38D-051 BP-2023-0585
41 WINTHROP ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38D-051-001 CITY OF NORTHAMPTON
Permit: Addition
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0585 PERMISSION IS HEREBY GRANTED TO:
Project# NEW GARGE 2023 Contractor: License:
Est. Cost: 80000 HANS DALHAUS 101628
Const.Class: Exp.Date: 11/17/2024
Use Group: Owner: LEVIN SUSAN B
Lot Size (sq.ft.)
Zoning: URB Applicant: DALHAUS CARPENTRY INC
Applicant Address Phone: Insurance:
11 CHERRY ST (413)977-6094
EASTHAMPTON, MA 01060
ISSUED ON: 05/16/2023
TO PERFORM THE FOLLOWING WORK:
BUILD NEW 1/2 GARGE AND RENO EXISTING GARAGE INTO STORAGE SPACE
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:
,AM
Fees Paid: $520.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
File #BP-2023-0585 2" 6 l�
APPLICANT/CONTACT PERSON:DALHAUS CARPENTRY INC
11 CHERRY ST EASTHAMPTON, MA 01060(413)977-6094
PROPERTY LOCATION 41 WINTHROP ST
MAP:LOT 38D-051-001 ZONE
THIS SECTION FOR OFFICIAL USE ON:.Y:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $520.00
Type of Construction: BUILD NEW 1/2 GARGE AND RENO EXISTING GARAGE INTO STORAGE
SPACE
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
Driveway Grade%
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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 Water Availability Sewer Availability
Septic Approval Board of Health Well Water P tability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission 'Permit DP Storm Water Management
Demolition Delay
j/.& S- I) 2025
Signature of Building Official ID ate
Note:Issuance of a Zoning permit does not relieve a applicant's burden o comply with all zoning
requirements and obtain all required permits from Board of Health,Co servation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standa i s of MGL 40A.Contact Office of
Planning&Development for more information.
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The Commonwealth of Massachusetts n T o� S /Board of Building Regulations and Standards ,o9r o FO "�
,#) Massachusetts State Building Code, 780 CMR ti ICIPALITY
Building Permit Application To Construct,Repair, Renovate Or Demolish a Rw'" , 1
One-or Two-Family Dwelling °so°'t's /
This Section For Official Use Only
Building Permit Number: )P•A ,3-;6 5 Date Applied:
i Rf 1 _sl 3
Building Official(Print Name) Signature / Da e
SECTION 1:SITE INFORMATION
1.1 Propertx Address:S\ 1.2 Assessors Map&Parcel Numbers
1.1a 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 ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
10 ' &O ' LA ' LI ' 9 ' to
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. Owner'of ed:.,
o •. LEA)
cor NY‘......) �a r .P � MA O't D-,-► ,'Y'\ ; 1 - (,C,
ame(Print) City,State,ZIP
41 \AYWCV\AVO f 1113 171 601q 50SA1AOltO,v;
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction le_ Existing Building 13 Owner-Occupied lift Repairs(s) Ili Alteration(s) 0 Addition 0
Demolition 1f Accessory Bldg. 0 Number of Units Other ❑ Specify:
Brief Descri tion o`f Proposed Work':a 'D�yt�2 O-�;er,�- : 1. y; a��„� v\e y. 1`�2 (tr
aJA1Loti. • sQlv..? v.,y t c ok tp,(,i riv - et‘,n\m� ' . (a LI r i _ y•.- `
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 10
( t 1. Building Permit Fee: $ IndicateFee how fee is determined:
2.Electrical $
0 Standard City/Town Application
b‘ Lfro 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:$1 A9
Check No. /171 Check Amount: 5 Cash Amount:
6.Total Project Cost: $ , (am) 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
' ` CS-fvi6d8 II ,i�aoal
- W rS , G'\6,v/ License Number Ekpiration Date
Name of CSL Holder
'' / S List CSL Type(see below) U
No.and Street Type Description
S� N' f n v/1 n D� U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 FamilyDwellin
ity/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
ii,s TI 1 (6 y .ihc\AC4loe1 e timiC,i l I Insulation
telephone Ema address D Demolition
5.2 Regi tered o�me Improvement Contractor(HIC) l p 4
-'G A. A,11 \G.kb HIC RegistrationCC Number E it ion Date
3_C Company Name or HIC Registrant Name
11 N S - 5f e a L a.,..A---
(�r ���1 Jvt i k 01 61-1 LIR 7-) 6 Oqq Email address
City/Town,State,ZIP Telephone 1
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 . sr 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 D,,l I 60, (4(
to act on my behalf,in all matters relative to work authorized by this building permit aaplication.
‘e,\.)‘NP----' S(7- '- _____
Pnnt er's Name)lectronic 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 e best of my knowledge and understanding.a
44A
Print Owner's or Authorized Agent's Name(E7ectr c ature) 1
g 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
i - �` Massachusetts ��+5 ' c'e`
1 t•�,�.` • DEPARTMENT OF BUILDING INSPECTIONS �' 4
cu
'�' 'r'� �.'if 212 Main Street • Municipal Building yv6 CD.
Northampton, MA 01060 I''kJ, WO\^°
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: ` alA,
The debris will be transported by:
Name of Hauler: )\-A, Q A\,J\V\,)
is
Signature of Applica t• - Date: S cl -�5
The Commonwealth of Massachusetts
11:91S Department of Industrial Accidents
�1= 1 Congress Street,Suite 100
Eli A
Boston.a19 02114-2017
www.mass.gor/dia
11 rakers'Compensation Insurance affidavit:Builders/('untractors'faertricht Plumbers.
10 Bt.t 11.1_D N II H I t1E PERMITI ING.11 111012111.
Applicant Infarmation Please Print Le-gilds
Name(BustrttessiOrganrzationlndivudurl):DG. l (;irfpi•A _._.
Address: �
City/State/Zip: � � set\ /oft Phone#: 4 I>
Are you so eayr yd!(.leek the appropriate boo:
Type of project(required):
t.❑I am a emplayra with- employees tfull and o part-tuna• sii i3 Ness construction
2.1 am a sok proprietor ur prtaaship and has:no curio)tam workure far me in Remodeling
any capacity.[No webers'temp.insurance. n4wrcd.[
30 I am a kruituwm duringall work myself.[No worker.'comp.'nominee:regwd]ra 9. IkmultUun
10 0 Building addition
4.Q I am a 6omniwner and will twit hiring emigration to conduct all soil un my pn.pt rty. I sill
maw that all eialitaelors ntlnt lase worker`compensation rn.uranec or arc sole I electrical repairs or additions
proprietors with nu employer..
12.0 Plumbing repairs or additions
50 I am a general eorra-wr and I tree hired the sab-s atrators lt.I.J on the rooked abaft.
These sab-cvnuxtun haw employers and have woheis'coop.trutirimor t 13 D Roof repairs
6.0 We are a colprareion and its officer,have pet raiscised astir meld of cecrrtpliaa t 61161.r. 14.❑(AO
152.t 1 f4).and we haww nu emtdnyees.(tdti wahcm'nary* tn.uran.e irgoired]
*Any applicant that checks has#1 most also fill out the sisintiun below.h.nsiag*stir weans'ro perwattuat polies inf.rnuation.
4 lhaucowncn who a ties attid It indicating tfkl are Joint all work and chits lire ortsrtlr.ontr..iuis mon submit a mew atftdJs rt erkheating stitch
(ontraeiurs that cheek this his must att..lwd an.atdettonal sh,xl.how tnE tli.name of the stsb,at ton. whether in not t1r..e cm-mite.has.:
cin ..pllees. It the Sub-I:utainatars lus.-erryrlos es.kites must pro..rdt:their worker Uernp..poll nuinh.7.
I ant un employer that is providing worLers'compensation insurance for my employees. Below is the policy and job site
information.
lst.ur.niee Company'Name:
Polley#or Sell-ins.Lie.rt: 1 3 n 8;y\ I.rpiration Date:S S-10/
Job Site Address: 4 I VJ i A+ (t `p � City State Zip: kook ` vcrl- 1 ,M 01 0 cal
Attach a copy of the workers'compensation policy dedlarsties pige(she%iag 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 S 1.500.00
andi'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 of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certily under t, y . and t, (perjury that the information provided abovet
is
true and correct.
Signature: 4 J ., a ` 1)aic. c/ c//
2
Phone t;: 4 t 2 i i ( O i 11
Official use only. Do not write in this area,to be completed by city or town official
( its or Town: Permiti l.ke■se#
Issuing.tuthority(circle one):
I.Board of Health 2.Building Department 3.('it v1 ioan Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
contact Person: Phone#: