38D-044 (6) BP-2024-1418
28 HARLOW AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38D-044-001 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-2024-1418 PERMISSION IS HEREBY GRANTED TO:
Project# WINDOWS 2024 Contractor: License:
Est.Cost: 5000 AAREN HAWLEY 098625
Const.Class: Exp.Date: 02/09/2026
Use Group: Owner: LOCK, ROBERT W. & ROXANNE A.
Lot Size (sq.ft.)
Zoning: URB Applicant: AAREN'S HOME IMPROVEMENT
Applicant Address Phone: Insurance:
PO BOX 5 (413)563-2985 UB-5R85561 1
HUNTINGTON, MA 01050
ISSUED ON: 11/12/2024
TO PERFORM THE FOLLOWING WORK:
ADD WINDOWS TO SUN 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: 172-
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
RECEIVED
The Commonwealth of Massachusetts OCT 2 Q 2024
Board of Building Regulations and Standards FOR
_MUNIC IPALITY
Massachusetts State Building Code, 80 O T nU ,No Tr,c INSPEC ions SE
Building Permit Application To Construct,Repair, o ' A 01060Ro»;no ar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: ifjI ea Ph/ Date Applied:
Weti,* �� /i� 11- IZ-Z,Zq
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
ae mac.,-iow A'-
1.1 a Is this an accepted street?yes K. no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Ro3b.'e 440c4. AA''s ,i4- $414
Name(Print) A City,State,ZIP
42J /4." l01 TVL 6/7 5"7/ 4.2oY /ocI. C4'?
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building 0 Owner-Occupied ❑ Repairs(s) 0 Alteration(s) Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2: +2,i A,/ /!ee✓ "Tell," 'f it.dkobes.0/In .f✓mot f'c',
DU�:�ud(o..✓s •s is/ .•3/)
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ Oa 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 7 ❑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 Fees:$
6.Total Project Cost: $ Check No.j 3 r I Check Amount: Cash Amount:
�f 0 17� 0 Paid in Full 0 Outstanding Balance Due:
S - -
City of Northampton
't Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building �Jk•., �, �'�
�. Northampton, MA 01060
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES,
FENCES, GROUND MOUNTED SOLAR, ETC.
I. 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 and hard copy)
3. Site plan with location of proposed structure(s) and set backs.
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 CS License. HIC Registration and proof of Liability Insurance.
7. Energy Conservation Compliance Certificate (new/ replacement windows).
8. Home Owner's License Exemption Form filled out and signed by Homeowner (if applicable).
9. Note any Conservation and/or special permit requirements (if applicable). 10.
Driveway Permit (if applicable).
11. Proof of Water and Sewer entry fees paid (if applicable).
12. Trench Permit - public land by DPW / private land by Building Dept.
13. Stretch Energy Code - all new construction will require a HERS Rater Affidavit to be submitted with permit
application before issuance of permit.
14. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton.
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
ei f License Number Expiration Date
Name of CSL Holder Do P X List CSL Type(see below)
No.and Street Type Description
,L44 / �32,� a iyS U Unrestricted(Buildings up to 35,000 cu.ft.)
Z'r'S�jP/"' �-�'V Restricted 1&2 Family Dwelling
City/Town,State, M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
eil3 -6 3 7d GaJ e-i m a,ck_hw.?te ant I Insulation
Telephone Email address CD.M D Demolition
5.2 Re istered Home Improvement Contractor(HIC) Piff
oZs-
HIC Registration Number Expire on Date
HIC Company Name or HIC Registrant Na
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 No ❑
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.
Print Owner's or Authorized Age 's Name(Electronic Signature) ate
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
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
,
City of Northampton
?o.-..., .'tip s:� - :r ,
y'r Massachusetts w_
w
i :f, p r DEPARTMENT OF BUILDING INSPECTIONS r, `r,..1
'S-' +�,`° 212 Main Street • Municipal Building �_ �,
Northampton, MA 01060 rs.rh .;.-?\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: 64--//-�-i gec7•c2
The debris will be transported by:
Name of Hauler: 4—/l.1
Signature of Applicant: Date: !o A-0 r
The Commonwealth of Massachusetts
Department of Industrial Accidents
-' 1 Congress Street,Suite 100
'' Boston, MA 0211 d-2017
-r, www mass.gor/dia
11 orkers'Compensation Insurance.tffidat it:Builders/ContractorsfElectricianstPlunrbers.
10 BE FILED s11 I ti 111E Pt:1011 1 11NC AI:"1 IIORI I1.
Applicant Information Please Print Lei ibis
Name 1 Business,.(hgattir.attan'Ittdtvtduall: .(itS fr�t�..Q ""ice
Address: TO h 4 5
City/State/Zip: vn d 1-4 Pk 4't D/"Sb Phone P: `7r13 S?o 3 7�S
Are you an employer?Cheek the appropriate dos:
Type of project( aired):
l lama employer with 3 employees t lull motor part-time).* 7. CI New colts -lion
20 1 am a sole proprietor or partnership and have nu employers working for me in S. 0 Remodeling
any capacity [No workers'comp.insurance requiem.)
1.0I am a hu ancr doing all work.myself.[No workers'roar.insurance yet umd.l'
9. El Demolition
mew
10 O Building ad ition
�.a 1 am a hurttwwncr and will be hiring contraoors to conduct all work on my property. 1 will
ensue that all rontrs:tors either have workers'compensation insurance car are sole i i. Electrical refairs or addition,
propnetsxs with no employtes- 12.0— Plumbing r irs or additions
so 5O I am a general contractor and I have bred the sub-contractors listed on the attached shell i 3J i Roof repairs
w
Ttrese sub-cunvtnrs Kist cmpluyres w and have uhcrs emir.insurance.:
LJ
6.0 we arc u cortwef.ion and it`,officers have exercised then nght of exemption pet MCA.c 14.��.Other dxJ 4,s4..),
152.y§'144).and we have no employees.!No worker'comp.insurancereguired.l
'Any applicant that chocks box a1 must also till out the section below showing their workers.'cuntpensahon pulley information.
{ihmtetlwners who submit this affidavit indicating they are doing all work and then hire outside contractors must suhttut a new affidavit indicating such.
Contractors that check this box trust attached an additional sheet showing the name of the subcontractors and state Y.helper or not those entities last
employees lithe sub-corm-actors hive eatploytes.they oust provide their workers'comp.pulley number.
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
insurance Company Name:
Policy#or Self-ins.
�c.Lic.#: GG ZC() g—_S"/Z�'-$�"{p/— /-. xpiration Date:
Job Site Address: oc-I /low )*t-/ City/State/Zip: ,''!R D/D‘,d
Attach a copy of the workers'compensation policy declaration page(showing the policy number and iration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a line u to S 1.500.(X)
and/or one-year imprisonment.as well as civil penalties in the font.of a STOP WORK ORDER and u tine 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.
I do hereby certify and a pains and penalties of perjury that the information provided above Is true and correct.
Signature: Date: Q/oZ_3 ( r
Phone#: `7'I) i4 ' '2-
Official use only. Do not write in this area.to be completed by citp or town official
('it) or Town: Permit/ll.icense#
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.City f l own Clerk 4.Electrical Inspector 5. Plumbing Inspector
fr.01 her
('cuttact Person: Phone#: