32A-260 (6) 58 BRIDGE ST BP-2017-0011
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32A-260 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: REPAIR BUILDING PERMIT
Permit ft BP-2017-0011
Project# JS-2017-000020
Est. Cost: $30000.00
Fee: $210.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: KRIS THOMSON 084152
Lot Size(sa. ft.): 21344.40 Owner: NORTHAMPTON HISTORICAL SOCIETY
Zoning: URC(I00)/ Applicant: KRIS THOMSON
AT: 58 BRIDGE ST
Applicant Address: Phone: Insurance:
362 KENNEDY RD (413) 549-1027 O
L E E D S M A 010 5 3 ISSUED ON:7/18/2 01 6 0:00:00
TO PERFORM THE FOLLOWING WORK:REPAIR POSTS & SILL
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: OI: 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 7/18/20160:00:00 $210.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0011
APPLICANT/CONTACT PERSON KRIS THOMSON
ADDRESS/PHONE 362 KENNEDY RD LEEDS (413)549-1027 0
PROPERTY LOCATION 58 BRIDGE ST
MAP 32A PARCEL 260 001 ZONE URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FO OUT
Fee Paid 7/� + '3 ay I
Building Penn rut- out
Fee Paid
Tvpeaf Construction: SILL& POST REPAIR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 084152
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOIIMATION 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
eir
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.
Version) 7 Commercial Building Permit May IS,2000
(— Department use only
City of Northampton status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability .,
�� - Room 100 Water/Well Availability
,_---- - - Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PlotSite 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
t.tPropert�}yAddreJss. This section to be completed by office
57 Br ctq L 5t ' Map Lot Unit
V01 Ali 41^...¢ }-b 1,4 .k19 . O )0 GO Zone Overlay District
-- --- - --- --- Elm St.District Ca District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
f- (11- So.Pu,e
Name(Printlr Current Mailing Address
v ` 413 ' CVC • 3�( t
Signature 1, „ r "' '— Telephone
2.2 Authorized Agent:
Yi 5-114.O144'9 C) 3(dZ „e14.1n-to Li 1-.22G{ y. 44c, ,
Name Pnnt) Cunent Mal ing Address
413-•_b95 • l_x1'7
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 3Qf OU p (a)Building Permit Fee
2. Sestina! — (b)Estimated Total Cost of - --
Construction from(8)
3. Plumbing Building Permit Fee 1
4. Mechanical(HVAC) 0,20
6. Fite Protection .__ _ �/'
S. Total=(1 +7+3+q +5) � OOo Check Number33A en
Section For Official Use Only
Building Permit Number Date
Issued
Signature.
Building Commissioner/Inspects of Buildings Date
Version] 7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wall Signs 0 Demolition El Repairs Additions ❑ Accessory Building
Exterior Alteration 0 Existing Ground Sign 0 New Signs 0 Roofing Change of Use Other]ZI
Brief Description Enter a brief description here.
Of Proposed Work: SII+ P65+ rcpo4r
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 Iry 'A 0
A-4 0 A-5 0 1B 0
B Business 0 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F-1 0 F-2 0 2C 0
H Hioh Hazard ❑ 3A C
I Institutional ❑ 1-1 0 1-2 0 1-3 ❑ 38 ❑
M Mercantile ❑ _ 4 0 1
R Residential 0 R-1 0 R-2 ❑ R-3 0 5A ❑
S Storage 10S-1 0 5-2 0 i 50 0
U Utility ❑ Specify
M Mixed Use ❑ Specify
S Special Use C Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Groap: _.._. _. 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)
__... 1" . _...
1st -- - _.
grid -"- -. _.....
2nd __. _ --—
3rd
flth
Total Area (sf) 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 0 Zone __..__ Outside Flood Zone❑ Municipal ❑ On site disposal systems
Versionl.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size _. .
Frontage
Setbacks Front
Side L R _.._ LR
Rear
Building Height -- -
Bldg. Square Footage
Open Space Footage _.
(Lot area minus bldg&paved
parking)
of Parking Spaces - --
Fill: _.
(volume&Location) _... ...
A. lias a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DONT KNOW g YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW Q YES Q
IF YES: enter Book Page '.. and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO g) DONT KNOW Q YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued:
C. Do any signs exist on the property? YES NO Q
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO
IF YES, describe size, type and Location:
E. wll the construction activity disturb(clearing,grading,excavation, or filling)over 1 acre or is it part of a common plan
that will disturb over l acre? YES Q NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version1.7 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
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
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Reg.stration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registrabon Number
Signature Telephone Expiration Date
9.3 General Contractor /�
�..rls 11r/toon5UM C.f_Y'�7'L't^tY __ Not Applicable El
Company Name:
Responsible In Charge�of Construction
)Lri5 ' 1VlOWSoti 3(nZK-6.4‘hedRd .LesdS.
Address
(09 5 Cleft 7
Signature Telephone
VersionL7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.14)
Independent Structural Engineering Structural Peer Review Required Yes Q No 0
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, _ ♦ la/ ��,7,y�.� . : r4/1/ IPO 71 (sr 't1 . . L� •i �w t�e subject property
hereby authorize K--,r S l t bL✓t Sb In .._ _ to_. to
act o , behalf, in all matters relative to rk au horized by this building permit application
° 5 age
Sign. - of• erg D2te
I, r icillsorn,Sole%_... _. __. ,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__Eit nd penalties of perjury
-04i5 eMn5an, _._ .. . .. ... _ _..
Print Name
Signature of OPfier/Ayen Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder: K✓, 5 . 1"r 614.1$051-, _. CS •O 4 (57--
License Number
5 2 14.-eiAineolr LSCL e ..a -Mc, _ 4)9 117
Addre s ^ J Expiration Date
Signatur 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 afdavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes No 0
The Comntwzwealth of Massachusetts
_ Department of Industrial Accidents
Y om% Office of Investigations
—. —�- 600 Washing on Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information 1 Please Print Legibly
Name (Business/Orpanizatiovmdividual): Kv s "rVL c✓IA sat.
Address: J b Z 4-e ht vi -Qt:4 RA '
City/State/Zip: Lt.eols ✓1tc . O )o53 Phone#: - ) 3 • C 3". Co 4-1
Are you an employer? Check the appropriate box: Type of project(required):
1 Ti employer
1 am a em to r with ? 4. ❑ I am a general contactor and I ❑
have hired the sub-contractors 6. New construction
employees (full andlor part-time).*
2.7 I am a sole proprietor or partner-
listed on the attached sheet 7. emodeling tf
ship and have no employees These sub-contractors have g. ❑ D motition
work's for me in anycapacity. employees and have workers'
S pa ty 9. U Building addition
[No workers' comp.insurance comp. insurance.:
required.] 5. L We area corporation and its 10.7 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.❑ Roof repairs
insurance required.] t c. 152, §I(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.
r Homeowners who submit this affidavit indicating they are doing all welt and then hire outside contactors must submit a new affidavit indicahne such.
tContactors that check this box must attached an additional sheet showing the term of the sub-contactors and state whether or not those entities have
employees. If the sub-contactors have en ployees,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. 1111 CC 11
Insurance Company Name: •e I�3N�JQ vac
.)\
or Self-ins.Lic. I
ti:
pp(hS6006'O(w0 WQ I . 1 • I io Expiration Date: cf?el I /71 //yy''
Job Site Address:_ $ ll(io5 e. 54. City/State/Zip:ftpj}'t7Q.1"fo JIG.Oqo CO
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 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DLA for insurance coverage verification.
I do hereby certifj+( �thee pains and penalties of perjury that the information provided above is true and correct.
Signature: Date: i/5/ / (i
Phone g: 41 ; • 69 <• (wi 7
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#:
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste 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.
Address of the work: S% gni
The debris will be transported by: ,ID‘) 5e a v -1—y• u c-ki'N
The debris will be received by:
Building permit number:
Name of Permit Applicant K r i S I r N-
Date Signature of Permit Applicant
lilI
if
4 ` ) Pr CR r i
riti k €Lot gi
Scope of Work - - - -
Parsons House
- Remove affected exterior cladding
-Assess extent of repairs required
- Repair sill and posts as needed
- Re- deck side porch
- Install sheathing
- Install water barrier
- Install siding, water table, and corner boards
- Replace three (3) rotten sash
- Repair miscellaneous siding, as needed on main building
- Repair side porch post bases
- Re- grade affected area
Materials:
-All sill stock shall be white oak (as they will be sitting below grade)
- Sheathing and siding shall be white pine to match existing
- Decking on porch shall be fir
1
Parsons House
4. Floor Plano
� ,2tJue�ts f Guar/ __
�, e '(,, 1
II
Kiri
PARSONS NWSE f- D�+N 0qj IONS
LI Sf ! ( s CAkct Posts +"o be r-e paired se rt.",kced