Loading...
24A-124 (5) 5 CALVIN TER BP-2018-1359 CIS#: COMMONWEALTH OF MASSACHUSETTS MapHlock: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:Deck BUILDING PERMIT Permit# BP-2018-1359 Pro ject# JS-2018-002225 Est.Cost:$8000.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: TIM STOKES 083602 Lot Size(sa.ft.): 6621.12 Owner: POLLIN MILLER SIGRID zoning:URA(1001/ Applicant: TIM STOKES AT: 5 CALVIN TER Applicant Address: Phone: Insurance: 20 TURKEY HILL RD (413) 203-3046 (l WESTHAMPTONMA01027 ISSUED ON:61202018 0:00:00 TO PERFORM THE FOLLOWING WORK 1 OX15 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: 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 PI'S RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeTyoe: Date Paid: Amount: Building 6/20/20180:00:00 565.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2018-1359 APPLICANT/CONTACT PERSON TIM STOKES - ADDRESS/PHONE 20 TURKEY HILL RD WESTHAMPTON (413)203-3046 O PROPERTY LOCATION 5 CALVIN TER MAP 24A PARCEL 124 001 ZONE URAQ00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST SED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid TvreofConstruction: IOX15 DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 083602 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO""ATION 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 Si uildin O t Date 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. gaglO tlW'NO1dWtlH1bON �[(�99 • :..b !I�wee ordy City of Northa pto it n� lreh Building Depa me 8102ParmX=—^r^�� f 212 Main St Set 6 ( N '�' III dry Room 1 Northampton, M 01(6@3 0 '$new I'I ili'1'21' . phone 413-587-1240 Fax - - Olhm' i II�I�ii i 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 Jr {�7 CA-L-w-47 L.d Zavlz Map Lot Unit 40ai � I Zone Overlay DistrIc 61060 Elm SC Disbict Ce Distinct — SECTION 2-PROPERTY OWNERSHIPIAUTHORIZEDRGENT 2.1 Owner of Record: C,� k \IA.W` t1 Name IF- 1; r /� - Current Iia Q,q Add jjg� Z ����r(y-�J�{1oL I Telepho4n\e .S S Signature 2.2 Authodzed Agent: ,'I t t w S.+T]�..-tJZ ZU' J W rAJ Name P'iy��� Current Mailing Address a 11 L� Ata 6°15 zz c4 SignatureTelephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building WO (a)Building Pemrit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) JY J 5. Fire Protection 6. Total=(1 +2+3+4+5) 8,000 Check Number S'755 This Section For Official Use Only Building Permit Number: Date Issued: Signature: / Building Commi-141trispecor of Buildings Date TT C�"6staty�>en C(wl �L , (OWI EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) a Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing - Ptoposed Required by Zoning This column to be filled us by Bolding Depedment Lot Size — Frontage ----- -- - Setbacks Front -- - Side L R _ L: R: Rear _. Building Height --- - ' Bldg.Square Footage Open Space Footage % _ (Lot area minus bill,&paved akin #ol'Parking Spaces Fill: _... . _..... volume&Locatioal ---------A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW © YES 0 IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO & DON'T 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 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. SECTION S DESCRIPTION OF PROPOSED WORK)shack all applicable) New House ❑ Addition ❑ Replacement Windows Alteratlori Roofing ❑ Or Doom O Accessory Bldg. ❑ Demolition ❑ New Signs [[I] Decks [M SIdIngi0] Other[pi Brief De cription of Proposed Work: F 0 i ___Yesp Alteration of existing bedroom___Yes y No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes �!-, No Plans Attached Roll heal / Barth New house and or addition to existing housing, complete the toiiowine a. Use ofbuilding: One Family Two Family Other It, Number of roams 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? I. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction wthin 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_ Pnvate well City water Supply SECTION 7a-OWNER AUTHORIZATION•TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Slt'AtUO MN A.IP- tlw1 ,as Owner of the subject property 1� hereby authorize Y N, , w J to act on shelf, in all m ers relative to thorized by this building permit plication. � k 1� �' Signature of7Y&er Date I, 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 belie( Signed a pains and penalties of perjury. 1 Print N A// /7a 7ais, Signature ofitmerlAgent Date YY SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable /❑ Name of License Holder: License Number 216 lzo/y Atl s Expiration Date 6°l Signature Telephone 9.Repisrered Home Improvement Contractor: Not Applicable ❑ w �qr�s l t5otz5 Comoanv Name `` '' Registration Number Zo��u Tz[.r✓/ Cl w �n� �q 1q Atltlress/ ,} Expiration Dae e Telephone 4 IS 6 OS 1 Z SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT Ill e.152,§25C(l 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 —.. Massachusetts Y DEPAnTNENS OF SDILDZNG INSPECTIONS 212 l in StetMunicipal Building Northe ten, . 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 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 pre2xisting 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 registered contractors. Note:/f 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 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: G /tcf /u r g' 'i I,., Sva vis 1 -1501716 Dale 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 \... ..sic Massachusetts DEPART T OF BOILDINO INSPECTIONS 212 Main 8tre t a Bunicipal Building Narthv ton, M 01060 `J Massachusetts Residential Building Code Section 110.85.1.2 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 110.85.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 11 0.85, 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. s City of Northampton " Massachusetts i I IEPARI4IENT 08 BUILDING ZNSplCTIONS 212 Nein Strwt •Nunicipal euildia, Northampton, ! 01060 IYjY \�6 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: (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: MIty-4Si (Company Name and Address) 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. . i The Commonwealth of Massachusetts Department of Industrial Accidents 7 Congress Street,Suite 100 Boston,MA 02714-20177 wsvw.mass.gov/dia Rockers'Compensation Insurance Affidavit:Builders/Cootractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant If rm tt Please Print Leaddy Name(Business/OrgmizatioNmdividuap: i 1 y— ,gyp Wy Address: City/State/Zip: Phone#: 413 cls ZU4 Are you an employer?Cheek the appropriate box: Type of project(required): L[:]l an a employer with employees(No sad/or pmt-hovel.• 7. ❑New construction 21�1�asole proprietor or partnership an haee no employired. ees working far.,. $. -flRemodeling y cWmiV ybi workers comp.insurance requ ] LL.� 3❑ rs 1 am a homeowner doing all work myself[No workecomp,insurance required.]' 9. ❑Demolition 10 E]Building addition 4esueWmeowrmrandwilltehhave wormctorsmcoMudauworke my or twill ensure that all contradurs eider have workers cumpensanon mswance or are sole 11.❑Electrical repairs or additions proprietors with no employsen 12.❑Plumbing repairs or additions 5 1 am a general conaactor and I have hired the subcnntnnors listed on the attached sheet. These me,,onnacmrs have emoloyees and have waders'comp.insurance. 13.F]Roof repairs 6.❑We are a cer,ar ion and its urftcers have exercised thekright ofexemption per MGL c. 14.❑Other 152,k1(4),and we have no employe¢Mo workers'comp.Insmmme mquavd] *Anyapplicantthatchecksbox#1 must ako fillout desertion below showingtheirworkers comperaconpolicymfmmetiun. 'Homeowntn who submit this affidavit indicating they are doing all work and then hire outside r—o etors most submit a new affidavit warrants such. :Coneracturs that check this We mast attached an additional sheet showing the name of the sub-coneracmrs and state whether or not those entities have employees. If are sub-conhucmrs have employees,they must provide their workers soni policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 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 MOL e. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or ane-year imprisonment as well m 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 of the DIA for insurance coverage verification. 7 do hereby cera oder pains d penalBes of perjury that the information provided above is true and correct Si nano . Date: 6 Ids LOI� Phone#: ala S z 7-6a' 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/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I , 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 any 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 ofthe foregoing engaged in ajoint 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 151§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance 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-contractors)name(s),address(es)and phone numbers)along with their certificate(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 does 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 pent it/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license 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 proof that 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 I 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 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 any 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 ofthe foregoing engaged in ajoint enterprise,and including the legal representatives ofa deceased employer,or the receiver or trustee of an 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 ofpub]ic work until acceptable evidence of compliance 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 your insurance company's name,address and phone number along with a certificate 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 does 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 retumed 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 permit license number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(ifnccessary). A copy ofthe affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit most 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 Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 www.mass.gov/dia turn Revised 02-23-15 EhIMIL61nu, h1h, 1Uh, 6 i I — —1 l j _ P_ SA� 1 I 15'-0" i i (2) 2 X 10 PT GIRDER BELOW JOISTS FOOTING BELOW POST, TYR \ p � p ti 2 X 8 PT AT 16" O.C., BLOCK AT MID-SPAN (2) 2 X 8 PT BAND JOIST (2) 2 X 10 PT GIRDER 5 CALVIN TERRACE REAR YARD DECK: FRAMING PLAN SCALE: 112" = V-0"