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31A-090 BP-2024-0609 63 WASHINGTON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31A-I90-001 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-2024-0609 PERMISSION IS HEREBY GRANTED TO: Project# PORCH REPAIR 2024 Contractor: License: Est.Cost: 10000 SAMUEL TAYLOR 118933 Const.Class: Exp.Date:02/21/2027 Use Group: Owner: MACNEILL, FIONA &BRIDGET Lot Size(sq.ft.) Zoning: URB Applicant: SAMUEL TAYLOR Applicant Address Phone: insurance: 245 NORTH ST (413)588-7421 WC5-33S-B24Q42-013 NORTHAMPTON, MA 01060 ISSUED ON:05/16/2024 TO PERFORM THE FOLLOWING WORK: PORCH REPAIR 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 aECERIE[. , MAY 1 5 2024 IL, The Commonwealth of Masachy �SOF RUILDIN(;INSPECTIONS FO;, Board of Building Regulations d Stand_atxtslA'.tp-rnN.MAou6o CIP Massachusetts State Building Code, 780 CMR y� — NICIPALITY 1 USE Building Permit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling s Section For Official Use Only Building Permit Number: All-)'1 u Date Applied: 4..., a055 5-k-zoLy Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: A-- __ 1.2 Assessors Map&Parcel Numbers 1.la Is this an acceptid street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(it) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Wat p Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Dysposal System: Public il5 Private 0 Zone: Outside Flood ne? Municipal®/On site disposal system 0 Check if ye SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of--r-ttd:t41 l 1 AA b ID 6O £' rinir) City,State,ZIP� �L !"vim 1 - t!. ,.,o„ti �7�iQtw.bwXi 4 413—s t e — T Z)1 S(r��d ., M� No.and Street V Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check a that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: -- t �� -- $mac SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $10 0 o 1. Building Permit Fee: $ Indicate how fee is determined: f 0 Standard City/Town Application Fee 2. Electrical $ �� 0 Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ —f 2. Other Fees: $ 4. Mechanical (HVAC) $ .,----- List: 5. Mechanical (Fire $ `---/ Suppression) Total All Feesti- 6 Check No.aO Check Amount.. Cash Amount: 6.Total Project Cost: $ 10 00 0 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS (tgot 33 ,�� &G►-w�uw( 5 TQ• „ ( f License Number Expiration Dat Name of CSL Holder .2-4.K N List CSL Type(see below) No.and Street - Type�r� Description w�� 0 / t,'-iY Unrestricted(Buildings up to 35,000 cu.ft.) r v �� �� v C� — R Restricted 1&2 Family Dwelling City/Town,State,Z1 M Masonry RC Roofing Covering . WS Window and Siding ,�/� SF Solid Fuel Burning Appliances f3—S S ZI/ ,.w' on , I Insulation Telephone Email address it.ohtudf Okra"... Demolition 5.2 Registered Home Improvement Contractor(HIC) 210Zl S 210L( 4) HIC Registration Number E pirati Date HIC Company Namgor HIC Registrant Name 2 q-S /U� P a 4 - "..-- MA S "410, s-1 I Cc No.and Street C(O 60 f 3-S 0$-744 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 Issuan of the building permit. Signed Affidavit Attached? Yes No .O 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 Slotrre fr to act on my behalf,in all matters relative to work authorized by thbuilding ermit application. ,- s/it412.4- Print Owner's Na' )m (Electron 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. So-,..,...._ lega4 47 P 4i'/* Print Owner's or Authorizeent'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. I42A.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.Rov/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 1 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 SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton S J �''�' Massachusetts ��S` �'c�. : DEPARTMENT OF BUILDING INSPECTIONS 9 ` 212 Main Street • Municipal Building Jp ce Northampton, MA 01060 �sph, w7N^�` 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: V 0.l i ac-ifc) The debris will be transported by: Name of Hauler: —n"'` . W J Signature of Applicant: __-'`C Date: .S /yZ_CA • 31' 8' ,Y 6' 4' -` Joist @ 16 a: 3-2x1©Lrn Beu 6x6 pc, • _I_ e _ L' d !; U to'---.--- Plan View RK MILES GENERIC CUSTOMER 207 PORTLAND ST 04/09/24 Ref:Deck24100 MORRISVILLE Scale:3/16"= 1' (413)247-8300 1 T. • ;\1 • i ' j i 6' 10 3/4" i 1 E i L.A ' J. 1 " 1 1/4„ T BEAM BEAM POST POST LABEL LENGTH COUNT SPACING A 30' 9" 3 14' 7 3/4" Post spacing is measured center-to-center. Beam Layout RK MILES GENERIC CUSTOMER 207 PORTLAND ST 04/09/24 Ref:Deck24100 MORRISVILLE Scale: 1/4"= 1' (413)247-8300 i N l_; , p _ A B A r. Al' A A -. ,- '' .N IA C G D' • E r r E • LABEL LENGTH BEVELS LABEL LENGTH BEVELS A joist (11) 7' 7 1/2° I rim 30' 9" B Joist 7' 6 1/4" FO R45 J fascia 8' 1)45 2)0 C joist 6' 2 1/4" FO R45 J rim 7' 7 1/2" D joist 4' 10 1/4° FO R45 K rim 8' 10' 1)0 2)45 E joist (5) 3' 7 1/2" L rim 5' 9 1/2' 1)45 2)45 F joist 4' 5 1/4° FO R45 M rim 6' 4 1/4" 1)45 2)45 G joist 5' 9 1/4" FO R45 N rim 5' 9 1/2" 1)45 2)45 H joist 7' 1 1/4" FO R45 0 rim 7' 10' 1)45 2)0 I fascia 31' 1)45 2)45 P fascia 8' 1)0 2)45 P rim 7' 7 1/2" Cut List RK MILES GENERIC CUSTOMER 207 PORTLAND ST 04/09/24 Ref:Deck24100 MORRISVILLE Scale:3/16"=1' (413)247-8300 ./Trex SOiSF;C3scnde 33 Fowler Street Extension •Westfield, MA 01085• 877-462-6473 •413-572-2995 (z:.< .., ,,,..._ -,i;\ .. . (....„ , ......c ,., ( /....J AZ t‘ I ., .-- , I i 0., t•' . 1 -... t 1 1 *•:...$•'' -''^' ,9 ...-------)-- •-4- . { I f 1 \ , \ - c-22------ ‘.:,.. .) ... ... ________ • k i The Commonwealth of Massachusetts Department of Industrial Accidents 1 if Congress Street,Suite /00 11 a i t 4,,,,,,,. Boston, MA 021!!-I0l ivwWmass.gov/dia LI wikers' Compensation Insurance.1f1ida%it: Buildersi('ontractorsiElectriciansfPlutnbers. I'()Bk.F71-F.1)N I I II 1111. PF.R0I1 I I'IM,.lt 1-110R1 I'1. Applicant lulus illation ^�- / Please Print E.eQibls m Name 1KusincssOrgazauomIndntdual):_.--- ` ?.floc \(, Address: No J A- 0/b6 v C'ity/State iZip: -__-- ..__._...__-- Phone 9-I r— See— 7�I 11.•Z / kreyo an employer?('heckle the appnipriate box: Type of project(required): t.Iarn a employes with " emplmoces(full and or part•urn 1.• 7. D New construction 20 I am a suk proprietor or partnership and have nu employct,working for MC in 8. 0 Rcmodc1ing any capacity.(No workers'comp.insurance required.) 9. p Demolition ICJ I ant a Imrrratiwntr doing all work myself INo workers'i:uni insurance required J 10 0 Building addition 40 I ant a lions o%net and u ill he hiring ctrrrttaclor,to conduct all u otk on my progeny I t.i II ...mute that all cr•ntiachm either lri ile,:r t.riilVn.atton insomnia;is are sole i 1.0 E:lectrical repairs or additions ra upnc lori u ith no cmplo o ec. l_.0 Plumbing repairs or additions 50 I am a general contractor and I lac c hued the suh-.unit a.(u1i.listed on the attai.tii d,kiec1 These sub-contractorstn hat c employees aril!hat c uu n ;trim tke ':tri insurance. 13 jJ Roof repairs 14.0Othel 60 N e an:a corporation and it,officers hate exercised their right et etternptiun p.r SKit t ----- 152.*114).and we hats no employees.[No uurkc"'cutup.insiaance rcgoucii j R •Ant applicant that chats hose a l mint alto till out the section Kim ,how ing then u.i ..,',•.nlilperisatitin polio inforataticrri i 1104m::owners oho submit tins allidatii indicating they a1e doing.all t.oik and then Mir:outside soulra..•ter%must,uhnut a nen at:id<n it indicating such. ('untractu s that check this kitty must attached an addiuu:ial sheet.imu in?!:lie nanie c•t the sus•cuauacter,and state whether or no!Ilium:atlitic,hate e iiplw cc,. Itite sub-contractors hate ctrg'lutcrs.Ihicy niu.I ptotidc Inch corker. ....rip.poh.•; manner I am an employer that is providing workers•compensation insurance for my employees. Below is the polio.and job.site information. / � insurance Company Name: till Ge' ►N'l ,.Q _ 013 /1 Policy#or Self-ins.Lie.#: �C S 3 -a Z.* ,_- Expiration Date: `1 2 r 4- Job Site Address: -/-�--- _ ( ity State Zip 1p C'/1 44- oe Attach a copy of the workers'cotnpen. lion polies declaration page(showing the policy number and piratiun date). Failure to secure coverage as required under\l(il.e. 152. §25A is a criminal s tolation punishable by a tine up to S 1.500.0O and or one-year imprisonment.as ssdl as ciyi:penalties in the?hunt old STOP WORK ORDI.R and a line 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 cos crap:S eritication. 1 do hereby certify under pains and penalties of perjury tiwl the information provided above(is true and correct. Sit(iiattltte: i I)ate_ ©S /l417S1' Phone=. it:) Wt.? -SS 8 —2- J Official use only. Do not write in this area.to he completed by city or town official City or Town: Permit/License Ir Issuing Authority (circle one): I. Board of Health 2.Building Department 3.('it}A own Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone t!: ' ' WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY . .; Liberty Mutual. INSURANCE AR INFORMATION PAGE , 175 Berkeley Street Boston,MA 02116 `" Issued by LM INSURANCE CORPORATION 27243 Policy Number WC5-33S—B24Q4Z-013 Issuing Office 016C NEW BUSINESS NEW Issue Date 11-26-23 Account Number 3—B24Q4Z Sub Account 0000 1. Insured and Mailing Address SAMUEL TAYLOR RISK ID 001290816 25 EDWARDS SQUARE NORTHAMPTON,MA 01060 Status 01 — INDIVIDUAL Other workplaces not shown above: SEE ITEM 4. PREMIUM-EXTENSION OF INFORMATION PAGE 2. Policy Period:The policy period is from 11-21-2023 to 11-21-2024 12:01 A.M. standard time at the Insured's mailing address. 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE END WC 20 03 06B D. This policy includes these endorsements and schedules: SEE EXTENSION OF INFORMATION PAGE 4. Premium: The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Code Premium Basis Total Rate per$100 Estimated Annual Classifications Number Estimated Annual Remuneration of Remuneration Premium See Extension of Information Page Minimum Premium $ 500 (MA) Total Estimated Annual Premium $ 4,181 Premium will be billed ANNUAL Producer 0004-017316 BRESNAHAN INSURANCE AGENCY INC 100 WHITING FARMS RD HOLYOKE MA 01040 WC 00 00 01 A © 1987 National Council on Compensation Insurance,Inc. WC 00 00 01 B (CA) Ed. 07/01/2011 All Rights Reserved Page 1 of 1