44-063 (4) BP-2021-2278
949 FLORENCE RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
44-063-001 CITY OF NORTHAMPTON
Permit: New Build
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2021-2278 PERMISSIONIS HEREBY GRANTED TO:
Project# GARAGE Contractor: License:
Est. Cost: 13000
Const.Class: Exp.Date:
Use Group: Owner: MOLITORIS TIMOTHY J& SAMANTHA C
Lot Size (sq.ft.)
Zoning: WSP Applicant: C MOLITORIS TIMOTHY J &SAMANTHA
Applicant Address Phone: Insurance:
949 FLORENCE RD
NORTHAMPTON, MA 01062
ISSUED ON:12/14/2021
TO PERFORM THE FOLLOWING WORK:
DETACHED GARAGE
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.
Signature:
Fees Paid: $65.00
212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272
Office of the Building Commissioner
z-3,
RECEIVES:_:
I 1
DEC 9 2021
The Commonwealth of Massachusetts
it Board of Building Regulations and Standards MUNICIPALITYOR
F
� chusetts State Building Code, 780 CMR
i `t PT of suarnNO I�N�SP�n USE
--- NOR l! ri l)wiRi'+6�ppiieaii
3"u ton To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 69-3J - _3,2..77 if Date Applied:
c ilf t C I'
Building Official(Print Name) Signature J — a
011
SECTION 1: SITE INFORMATION
1.1 PropertyAddress: 2 Assessors Map&Parcel Numbers
9V1 oRbw etc i?b.> rk e ' '
1.1 a Is this an accepted street?yes no 0106.1 Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
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 Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone?
_ Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1_Qwner'of Recol-II:
//i , A4oliPI& 5 47►2G c l V9 D/DCo..
Name(Print) City,State,ZIP
9y, F/dim ,d Y/3-g23 -,Yogi" trno/u7,0,aw214eyAyb,0.&..-1
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ Specify:
Brief Description of Proposed Work': DeMaiet, �'i, 2n6. (
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ /a 000 1. Building Permit Fee:$ Indicate how fee is determined:
!
2.Electrical $ 0 Standard City/Town Application Fee
000 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:$ ti/,�/,
Check No.1061 Check Amount: J Cash Amount:
6.Total Project Cost: $
' i 00 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
[ Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
City/Town,State,ZIP Telephone
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 Issuance of the building permit.
Signed Affidavit Attached? Yes 0 No .❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
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.
1701 Mpu/04 .s a/Ioat
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
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 lamed,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"
City of Northampton
��� Massachusetts y� L ��'fc
e
,1 r DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building ;,_ b
Northampton, MA 01060 3rw4 : '�''''
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:
V/.6:1/ ReG ycli�G-;
Location of Facility: .. 3 '/ eft5%//7))//1/9M/I 7 ) Akkti AMA) AM- 691O a
The debris will be transported by:
Name of Hauler: �1
i"
rw
Signature of Applicant: / , Date: ia V 20-2 l
--- The Commonwealth of.%lussaehusetts
Department of Imlustriul Accidents
I Congress Street,Suite 100
Boston, MA 02114-201
www.mass.govidia
flatters'Compensation Insurance.Affidavit:BuildersJ('ontracturi/Ekctrieianstl'lumbers.
ft)HI FILED tt till HIE PE:It%U7TIM(:At I ttcittiTY.
Applicant Information Please Print Eteihis
Name lRusines.s.t_1t;w.rnaralien.individual►:��/ Ob I 7‘D/2-4 S
Address: [ R04_0
City/State/Zip: / Vl Ef 7 777,/-0 NA- °/Yl'ione #: y/3- 9 a &-0 �S
A1rr yea an eiiptoyer?Check the.rIrp toast tate bar1,; Type of project(required):
1.�i AM a employe with iW,Moyees tied and or part-lintel• 7_ Neu. construelaon
�'LJ I am a wile proprietor or patiaerwisp and hare no employee,working for nx in 8. 1:.J Remodeling
any capaeity.[No workers'cutup.inianimee roomed.) �—+
9. E]Demolition
3 !ant a lwntcxrWtter doing all work myself.[No esc4 er comp.rtxiurautQa reetaireli_l"
II[3 Building addition
4.0 1 am a 1ut3113xzan+:r and w nil be hinny exngrastur,ra edrnduct all w oik nn my Noprrrty_ 1 will
enaun that all evnFraa ura either lave worker,'eomp tivataoi uanuraner an are male I t.J Electrical repairs or additions
prupti<<!vn with runemployees, 2.0 Plumbing repairs or additions
5 1 am a gcraral currtractur and 1 hare dared the 4ub-contractor,ltste+d an the attached.'dart. l 30 Roof repairs
These uth-a untraetura hide employee,.and has a worker,'camp.insurance.:
6.EJ We art:a evaporation and its officers hare:exercised their sight of eat €iiox per\f(it..c. l Other
152,'Ii41.and we hate no emeployeea.[No workers'comp.iruutancercyuueJ.f I
l
*Art}applicant that cheeks box xl merit alw till uut die seetioar below showing their workers`eompen*attun pokey information.
r tbwnetwinerm who srtlnnii Uua atintarit inrlieatnng they arc doing all work and then hire outside cunuwetoca mist submit a nt:w aftiiJar it indicating%tack
:('unuacta,rs that cheek the,h ni rnuni attakfi d an:alditiuttat shed ahawing the name raf the sat*-i t.rtarasi.-ir,and,rare+r hethcr t_n nisi'how cnduea lease
It the mAs-eitiariretor,Lose cii{':cea.the p inu.,i prur`tile their worker;omtip s.t r.ei nf,:r
/am an eniploi°a'r that is prnviufing.,turAers'a`Ampettsftliapi ittsuranee four lttp Cmplaj•ee . Below lA the polity hirer jot site
information.
Inbur.cii.•e CompanyName: _. _..
Policy#car Self-ins.Lic.#: Expiration Date:
Job Sur Address: City;Stute,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 VIGI.c. 152,*25A is a criminal violation punishable by rt fine up to 51,500.00
and;'ur one-year imprisonment,as well us civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.{M(M a
day against the violator.A copy 'statement may be forwarded to the Office of Investigations of the DIA for insurance
coVer:tee xerihcstixm.
I do hereby certify e 1 a and penalties of perjury that the infertrioNon provided above i.+true and correct.
S t a .: . Date. )-z/9/a- /
l'lactm: VIS — 923
OJiufrxt uvt will. Do not write in this area.to be completed by city or town of/ic Seal
City or Town: Permit/License it
Issuing Authority (circle one):
I. Board of Health 2.Building Department 3.( itr 401411 Clerk 4. Electrical Inspector 5. Plumbing Inspector
b.Other
Contact Person: Phone#:
City of Northampton
;i rr 44,, sus ,,. `,cam,
,�' .'
r
� Massachusetts ��� �- ���S DEPARTMENT OF BUILDING INSPECTIONS S g
r 212 Main Street • Municipal Building
Northampton, MA 01060 rs6 tik�
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
�� 312?1/�1
I, / !/� J� j_r /t ld (insert full legal name), born (insert month,
day, year),hereby dep se and state the following:
1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a
parcel of land to which I hold legal title.
2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption,
does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3.
3. I qualify under the State Building Code's definition of homeowner as defined at 780 CMR 110.R5.1.2:
Person(s) who owns 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 home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for
and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work
on my parcel, I am not engaged in construction supervision in connection with any project or work involving
construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any
provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my
parcel,I acknowledge that I am required to and will act as the supervisor for said project or work.
°I
lt
Signed under the p ' sand penalties of perjury on this t day of D ► -- , 20 a I
Signat e)
(-/-F) /9 J- .
_.
1 , 1-, in -4
I
- (47.1/12 -3? 'c'41 ,
&? -9
b
-I -/' '6
c-, I (-/-/)
111
i \\ t------- /ge I I
i.---
a —( -/ ) 1 3 S''62fl
, 510 -� Iv (L51 x?
I cidQ
i
�i ve _?d ri?..Afcjj 617& CroOleii
( v- Q 1_Q(v
/z '&ec mfr Dioro �,
,
,-/, !iw'°° "'`/ e-I `P s
v l /+ S tt'A44
l API
G
Po �• Js� s
a
,e o c
.�.� r..
- Do"91r arc 1a µe PD8Z Dv)31e 7A)� 1 '? 7'L.
_ �l >=i LCE2 �-1�d� %/ Fi l.(.t't. Q-1„14
,, '')41y I ��/e; 13►ZouJ
gyp ' oaf ` i ! ' p"`'
'DW31e TA eic5�
?."r' N 5►�1; UGH' sibs,
eami. 1-01,54 tal:' 1 i,---_,..- —
I-244
i a,S
Sl,o 00 pSr 11 ,
'PI get. ketAi u� i / N._)<
c-Re-rer furl 4/1' TH7Gk_ siA8 Th
��/�Ri2 �ER� r» ��
►1 �usi4 >C a y OF sills
o a PV' nil vnv v / ii-iii.c S!Aa
mar_ -to Saitie
' ..-..Cr...
VS
I A ojec,,
......• co ez.....
et
't"...6".
dk--------- f. ..l. • . ,. ...
ZG,
t‘. e:s
44 ,A.
CI4
ta - :- 4 P
- - i,,
Zo.
)
2....
..r.,.. 6.
•Tc‘11 ,4 N,
Iv
-,,,--• i
1 \
1
1
V '
.
V / 1
'7 I
,I ,
— Y--
2 '474%, 1 ',/' '
1 "
0 7'
•
-C
.._...„...__.
CP
ito V
. _......_
SW .'- ! t
In I
---. v,
.1.1
_ \ .
- -
,,0\11,4 .,.... .,-„ . • . ,..‘,_,..\.:,,,
I
k.
_....
w 1
IA mt,
11; 1 v. —i- .... ,ar le ,
V .-
Sb
7,,
ivc.., ),.. -A ..,-i
It- ,
I'
'‘',„"6
•
, .
• . _
1..i..,-
. 6
•
--........-_,,,...__ -
Nti
' ..........---,-......,,..........6„
------------- '''''
...,
,..
. ., .
, ' 6
*I,.
f I Z. cr r
5 .
• r . .
ii,„,,1: i. "' ''',, , :
4 ) S--'
. i I
. ,
...._.......
,„
1111 1
. ,. .
\- OQ ----1
.S.-
' q
-KJ
949 Florence Rd-Google Maps helps./Muss googlc.com/mapo/place/949+Florence+Rd.+Northampton.+MA HI1062/'n 42....
Go:; kg Maps 949 Florence Rd
1
i
a Coogle =; ',
Imagery C2021 MassGIS,Commonwealth of Massachusetts EOFA,Map data L2021 20 k
I oft II/292021.4:26 PM
-••VN 'ci's ,i 7 /49tP (
c A `1
marZiw5 _-2.1 5V0V lM 7-7 is (14,1V.: ,01 4-zln55=?eq 50 '4
::,,,A,\
1)9°3 ` , ., -)' snvQd h 7c 1.0 sig.tt o C
.l�� !i C
SQL i P
E s
'.1- ..? , 1 . \ \ \ ,
ems , r g
‘Qo�
d
--,_ Ir'X',,,‘,. i ! v%$\,, i-4,(Ti-St, 1
Ott- � 1419
-,�` � i
( - VI,J14113:A
41 G �v.
NNNN Q �' tt
55�,-�L Se he 'f A
5 � i n E)
`N
_g.-9 ki-v.t-f-C) ;-3, 0 -74,--8?...,
N:
949 Florence Rd-Google Maps Imps./M-nn.googk wMmaps/place/949+Florence+RA.+Nonhamplort+MA+01062/n J2...
Go g e Maps 949 Florence Rd
,, ter
i •
-;\ v
Google
Imagery C20]1 Manors.Ooavnonwea0h of Maon0005ena EOEA Map SI.L2021 20 n
1 I
I I/292021.4:27 PM
f7
'' Mgt ,: ..q"' :.*„ , ti ,k.z1 ',ty,t,„:‘ i,k,t.,'c ', f p y r x; J..�'' '
y 5
�, tea. a ,*Si J/ x W ,i:,_4//,-.4,,1.."‘..-:-'-,'4-:1'' •
A .-i'
.41
";r'<.
•
,,„/0 '47-44'':',„ ?':,,,,,:,..%,:';7:,..;..:—',„'"' ,..-1!.:'1','..,,,,,,"'",!,-;;;',,.:',U:::" r1;:'
47
'a,
;Art , ��n i, ��' a ,; • ,xw
•!'-.474-:-;,',4!/"W*94',,,--,,, ir2:4tft-tik'• ;f";17'''i". '', 7-"1:P4i,,'444:,''''14'. .,"•-2 4.!--s•r,.,..-4.44-- .,2,'.4*-,
t �, - fir,- �' ggei i -_
mow. 4 ' d, 0.