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17C-144 (8)
BP-022-1093 40 KEYES ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-144-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-1093 PERMISSION'S HEREBY GRANTEI TO: Project# BATH RENOS Contractor: License: HAYDENVILLE WOODWORKING & Est. Cost: 46385 DESIGN INC 116208 Const.Class: Exp.Date:04/13/2025 Use Group: Owner: F. CRONIN, DENIS Lot Size (sq.ft.) Zoning: URB Applicant: HAYDENVILLE WOODWORKING & DESIGN INC Applicant Address Phone: Insurance: 35 CONZ ST (413)665-7402 WMZ-800-8007423-202 A NORTHAMPTON, MA 01060 ISSUED ON:09/02/2022 TO PERFORM THE FOLLO WING WORK: REPLACE LALLY COLUMNS AND RENO 2 BATHS 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIO ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: it a ry Fees Paid: $299.00 212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner •r lE 'FL:fit Department use only .OQ[,f1_AMP>U\ City of Northarnpto i-- ----=..` Status of Permit: Building Department Curb/Cut/Dtiveway Permit (11 1: 212 Main Street• SEP _ l Sew r/Septic Availability r 'fi t Room 100 e02c Wat MVe(I Availability Northampton, MA Q a960 Tw Sets pf Structural Plans phone 413-587-1240 Fax 413 , av iNsPEc-ASite Plans +titer cp city APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: . Map /7 C Lot ‘,/C/f/ Unit 40 Keyes St., Florence Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Denis Cronin 40 Keyes St.,Florence Name(Prin Current Mailing Address: (860) 299-4605 Telephone Signature 2.2 Authorized Agent: Haydenville Woodworking&Design,Inc./Zinnia Stetson 35 Conz Street,Northampton,MA 01060 Nam Print) Current Mailing Address: 413-665-7402 Signatu le Telephone \fiEVION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 32,410 (a) Building Permit Fee 2. Electrical 1,950 (b) Estimated ConstructionTotal from Cost(6)of 3. Plumbing 12,025 Building Permit Fee y� L �qq 4. Mechanical (HVAC) 5. Fire Protection 0 6. Total =(1 +2+ 3+4+5) 46,385 Check Number $ 7,1 This Section For Official Use Only Building Permit Number: 60- ? �� Date Issued: Signature: 1/7Z 7` /. Z02 Building Commissioner/Inspector of Buildings Date Zinnia HaydenvilleWD.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: . R:L Rear --i Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained 0 , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O 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 O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition [] Replacement Windows Alteration(s) El Roofing n Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [E] Siding[D] Other[D] Brief Description of Proposed Replace 3 lally columns, renovate two bathrooms Work: Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes x No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Denis Cronin I, , as Owner of the subject property Haydenville Woodworking & Design, Inc./Zinnia Stetson hereby authorize to act o y behalf, in all matters relative to work authorized by this building permit application. • ._ c..,--- g/Z 1/2,Z Signature of Owner Date Zinnia Stetson / Haydenville Woodworking & Design I, , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Zinnia Stetson Print Name c'S S. na ure f Ow r/A nt Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: Zinnia Wu Stetson License Number 35 Conz Street, Northampton, MA 01060 116208 Address Expiration Date 413-665-7402 04/13/2025 Signature Telephone 9,Re ter®d ome rovement Contractor: Not Applicable 0 Company Name Registration Number Haydenville Woodworking & Pesfgh, nc. Zinnia Stetson 110732 Address \J Expiration Date 35 Conz Street, Northampton, 01060 Tel60-Ang65-7402 11/2/2022 SECTION 10-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 City of Northampton Massachusetts ��?• a._ 'rr ri W; • ,� DEPARTMENT OF BUILDING INSPECTIONS �'• �_ `" 212 Main Street •Municipal Building 17s, Northampton, MA 01060 �S'Yh; WO°o Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 40 Keyes St., Florence (Please print house number and street name) Is to be disposed of at: Valley Recycling, Northampton (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) S. n of er it App is t or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts --, Department of Industrial Accidents t*= rl i -_-)�I=6' Office of Investigations r;,=,'y 600 Washington Street • =:t:�_ _ Boston,MA 02111 ,Y '.�,, www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Haydenville Woodworking & Design, Inc./ Zinnia Stb Address: 35 Conz Street, Northampton, MA 01060 City/State/Zip: Phone#: 413-665-7402 Are ou an employer?Check the appropriate box: Type of project(required): II am a employer with 4. El am a general contractor and I 6. ❑New construction x employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.$ 7• %Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. workers'comp.insurance. 9. ❑ Building addition [No workers'comp.insurance 5. 0 We area corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.0 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A.I.M. Mutual Insurance Policy#or Self-ins.Lic.#: WMZ-800-8007423-2021A Expiration Date: 12/1/2022 Job Site Address:40 Keyes St., Florence city/state/ziJorthampton, A 01060 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expir tion date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal p:nalties 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 O' DER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the 0 ce of Investigations of the DIA for insurance coverage verification. I do hereby certifyunder the pains and penalties of pedury that the information provided above is true and correct. Signature: A 79 Date: 7 24 2-2.- Phone#: 411665 74 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# 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#: 6o" / / \ 3o" N. ( \ / .f' / tle \ in —._. r \ O �� tile — 4 - ) .-,N. l cn O _ I } a —Cr' II \ , 1\ 1 ' Demo clawfoot tub.Cap two sconces above tub. 1 . Install fiberglass/acrylic shower pan 6ox32 3x6 white subway tiles on three walls with bullnose edging Custom glass shower door,TBD.L. Retrim window in PVC Replace bath fan in same location+switch Option to replace window with tempered REVISIONS Il: Haydenville Woodworking& Design, Inc. 1-4 III MM/DD/Y1 REMARKS 0 7[t� Design+Build—General Contractors—Residential Construction--Since 1984 1 —_/--/-- - First Floor Bathroom I 17YY1! 2 — CRONIN 40 KEYES AVE FLORENCE a __/__/__ ... Ql