31A-147 (9) BP-2022-0734
16 FORBES AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31A-147-001 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-2022-0734 PERMISSION IS HEREBY GRANTED TO:
Project# DECK RENO Contractor: License:
Est. Cost: 1 1 150
Const.Class: Exp.Date:
Use Group: Owner: GILBERT BORER, JEREMY& EMILY
Lot Size (sq.ft.)
Zoning: URB Applicant: GILBERT BORER,JEREMY&EMILY
Applicant Address Phone: Insurance:
16 FORBES AVE 917-328-1193
NORTHAMPTON, MA 01060
ISSUED ON:06/28/2022
TO PERFORM THE FOLLOWING WORK:
REMOVE EXISTING DECK AND REBUILD
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:
cs-
Fees Paid: $72.50
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
Z c.t ✓
File #BP-2022-0734 �7 /
APPLICANT/CONTACT PERSON:BORER, JEREMY &EMILY GILBERT
16 FORBES AVE NORTHAMPTON, MA 01060 917-328-1193
PROPERTY LOCATION 16 FORBES AVE
MAP:LOT 31A-147-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $72.50
Type of Construction: REMOVE EXISTING DECK AND REBUILD
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOfiWATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Penn it With Site Plan
MajorProject: 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 Perm its 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
//://-/ Z8-2022
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.
sZ, The Commonwealth of Massachusett
Board of Building Regulations and Stan ds JUN 2 OR
€ Massachusetts State Building Code, 780 2
CIP ITY
USE
USE
Building Permit Application To Construct,Repair,Ren to Ltf i d M 2011
One-or Two-Family Dwelling AM"TON,►S �osooNS
This Section For Official Use Only
Building Permit Number: 5°- Z — 7.3/ Date Applied:
4,„ .,. 4 /7/ :---- 6 08-zozz
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
16 c oik.tE.S A\tE. 31 P‘ 1,1
1.1 a Is this an accepted street?yes ✓ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
uM4. ii41A0
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
kS ` 1s` az' aa,
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private 0 Zone: _ Outside Flood Zone? Municipals(On site disposal system 0
Check if yesk ✓
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
3tiket4VI goRE& Isinikli ikiNVT 11 t MR pkobo
Name(Print) City,State,ZIP
16 fo•RrS putt_ q\1- -tl43 lc:Wm$44 Q GMP2t bra
-
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction 0 Existing Building tit Owner-Occupied iffk, Repairs(s) 0 Alteration(s)X Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2:
iktfo ►4+- 2tx,S,N+n a car dark. A1W sou e• s� i add. atik4o&( .46.1. , "Nu.)
�tclk.n.) 4- cad t .nett S S j c4�Mo.M V.i `^ CNifel Stkb..clCs.
.•ll SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ `L i \S 0 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$ ,60
Check No.l 46 Check Amount:f— Cash Amount:
6.Total Project Cost: S 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
P4( License Number Expiration Date
Name of CSL older
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
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
� HIC Registration Number Expiration Date
HIC Compann 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 yL No .❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,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.
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 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
* \•Qp`be- S/2-k C( I .C1\112.1 "
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
Rear Property Line-1,
16
Forbes
Ave. o
Deck st_k„Lk
Desigr
PAT I O
\S' Sck`°•.ck
i________)
Left DECK
Side LI
Property STAIRS
Line STAIR`- DX 5._ID&c L
l
BULK DECK
HEAD
r"------
SUNA.c HOUSE
` S°b`ss;
•
City of Northampton
,,„
} Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS OVer
"ate' r.,' 212 Main Street • Municipal Building
Northampton, MA 01060
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:
The debris will be transported by:
1\16
Name of Hauler: D S\f\-J \A 013kj
Signature of Applicant: Date: l�
The Commonwealth of Massachusetts
I'—� I Department of Industrial Accidents
;ire_ ; / Congress Street,Suite 100
•
Boston, MA 02114-2017
www.inass.gov/dia
%$utkers' ('ompensation Insurance AffidA%it: Builders('trntractor' Electricians/Plumbers.
I() FILED Willi I lik 1'F.RSIl i l I\(. \l 111OKI 11.
Applicant Information pD � Please Print Legality
Name Business a. ntrJ u on Indt%iduaIr. .3" s3^.gypp
Address: `o cto U ES
CitytState/Zip: D(---C\'krk TkRcb 1 MPr °\°` ° Phone#: `\l"1 - - AS
Are yuu an emptuyer?(bock tic eI a priale hot: type of project(required):
J.Q I am a employee with --- .esuplay:es(full aatd`ar pat-tiro)_' 7. O New construction
I am a sok prupntlor or partnership and have nu ernpknyemt working fur me in 8. D Remodeling
an%capacity.[Nu workers comp.insurance required"
0 m I am a huouwncr doing all work myself.[No workers'comp.rtasuranee required]" 9. ❑Demolition
10 Q Building addition
:' ant a homeowner and will be hiring cvntr�lurs to conduct all work on my propes ty_ I will
•rusurc that all c n raeturs either hate wurken'caermensatwn minnows:or are sole 110 Electrical repairs or addifen a
propnekn w ith no cmpluyees,
12.0 Plumbing repairs or additions
50 lam a getiaral contractor and I hale hued the sub-contractors listed on the attached shreet. {'�
These sub-contractors base employees and have workers'comp.insurance. 13 L J RooI r
6.0 We are a corperatiun and its officers base exercised their pike of exemption per Ak(rL c. 14 ()then �/�-(-F-
I ft2.51141.and we base no employees.[Nu workers'comp.insurance required.
'An)applicant that chocks box al must also till out the section below showing then worker.'compensation polio}nnfoxmatiuu.
t Fte-mi.rwnen who submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidas it indicating such.
:Contractors that check this hot must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
unplu.cc, It the sul, ., c e-urpluyccs.they onus pn' ids their wutters'emnp.ponies number
I am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and joh site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: CitytStatelZip:
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 tine up to S1,500.00
and or 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 oftht statement may be forwarded to the Office of Investigations of the DIA for insurance
cos crag*:verification
I do hereby cert. • itirrle'r the pain unit penalties ni perjury that the information provided uhuve is true and correct.
Si_maturc Date: aa-
P sons r.; ln✓ .bajt
Official use onto. Do nut write in this area.to be completed by city or town official
('ity or Town: PermitiLicense
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.( its 'l ussn(Teri. 4. l kut -kcal Inspector 5. I'Iutnbiu!_ Inspector
6.Other
('ontact Person: Phone#:
City of Northampton
rS H M TO S�5 , . 5,�.
�, Massachusetts ti� %
1.
DEPARTMENT OF BUILDING INSPECTIONS T
s
4dS i 212 Main Street • Municipal Building J,4-
,is
��
� ,. Northampton, MA 01060 f,
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I �'QQ' y \bocce (insert full legal name), born (insert month,
day, year), herebydepose anri 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.
Signed under the pains and penalties of perjury on this day of Sv NIL. ,20 .).?"
.ignati r
Deck build 7 x 15'
To be extended on from existing deck structure
Existing deck will be modified and inspected,reinforced as needed to accommodate new structure.
Footings include 18"sonotube,48"depth.
Installed every 4 to 6'depending on deck layout.
6x6 pt posts will sit in galvanized Simpson ties,anchored into footings.
Double 2 x 12 rim joist with 2 x 10 joists 16"on center.
Joist hangars installed on all joists.
Triple 2 x 12 beam will be installed over footings.
Solid blocking will be installed between joists along center of framework.
5/4 pt decking screwed down to deck surface.
4x4 posts between railings.
5/4 railing top with 2x4 frame to accommodate balusters
Stairs will include 2 x 12 pt stringers with decking to match
Railings will match deck.
Ada , '
3
,
,
Say Asa -'L.:.
tip m ,
J �1
t*I!, 4+'ii,.:,,,, 4 ,
•