39A-063 (7) BP-2021-2 177
69 LYMAN RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
39A-063-00I CITY OF NORTHAMPTON
Permit: Addition
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-2177 PERMISSION IS HEREBY GRANTED TO:
Project# SCREENED ROOM Contractor: License:
Est. Cost: 15000 THAYER STREET ASSOCIATED INC 045159
Const.Class: Exp.Date:09/03/2022
Use Group: Owner: LEVITT SAMUEL W& ELLEN L GOLDSMITH
Lot Size (sq.ft.)
Zoning: URB Applicant: THAYER STREET ASSOCIATED INC
Applicant Address Phone: Insurance:
8 Coates Ave (413)665-4018 0 WM28007499
DEERFIELD, MA
ISSUED ON:11/19/2021
TO PERFORM THE FOLLOWING WORK:
SCREEED ROOM
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.
Signature: Q
164E11\1/4_
Fees Paid: $97.50
•
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
•z-0K
RECEIVED
The Commonwealth of Massachc setts
FOR
50 Board of Building Regulations and Standa-ds
einnd
NOV 10 cuc MUNICIPALITY
Massachusetts State Building Code, 780 CMR USE
Building Permit Application To Construct,Repair,Keno Me O n li h R 'ise1 Mar 2011
DEFT.OF BUILDING INSPEC-IONS
One-or Two-Family Dwelling NORTHAMPTON.MA 01060
This Section For Official Use Only
Building Pe it Number: e,P J I a 17 7 Date Applied:
EOM, 45 4/ 11- pitio2(
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
cDCI L I 1.1a Is this an ccepted street?yes V 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:
Zone: _ Outside Flood Zone?
Public l� Private❑ Check if yes❑ Municipal rie6 site disposal system 0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Recorsl:
csc\ ` e v 1 1-r Igor c e M C\ � O10000
Name(Print) City,State,ZIP
L113-Sao• Cot a•1Y1@ (oa I Liman . coTMe\
No. and Street Telephone 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) 0 Addition 0
Demolition 0 Accessory Bldg.lY Number of Units Other 0 Specify:
Brief Description of Proposed Work': SereerN
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:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $_
4. Mechanical (HVAC) $ List: _
S. Mechanical (Fire
Suppression) $ Total All Feeq �/
Check Nor? "Check Amoun"l: 11.9 Cash Amount:
6.Total Project Cost: $ I Si alb ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES .
5.1 Construction Supervisor,License(CSL) QQ 0 1 S9 3
Ve r1C1C1 `,� — License Number Expirati n Date
Name of CSL Holder
((�� List CSL Type(see below)
da t S 1 I use Type Description
No.an Street �;,
gyp+ + ,f\ Q\3-13 CU) Unrestricted(Buildings up to 35,000 Cu.ft.)
TQ M R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
Li13"(o1PS" i- V'eYtNe- ersN• eRkstaTioc taiRS.Cam I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) g l CY35 0'1 (Lo a -n-
Vel txx, \\<t 1/4)`('\ HIC Registration Number Expirati n Date
HIC Compan2y Name or HIC-Registrant Name
C OC_ThS Gn� VeVI1R_}4nau.tefShree!-rise ci f .Corti
an Stre Email address
� e 2Xc 1 MA C7t3�3 113-loloS-�Ot$
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,h- -, authorize €e.r ‘ \\C T\. \('\T')t\
to act on my behalf,in all matters r lative o work a on d by this building permit plication.
IIPP
Sa t`r1 �-te� 1 Ce.A.c 1,----*--- gk'
1‘\lCira'761
Print Owner's Name(Electronic Si iature) Date
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
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.
Ver nor r 1 n !a.i.,.c-„ , A_IC). -425-al
Print Owner's or Authorized Agdnt's Name(Electronic Signat e) ate
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
1 3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton • •
44, S.s " sr
r
Massachusetts ' 'ViDEPARTMENT OF BUILDING INSPECTIONS t'. 4'
212 Main Street • Municipal Building yta *
` —•-! Northampton, MA 01060 jk��
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: G` Otxr�JS- r- Qt- st-t
The debris will be transported by:
r ,
Name of Hauler: \-\\ \\ 0\S SQA
_LiSignature of Applicant: Date: /40a/
The Commonwealth of Massachusetts
Department of industrial Accidents
m-till----
',;-..*--1 1 Congress Street,Suite 100
v:.to B.ru b
, , ,,...... . Boston,MA 02114-2017
,...z.,., www.ntass.govidia
Bothers'Compensation Insurance Affidavit:Builders/ContractorsiEtectriciansiPlumbers.
PO BE HIED iti III)Illt:PERM111-1ING At ITIIORITV.
Attnliettnt Information Phase Print Lei
Name 413 ustnes,I)r/,ailiZatk.11 1 ildiindU :77r\-8 tAer 0.-e.e.-1- ilsoc...t.o_l_i% rir)C,_
Address:
cc;(/`b,51
City'State/Zip: ).'‘,A Phone P: t B -CotO • kk0 11
— _
Are NUM Ili employer?Cheek the appropriate has.: Type of project(required):
1.5" 1'int a entrin?pa•with a() erninfYy,ces(hat and-of part-time t.• 7. 0 New construction
_D I AM a mle.proprietor or partnership and time no emptol‘ees winking tor me in /I. 0 Remodeling
any L-apacity.[1.,hi workers'ei.nop.orsurance required,j
9, [I] Demolition
;.0 I am a lionasiwitei doing all work irtyAelf.[No w‘irtaas.corm nrgintilaX required"'
109 Building addition
40 I am a homeowner and Ail]1:4,c kin En xiors to i.-oncluct all work on rity poverty. I will
=Qin!that all ektamacturN cid-xi°Ita%e%viler."evomett..lation insurance DT MTV sole 1 1 a Electrical repairs or additions
proprietor,*with no employees.
110 Plumbing repairs or additions
am a general contractor and I hone hired the skib-cuntractom listed on the attached sheer
i 31:1 Roof repairs
These*iiii-coritracton.Isseo,e.employes:*and lame workers'eomp.insurance:
14.1.4st Xhier.sc reen ronrc•
01.0 We sue a corporation and IL1,.ofikerh hat c exincised their right of exemption per WA,c.
152,§1441.and we&rye no arapk!ees.I',,o workers'einem.insurance reunited.]
'Any appl 1....J31 I Mai:clux.k.%NA 4 I anus Aso iili kiut the section below allowing then workers eimirien,ation policy information.
+Homeowner*Ann submit this affidavit indng they are dorms ail Wuri,and then hire outside contractors nint*about a new eliding inslii_uting such.
:Contractors that cheek this box mom attached an 44.kIniunal sheet show trig the name of the aah-curacturi and 3rtatc v,itctlicr or nut those Iconic',lime
iphyy cc* if tft,:auli-eurneactina KAN-e eltIplkIV CC!,the!,MUSA ri“,,,h.-thcir vk....11,31.„'0,.1111,,1,0:1‘.:-., ni,,,-nibei
1 am an employer that is providing Workers"compensation insurance far my employees. Below is the policy and job sire
infOrmation_
Insurance Company Name: R5.__CNC\ —
Policy 4 or Self-ins. Lic.4: )r Q't 4:::)(AcC)9 4 ctS - .(z)at A Expiration Date: 5\tl ZO.Zirr\
Job Site Address: Ur3\ \....I.V\C3,5"\ \" City/StateZipf\CYANYaNNOt0( . 1\14\
Attach a copy of the workers'coiniwnation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under N1GL c. 152, 1,;.25A is a criminal violation punishable by a fine up to S1.500.00
andor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.90 a
da. agatrist the violator..A copy olthis statement may be forwarded to tin.Office at investigations of the DIA tar insurance
co'crape N e ritication.
I do hereby certif under the poi .s andpenaltieS afpe - ry that the infOrtaation provided above i.‘trite and correct.
Signature: tkia.,,s41._ lAA4-4.-...(7r•\._ A-C-0 Date: k\\
Phone 4: L\\-S-
, —
Official use only.. Do not write in this area,to be COMplered by city or town official
t'ity or Town: PermitiLicense#
.__
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.CityrinSkti Clerk 4. Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone 4:
CITY OF NORTHAMPTON
SETBACK PLAN
mARIM LOT: a 3
LOT SIZE: k i (tO Ae N
REAR LOT DIMENSION: #73., t t,
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REAR YARD
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SIDE YARD 1 SIDE YARD
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1 FRONT SETBACK
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FRONTAGE
• DRAWING LIST
SHEET# SHEET NAME
AO PERSPECTIVES&TITLE SHEET
Al FIRST FLOOR PLAN&SECTION
A2 EXTERIOR ELEVATIONS
A3 FOUNDATION&FRAMING PLANS
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Title:
Ts' THAYER STREET ASSOCIATES, INC.
8GOLDSMITH/LEVITY
69 Lyman Rd scale: AO
` CoatesAve. SouthDeerfield,
MA01370 PERSPECTIVES & TITLE SHEET
413-665.4018 Northampton,MA 01060 Date: 11/09/21
DINING
—1. v. v. 41— 1 \ \ 1
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EXISTING / I
STEPS I
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MDO&BATTEN CEILING I
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4 / STANDING SEAM
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'_.) _ I_ i t—III— I _ I I_III COLLAR TIES ABOVE
I aa.1111.111.1-I 1 _1-I I I I.1.11 I ill l-I I_I: 1 _ - _ , _III_ i
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-1 I I-1 I I III III -1 11-1 11-H 11-1 I -11 1-11 1-I 1 -1 11 fo r 1 I (-I 1 I 1 1 i ' �/ 4X4 CEDAR POSTS
SECTION A CEDAR TRIM TO
A 3/$"=1'-0" II16'-0• MIMIC CEDAR POSTS
T&G ON INTERIOR WALL Eh
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it
CEDARCLAPBOARD
SIDINGG EXTERIOR WALL =Ili b
16'-CP / FENCE
FIRST FLOOR PLAN
1 1/4"=1-0"
Title:
TsN '', DRYER STREET ASSOCIATES, INC. GOLDSMITH/LEVITY Scale: As indicated
8 Coates Ave. South Deerfield,MA 01370 FIRST FLOOR PLAN & SECTION Al
69 Lyman Rd
___ 413-665-4018 Northampton,MA 01060 Date: 11/09/21
•
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ICI I I PI I I I'°I I I I I I I I l 1111111:I:I:maai - 111 IU 1:1:1:1-1+11:11:11:H:I I I=11 I i I I I Itl l-1 I W°I
_ I I—I I I—I►1—III—II —11 I-111-111-111—I 11
Elevation Side Elevation Side
4 1/4"=1.-o" 3 1/4"=r
CEDAR CLAPBOARDS
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=1 1= I =1 i i=1 I=1 I I=1 i i=1 i t III—I I f=1 I I=1 I I—III=1 I I=1 I I=1 ! I—I I—i I I—III—I I—III—III_I l i—I 11—I I i—III—III I -
Elevation Rear Elevation Front
2 1/4"=1'-0" 1/4"=1'-0"
Title:
Ts THAYER STREET ASSOCIATES, INC. GOLDSMITH/LEVITY
69 Lyman Rd Scale: 1/4"=1'-0"8 Coates Ave. South Deerfield,MA 01370 EXTERIOR ELEVATIONSA 2
413-665-4018 Northampton,MA 01060 Date: 11/09/21
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f\ 10"DIAMETER
(2)2X10 B MS /� 48"DEEP
(2)2X10BEAMS 2X6 LADDER TYPICAL (� 1-
\0 16'-0" SONATUBEFOOTINGS
TYPICAL -------- FRAMING
Z 4'-0" di., 7'-101/4" lI 7-101/4"
—"_____11„,1 .. 21.,...14.1
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FIRST FLOOR PLAN FLOOR FRAMING PLAN FOUNDATION PLAN
3 1/4"=r a� _ 2 1/4"=r-0" 1 1/4"=1'-0"
Title:
T^ THAYER STREET ASSOCIATES, INC. GOLDSMITH/LEVITY Scale: 1/4"=�'-0"
s 1 8 Coates Ave. South Deerfield,MA 01370 FOUNDATION & FRAMING PLANSA 3
J 69 Lyman Rd
413-665-4018 Northampton, MA 01060 Date: 11/09/21