17B-009 428 BRIDGE RD BP-2019-1378
GIS H: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17B-009 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category, renovation BUILDING PERMIT
pennij H BP-2019-1378
Project H JS-2019-002217
Est.Cost:$27500.00
Fee:$18200 PERMISSION IS HEREBY GRANTED TO:
const.Class: Contractor. License.
Use Group: QUINLAN BUILDERS 011289
Lot Size(sp.ft.): 29010.96 Owner: QUINLAN THOMAS
zoning: RIn00VRRn00V Applicant: QUINLAN BUILDERS
AT: 428 BRIDGE RD
AvolfcantAddress: Phone: Insurance:
94 HUNTINGTON (413) 549-5474 O
HADLEYMA01035 ISSUED ON:6/312019 0:00:00
TO PERFORM THE FOLLOWING WORK:NEW ROOF, WINDOWS, SIDING AND MISC
INTERIOR RENOVATIONS
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 H 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 6/320190:00:00 $182.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
i
File#BP-2019-1378
APPLICANT/CONTACT PERSON QUINLAN BUILDERS
ADDRESS/PHONE 94 HUNTINGTON HADLEY (413)549-5474 O
PROPERTY LOCATION 428 BRIDGE RD
MAP I7B PARCEL OD9001 ZONE RI(IOO)/RR(IOOV
IHIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
SED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TypeofConstructiom NEW ROOF,WINDOWS, AND MISC INTERIOR RENOVATIONS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 011289
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 Projea: 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 Cutfrom 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
De,rimolition Delay
G-3-2019
Signature of Building Official Date
Note: Issuance of 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
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
1 Room 99 y]� ell Availability
Northampton, ARECEIVE Se s of Structural Plans
phone 413-587-1240 ax 13-587-1272 - _a VSit Plans
her ity
APPLICATION TO CONSTRUCT,AL AIR,RENOVATE ORD i
MOL IN A ONE OR TWO FAMILY DWELLING
HEFT.OP ITMID001 INSPECTIONS P- 17-N1378
SECTION 1 -SITE INFORMATION NoeTwvnP .Wolm nJ
1.1 Property Address: This section to be completed by office
yds Be, "d', C Roctol Map 176 Lot 00 Unit
Zone Overlay District
Elm SL Distdpt CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
21 Owner of Repord: I
-Av&tas
Name,(Prinl) Cu'Ving _ O F
-77 b ry
Telephone
f
Signature
2.2 AuAu^thodz A n : p �/ 1 Q
1104
Name(Pnm) Current Mailing Address:
413- 364 -778 '-'
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building / 000 . 00 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
"Y's 00 v 0 0 Construction from 6
3. Plumbing 45 000 a 00 Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection
6. Total=(1 +2+3+4+5) 1 V7. 500, 00 1 Check Number
This Sscdon For Official Uss Only
Building Permit Number: Issued:
Signature: 4-3-201?
Building Commissioner/Inspector of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4, ZONING ALL Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to he filled in by
Building Uyanm m
Lot Sim
i
Frontage
Setbacks Front
i
Side L: R: a L: R:
Rear
Building Height /
q�(C
Bldg. Square Footage %
Open Space Footage %
(tat mm minus bldg&pared
Ain 1
#of Parking Spaces
Fill:
i colmoe&Laaationl
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 O DONT KNOW ® YES O
tF 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
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 Icheck all applicable)
New House ❑ Addition ❑ Replacement VAInclows AKeration(s) Roofing 91
Oro Jr I
Accessory Bldg. ❑ Demolition Now Signs iC7] Decks [q Sidingg) Other[CI]
Brief Description of Proposed, r�i1 I n _
Work: te / mna,Qd ga (W."wo OW3 S 6- rr►,.sc�• ,r,n,r�fl/1rb
Alteration of existing bedroom_Yes_No Adding new bedroom X Yes No Ib1'r
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa.if New house and or addition to existing housing, complete the following:
a. Use of building:One Family K Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached? N O
d. Proposed Square footage of new construction. VO $f� ��–• Dimensions
e. Number of stories? p
I. Method of heating? (�'oD6ne Fireplacesor Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
1. Is construction within 100 n.of wetlands? Yes _�No. Is construction within 100 yr. floodplain_Yes A�—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 AUTHORVATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
[
I, / 'r0'n4 5 0Vrvitlg't .as Owner of the subject
property
hereby authorize V 114�Q
to act on my be If,in I matters relative to work authorized by this buildin permit application.
36/ i
Sigeaa,re of Date
I, S 0j"Lp� ,as OwnedAumonzed
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.
1 toM4S !OLawIvl
�9�
Signature M OwnerlAgielt Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: /X� Not Applicable El
lde
Name of License HOW : TO M Caq,I ,1 CS— of I _16q
qqS9
9Licensea7mbar
4 I {vti�r`tiy 'b, Ro4al � ).)oao
Address Expiration Data
�I(3- 76Y-778''
Signature / Telephone
r
9.Re istered Home Im ovement Contractor: Not Applicable ❑
7—A°1 QVOL La . Ib1 7 V7
Company Name Registration Num r
7L( RU4 �+' Kd• 6/j9 asap
Address Expiration Date
0J U [7 Telephoneyi3.31'f-7
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.C.152.1 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....... ❑ No...... ❑
5/28/2019
Work on home located at # 428 Bridge Road
1. New Roof
A. Strip 2layers
B. Install 6 feet of Ice &Water Barrier
C. Install 30-year Tamko Arch.Shingles
D. Cut&Install roll vent with cap over to ridge
2. New Windows
A. Remove all existing windows
B. Cut Brick to make sure all bedrooms have a window to meet egress.
C. Reframe as needed(all widths to be the same size or smaller-Nonstructural).
D. Install Harvey Classic windows with U-value of 0.26 or better.
E. Install windows with tempered glass as required.
3. Siding
A. Remove existing 3 gable ends siding and install new mastic double four vinyl (note
all exterior walls have brick).
4. Kitchen/Family Room
A. Remove chimney and existing wall between.
B. Install proper sized LVL's to support ceiling and roof load (with posts this will be
under 10-foot spans).
C. Redo kitchen.
S. Existing Bonus Room
A. Remove one nonbearing wall.
B. Frame for Master bedroom, Bath, Mudroom, & Laundry.
6. Insulation
A. Upgrade attic to R-38.
7. Exterior Doors
A. Remove two and replace in same opening(Nonstructural).
�\ The Commonwealth of Massachusetts
lljj66 Department of IndustrialAcciderits
1 Congress Street,Suite 100
Boston, MA 02 114-2 01 7
„ www,massgoP/dia
tl'urkers'Compensation Insurance Affidavit:BuBders/Contractors/Electricians/Plumben.
To BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Lestibly
Name (BusinesNOrgani atioMndividuap: r O A4 (.krV rt't. (&#I
g
Address: ( y j4vAj+1;f hW lr,.o20A
City/State/Zip: � � M 010 3 Phone M 'i'/j 3 781
Arc you an empbysw^Cheek Me apprapdaM baa:
Type of project(required):
L E]lamacmployawith etttplmycn Tull mMmr pat-bete). 7. ❑New construction
2.l yll am a sole proprietor or partnership and have an employees working formein g. E]Remodeling
7`ny capacity.[Nowmkcn'comp.insumnce acquired.]
l.[j l am a humrowner doing all work myself.tNo wotken.'mmp.insurance required.]t 9. ❑Demolition
4.n I am a hmmrovam and will tie hiring womnurs m conduct all wad on myproperty. [will 10 Building addition
conam flat all contractors either have worker.co rpereatiun insurance or am sale 11.[]Electrical repairs or additions
propel von with nu employ..
12.E]Plumbing repairs or additions
50 i am a gaxr l amtramm am 1 nave Hite the sulwmtrachm h.ad rat th<attaenee vicar' I l E]Roof repairs
Thcsc vtlsaontncum have emplmym and have wthcn'comp.ans..:
6.Q We arca empnmliun and its olrwers lave exercised rich right ofcumption per NGL c. 14. Other
152,§1(4).and we have no employees.]Nm workers. compinsurance aquimd.]
"Any applicant that checks bon#I must also fill out the section bclox showing limit wort ns'ins meation policy information.
Bommwnen whm.eubmh this altidavit indicating they are doing all work and then hire outside counicton must submit a new alidavo indicating such.
:Coal,. n that check this hus most attached as additional short showing the name of the suuommams and state whether or not hnse emitia have
employees. If the suh<ontraemn have employers,they must pro%de then xorken'comp.relic}number.
fans an employer that is providing workers'compen.saann insurance for nsy emploe'ees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Sclf--ins.Lic. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the worken'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.
I do hereby certify under the nysAa/nd penalties ofperjmy that the hiformafion provided above is bee and correct
Signature: f,/�M /_ -k Date: L��/�g
Phone#:
Oficial use only. Do not write in this area,to be completed by city or town oJrciat
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Chyti own Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
City of Northampton
, r�. Massachusetts
� c
lA � OEPA TMENT OF BUILDING INSPECTIONS ;
zlz na,,, scre•c •nun.aPsi eu,ieiny
"�!�— Noe Lnamptoc, Mn 01060 PfrY�o
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 act"governed by this Building Permit shall be disposed
of in a property licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
yd8 Brr°chic hoar)
(Please print house numberAind street name)
Is to be disposed of at:
VtIIeH
(Plume and IoQtbon of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
Ar,AeF Irvc1<<n
(Company Name and Address)
Signature of Permit Applicant or OwlWr 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.
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
of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnctship,association or other legal entity,employing employees. I lowever 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 to the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.1
Additionally,MGL chapter 152,§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 of this 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),addresses)and phone number(s)along with their certificates)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,arc not required to tarty 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 a0idavit 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 permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permitAicense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Joh 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
1 Congress Street, Suite 100
Boston,MA 02114-2017
Tiel. #617-727-0900 cxt. 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.mass.gov/dia
City of Northampton
Massachusetts
I DSPARI!ffiT OF BUILDING INSPECTIONS
212 Main street • Municipal auilaing
Mortn�ton, car 01060
LOUIS HASBROUCK
BUILDING COMMISSIONER Effective July 1,2015
Phone: (413)587-1240
Faz: (413)587-1272
Residential One and Two Family Building Permit Fees
htlo/tv .northamotonma.goy/702/Building-Department
Fees for work not listed will be determined by the Building Department
Any work beginning before a permit has been issued is subject to double fees and a stop work order removal fee
Hours of operation are typically Monday thm Friday 8:30 to 4:30,Walk-In hours are closed at 12:00 pm Wednesday
Permit Fees are paid to the CITY OF NORTHAMPTON CHECKS OR MONEY ORDERS ONLY: NO Cash or Credit Cards
Checks or Money Orders Must Be Submitted with the Application or it will not be acted upon
To Be Processed,Applications Must Be Complete and Include ALL Required Attachments
All Applications Are Subject To Zoning Review.The Weekly Filing Deadline is 12:00 pm (noon)on Wednesday.
Building applications-Require a plot plan,floor plans, elevations, structural and energy information as appropriate
Sign applications -Require a photo of the existing elevation and a photo shopped placement of the proposed sign
Applications may be subject to Central Business,and or Historic and Demolition Delay reviews
It is the Owners responsibility to verify property bounds and conservation issues
COMPLETE DEMOLITION Accessory Structure------- ............... ................................... ------------$30.00
One or Two Family House-------------------------------------_---------------------_---------$75.00
NEW CONSTRUCTION All Occupied Floors per sf-------------- -----------------------------------------------$.50
Floors,Walk-In Attics,Basements, Garages per sf----....--....-----..-.$.20
Decks, Porches, Canopies, Porticos per sf $.20
NEW ACCESSORY STRUCTURE Free Standing Decks----------------------------------------$.20 per sf, Minimum $50.00
Shed up to 200 sf zoning review----------------------------------------___ -------------$30.00
Shed over 200 at---------------------------------------------$.20 per sf, Minimum $35.00
Tent over 200 sf__—___....................._................................. .
Above Ground Swimming Poot................................................................$40.00
In Ground Swimming Pool.........--------------------------------------------------------------$75.00
REPAIR, RENOVATION.ALTERATION$6.50 per$1000 of estimated cost(rounded up).....................-Minimum $65.00
SIGNS Wall Sign for Home Occupation-- ------- $40.00
SPECIALTY PERMITS Reefing----------------------........................_.- -----------------------------------------------$40.00
Siding.----------------------------------------------.._._.------------------------------------- -.----.$60.00
Non-Structural Door&Window Replacement---------- $40.00
Solid Fuel Burning Appliances............................................. ........... .......$40.00
Sheet Metal $25.00 with building permit on she;Otherwise $50.00
SOLARRoof Mount--- ----- --_._..._......_...-...__ ---------------------------------------------
Ground Mount up to Blow or 100%of demand-----------------------------------------
Ground Mount up to 200%of demand--------------------------------------------------$100.00
Ground Mount over 200% Use the commercial rete calculator
OTHER SERVICES Request For Zoning Determination $30.00
Home Business Review& Registration.....-----------------.-----------... $30.00
Replacement Permit----- ----......................-----------------------------------------------$30.00
Contractor Change ---------------------------------$30.00
Temporary Certificate of Occupancy.......................................................$75.00
Additional or Requested Inspections-------------------------------------------------------$75.00
Removal of Stop Work Order------------------------------------------------------------------$75.00
v ConwronweaRn of Massachusetts
Division of Professional licensure
Board of Building Regulabons and Standards
Construction Supero�sor
CS-011289 Expires:02/27/2020
THOMAS F OUINLAN
S HILLSIDE DR
HADLEY MA 01035
Commisswner �/'"'
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