35-262 (5) BP-2024-1430
62 WEST PARSONS LN COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
35-262-001 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-2024-1430 PERMISSION IS HEREBY GRANTED TO:
Project# BASEMENT RENO 2024 Contractor: License:
Est.Cost: 35000
Const.Class: Exp.Date:
Use Group: Owner: W SMITH,SCOTT
Lot Size(sq.ft.)
Zoning: WSP Applicant: W SMITH,SCOTT
Applicant Address Phone: Insurance:
62 WEST PARSONS LN
FLORENCE, MA 01062
ISSUED ON: 11/04/2024
TO PERFORM THE FOLLOWING WORK:
ADDING CABINETS AND FULL BATHROOM TO BASEMENT
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Lnderground: 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: .�
Fees Paid: $263.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
^ _j { ,,,
-i1
The Commonwealth of Massachusetts 1
OR
: Board of Building Regulations and StandardsppT 2 9 2024 MUNICIPALITY
1 Massachusetts State Building Code, 780 CMR
; I USE
Building Permit Application To Construct, Repair Renovate:Or-H7elish-a__RevisedMar 2011
One-or Two-Family Dwel '`
This Section For Official Use Only
Buildin Permit Number:CP'.).'1 `/ 30 Date Applied:
ii _ 4? i-y•26Z
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
C 2 0- NA-.S-yns L'N / 0 1 ce
1.1a Is this an accepted street?yes J no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
2.5 NIP
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft) tv i A
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:
Zone: _ Outside Flood Zone?
Public 0 Private 0 Check if yes!: Municipal 0 On site disposal system 0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record; j_I o�,��c t' P 010(�
Sc. S wn;
Name(Print) City,State,ZIP cly e otJ i, C�•-N
6 Z \,.). ?neon S ►, 413-'d4 6-CS Zg 5 tr" r� eQ I
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building SI 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: Add'.n,N C.4aior 4e M b.:44-sr ) ' ic- }t.c
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ i I?,Oa 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ Z,9pq ❑Standard City/Town Application Fee
❑Total Project Cost3 (Item 6)x multiplier x
3. Plumbing $ 1 S,OXJ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $ 3,0a
Check No.51). Check AmountO Cash Amount:
6.Total Project Cost: $ 5 , 000 0 Paid in Full 0 Outstanding Balance Due:
5C...r t••rrttt. it-i
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
N/ r` 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
Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
NIA 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
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.
Sck4).s 1, ,Oattli/ u /4 -2G-2.y
Print Owner's or Authorized Agent's Name ,ectronic 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(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.) 4 ISb 544. (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 +1 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:
NlA
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
NIIMpJ�.
O a< F oy `S . . Si ..
Q7'�" Massachusetts A. c'e..,
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A I , . DEPARTMENT OF BUILDING INSPECTIONS y e
♦ /j4 212 Main Street • Municipal Building vti OD
,. aa" Northampton, MA 01060 �J','W 3,��1�`
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: vaIlc7 Rcy�i'"`) 'vO` '�'-lpt 0'1
The debris will be transported by:
Name of Hauler: O`_ylc,`_
Signature of Applicant: Airdor 71/11t,iti. Date: /O-Z6- Z
The Commonwealth of:tlassachusells
l 1,—�-,^ Department of Inthislriul Accidents
n
ll I 1 Nor-
1 Congress Street,Suite 100
`•=, ; Boston,MA 02114-2017
www.mass.gov/dia
wo %nutters'Compensation Insurance Affidavit:Builders/Coatractors/Ekctriciaus/I'lumhers.
1'O Kt:FILED V1 ITH THE rEnmr rING AI'`1'HORI'1'v.
Annlicant Information Please Print Leogihls
Name(13usinessOrganizatiomindividuaq: S<-044 Sv,:}l‘
Address: 62 0. Q4t-sus Lr,
City/State/Zip: 1r-^ MA QII0EZ Phone#: y 13 - 449 6- 5-S 2(1
Are you a0 employer?Check the appruprhatr hoar:
Type of project(required):
t.0 I am a employer with employees full and'ut part-time).* 7. O New construction
201 am a sole proprietor on partnership and have no employees working for roc in S. El Remodeling
any capacity.(Nu workers'comp.iteaurrnix required"
30 i am a loin wne r doing all work myself:(No workers'comp.insurance require tall'
9. 0 Demolition
o
4.®I am a Irocontractors eowncr and will be hiring to conduct all work on m op y property. I will 10 CI Building addition
assure that all contr'Jeturs either have workers'compensation uisurmce or are sole nciElectrical repairs or additions
proprietors with no cnrupluyv eu. 12.0 Plumbing repairs or additions
50 I am a general conuactor and I have hired the sub-contractors listed on the attached sheet.
These sub-contractors have employees and limy:workers'comp.insurance. ]3 Roof repairs
ts.EI We are a corporation and its officers have esencised their right of exemption per MCiL e. 14.0 Other
152,¢t(4).and we have no cttrployces.[No workers'comp.insurance requited"
"Any applicant that cheeks box Ill must also fell out the section below showing their workers'compensation policy information.
+Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities luaw e
employ cc>. It the sub-contractors have employees.they roust provide their workers"comp.policy nuntdvi
I um an employer that is providing workers'compensation insurance for my empluret.s. Below is the policy and jab site
infurmuliun.
In>tsraut e Company Name:
1'oliL-> or Self-ins.Lie.#: Expiration Date: -
Job 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 requited under MGL c. 152,§25A is a criminal violation punishable by a tine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 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.
I do hereby certify under the phis and penalties of perjury that the information provided above is true and correct.
Sitmature: . jji, Data: /ei "2 4 .-6Y�
Phone:=. 'f13 LP/6 652,9
Official use only. Do not write in this urea.to be completed by city or town of/h tat
('its or Tossn: Permit/License ;+
Issuing:tuthorit (circle one):
I. Board of Health 2.Building Department 3.('it)floss ii Clerk 4. Electrical Inspector 5. Plumbing Inspector
G.Other
(`ontact Person: Phone#:
City of Northampton
j 1."
�✓ °' Massachusetts
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4DEPARTMENT OF BUILDING INSPECTIONS S
212 Main Street • Municipal Building "ti a
Northampton, MA 01060 .rst`Y A,-s‘'c�'
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, StA L0.S rn i- - Ar,rn 09-4-/96 t (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. 1 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 Oc...d 'r , 20V.
AIP-941-W-jink-
(Signature)
4S h a1n
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•
(1, ]t ' Northampton Kevin Ross <kross@northamptonma.gov>
Building permit
2 messages
Kevin Ross <kross@northamptonma.gov> Fri, Nov 1, 2024 at 9:40 AM
To: "ssmith8094@aol.com" <ssmith8094@aol.com>
Hi Scott,
I am reviewing the permit application for adding a bathroom to a finished basement. I will need the dimensions of the new
bathroom before I can approve the permit application.The bathroom will need an exhaust fan per code.
Any questions, please let me know.
Thanks,
Kevin Ross
Building Commissioner
212 Main Street 587-1240
Northampton,MA 01060 Fax 587-1272
kross@northamptonma.gov
Scott Smith <ssmith8094@aol.com> Fri, Nov 1, 2024 at 10:50 AM
To: Kevin Ross <kross@northamptonma.gov>
Hi Kevin,
The dimensions are 10" x 10", there will be a fan installed by an electrician that will vent to the
exterior.
Scott Smith
62 W Parsons Lane
Florence, MA 01062
Cell 413-446-5529
[Quoted text hidden)