10B-099 BP-2023-1207
79 RESERVOIR RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
10B-099-001 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-2023-1207 PERMISSION IS HEREBY GRANTED TO:
Project# KITCHEN/BATH RENO 2023 Contractor: License:
INTEGRITY DEVELOPMENT &
Est.Cost: 223658 CONSTRUCTION INC 090514
Const.Class: Exp.Date:09/12/2024
Use Group: Owner: SKOIRCHET,ANDREW & SPRIGGS, ELIZABETH
Lot Size (sq.ft.)
INTEGRITY DEVELOPMENT &CONSTRUCTION
Zoning: RR/WP Applicant: INC
Applicant Address Phone: Insurance:
110 PULPIT HILL RD (413)549-7919 WMZ80080062242021
AMHERST,MA 01002
ISSUED ON: 09/21/2023
TO PERFORM THE FOLLOWING WORK:
KITCHEN AND BATH RENO, ADD EXTERIOR STAIRS AND LANDING
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:
Fees Paid: $1,450.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
File #BP-2023-1207
APPLICANT/CONTACT PERSON:INTEGRITY DEVELOPMENT &CONSTRUCTION INC
110 PULPIT HILL RD AMHERST, MA 01002(413)549-7919
PROPERTY LOCATION 79 RESERVOIR RD
MAP:LOT 10B-099-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $1,450.00
Type of Construction: KITCHEN AND BATH RENO, ADD EXTERIOR STAIRS AND LANDING
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
Driveway Grade%
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
X( 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
111
(3/110/ 3
' `
Sign re 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,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.
RECEIVED
T e Commonwealth of Massachusetts
SEP - 5 2023 oar of Building Regulations and Standards FOR
assa husetts State Building Code, 780 CMR MUNICIPALITY
USE
tfNAppl ation To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
DEPT OF BULL
NORTHAMPTON.MA 01060 One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 6P-. ..10 7 Date Applied:
BuildingOfficial(Print Name) Signature i�
SECTION 1: SITE INFORMATION
1.1 Property Address: 79 Reservoir Road,Leeds 1.2 Assessors Map& Parcel Numbers
10B 099-001
1.1 a Is this an accepted street?yes X no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
RR Same 45,580 1779
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
40 103 20/20 37 L/43 R 50 197
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 On site disposal system 0
Check it'yes®
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: Leeds,MA 01053-9731
Andrew Skoirshet
Name(Print) City,State,ZIP
79 Reservoir Road (312)919-0716 andrewskoirchet@gmail.com
No. and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building Owner-Occupied 1l Repairs(s) 0 Alteration(s) IN Addition INJ
Demolition 0 Accessory Bldg. 0 Number of Units I Other 0 Specify:
Brief Description of Proposed Work2:
Kitchen&Bathroom Remodel.Replace exterior door,add exterior stairs& landing.Convert heating system to
geothermal.Replace water heater+Convert enclosed porch to new living space.
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 126,104 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 13,031 ❑ Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier _x
3. Plumbing $ 11,750 2. Other Fees: $
4. Mechanical (HVAC) $ 82,773 List:
5. Mechanical (Fire $ 0
Suppression) Total All Fes,.$) ' 466
Check No.► 0 " Check Amount • i Cash Amount:
6.Total Project Cost: $ 223,658 0 Paid in Full Cl Outstanding Balance Due: _ _
77 SECTION 5; CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS-090514 09/12/2024
Anna Cook License Number Expiration Date
Name of CSL Holder
113 January Hills Road List CSL Type(see below) U
No.and Street Type Description
Amherst,MA 01002 U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted l&2 Family Dwelling
City/Town,State.ZIP M Masonry
RC Roofing Covering
WS Window and Siding
(d 13)3 T4 2322 anna'a integbuild.cam SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) • 118041 01/19/2025
Integrity Development&Construction
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
110 Pulpit Hill Road anna@integbuild.com
No.and Street Email address
Amherst,MA 01002 (413)549-7919
City/Town,State,ZIP Telephone
SECt ION 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 .❑
S N I ,OWNER AUT ORIZATION'TO BE COMPLETED WHEN
O 'S'AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT,
I,as Owner of the subject property,hereby authorize Integrity Development and Construction
to act on my behalf,in all matters relative to work authorized by this building permit application.
E izabeth Spi-{ J Sep 8,2023
Print Owner's Name(Electronic Signature) Date
SECTION lb*OWNEkt tlll!t'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.A
7. 0.2 l -CV, --C &
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NO'i ES:
I. 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. I42A. Other important information on the HIC Program can be found at
www.mass.govloca 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 ofhalfi'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
SETBACK PLAN
MAP: 10B LOT:
LOT SIZE: 45,580 sq ft
REAR LOT DIMENSION: 220 ft
REAR YARD 197 ft
SIDE YARD 37ft SIDE YARD 43 ft
FRONT SETBACK 103 ft
FRONTAGE 109 ft
City of Northampton
Massachusetts a, ' 'ttt
m
DEPARTMENT OF BUILDING INSPECTIONS ?
212 Main Street • Municipal Building 0 , /,
Northampton, MA 01060 ,,
iN
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 TBD 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: Roll off Dumpster
Location of Facility: S&G Recycling, 9 Shoham Road, East Windsor, CT
The debris will be transported by:
Name of Hauler: Wickles
Signature of Applicant: ,1(.1. CaS1C-- Date: .-/S- /_
The Commonwealth of Massachusetts
Department of Industrial.4ecidents
1 Congress Street,Suite 100
e?' Boston, MA 02114-2017
www.mass..gmildia
II orkers'Compensation Insurance Affidavit: Builders/C7ontractorsiElectricians/Plumbers.
TO RE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name(nusinessiorpnizaiionnndividuah: Integrity Development & Construction
Address: 110 Pulpit Hill Road
City/State/Zip: Amherst, MA 01002 Phone#: (413) 549-7919
Axe year an employer?Cheek the appropriate hot: Type of project(respdred):
Ks lam a empkiyer with employees main'parriimet.* 1. a New construction
2.EI I am auok proprietor or ixemership and hail:nu employees working for me in K. r Remodeling
any wipacity.[No workers'comp.imUnteme eritturall
9. rj Demolition
30 I am a humniwiter tieing all work myself INo workers comp.itnammoe required.]'
100 Building addition
4.C:1 I am a homeowner and will be hiring cootraxiots so conduct all work on my property_ I will
atielet that all Limn-actors either have workers'danipcituation ineuranee or are sole 1 I In Electrical repairs or additions
proprietors with no employees_
1.2..M Plumbing repairs or additions
51 am a gelieral cormactor and 1 have hired the sub,contractors hated en the attached sheet_
Roofrepairs
These',eh-contractors,hese employee. and have workers'crimp.imurance.;
14 °Other
613 We are a comm.-anon and its offioers have exercised their eight Of exeinplieei per Wit.c.
112,§1114i,and we have no employees.[No winters'comp.insurance requited.[
Any applicant Ctittielericks box al enfant ak6 Allan the section hewn thawing their onnitees'compensation pulley information.
Homeowners who submit this affidavit iludicating' they are doing all work and then hire outside contractor%muss submit a new affidavit indicating such.
1Connuctor%that check area box mum attached an Iddittanal%beet showing the name of the sub-contracteris and state whether in nril those entities/1.15nt
employee, Lithe sub•contraettirs have employees.they mina provide their At)rkas'crimp.policy number.
I am an employer that is providing worhers'compensation insurartce for my employees. Below is the policy and job the
information.
Insurance Company NaNan : A.I.M. Mutual/A.I.M.
Policy#or Self-ins. Lie.#: MW Z80080062242023A Expiration Date: 04/10/2024
Job Site Addre 79 Reservoir Road CityiStatealp: Leeds, MA 01053
w
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to qesclue coverage as required under MGL c. 152,*25A is a criminal violation punishable by a tine up to$1,500.00
andfor one-year imprisonmimt,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. A copy of this statement may he forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ida hereby cent under the pains and penalties ofperfitty that the information provided above is true and correct
Signature: LC-61c-
ate
Phone#:
Official use only. Do not write in this area,to he completed by city or town official
City or Town: Permit/License N
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
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T \ > 110 Pulpit Hill Road
T N '� '� 79 RESERVOIR RD.LEEDS,MA 01053 SET Amherst.Mo 01002
O T = Z 413-549-7919
RENOVATION EMAIL INRSINTEGBUILD.CO
®Integrity Deve op ent&Constructionn,IInc.(2022).
All nohiS reServed.