24A-1245 CALVIN TER BP -2018-0959
GIs u: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24A - 124 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: KITCHEN RENO
Permit BP -2018-0959
Project T JS -2018-001755
Est. Cost: $30000.00
BUILDING PERMIT
Fee: $195.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: LARRY RIDEOUT 11635
Lot Size(sq. ft.): 6621.12 Owner: POLLIN MILLER SIGRID & ROBERT
Zommz: URAn00)/ Anolicant: LARRY RIDEOUT
AT: 5 CALVIN TER
Applicant Address: Phone: Insurance:
17 POWDER MILL RD (413) 885-2876 WC
SOUTHWICKMA01077 ISSUED ON:4/4/2018 0:00:00
TO PERFORM THE FOLLOWING WORK: INSULATENVEATHERIZE EXISTING
BREEZEWAY AND RENOVATE EXISTING KITCHEN -WITHOUT 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:
Smoke:
Final:
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:
FeeType: Date Paid: Amount:
Building 4/4/2018 0:00:00 $195.00
212 Main Street, Phone (413) 587-1240, Fax: (413) 587-1272
Louis Hasbrouck — Building Commissioner
File # BP -2018-0959 L
APPLICANT/CONTACT PERSON LARRY RIDEOUF
ADDRESS/PHONE 17 POWDER MILL RD SOUTHWICK (413)885-2876
PROPERTY LOCATION 5 CALVIN TER
MAP 24A PARCEL 124 001 ZONE URA(100E
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
New Construction
Non Structural interior renovations
Building Plans Included:
Owned Statement or License 11635
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF MATION PRESENTED:
VApproved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/Oft _ __Special Permit With Site Plan
Major Projee¢ 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 Delays
�J fJ
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
\t'
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.
�I
QPCity Of
5 Calvin Terrace
1 message
Louis Hasbrouck <Iasbrouck@northamptonma.gov>
To: Iarry.rideout@comcast.net
Larry,
Louis Hasbrouck <Ihasbrouck@northamptonma.gov>
Mon, Mar 26, 2018 at 8:23 PM
We're going to need an accurate plot plan. Based on the city maps, the new deck may be too close to the rear property
line. The required setback in that district is 20'. By right, the deck can go 5' into that setback because of the existing
building setback. It can't go to the edge of the existing building without a finding from the ZBA. It's complicated; see
attached, section 350-9.2 (B). 9.3 (A) 5, 6 and 7.
When we get an accurate plot plan, we will finish reviewing the application.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413) 587-1240 office
(413)587-1272fax
2 attachments
n 350-9 nonconforming.pdf
170K
5 Calvin plot.pdf
173K
MAR 2 6 '-
SECTION 1 -SITE INFORMATION
Department use only
- _—'— ---,vs Ci y of Northampton
Status of Permit:
- -- -- ilding Department
Curb Cut/Driveway Permit
�- 'A I. 212 Main Street
Sewer/Septic Availability
it Room 100
Water/Well Availability
Northampton, MA 01060
Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272
Plot/Site Plans
/
Q�Q G Q
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address:
section to be completed e
by offic
/ /%O
I Qri
C 4
��T(hiss 1pleted
Map Lot v -I Unit
Nor �hainp,'�
MA
Zone Overlay District
/
Q�Q G Q
Elm St. DlsMol CB District
SECTION 2 - PROPERTY OW NERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
sjm rce M;ller 1P.4;,
P gibe f POI(ct
Ia.40 s.E:"T' s7- 49 yi.e..at j�Y4.
Name nnn
Cunent A]�i�g Atltlre�ssc:/�-O
/,/tA�
D/
` ��
Telephone
Signature
2.2 Authorized Agent:
o w�7
L/ e,r tj
/7 Pe. dev 017.6Ied $,,Alun
Name (Pdnt)4
Current Mailing Address:
V [�
`3B6yS a8�b
SignaNrel e
Telephonene
SECTION 3 - ESTIMATED CONSTRUCTION
COSTS
Item
Estimated Cost (Dollars) to be
Official Use Only
completed bpermit applicant
1. Building
000
(a) Building Permit Fee
2. Electrical
doe
(b) Estimated Total Cost of
Construction from 6
3. Plumbing
Bei
Building Permit Fee
'
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1+2+3+4+5)
Check Number
This Section For Official Use Only
Building Permit Number:
Date
Issued:
Signature:
Building Commissionerllnspector of Buildings
Date
io.rv'�4e r' ole••��, la Co- cast • ✓et'
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION S DESCRIPTION OF PROPOSED WORK (c e k all applicable
New House ❑
Additlon ❑
w�,
Replacement Windows Alteratlon(s) IX I Roofing El
Or Doors 7P !O'
Accessory Bldg. ❑
Demolition pJ
New Signs [I Decks Siding [O] Other is
Brief Description of ProposedP
S>L �o6PN
Work: rt —Tl
r9 Ki
r re $//
Alteration of existing bedroom _Yes X_ No Adding new bedroom Yes X No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
Ga. If New house and or addition to existing hous[na- comolete the following:
a. Use of building. One Family Two Family Other
b. Number of roams in each family unit: Number of Bathrooms
c. Is there a garage attached?
it. Proposed Square footage of new construction. Dimensions
e. Number of stories?
I. Method of heating? Fireplaces or Woodsloves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. Floodplain _Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank_ City Sewer_ Private well_ City water Supply_
SECTION 7a- OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, S ii'l � I�e ` I O � � t
r � r•. C) r f— r , as Owner of the subject
progeny
1
hereby authorize-4voYrOBOt%�
to act�+`in behalf, in all matters re alive to work authorized by this building permit application.
/ia { L, f0 /2— !�y- ( 27 201$
Signature Owner Date
ENnu—
/I q
I, hMt// T , dQo t' , as Owner/Authonzed
A fir hereby d Gare that the statements and information on the foregoing application are true and accurate, to the best o my no e e
and belief.
Signed under the pains and penalties of perjury.
A -q,11 R• a�2a ✓
Print Name
azz V aa
Signature of er/Agent Date
Section 4. ZONING
ALL Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing
Proposed
Required by Zoning
This column to be filled in by
Building Depedmem
Lot Size
Frontage
0 '
S�
Setbacks Front
Q!'
25'
Side
L: /0 R: /0 r
L: /E a R: /d ,
Rear
Building Height
�r
Bldg. Square Footage
11 Zf
1-7 %
11$/
17'
Open Space Footage
(Lot ares minus bldg&paved
9
AAA
rkin
7—
ft of Parkin Spaces
Fill: Fill:
volumc & Locafion
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO (OV) DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document k
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW O 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
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 (9
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, vaBon, 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.
City of Northampton
.\�.. Massachusetts .�s` • .:��
DEPARTMENT 0£ BUILDING INSPECTIONS 2 r V
212 win Street • Municipal Building
Northampton, rm 01060 +:•p. y�P°�
Debris 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.
The debris from construction work being performed at:
g Calwn �2rreu
(Please print house number and street name)
Is to be disposed of at:
(Please print name and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
PUsea u U454—
(Company Name and Address)
- /l , l L ;o9 //—' Q 27 101
Signature of Permit Applicant or Owner Date
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
City of Northampton
ss
Massachusetts
DEPARTMENT OF BDILDING INSPECTIONS n
312 Win at[eet • Nivai<ipel Building
Northampton, Kh 01060
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation ("OCABR") regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes. Prior to
performing work on such homes, a contractor must be registered as a Home Improvement Contractor ("HIC').
M.G.L. Chapter 142A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion,
improvement, removal, demolition, or construction of an addition to any preoristing owneroccupied building containing
at least one but not more than Pour dwelling units.... or to structures which are adjacent to such residence or building' be
done by registered contractors.
Note: If the homeowner has contracted with a corporation or Ld
LC, that entity must be registered.
Type of Work: Kt tbNe h G --J :Re"yAi1jb Est. Cost: j22,0
i
Address of Work:(na�V vv. ionsc �—e_
Date of Permit
I hereby certify that:
Registration is not required for the following reason(s):
_ Work excluded by law (explain):
—Job under $1,000.00
_ Owner obtaining own permit (explain):
_Building not owner -occupied
Other (specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L. Chapter 142A. SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT. SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
3•a6 - got g Lavey�t�Gx%` I5L91lGs
Date Contractor Name HIC Registration No.
OR:
Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:
Not Applicable ❑
1_
'RI
Name of License Holder: L I.rr\J
/
License umber
l7 f�ew�e,wlrU .bAp,,Lk
MC, O[077
Address
Expiration Date
Signature Telephone
9. Registered Home Improvement Contractor:
Not Applicable ❑U
LA7 W,, - /&ei4
y+ ,J
1
«4 TSU
CompanvN me
Registration Number
a 7 e, r,✓c�za- GLw
uir-e %% Oto?7
oB�a a /moo
Address
Ezpira onEzpira on Dam
Telephone Y.3 8ArAT"74'
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(8))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
The Commonwealth of Massachusetts
Department oflndustrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leeibly
Name (Business/Orgmiz tion/Individu 1): /,grr* RIAP001-/ L)" PbV 14 �VL��er'S
Address:_ 17 Pow Jer yn, LL tC vl
City/State/Zip: So✓tt�w_,ck /jig Oio 77 Phone #: IV 3 - SBS- _1876
A,r--e,/you an employer? Check the appropriate box:
1.1YJ 1 am a employer with 1 4. ❑ I am a general contractor and I
Type of project (required):
6. ❑ New construction
employees (full and/or part-time).•
have hired the sub -contractors
rq�,
7.�jtemodeling
2. ❑ I am a sole proprietor or partner-
listed on the attached sheet. t
ship and have no employees
These sub -contractors have
S. ❑ Demolition
working for me in any capacity.
workers' comp. insurance.
9. ❑ Building addition
[No workers' comp. insurance
5. ❑ Weare a corporation and its
ME] Electrical repairs or additions
required.]
officers have exercised their
3. ❑ I am a homeowner doing all work
right of exemption per MGL
1 I.❑ Plumbing repairs or additions
myself. [No workers' comp.
c. 152, §1(4), and we have no
12.❑ Roof repairs
insurance required.] t
employees. [No workers'
13.F] Other
cmc
m�. inaurane r,nuired 1
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
'Contractors that check this box must attached an additional sheet showing the name ofthe sub -contractors and their workers' comp. policy information.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy andjob site
information.
Insurance Company Name: fit 4o,,'t, 'C CA&_ ftr ...ta sa
Policy # or Self -ins. Lic. #: ryl-} I Cwt C{t/ Za.G Expiration Date; O'S - tq- ]Ql �
Job Site Address: iJ C'4iyr.-, je P�SC-P City/State/Zip: 416k pvl lW CYOJCO
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 insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
-?'k76
Official use only. Do not write in this area, to be completed by city or town ojjlciat
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
CERTIFICATE OF LIABILITY INSURANCE
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 INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: It the Certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
Ute terms and conditions of the policy, certalre policies may require an endorsement A statement on this certificato does not confer rights to Ne
certificate holder in lieu of such endorsernae fsl.
PRODUCER
ALEXANDER W BORAWSKI INC
88 KING STREET SUITE A
INSURED
LARRY RIDEOUT
RIDEOUT BUILDERS
POB 290
SOUTHVJICK MA 010]]m�eF �I
COVERAGES CERTIFICATE NUMBER: 2503D] REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXC W SIGNS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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DESCRIPTION OF OPERAnONS ILOCAnMS I VEHICIFS IAegiD 101,AE0Xl[nal RemaMa S[M1eOule, may YwetlacM1aJ Tnxgo aW�oN reyulraEl
Workers' Compensation benefits will ES paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B. no autimno etion Is given to pay dams for benefb to
employees in states other than Massachusetts if the Insured hires, or has hired Nose employees outside of Massachusetts
This cedificate of insurance shows Ne policy in once on the data Oat this cartifcete was issued (unless Oe e,l ation data on the above polity premdes Ne issue date of this
cedificate of insurancej. The ance, of this coverage can be monitored daily by accessing Oe Pmof of Coverage - Coverage Verification Searcn tool at
wMw mass.govllwdM rkel mpensbOnfinvesUgatlonV.
Sole proprietor has not elected COVerege.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS.
City Hall 210 Main Steel
AumDRREDREPREssNTAnvE
Northampton MA 01MO `-" Xx
Daniel M. Crr>rvJey, CPCU, Uce Presitlent- Resitlual Market - VJCRIBMA
reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD