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23A-174 (6) 36 PINE ST BP-2019-1489 GIs#: COMMONWEALTH OF MASSACHUSETTS Mav,Block:23A- 174 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Calegorv:renovation BUILDING PERMIT Permit BP-2019-1489 Project# JS-2019-002413 Est.Cost:$24000.00 Fee:$156.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: HANS DALHANS 101628 Lot Size(su.R.): 5183.64 Owner. William Girard Zoning: URB(1001/ Applicant. HANS DALHANS AT. 36 PINE ST Amdicanf Address: Phone: Insurance: 11 CHERRY ST (413)977-6094 EASTHAMPTONMA01027 ISSUED ON:605/20I9 0:00:00 TO PERFORM THE FOLLOWING WORK RENO EXISTING SUNROOM INTO OFFICE SPACE 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 6/25/20190:00:00 $156.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck-Building Commissioner 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 Plot/Site Plans Other specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: -}. �zThis section to be completed by office Yp fin/. S4,A&+ Map // Lot 17 47 Unit Flo,xna, MA 0106 . zone Overlay District Elm SL District CB DIWICt SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: //�� 11 -'�// Wil (2.'J 3G Fete S+ f�Dt^jnce MA 0) Name(Print) " Y�"" V Currem n eAmg tl r,� 370 - -1.1 4q Telephone Signature nz A ant: \ l 111 \ IJG' 4y.� �1nf�f�P1n"1""(1'1 1�V�8M! � �GS"Ihnr���Tl1^ ame(Prim) G�urrent Mailing $s 3—� 60j Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a)Building Permit Fee 2. Electrical l (b)Estimated Construction from oof 6 3. Plumbing / O , W Building Permit Fee T 4. Mechanical(HVAC) tF6,6- T" 5. Fire Protection 6. Total=(1 +2+3+4+5) 06b- w I Check Number This Section For Official Use Only BuildingPermit Number: Date Issued: Signature: 1,72101a i Building Commissionerllnspector of Buikfings Dale 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 mus column to h filled in by Building Depamnent Lot Size Frontage �_ ---- Setbacks Front Side L:_R: L:Q R:Q Rear Building Height O Bldg.Square Footage Open Space Footage (td area minus bldg&pav J _— #of Parking Spaces FII: ._._. volume&Location ---_._.___ __.. A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O 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 © YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , 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. i SECTION 5-DESCRIPTION OF PROPOSED WORK(Meek all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ® Roofing 02 pp7�� Or Doors M Accessory Bldg. E3 Demolition vq New Signs 101 Decks IM Siding[W Other[a Brief Description of Proposed � __ a4 f coo k:Ip , -, , -- In S W) 4wra �n ni ilx- tri 1 7 e . Ce Alteration of existing bedroom_Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement _Yes _:� _No Plans Attached Roll -Sheet A5 so.If Now house and or addMon 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? I, 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 8.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 Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS f,,AGENT OR (CONTRACTOR APPLIES FOR BUILDING PERMIT 1, willj� v`^A�� as Owner of the subject Property 1 he by authorizr-1 to acto my e m all matters r ive to�8UIh0 y thisbuil ing permappli �on. a p Si nature of Owner I Date I, \ h as Owner/Authorized Age hereby d that the statements and information on the foregoing application are true ntl,Accurate,to the best of my knowledge and belief 'g ed under ih ins andnakies of perjury. Pinirk Name 01 ure of Owner/ Date SECTION 8-CONSTRUCTION SERVICES .1 Licensed Construction rvisor: Not Applicablel❑U Name of License Hottler: S A I�U'.� CS-101 6 aH \ License Number Atltlresa E�retion Dete 113 q 3-1 dl Signature Telephone 9.Realatered Home ImDrovemao ContlA=, Not Applicable ❑ An" L cos ✓1 � ILI m 3t' Ram mber - L 0 Address Telephoneu Eap � SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152,§25C(8)) 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....... ANo...... ❑ City of Northampton _ Massachusetts �I _•� io; e s PEPART1d8NT 08 80ILDIMG IMSPECTIODi3 212 Hain arrear lNnicipel HuilQing C� Northampton, Ma 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes.Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, milaii modemization, conversion, improvement, removal, demolition, or construction of an addition to any preexisting owneroccupied building containing at least one but not mom than four dwelling units....orto structures which are adjacent to such residence or building"be done by registered contractors. Note.If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work—Ron, -Al' Est,Cost�oC 1. DOD Address of Work: 3 ?'^0 �� • b l'Q;1n lR Date of Permit Application:'Zo"t . a!r tri�(4 1 hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): —Job under$1,000.00 _Owner obtaining own permit(explain): Building not owneroccupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBI.ITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT. �E NE7 GE FOR MORE INFORMATION. Signed under the penalties of perjury. I hereby apply fora building permit as the agent of the own ��Tl - 1' klll b'kL" ( OWIkZ4;;�; Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature _ City of Northampton Massachusetts DEPAET s OF BGZDDZEG ZESPECTZOES Nun 212 tiwt • en 09uilflinq \�S�// C� �Q NoigfGmptou, la 01010 60 Massachusetts Residential Building Code Section 110.125.1.2 Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section IIO.R5.13.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hive to perform work for you under this permit. City of Northampton i Massachusetts s 1 l AR23SNT GP aUXWG G ZRSPZ=WS 1 :Z 212 Nein SLr t omnicipel me 1g 4f 0p� Northampton, NA 01060 ✓k ap 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: S 6 -ply"A— `JIT P'� :0(Niyas a— (Please print house number and street name) Is to be disposed of at: (Please print name and location of facility) Or will be disposed of in a ddumpster onsite rented or leased from: ' po BA FJCNG ( t)Yh%A C;1 (ComppJanyy Nal an Address y/ ff ture ofTkeftit Applicant 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 oJMassaehusetts U,krkers'Compensation DeparnmentCongr ss IndStrec4 SuAccidents I Congress Street,Suite 700 Boston, 1114 01114-2017 wwwmades.gov/dia Insurance Affidavit: Builders/Contactors/Electricions/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Bmines,VOrlgmieation4ndividual): I �hA Address: 11 ,¢fVV �• I I / ,/ City/State/Zip: ,A hone#: I3 9�1 (1 C�y`f Art you an employer'.Check the appr"mft box: Type of project(required): 1.0 1 em a employer with employees(full mdbr pen-time).• 7. ❑New construction 2. 1 vn a sole proprietor or partnership and have no employees woM1ing for me in any capacity,poo workers'comp insuraree require.] 8. ®Remodeling 3.[-]l vn a homeowner doing all work myself(No workers'comp itaure me required.] 9. ®Demolition 0.[:]1 am a homeowner and will be hiring contractors to conduct all work on my property I will 10 Building addition aurum thtt all convectors either have workers'compenvniou insurance or one sole I LRJ Electrical repairs or additions proprietors with an employees. 12.M Plumbing repairs or additions 5.0 Ieme generalwntrrcmr and1havehired the sub-crkers'colisndonthe attached sheet 13,®Roofreairs These sub-wntredprs have employees and have workers comp.insurance? p 6.15We are a corporstion and in mTi=have exercised thea right ofexempion per MGL c. Icy.[]Other 152.91(t.ttM we have m anployces_poo workers'wrap.insurancerequired.! "Any applicant that remissions#1..raise fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work andthen hire outside tantrums must submit a new affidavit indicating such. :Comma ars that check this box must attached an additional sheet showing the name of the sub-cammemr,and state whether or uonhose entities have employees. If Nc sub-wnUwtom have employees,they must provide their workers'com,v policy number. I am an employer that is providing workers'compensanon 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 MOL a 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the foal 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 Office of Investigations of the DIA for insurance coverage verification. I do hereby cern un /he pains penalties of perjury that the information provided above is true and correct. Si aN Date: h Phone#:�fI-.-?, R77 02 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): I.Board of Health 2.Building Department 3.Cdtyffown Clerk 0.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the Insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city tar town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter thein self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under`Job Site Address"the applicant should write"all locations in_(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 Tel. #617-727-4900 ext.7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia w �w ars ri 1 I -� i Roof to be stripped and Two 14.5 x 48" fixed Newly flashed and Shingled. and tempered skylights To be installed / evening spaced. 2x12 roof rafters with R-value 49 with closed cell spray foam. —_�- C 1/2" Cdx ply under Tyvek house wrap a� Taped at seems. Cathedral ceiling With two exposed Collar ties carrying � s From top front wall To house. 2x4 wall framing w/ R-value 19.5 closed cell Addition rim joist to be fastened sprayfoam. To the house rim joist with ledger locks. Exterior vinyl siding To match existing House. (3) 12" piers 48" deep 2x10 floor joists w/ ' i to carry load of front wall R value 35 with open cell I ) -- Spray foam. I 1 In fill existing window and door opening. Existing house. New opening to office with pocket door Access to be framed Track lights to be installed on collar ties. / out from playroom. L� Triple 2x12 header q,� � � � to be installed. d� d [ICI New Vinyl Paradigm windows To be installed. In fill porch door opening. WK&WIl LA iA is�� Existing porch roof 36 Pine Street Scope of Work -Demolition of existing sun porch to reframe for interior space. -Temporarily post roof to re-frame walls and floor to convert to interior space. -Strip and re-shingle roof with new underlayment and flashing. -Install two new tempered fixed skylights. -Install new paradigm vinyl double hung and awning windows. -Pour 3 new 12" concrete piers evenly spaced on front wall. -Deck ledger to be ledgerlocked to existing main house framing. -Frame floor with 2x10 floor joists with Y2" pt ply between the bottom side of the joists for insulation. -Insulate floor joists with closed cell sprayfoam. -Cover decking with %" Advantech play. -Walls framed with 2x4 kd framing. -Walls insulated with closed cell spray foam. - Roof framed with 2x12 roof rafters. Cathedral ceiling with two collar ties evenly spaced. Collar ties size TBD. -Roof to be insulated with close cell sprayfoam. -Exterior walls to be sheathed in Y2" cdx 5 ply under Tyvek house wrap. -Exterior siding to be vinyl to match the existing house. -Interior partition walls; Remove existing entry door to porch and frame opening. Remove two existing windows on interior porch walls and frame opening. -Frame new pocket door opening from playroom into new office (porch) space. -Install new gas fire place on living room side interior office (porch) wall.