31A-013 (2) BP-2024-0959
231 ELM ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31A-013-001 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-2024-0959 PERMISSION IS HEREBY GRANTED TO:
Project# PORCH REPAIRS 2024 Contractor: License:
Est. Cost: 5700 EDWARD RICKEY 96159
Const.Class: Exp.Date: 07/13/2026
Use Group: Owner: MOGGIO MARK A
Lot Size(sq.ft.)
Zoning: URB Applicant: EDWARD RICKEY& COMPANY
Applicant Address Phone: Insurance:
80 SOUTH ST (413)695-7059
CHESTERFIELD , MA 01012
ISSUED ON: 08/01/2024
TO PERFORM THE FOLLOWING WORK:
PORCH REPAIRS
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. j�
Signature: !�/�[.—.-
Fees Paid: $125.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
-K o f l gads. ,yam.
The Commonwealth of Massa u� is ,Q
Office of Public Safety and Insp ?2.9
Massachusetts State Building Code(780 '0,94,
Building Permit Application for any Building other than a On Family •
.
(This Section For Official Use Only)
Building Permit Number. '1 9%51 Date Applied: Building Official: �o`DNS
SECTION 1:LOCATION
a31 Ft.,St ,IAA 01640
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used Y If New Construction check here 0 or check all that apply in the two rows below
Existing Building 0 Repair 5/ Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use ❑ Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No Ite-
Is an Independent Structural Engineering Peer Review regpired? Yes
Brief Descriptioq of Froposed Work "Rt.dista. Ceim1A* e .
t M L J)�L�AIh� C JGOW . �dtd�- r
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft)
Total Area(sq.ft)and Total Height(ft)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5❑ B: Business 0 E Educational 0
F: Factory F-1 0 F2 0 H: High Hazard H-1 ❑ H-2 0 H-3 0 H-4 0 H-S 0
I: Institutional I-1 ❑ 1-2❑ 1-3❑ 1-4❑ M: Mercantile 0 R: Residential R-1❑ R-2 Be R-3 0 R-4 0
S: Storage S-1❑ S-2❑ U: Utility 0 Special Use❑and please describe below:
Special Use Description:
SECTION&CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB ❑ IIA ❑ IIB ❑ MA I11B0 IV VA VBJ
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Sup ly: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal:
/ A trench will not be Licensed Disposal Site Di
Check if outside Flood Zone 0 Indicate municipal a required 0 or trench or specify:
Private 0 or indentify Zone: or on site system❑
permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic( omrnission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No$
SECTION&CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
City of Northampton
,1a44. --
�: Massachusetts {r .1. ''
T w,
.14 DEPARTMENT OF BUILDING INSPECTIONS 7? n
212 Main street • Municipal Building 1:� ^b�
Northampton, MA 01060 rsh � �
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR COMMERCIAL &
MULTI-FAMILY NEW CONSTRUCTION/ADDITIONS/ALTERATIONS
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 & Hard copy).
3. Site Plan with location of proposed structure(s) and setbacks.
4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
6. Contractors must supply a copy of CSL and proof of Liability Insurance.
7. Energy Conservation Compliance Certificate (if applicable).
8. Note any Conservation and/or Special Permit requirements (if applicable).
9. Driveway Permit (if applicable).
10. Proof of Water and Sewer entry fees paid (if applicable).
11.Trench Permit (if applicable).
12. Initial Construction Control Documents filled out and signed by the Registered Design
Professional in responsible charge.
13. Please provide the appropriate fee in the form of a check made payable to: The City of
Northampton
. SECTION g PROPERTY OWNER AUTHORIZATION
' Name and Address of Property Owner
7Yla 44. Th ' y5 44 At, ?fl 4
Name(Print) No.and S City/ own Zip
Property Owner Contact Information:
Ow?.... y13 -32e- 17tO -
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the Property owner hereby authorizes:
Cd4,404, 2o ,gout" • ciuur t d won.Na me Street Address City/To n State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft of enclosed space and/or not under Construction Control then check here D.
Otherwise provides osc+:ru,:trs.n.ss-)tt. 1 tG>rrnss see section 107 in the code as .uired.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
ettuett,G 724 d 6-
Company Name . I
4IWikdt. CS -014t0 CSI.
Name of Person Responsible for Construction License No. and Type if Applicable
$o Saint. ,8* inA 01012.
Street Address Ci /Town State Zip
_ yi3 -69S- 700 gr 7d21113764 r1ckcyIoracintprov clt7S ' .
Telephone No.(business) Telephone No.(cell) a-mail ad'dress 011,17
SECTION 11:W'>RF F i., (OMIT N',AT1ON IV-RAN(I-AFEii>AN IT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit
Is a sipped Affidavit submitted with this application? Yes 0 No Cl
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ 5 Z00.de
� Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)_$ .
3.Plumbing $ 1
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ 51700. °a (contact municipality)and write check number here 3( k
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
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.
emiumAe.A. 9yt3- 6tS las1 7•.2?~.2
Please print and signname Title Telephone No. Date
g0 Ae.a,..0 744 010/P. rickAlketsmsityrovomen4 4.
Street Address City own State Zip Email Address 1
Municipal Inspector to fill out this section upon application approval: //& 8-1-2Oziy
Name Date
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
• • REAR LOT DIMENSION:
REAR YARD
•
• SIDE YARD •. . " SIDE YARD
•
FRONT SETBACK
FRONTAGE
City of Northampton
+/,"F - ,,s , sic
rl / Massachusetts �� .._ '{
• w ,t
-,i_ t DEPARTMENT OF BUILDING INSPECTIONS y t
f ,•• 212 Main Street • Municipal Building ti ,,e
Northampton, MA 01060 -SNy, 3'3 X*.‘�`
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 / 1 • M4 Ci C
The debris will be transported by:
Name of Hauler: �a cAou2 tJ7
Signature of Applicant: Date: 7-427-o?$V
. The Commonwealth of Massachusetts
t Department of Industrial.-ccidenA
Ii _ � ; I Congress Street.Suite 100
.. _•l:!= r Boston. MA 02114-2017
�`' www.mass.gor/dio
11urkers'('ontpensatiun Insurance Atlidasit:Builders+('ontractors Electricians Plumbers.
itl1HF.FILED NIID1HEPkR t1FtlM:Al'1 oast-1.
Applicant Information _ x_J //�_,/- /` Ileum. Print t ills
Name(Business.Organization Inds'dual)- t -
Address: 90 %
City/State/Zip: i fl2'4 010/Z Phone tt: 41/3 `6 95— 7067
.arc yam am.Mayen(lank tke aNtarpelwrttra: Ts pr of project(rrgetired):
1 E3 I am a cock".with _____ --,employees(lull and or pat-tins:L• 7. CI Ness .onstr ucttc►n
20 i am a wile pn pti tar or partnership and hair ISO empkrycaa working for me in K. Remodeling
ant carmen..(No wirier.'comp.ueananor requited]
1O I am a homeowner doing all work myself.geo workers'comp_insurance tt'qurhd-I' 9' Demolition
i.0 I am a homeowner soil*AI be)less ommataas to c endrey all work- mat prop i! I will 10 CI glllldlrl}!addition_a trwn that all.impactor.either hair woeitm'c.Mapenuat►un unurance or are sole 1 i.l Electrical repairs or additions
ptuprxtoca*eh no cturillowen.
i2.0Plumbing repairs or additions
s.0 I am a ia'aeral contractor and I hale hued the rub-corns ac&Ns laced on the attadwd sheet_These130Roof repairs.
N �siors haft employees hat a workers molar stretanacC
h.Q We e a a coipudtimn and its officers hash exercised their nett of cu.-moron per WILL c. I4. Otter
152.f N4l<and we tract no at4rt. ar*.U o workers'camp raor.1ew l
*Any applicant that cheeks bun al mint also fill out the section below showing their warty**comperealion policy ittforrutiew.
•Hammciow nets who autinut thud affidavit indicating rakes are doing all work and then hue outatdc contractor.must autsuit a new attidat it nmdioa*ig au:tt`
1Corutrctcm that check this box must attached an additional sheet show inc the name of the sob-contractors and state whether or not thine entities have
c7 toi ear II lie*A.contractor.haw curio. .tb.%Hint rw.ak t4x-.. wuri..-4 .0171r rav:x-+ntxri T
I am an employer that is providing worllers'compensation insurance for m►'employees. Below is the policy and job.site
information.
Inw ram e('.rnipany \atfti • —
Pulse)z ur Sell-ins.Lie.#: l:spurauon Date:
Job Site Address: ("Rh State Zip:_ -
Attach a copy of the tsorkers'compensation policy declaration page(Ikon ing the policy number and expiration date).
Failure to se star can crap:as required under MGI.c. 152.925A es a criminal s'illation punishable by a fine up to 5 l.500.00
andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fink of up to S250.00 a
day agamst the stotatcx_A copy of this statetttcnt may be forwarded to the Office.of Intestigattuns of the DIA for Immo/ar-e
eo%erdge 1 ertrkatton.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct
Si t:►[cuc_ r Rite `L 4 ,f, �07)1
Phone /13.6 S` 70 7 I
Official use only. Do not write in this urea.to be completed by city or town official
( its or l ass n: Permitllicense I
Issuing.%uthorits Icircic ouch:
I. Board of health 2. Buildinu Department 3.City/Tenn Clerk 4.Electrical inspector 5. Plumbintt Inspector
6.Other
( (intact Person: Phone 4:
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
6 \ for work per the ninth edition of the
'• ►¢4` Massachusetts State Building Code, 7S0 CMR, Section 10:
Project Title: Date:
Property Address:
Project: Check (x) one or both as applicable: New construction Existing Construction
Project description:
I MA Registration Number: Expiration date: ,am a registered design professional, and I have
prepared or directly supervised the preparation of all design plans.computations and specifications concerning::
Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information, and belief such plans,
computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780
CMR), and accepted engineering practices for the proposed project I understand and agree that I (or my
designee) shall perform the necessary professional services and be present on the construction site on a regular
and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 760 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the
progress and quality of the work and to determine if the work is being performed in a manner consistent
with the approved construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments.in a form acceptable to the building official.
Upon completion of the work,I shall submit to the building official a`Final Construction Control Document'.
Enter in the space to the right a "wet" or
electronic signature and seal:
Phone number: Email:
Build ixg Official Use Only
Building Official Name: Permit No.: Date:
Note L Indicate with an"x'project design plans,connputat.ons and s,ecificat_ons that you prepared or directly supervised If'other'is
chosen,provide a description
Version 01 01 201S
Appendix 1
Construction Documents are required for structures that must comply with 780 CMR 107. The
checklist below is a compilation of the documents that may be required. The applicant shall fill out
the checklist and provide the contact information of the registered professionals responsible for the
documents. This appendix is to be submitted with the building permit application.
Checklist for Construction Documents*
Mark"x"where applicable
No. Item Submitted Incomplete Not Required
1 Architectural
2 Foundation
3 Structural
4 Fire Suppression
5 Fire Alarm(may require repeaters)
6 HVAC
7 Electrical
8 Plumbing(include local connections)
9 Gas(Natural,Propane,Medical or other)
10 Surveyed Site Plan(Utilities,Wetland,etc.)
11 Specifications
12 Structural Peer Review
13 Structural Tests&Inspections Program
14 Fire Protection Narrative Report
15 Existing Building Survey/Investigation
16 Energy Conservation Report
17 Architectural Access Review(521 CMR)
18 Workers Compensation Insurance
19 Hazardous Material Mitigation Documentation
20 Other(Specify)
21 Other(Specify)
22 Other(Specify)
*Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified
must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the
authority having jurisdiction.
Registered Professional Contact Information
-
Name(Registrant) Telephone No. e-mail address
Registration Number
Street Address City/Town State Zip Discipline Expiration Date
Name(Registrant) Telephone No. e-mail address
Registration Number
Street Address City/Town State Zip Discipline Expiration Date
Name(Registrant) Telephone No. e-mail address
Registration Number
Street Address City/Town State Zip Discipline Expiration Date
Please follow this link for construction control forms to be used by Registered Design Professionals.
117 Commonwealth of Massachusetts Construction Supervisor
Division of Occupational Licensure Unrestricted-Buildings of any use group which contain less than
Board of Building Resulations and Standards 35,000 cubic feet(991 cubic meters)of enclosed space.
ConskEkton Sap rvllsor
CS-096159 spires:07/13/2026
EDWARD J RICKEY
80 SOUTH SEET
CHESTERFI MA 01012
?_ O
r1., o
i.LVAP' Failure to possess a current edition of the Massachusetts State
Building Code Is cause for revocation of this license.
Commissioner C .)-.Z',#r — Contact OPSI:(617)727-3200 or visit www.mass.govldpllopsl
CONSTRUCTION CONTROL WAIVER
From:
70eile-7 / 6,
To:
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, I request that you
grant a modification to waive the requirement for construction control of the project at
0 3/ gem, 2 L — , 774 0;06 (3
because the work is of a minor nature,will not structural elements, health, accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,