42-132 910 WESTHAMPTON RD BP-2018-1145
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:42- 132 CITY OF NORTHAMPTON
Lot -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2018-1145
ProjectJS-2018-002062
Est.Cost:$27000.00
Fee: $175.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THOMAS DISANTO 069144
Lot Size(sp.ft.): 15942.96 Owner. MORINI JEREMY
zoo Applicant: THOMAS DISANTO
AT. 910 WESTHAMPTON RD
ApplicantAddress: Phone: Insurance:
420 HOLYOKE RD (413) 568-7036
WESTFIELDMA01085 ISSUED ON:5/412018 0:00.00
TO PERFORM THE FOLLOWING WORK.•REPLACING WINDOWS, VINYL SIDING,
REMOVE NONBEARING INTERIOR WALL
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:
FeeType: Date Paid: Amount:
Building 5/4/2018 0:00 00 $175.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File 4 BP-2018-1145
APPLICANT/CONTACT PERSON THOMAS Vi SANTO
ADDRESSTHONE 420 HOLYOKE RD WEF TFiELD (413)568-7036
PROPERTY LOCATION 910 WESTHAMPTON RD
MAP 42 PARCEL 132 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
CLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tvoeof Construction: REPLACING WrNDO1 VE NONBEARING INTERIOR
WALL
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included'
Owner/Statement or License 069144
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF4?RMATION 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 Delay
ire of Building O cy Dale
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.
f Northampton Status of Permit: Department use only
EVE®uilding Department Curb CuVDriveway Permit
-7 21 MainStreet Sewer/Septic Availability
f 00 Ti 100 Water/Well Availability
2 2018 N rtha pion, MA 01060 Two Sets of Structural Plans
phone 41 587 1240 Fax 413-587-1272 PloVSite Plans
ce"..of stI0.01N0 Other Specify
esp
APPLI ,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address- This section to be completedby office
q1/0 WC5i-hAWf1/q+o-\ -9A, . Map Lot / 1 , Unit
-♦��o V.2�Lz. W T ' Zone Overlay District
Elm St.District Ca District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
c 12Ew1u�'lgR�rJI 9)b W(nAe,Y�
NameV Cu'nIent Me"Address:
p 7 247 " 5'3
e Y1/PM.t N Telephone
Sigretu
2.2 Authorized Aoent: ifI v flo
tf aS ' 5V5XAto (/,j QS'V ,6L 24A 0(ok
Name(Print) Current Mailing Address:
till s .2 `J- &7a s9
Signature Telephore
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by pennit applicant
1. Building 2
7 d00 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) I Check Number I ? p
This Section For Official Use Only
Building Permit Number Date
Issued
SignaWr .
Building Com loner/Inspector of Buildings Date
.`J,M4-5dls0t--tb @ he`tM2'tl . can
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
__ .
{ vine :,tb�t3
$ ._�.�..�.—.mow...
yy 4
L ._.........N..v�;c-�
5' }
Section 4. ZONING All Information Must Be Completed, Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This m[aran to be fi1]N in by
Building Department
Lot Size
Frontage
Setbacks Front
Side U R: L: R:
Rear
Building Height
Bldg.Square Footage
Open Space Footage
(L.,s.minus bldg&paved
parkin')
#of Parking Spaces
Fill:
volume&location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW YES O
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO -(b 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 I yl
IF YES, describe size, type and location: Y"
E. Will the construction activity disturb(clearing,gradin999�te GGpaaavation ,or filling)over 1 acre or is it pan 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(check all applicable)
New House Addition [ReDpI0ac:ementnTA`d-ws Altemetion(s) Q Roofing
,�,( oAccessoryBldg. ❑ Demolition L igns (0] Decks (q Siding ] Other(t7J
Brief Description of Proposetl
Work: %Oi�Y'rm� e l 7taD'w14I Uvhu 6),Z3 Y 4hnv CA, Int. Wd( �Y101A �XQr�rt�
Alteration of existing bedroom_Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
Oa. If New house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family Omer
b. Number of rooms in each family unit: Number of Bathrooms
c. Is mere a garage attachetl?
d Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of healing? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of Construction
i. Is construction within 100 fl.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 A''GrrE.,N��T OR CONTRACTOR APPLIES FOR BUILDING PERMIT
JygeI, u I V�()YI 11 I as Owner of the subject
property I f���q�� ^ /
hereby authorize _ ykkl
to act on my behalf, in all matters relative to work authorized by this building permit application.
.Q,fZtA✓kL� 6/2/18�
Signature of Owner Date
I, I Ylr�tAO S �`-ScID..dro 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 and penalties of perjury.
aS V/ Sp,ni'o
Print Name
�� ti5 �MnscS- S�L�I�
Signature of OwnedAgent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Constnucti�on yS�u�cer oorr-: / _ Not Applicable ❑
Na.of License Holder'. 1''V�M1^oS V) Y,,A c)(01
� f pp License Number
`�' (tiekz [� WPS'FA'10 �� V1�- OloB� 7�13�1A
Atltlress ..n1 Expiratio Date
u��
Si nature Telephone
9.Registered Home Improvement Contractor: Not Applicable ❑
110710
Company Name Registration Number
�I�v`1� 7f orrt2�/1�tO t'a J-ta„P.a /1
Address 11 Expilation Date
1 o d Telephone S(aal'f-703
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
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... No...... ❑
City of Northampton
R Massachusetts
� i.
1(y� msnxzraarT OF BaILDIPG INSPECTIONS
212 Main Street • lNn 010 auiltling
1� Noxthamp[an, MR 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("H IC").
M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion,
improvement, removal, demolition, or construction of an addition to any pre-existing owneroccupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building" be
done by registered contractors.
Note:irthe homeowner has contracted with a corporation or LLC,that entity mast be registered
Type of Work: /tu Ilri„rs Est. Cost:_276ou . c°
Address of Work: 9 iD (A/eA , ZA (An?.
Date of Permit Application: s/L/I Y
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:
1 hereby apply for a building permit as the agent of the owner:
/Z_11y �� D;st�� 11071(3
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
City of Northampton
pp ,k Massachusetts
D ARTS r OF BUXWD G MS ECTIONs .
L -'3 212 Main Street N 01 ci Building
oxfff
�T MNamptonon, M� 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c40, 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:
(Please print house number and street name)
Is to be disposed of at:
414 fto�ai� Rd WVsVRC � - amp sre✓
(Please print name and locafion of f".1.yi:)
Or will be disposed of in a dumpster onsite rented or leased from.
Coopr� Il2MC�
(Company Name and Address)
S/2/1I
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.
_---''=--- The Commonwealth ofMassaehusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston,MA 02114-2 01 7
-. www.massgolvdia
\\orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
'f0 BE FILED WITII TIIE PERM IH NG AUTHORITY.
Applicant Information p Please Print luestibi
Name (Business/Organieetion/Individual): /YVs vtl �D„ur}U-_ O `rAn fi 4�U,(bylpyt� _
Address:
City/State/Zip: 61,ok• Ola fr) Photic#: 413 " Sb8'-703 1,
Are you an employeR Check the appropriate or.:
Type of project(required):
I_b�l oma enrployer with 2 empuy,e0ulandrorpae-time7'
7. F1 New construction
2.F1 l am a sole proprietor or pannmhip and have no employees working for mein R. aRemodeling
any capacity_(No workers comp,insurance 2yuired.1
1❑l am a homeowner doing all work myself[No workers'wmp.insurance required]' 9. LBEhermartion
10❑ Building addition
4_MIni a homcownerand will
ether havring e
worraemrsmpenanm all work
rance or
soeny_ Iwill
ensuremm all wmraemrseiNer have workers compensation inaaranceor am sole 11.[—] Electrical repairs or additions
proprfuors with no employees. 12.El Plumbing repairs or additions
5_❑Ia.a gen rut contmnor and l have hired the sub-contractors listed on the aaachW sheet 13 Roof repairs
These suboontmetom have cmployce and have waders comp_i sumnee.
s n t
6.0We am acotion and its officers have cxereised their right of exam 14.00ther_
ryora y ocean per MGL c.
152.$qq),and we have no employees.IIJe waders comp.'nuvrenecrryuirexl]
"Aav applicant that checks Inx#1 must also fill out the section below showing their workerscompensation policy information.
'I bravowman who submit this affidavit ndicating they are doing all work and then hire outside connotes,must submit a new effacer molecule such.
:Contractors that check this box must muched an additional sheet showing the name ofthe sub-comractors and state whether or not these entities have
cmployws. 11'the mme-a mmcmrs have employees,they most provide their waders comp_policy mureau
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. _
Insurance Company Name. ) /— ��f�s
Policy N or Self ins
Lic.k: ('✓C Expiration Dale' ZO q
�����,�,� � 1
Job ch Address: �ti9 �11.f��. �� City/State/Zip:
Attach a copy of the workers'comp nsation policy declaration page(showing the policy cumber and expira[io date).
Failure to seeure coverage as required under MGL c. 152, $25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations oflhe DIA for insurance
coverage verification.
I do hereby ccer i11fy_under th(eepaiins and penalties olvaerjury that the information provided above is true and correct.
Sienature: I,WM1'�d l �)tJ.cw.'Y' Date: Z i
Pwme# 90 - 244 - 0G51
Official use only. Do not write in this urea,to be completed by city or town official.
City or Town: Permit/License a
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: Phoned:
G�o;v, w.. dvtct
......... izcw:nuEn ,r ( l k
x
r ti
i
r-
�fl
LIVW6 AREA wy
wESTFIeLD,MA Oise
tis-SWM
Tom D1Snnto Home Improvement
414 Holyoke Road, lVestfield MA 01055
CSLT069144 Reir4110710
PhonetFax 413-565-7036
Email:
Web Site DiSante Horne ImproeemenLcom
Estimate Prepared for:
Jeremv Morin: April I ' 2018
410 Westhampton Rd
Florence MA
413.297-1153
OvervietY' General interior and zsiznor rzmode!ine.
To include:
Il purmit Ne will apply for and obtain a bmildir ,permit -a required- Cost 5400.00
21 Prep Exterior Strip the existing Masonite siding and dispose of t!:e debris,'_:00 st:
P-_emgce the front wend amrr deck and steps.
Remove and dispose of 2 kiic.ten rt-indoves and re-fame wall rot a sink w(ndow,4-1r36
Remove and dispose of5 ai n taus on porch and reframe>_ walls her a 6`patio siidi-i�
door in the back tial; and a 5 z {'Nlime ,kundo,, in It,gable mall.
Prep Interim.- Reme,a the all henvecn the Kite a and Porch
Extend the mid scan wall to c Bate a nese cellar enrrr_
Finish n'ork...etudes "print ready'dnunll but no painting included.
Cost: S10,800.00
3! Siding Install Mastic Oealion Ncnuan Buv any: siding o�er MS',bantold,insulation boar'.
INIn evinyl soffit material under save.
Can all trim wood mt'l nIwe aluminum coil stock.
Supply and install aecesson•mounting blocks for lights, faucets.
The Garage a H'oe sided,Deer the exiling aood siding,and lammed the same es the house,
Cost: SIMoodo0
s'nt,. y rmmn vood is du'carered"Ii"!ippi.tg in '!a'id"" addinonat ckorger u5(l ne morn ed(m
16e repairs needed before catering"11,'1, "eing
tlindorrs Replace the hyo bedroom units,Milli F'nnre C7,salc win le.replacement windons.
Replace the Living room windows alith a Bay at 30 d'arn's with casement[lankers. '24 x 4b'
The Bay t,ill have a roof built m e'it no the exterior and new 35 'casing on the interior.
Cost:53.500.00
5)Decks Build a from entry with a 3 x 4 foot lar dim and steps,Azck decking,hand rail at steps.
Cost: Si500.00
Resoedtdly Submitted
Sime to T o"IlO 3'I1.S"to- _ Date April 11.2019
Tom DiSanto Home Improvement
414 Holyroke Road,Westfield MA 01085
CSL#069144 Regif110710
Phone/Fax 413-568-7036
Email. _
Web Site:Di Santo Home 1mprovementcons
All material is guaranteed to be as specified,and the above work to be performed in accoraance
with the drawings and specifications submiped for the above work and completed in a substantial
workmanlike manner for the sum of
ate •�60d ��dt<
Ta,enry seven thousand
Dollars(529,OOt7.QO)
With payments as follows; 1 3 at signing,step payments as required,balance on completion.
Acceptance of oroposal
The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do
the work as specified. Payment will be rade as outlined above.
Si azure / Date / fl