24D-128 (2) 239 STATE ST BP-2019-0365
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man:Block:24D- 128 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ADD BATH BUILDING PERMIT
Permit# BP-2019-0365
Proiect# JS-2019-000593
Est. Cost: $22500.00
Fee: $146.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
!Jse Group: WYNTER HOWLAND 109919
Lot Size(sq. ft.): 4312.44 Owner: BERMAN EVELYN S
Zoning:URC(100)/ Applicant: WYNTER HOWLAND
AT: 239 STATE ST
Applicant Address: .Phone: Insurance:
45 PLEASANT ST (413)522-1012 WC
SOUTHAMPTONMA01073 ISSUED ON:9/28/2018 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMOVE PORCH & PUT BATHROOM UNDER
EXISTING ROOF, ADD SMALL LANDING TO NEW STAIRS
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 9/28/2018 0:00:00 $146.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2019-0365
APPLICANT/CONTACT PERSON WYNTER HOWLAND
ADDRESS/PHONE 45 PLEASANT ST SOUTHAMPTON (413)522-1012
PROPERTY LOCATION 239 STATE ST
MAP 24D PARCEL 128 001 ZONE URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED
Fee Paid v
Building Permit Filled ,
Fee Paid
Typeof Construction: REMOVE PORCH&PUT BATHROOM UNDER EXISTING ROOF,ADD SMALL
LANDING TO NEW STAIRS 401
New Construction
Non Structural interior renovations
Addition to Existin
Accessory Structure
Building Plans Included:
Owner/Statement or License 109919
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9RMATION 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
Signature of Building Official 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.
Department use only
1irsrr City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
( 212 Main Street Sewer/Septic Availability
4-� Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCTj ALT R` f'P WEIMTf OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address. SCC
P Z 2018 i This section to be completed by office
C� C
3 ct S Map a / Lot Unit
/ ,frt/, DEPT OF BUILDING INSPECTIONS
i)✓ U'V% NORTHAMPTON,MAo2ane Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
�kk
Name(Print) P Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
(64
Name(Print a ( 1
Curreent/Mailing Address:
- IZ-l - a-Z C)�
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (-7, CM (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from 6
3. Plumbing Gj) Building Permit Fee
4. Mechanical(HVAC) y�
5. Fire Protection
6. Total = 0 +2 +3+4 +5) Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
SignaturL
P Bu ing Commissioner/Ins ector of Buildings Date
I� Cc 6c,
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
' , .. -_. .
( ;� _ ,
�:t � w
�,, f,
I
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks Siding[0] Other[O]
Brief Description of ProPed
Work: T�pLAA4L.p ��JrC� elktA n✓� . La^t��l�(W� �/, C S(���I � r(u+-
���� Vt.e� f
Alteration of existing bedroo Yes No Adding new bedroom�� Yes No
Attached Narrative Renovating unfinished bas(ment Yes �No
Plans Attached Roll Shee
6a. If New house and or addition to existing housing, complete the following:
a. Use of building :One Family 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?
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
I, vy v as Owner of the subject
property
hereby authorize
to act on my 4ehalf, in all matter�re tive to work auth rized by this b ilding permit application
AA DIY) 110
Signature of Ownef I Date
I, Q LIJU&4e C4V_ JQ , as Owner/Authorized
Agent hereby declarb that the statements and information on the foregoing A61ication are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties f perjury.
Print Nam
of lQ Zee I q
Sig natu er/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction S(up'e viispor:_ Not Applicable ❑ I
Name of License Holder: L y""` v V J —`y� q l q
License qumber
Aq (-I Qhj-zj
Addres Expiration Date
Si at
Telephone
9.Reallstered HomeImprovelAent Contractor Not Applicable ❑
l f i
&A, (1611 VLr (' (J I of S Cote'��'7 { � I q q6
Company Name Registration Number
U (z Zzc�
Address i' Expiration ate
`\ UTelephone ("(N- 111-G�H
SECT ORKERS'COM N IO NSURANCE 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....... Z No...... ❑
I
City of Northampton
515 sic.
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
" .,..__
Northampton, MA 01060
! SrNW 3 a\1`�
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 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 registered contractors.
Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered.
Type of Work: PRL,4Vc C(, Est. Cost: —7-C -V
Address of Work: _7-
Date
Date of Permit Application: I l(d
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:
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
Massachusetts
� A H A
e , DEPARTMENT OF BUILDING INSPECTIONS ? z
`t n,
212 Main Street •Municipal Building Jt
Northampton, MA 01060
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:
C d l
(Pleal,se print name and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Signatu e o er pplicant dr 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 of Massachusetts
IVDepartment of Industrial Accidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www.massgov/dia
Wovkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information / Please Print Legibly
Name(Business/Organization/Individual): \J4JV IMS eHnr�B t�C�. (,T(t(f C4 J'I
Address: 4 q- & (tU./-
City/State/Zip: JA 64dX,7 hone
Are you an employer?Check the appropriate box: Type of project(required):
1�_a employer with_employees(full and/or part-time).* 7. ❑New construction
2.❑I am a sole proprietor or partnership and have no employees working for me in $,-E'Remodeling
any capacity.[No workers'comp.insurance required.]
9. El Demolition
3.O I am a homeowner doing all work myself.[No workers'comp.insurance required.]t
10 Q Building addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance.:
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
•Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t 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 of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. A
Insurance Company Name: Ll` 1 Vl �I- t�
Policy#or Self-ins.Lic.#: V Z 3 ' S b �� [ ' 0& Expiration Date:
c
Job Site Address: / City/State/Zip: GV (kIK
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 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.
Ido hereby certify the pai d penalties of perjury that the information provided above is true and correct.
Signature; Date: Z t
Phone#:
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 �
I
REMOVE DOOR- KEEP EXISTING EXTERIOR
OPENING TO DOOR FOR REUSE
REMAIN NEW VENTED
REMOVE EXISTING WINDOW, HOUSE EXHAUST FAN
PATCH WALL AND FINISH TO INTERIOR T-5112"VIF 10
MATCH EXISTING 7� NEW 220V ELECTRIC
3'-0 4'-1" BASEBOARD HEATING
ii BELOW WINDOW
II _. 2'-6"MIN T-7"
1 i u..........._...........� FRAME NEW FLOOR TO NEW 24"W x 18"H
T _ BE LEVEL RI EXISTING AWNING WINDOW, ^ U
——— v"' i INTERIOR FLOOR ALIGN TOP W/DOOR 'LtJ
NEW LIGHT OVER SINK�v
NEW FLUSH-MOUNT
i CEILING LIGHTS(2)
REMOVE SIDING AND L CENTERED ON SPACES j C
PREP FOR DRYWALL 771 ► NEW FRAMED FLOOR:
FINISH AT INTERIOR �I TILE FLOORING
LATEX MODIFIED MORTAR
it -CEMENT BACKERBOARD
SE IN THINS
- '
Ni
i TILE FINISH ON ALL i 6�F O S AMING 16"O.C.
VDEMO
----+�INEW FLOORS j /BLO -IN CLO D CELL
-___LJ SELECTED BY OWNER,WOOD BASE AND TRIM 1/4"PT PLYWOOD TO
TO MATCH EXISTING , PROTECT INSULATION
LIGHT OVER SINK 20 MIL VAPOR RETARDER AT
24"W x 18"D VANnYGROUND SLOPED AWAY
FROM EXISTING FOUNDATION
NEW EXTERIOR LIGHT
NEW FRAMED WALL:
NEW EXTERIOR DOOR12"DRYWALL FINISH
2X6 FRAMING 0 16"O.C.
BLOWN-IN CLOSED CELL
EXISTING DECK FOAM INSULATION TO FILL
STAIRS&RAILING-EXISTING CAVITY
ROOF ABOVE TO REMAIN I NEW 4'x4'FRAMED :7/1 6"ZIP SHEATHING
LANDING W/ 1x3 STRAPPING SCREWED
RAILING THROUGH TO FRAMING
-SIDING/TRIM TO MATCH
NEW STAIRS TO EXISTING
EXISTING MATCH EXISTING
EXTERIOR WALL EXISTING ROOF:
OPEN ROOF FROM BELOW
AND ADD CLOSED CELL
i� SPRAY FOAM TO MEET CODE
\ INSULATION REQUIREMENTS
Level 1 -Existing+Demo �1� Level 1 -New
3/8"=1'-0" 318"=1'-0"
J
DATE STAMP CONSULTANTS CLIENT PROJECTS,CALE DRAWN BY
SIMPLE 09/04118 Mary Price Price Addition 3/8"=1'-0" BTB
CITY SIMPLE CRY STUDIO LLC ADDRESS DRAWING SET A 1 R 1
Architecture Interiors&Planning 239 State Street
wwwsimpledtystudio.00m Floor Plans li
FSTUDIO 857.225.2779/206.375.5126 Northampton, MA Schematic
2 Juniper St Florence MA