accessory Bldg. Li Demolition ❑ New Signs ID] Decks IR Siding ICU Other(Eli
Brief
Work ascription of Proposed K (aZb1:71 ce,,,,iek ) %� C� � ,I o fiqQtv-
Alteration of existing bedroom Yes No Adding new bedroom Yes f- No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a. If New house and or addition to exisfina houslna, complete the following.
a. Use of building_One Family Two Family Other h
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 ftof 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 la-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMITy �_"
I, J (jt 1( e.eC OE -1Yt�- 5-/A/,- 6✓/ee5c as Owner of the subject
property /� �L J
hereby authorize �Q-L &?fflc nCt&f/en LL.0
to act on my behalf,in all matters relative to work authorized by this building permit application.
of Z.-e.Lcer ° a2 - IL
ion: a of Owner Dote
., ni:
I� te ,as Owner/Authorized
t reby declare f t the statements and information on the foregoing application are true and accurate, to the best of my knowledge
a elief
Signed under the pains and penalties of perjury.
ACV� �
ra atur of
Owner/Aeon Date
tOZIZ 7i
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Sume_rvisor: Not ApplicableE
Name or.Licansa Houde•: [nal) layuc- .-_ - -
License Numbar
11 N,Snr
h � �1o� D N Sfi'�
Fir Id /+tpoloe5 C-S-c) Lie I
Address 6:FIr2Oon Date
i/ AZ iL/i3- 717 - 3672 �� ,
Signsur/ Telephone
9 Registered Home lmerovement Contractor: _ Not Applicable £
lro53K
Company Name Registration Number
Address Expiation Date
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
Signed Affidavit Attached Yes E No
11. - Rome Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwelhnes 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 fans
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 fonn acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the bnildinc hermit.
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 may be liable for person(s)
you hire to perform work for you under this permit
The undersigned"homeownci"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
tea'' The Chotiononvetiiich of Attitissochitsegs7
alt h ? Deportment'oflodit a 1 icei e its
t Yt fior of lion stger ns
O atnitk,. 600 Washington Den
Workers' Compensation husurance Affidavit -.alidernillolagractacorn//Ellectrnc.ians/pionnbers
Applicant Information Please Pe ru®t LeuH filly
Name(Business;Organizatioussoilvidual): 2t.- _`Yl }r Cho^ "LC-
Address: 69 P2ca, -Cern, Dr -e.n3 rt.ecq,c(-o., (v./ Pt o �S
City/Stat'e/Zip:Lica 4..o. r mp.5 CSifc__ Phone#: Lig e)4 5-7o9•
Are you an employer?Check the appropriate box: 'Type of project (required):
1.A I am a employer with 4. Li tam a general contractor and I
I employees (full and/or part-time).'
have hired the sub-contractors6. ❑ New construction
2J I am a sole proprietor r partner- listed on the attached sheet, 7. Q Remodeling
ship and have no employees These sub-contractors have g, U Demolition
working forme in tory capacity, employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.`=
required.] 5. D We are a corporation and its 10.E Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their i 1.E Plumbing repairs or additions
myself. [No workers' comp. right of exemption per Ma 12.E Roof repairs
insurance required.) t c. 152, §1(4), and we have no
employees. [No workers' 13.7 Otter
comp.insurance required.; ..
"Any applicam that checks box 41 must also fill out the section below shoving their workers'compensation policy information.
tHo meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
1 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 mnstprovide their workers'comp_policy number.
Yam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: HA& 301.tinarl''(rn1o„A q
Policy 11 or Self-ins. Lie. x: Vic 55 €S I�X?t10 Expiration Date: /- 7 —oloI
lob Site Address: )35 efrn SY mb-114,vpicon Mt-3 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 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&warded to the Office of
Investigations of the DLA for insurance coverage verification.
I do hereby certify under the pains and,penalties of perjury that the information provided above is true and correct.
Signature: I /L....... Date: 9-4-42,---,--
Air
Phone 11: Li/'3 —l) //e ,al
Official use only. Do not write in this area, to be completed by city or town n,ffecial
City or Town: Permit/License'#
issuing Authority(circle one):
J. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other Contact Person: Phone#:
City of NNNc ha rQtozk
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Northampton, MA 01060
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INSPECTOR
Louis Hasbrouck Chuck Mfler
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
( The State of Massachusetts allows the homeowner the right under 78OCE R 1083.4 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 period 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 reauired) and a final building inspection.
The building 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.
It 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 permits 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 b?ain Street, Northampton, MLA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, 554, I acknowledge that as
a condition of tie building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a roperly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: I3v Elm . S-1-
The debris will be transported by: ZAy. .c Con5fi4e1 'i
The debris will be received by: Wit/ .._Rec/cl;
Building permit number:
Name of Permit Applicant _
22, /7 Net,_
Date Signature of Permit Applicant
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825/2016 City of Northam prop Mal-138 Elm St
City of
s Ix�y�yaj� Louis Hasbrouck <Ihasbrouck@northamptonma.gov>
on
138 Elm St
1 message
Louis Hasbrouck <lhasbrouck@northamptonma.gov> Thu Aug 25, 2016 at 6:05 PM
To: James Lucey <jlucey@smith.edu>
Jay,
I can't read the contractors email address. Can you pass this along? Thanks.
I went over the proposed work at 138 Elm St
You can replace the trim and lattice with the same design and materials (wood for wood)without review.
Different materials require Planning staff review. Anything else requires commission approval
Structural repairs to the porches don't need review as long as there's no change in appearance. Repair
and replacement of steps, stairs and railings with the same materials and design or appearance is OK,
as is trim work (same design and materials).
We'll need photographic documentation of all the existing conditions before you pick up the permit.
The Planning Office staff will want photos of existing and drawings/cut sheets/samples for their review(if
needed).
I've attached a copy of the Historic District regulations.
We don't need printed photos; you can bring your camera to the office and we'll download the images.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413) 587-1240 office
(413) 587-1272 fax
195 Historic District 2016-08-25.pdf
1724K
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