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11C-039 (10)
73 FLORENCE ST BP-2018-1166 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: IIC-039 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Pennit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: GARAGE BUILDING PERMIT Permit# BP-2018-1166 Pro ject# JS-2018-001013 Est Cost:$36200.0 Fee:$134.00 PERMISSIONIS HEREBY GRANTED TO: Const.Class: Contractor., License: Use Group: Homeowner as Contractor_ Lot Size(sq.ft.): 16552.80 Owner. JUDGE DONALD P&KAREN M zoning:URA(100)/ Applicant: JUDGE DONALD P & KAREN M AT. 73 FLORENCE ST Applicant Address: Phone: Insurance: 23 EAST CENTER ST LEEDSMA01053 ISSUED ON:6/19/2018 0.00:00 TO PERFORM THE FOLLOWING WORK:NEW 24X28 2 CAR GARAGE 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: FeeTvoe: Date Paid: Amount: Building 6/19/20180:00:00 $134.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2018-1166 APPLICANT/CONTACT PERSON JUDGE DONALD P&KAREN M ADDRESS/PHONE 23 EAST CENTER ST LEEDS PROPERTY LOCATION 73 FLORENCE ST MAP I IC PARCEL 039 001 ZONE URAf100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST_ ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out _ Fee Paid Tvoeof Construction NEW 24X28 2 CAR GARA New Construction Non Structural interior renovations Addition to Existing Accessory Swc[ure Buildine Plans Included, Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 Penni[ 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 Welt Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management ii' n Delay Llugoffi ya Dale Now: Issuance of a Zonii/n/gg 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. REU ity of orth mpton Bli ing Dep rtment /AY - 4 2212 in treet } Ro m 1 0 EPT. FnUILDI mplarl, A01060 d� isbf Oriel x 413-587-1272dA APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: �../ This section to be completed by office 13 1 I . r-f IJCL �-1-- Map �.(t - Lot (/ 3 Und Is-J� O1693 '. Zone Overlay District Elm St.DistrictCB District' SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: in roS3 -MoAtel 7 KAr,EA-) 106�E � 2 �IccxFacE Sf. �££c45 M9. Name(Print) Current Mailing Address'. a��d58 baa moa r � +'' l� Telephone 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 2,60© CO (a)Building Permit Fee 2. Electrical a00- 60 (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) Aoc. 60 Check Number 01.$'9.3 This Section For Official Use Only Date Building Permit Numb Issued: Signatur Building Cossionedlmpector of Buildings Date 0 EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING At Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed ReqalIE'd b I butil This column to be filled ark Building Department Lot Size Frontage Setbacks Front _ Side L ! R i_ L:_R - �_ Reaz Building Height --' i Bldg. Square Footage —...-...._... ___—_ % Open Space Footage __---- ___„_ % _ (Cot area minus bldg&paved Forcing) #ofParkin Spaces — Fill: (volume&Location) --� ---- A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DON'T KNOW O YES Q IF YES, date issue& IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW Q YES 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 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q 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 0 NO O IF YES, describe size, type and location: E Will the construction activity disturb(clearing,grading,excavation, or filing)over 1 ave or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Sic”Water Management Permit from the DPW is required. J SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows A6eration(s) ❑ Roofing ID Dr Doers � Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [0 Siding [C]] Other[pj Brief Description of Proposed Work: x r2a Alteration of existing bedroom_Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.If Nei titwse and or addition to existing housmst.c0m iefe the foltoWl"m a. Use of building : One Famili Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? In. 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_ CiftySewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner } Dale 1, -Zoppp(3r ,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. OUR« e U Print Name 1-� p �- 1 - kJ Signature o Ownar/Agent Data SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable D Name of License Holder'. License Number Address Expiration Date Signature Telephone 4.Registered Home Improvement.Contractor: Not Applicable D Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§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....... D No...... D / City of Northampton J Massachusetts 34s = `"Rjvr / Y DEPARTMENT OF BUILDING INSPECTIONS 212 Nain Street • Nunicipal Builang Northampton, M 01060 6 ;6 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 most 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 pre-existing owner-occupied 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 reldstered contractors. Note.If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: Est. Cost: Address of Work: Date of Permit Application: I hereby certify that: Registration is not required for the fallowing 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 pequry: 1 hereby apply for a building permit as the agent of the owner: 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: S- 7- is Date Owner Name and Signature City of Northampton f Massachusetts + i DEPARTlDaT OF BUILDING INSPfiCTZONS ` 212 Nin 9tr et * icipalBuiltl ng S4S pa thane tfi Massachusetts Residential Building Code Section 110.R5.1.2 Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section I IO.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. 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: q 0 NA - 6k!93 The debris will be transported by: LK10 le) The debris will be received by: Building permit number: Name of Permit Applicant �/ // S"--7- lF ter, �JE 'bAl Date Signature of Permit Applicant The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite 7 Boston,MA 02114-201 01 7 wwwmass.gov/dia NN orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AN rHORITY. Applicant Information p —e+ Please Print Legibly Name(B s ...dnap: �D 01.3 P, Address: {i FLOf�CeocL It s City/State/Zip: L E ,J Phone#: 4(3 95b3aa Are you an employer?cheek the appropriate box: Type of project(required): I.❑I am a narrative,with employees(fall and/or....forc" 7. Lh�New construction 2.❑i am.,.In proprietor or parmership and have no employees working for me in g. ❑ Remodeling ny capacity.[No workers'comp.it mmove required.] on 3.�amahomcowwr doingall workm If. No workers'em .insurance d 9. ❑Demonga a myself.[ pin erequirc l' 4 E I am a homeowner and will be forms imdors to conduct all work on my n . I will TOE] Building addition g con props y arc mat all rnntacmn timer nava wnrkcm"wmpcnsm,nn.n:mmcc or are solo 11.[]Electrical repairs or additions ,produces with w employees. 12.❑Plumbing repairs or additions Srl I am a general contractor and l have hired the sub-contractras listed on me attached sheet 13.E]Roofrepairs These subcontractors have employees and have workers'comp,insurance 6.❑We a corpomuon and its of or have seemed their right of exemption per MGL c, 14.❑Other 152,§1(4),and we have no employees.Mo workerscomp.Insurance required .Any inflicting that checks box#1 must also fill out the settle below showing their workers'compensation policy information_ e Homeowners who submit this affidavit indicating they are doing all work and then hire outside comraeton must submit a new affidavit indicating such. leontractors that cheek this box must anaehed on additional order showing the name of the sub-connectors and state whether or not those entities have employees. Ifthe sub-contractors have employees,they must provide their workers comp.policy number. I am an employer that is providing workers'compensation insurance(or my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/Slate/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 fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form ofa STOP WORK ORDER and a fine ofup to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 7 do hereby carer ,under th a is andpenalfies of perfury that the information provided above is true and correct Set �o /2 -0 -Date S-1 l8 Ph 4: A13 as''a a,3aa 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): 1.Board of Health 2.Building Department 3.City?own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under my contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee ofan individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the Insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence ofcomphanee with the insurance requirements ofthis chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone numbers)along with their comficate(s)of insurance Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP docs have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permiulicense number which will be used as a reference number. In addition,an applicant that must submit multiple permiblice arse applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia Hill architects RECEIVarchitED engineers planners May 21, 2018 DEPT OF ti UII OIN6INSPECTIONa Don and Karen Judge NoarllnrnProN.nnn mo6o 73 Flordhce Ave. Leeds, MA 01053 Subject: Residential Garage,Foundation and Elevated Slab Design Dear Don: It was a pleasure to meet with you to discuss your project. Hill-Engineers, Architects,Planners, Inc. (Hill)is pleased to submit this proposal to provide engineering services for the subject project. Having met with you to review the subject project, we understand the scope of the project to be: Project Scope You intend to build a garage that requires a retaining wall and foundation design, as well as an elevated slab that will support vehicle loading. Sketches based on a prior design have been prepared, however, the local building official is requiring that a professional engineer stamp and seal the plans for permit. Hill will review the provided sketches for building code compliance and provide stamped permit documents. To help you to accomplish the project scope, we propose to provide the following Scope o7 services: Scope of Services This section details the services we propose to provide for this project. Additional Services, which are not part of this proposed service scope, are listed for your review and consideration in a later section of this proposal. 1. Review the provided sketches and check them for structural compliance with the 9" edition Massachusetts residential building code. 2. Provide structural design for alterations to the sketches required for code compliance. 3. Provide constmction documents suitable for obtaining a permit. The construction documents shall be limited to the review of the foundation and elevated slab. © 50 Depot Street • Dalton. MA 01226 . (413( 684-0925 , Fax (413) 684-0267 , hill@hillengineers.com 44 Spring Street • Adams.MA 01220 • (413) 743-0013 • Fax(413 743-0790 • hill-odams@hillengineers.com FIM Facehook wwwaillengineersma.com Assumptions • The intent of this proposal is structural only and is limited to the foundation and elevated slab. A review of the proposed wood framing above the slab can be provided as an addition to the scope and services provided above. • Architectural and Civil Survey services have not been included in the scope of work. The nature of the design is intended to be residential. Vehicle use of the elevated slab is assumed to be within the limitations of 50 psf uniform load/ J 2000 Ib point load over 20 square inches per table R301.5 of the 9ih edition Massachusetts residential building code. • The retaining wall of the garage will be buttressed at its center point as discussed in our meeting. Soil conditions will be based on conservative assumptions. • The project is residential in nature and construction control services are not' provided. • The project requires no bidding services and all work shall be performed by a licensed contractor familiar with the scope of work. Deliverables • Construction Documents suitable for permit for the foundation and elevated slab Fee Hill proposes to perform the scope and services on a time and expense basis. The project fee to perform the services described above is an estimate of$2,000.00, based on our standard billing rate schedule,including Reimbursable Expenses. The actual fee will be invoiced on an hourly plus expenses basis and may be higher or lower than the estimated fee. Reimbursable Expenses The following reimbursable expenses are included in the fee: • Prints,Copies • Mileage • Mailing Charges Available Additional Services Hill offers a wide range of professional design and engineering services. The following services are not included within the scope of this proposal as presently formatted. These services are available for additional fees when so agreed in writing. • Modification of design of space layout once agreed upon 2 WINDOW SCHEDULE Key MAKE Model Type Rough Opening Header Head Remarks QTY HT. A Integrity Wood-Ultrex ITDH 3048 Double Hung 2'-6Ye"x4'-OY4" 2-2x8 T-0" 6/6 3 B Integrity Wood-Ultrex ITDH 3052 2W Double Hung, pair 5'-0"x4'-4 Y" 2-2x10 T-8". 6/6 1 C Integrity Wood-Ultrex AWN 29272W Awning,pair 4'-9"x2'-33/8" 2-2x10 T-8" 6lite 1 6 ��2 _ ____— Gte.rc.L i_ecr A'SPi+�T R.meF SH-r'+tnt.LS ___._Z"'tP l(dl.' 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