24B-079 (25) 73 BARRETT ST#4138 BP-2017-0755
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 248-079 CITY OF NORTHAMPTON
Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Deck BUILDING PERMIT
Permit# BP-2017-0755
Project# JS-2017-001263
Est.Cost:$1600.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JONATHAN DEVINS 083221
Lot Size(sq.ft.): 785822.40 Owner: HATHAWAY FARMS TOWNHOMES LIMITED PARTNERSHIP C/O SPEAR
MANAGEMENT
Zoning:URC(100)/WP(7)/ Applicant: JONATHAN DEVINS
AT: 73 BARRETT ST#4138
Applicant Address: Phone: Insurance:
73 BARRETT ST SUITE 2000 (413) 586-1405 (5) WC
NORTHAMPTONMA01060 ISSUED ON:12/12/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:BUILDING A 12X15 DECK OFF OF THE BACK OF
APARTMENT FOR RESIDENT USE
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 ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 12/12/2016 0:00:00 $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0755
APPLICANT/CONTACT PERSON JONATHAN DEVINS
ADDRESS/PHONE 73 BARRETT ST SUITE 2000 NORTHAMPTON (413)586-1405(5)
PROPERTY LOCATION 73 BARRETT ST#4138
MAP 243 PARCEL 079 001 ZONE ORO100VWP(7)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OCT
Fee Paid
Building
gitding Permit Filled out �J
Fee Paid
Typeof Construction: BUILD - IS DECK OFF OF THE BACK OF APARTMENTF R RESIDENT
USE
New Construction
Non Structural interior renovations
Addition to Existing
Accesso Structure
Building Plans Included:
Owner/Statement or License 08322 I
3 sets of Plans/Plot Plan
THE FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
I F MATION 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
Signature o 1u' 1 ng ' dial L to
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 MOL 40A.Contact Office of
Planning&Development for more information.
SILLVersion).7 Commercial Buildint Permit May 15,2000
Department use only
g _ City of Northampton Status of Penni:
/ Building Department Curb Cut/Driveway Permit ,,,,
• 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PioUSite 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 L
1.1 Properly Address, This section to be completed by office
73 Bonnett it Apf ' ft3S Map Lot Unit
NJof H14MptorJ MA 01060 Zone Overlay District
Elm St District Ca District
SECTION 2-PROPERTY OWNERSHItAUTHORIZED AGENT
2.1 Owner of Recorda:-�
H4th .. 'chins lcw,u lanes l T' 73 Jcneit 34reet Sw+c o7Q0o Norttssintsisassa
Name(Print) omen Meiling Address
413 -5fria-1405
Signature Telephone
2.2 Authorized Agent�:ry �p
11W4MP", yc✓iN-+r Axri.+h.�rf- Mar+.Jee 73 YCr/rtt arta() 5..,4e tow Aiorrns,-p+w+MR
Name(Prior) U Current Meiling Address:
413-44% -/Yof
Signature // ne
Telepho
SECTS r-ESTI.; lOCs Stti. TION a.c
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
/400.00
2. Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection �r
6. Total=(1+2+3+4+6) Check Number t t1 8 (.49 1/a✓r)
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
) Y7— 07?
Versionl.7 Commercial Building Permit May IS,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wall Signs ❑ Demolition 0 Repairs 0 Additions 0 Accessory Building
Exterior Alteration 0 Existing Ground Sign 0 New Signs❑ Roofing❑ Change of Use❑ Other El
Brief Description Enter a brief description here. B“,i4:,t 4. i7 715 deck off o4 tie 174.41/4. of
Of Proposed Work: Ike cert,"e-+4 for resit.*4 J+ 3c
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 0 A-2 ❑ A-3 0 1A ❑
A-4 0 A-5 0 1B ❑
.._
B Business 0 2A 0
E Educational ❑ 2B ❑
F Factory ❑ F-1 0 F-2 0 2C ❑
H High Hazard 0 SA 0
I Institutional 0 71 0 72 0 F3 0 38 ❑
M Mercantile 0 4 ❑
R Residonbal ❑ R-1 0 R-2 ❑ R-3 ❑ 5A El
s Storage 0 5-1 0 S-2 0 5B j 0
U ll5lity ❑ Specify:
M Mixed Use ❑ 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 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(st)
2m 2°
3'1 3a
4th 4th
Total Area(sq Total Proposed New Construction (s0
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 0 Private 0 Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑
Versionl.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column in be fined in b)
Building Depanmcm
Lot Size
Frontage
Setbacks Front
$ide L:_ R: L: R:
ear
Building Height
Bldg. Square Footage
Open Space Footage /
(Lot area minus bldg&paved
parting)
#of Parking Spaces
Fill:
(voteme&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO * DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW O YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO fill DONT KNOW O YES O
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained Q , Date Issued:
C. Do any signs exist on the property? YES 40 NO lJ
IF YES, describe size, type and location: }coo estrascc 1;705 or .,reit $F ide,ab;<y;,s0 IWtr.e.,.y
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 40
IF YES, describe size, type and location:
E. MI the construction activity disturb(clearing,grading,excavation,or filling)over i acre or is it part of a common plan
that will disturb over i acre? YES 0 NO 40
IF YES,then a Northampton Storm Water Management Penna from the DPW is required.
Version L7 Commercial Budding Permit May I5,2000
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 ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Registrant):
Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registtation Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date .r
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address .�.
Signature Telephone
Versioni.7 Commercial Building Permit May 1.5,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No O
SECTION 11-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
c4 9,f 2 41/11Q-ler5
c�
�r ._._ _,as Owner of the subject property
hereby authorize oNM ,4J .PLye✓/rS to
act on my bo -" all .iters r:;, ye to -• authorized by this building permit application.
e
v' e R .. // 7//10/6
Signature of a. • / Date
I,^...i....{�0i✓4JA<r+ yc✓!r's .as OwnertArMorized
Agent hereby declare that the statements end information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
j}o
Print Name �JJ�
//ii70/(n
Sig of Owner/Agent /D
S I0N 12-CONSTRUCTION SERVICES
10.1 Licensed Constructio.n.--�SSuPervisor: Not Applicable Cl
Name of License Bolder: Z/arorlAom De✓ir✓ . C5-0/3.2.2 (
�ry License Number
IS pgr/cSivice+. ,$, t+c g000 9//>42
ao/S
Address ExpIrafion Da
Y/3-586-Pier-CO
5:. .:.•�. Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(5))
Workers Compensation!nsurane/a affidavit must be completed and submitted with this application.Failure to provide this affidavit will result
in the denial of the issuance of thebuildingpermit.
Signed Affidavit Attached Yes a+ No
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, 554, 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 150k
Address of the work: 73 Bctie$` Sic
The debris will be transported by: ' .� .lic ervicc
The debris will be received by: `Rcf4hc Ser ✓;<e
Building permit number:
Name of Permit Applicant 1;Jc/tr.-, 12/ler-s"
Date gnature of Permit Applicant
S" 1n commonweaun of massacnusetrs
Department of IndustrialAccidents
It c=_YD -= a Office of Investigations
SNOW
6 as 1 Congress Street, Suite 100
" —` al' 0 Boston, MA 02114-2017
_ wwft'.mass.govidia
Workers Compensation InsuranceAffidavit: Builders'ContractorsfEledridansPlumbers
Applicant Information Please Print Legibly
Name(Business:OrganizationIlndividual): er . G . i.r . _ r.,r P
Address: 73 'Barre* <Slree-I „ .St.ite,,,,, Ooo0
Ci /State/Zip: ,,,, ,, ., r , . _, Phone#:- o Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. 0 I am a general contractor and I
employees(MI and/or part-time).* have hired the sub-contractors 6. 0 New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. D Remodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working for me in any capacity. employees ad leve workers
9, 0 Building addition
[No workers' comp. insurance comp. insurance.t
required.] 5, l We are a corporation and its 10.D Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 1 I.❑ Plumbing repairs or additions
myseff. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] r c. 152, §1(4),and we have no
employees [No workers 13.0 Other
comp. insurance required.]
*Arty applicant that dteala bac#1 must also WI out the section bdav slowing their wwke'3 compensation policy irtanaiat.
I Homeowners who submit this affidavit indicating they, arc doing all work end 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 subcentra2arsteeee tcy tlaf mum 1ral4dettidr wakes coup.polio mutt
I am an employer that is providing workers' compensation insurance for my employees. Below lathe policy and job ate
information.
Insurance Company Name: A j M Ikiuj as I
Policy#or Self-ins. Lic.#: vtl M7 . 800 - 60061 e g - Bolen Expiration Date: 7pp4/'a 17
Job Site Address: r73 13s rctit SF City/State/Zip: No,ft,,..yV.N M4 oio60
Attach a copy of the workers* ampensation 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 ceHib
under thepainsand penalties of perjury that the information provided above is true and correct.
Signature:
S�/---.e..„O Date.
,
Phone# W/3-,f 86 - /YOS _ ro - -
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):
I.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
ACORD* CERTIFICATE OF LIABILITY INSURANCE CATE(MWDOMYYT'
fie,./ 10/18/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERISI, AUTHORIZE[
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: II the certificate holder is an ADDITIONAL INSURED,the potieyties)must be endorsed. H SUBROGATION IS WAIVED, subject IC
the terms and conditions of the policy,certain policies may require en endorsement. A statement on this certificate does nol confer tights to 14M
certificate holder in lieu of such endorsements}. —
PRODUCER I COONTACTMichanl SonacoraO i.�.
Banecorso insurance Agency, Inc.
NAME-
PHONE E^, (T 81)53'1-3200 __ .mc M10$115 320a
.10 Cedar Street aoBa[as.michae1tbon co coins.con,
Unit 132 INSURERISI ARORUING COVERAGE NAIC P_
Hoburn MA 01801 i INSURER AIM Mutual
Rfb
Hathaway Farms Townhomes, LF
INSURER
c/o Spear Management Group I INSURER
575 $outhbri do* Street (INSURER E:
Auburn MA 01501 l INSURER w. LT
COVERAGES CERTIFICATE NUMBER,CL1532703828 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI01
INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM!
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
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CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL aE DELIVERED IN
210 Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Northampton, MA 01060
AUTHORIZED REPRESENTATIVE
01968-2014 ACORD CORPORATION. All rights reserver
ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD
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athaway Farm
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Commissioner Hasbrouck 12/7/16
Subject: Request for Waiver
t request that you grant a modification to waive the requirement for control construction for the Patio
Deck at Hathaway Farms Townhomes 73 Barrett Street,Apartment 5148, in Northampton 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 control construction is considerable when compared
to the cost of the proposed work.All work will be completed within the prescriptive requirements of
780 CMR.Thank you for your consideration.
"Mass Amendments, sections 107.1 allows for an exclusion from control construction for this project"
Respectfully,
Jonathan Devins
Operations Manager
Hathaway Farms Townhomes
73 Barrett Street
Mass CSL CS-083221
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��� City of Northampton
Building Department
Plan Review
212 Main Street
Northampton, MA 01060