35-070 (6) BP-2024-1365
900 RYAN RD COM M ONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
35-070-001 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-2024-1365 PERMISSION IS HEREBY GRANTED TO:
Project# PORCH 2024 Contractor: License:
Est.Cost: 6000
Const.Class: Exp.Date:
Use Group: Owner: POLLARD KRISTINE E
Lot Size (sq.ft.)
Zoning: WSP Applicant: POLLARD KRISTINE E
Applicant Address Phone: Insurance:,
PO BOX 94
WILLIAMSBURG, MA 01096
ISSUED ON: 10/18/2024
TO PERFORM THE FOLLOWING WORK:
REPLACE EXISTING FRONT PORCH
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:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: ./.<7
Fees Paid: $150.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
r`ti `
i/1767)(I C114,_ / i----------.C-k*-1 1>/,
IZ, The Commonwealth of Massachusetts 0Cj 1
Board of Building Regulations and Sta dards/, 6 20 iOR
Massachusetts State Building Code, 78 R,'/'o,., 2UNICIP 1TY
o,,>, Un.t I US
Building Permit Application To Construct, Repair, Renovate Or olts�l tp., ev sed ar 2011
One-or Two-Family Dwelling • '�"'c.;t;`''`� >
This Section For Official Use Only
Building Permit Number: -'... 5i— /. 6... Date Applied:
4U)/3 a,
// -z._
0_ 1 8-7424
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
900 Ryan Rd
1.la Is this an accepted street?yes x no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
resdiential 1/2 acre 60 ft
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 la Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Kristine Pollard Florence Ma 01062
Name(Print) City,State,ZIP
900 Ryan Road 413-961-9051 daxcat60@gmail.com
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building❑ Owner-Occupied la Repairs(s) CI Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work':repair and replace existing front porch
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $6,000 1. Building Permit Fee:$ Indicate how fee is determined:
2. Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All e
Check N . eck Amount: p Cash Amount:
6. Total Project Cost: $6,000 0 Paid in 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(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
City/Town,State,ZIP R Restricted 1&2 Family Dwelling
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 0 No .0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize Jesse Geary
to act on my behalf,in all matters relative to wor thorized by this building permit application.
Kristine Pollard 1 10/8/24
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER1 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.
Kristine Pollard 1c „ n4 10/8/24
Print Owner'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 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"
City of Northampton
�:tt tip
so..7 sirs
Massachusetts . ./e
tit
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
" Northampton, MA 01060 sp •_ \1,C`
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
Kristine Pollard (insert full legal name), born MAIM& 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 qualifiy 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 8th day o f October , 20�4
Kristine Pollard 1C '•.6(14
(Signatu re)
City of Northampton
*. Massachusetts•
(: DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street I Municipal Building
Northampton, MA 01060 J-P , .3,0C"'
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: Pioneer Valley recycling
The debris will be transported by:
Name of Hauler: Jesse Geary
Signature of Applicant: 16t.;b- Q ' Date:
/ 2In_onA ts; I.)N94i.)4-3 (-3(1%.012i--* 7, x.o‘-1 ik
�- - -- '-..,-
mad 0)1 U)3 z. )?)t)SS).16 hh k 11
/\ .
Q bov 1=P ,-A")3 c 0 3 A u ). 2)(1 3-i d 9 N4 ( —
W03a
k09 1---)N wvza O-3 i 21. 3 u nss ?ag q - 2
�)e� � Fk-.) v--9-1.>okn
13S ,.
/\, , 1.,,,;,,,, 1.pi3u19)
S3►4,1.S •
P
. 1.„.....\ '; Zi
Q f
} Q M
j r a
r "'
S 1,S�.j , i