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18D-053 (18) 80 UAMON'RD BP-2009-0104 GIS#: COMMONWEALTH OF MASSACHUSETTS 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-2009-0104 Project# JS-2009-000136 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: RO B E RT ARD I ZZO N I AT: 80 DAMON RD Applicant Address: Phone: Insurance: 7 LAKESHORE DR (413) 531-4841 WC HOLLANDMA01521 ISSUED ON: TO PERFORM THE FOLLOWING WORK:BLDG 6 - 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 8/4/2008 0:00:00 $50.002634 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo • File#•BP-2009-0104 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 y J?� � Fee Paid G�'(O, 0661 Typeof Construction: BLDG 6-REPAIR DAMAGED SILLS,PLATES,FLOOR JOI ST,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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved 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 De 'on Delay Signature of Buildin icia Da zte Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. Versionl.7 Commercial Building Permit May 15,2000 _ Department use only • City of Northampton Status of Permit Building Department Curti Cut%Drivway-Permit 212 Main Street Sewer/Septic; vailabil►ty Room 100 Water/WellA.'atlability Northampton, MA 01060 TWO Sets of ructurat Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plan ' '# 4 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 • DR► 1 o PJ f\ 11 1m 'Gs' map Lot Unit Zone Overlay District 1\)o tt,,gcr%pto . Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: RMC'g RUN)N CO p.3o( r\ At\ DA. .oW) . Name Print Current Mailing Address: Signature V Telephone 2.2 Age Authorized nt. _w .. .._� __. Ti1.ABC k( OQ' A -- r�-++..t Name(Pent) 1-0�ZZV 5.1�"___ Current Madan Address - �N... (V1_-f iOt52.1 Signature /(`� V (_A Telephone 43 5 SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com leted by permit applicant 1. Building J C,i(33o (a) Building Permit Fee • 2. Electrical __w__, (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 _426 �,�/ v4;1 — This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Version1.7 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 0 Repairs 0 Additions 0 Accessory Building 0 Exterior Alteration 0 Existing Ground Sign 0 New Signs 0 Roofing 0 Change of Use❑ Other 0 Brief Description Enter a brief description here. Of Proposed Work: 06 R 1 a\r2_ Q -Qr3 SAS/ PIA'VES..) _Elmtd is T_S-i u6s . _. SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 0 A-2 0 A-3 0 1A I 0 A-4 ❑ A-5 0 _1B 0 B Business 0 2A 0 E Educational 0 2B 0 F Factory 0 F-1 0 F-2 0 2C 0 H High Hazard 0 ' 3A 0 I Institutional 0 1-1 0 1-2 0 1-3 0 3B ❑ M Mercantile ❑ 4 0 R Residential 0 R-1 0 R-2 R-3 0 5A I 0 S Storage 0 S-1 0 S-2 0 ( 5B J U Utility ❑ Specify I _.._ M Mixed Use 0Specify: S Special Use ❑ Specify: • COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE r�l Existing Use Group: 1.,.,___,__,,._ _ < Proposed Use Group. ._._.___.._ ._ Existing Hazard Index 780 CMR 34): . .. ._....______ __ _.. _ Proposed Hazard Index 780 CMR 34):I SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1st ! , 1st _. 4d' __ __ — 4 ._____ _ -- Total Area(sf) V Total Proposed New Construction(sf) Total Height(ft) Total Height ft ,__.,._, W...�_ _ v 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone❑ Municipal 0 On site disposal systems Version1.7 Commercial Building Permit May 115,2000 8. NORTHAMPTON ZONING . Existing Proposed Required by Zoning This column to be filled in by Building Department i l w _ Lot Size ____ _ _ f- �... ._... _Am_._. Is Frontage _....._.....w...-...._._._____ , _____ ________ . _ Setbacks Setbacks Front — )c Side L: R:#_ L:_.. a R:___ _ ! _..__.__. . f Rear _._ —..._. . building height Bldg. Square Footage - % .. .._..._..... Open Space Footage .._..._ _-_.. % ..._-• •---.- (Lot area minus bldg&paved ,,,; ,—I L-- .-_. parking) #of Parking Spaces --..._._..- _'_.`" Fill: gi (volume&Location) _._ _ __ __._ -------------, . A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW ® YES IF YES: enter Book Page ' and/or Document# M»M B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW a YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for th property ? YES 0 NO 2 �� �_ � IF YES, describe size, type and location: _—i 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 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW - required. Version 1.7 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 El Name(Registrant): • ---•--- -- Registration Number ___ Address ---------....- - Expiration Date -— Signature Telephone 9.2 Registered Professional Engineer(s): • Name • Area of Responsibility. . Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility i Address ry _ -..._�-^-_�__—_�.�._ _ _..___ - Registration Number __�r ___ i Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number I Signature Telephone Expiration Date Name Area of Responiibility �� _ _ Address _ Registration Number Signature Telephone Expiration Date - 9.3 General Contractor RQbe)r-A- Ar61Z.1,01\) ) Not Applicable 0 Company Name: Responsible In Charge of Construction Address IBC S \Awe Ib it .14o\Ft I..J0 m Pi y�33i=� 1 Signature0 .----"'----..* Telephone Version1.7 Commercial Building Permit May 1.5,2000 ‘ SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 10 No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 56 '`1 rt{ AGNE Q (.,!'("t 612_ �.. 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. Signature of Owner Date I, as Owner/Authorized )1Agent 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 perjury. Print Name r"--- 1 1 Signature of Owner/Agent Date • SECTION 12-CONSTRUCTION SERVICES r10.1 Licensed Construction u rvisor: Not Applicable El Name of License Holder. _... License Number os Address Expiration Date 7 LP1 Kc S rte ,DR, N©lfRO fm.As . _ 531.- j . t 1 /05/ 0? Signature Citti. neTeleph8 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 1 in the denial of the issuance of the building permit. Signed Affidavit Attached Yes tip No 0 I The Commonwealth of Massachusetts Department of Industrial Accidents ' ' Office of Investigations ' 2' 600 Washington Street Boston,ltiLI 02111 r �' www.mass gov/dia -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Anolicant Information Please Print Legibly Name (Business/Organization/Indivicinal): RCtX I' — Arc' ic Nj ' Address: —7 _alze 5 ttant OR, City/State/Zip: H 6,\i t ) mp, Q ,jd,i Phone#:: LI 13 531 ` `42'I I Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I : have hired the sub-contractors 6. ❑New construction 2.0 employees(full and/or part-time).,I am a sole proprietor or partner listed on the attached sheet. 7. 0 Remodeling shin and have.no employees These sub-contractors have. g- ❑Demolition workinn for me in any capacity. employees and have wormers' 9. Et Building addition [No workers'comp.insurance required.] comp.iinsurance.:5. ❑ We are a corporation and its 10_❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11_❑Plumbing repairs or additions myself [No workers'comp_ right of exemption per MGL 12.0 Roof repairs insurance required)t c. 152,§1(4),and we have no 13.❑Other tkiPi 0 k employees.[No workers' A r�S comp.insurance required] 'Any applicant that checks box#1 must also fill out the soon below showing their worecrs'compensation policy information. t Homeowners who submit this affidavit indicaIIng they are doing all work and then hire outside contractors must submit a new affidavit indicating Q,ch. 'Contractors that check this box:gust attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their'worke s'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#or Self-ins.Lic.#: 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 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 azainst the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverass verification. I do hereby certify/ç: k2 derains penalties of perjury that the information provided above is true and correct. Sisnat�ire: , / Date: /l.t Phone#: )3 - .;.3 1 4./T1../ ) _ Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License T Issuing Authority(circle one): 1.Board of Health 2.BuiIding Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other r 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, �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