24D-198 (7) II WARFIELD PL BP-2017-0509
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24D- 198 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Porch Repair BUILDING PERMIT
Permit'# BP-2017-0509
Project# JS-2017-000831
Est.Cost: $31714.14
Fee: $206-00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
UseGroup: THOMAS MALONE 055236
Lot Size(sq. ft.): 4617.36 Owner: SCARBOROUGH ADAM&CECILIA SHINER
Zoning: URC(100)/ Applicant: THOMAS MALONE
AT: 11 WARFIELD PL
Applicant Address: Phone: Insurance:
128 RYAN RD (413) 885-9038 WC
FLORENCEMA01062 ISSUED ON:10/20/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:RENOVATE FRONT PORCH & REAR DECK
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 10/20/2016 0:00:00 $206.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File 4 BP-2017-0509
APPLICANT/CONTACT PERSON THOMAS MALONE
ADDRESS/PHONE 128 RYAN RD FLORENCE (413)885-9038
PROPERTY LOCATION 11 WARFIELD PL
MAP 24D PARCEL 198 001 ZONE URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED UI p
Fee Paid 'PDA �W
Q
Building Permit Filled o t
Fee Paid —7-
Typeof Construction:_RENOVATE FRONT PORCH&REAR DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 055236
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOBMATION 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 Dela Q �(/
/a// /t1
Si ure of uil n 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.
to
� \ Develme t use only
r \\\\City of Northampton Status of Permit:
. ` $wilding Department Curb CUVDdvexay Penult�'' " ,I��
1 "/"'/' 212 Main Street 5ewer13ep1icAvailability
r Room 100 walnrlWaq Ava7ebdity
/- Narthampton, MA 01060 Two Sets of Structure(Penns
4://..1,p-h'
`` phone 413587-1240 Fax 413-567-12T2
PROMO Plans
Other Specify
PLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 PrimertY Address: This section to be completed by office
\\ wcc cL,� 6(CL Map Lot Unit
Zone Overlay District
Elm St.District CS District",_„__
SECTION 2-PROPERTY OWNERSHI'tAUTHORIZED AGENT
2.1 Owner of Record: p
R-L.n.,v. `xcc 4.r cw4, / �Ce:\� ` L rr-( \\ cora CSL-\L ,P\cc.c..
Name(Print) Current Mame Address:
CAA
`113 '-3411-32-4i
t.�!-9 Telephone
Signature ..
2.2 Authorized Aslant:
Name(Print) Current Mailing -ru =.s:
Taile �Ir'�.�r.� ..
-&\\ -rat-401i
i.
Si. a .iiir - Taeptwne
SECTION 3•ESTMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Bukdi g {a)Budding Permit Fee
2- Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.FireProtection y([
6. Total-40 +2+3+4+5) V) )1\,t\'1�^ Check Number ‘a,9&V rsrr 0.(0
This Section For Official Use Only
Date
Building Permit Number: — Issued:
Signature:
Building Commissioneritinspeetor of SuMiogs Date
Section 4. ZONING AU Information Must Be Conpteted.Permit Can Be Denied Due to incomplete Information
Existing Proposed Required by Zoning
This column to be MIS in by
Building Department
Lot Size
Frontage
Setbacks Front
Side LL It: L: K:
Rear
Building Height
Bldg.Square Footage
Open Space Footage
(lit area minus bldg&pave
parking)
#of Parking Spaces
Fill:
volume&location) .. J..
A. Has a 5 ial Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES 0
IF YES,date issued:
IF YES: Was a permit recorded at the Registry of Deeds?
NO 9 DONT KNOW 0 YES a
IF YES: enter Book Page and/or Document
B. Does the site contain a brook, body of water or wetlands? NO C5 DONT KNOW Q 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 e
l.
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 t../
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,ex widen,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(chock all applicable)
New Mouse 0 Addition 0 Replacement Windows Alteration(s) [] Roofing
Or Doors 0
Accessoory Bldg. 0 Demolition ❑ New Signs ID) Decks [0 Siding[D] Other[p]
Brief Work: a 1L ^Oa:Mon ofP�C. 4"��7tl'T et con a-.�...- (tom{' A&cY- •
Alteration of existing bedroom Yes _No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Rog -Sheet
O .It New house and or addition to existing Mousing.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?_
L 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
i. 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 CONTRACTORwr � APPLIES FOR BUILDING PERMIT
it Into.*C-SC\CA P4y tAtarknanc'Or, ,as Owner of the subject
property
hereby authorize _ L ' 5? CV kcyft.--
to act on my behalf,in all matters relative to work authorized by this building permit application.
c -�- --
Signature of Owner -J Date -
I. I O Ass ' .as OwnertAuthorized
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 penjury.
Print Name
A /L
Signature of r- :rAgent Date \U "\`y- e
SECTION 8•CONSTRUCTION SERVICES
0.1 Licensed Construction Supervisor Not Applicable 0
Name of License Bolder: Ti/v""a �kvr �� '-n ss1,36
License Number
Vdst 0-03r.‘. (t- �,Lier- c tVAP's- alp(' L \-V4" -701y
Address Expiration Date
+de5037
Signature Telephone
S.Registered Hope(mpruvepm� en�t Contractor I Not Applicable 0
Company Name Regis'.Ion umber
\. . L . _ a _ S 0\0(0- xbira ZUtb
Address Expiration Date
.. _. Telephonesvf
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MAL.e.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 ❑
11. —Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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 in
responsible for all such worts 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 may 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
Nonha opton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature _,
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: \\ l4CC,
The debris will be transported by: ' -K"S^o_rns'. (`(\s1U-Z_
The debris will be received by: v 4.ta1 s(VC 2ty Vt -
Building permit number:
Name of Permit Applicant " Vseno S
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of IndustrialAccidents
-
� 1W= Office of Investigations
a =Milt I Congress Street, Suite 100
as � Boston, MA 02114-2017
www mass.gov/dia
Workers'Compensation Insurance Affidavit: BuilderslContractors/ElectriciansfPlumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual):
Address:
City/State/Zip: - Phone #: _
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. 54 I am a general contractor and 1
employees(full and/or part-time).' have hired the sub-contractors 6. ❑ New construction
2.9 1 am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. employees and have workers' 9 0 Building addition
[No workers' comp. insurance comp. insurance)
required] 5. 0 We are a corporation and its 10.0 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
12.0 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 In must also till out the section below showing theirworkers compensationpolicy information.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tcontactors 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.
lam 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 aad 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
Signature_ Date: _.
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 it:
a _
-_. a._ __ .... . _
Estimate
Raiwi.au 128 Ryan Road
i1G,Yf7�L�LLLL Florence,MA 01062 Date Estimate#
y
8152016 1561
Name/Address
Adam Scarborough and Cecilia Shiner
II Warfield Place
Northampton,MA 10160
Terms Project
On receipt Scarborough porch
Description
Jack hammer rental
1Ea
Demo concrete stairs in front of Roust
48 SF
Removal of nailed hardwood flooring
32 SY
Removal of vinyl ceilings
288 SF
Removal of wood boards behind vinyl
288 SF
Removal of wood stairs Risers(with tread)
40 SF
Removal of wood stairs Handrails
94 LF
Removal of wood stairs Posts
96 LF
Excavate post hole by hand
10 Ea
Column forms for round columns sorra tubes
28 LF
Shores for roof support
7 Ea
Concrete
I CY
Post top tie or anchor, 18 gauge 6 in.x 6 in.(AC6)
IO Ea
Wood columns and porch posts
12 Ea
Deck,2 in.x 8 in.recycled composite lumber deck tongue and groove for front porch and 10 x 19 deck on rear
244 SF
Deck railings,42 in.high handrail.Redwood,select heart,per tanning foot
138 LF
Total
Phone# E-mail C '
Signature /�
(413)341-3838 tom@rainhome.nel jl /"' /f
Page 5 a1C(�-+-i.\.3 ��(���'" 1
Rafffuo
/.\�..:. 128 Ryan Road Estimate
Florence,MA 01062 Date Estimate#
8/5/2016 1561
Name/Address
Adam Scarborough and Cecilia Shiner
Il Warfield Place
Northampton,MA 10160
Terms Project
On receipt Scarborough porch
Desuiption
Concrete footing to support stairway
4 Ea
Deck stairs,three or more steps high,with recycled composite lumber risers
45 LF
Vinyl soffit systems
288 LF
Recycle fees Mixed loads,per load(7 CY)
3 Ea
Building permit fees
1 LS
Repointing brick
104 SF
Project material,labor,equipment,subcontract
Material,per job
Labor,per job
Equipment,per job
Subcontract,per job
"Project Subtotal
"Project Total
Total $31,714.14
We propose to hereby to furnish material and labor-complete in accordance with the above specifications,for the sum total.Payments to be made
as follows:half of full total upon acceptance,one quarter of full total upon the start of the project and the full balance due upon completion.All
material is guaranteed to be as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from
above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.
All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.
Acceptance of Proposal will commence with the home owners signature.Prices,specifications and conditions are satisfactory and are hereby
accepted upon signature.Rainbow Home Improvement is authorized to do the work as specified and to be paid as specified.
Phone# E-mail
Signature
(413)341-3838 tom@reinhome.net
Page 2
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Cityof Northampton
Building Department
Plan Review
212 Main Street
Northampton, MA 01060
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