37-015 (8) BP-2024-0408
669 FLORENCE RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
37-015-001 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-2024-0408 PERMISSION IS HEREBY GRANTED TO:
Project# STEPS 2024 Contractor: License:
Est.Cost: 6400 RICHARD DENNO 066189
Const.Class: Exp.Date: 10/20/2025
Use Group: Owner: FX TOBIN INGRID F&WILLIAM
Lot Size (sq.ft.)
Zoning: SR Applicant: RICHARD DENNO
Applicant Address Phone: Insurance:
551 FLORENCE RD (413)531-0867
FLORENCE, MA 01062
ISSUED ON: 04/08/2024
TO PERFORM THE FOLLOWING WORK:
REMOVE CONCRETE STEPS AND REPLACE WITH 4X8 LANDING
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:
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
The Commonwealth of Massachusetts FOR
Board of Building Regulations and Standar ir
Massachusetts State Building Code,780 eMDo '8 2°24 I US ALITY
Building Permit Application To Construct,Repairl ReniyJe Or Demolish a ;Revised Mar 2011
One-or Two-Family Dwell ng T e f' ,<<r ,N!^. ,o:s
� Thi Section For Official Use Only " ""
Building Permit Number: '✓/21� ll'IP / Date Applied:
/ 1�0r5•5 ` Li-8'ZZ/.
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Prope ty Address: 1.2 Assessors Map&Parcel Numbers
469 P6rsOs zse la44
1.la 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❑ Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 n r'of Re rd•
ram. a(th cs6 co 2
Name(Print) City,State,ZIP
46f /Z6 shGt q4 S88 -6‘66
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK"(check all that apply)
New Construction ❑ Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2: lne, £X1.0 Ah Fib Al ADD/ Celt e.K h Sit?c
cj.1e W/ it x &' LAu1171.4
�J
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 4 4615, -02) I. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
❑Total Project Cost' (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) Total All Fees: $
Check No.)4.)4 Check Amoun : (16
6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due:
f
c
City of Northampton
LT„F
Massachusetts w •
C't{
DEPARTMENT OF BUILDING INSPECTIONS72,
212 Main Street • Municipal Building ti3y �b
Northampton, MA 01060 'j""� 46'0'�
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR WINDOWS,
DOORS, ROOFS,RENOVATIONS, ROOF MOUNTED SOLAR, ETC.
1. Building Permit Application signed by legal owner and filled out
by owner or authorized agent.
2. One set of plans and specifications of proposed work (Digital and hard copy).
3. Construction Debris Affidavit filled out and signed by applicant.
4. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance.
6. Energy Conservation Compliance Certificate (new/replacement windows).
7. Home owner's License Exemption Form (if applicable).
8. Note any Special Permit requirements (if applicable).
9. Energy Code —all new construction (Gut/Rehab) requires a HERS Rater Affidavit
10. Please provide the appropriate fee in the form of a check made payable to: The City of
Northampton.
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
D(o'r S 9 a z5
V� 9 License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) 1l
Sal
flrvhty iei
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
a✓y.i 1 Gs e u O 1 B 62 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
7eickoheit 11 L'Oh o�k SF Solid Fuel Burning Appliances
s3/--6 86, C o)tl to s 1<., Nv 9. I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 3 t/L 6
/LaA e6
lei Gk -Dt h h 6 HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
1=2d ,revry eildt
No.and Street Email address
r CiCn.r,cy rti/ss a/®6Z s /- o E 6`�
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 EK' No 0
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 ' 7 e 1 ID, )1 yt o
to act on my behalf,in all matters relative to work a ed by this building permit application.
1! T•o a a fop '/��,� ;, le-lard lQ2¢
Print Owner's Name(Electronic ignature) 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.
#./.0fre/ 4 Le 2..4
Prm w uthorized 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" `�'4`-tDe a 6
106
.)
The Commonwealth of Massachusetts
,
4 Department of Industrial Accidents
.1.1‘ 1 congress Street, Suite 100
Boston,MA 02114-201 7
www.inass.gov/dia
SI us kers' Compensation Insurance:Iliffidas it: Buildersit'ontractorstElectriciansfPlumbers.
It)BE t 11.ED‘11111 111E PERA111104; ta 1110R1
Applicant Information Please Print Legibls
Name(BasinessiOrganizationilndividual)! 1E2)_4i '13-e 11))a X4 e,
Address: F2 prom cl
City/StatelZip: 1-qoryo vi )4'1 esj Phone#: - a •
Ar. employer"Cheek the apprapriale hot: Type of project(required):
tin lam a employer with einpkqees(full andoor part-timet* 7, CI New construction
2.C3 am a sole proprietor or pirtnershm and hare no employee%working for me in 8. C3 Remodeling
any capacity [No workers'comp.nisurantie SVgattredl
9. 0 Demolition
30 lam a homeowner doing all work myself.[No vomiters'comp_Ifburance required.]'
10 Building addition
4.0I am a homeowner and will be farms contractors eil ounduct all work on my property. I will
ensure that all contractora either have worker. compensation utsUram'r We sole . I I a Electrical repairs or&Minions
proprietors with no employees_
12.0 Plumbing repairs or additions
SI am a semi al contractor and I have hired the xib-contrackus laited on the au:idled thee.
Di]Roof repairs
Theae sub-cuntraciors have employees and lhave workers'conc.rasurance.:
14..00ther (444
6ZSI/o'e are a corporation and in officers have exercised their risk of etemp4i4A1 per/t4GL 4:.
152,§104,and we have no employees.[No-workers'comp.insurance required.) Sjl?' / 4.r 9
*Any applicant that dwelt%box in must also fill out the section below showing their-workers'compensation poen),informaricn
+Homeowner who submit that atralitit unite:ming they an doing all wort and then lure ointide contnacroiN alien submit a new affiskiwit=fitments such.
Contraceors that check dna.box must attached an additional shed showing the name of the sub-cuittrieteirs and stale whether or not those entities have
employees. If the.uh-vontractors have etripluyee-h.they mum provide their worker. comp.policy number
I am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy•te or 'Self-ins.Lie.#: Expiration Date:
lob Site Address: City/State)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 MGL c. 152, §25A is a criminal violation punishable by a fine 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 of this statement may be forwarded to the Office of Investigations of the DR for insurance
coverage N-e n tication.
I do hereby ct?fi under the plAins and penalties of perjury that the information provided above is true and correct_
Signature: Date:
Phone' : S-3/ 0 ii4"7
Official use only. Do not write in this area,to be completed kv city or town official
City or Town: Permit/License#
Issuing Authority (circle one):
I. Board of Health 2. Building Department 3.City/Town Clerk 4. Ekctrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
_ City of Northampton
` °ti;, ' sic
•; Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS x
212 Main Street • Municipal Building
Northampton, MA 01060
amp
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: )Jq/l6, /;
The debris will be transported by:
Name of Hauler: )o UId /Yleti
Signature of Applicant: i Date: JJ /Z
City of Northampton
C' `rosy7�Sst
` Massachusetts °c't
DEPARTMENT OF BUILDING INSPECTIONS a
iti
� 212 Main Street • Municipal Building tOr-s D�
w - Northampton, MA 01060 1rt,W ‘'% .'
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, (insert full legal name), born _ (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. 1 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 , 20_.
(Signature)
3/25/14,6:28 PM Northampton MA,Web GIS
a• 669 FLORENCE RD
Search Results TOBIN INGRID F & WILLIAN
Parcel ID: 37 -015-001
parcel Details view Details
669 FLORENCE RD
661 '
18-00108
=. . 7 i
37-015- 1 it
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TOBIN INGRID F & WILLIAM FX
669 FLORENCE RD
FLORENCE, MA 01062 Li
Parcel ID: 37-015-001 37 70-0ii
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