23A-292 (3) BP-2024-1130
180 NONOTUCK ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23A-292-001 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-2024-1130 PERMISSION IS HEREBY GRANTED TO:
Project# REPAIRS/UPGRADES 2024 Contractor: License:
Est. Cost: 6500
Const.Class: Exp.Date:
Use Group: Owner: BRIAN CANNING
Lot Size(sq.ft.)
Zoning: URB Applicant: BRIAN CANNING
Applicant Address Phone: insurance:
180 NONOTUCK ST
FLORENCE, MA 01062
ISSUED ON: 09/06/2024
TO PERFORM THE FOLLOWING WORK:
WIRING UPGRADES/REPAIRS, INSTALL FIRE BLOCKING
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: Fina I:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: ifie".7
•
Fees Paid: 575.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
�QED
The Commonwealth of Massachusetts U 2024
Board of Building Regulations and tarfdaf , OR
Massachusetts State Building Code, 786 v�1i2,;l��n,.., CIPALITY
g rN.c USE
Building Permit Application To Construct, Repair, Renovate Or I- - i 9hR°''8 Rev sed Mar 2011
One-or Two-Family Dwelling
� This Section For Official Use Only
Building Permit Number: ✓a'04 q- /j Date Applied:
11 ,J / Kpy, //i/C (1-10. zozq
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
180 Nonotuck St.Florence.MA 23A 293
1.1 a Is this an accepted street?yes X no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
URB 12109 231
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
(—Only completing interior work)
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 El On site disposal system 0
Check ifyes0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Brian Canning/Heidi Johnson Florence,MA 01062
Name(Print) City,State,ZIP
180 Nonotuck St 6033155659 bacanning@gmail.com
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building El Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2: Full rewiring of 2nd floor, 1st floor lighting, butlers pantry,and select basement
appliances(HR to panel). Install fire blocking btwn stories during wiring. Repair plaster&misc. minor repairs and
trim work as needed. Electrical(service upgrade to 200 amps(separate permit filed by electrician,Aaron T. Knapp).
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item 1atimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 2500 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2. Electrical $4 ;00 ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ n/a 2. Other Fees: $
4. Mechanical (HVAC) :> ira List:
5. Mechanical (Fire
$n/a Total All Fa
Suppression)
�-
Check Nc V` Check Amos, 1- Cash Amount:
6.Total Project Cost: 1 c 00 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(sec below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted I&2 Family Dwelling
City/Town,State,ZIP Iv1 Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
1 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
n/a
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 the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic 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.
Brian A.Canning 8/12/2024
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
I. 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(1-IIC)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.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
•" Massachusetts }._.
( • ; t�,•,� • � DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building C�
Northampton, MA 01060 rsjv.. ,�a
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJEC I S)
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: Casella Waste Services, 686 Main St, Holyoke, MA 01040
The debris will be transported by:
Name of Hauler: 413 Dumpsters
Signature of Applicant: N Date: .2S/2024
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
t ItT.
x". �5' •' .
Massachusetts ��,: �._ •.<<
• DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building '3�;•.._ =c*�
Northampton, MA 01060 sr 4 1%`�0
HOMEOWNERS'EXEMPTION ELIGIBILITY ATTI UA. IT
4ra0n s$7
I, Brian A. Canning (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 Iwnreowners'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 perjuny on this 29 day of August , 20 24.
(Signs re)
The Coimmton s'c'alth of Alassachusetts
Ili`—'_' -••-r�fil. Department ofIndustrial Accidents
_.15l_ 4 • 1 Congress Street, Suite 100
-•• ���= _ Boston, MA 02114-2017
'.,."` wwn mass.gov/dia
Vsurkers'Compensation Insurance Affida►it: Builders/ContractorslElectriciansIPlumbers.
TO BE FILED WITH'THE PERM l-fl\C AtJTHORIT%'.
Ahttlicant Infurura(ion ('lease Print 1.e!ihls
Name I Business Organization Individual): Brian A. Canning
Address: 180 Nonotuck St
City/State/Zip: Florence, MA 01062 Phone#: 603-315-5659 Y _
.arc you an employer?Cluck the appropriate Ibex:
Type of project(required):
1.0 I am a employer with . cmpluyres(full and'ur part-time).• 7. 0 New construction
1 am a sole proprietor or partnership and have no employees w inking for ere in g
any capacity.(No markers'comp.insurance reymnd.) �• Remodeling
1.0 I am a homeowner doing all work myself.[Nu workers'comp.insurance required"' 9 ❑ Demolition
4.12:11 am a hm caow net and will be hiring contractors to conduct all work on Ins property. 1 will 10 O Building addition
ernsum that all contractors eith:t have workers'cunip.-nsat sun insurance or are sole 1 i J Electrical repairs or additions
proprietor.w nth no ctnpluyees_
12.0 Plumbing repairs or additions
tom I a a general eunlraetur and I have hired the sub-contractors listed on the attached sheet 13 o Roof repairs
u nccse sub-contractors have employees and have workers':cane.insurance.:
6.0 We arc a corporatism and ib officers have exercised their ngbt of exemption per hitiL c. 14.®Other
152.§1(4),and we have no orrplo}real.[No workers'camp.insurance required.)
•Any applicant that chucks buss tr I must also till out the seetion below showing then workers'compensation policy information_
} t►un euworn.who submit this affidavit indicating they are doing all work and then hue outside contractors mint submit a new affidss it mdicuialc si..I.
:Contractors that check this tux must attached an additional sheet shins ing the name of die suls—eentractors and state w Nether to not those croon.,lass,e
employees. If the sub-contractors have employee*.they must prosude their workers'wino ;xdbcy number
I ant an employer that is providing workers'conmpensation insurance for nor employees. Beloit.i.s the policy and job site
information.
Insurance Company Name:—_—
folk}z or Self-ins.Lie.#: Expiration Date:
Job Site Address: - CityiiStateJZip: -
Attach a copy of the►sorkers'compensation polies declaration page(showing the policy number and expiration date).
Failure to secure coverage as i,yuiied under M(;L 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 DIA for insurance
coverage verification.
1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Srtm.iture. t 1).itc 8/29/2024
Phone c:. 6033155 c 591
Official use only. Do not write in this area,to be completed by city ur town official
('ity or Tossn: Permit:l.icense#�
Issuing Authority(circle mi.):
I. Board of health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
('intact Person: Phone At: