18D-053 (17) •
111011111.111 Bit h/G s BP-2009-0105
GIS#: COMMONWEALTH OF MASSACHUSETTS
1111111111111111111111111, CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2009-0105
Project# JS-2009-000137
Est. Cost: $5000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ROBERT ARDIZZONI 051547
Lot Size(sq. ft.): Owner: RIVER RUN CONDO ASSOC
Zoning: GI Applicant: ROBERT ARDIZZONI
AT: 80 DAMON RD
Applicant Address: Phone: Insurance:
7 LAKESHORE DR (413) 531-4841 WC
HOLLANDMA01521 ISSUED ON:8/1/2008 0:00:00
TO PERFORM THE FOLLOWING WORK:BLDG 5 - REPAIR DAMAGED SILLS,PLATES,
FLOOR JOIST, STUDS
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 8/1/2008 0:00:00 $50.002634
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
\ File#BP-2009-0105
,
APPLICANT/CONTACT PERSON ROBERT ARDIZZONI
ADDRESS/PHONE 7 LAKESHORE DR HOLLAND (413)531-4841
PROPERTY LOCATION 80 DAMON RD
MAP 18D PARCEL 053 001 ZONE GI
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out ,¢¢��
Fee Paid Gi'i Ace-.
Typeof Construction: BLDG 5 -REPAIR DAMAGED SILLS,PLATES,FLOOR JOIST,STUDS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 051547
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
' ''',7V1------ C..2, .?C.0
Signature of Building Official Date
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comp with all zoning
requirements and obtain all required permits from Board of Health,Conservati n Commission,Department
of public works and other applicable permit granting authorities.
l
*Variances are granted only to those applicants who meet the strict standards of MG 40A. Contact Office of
Planning&Development for more information.
Version 1.7 Commercial Building Permit May 15,2000
J � Department use only
City of Northampton Status of Permit:
Building Department Curb Cut%Drive.way-Permlt
212 Main Street Sewer/SepticlAvatlability
Room 100
Northampton, MA 01060 W /W Avity
Twoater Setsell of S rueturailabilal Flans
phone 413-587-1240 Fax 413-587-1272 Plot/Ste,Plan , .
Other Specify;
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
I
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address- This section to be complete 0y office
S0 DAM o rj RO &i`ido,i ci 5 Map Loftl` U.slit
— s \
Zone Overlay District 1\C)% h
. \..____ _
__ Elm St.District z t CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
tOCg RUN aP OMI 1I'0M �b DAfY1o0.._. R. _____ i . _ ___ _
Name(Print)
1Z•• Cat ARQL
ZZo 13. Current Mailing Address:
Signature I . Telephone
2.2 Authorized Agent: •
Name(Print) K( (` / 1-0 C Z.Q 13�_..
_. 7 _. __AKe.s�o 0 ;_. . ___-.__.-_-__..__u
Current Mailing Address
Signature /Vt.) Ct 53 )- 4 g(,�l _
Telephone 4 1 113
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
corn leted by permit applicant
1. Building 5/030 (a)Building Permit Fee • �.
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 .76 ysg�D
This Section For.Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
Versionl.7 Commercial Building Permit May 15,2000 i
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs 0 Demolition❑ Repairs❑ Additions 0 Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign El New Signs❑ Roofing Change of Use El Other El
Brief Description Enter a brief description here.
Of Proposed Work: Scup\o',),Ay3 Sins, ks. , Fl.rog..INsi, `
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 0 A-2 0 A-3 ❑ 1A I 0
A-4 0 A-5 0 _1B ❑
•
B Business 0 2A 0
E Educational 0 26 I 0
F Factory 0 F-1 0 F-2 0 2C 0
H High Hazard 0 3A ❑
I Institutional 0 i-1 0 I-2 0 1-3 ❑ 3B 0
M Mercantile 0 4 ❑
R Residential 0 R-1 0 R-2 El R-3 0 5A 0
S Storage 0 S-1 0 S-2 0 5B 1 X
U Utility ❑ Specify'r
..w _.
M Mixed Use ❑ Specify:
i
S Special Use ❑ Specify: �..�....__._.,..�
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: i_, .____ __ Proposed Use Group: i J
__...
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)
1
1st
st
i
4th __ 4�' `..__ _ ...
Total Area (sf) ____ Total Proposed New Construction(sf)
Total Height(ft)
Total Height ft , __.___ _ _w, _ ,
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal 0 On site disposal system El
Version1.7 Commercial Building Permit May 15,2000
1 3. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
f I��
Lot Size ___......__ l , __.._...�....___..__.
j ' t
Frontage __......___, ......... __ _....._.__...._.___._. ._....._ __-. .._.. .
Setbacks Front I ____,
)c
Side L: � R:l i L:,.. s R:._._. 7
f
Rear .i !
Duilding TTeight .-,....,.,..,...
Bldg. Square Footage i
w % . _.___.. ,....--.---,
Open Space Footage _.._ % __.._ ______ s
(Lot area minus bldg&paved ._ `— —i
parking)
_ f-- ^^f
#of Parking Spaces -.--._-__- -- '-
Fill:
(volume&Location) _—____.. _._ '....__ __ ._,. ._
A. Has a Special Permit/Variance/Finding ever been issued for/on th site?
NO Q DONT KNOW YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW e YES 0 .�.._.__
IF YES: enter Book Page and/or Document# ______ ___
B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW a YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued: Y
C. Do any signs exist on the property? YES Q NO 0
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for th 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 Q NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version1.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Registrant): • „._..,_..
Registration Number
Address _._ ._._.:___.
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
- ._.... __ ....__....__...._.
1
Address Registration Number
1
Expirationy.........___.,._..._._. _..:_..
Signature Telephone Dato
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
1
Name Area of Responsibility
Address ._ _ _ _. Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
~_ ~Address Registration Number
i
Signature Telephone Expiration Date
- 9.3 General Contractor
_______I- Not Applicable ❑
Company Name:
Responsible In Charge of Construction
_ J
Address
1 Ke S Nort.. 6� o�1 tic �.„_„..a __
(7-...
y(3.�3� � .1
Signature Telephone
' 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 0 No 0
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, 5e( A T FIGt to b _(."[A 6(L. _ ....__.__.._...__. .._ . as Owner of the subject property
herebyauthorize . .. _. . ._. to
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
i, ,as Owner/Authorized
)iAgent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
\
and belief.
Signed nder the pains and penalties of,perjur __�_
Print Name
,
Signature of Owner/Agent Date
SECTION 12 -CONSTRUCTION SERVICES
r
10.1 Licensed Construction
. u rvisor: Not Applicable ❑
i
Name of License Holder._._,.,__ _ rr 4r Arao
A) I. :
..................
License Number
_ _ : .. .o5 I5 -r
Address Expiration Date
7LA Ke S-4 .e ,D� Hoi(0,6 t - s�
Signature Telephone(11.3 531a� (1 7
05 O?
��
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
i in the denial of the issuance of the building permit.
L
Signed Affidavit Attached Yes 16 No 0
f
The Commonwealth of Massachusetts •
Department of Industrial Accidents
Office of Investigations S
600 Washington Street
Boston,!vL4 02111 .
www.mass.gov/dia •
-Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Aimlicant Information - Please Print Lezibly
Name (Business/Organization/Individual): RC&X' IA
rc i22 c IQ \ ,
i Address: ORC 0 i
City/State/Zip: H dt\T►P ()•(\ cl) 154 Phone.#: LI 13 531 - 42(4 I
Are you an employer?Check the appropriate box: Type of project(required): 1
1.❑ I am a employer with 4. ❑ I am a general contractor and I
have hired the sub-contractors
employees(full and/or part-time).* 6. ❑New construction
listed on the attached sheet 7. ❑RA-modeling
2.N.I am a sole proprietor or partner-
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. employees and have workers'
(No workers'comp.insurance comp.insurance.: 9. ❑Building addition
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing o all w rk ofcers have exercised their 11.0 Plumbing repairs or additions
myself [No workers'coma. rift of exemption per MGL 12.0 Roof repairs
insurance required.]t c. 152,.§1(4),and we have no
' employees. [No workers' li.❑Other WPM kCp A ri S
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
'Homeowners who submit this affidavit indicating they are doors all work and then hire outside contractors must submit a new affidavit indicatins such.
iContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employes. lithe sub-contractors have employees,they must provide their'worrers'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 4 or Self-ins.Lic.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 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 penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
n
I do hereby certify u der th pains penalties of perjury that the information provided above is true and correct.
Sianature: f ` Date: i l/i /O _
Phone r: 4- )3 _ -; 31 t j'Li ), ..
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License 4 •
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#:
River Run
Condominium
80 Damon Road • Northampton, MA
January 3, 2008
City of Northampton
Building Commissioner
Inspections& Licenses
212 Main Street
Northampton, MA 01060
Dear Building Commissioner:
At the 2007 annual unit owners meeting of River Run Condominium Association the
residents approved funding an extensive capital improvement plan for the community. The
plan calls for common hallway work to be done in each of the eight buildings located at
80 Damon Road.
The hallway work encompasses new secure entry doors, painting and carpeting,
replacement of the existing intercom and the installation of an air filtering system.
Unexpectedly, during the recent renovations, a number of obstacles were uncovered. The
domestic drain system appears in need of some repair which consequently caused some
structural damage, such as sill plates,top plates and the occasional stud or rafter.
The Board of Trustees has hired an independent, licensed professional to repair the
plumbing and apply for any necessary plumbing permit(s).
Any necessary structural work is being done by a licensed contractor on River Run
Condominium's staff. On Monday, January 7, 2008 our licensed contractor will be
applying for two permits for work to be done in Buildings 2 and 3. In anticipation of your
approval, thank you.
Sincerely,
t0( r6 L
�V
Mary Jane Gaumond
On behalf of the River Run Condominium Board of Trustees
Classic Management • 100 Maybrook Road • Holland, MA 01521-2025
Phone: 413-245-7100 • Fax: 413-245-4266