38D-056 (8) 40 WINTHROP ST BP-2020-0834
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38D-056 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit# BP-2020-0834
Project# JS-2020-001439
Est.Cost: $17300.00
Fee: $112.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: HANS DALHANS 101628
Lot Size(sq. ft.): 6403.32 Owner: ERIN HOLMAN
Zoning: URB(100)/ Applicant. HANS DALHANS
AT. 40 WINTHROP ST
Applicant Address: Phone: Insurance:
11 CHERRY ST (413) 977-6094
EASTHAMPTONMA01027 ISSUED ON.1/31/2020 0:00:00
TO PERFORM THE FOLLOWING WORK.-ADDING LOFT TO BEDROOM ON 2ND FLOOR
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 1/31/2020 0:00:00 $112.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
Department use only
City of Northampton Status of Permit:
., Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
F) pecify
APPLICATION TO CONSTRUCT,ALTER, R AIR, RENOVATE OR DE MOLI SH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION JAN 2 2 2020
1.1 Property Address: Th section to be completed by office
DEPT.OF SMI)ING INSPECTIONS �
NORTHAMPTON�. y01060 Lot is '�V' unit
� W����rip �fi �
Zone Overlay District
I� O Y t Wk PA r ry\ AAA vi D&0
Elm St. District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
1P2.1 Owner of Record:
Ea u,l i v►�c�� 0 IN w� 1h v�h S't
(Print) Current Mailing Address.
0� 59 _��c42
Telephone 4
Signa re
2.2 Authorized A ent: ��� C
G& � JUI
Na (Print) Cu rent Mailing A dress:
�4 991
na ure Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building ` (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
0c) Construction from 6
3. Plumbing /6L Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = 0 +2 + 3+4 + 5) Check Number
This Section For Official Use Only
BuildingPermit Number: �+'' Date
Issued:
Signature:
VU I
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 be filled in by
Building Department
Lot Size
---------------------------------------_
Frontage _.....
Setbacks Front
Side L:= I L:
Rear .V
r i
Building Height
Bldg.Square Footage `"�"' %
Open Space Footage %
(Lot area minus bldg&paved _
parking)
#of Parking Spaces
Fill:
(volume&Location)
r �
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW 0 YES
IF YES, date issued:!
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES Q 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 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing El
Or Doors Ems'
Accessory Bldg. ❑ Demolition New Signs [O] Decks [0 Siding [o] Other[0]
Brief De cr'p ion of ro ed
k, ()v.\ �12'j �011C_
Work:
Alteration of existi g bed roo Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll C--Sheet
sa,if New house antl or ad4lt on to existing housfna, complete the followina:
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
as Owner of the subject
property
hereby authorize \\_\ov'�'>
to act o my behalf, all matters relative to wok authoriz d by this building permit application.
Ai,'tA �� wue� 1 -)-�1-
Sig nakfe of own r Date
R'V as Owner/Authorized
Agent ereby declare that the stateme is and information on the foregoing applic ion are true and accurate, to the best of my knowledge
and belief.
Signed under the pains ar penalties of perjury.
Print Name
ignature of Owner/A) Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Su ervisor: Not Applicable ❑ Q
Name of License Holder: pck(�,OS C-S- 1 O 1 6 2(/
License Number
Addr ss Ex iration Date
ignature Telephone
9.Reallstero Home ImDrovement Contract „.... Not Applicable ❑
ComDany Name Registration Number
Address L Ex rati n Date
Telephone
Yj-SM (07V
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....... No...... ❑
4
City of Northampton
Massachusetts
Q
DEPARTMENT OF BUILDING INSPECTIONS �
212 Main Street • Municipal BuildingJJbR
Northampton, MA 01060 ��vj���
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 reuistered 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 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 permas the a ent of the owner:
s
Nate ontractor Name HIC Registra on 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
t DEPARTMENT OF BUILDING INSPECTIONS h
212 Main Street • Municipal Building �� Cbz
Northampton, MA 01060 '°^ 1�0
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 110.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
Massachusetts
r.=
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street •Municipal Building �.
Northampton, MA 01060 �S`zxq^
Debris Disposal Af f idavi t
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:
40 W tAL�� S� I Wo ko
(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:
(Company Name and Address)
ature of t 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.
The Commonwealth of Massachusetts
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 Please Print Leeibly
Name (Business/Organization/Individual): C \ G,t
Address: �(. 6% (�4 ,
City/State/Zip: &-_ AA A d 0 Phone #: Z73 07
Are you an employer?Check the appropriate box: Type of project(required):
1.1—]1 am a employer with employees(full and/or part-time).* 7. ❑New construction
2.[—]l am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling
any capacity.[No workers'comp.insurance required.]
9. ❑Demolition
3.❑1 am a homeowner doing all work myself.[No workers'comp.insurance required.]T
10 ❑ 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.rl I am a general contractor and I have hired the sub-contractors listed on the attached sheet.
These sub-contractors have employees and have workers'comp.insurance? 13.❑Roof repairs
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#1 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.
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 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 cop f this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do here ert' un r th s nd p allies of perjury that the information provided above is true and correct.
Si natur • Date: 2o�Q
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#:
MAPLE STREET ARCHITECTS
39 REVELL AVE NORTHAMPTON,MA TELEPHONE:413 570-3213
NEW SOFFIT VENT AT EACH
RAFTER BAY
EXPOSED EXISTING RAFTER
NEW PROP-A-VENT OR SIMILAR REMOVE 3
ALTERNATE
NEW DENSE-PACKED i RAFTERS
CELLULOSE IN EXIS. FRAMING i
NEW CONTINUOUS POLYISO =
INSULATION TO REACH R49, - \ / \ /
- B E D RM . 3 \ �� II / � / NCLOSURE
-3 s
NEW LADDER 2051
BEVR \ / O
05
NEW PAINTED WOOD RAILING 41 ovi ACCII ,5
3-
I PAKL
EXISTING RIDGE VENT ATTICov
f 301
STORAGE
SHELVES
_ BEDRM . 2
NEW DENSE PACKED 2 04
CELLULOSE R19 -
NEW GABLE END VENT \
\���RE D ARI
Q�G STFj� FL
Q�
No.20604 Nv)
CAMBRIDG t SECTION LEVEL 3
LEVEL 2 REMAINS AS EXISTING (PLUS LADDER)
OF MPSc,P
Donson Holman Residence N 0 6"1' 2' 4' 8' PROPOSED A2
40 Winthrop St,Northampton,MA
MSA PROJECT 19MA SCALE: 1/4" = 1'-0" SCALE:1/16"=V-0"
January 9,2020
MAPLE STREET ARCHITECTS
39 REVELL AVE NORTHAMPTON,MA TELEPHONE:413 570-3213
BATH
202
BEDRM . 3 ,
12051 -
BEDRM . 3
205 ,'� _ �� HALL
[ 201
� � BEDRM . 1
- - - - 203
I FF�
BEDRM . 2 BEDRM . 2
204 204
\���RED AqCy
ST
�v 2
n No.20604 N v,
o CAMBRIDG
SECTION---- - LEVEL 2
0
FM P55P
Donson Holman Residence N 0 6"1' 2' 4' 8' EXISTING A 1
40 Winthrop St,Northampton,MA
MSA PROJECT 19MA SCALE: 1/4"= 1'-0"
SCALE:1/16"=1'-0"
January 9,2020
MAPLE STREET ARCHITECTS
39 REVELL AVE NORTHAMPTON,MA TELEPHONE:413 570.3213
4 NEW IC-RATED RECESSED CAN LIGHTS
ELECTRICAL SYMBOLS
SWITCHES ON LEVEL 2 BELOW SYMBOL
$ SINGLE POLE SWITCH
$3 THREE WAY SWITCH
O
EDR / / STANDARD DUPLEX OUTLET
2 \ / STANDARD QUAD OUTLET
P \ /
\ / W �A WALL MOUNTED LIGHT FIXTURE
B
- - -- - - - - - - - - - - - - - - - - - - -
/X\ � /�\ ��' -- �B IC-RATED RECESSED CAN LIGHT
SWITCHING CIRCUIT
.......-._
SMOKE DETECTOR
s i
W ATTIC 0�
i
/Q 301 ELECTRICAL NOTES:
�B �B
DRAWINGS ARE INTENDED TO CONVEY DESIGN INTENT ONLY.
CONTRACTOR PRICE SHALL INCLUDE ALL WORK& EQUIPMENT
NECESSARY FOR FULLY FUNCTIONAL SYSTEM, INCLUDING BUT NOT
LIMITED TO:
17" 17"
OUTLETS TO BE PROVIDED AT MINIMUM DISTANCE PER CODE IN
- - �- - - - - - - - - - - - - - - - - - - - - - ADDITION TO LOCATIONS SHOWN.
RELOCATE EXISTING BEDROOM SMOKE -ALL FIXTURES AND DEVICES TO BE LOCATED ON SITE WITH
DETECTOR TO NEW CATHEDRAL CEILING ABOVE OWNERS.
-ALL WIRING &CONNECTIONS REQ. TO "MAKE LIVE" INLCUDING
COORDINATION W/EXISTING SERVICE AND PANELS AS REQ.
- IT IS THE ARCHITECT'S INTENTION THAT FIXTURES ALIGN WHERE
DRAWN IN A LINE, AND THAT THEY ARE NEATLY LAID OUT PARALLEL
OR PERPENDICULAR TO ADJACENT WALLS
- ALL IC FIXTURES TO BE SEALED AT CONNECTION TO INTERIOR
LEVEL 3 INTERIOR FINISHES AND LABELED TO INDICATE MAXIMUM 2.0 CFM LEAKAGE
���� �srfcy'F ELEVATION AT 75PA.
Q k/ LF2 �a EXISTING ELECTRICAL PANEL PROVIDES A DEDICATED CIRCUIT TO
C1 No.2060a N �
BEDROOM 3.
3 CAMBRIQ6
G�
OF MPSgP
Donson Holman Residence N 0 6"1' 2' 4' 8' ELECTRICAL A3
40 Winthrop St,Northampton,MA
MSA PROJECT 19MA SCALE: 1/4" = 1'-0" SCALE:1/16"=1'-0"
January 9,2020