38B-050 19 LYMAN RD BP-2020-1002
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38B-050 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ROOF BUILDING PERMIT
Permit# BP-2020-1002
Proiect# JS-2020-001692
Est.Cost: $10000.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: TIMOTHY LUCE 100515
Lot Size(sg.ft.): 0.00 Owner. LYMAN RD CONDO ASSOC
Zoning Applicant. TIMOTHY LUCE
AT. 19 LYMAN RD
Applicant Address: Phone: Insurance:
PO BOX14 (413) 387-9800
LEEDSMA01053 ISSUED ON:3/9/2020 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE SECTIONS OF BUILDING'S
ROOF
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. 13uildiiig 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 SiLnature:
FeeType: Date Paid: Amount:
Building 3/9/2020 0:00:00 $100.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Zoa�oaS
O
rn rn F
v
O� y
in ; Version 1.7 Commercial BuildingPermit May 15,2000
� Department use only
o cD City of Northampton Status of Permit:
5 0 Building Department Curb Cut/Driveway Permit -
o O 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
zNorthampton, MA 01060 Two Sets of Structural Plans
hone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address:
This section to be completed by office
19-29 Lyman Rd Map /� Lot O �SV Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
.ejk 3a�o /WI'71/�O
Name(Printatm-S"9t�� 1 Current Mailing Address:
i j `113 —�S3_-oc�� __•--__._. _ . .�
Signature4-'PA-AXI C — Telephone
2.2 Authorized Agent:
jimothy J. Luce �PO Box 51068, Indian Orchard, MA 01151
Name(Print) Current Mailing Address:
413-387-9800
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building j 10000! (a)Building Permit Fee
i
2. Electrical ' (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) Check Number
This Section For Official Use Only
Building Permit NumberD Date
60. d 0 — �, Issued
Signature:
& � -
. . 3/9 a0
Bulldf Commissioner/Inspector of Bwldin Date
Versionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing Change of Use❑ Other❑
Remove and Replace existing low slope 2nd story roof areas at rear of building with Membrane(approx.600 SQFT)
Brief Description !Add tapered insulation to correct drainage. Existing Below deck insulation currently meets code.
Of Proposed Work:
I
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H Hi h Hazard ❑ 3A ❑
1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:L_
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): __ ___ Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf]l
_ .. 2
ria
2"d
3`d 3m
4th 4th
Total Area(sf) I I Total Proposed New Construction(sf)
_J
Total Height(ft)
Total Height ft I
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone( I Outside Flood Zone❑ Municipal ❑ On site disposal system❑
Version 1.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes O No
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property
hereby authorize(Timothy J. Luce to
ehal, all matters relative to work authorized by this building permit application.
a—o24) _
Signature of Owners Deft
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 periurV.
Timothy J. Luce
Print Name
.3-2--2v
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:.,'Timothy J. Luce 1100515
License Number
PO Box 14 Leeds,MA 01053 '7/15/2020
Address _ Expiration Date
:1413-387-9800
S gnature Telephone
SECTION 13-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 O No O
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: P-d
The debris will be transported by: 5s0C'�.
The debris will be received by: _ -*4j
Building permit number:
Name of Permit Applicant
- 2 2J
Date Signature of Permit Applicant
BOARD OF
SHEET METAL WORKERS 7,
ISSUES THE FOLLOWING LICENSE
MASTER-UNRESTRICTED
;a
TIMOTHY J LUCE .. z
PO BOX 14 :. v
LEEDS, MA 01053-0014Itu
.z
., W
sJ
13395 07/28/2020 522276
Office of Consumer Affairs & Business Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE: Individual
Registration Expiration
149288 12/14/2019
TIMOTHY J LUCE
TIMOTHY J. LUCE
122 AUDBON RD.
LEEDS, MA 01053
Undersecretary
Commonwealth of Massachusetts
Division of Professional Licensure
f Board of Building Regulations and Standards
r
Con str, irvisor
CS-100515 E'_ ires: 07/15/2020
TIMOTHY J LUCE
PO BOX 14j
LEEDS MA 01053,
Commissioner
The Commonvi ulih ofMassachusetts
� Dzpurlmentoflndustriczt�cc�nts
Off ice Of Invesfigadons
600 Wohingfon Street
- B40s10n,MA 02111
imp mass.gov/dita
Workers' Compensation Imursnea A-Mdavlt:'Faders/ContractoraMectririans/Plumbers
AD Reanthformaiion FleasepantLezrMU,
NaMe(Business/Otraaization/indlviduan' J•D.Rivet & Go . , I ne.
Address: 1635 Page Blvd.
City/Stale/Zip: Springfield, MA 01104 Phone#: 413-543--5660
Are you an employer?Check the appropriate box: Type of project(requirotxl):
1. I am a employer with 50 4. ❑ I am a general contractor and 1 6. E]New construction
employees(full and/or part time}.* have hired the sub-contractors
2. 1 am a sole proprietor orpartner- listed on the aHached sheet 7. ❑Remodeling
ship and have no employees 'mese sub-contractors have 8- ❑Demolition
working for me in any capacity' employees and have workers'
9. E]Building addition
[No workers'comp.insurance Comp-insuranmt
fid,] S. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.[1I am•a homeowner doing all work officers bavt;exercised their ILL]Plumbing repairs or additions
•myself.[No workers'comp. right ofexemppon per MGL 12.E]Roofrepairs
insuraizce required.]t c.152,§1(41 and we have no
employees.[No workers' 13.0 other
COMM itutrranaerequired.]
.Any apptica dUd checks box#1 mud sled 1311 out the section below showaag theirwndcmre eompansation policy infnmmnrion.
t llowwwaerswho sabmit tiag aM&evitindlcsdng thv=doing all worn and then hhc outside contractors mwtsabmir it newaM&*ladicutiag sucb.
rCosmhacwzs that eheckthIs box aawtauached an uddltional sheetshowing the name aflhe atmb eontracAorsandstara whether or naihwo entities have
employees.If the sub.coatr etors have employtes,tiny ears!pmavlde their wee em'comp,policy numb=
ram an employer that is proyIdUig workers'compema&n insurance for my employees. Bdvw is rhe po&y and f ab s11e
irsfornmdoa. -
ImsurureeCompauyName• American Casualty of Reading PA
Policy#or Self-ins.Lia.#: 5092136486 l acpuation per: 05/01/2020
Job Site Address: City/Staftaip;
Attach a copy of the workers'eonmpeasation policy declaration page(showing the poliayuumber and expiration date).
Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one year imprisonment,as well as civil petralties in the form of a STOP WORK OMER and a fine
of up to$250.00 a day against the violator. Be advised that a copy ofthis statementmay be forwardedto the Office of
Investigations ofthi DIA for insuza+ce coverage vemdfication.
147 hereby certify under ihepaba and,penallies ofperJury fhal ae infanna&nprovlJedaboYe fs txua audcomect
Sititre' Date-
glt6nD�'
O,Qrdal use omly. Do not write to Mfs area,to he completed by effy or 10 wn a ficlaZ
City or Town: - Permit/idceme#
Issuing Authority(circle one):
1.Board OfHealth 2.k3allding Department 3;Cityffown Clerk 4.Electrical Inspector 5.Pltanblug Inspector
6.Other
Contact Person: Phone#:
From: Lc- Tvic,
To:
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, 1 request that you
grant a modification to waive the requirement for construction control of the project at
)9 -2 9 44" (0-
because thew rk is of a minor nature, will not affect structural elements, health, accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,