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39A-052 (5) BP-2024-0710 86 LYMAN RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 39A-052-001 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-2024-0710 PERMISSION IS HEREBY GRANTED TO: Project# REPLACE DECKS 2024 Contractor: License: Est Cost: 40000 PHILIP SHUMWAY 105743 Const.Class: Exp.Date: 01/14/2025 Use Group: Owner: L ARNOLD KENNETH D& WENDY Lot Size (sq.ft.) Zoning: SC/URB Applicant: PHILIP SHUMWAY Applicant Address Phone: Insurance: P O BOX 522 (413)687-9400 HADLEY, MA 01035 ISSUED ON: 06/05/2024 TO PERFORM THE FOLLOWING WORK: REPLACE STAIRS 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. i� Signature: ����C:�.--.. Fees Paid: S280.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner \ -v-A-E---6-E1VED _ The Commonwealth of Magsac us s_ A i024 .. lift 7.L_ ;, Office of Public Safety and Insecti s I 1 Massachusetts State Building Code( 0 C R) 1 Building Permit Application for any Building other than On l P c t ng II (This Section For Official Use Only) DF'No THAtiy•ON.e�__ 1 Building Permit Numbero7/' 7/Q Date Applied: Building Official:4 /( SECTION 1:LOCATION 615121 It 1 �yiv% rl N•c r4-1,c-.,j) C k oc No.and Street City/Town Zip Code • Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2 PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair Alteration 0 Addition❑ Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes No ❑ Is an Independent Structural Engineering Peer Revi uired? Yes 0 No � — Brief Description of Pro s d Work: G 4 e_C.14/ Sort �per•) SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) O Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ 1-3❑ 1-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA CI IB 0 HA IIB ❑ MA IIIB0 IV 0 VA 0 VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Sup, Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public Check if outside Flood Zone U Indicate municipal ® A trench w}H not be Licensed Disposal Site Id- Private El or indentify Zone: or on site system 0 required NI or trench or specify �13 /-J permit is enclosed❑ Railroad right-of-w Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable Is Structure within airport approach area? Is their review compl d? or Consent to Build enclosed 0 Yes 0 or No Yes 0 No II SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Wcn2 /,MII 7 S 1��)-1 cr far 12 fie-) Name(Prifit) No.and Street City/Town Zip Property Owner Contact Information: 4w n cr _ _ _ _ VA//'d !2 I' 3C 4F41k1"— Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable,the property owne hereb authorizes: S,area Name Street Address City/Town ,State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 1. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) 5 Its* li l't4 I ..ree 01, .A.con Name(Registrant) Telephone No. e-mail ddress Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor 4wi"t�aj çervi -r Compan ame .\ vM CSC - v Namebf Person Responsible foi Construction License No. and Type if Applicable 6arcA — HaeI e k MI - . Street Address City/Town State Zip == — '\1't- 4?- 44on Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the' suaiice of the building permit. Is a signed Affidavit submitted with this application? Yes No 0 SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ i�1Q t� Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ . 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ _(contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ LA Li!¢ol) (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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. ciA it{L Ct 44'1a/4 -____- Please print and sign name Title Telephone No. Date Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: C t S fs h ra;�t a— 6l� �1 t'u / Name late sS 1\\ I CITY OF NORTHAMPTON VSETBACK PLAN MAP: LOT: CI k3'1. LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton ?iaYr1Arnr,o\ Massachusetts ��?` '� t111011 yrg ; i'. DEPARTMENT OF BUILDING INSPECTIONS °. I.° 212 Main Street • Municipal Building yJy Cm \,. 1.07:1�i. :,. O "'t Northampton, MA 01060 i -. �^ 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. The debris will be disposed of in: nil 4 1 k r Location of Facility: 1. f\\75 The debris will be transported by: tA \Name of Hauler: (/ 5�k� Signature of Applicant: Date: 1 `'� The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Amdavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annlicant Informatkoo Please Print Levibly Name(Business/Organization/Individual): Philip Shumway Inc. DBA Shumway Services Address: P.O Box 522 City/State/Zip: Hadley MA 01035 phone#: 413-687-9400 Are y.e es employer!Cheek the appe.prlate bar Type of project(required): 1241 am a eeepbya wNh X employees(Adl and'or parttime).• 7. ®New construction 20 I am a sole proprietor or paeonetabip and have no employees workma for me m 8. m Remodeling any capacity.(No workers'comp.'nominee mooed.) 30 1 am a homeowner dome all wu t myself.(No workers'comp.mn a uuoe re uered.) 9. ❑Demolition ILO ass a homeowner and will be hiring coatroom bnd conduct all work on my propriety. I will 10 O Building addition ensure thn all contractors either have mikes'compensation ire rase r or are sole 1 I a Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5 I am s general contractor and I have hated the sub-contractors hated on the attached sheet Thew aubaantmctoes lose employees and have trotters' ro ters'comp,enwunce.t 13{3 Roof repairs Th 6.0 we a a caporaraon and its officers hove exercised their of exesaptaoo M per GL c. 14.BOdler an 1(4).and wK have no employees.[No workers'comp.insurance required.] 'Any applicant der checks boa a I mint also fill out the section below shame their waders'compensation policy informatim. Honseowwers who sinew this st1'riacst indscatina they arc dome all work and then hire outside cattractaas mot submit a mew affidavit indicating such. tCoau:tws that cheek the box must attached an additional sheet showing the name of the sub•contnctors and state whether a not those entities have erm'loyom It the subaaatractors have employees,they maW provide their waters'comp.policy number. l ass an employer that!s providing writers'compensation Insurance for uiy employees. Below is the policy and job site inforstads& Insurance Company Name: Wesco Policy#or Self ins.Lic.tt: WWC7569281 Expiration Date: 02/2023 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 MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisoemtent,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 be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perfrry that Ike information provided above is erne and correct cior�lure: : Phone tt: 413-6B7-9400 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License M Inning 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 0: Initial Construction Control Document ? lit rt To be submitted with the building permit application by a s \ { �.l �e Registered Design Professional for work per the ninth edition of the ''._..-., Massachusetts State Building Code, Y80 CMR, Section 10Y Project Title: Exterior Egress Replacement Date:01.09.2024 Property Address: 86 Lyman Rd,Northampton,MA 01301 Project: Check(x) one or both as applicable: New construction (X) Existing Construction Project description: I,Seth D Wilschutz MA Registration Number:952505 Expiration date:08/31/2024,am a registered design professional,and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerningl: X-Architectural Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a'Final Construction Control Document'. Enter in the space to the right a"wet"or �S .00ARC* electronic signature and seal: N N • •"2 ' iiir • 61441OFMpSyP Phone number:413-489-1951 Email:seth@seth.design Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an'x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen,provide a description. 1 1