The URL can be used to link to this page

43-065 (10) BP-2023-0932 56 DUNPHY DR COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 43-065-001 CITY OF NORTH PTON Permit: Acc Structure PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0932 PERMISSION IS HEREBY GRANTED TO: Project# GARAGE 2023 Contractor: License: Est. Cost: 10150 Const.Class: Exp.Date: Use Group: Owner: D KO L AMY Lot Size (sq.ft.) Zoning: WSP Applicant: D KOT L AMY Applicant Address Phone: Insurance: 56 DUNPHY DR FLORENCE, MA 01062 ISSUED ON: 07/24/2023 TO PERFORM THE FOLLOWING WORK: BUILD ONE CAR 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: 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: 41 A cfri'I • Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissii ner RECEIVED The Commonwealth of Massachusetts JUL1 2023 W Board of Building Regulations and Standards FOR mUNICIPA L ITY Massachusetts State Building Code, 780 CMR DEPT OF BUILDING INSP NS NORTHAMPT MA0 Building Permit Application To Construct, Repair, Renovate Cr Dema-tisn a w 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: ,. -- 3 93 Z Date Applied: VI eu►- `.Cosa �� 7 ZLI-Zoz3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro Address: 1.2 Assessors Map&Parcel Numbers 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 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❑ On site disposal system 0 Check ifyes❑ 2.1 Owner'of Record: A M o�.v., k t n re,„,L, , At, © to ja Name(Print) City, State,ZIP S'6 DVA lv) Or. y►3.9a3 -aScir 1 o.d k-zab0sevs.;l.e.,r,., No.and Street Telephone Email Address New Constructioryr Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition Cl Demolition 0 Accessory Bldg,IIi Number of Units Other 0 Specify: Brief Description of Proposed Work': 0 I t a�j e n,�X� --1-(3`�-'1w )Se a`4 3,— 40 c o-t -4{,,e rA c i'Vc-wet.7 Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ (0/0 6 1. Building Permit Fee: $ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ I O 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ ) Total All Fees:$ I t\ Suppression) Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 16 , t50 0 Paid in Full 0 Outstanding Balance Due: d,110-ex(..':-V Al6Z-It Sk., +1" (110ASI , 43+' 313g li ya3-- 717 - citd 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 I 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 ❑ No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of e subject hereby authorize to act on m be alf,in all tters lative to work authorized by this building permit application. .7/I c7 0 Print ner' Name(Electronic ign e) Date 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. A �n .De.�k, ► 6,1Vis-/a3 Print 0 er'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 ad 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 MAP: LOT: i / LOT SIZE: ti g x J 6 0 / REAR LOT DIMENSION: REAR YARD ' SIDE YARD ( � SIDE YARD folZa do � d 1.0 FRONT SETBACK 41 FRONTAGE 9 3 xi' r1c +' 7,poi^ <rips VI 21ce ja Q4 ," 7'IS 2/s s d'.p.) 9xf ,E x,,l, r ","1 h CA Af s/ C' 'ai.c w 1- os19 1-T1 O) 'et/9 ,e'Q� to rpS,` .91 o pce ) (VT 2C."40 .9 fc6 ,r-z7 -An ,,21 CA ,.v vitt 1_7 x .e 1 - ,hl 1 yy�/ I Lti , L , P i i City of Northampton a, M T :? Massachusetts kk? ___ '<< 4ifSt II DEPARTMENT OF BUILDING INSPECTIONS y � 212 Main Street • Municipal lding v a ae Northampton, MA 01060 SS111' 1^``C (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: Tor Uey 1'r,"-.kt,, The debris will be transported by: Name of Hauler: PtA Sri-4 G ( IA,I l, � Signature of Applicant: /, Date: Ile Commonwealth of iassachasetts k� Department of Industrial Accidents �WPM _ Congress.Street. Suite 100 "�'�_ Boston,1ii 02114-201" 4;'^r^r 1t'111r.dnaSS.gov.'dia 1%.ushers"Compensation Insurance Affidaait:Builder:'Contractors.Electricians,Plumber:. TO BE FILED Iani THE PERXIITILNGALTtHORIIF_ Applicant Information Please Print Leg bly Nance (Bu mess.Or anon lndinch a1): Adclte ,.: Citv,'`StateZip: Phone#: Are von ea employer'.t heck the appropriate box: Type of project(required): 1.O I arm a ampiovar with amplo;as:IYu1 oast or part-rise)' - ❑New tom-tr ctlon .II alma solepaoprirmr or parnwniap and have AO employee:'a•osking fox ma in S ID I+'..eulodehrte ai! !-piitiadtars'cam.avaaca revised.] 4. ❑Demolition 10[]Building addition ,>-- �.. •-. 11.0 Electrical repau:or addition. .........1.:... 12.E0 Plumbing repair:.or addition: 5.0 I amr a general contractoraodIheca lined the int-contractor.kited on the atta_had::area , Thane sub-cc*rruactor.ha+:a e tea.and fine nix ker.•comp. :moans' ]�.® �f iep.3Ilr: IIIIPPRWM Orh 5.0 We a a corporatocn and ir.officer;ha+.•a exarci:ad their right of anampnca par 3,1GGL c 14.® �WO 112, 114;I.and we ha:•a ao aaip:o:•ae:.[No worker..comp Lawrence reva ed: "Ater applicant that chadtsbox al mutt alto Eli ant the:action he ow;lowing their ambers'compeasat<onp+oliC1_ inlfotmaooa "Ham owner who smut this sf.da,at sdicatsaa they are doing ail work and than his outside cos/actor.mull:await anew affidacst sadicatiar;uc.'1 oatractors that check Ibis boa mast attached an additional sheet showias the name claw solreeeihartor:and state whether or dot those entt er ha•e emaplc3ee:. If the sub-extractors hare smpicr.oe:.they artist pro,.•tie their workers'comma polio*a3mhar I ant an ennplos'er that is providing workers'compensation insurance for my employes. Below is the policy andjob site information_ Insurance Cou3pany Name. — Polic±;=or Self-:,.Lic. _: EvuatronDate Job Site Address:_______ _City State Zip: Attach a copy of the workers' compen_ation policy declaration page tshoivsg the policy number and expiration date). Failure to secure co T erage a required cadet ` GI.. . 152.§25A is a apron non puni:liable bs a fine up to SI_500.00 and or one-vear rutpn:on ent. a,well a.civil penalties:altie:in the form of a STOP WORK ORDER and a fine of up to S250.00 a day aaam t the'isolator.A copy of rill- state;rent may be fonaarried to the Office of In.•eArgations of the DIA for i zurance coveiaee.-enfication. I do herebs° r . ,,'.•penalties ofpenjur*that the information provided abai r/i/s e cont ic IIPP J�J date JJJ / , 9' s'� / Official use only.. Do not*site in this area,soirecompleted by city or tour ttffcial C ity or Town: Permit License= Issuing Authority(circle one): 1.Board of Health 2.Building Department 3,City Town Clerk 4,Electrical Inspector c.Plumbing In:pector 6,Other Contact Persoaki, Phone=: City of Northampton Massachusetts �. '<< 4 � G DEPARTMENT OF BUILDING INSPECTIONS x \ ter. 212 Main Street • Municipal Building ti jji1.1 Northampton, MA 01060 ssbjy <‘\ I, A r Dct 'v I c I (insert full legal name), born 9/d! (insert month, day, year), hereby depose 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. Signed under the pains and penalties of perjury on this I S day of J�-/ , 20 c/ (Signatur