31B-224 41 & 45 ELM ST - DUCKETT & CHASE HOUSE 41 ELM ST-DUCKET&CHASE HOUSE BP-2021-1332
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:31 B-224 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit# BP-2021-1332
Project# JS-2021-002205
Est.Cost: $647227.00
Fee: $4530.61 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: D A SULLIVAN & SONS INC 053667
Lot Size(sq.ft.): 51400.80 Owner: SMITH COLLEGE
Zoning: EU(100)/URC(100)/ Applicant: D A SULLIVAN & SONS INC
AT: 41 ELM ST - DUCKET & CHASE HOUSE
Applicant Address: Phone: Insurance:
82 NORTH ST (413) 584-0310 Workers Compensation
NORTHAMPTONMA01060 ISSUED ON:5/13/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:exterior renovations including re-roofing
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.
r 5
Certificate of Occupancy Signature: I
9:1„
FeeType: Date Paid: Amount:
Building 5/13/2021 0:00:00 $4530.61
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
. - • / kk"-e"-'''' ,
The Commonwealth of Massachusetts ? 2021
:--------7-
�� °� Office of Public Safety and Inspections r 0,
Massachusetts State Building Code(780 CMR) ,'-r,qt
Building Permit Application for any Building other than a One-or Two=' a g
(This Section For Official Use Only) '�r o NII
Building Permit Numbe>egr p7/'13)s.1 Date Applied: Building Official:
\ SECTION`. 1:LOCATION 'p
W( KS &(N • �� NsR. cin,4 , It kO/OCo0 C so JGIGk[4 CcduLo.%
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used 1 ' If New Construction check here 0 or check all that apply in the two rows below
Existing Building Q'j Repair Cif/ Alteration ❑ Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use ❑ Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes No 0
Is an Independent Structural Engineering Peer Review required? Yes ❑ No Eli
Brief e riptio n o ropose Work
>` to Ao aL c � - eoc tyli ciis� #tfo s0 SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Buildin Investig tion and Evaluation is enclosed(See 780 CMR 34) 0 n
Existing Use Group(s): QZ- aR H t� Proposed Use Group(s): ...1- R.rk%
SECTI 41 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.) " /t!"" __.i ti ya' N le,ooa ti+ IttV'
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0
F: Factory F-1 ❑ F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 H24 0 H-5 0
I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 Cd R-3 0 R-4 0
S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable) �/
IA 0 IB ❑ rIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV 0 VA 0 VBQ
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit Debris Removal:
A trench will not be Licensed Disposal Site 0
Public 0 Check if outside Flood Zone 0 Indicate municipal 0 required 0 or trench or specify:
Private 0 or indentify Zone: or on site system 0 permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes 0 or No 0 Yes 0 No 0
5 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code:It-iLo�1 Use Group(s): Q.Z. Type of Construction:
Does the building contain an sprinkler System?: Pc Special Stipul tions:
Design Occupant Load per Floor and Assembly sOace: N v c o+t*, e 4 C
• I SECTION 4: PROPERTY OWNER AUTHORIZATION
Name a.rid Address of Property Owner �'f
—..SNIT{ L t ff/6 (.I M c . t o ,,, G1 ( KA 6 f oc-o
N,,ne(Print) No.and Street City/Town Zip
roperty Owner Contact Information: P«SoJ A,, 01� 4 ffrr II-
\)P�QCQ ftaAnet_ t_1�- -'� L( I6-�-Zlat alq�d[c6 2 ,k1 eStac4. 6aLt
Title �J Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the prop owner hereby authorizes:
N(I5� va 1 ( e sary AS PIO 06
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0.
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control (the professional coordinating document submittals)
Lcaup,k, t. TI-0. to__5ipt_ 51-tct I f�z�C'VcActkch,k,96�.cdl<•. i &
Name egistr t ele hone o. e-mail add ss Q > gis ritionlNmnber 24
r(t) y Ht 1( Qoaa �Iv sJ t IOa2 Q , e
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
D_ R. _Su.t(Wan k -SOt\s ,Tnc.
Cnripar Name
1 ort Sctt(,00f ( -13CoG4
Name of Peison Responsibl for Construction Li nse No. and Type if Applicable
561. _
noel 6a A 1LcL , r1 k o 1s�6
Street Address( City/Town State Zip
YO -AT d)io '•fij -` 1 - 51.0`I• rttri: e a4skll l al A. ear
Telephone No. (business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the(sguance of the building permit.
Is a signed Affidavit submitted with this application? Yes(u" No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Estimated Costs:(Labor /
Item and Materials) Total Construction Cost(from Item 6)=$6" t,Z2-t•CO
1.Building $ (9 5 ITS .00 11•'
1 Building Permit Fee=Total Constructio• ost x (Insert h•re
2.Electrical $ appropriate municipal facto )=$ Lf,S16.Cn t
3.Plumbing $ ( A 1,e? Cp, OD.
4.Mechanical (HVAC) $ Note:Minimum fee=$ r4 k (contact municipality)
5.Mechanical (Other) $ Enclose check payable to Ci Q •'"ILA
6.Total Cost $ 1f{ 22' .66 (contact municipality)and write chick number hereG f jZ
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name belo attest and the pains and penalties of perjury that all of the information contained in this
application is true an accurat to the best of knowledge and understanding.
nn
on
4,5 10(1 t
at irrk 10) _5n_nAn__ Si/2-12-4
Please'print d si na e / �A-^ ( �T,',tle Telephone N�vo. Date
*a.. BL( r cit S dR`' tar' aiaGv ram/a <'aa stcfC(�an. ed•..
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: `'`�w1 5 es
Da e
City of Northampton
t mow?' _ ce
DEPARTMENT OF BUILDING INSPECTIONS � ,4
(r---
Massachusetts
' 212 Main Street • Municipal BuildingyJ ��Northampton, MA 01060 J..... ••a;j`'�0
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: o� --et- IbC AL — tl- t1� MG1.1\ ( K�
The debris will be transported by:
Name of Hauler: 14\-a31 LGq 1--airr.1` SpiVc,.2) I"`t'L
Signature of Applicant: y„, ..{ Date:--S 12/2-(
1
The Common Iveulth of Massachusetts
t WNW 1••••••• Department of Industrial Accidents
__� 1_= t I Congress Street, Suite 100
or t""• Boston, MA 02114-2017
www.niass.gov/dia
1linkers' ('untltrrisulion Insurance Afiidnvlt:Buliders/('ontractorsfElectrieiaus.Plumbers.
10 like I II.1•.D WWI i IIk:PER.Mli1'ING Al 1 H()R1 IA.
.ki,nlicaiit information n Please Print Leiiil►l%
Name ll3utimess,Orgnnuatiowindtvidual):P.
� t\. SU t((004 �- SO �i-1G. — _.
Address: ' S6 aoit P. s -.
City/State/Zip: A0V.V11/4614Aella KA O heap Phone#: f/ It • St' 61 I b
Are von an employer?('heck the appropriate bat:
Type of project(required):
I. i am a employer with 1.15 enuptoycea(fill aad'oe part-time 1• 7. 0 New construction
20 I am a suk proprietor or partnership and have nu employees working for me in g, Q Remodeling
any capacity_(Nu workers'carp.unurance requited]
3.01 am a hoe Tuner doing all*tick myself.(No workers'comp.ensuruux required]' 9. El Demolition
m
4. mw I am a lwouner and will be luring oimtr-.tcturito conduct all work on my paawl sty= I will ICI El Building addition
u ensure that all contranun either have workers'isom oisataal unurunee or:tic Bole I ICI Electrical repairs or additions
prupneton V.ith nu employees_
12.E Plumbing repairs or additions
50 I am a eeaerah eunaraetur and I have hired the sub-caatruturs listed on the attaebed sheet .
These sub-contractorshave employees and have workers'comp.insurance.: l3❑rRUUf re ittO[ltcr ( (( low( i
]�/I 14.Lf (0{I
6.0 We arc a output-Aaiun and its officers have exercised their nght of euarpuun per MGL e.
152,§l(4).and we line nu eraptoyeeii.[No work 'comp.insurunce required.]
'.Any applicant that checks boa ci mint also till out the section below showing their workers'eunopensutiun policy information_
t Homeowners who submit this affidavit indicating they arc doing all Kirk and then hire outside contractors must submit a new arti lair it indicating such.
:Cunrraeturs that cheek this lox must attached an additional sheet showing the name of die sub-contractors and state whether or not those entities have
ernpluyees. If the sub-contractors have employees.dozy must pruviJc their workers'ournp.pokey ntnntwr.
urn an employer that is proridinR workers'compensation insurance for my employers. Below is the policy anti job site
infiernreeliou. �� � � ��
Insurance t_tunpany Name: tit
Policy#or Self-ins.Lie.#: Re e.2.06 2Oc C .s 2O2Q A Expiration Date: 11 t 12
Job Site Address: tit s'- ifs tit.,t- S . CitylStaielZip: /V d% ,aet� E f `-+� a ID0�0
Attach a copy of the workers'compensation policy declaration page(showing the policy number and cm) Alton date).
Failure to secure coverage as required under MGL c. 152, *25A is a criminal violation punishable by a line up to SI,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.
/do hereby certify'one r t1 •pai hill unities of-pee/toy that the information provided ohm?t.. true and correct.
Stgnature: / llatc: 5(/2- Z t
Phone. : tr//) • S% (• o(6
Official use only. De'not write in this area.to he completed by city or town(Ovid_
City or Town: Permit/License#
issuing Authorith (circle 'mil:
1. Board of ilealth 2. Building Department 3.CO:limn Clerk 4. Electrical Inspector S. Plumbing lnslrrctur
b.Other
Contact Person: Plume :
f Initial Construction Control Document
ill 1 1 To be submitted with the building permit application by a
Registered Design Professional
fr for work per the 9th edition of the
..- Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Chase-Duckett Houses Exterior Improvements Date:4/25/2021
Property Address: Chase -Duckett Houses, Smith College Campus
Project: Check(x) one or both as applicable: -New construction x Existing Construction
Project description: Re-roofing and miscellaneous exterior repairs
I, Laura Fitch,MA Registration Number: 8835 Expiration date: 8/21,am a registered design professional, and I
have prepared or directly supervised the preparation of all design plans, computations and specifications concerning':
x Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information, and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I (or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports (see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'.
Enter in the space to the right a"wet"or electronic ��,ED,,A�
signature and seal: sQ�aSJM E.F�yFq,
ti8E8RST
35
Phone number: 413-549-5799
�RMHs
7710F
Email: lfitch@facdarchitects.com
(4ata- e
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen,
provide a description.
Version 06 11 2013
Appendix 1
Construction Documents are required for structures that must comply with 780 CMR 107. The
checklist below is a compilation of the documents that may be required. The applicant shall fill out
the checklist and provide the contact information of the registered professionals responsible for the
documents. This appendix is to be submitted with the building permit application.
Checklist for Construction Documents*
Mark"x"where applicable
No. Item Submitted Incomplete Not Required
1 Architectural
2 Foundation ✓
3 Structural
4 Fire Suppression
5 Fire Alarm(may require repeaters)
6 HVAC
7 Electrical
8 Plumbing(include local connections)
9 Gas(Natural,Propane,Medical or other)
10 Surveyed Site Plan(Utilities,Wetland,etc.)
11 Specifications
12 Structural Peer Review
13 Structural Tests&Inspections Program
14 Fire Protection Narrative Report
15 Existing Building Survey/Investigation
16 Energy Conservation Report
17 Architectural Access Review(521 CMR)
18 Workers Compensation Insurance
19 Hazardous Material Mitigation Documentation ✓
20 Other(Specify)
21 Other(Specify)
22 Other(Specify)
*Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified
must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the
authority having jurisdiction.
Registered Professional Contact Information
fat G ;-1 4cs. sytt LVl e .caaR&!i'APct5 ,eat. VBJS
Name( egistrant) Tele ho e No. e-mail address Registration Number
/in 4C k Pc(it 64� rt e5`t 4 _ b(662 A 2.!
Street Address City/Town State Zip
Discipline Expiration ate
- -
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
Please follow this link for construction control forms to be used by Registered Design Professionals.