32C-288 (6) 126 WILLIAMS ST BP-2021-0094
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C-288 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:demolition BUILDING PERMIT
Permit# BP-2021-0094
Proiect# JS-2021-000146
Est.Cost:$1000.00
Fee: $30.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: CHARLES GROWHOSKI 052458
Lot Size(sg. ft.): 9191.16 Owner: CAROLINE GROWHOWSKI
Zoning: URC(100)/ Applicant: CHARLES GROWHOSKI
AT. 126 WILLIAMS ST
Applicant Address: Phone: Insurance:
57 SOUTH ST (413) 527-5857
EASTHAMPTONMA01027 ISSUED ON:7/24/2020 0.00:00
TO PERFORM THE FOLLOWING WORK.-DEMO 20X20 BARN
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department 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.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 7/24/2020 0:00:00 $30.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
47
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The Commonwealth of Massachusetts �""nwn
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�. Board of Building Regulations and Standards IONS
.; a, - ,
t Massachusetts State Building Code,780 CMR' Mt]NIUSE
Building Permit Application To Construct,Repair,Renovate Or Demolish a 'Revised Mw-2011
One-or Two-Family D%Wling
This Section For Official Use Only
Building Permit Number: Date Applied:
a� a�
Building Official(Print Mum) Signature VU Dde
SECTION 1:SITE INFORMATION
1 1 Pr party }dress: 1.2 sensor Map&Parcel Num
��
t 1a Is this an accepted street?yes ZIL no Map Number Parcel Number
1.3 Zoning Information: IA Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(tt) .
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Requirad Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
PublicPrivate❑ Zone: ` Outside Flood Zone?
. Check if yesL] Municipal O'bn site disposal system 13
SECTION 2: PROPERTY OWNERSHIP'
2.1 Omler'of Red: ;
inl jil lrru ids 1S/ &--(Z" 7-&M . bl),� fOvZ?
Name(Print) City,State,ZIP-
No.and Street Telephone Finail Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that appIy)
New Construction❑ Existing Building Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
Demolition Accessory Bldg.❑ I Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
/W C_ a/-y<� Qi 6) vZG' Bei r/1
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item
Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 1. Building Permit Fee:$ indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing S 2. Other Fees: S
4.Mechanical (HVAC) $ Wit:
5.Mechanical (Fire $
Suppression) Total All Fees:S
Check No�Check Amotm Cash Amount
6.Total Project Cost S ❑Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License,(CSL)
License Number Expiration Date ?/
Name of�Golder
7 � �� e List CSL Type(see below)
No.and Street J�� Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
C 62 R Restricted 18:2 Family Dwelling
City/'Town,State,ZIP M Masonry
RC Roofin Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement ontractor(HIC) !� Q-j -//
`SC4,-� u 's a" HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
CityPTown,State,ZIP Telephone
SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(NML.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...........Ell,
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WAEn'
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize �t l la"r l-:�5 i C/A,-, K /
to act on my behalf,in all matters relative to work authorized by this building permit application.
-Z
t Owner's Name(Electronic Siiaturc) 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 mmy,knowledge and understanding.
('7/! +/ L '/Z l' l G`.Y)1 LJc(� . Zdl(��� C
Print Owner's or Authorized Agent's Name(EliLictronic Signature) • Date
NOTES:
- An Owner who obtains a building permit to do his/her otvn 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 he found at
www.mass-gov/oca Information on the Construction Supervisor License can be found at«winv.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.fr.) (including garage,finished basement/attics,decks or porcb)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halfibaths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost" '
I
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: I t0f, /mit, sT 1Yc rT7�c,-, 1n1O'1—01
The debris will be transported by: [''�%f, S �1"v rvd�USfs/
The debris will be received by: (/a,//r-y /tet ec; M(m 15�
Building permit number:
Name of Permit Applicant 1',�Yo�/�� ����' o
i
Date Signature of Permit Applicant