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32C-287 (8) � a j Y yr�.� o :� f,��,r 4 t, 3 VIV rlt1 ,�� Nk r s •�!�a�m':.�.i»^x .�°�'�p`'= ,ar.c�,s°»yam. , Y r ,K 6 40. "'t, $. R a ti M , ,r t ✓?" t' • r • J� iS � oil +W w3�`��"a::�- AWy . ,��!►�#iY� Y ti � , r tr �r 5 z Y t BRUCE TAUSCHER Home Improvement Repair and Maintenance 54 Adams Road Haydenville, MA 01039 Tel 413-268-3814 Permit application for 120-122-124 Williams Street Porch roof modification Commissioner Hasbrook, Enclosed please find my application letter to grant a modification for the above referenced project. Also,after discussion with Charles Miller I have reviewed the existing supports and find they rest on the existing concrete steps. I will remove the existing steps and install new concrete 8"footings with 4X4 post and 2-2X4X full length girder under the porch and install new wood steps. I enclosed a drawing showing this modification. Sincerely,✓ Bruce Tauscher . Builders Letterhead Bruce Tauscher 54 Adams Rd Haydenville, MA 01039 Commissioner Hasbrouck August 20,2015insert date Subject: Request for Waiver I request that you grant a modification to waive the requirement for control construction for the(porch roof modification project)at(120-122-124 Williams Street) in Northampton because the work is of a minor nature,will not affect health,accessibility, life and fire safety,or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work.All work will be completed within the prescriptive requirements of 780 CMR.Thank you for your consideration. "Mass Amendments,sections 107.1 allows for an exclusion from control construction for this project" Respectfully, Bruce Tauscher 54 Adams Rd Haydenville, MA 01039 y a RAO i� 641 eo s �f�"ice `��'t•��°'= S`Z R S - t .t h A t;n'°'le, tJ t kit- t° rJ 4s.4 S V mif _ . _ 7 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): r�`� Address: 5Y Nowr-S 12 City/State/Zip: j44 ort v,1 Lei Phone #: 4 13-Z Are you an employer? eheck the appropriate box: Type of project(required): 1.❑ I am a employer with 4. Q I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction 2.[ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, Q Demolition working for me in any capacity. employees and have workers' 9. Q Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. Q We are a corporation and its 10.Q Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LF1 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.Q Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] "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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'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$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$250.00 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature•,&A6A. �', . !�� Date: Phone#: /3 Z 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#: Versionl.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 O SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, gG n TQ rn , l e n k-i;%,i as Owner of the subject property hereby authorize &Uc j s c'k e-/ to act behalf, in all m ers r ative to work authorized by this building permit application. nature of r Date I, s lruee 7Z5.C'K a"= 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 un:rrrvc,e pains and penalties of perjury. -T Eyscke,f" Print Name Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: ''�,� l4 Not Applicable ❑ Name of License Holder: �G'e [SGrye'��' C5 - 08-7399 ' License Number n Adwa Expiration Date Signature Telephone 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 in the denial of the issuance of the building permit. Signed Affidavit Attached Yes ® No 0 Versionl.7 Commercial Building Pennit 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 36,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable 0 Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(*): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor S mee T;;A'jsche.r- Not Applicable ❑ Company Name: Responsible In Charge of Construction 5Y AAe4 W,5 IW64 Address ¢'✓3'148 --.?Yl(l Signs ure Telephone _ Version 1.7 Commercial Building Permit May 15,2000 S. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Via' Side L: �`' P L: R: Rear 7 L}b 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 ® DONT KNOW Q YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW ® YES a IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 YES a IF YES,has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained Q , Date Issued: C. Do any signs exist on the property? YES © NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO Q( 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 © NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ® Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. C kQ v1 j 2 F.'e©r Pi-rC A Q W A D� Of Proposed Work: 410 o f- Kdair Z) Govel& s 7Z92S SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 36 M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: 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) St /st30 1� 2"tl /X7,0 2nd 3rd 3`d 4n, 4�' Total Area(sf) 3,000 Total Proposed New Construction(sf) Total Height(ft) Total Height ft 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 ❑ On site disposal system❑ - - -- - Versionl.7 Commercial Building Permit May 15,2000 ` 7 Department use only City' of Northampton Status of Permit: P , G 2 0 ��i 5 i Building Department Curb CuttDriveway Permit - -� 212 Main Street Sewer/Septic Availability [ __, , _� Room 100 Water/Well Availability coon Ortham ton, MA 01060 Two Sets of Structural Plans p one 413-587-1240 Fax 413-587-1272 PlotlSite Plans 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 Map Lot Unit Zone Overlay District Elm 8t District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: D/0G z Signature Telephone 2.2 Authorized Anent: $rsrc� sc�v S'� i �7• � 'e'r' Name(Print) Current Mailing Address: acts�l�e �GowicQ5l�.r►e� 144/ ,P&�f V 0LL&3- 3'9 Signature Telephone 4-13— 2-(P8- -?49-'Y SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by rmit applicant 1. Building * S� (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) Q 5.Fire Protection 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0217 APPLICANT/CONTACT PERSON JENKINS BENJAMIN J&KATHERINE ADDRESS/PHONE 149 FEDERAL ST FLORENCE01062(41)358-6839(7) PROPERTY LOCATION 120 WILLIAMS ST MAP 32C PARCEL 287 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinf Permit Filled out Fee Paid Typeof Construction: CHANGE ROOF PITCH&ADD 4'ROOF OVER STEPS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 087399 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 i 4=x��A 91 Z716- 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,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. 120 WILLIAMS ST BP-2016-0217 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-287 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2016-0217 Project# JS-2016-000366 Est. Cost: $3500.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: BRUCE TAUSCHER 087399 Lot Size(sq. ft.): 10497.96 Owner: JENKINS BENJAMIN J&KATHERINE Zoning. URC(100)/ Applicant. BRUCE TAUSCHER AT. 120 WILLIAMS ST Applicant Address: Phone: Insurance: 54 ADAMS RD (413) 268-3814 HAYDENVILLEMA01039 ISSUED ON:812812015 0:00:00 TO PERFORM THE FOLLOWING WORK.-CHANGE ROOF PITCH & ADD 4' ROOF OVER STEPS 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 8/28/2015 0:00:00 $100.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner