38B-050 (4) 19-29 LYMAN RD BP-2018-1258
GIS s: COMMONWEALTH OF MASSACHUSETTS
MN.Block: 38B-050 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Cateeorv, ROOF BUILDING PERMIT
Permit BP-2018-1258
Proiect# JS-2018-002240
Est Cow$23000.00
Fee: $161.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: TIMOTHY LUCE 100515
Lot Size(sq.ft.): 0.00 Owner: KENDRICK PROPERTIES
Zoning7 URB Applicant. TIMOTHY LUCE
AT. 19 - 29 LYMAN RD
Applicant Address: Phone: Insurance:
PO BOX14 (413) 387-9800
LEEDSMA01053 ISSUED ON:5/29/2018 0:00:00
TO PERFORM THE FOLLOWING WORK STRIP & SHINGLE ROOF ON BACKSIDE OF
BUILDING ONLY- 50SQRS
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 Skmature•
FeeType: Date Paid: Amount:
Building 529/20180:00:00 $161.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
449) Y
Versionl.7 Commercial Building Permit May 15,2000
Department use only
dY of Northampton Status of Pemar.
RECEIVED B ilding Department Curb Cut/Driveway Permit
212 Main Street Sewef/Septic Availabi6ry
2 d 2018 RP m 100 Water/WallAvailability
MAY No am ton, MA 01060 Two Sets of Structural Plans
phone 13- 7-1240 Fax 413-587-1272 Plot/Site Plans
illANG INSPPCnaus Other Specify
APP PAIR RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
/
SECTION 1 -SITE INFORMATION
1.1 Proaertv Address. This section to be Completed by office
4,Yyt,� A..A Map 3 6G Lot 060
Unit
Zone Overlay District
Elm SL District Ca Distrki
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
I-YIRIFl 1 lfD cJ moo s /9-moi cYOWA-)
fJa_m
JIG nrm tr&n44/C.0 19OW9. M6n.7-Cunent Mailing Address:
//6P�fi Fele �stoc. q/3 -';�3-0a.
Signatu �� Telephone
2 2 Authorized Agent,
Timothy J. Luce PO Box 14 Leeds, MA 01053
Name(Pnrd) Current Mailing Address:
413-387-9800
Signature Telephone
8ECTION 3-ESTIMATED CONSTRUCTION COST$
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 23 o" (a)Building Permit Fee
r
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee �p
4. Mechanical(HVAC) 1; /
5.Fire Protection s
6. Total=(1 +2+3+4+5) Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Si y� p
mm ions Spector of Buildings Date �/ /r�
Vcmionl.7 Commercial Building Permit May 15,2000
SECTION d-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition Repairs❑ Additions ❑ Accessory Building[j
Exaedor Ake atkul ❑ Existing Ground Sign❑ New Signs❑ Roogng0 Change of Use❑ Other❑
Brief Description Remove and replace asphalt shingles on backside of building only, 50sq of 30yr Architectural Shingles
Of Proposed Work:
SECTION 5-USE GROUP AND CONSTRUCTION tY
USE GROUP Check as applicable) CONSTRUCTION TYPE
jFactoy
ly &F-10
A-2 ❑ A-3 ❑ IA ❑
A-8 ❑ 1B ❑
s 2A ❑
nal 28 I ❑
F-2 ❑ 2C ❑ard 3A ❑al 1-2 ❑ 1.3 ❑ 3B
tile 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ SA ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ 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:
Existng Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION S BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(so
1. i"
2m 2m
3m 3.
d» dm
Total Area(so Total Proposed New Construction(at)
Total Height(ft)
Total Height it
7.Water Supply(M.G.L.c.40,Q 64) 7.1 Ffood Zons Information: 7.3 Sewage Disposal System:
Public Private ❑ Zone Outside Fiood Zone[( Murncipat ❑ On site disposal system❑
Versionl.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
71m rohuno to be fillM w by
Budding Department
Lot Sim
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot em minus bids&pavM
padding)
#ofParking Spaces
FiII:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O 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#
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YFS, 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 O
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 O
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Versionl.7 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 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Aschteeet:
Not Applicable ❑
Name(Reglexan0:
Regktretbn Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engines (a):
Name Area of Responsitx4y
Address Regismabon Numner
Signature Telephone Expiration Data
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Spnature Telephone Expiration Date
Name Arca of Responsibility
Address Registration Number
Signature Telephone Expiration Data
9.3 General Contractor
Timothy J. Luce Not Applicable ❑
Company Name:
Responsible In Charge of Consbuction
PO Box 14 Leeds,MA 01053
Address q
�l 387-9800
Signature Telephone
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
IndependentStructural Engineering Structural Pear Review Required Yes O No Q
SECTION 11 - VV TION-TOBECOMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
3C 0� Sill /'wjo yr
I, ,as 9w= of the subject property
Timothy J. Luce
hereby a
to
o m if,in a matters relative to work authorized by this building permit application.
Signature of QsueG,Vjpe4,, Date
Timothy J. Luce 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.
Timothy J. Luce
Print Name
Signature of oimerlAgent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Mulder: Timothy J. Luce 100515
License Number
PO Boz 14 Leeds,MA 01053 7/15/18
Address Expiration Data
413-387-9800
Sgn ure Telephone
SEC710N 13-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 O No
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: 19 '2 9 l yw w^ Q�•
The debris will be transported by:The debris will be received by:
Building permit number:
Name of Permit Applicant�'nw S • L � e—
Date Signature of Permit Applicant
The Commonwealth ofMassachuseas
Department of Industrial Accidents
1 Congress Street,Suite 100
Boston, MA 02114-2017
www.mass.gov/dia
\Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Plesse Print Levribl
Name (Busincss)OrganimtioNlrMividuaq:Timothy J. Lue
Address:PO Box 14
City/State/Zip:Leeds, MA 01053 Phone 0:413-387-9800
Are you ao a layer?check the appropriate boa: Type of project(required):
I.E1 nemployer with (full anchor pan-nrarV 7. ❑New construction
I amasole propricmrorpnnnershipaM havewemployccs working fornium E. ❑ Remodeling
' any
capacity [No workers'eme,insurance required.]
0
l n Isa m hommwner,doing all work myself[No work.,,'mmp.mamerso nyaind.]I 1Demolition
4.❑1 am a hormmwner ata will b:hiring mmmmara m conduct all work on my properly. 1 will 10❑ Building addition
,more thoull mmtxmrs either haveworkers'coulahmanun mamaracasresole 11.❑Electrical repairs or additions
propdemrs with no employees. 12.❑Plumbing repairs or additions
5C]l am.general comerem,and l have hired the sut-emamcmrs listed oa the attached drneL 13.O Roof repairs
These sob-c oorrame,have employees and have workers'comp.imhdatc,:
h.❑We om n mr,ohnion and in ollicers have exewlsm their right of,x xnpmr per MGL e. 14.[]Other
152,§I(4),and we have no cmplaysx.IN.workers com,insurance quiosr]
'Any applicant that checks I nx p I must also fill our the section below showing their workers'compensation pdicy information.
'Homeowners who submit this affidavit indicating they are doing all wmk and then hire outside mmracmrs must submit a new affidavit indicating such.
:Cora cmrs that check this box most attached an additional shttt showing the tame afthe sub-connucmn and smte whether or not those entities have
employees. If the sub-contractus have employces,they most provide their workers'mmp.policy number.
l am an employer that is providing worker:,'compensation insumnce for my employees. Below is;the policy and job.site
information.
Insurance Company Name:_
Policy#or Self-ins.Lic.k: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a tine up to$1,5(0.00
and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a fine of up to$250.00a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby cera erfl nrtIdes,ofperjury that the informaaon provided his is true/'J�nd correct.
Sienature —�— Date: �/20/ /
Phone#:413-387-9800
Ojzcial use only. lM not write in this area,to be completed by city or town official.
City or Town: Permit/Licerew#
Issuing Authority(circle one):
1.Board of Health 2.Budding Department 3.Cityrrown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
4/26/18
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main St.
Northampton, MA 01060
1 request that you grant a modification to waive the requirement for control construction
for the project at 19-29 Lyman Rd, because the work is of a minor nature,will not affect health,
accessibility, life and fire safety, or structural requirements and is impractical in that the cost of
control construction is considerable when compared to the cost of the proposed work. Thank
you for your consideration.
Respectfully,
Timothy Luce
PO Box 14
Leeds, MA 01053
a COMMONW LTH OF t$ 1GHUS Massachusetts Department of Public Safety
s • • • • �' Board of Building Regulations and Standards
SHEET MJETAiIWORKEJI&k; ', License: nS 100515
Supervisor' ISSUES THE,FALLOWING LICENS�71rzA Construction Supervisor
1TE&-UNHESTjIC#'ED TIMOTHY J LUCE
TullY J LUCE PO BOX 14
LEEDS MA 01053
j10 X 1,4
LEEDS,1M93.0014a.-
Expiration:
13385 97YY8@018 94536 �� Commissioner 071115R018
ONIu of(k nwmar Maim 6 Business Raaulation
HOME IMPROVEMENT CONTRACTOR Reglatr•tlon valid for individual use,only
TYPE:Individual before the expiration data. itloundratumta:
Reals$1DgD EaDlrlttlOD Office of Consumer AHeka and BusYMa Miagulelbn
149M 12J142019 10 Park PMze-Suite 51M
TIMOTHY J LUCE Boston,MA 02116
TIMOTHY J.LUCE
122AUDSON RD. C—
LEEDS,MA 01053 Undersecretary Not valid without signature