23A-126 (5) 30 MIDDLE ST BP-2021-1195
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23A 126 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ALTERATION BUILDING PERMIT
Permit# BP-2021-1195
Project# JS-2021-002000
Est.Cost:.$3000.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 15463.80 Owner: MENDELSOHN AARON
Zoning: URB(100)/ Applicant: MENDELSOHN AARON
AT: 30 MIDDLE ST
Applicant Address: Phone: Insurance:
30 MIDDLE ST (267) 254-4177 ()
NORTHAMPTONMA01060 ISSUED ON:4/20/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:RENO PORTICO
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. 14.
• . y2Ii
Certificate of Occupancy signature:i u Q
FeeType: Date Paid: Amount:
Building 4/20/20210:00:00 $65.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
ICE VETY-7 '4410
I- R-----E-----T
i
I 11 i
The Commonwealth of ass chu 5
Board of Building Regulati ns a d Standards 2021 ` FOR
Massachusetts State Buildi g Co .. CMMR ( MuCruipY
OF pull IN
Building Permit Application To Construct, ' NftEttiwattrotRrOkoZirgea Revised Mar 2011
One-or Two-Family Dwelling -- ...
I
is Section For Official Use Only
Building Permit Number: a/4 A_
Date A lied:
L4-04-/Z5
. ./// ti-zo-aki
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1Property3 da S TO v Ce. 1.2 Assessors Map&Parcel Numbers
.10
Li a Is this an accepted street?yes ✓no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSI TP',,o,,,
2.1 tvn(or I _ o !1d
vi
0 6 6 7
Name(Print) City. tate,ZIP
3U M ;4 cJ Je �. (Z G 7 2.5q /7 04,r-4.4444. 44 clei oitel 6 O
No.and Street ' elephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
iiiimiongeSed Wairi 12..Cr,�e .A....1-,\n,, esF 42140.L¢ 9otr.e c
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2.Electrical $
❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire Ca4r
Suppression) $ Total All Fees: $ t
Ch o. Check ount: " (.. Cash Amount:
011.1111111101161.11 $ 31151 — ❑Paid in Full Outstanding Balance Due:
_ City of Northampton
Massachusetts
a.
DEPARTLENV Ur BUILDING INSPECTIONS g ;-
212 Main Street • Municipal Buildin ti`.
Northampton, MA 01060 s ,Y y,,b
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 & 2 FAMILY DWELLING,ADDITIONS, POOLS,DECKS,ACCESSORY STRUCTURES,
FENCES,GROUND MOUNTED SOLAR,ETC.
1 .• r
• •
►..r
1. Building Permit Application signed by legal owner and filled out by owner or authorized agent.
2. One set of plans and specification of proposed work(digital and hard copy).
3. Site Plan with location of proposed structure(s)and setbacks.
4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance.
7. Energy Conservation Compliance Certificate (new/replacement windows).
8. Home Owner's License Exemption Form filled out and signed by homeowner(if applicable).
9. Note any Conservation and/or Special Permit requirements (if applicable).
10. Driveway Permit(if applicable).
11. Proof of Water and Sewer entry fees paid(if applicable).
12. Trench Permit-public land by DPW/Private land by Building Dept. . • e' "�4` '�+
•
13. Stretch Energy Code—all new construction will require a HERS Rater Affidavit to be submitted'with,
permit applicatipn before issuance of permit. ' • ►-
• • II Y
•
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.tt.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
City/Town,State,ZIP Telephone
SECTION 6: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 .0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print.Owner's Name(Electronic Signature) . Date
SE
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
tint Owner's or Authorized Agent='s Name(Electronic Signature)
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq. ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
•
FRONT SETBACK
FRONTAGE
City of Northampton
�!� Massachusetts tea, ` 1- t
t -'4' it
_ DEPARTMENT OF BUILDING INSPECTIONS S A
i ►i
212 Main Street • Municipal Building Jk.... zc:
Northampton, MA 0106041 jy.aj jV
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of
in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: 1/4 i(-ey X'&-c-A., Cl inj
/ /
The debris will be transported by:
Name of Hauler: d o 4 de ` -d k—
Signature of Applicant: L �— 0y/zDate: /
City of Northampton
` Massachusetts �
4 l ' 4 `` DEPARTMENT OF BUILDING INSPECTIONS ak
" � 212 Main Street • Municipal Building
r' 0500
4• Northampton, MA 01060 .'"' Vb.%
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, Wen Alit cre(SG 1-t-s (insert full legal name), born (insert
month, day, year), hereby depose and state the following: if/LT
1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or
work on a parcel of land to which I hold legal title.
2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'
exemption, does not involve the field erection of manufactured buildings constructed in accordance with
780 CMR 110.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2:
Person(s) who owns 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 home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I
qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of
the project or work on my parcel, I am not engaged in construction supervision in connection with any
project or work involving construction, reconstruction, alteration, repair, removal or demolition
involving any activity regulated by any provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on
my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this // day of I% r 1 , 20 2/.
(Signature)
. The Commonwealth of Massachusetts
Department of Industrial Accidents
h. .. t,", I Congress Street,Suite 100
� ` Boston! MA 02114-201'
�--- > ' 1vww.mass.go yid t'a
11 pikers' ('ompensaiion insurance Affidas it: BuildersK'ontractorsfElectriciansiPlumbers.
10 HE: FILED WITH THE PE1011141M Al''1'IlORITN'.
Applicant Information Please Print Le ibls
Name i Susan s or$imiiatton Individual): 7).-A.,a/4 --- iE?rf•td Q t a')
Address: 30 in/14/e- 5.A-
C'ity/State Zip:f-/are-411 <' AA 0/6 6 ?Phone#: 26 'l?' 4i/
1rc you an tint Ins er Cheek tbeatppropriate box: 'l pe of project(required):
1 :win a employer with . __employ+ees(full aad>or part-time).• 7. Q New construction
_.1 I on a sole proprietor or paatnerahip and have no employees working forme in 8. Lal_.A Remodeling
any capacity.[No workers'comp.insurance r qusnod.j
1 am a honmeuwnet doing all work myself.(No wodoers'cramp.awranc+e regard_j' 9. Demolition
l0❑ Building addition
.1.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all cvntruturs either hate wori,cn'compensation ucvuranee or We sold I I.Q Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
50 l am a general contractor and I have hired the sub-contractors listen on else attached sheet .3.0 Roof repairs
These sob-contractors have employees and have wage comp.nisuranee.•
4.0 ha We are a corporation and its officers have exercised theirnght of exemption per Wit.L. 1
152.v411aj,and we have no employees.[No workers'comp.insurance required.1
*Any applicant that cheeks bat RI must also till out the section below show tog their workers'compensation policy information.
t Homeowners who subunit this affidavit indicating they are doing all work and then hire outside etintrsctors must subunit a new al'idav it indicating su:h.
tContractors that check this box must attached an additional sheet showing the name of die sub-contractors and state whether or not those entities have
employees lithe sub-cuniractrns base employees.they must provide their workers'ernnp.volley number
I am an employer that is providing rtcorherc'compensation insurance.for my employees. Below is the policy and job site
information.
Insurance Company Nance:
Policy#or Self-ins. Ln. 4: 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 coverag:as required under MGL c. 152,§25A is a criminal violation punishable by a tine up to S 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 S250.00 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 lurin.s and penalties of perjury that the information provided above is true and correct.
Signature: �_`�—_ 1 :;:: l/ 4 2
Phones: Z4q- 25-7 4i/7-7-
Official use only. Do not write in this urea. to be c orriple'tee/by city or town official
' ("its or Tossn: Permit License#
l Issuing Authority (circle one):
I. Board of Health 2. Budding Department 3.('itsr l assn('Jerk 4. Electrical inspector 5. Plumbing Inspector
F 6.Other
Contact Person: Phone#:
Aaron Mendelsohn
30 Middle St. Florence.
Work to be completed by homeowner at 30 Middle St, Florence.
Timeline: June- August 2021.
Scope: All work to be performed shall be contained to the front portico area.
Roof: The roof to be replaced. Old shingles to be removed. New % plywood sheathing to be
installed. GRACE underlayment to be installed. Aluminum drip edge. Asphalt shingles with step
flashing.
Stairs: The 3 stairs leading up to portico to be replaced. Stairs to span the entire width of the
front of the portico.
Landing shall be poured to depth required by code (10 in?) with gravel poured first and
then concrete reinforced by rebar.
Stringers cut from 2x12 pressure treated lumber, and placed 9 inches on center.
Stringers connect to header with Simpson Strongtie LSCZ and Simpson Strongtie
fasteners. Header fastened to concrete block foundation with GRK concrete fasteners
(ACQ compliant)
Treads: Trex decking to be installed for stair treads according to manufacturer
specification.
Risers: Lifespan solid select outdoor trim. GRK finish fasteners.
34- 3.
Handrails: Height of 31 inches with balusters placed 2 inches apart. Handrails to
terminate into posts at the last step.
Posts: fasten to landing with Simpson strongtie Post base: ABA44z. Postes fasten to
stair framing with Simpson Strongtie Deck tension tie: DTT2Z.
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