29-346 (6) BP-2022-0642
80 AUSTIN CIR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-346-001 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-2022-0642 PERMISSIONIS HEREBY GRANTED TO:
Project# add door Contractor: License:
Est. Cost: 10000 JDR BUILDERS 074104
Const.Class: Exp. Date:04/09/2024
Use Group: Owner: E DUVAL JENNA
Lot Size (sq.ft.)
Zoning: WSP Applicant: JDR BUILDERS
Applicant Address Phone: Insurance:
P O BOX 66 (413)665-7587 WC9024479
WHATELY, MA 01093
ISSUED ON:06/13/2022
TO PERFORM THE FOLLOWING WORK:
ADD EGRESS DOOR
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.
Signature: Q (PlaiT
V • x1
Fees Paid: $65.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
File #BP-2022-0642
APPLICANT/CONTACT PERSON:JDR BUILDERS
P 0 BOX 66 WHATELY, MA 01093(413)665-7587
PROPERTY LOCATION 80 AUSTIN CIR
MAP:LOT 29-346-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $65.00
Type of Construction: ADD EGRESS DOOR
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF TION 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 WaterAvailability 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
NIT L
6 I b 61/)3 2
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.
/I>,.W
The Commonwealth of MassachusettV '�.; �_,
Board of Building Regulations and Star}iards/ JUy �l'
Massachusetts State Building Code, 786 C � E
MR, MUN ALIT
Building Permit Application To Construct, Repair, Renovate s ' h a
Revis Mar 011
One-or Two-Family Dwelling "' ).:'1.,,,,,,.,
This Section For Official Use Only � ,, j, o..,
Building Permit Number: eP`43' 0 4DA Date Applied:
(941,/k i `4',1 i , ,..,, ,
roP,3/ P-
Building (Print rint Name)
I Signature ' i Date
SECTION 1:SITE INFORMATION
1.l�r pe ty Address.: 1.2 Assessors Map&Parcel Numbers
by S11/✓ C .
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq 11) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
A./1i A/iP r 14- 'VA 'Id `
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone?
PubligJEK Private 0 Check if yes❑ Municipal I 'On site disposal system 0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Ze. "DLNaS* F1OVence,Mfq O VC)IOa
Name(Print) City,State,ZIP
[!J CAkS\i'r1 Gam 413. 1‘-1.6706 dl>`v4latm0A avzo,Corn
No.and Street Telephone Email Addrbils
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition 42
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work':
at A S x i ,64£83 .>r 997-/G1 t 77)
wticis oY 6its> ^-4
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
Cl Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: /
6.Total Project Cost: $ Check No.5 U 4 4
heck Amount:'Li Cash Amount:
/z) �— 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) i0�� ,9
pJ RR Z41
J/3yv)e� F-o s License Number Expiration Date
Naiipof CSL Holder
l' List CSL Type(see below)
No.and S et Type Description
Nd, ` AAA • b' 046. U Unrestricted(Buildings up to 35,000 cu.ft.)
City/Town,State,ZIP R Restricted 1&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding _ _
y(3-Ili— �, p��u �1if S.(i-� SF Solid Fuel Burning Appliances
[ !! I Insulation
Telephone 4 Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) t8G( '�S�- 43))2-- �J tZ' � l0)e' H1C /Registration Number Expiration Date
HI a a a any Nam or HIC Registrant Name
d ( t>Y-
No.ancl StaF41Email address
City/Town,Safe,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? YesX. No 0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES
SFFOR
,BUILDING PERMIT
I,as Owner of the subject property,hereby authorize :fp v" 1T ) ki '
to act . behalf,in all matters relative to work authorized by this building permit application.
A‘w- Vii--i0CtO au)lollaa
Print • e(Electr is Signature) Date
SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
By enterin y name below,I hereby attest under the pains and penalties of perjury that all of the information
containe � this ication is true
p and accurate to the best of my knowledge and understanding.
/ -1�r` D Q-b SS 6-Z-�ZZ
Print Own s or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An wner 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"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
LIvi-
nr
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
Massachusetts `+•sS sGs/
``
(\tl
�z DEPARTMENT OF BUILDING INSPECTIONS �.
" IK ��
. r 212 Main Street • Municipal •
Building 9vk
Northampton, MA 01060 �sdn ('`�
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: id(? 1)eG G('
� �
The debris will be transported by:
Name of Hauler:
Signature of Applicant: Date:
, The Commonwealth of Massachusetts
rG_- : Department of industrial Accidents
�:0 y / enngres_s Street.Suite 100
of Boston, MA 02114-2017
h
•`.__ • `t4' wli i.ntwss..t'ot/dia
• 11toleers'('umpc satiun Insurance AlTidasit:BuildervContraetury`EleetriciansrPlunrbers.
110 BE.FILED W'Il1l'171E II:R% 111111 GAUTHORITY.
. nnlicant Information Please Print Legiblw
Name(Rusinccsss��E.)rginrmtioonIndi'.idual): J])t2_ 1)L4 (.Ie 5 .s'''w-
Address: /d 6,9t `4S` ---
City/State/Zip JA i L 6, + - '" F3 Phone#: 3 74 - 71 g 3
Are yaw so employer?(tent Ow appropriate boa:
Typp w Iw of project(required):
Ii rg l ant a ealoyan,with 6,/ cnttplo'ees liu➢l and or part-trine l.' 7. O New construction
20 I ant a sok prupnctaar or par[nenttap and ha1.'MI entplo)cc,narking tut me On N. Q Rem,tuletina
any capacity-(Nu wurkcrs':Lnnp.uur..um.i naval cal
9. ❑Demolition
I ant a Iuna n uv r drain'all Hurl anyxl1.tNo noriers'comp.itt,uraace n carol i
10 Ca Building addition
4.0 l ant a hon,.,o m.-r and,w ill be hinny oindra.'tun i +,.a to.induct all le nitnth mown,_ 1%ill
emote that all contractors either lta'c'Aort:is l-K.Mnpcn.,:in nt insist-mit:or are sole 11.0 Ekcinurl repairs or additions
prupncton with n,employees.
12.0 Plumbing repairs or additions
5O i ant a general contractor and I have hired the contractors hated un Else ana.tt d,liar- I 3j—[Roof repairs
Thew nabcuntracton,have eanplu)�ces and have*others'comp.insurance. L
I4.Q Other
6.D N c an a coar,eanon and its officers have efun�xd'beta nght of currgptatn pet MC&c.
I51.v➢i 41.and a,c Julie no atrpluy sea.[Nita wurtainn'cornp.innueance required.f
'Arty applit.aatl that checks lit.1 in&t alms till out iih. '.+etum bcluw'lox inc:thcat r urk.zs.:onrpcnnataun policy infunnatitan.
+Iknnn'.mi:,.who subnnm this atfatkrsit itch aline cloy arcduing all work and then hut:outside:nntru:tunnand submit a news atlulae it aladicanng such.
;Contractors that click the Lvov anus[allaclw{I an additional hitch shot,inc the naive ut flue su crntr-a:tun and,talc ahcther ut not those ottaucs has:
nnployces. It the subcontraclaas have Onlalovecs.the}mint pro,ide their workers'.nnnp.tault:y number_
1 am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information.
Insurance Company Name: fil e{ 1'" - l nS GP ,
Policy ii or Self-ins.Lie.#: W ( + C)b Z / / 7 7 Expiration Date: 1'0/ Oki
Job Site Address: 5-105141) t.-/i2 C4 Cityr'Stat&'Zip: 1-10444/ -
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under M iL e. 152,§25A is a criminal violation punishabk by a tine up to SI,500.00
andior 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 for++aided to the Office of Investigations of the 1)IA for insurance
coverage verification.
1 do hereby certifi'under pains. penalties ofperjury that the information provided above is true and correct
St_nature: r��C
7. 2-
/ 1) 1 : Z�> . 2
Pisan 11l 5- 3 7 i/. /c 5
Official use onl➢. Do not write in this area,to be completed by city or town official
City or few n: I'ermiti'License t
Issuing:tu[hurl ty (circle one):
1. Board of Health 2.Building Department 3.City aims Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
JDR Builders Inc.
80 Austin Circle, Florence, Ma.
Jenna Duval- Owner
72.0000
87.0000
New finish grade
Basement Floor _ Current finish grade 48.0000
60.0000
9.0600