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31A-315 139 VERNON ST BP-2022-0108 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31 A-315 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Porch Enclosure BUILDING PERMIT Permit# BP-2022-0108 Project# JS-2022-000191 Est.Cost: $19500.00 Fee:$127.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JAMES PHANEUF 011632 Lot Size(sa.ft.): 23696.64 Owner: SCHAPIRO STANLEY&JOAN WIENER Zoning: URA(100)/WP(43)/FFR(4)/ Applicant: JAMES PHANEUF AT: 139 VERNON ST Applicant Address: Phone: Insurance: 74 Old Stage Rd (413) 247-9993 W HATFI ELDMA01088 ISSUED ON:7/28/20210:00:00 TO PERFORM THE FOLLOWING WORK:MAKE EXISTING PORCH INTO 3 SEASON 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. 11 Certificate of Occupancy si nature' ' +# I FeeType: Date Paid: Amount: Building 7/28/2021 0:00:00 $127.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner ���The Commonwealth of Mass'chus FOR Ikktv Board of Building Regulations.nd S :ndarl Massachusetts State Building ►•de)•,TI CMR <-184 t USEALITY Building Permit Application To Construct,Repair, ''-p(3i•i. - Or De3ish a Rev'.ed Mar 2011 One-or Two-Family Dwelling '14f,4 This ection For Official Use Only •444se ^ Building ennit Number: 6fi')}' (O Date Applied: '�o�otis Kay j� a5 /Z� 7- z9 zozj Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address:A t \ '. 1.2 Assessors Map& Parcel Numbers , 9 jr7hJOi.J ,3t f} 3/5- 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 �pe rt 4Dimensions:` 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 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage posal System: Public is Private❑ Zone: Outside Flood Zone? Municipal li On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of ecor • �T—Aki p/NA /JO 0+41'47retki Name(Print) City,State,ZIP /3 g 1)E4 JO Cr 9(9 0 qn 18-a? No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s)-al Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: BriefJ)escri tion of Proposed Work2: .'"V8 KO]Jig, C.- . 1_it 1JG—( 11J Lt, A WI,A)£ - S) ' 'tAM.Iz / SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ r4g, ,r-° 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 's0-0 / 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ Check No.35 heck A o 6.Total Project Cost: $ 11/S d 0 0 Paid in Full 0 O to •'• .lance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) d t C 4 3 1, -3 /ZZ, :4't1A& r License Number Ex iration Date flame of CSL Holder s 4- S'�'� J -I List CSL Type(see below) No.and Street Type Description I, t/J,�,�,,, ©(C �U Unrestricted(Buildings up to 35,000 cu. IL) w it`"'P"i R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 2 7 q/C 3 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) c�/,, ,p�s zoq P/'t HIC Registration Number Expiration Date HIC Company Name or HIC Registrant No.and Street 74,- /n p !h n €4 7 qj p('s Email address City/Town,State,ZIP , '�C�C. Telephone ` li J''' SECTION 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 Issuan e of the building permit. Signed Affidavit Attached? Yes No .0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR�+y APPLIES FOR BUILLDING PERMIT yf c I,as Owner of the subject property,hereby authorize J M 7HMii/ U to act on my behalf,in all matters relative to work authorized by this building permit application. c1-h1 ? A412-0 71244 Print Owner s Name(Electronic Signature) te SECTION 7b: OWNER' OR 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. TA-m-(cs•12k-t--- 7 Z6 4 Print Owner's or Authorized Agent's Name!(Electronic Signature) ate NOTES: 1. 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. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca 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 of half/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" 0 _ - 1 r \HA Wc. \Al � r ti j 1 . , '- - I M 12-421A c'6 st,rD tkt&--bow., , t,J i c.„As�rvlS�h1"rS 11 l l) ND 0 C�J.}-,�.e, C, S to 0 4 -,o-tie, 13' S 412 ( jVO W1 Oqir&t.i oKJ ST City of Northampton `T,,GTc,rft�., `S — SI. ' Massachusetts ��+5 ,� c,,c t. .A°. .t i! DEPARTMENT OF:toUenImunL,DING INSPECTIONS S.. "' 212 Main StreeicipalBuildingy`�6 CDC --''. Northam MA 01060 rfN ..IY `,J 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: Location of Facility: f/ Rua/ A The debris will be transported by: Name of Hauler: fit. /44A-t.Q 7 -cIw1 Signature of Applicant: 91)1(-1' Date: 7 /24/Zi it S The Commonwealth of Massachusetts I:,beare!Wan Department of Industrial:-accidents I1.f� I Congress Street,Suite 100 Boston.MA 02114-2017 www.mass.gov/dia )1 miters'('ompensaiiun Insurance:Midas it:Builders!(contractor!JEketricianslPlurnbrrs. 10 BF: I71..11)V.1111 T111 PERMI'i'1'11G AI I I1 IW'1'Y. Applicant information Please Print Leeibh; Name(Bus ute-ss nizatiadls dividu.l): 244 EsS ( !\) tit-f Address: (9-es (U. City/StaterZip: (t),/- ,,0160-00, Phone is 6 z4 / r o d Art...it( I %rr (heck the appropriate hors_ Type of project(required): 1.0 I am a employer with enpkoyee%Iftdl anitorpart-tarry 7. Q Ncu construction 221 I am a sole proprietor or patncrship and hate no employers working Itur me in R. Er todeling any capacity_(:Sow takers'ca*np.unuramee requrred_j 9. ❑Demolition AO I ant a Inomoottnot donne;all work rny'clf:.!Nu suutkers'coop.insurance required.l s 41.0 I ant a IKoorw ner and Is 1.e htrmtp i untrar9ora to conduct all wt'rk on my property. I will 10 0 Building addition nm ensure that all contractors either hat c workers'compensation utsuranee ter arc vole 11.C]Electrical repairs or additions pnoprieturs with no employees_ 12.13 Plumbing repair:or additions am a gcn cal contractor and 1 hate hind the sub contactor.listed on the attached sheet_ Meese subcontractton losem employees and hate workers'cop.insurance. 13❑Roof repairs Other 6.0 we arc a corporation and its officers has e exercised then right of exemption per N161_c. 14.0 — 32,§lilt.and we hale no eaployecs.(No workers'comp.insurance required.' 'Any applicant that checks but a1,risk also fill out the section below showing their workers'compere/aim polity information_ llornoawners who submit der atfmdatit imnheating they arc doing all wink and then hire outside eontractu s must submit a new-atriida%it 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 hate employees_ If the sub•contraewn hate eu ikiyeus.they nmust pnosidc their workers cutup.plies number_ l am an employer that is proriding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy #or Self-ins.Lie. #: Expiration Date: Job Site Address: City StateZip ___ Attack a copy of the workers'compensation policy declamation pie(showing the policy number and expiration date). Failure to secure coverage as required under MG1.c. 152,4125A is a criminal violation punishable by a fine up to$1:r►00.00 andlor one-year imprisonment,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 the painsa penal ' f perjury that the information provided bore iq�}true and correct b v 1/4 Signature: "' D,rtc.. 7,6 d`— Phone#: b / l e 0 1 Official use only_ Do not write in this area.to be completed by city or town ofliciat ('its or Town: Perniitil.icense#i _ Issuing authority(circle one): I. Board of Health 2. Building Department 3.City./Town Clerk 4.Ekctrical Inspector S. Plumbing;Inspector 6.Other Contact Person: Phone#: