05-032 (2) 118 RIVER RD BP-2017-0783
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:05-032 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY� FUND (MOL c.142A)
a
Category: . Re.tac:t ant BUILDING D(
G 1 ERM,IT
T
Permit# BP-2017-0783
Project# JS-2017-001300
Est. Cost;$4500.00
Fee:$100.W PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: MARK SARAFIN 053434
Lot Size(sq,ft.): 134164.80 Owner: CRD METAL WORKS LLC
Zoning:WPU22VGI(1I7)/SR{S)NRA(0)I Applicant: MARK SARAFIN
AT: 118 RIVER RD
Applicant Address: Phone: Insurance:
42 Pomeroy Meadow Road (413) 529-7812 Workers
Compensation
SOUTHAMPTONMA01073 ISSUED ON:12/13/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:FRAME IN NEW OVERHEAD DOOR, INSTALL
DOOR, REPLACE EXISTING OVERHEAD DOOR IN OTHER LOCATION
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 It 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 FIS RULES AM)REGULATIONS.
Certificate of Occupancy Signature:
FeeTepe: Date Paid: Amount:
Building 12/13/2016 0:00:00 $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0783
APPLICANT/CONTACT PERSON MARK SARAFIN
ADDRESS/PHONE 42 Pomeroy Meadow Road SOUTHAMPTON (413)527-7812
PROPERTY LOCATION 118 RIVER RD
MAP 05 PARCEL 032 001 ZONE WP(122VG1(117)/SR(SWRA(0)(
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT > �
Fee Paid l
Building Permit Filled out `
Fee Paid
TofConstruction: FRAME IN NEW OVE E R INSTALL DOOR,REPLACE EXISTING
OVERHEAD DOOR IN OTHER LOCATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
BuildingPlans Included:
Owner/Statement or License 053434
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
"INFORMATION
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 Variances
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
Pemol' io ' -lay
/,�► �' /2 —/5— x ........
Siy = e of Bu di _ i"'icial 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.
Versionl.7 Commercial Buildin• Permit May 15,201X)
F 1 ?itU ki ity of Norfhampton Department use only
3 Status of item,
Tiding Department Curb CutfOmewey Permit
72 Main Street
1L Sewer/Septic Avallelsfily
c Room 100 Watelmell Availability
Northampton. MA 01060 Two Sets of Structural Plans -
phone 413-587-1240 Fax 413-587-1272 PbUSite 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 I•SITE INFORMATION
1.1 Property Address: This section to be completed by office
t i 8 2.,,c 2 QOa CO Map Lot Unit
Leek , W.,... zone OverlayofsMM
Elm St.District Ce District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
i
C e O Wk'CAL WON-VS l /? .2/>,/,/,;///1 Fr'
Name(Print) Current Mailing Address:
Signature (<1.44:1 �AK.S nlSt1 7 '>7r e,..,.j AT) 1 C717 • / I�c�'".
g Telephonele
2.2 Authorleed Agent
VV\+het-\C.. 5sYLw.'F•ih uka1 ConAvto v44•44:10.--1Name(Pant) Current Mailing Address: t
Soar*wf,to , An NA, 640-}
Signature Telephone 413. <to'‘-q fl-to
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 4 _t (36, (a)Building Permit Fee
2 Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Penult Fee
4. Mechanics}(HVAC) •
5.Are Protection
6. Total t(1 +2+3+4+5) Check Number ,pt{yf3 4/10
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/inspector of Buildings Date
Version! 7 Commercial Building Permit May 15,20(X)
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions 0 Accessory Building❑
Exterior Alteration *Existing Ground Sign❑ New Signs Roofing❑ Change of Use❑ Other 0 (�
Brief Description Enter.s—e� a brief description here. Vawe "spa-,"spa-,c . —ves s 0 on�41b- +a� & reoTt
Of Proposed Work: 4.Aeakigt\ &ODIC, Qt plate eA.s-1, eoe<NWD Sdoaae .r` 1344Ve2
SECTIONS-USE GROUP AND CONSTRUCTION TYPE (^o GA
_ USE GROUP(Cheek as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 0 A-2 ❑ A-3 0 to I 0
A-4 0 A-5 0 18 0
S Business O,... 2A 0
E Educational 0 28 ( 0
F Factory 0 F-1 0 F-2 0 2C 0
H High Hazard 0 3A ❑
I Institutional 0 I-i ❑ I-2 0 I-3 ❑ 38 n
M Mercantile 0 4 0
R Residential 0 R-1 ❑ R-2 0 R-3 ❑ 5A ❑
S Storage 0 s-1 0 5-2 0 58 I 0
U Utility ❑ Specify:
M Mixed Use o Specify
S Special Use ❑ Specify:
COMPLETE THIS SECTION iF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard index 780 CMR 34):
SECTION 0 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
1st
2"
2" .
3' 3"
4" 4a
Total Area 1st) 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 n Private S Zone Outside Flood Zone❑ Municipal❑ On site disposal systems
Version!J Commercial Building Permit May 15,NMN)
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be fined in by
Building Department
Lot Size
Frontage
Setbacks Front
Nide
Rear
Building Height
Bldg,Square Footage k ---
Open Space Footage T
(rot area minus bldg&paved
L�
II of Parking Spaces
File
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DONT KNOW 0. YES Q
IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW YES Q
IF YES: enter Book Page and/or Document if
B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW kl,SA YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Heeds to be obtained 0 Obtained Q , Date Issued:
C. Do any signs exist on the property? YES `„ NO Q
IF YES,describe size, type and location:
D, Are there any proposed changes to or additions of signs intended for the property? YES Q NC)
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or tilling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO •
IF YES.then a Northampton Storm Water Management Permit from the DPW is required.
• Version!,?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 115(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable 0
Name(Registrant):
Registration Number
Address
Expiration Date
Signaime Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Exptiaton Date
Name Area of Responsibility
Address Registration Number ....
Signature Telephone — Eviration Date
Name Area of Responsibly
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone _ Expiration Date
9.3 General Contractor
Not Applicable ID
Company Name:
Responsible In Charge of ConsWction
Address _.
Signetum Telephone
•
' Version!.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes O No Q
SECTION II-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS
'\
e-AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
} 1, -AA (\rj �,.)J C\ \ ,as Owner of the subject property
A hereby authorize 1'^t` `�{-1".L /� '4, da✓Zv�TFs v1 to
1 ` act on my behalf, in e,(F matters IativeAo v)ork authorized by this building permit application.
��1/Ai / la-- is—lUa
Signature of Owner �+ L. Date
I, �Nw"~C J Vbrilasaea^_ ,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 under the pains an penalties of perjury.
� �
�' .
Print Name �
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10,1 Licensed ConstruQUO,nr,Supervisor: Not Applicable ❑
peme of License Holder• V'\t&n.L S\+ea we-\,... C'S—OS 54 3`-1
License Number
Lik PO 410,04.2 Wk.% o.,, S*0taW,p t \ /Al v4- - a a-)-1-
Address 010:1-.V Expiration Date
//
413-5 r3-%DS"
Signature Telephone
SECTION 13-WORKERS COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.152,9 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 SJ'-'V No C{
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: \\, C atZ god.c0 &erepS
The debris will be transported by: 5veavb.c -... 1—€V•\Sid *x
The debris will be received by: vat\ °rcicL ..4
Building permit number: t �t 1
Name of Permit Applicant Y t� -ait ,% Jc2o4FN✓i
/�C -'2�✓cA /
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
n n Department of Industrial Accidents
-"—.IG—El Office of Investigations
ISM
1 Congress Street,Suite 100
r f, Boston,MA 02114-2 01 7
www.mass.govldia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information /, Please Print Legibly
Name(Business/Organization/Individual): yy AUK([ 1.sAk s. a
Address: `{La 1'Po e#CeK(A W‘�gpt�..v
City/State/Zip: M,s}$ ekun \ QA/\b D1
O( lleSec pe#: of-3- `i - 8\
Arc you an employer?Check the propnate box: Type of project(required):
I. am a employer with I , 4. 0 I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. New construction
listed on the attached sheet. 7. 0 Remodeling
2.0 I am a sole proprietor or partner-
ship and have no employees These sub-contractors have S, ®Demolition
and have workers'
working for me in any capacity, employees 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
3.0 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
12.0 Roof repairs
insurance required.]f c. 152.§1(4),and we have no
employees. [No workers' 13.0 Other
comp.insurance required.]
'Any applicant that checks box 9I mint also fill out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suck
: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 subcontractors have employees,they must provide their workers'comppolicy 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: A I vv. ,
Policy#or Self-ins.Lie.k: aoi b`4'
SIL,C. —p too Coo lv3a — Expiration Date: tl'I�IS�( le
Job Site Address: 1 tg QW42 goad City/State/Zip: LP'PO4
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 insuran cove e verifi r r ion.
I do hereby certify pain d p hies o lerju at the information provided above is true and correct.
Signature: -t Date: /al"-/a"7CD
Phone#: q�3-7/ ' 7 - 9' 1 "7
(Oficial 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#:
December 10, 2016
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton,Ma. 01060
I Request you grant a modification to waive the requirement for construction control of
the project at CRD Metalworks at 118 River Road in Leeds because the work is of a
minor nature, will not affect health, accessibility, life and fire safety, or structural
requirements and is impractical in that the cost of construction control is considerable
when compared to the cost of the proposed work. Thank you for your consideration.
Respectfully,
/2)/ //-1/
Mark Sarafin
Sarafin Builders
42 Pomeroy Meadow Road
Southampton, Ma. 01073
Octobe22,2015
Louis Hasbrock
Building Commissioner
21 Main Street
Northampton,Massachusetts 01060
Re: Equinox Partners
118 River Road
Leads, Massachusetts
Subject: Addition of overhead 12'x24'door replacing an overhanging'x8'door and an adjacent 3'x7"
door.
Dear Mr. Hasbrock:
For the above reference a new overhang door, 12'x24',wili replace an existing 8'x8'overhead
garage door and a3'xTdoor. The overhang door will be installed between existing columns spaced
at 25', The 12'x14'opening is a non bearing wall.Since it is anon bearing wall the as-built structure
wil not affected.
Yours truly, /I
ri.„0
Frederick J. Dzialo
4. FREDERICK`?:
J.
OZIALO
No. 17657
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