35-181 BP=2022-1510
4 PINE VALLEY RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
35-181-001 CITY OF NORTHAMPTON
Permit: New Build
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-1510 PERMISSION IS HEREBY GRANTED TO:
Project# 2022 ADU Contractor: License:
Est. Cost: 100000 DAVID REARDON
Const.Class: Exp.Date:
Use Group: Owner: S ORTIZ ANGEL
Lot Size (sq.ft.)
Zoning: WSP Applicant: TERRAN CONSTRUCTION INC
Applicant Address Phone: Insurance:
499 WATER ST (413)232-9520
WILLIAMSTOWN, MA
ISSUED ON: 12/13/2022
TO PERFORM THE FOLLOWING WORK:
BUILD DETACHED RESIDENCE
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 VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
%Ty
Fees Paid: $300.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
Z-O IZ
File #BP-2022-1510
APPLICANT/CONTACT PERSON:TERRAN CONSTRUCTION INC
499 WATER ST WILLIAMSTOWN, MA (413)232-9520
PROPERTY LOCATION 4 PINE VALLEY RD
MAP:LOT 35-181-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $300.00
Type of Construction: BUILD DETACHED RESIDENCE
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
1( 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
eke& I
s /13/d.)—
Signature of Building Official / Date
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,Depar i ent
•
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 ,f
Planning&Development for more information.
-
The Commonwealth of Massachusetts, Novi
e I Board of Building Regulations and Standards 2 1 2022 IFOR
Massachusetts State BuildingCode,780
IPALITY
e
,' ,,. USE
Ion
Building Permit Application To Construct,Repair,Renovate a _ , :- ievised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only f
Building Permit Number: OP- 0`3 2- /Si 0 Date Applied:
_-
Building Official(Print Name) i Signature te
.
SECTION 1:SITE INFORMATION
r
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
,,
L( P, e Vit/ley // 1,'&-,� uir,/r 35-- /Fi
Li a Is this an accepted street?yes no Map Number Parcel Number
I
1.3
Zoning Information: 1.4 Property Dimensions:
sI. 7ZjI0 0 ST..
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
20f > 3 , ' 15 ' > zV ' , ? lc
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private❑ Zone: _ Outside Flood Zone? Municipal 12f On site disposal system 'I❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Name'1rint) q City,State,ZIP L
L I , t 17 - I3-7? + cl rye./Sort/'?�Z. GSma. �t-o..c
/ fin (/� y� �.
No.and Street / Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction il Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition 0
Demolition ❑ Accessory Bldg.0 Number of Units Other 0 Specify: _
Brief Description of Proposed Work2: 8 i,// 4 r et 6,-1--et.c lie/ 446//,,,I j v,., i-'.
F44a•n 7 60,mail Gri cc-vv-ed Cc'/ / 3 / 7022_
Ce4),6 o o Pa k cu.-s c, wti, e.4, ,c — PA C••,, ; f 6'/ne v /.c7 rid•
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ SV Q 0 0 1. Building Permit Fee:$ Indicate how fee is determ' ed:
0 Standard City/Town Application Fee
2.Electrical $ 7V / O C ❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ Plan b;,y..r 4tM-G 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) Total All Fees: $
Check No. I J )7 Check Amount: sh Amount:
6.Total Project Cost: $ / / oo 0 0 Paid in Full 0 Outstanding Balance Due: ,_
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) C S, i/2 0 +L C Zc z 3
/Cq v� E u r��n J f, License Number Expi tion to
Name of CSL Holder
r� / n List CSL Type(see below) U
›�o Stv, -, Yr .S4�
No.and Street Type Description
G
7 d G Z U Unrestricted(Buildings up to 35.000 Cu.ft.)4 ? 5. < f °v� 4- R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
9,11 eirea,-,6, ,)//Yli 4Coes41/4 .i I Insulation
Telephone Email address - t D Demolition
5.2 Registered Home Improvement Contractor(HIC) Z p i/
ref r r( 60 a fi r v /o y , 1 vi L, HIC Registration Number xpiration Date
HIL//Company Namef_ or HIC Registrant Name
L/ ^
7 9 4r?'Le Sfi heft I/O t a t-6,7A CEAJ7ry CA• 6$M
No.and Street Email address
// /41s te l.v 7) 10 0/2 /J-Z 3 z-9r-DC
City/Town,State,LIP 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,hereby authorize David Reardon
to act on my behalf,in all matters relative to work authorized by this building permit application.
Angel Samuel ONz �., ,. . 11/15/2022
Print Owner's Name(Electronic Signature) 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.
Obt f,/R /,o.-, �/f� -L,"
f �/
Tecf• a7 (c,r 5 !`vL G n d li' . , fro l// /5-120 2 Z
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
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
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton
8., M 7
Massachusetts
Jlt I- -A*
I
H .� � DFPARTAtENT OF BUILDING INSPECTIONS r-
',7* ` 212 Main Street • Municipal Building a
Northampton, MA 01060 f�s`Mh (', �C�
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.
W2 P lit4 1s'? V5c C4i l/vt. WcesLe . F6i - I,'LI,961—LZ
f Ca.d_die,, no-7L o 1/'Ia,:. �� Lt .^e hvi' I/ n°
104,6 1, of.1102- 15 v _ f.�� ,
The debris will be disposed of in: �J
Location of Facility: Cie,5-c, G(4 ,
The debris will be transported by:
Name of Hauler: 624 ((r ,
Signature of Applicant: L" / L /4 / Date: 11
The Commonvealth of Massachusetts
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Department of Industrial Aceitlents
I Congress Street, Suite 100
Boston, MA 02114-2017 •
• .,,-.:„..,.„..,7 4;
mass.gorldia
‘1orkers'('ompeosation Insurance..-kffidas it:Buddervti-ontractor,:iClectriciansletumbrrs.
10 HE fit.E.D VS1TH't iii.PLIMITItNi.; ‘t I Itt)Itt I N
Anolicant,Information Please Print 1.ceibh
Name 1:..11.1sincss,t)rganya2rtionindwicklaii: 1:ezra...r (0 P7J6.1 v c-i2
Address: 119 11/6,71-e r•
A 01744"
CiryStateiZip: Lir,11.44 vu, 't in/t PhOne lli 11 13- 23z- - 9,)- •°
. •
Are}tor an ettipkiyml flea die appropriate bat: il Type of project(required):
. ..,..nri-uyees(Sall and og put-timet,* 7. ,a-N -vi, i:onstruclion
ZO I XII a saila pcirptictin in Inenier,ihip attahav,no LITIpti.iye0.Werktlig fin;Th:it X. 0 Remodeling
all: ,zpactry.[So..,v.,utikcn:ccazip..LAOLirin10: reiliurtill
$ 9, 0 Dernolitkin
10 I Art iscarricoono..4,,in g all 4‘..rk myss lf.iNit v.intias`emir uuuratcr rvelturettj•
1
t 100 Building addition
4.C11 1 aim a thszta.x.wticr sad will ibe Ettriv ontraraurz.ii,voitiluei all work on tny prirpert2i 1 will t
motor that all c‘rutractora either have workers't..riapert.satiati utauttinee sat are stile ILO Elcx:trical re-pairs or additions
propimors..,.fat no einpintes i i 10 Plumbing repairs or additions
s.0 I arts a general unrariartin awl I have hard the mill-onitsui:trrrs ii-Acd an'.1•a:zrthiluni sheet
13 ri Roof repairs
i.....i
Thow, a.rt,-...JaltracturN tuo.et..-arplityces ionl bare si,urkers'vomp.insaratsce)
I I 4.0 Other
6.1:3 V. att.a cisrporation anti as.titticets has c exercises!then risht istexemption pa Ntal.e i
I:51. II 4 I.snit we kuve no anployires.I Sit VfOtigirit.i:orup.insugatiee Trcituscd.j
t,.. .*Am applicant that chivks hit‘g•I must 41.1.4.1 fat tag the ction bc-1014 NtwwtzlE then A urktrz'eempensation policy informatiun.
'Ilirtnivwners'Abu suhruit this aftistak it mthicaung they are ileinE all wink mil then hoe outside emu-actor,must mibrisit a nest affitiasit mak:ging ii...E.
f C'untnc:tvm that ch....IA.-dm.ivx mtis4 tsitaAwd 44 Idditional hbod htlo*Ist.$the mine a the s -eutitraetnes and state whether in mil Enos,:oitities haw
ernplo:.;%i_ If thw sub-eutitracturs tue•i:employrmethey 131WA pris'ilik If.:It" liktirka%*•'>ItIr pilly ill2nItict
. „. .
I am an employer that is providing worLers°compensation insurance for my employees_ Below is the policy and job.site
infOrmation. ..
insurance Company Nanic:___?t,r_c c G 4_______4. ef.:I c.a. l__ //.?5 lec 0 Del 4.4, 60
Policy #or Self-ins.Lie.#: aVaipi ,, 2 1 7-_1 Expiration
Job Site Address: li 4 h e a /4.e.7 A I city.smtezipWor&r.,Iv 4 ,f.i f 4_
_ _..
Attach a copy of the workers'compensation fit/i1C) declaration page tsitowing the policy number and expiration date).
Failure to secure coverage as required unties MCil., c. 152. 25A is a criminal s.tolatiOn punishable by a fine up to SI.500.00
and,or one-year intproionment,as IA cll as civil penalties tn the form of a STOP WORK ORDER and a fine of up to$250,00 a
day against the violator.A copy of this statement may be forwarded to the Oflice of Investigations of the DEA for insurance
coverage s-crification. . . .
.
Ida hereby certi . der the pains and penalties of per/lily thw the information prodded above is trite and correct.
Sumatuiv: cvs. /Zi-il Date:
•
Phone : V/ 5 - 2, 3 2 - 5-"J 0 Cc (/ 11/7- 4.5-2 — 7.7ti5-
_,
Official axe only. Do not write in this area.to he completed by city or town official('itt or Town: rermitiLiceihe# ,
Issuing Authorit (circle one):
I. Board of Health 2.Building Department 3.City rri),4 11 Clerk 4.Electrical Inspector 5. Numbing Inspector
6.Other
ontact Persian: Phone t$:
— — ....
............—..-... ...„*„..........i
MUNICIPAL WATER AVAILABILITY APPLICATION
Northampton Public Works Director
Water Division
125 Locust Street
Northampton, MA 01060
413-5R7-1097
A Department of Public Works Trench Permit shall be required prior to any construction or
connection activity associated with this application,
Location: 4 PINE VALLEY RD
Inquiry Made By: DAVE REARDON 413-652-7745
(Name) (Telephone Number)
Date of Inquiry: 12/5/2022 Fire Line Irrigation Domesti 4 X
Number of Units: l Type of Units: Type of Ownership:
Single Family X Privat,
Apartments Cond.
Multi-Family Renta
Commercial
(Applicant to fill out the above)
Municipal Water Main in Front of Location: Yes X No
Existing service to site? Yes X No
Size of Water Main: 6" Material: Asbestos Cement Age: 1961
Approximate Static Street Pressure: 50 Flow Test Conducted: Yes No X
(If flow test conducted attach r:sults)
Size of Service Connection: 1" Suggested Meter Size: 5 8"
Comments: The Water Department cannot guarantee adequate water pressure during
peak demand times at elevations above 320'
- A corresponding water entrance fee shall be paid prior to making any connection to the municipal
water system.
-Arrangement of such installation shall be made with the Northampton Water Department within a
minimum of 5 working days notification.
-All work shall conform to Northampton Water Department specifications.
Keith Snape 12/6/2022
(Water Superintendent) (Date)
*Water Entry X ($1,250) Domestic *Meter $ 450 *Radio Read $150
(fee to be determined)
(includes fire line if required)
cc: City of Northampton Building Dept/Commissioner
NOTE: If this availability is for new construction,it must be submitted electronically or mailed to
mailed to the Building Inspector
*Fees will be charged based on current fee structure at the time of entry application
MUNICIPAL SEWER AVAILABILITY APPLICATION
Northampton Public Works Director
Streets Division
125 Locust Street
Northampton, MA 01060
413-587-1570
A Department of Public Works Trench Permit and Sewer Entry Permit shall he required prior to any
construction or connection activity associated with this application.
Location: 4 PINE VALLEY RD
Date of Inquiry: 12/05/22
Inquirer with contact info: DAVE REARDON TERRAN CONSTRUCTION
Reason for Request: NEW DWELLING ON PROPERTY
---- For Office Use Only Below This Line
Municipal Sewer Main in Front of Location: Yes X No
Size of Sewer Main: 8" Material: PVC Age: 1984
Depth of Sewer Main: 5.5'
Length of Sewer Main: 232'
Size of Service Connection: 6"
Type of Service Connection: USED FOR EXISTING HOUSE
Domestic Tie In: $1.250
Tie-in to Existing Sanitary Service: $1.250
Comments: Connect to service from existing house
City Requires 6" cleanout installed at City Property Line
A corresponding"sewer entrance fee" shall be paid prior to making any connection to the
municipal sewer system.Arrangements of such installation shall be made with the Northampton
Streets Division with a minimum of 5 working days notificaiton. All work shall conform to
Northampton Streets Division specifications.
Brendan Shea Date: 12/7/2022
Sewer Foreman
*Sewer Entry$ 0.00
*Fees will be charged based on current fee structure at the time of entry application
If this availability is for new construction, it must be submitted electronically or mailed to the
Building Inspector.