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23A-295 (2)
29 LANDY AVE BP-2021-0147 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A-295 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Above ground pool BUILDING PERMIT Permit# BP-2021-0147 Project# JS-2021-000242 Est.Cost:$10780.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sg. ft.): 6751.80 Owner: PALLADINO CELESTE Zoning: URB(100)/ Applicant: PALLADINO CELESTE AT. 29 LANDY AVE Applicant Address: Phone: Insurance: 29 LANDY AVE (413)362-5153 (� FLORENCE ,MA01062 ISSUED ON.81612020 0:00:00 TO PERFORM THE FOLLOWING WORK.-ABOVE GROUND POOL 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 Siznature: FeeType: Date Paid: Amount: Building 8/6/2020 0:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner I'1 c—�--� 7�, UYY c i CD cn o The Commonwealth of Massachusetts o Q Board of Building Regulations and Standards FOR o Massachusetts State Building Code, 780 CMR MUNICIPALITY USE ermit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling A 11 This SectiomFor Official Use Only Buildi Permit Number: Dqte AMlied: EVi1J 053 � �-� ZDV Building Official(Print Name) Signature Date SECTION :SITE INFORMATION .1pertn�ddress:� a, � a o 1.2 Assessors Map&Parcel Nu>�er,sg.qa �. 1.la Is this an diecepted street?yes 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❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if XesO SECTION 2: PROPERTY OWNERSHIP' wne of Rmk:(�,J C.I GS A- a O Name(Print) City,State,ZIP i L2 nd l SIS Ce lts ItP JU�-�',► '�I o.and Street Telephone mail Address Seim UN 3:IiESCitI I01+fi OF PI30POSEII►WORD(sheekk an that appy) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units I Other 421"Specify: Z-Ve. / ti Brief Description of Proposed Work': '1 ROD SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: ic' Use Only (Labor and Materials 1. Building $ s-, p 1. Building Permit Fee: Indicate how fee is determined: 2.Electrical $ 13Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check Amount:' Cash Amount: 6.Total Project Cost: I s y , v o Paid in Full 13 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. R Restricted 1&2 Family Dwelling City/Town,State,ZIP 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) H HIC Company Name or HIC Registrant Name IC Registration Number Expiration Date No.and Street Email address Ci /Town State ZIP Tel hone SECTION 6:WOM.:11 'COMPENSATION INSURANCE AFFIDAVIT(M.GJI c.152.4 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........... ❑ SECTI©N*OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CON'T'RACTOR 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:OWNERr 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 ap lication is true and accurate to the best of my knowledge and understanding. �oa-0 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(RIC)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 ,wiw.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass. g"M s 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 r DEPARTMENT OF BUILDING INSPECTIONS . "•s 212 Main Street • Municipal Building Northampton, MA 01060 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: c� �-J�C'/► (�� 0/ 0 Z The debris will be transported by: Name of Hauler: CdeL� Signature of Applicant: Date: The romixonweaft ojMmmehIr>u Dens of 1mks#*1 Ard*nb 1 Congress Sid ret,Sum 100 Boston,MA 02114-2017 WW .»4Wx, / 11`orlters'C"ta=paensatiiat i ur MdavitM llw l lcc riclan Plum cra. Applicant Name r _....... s t . �. .a► x �-�rc� � 3 � a " rat tette*Chftk dr ttW+rt i%to bats: "_.. t.I l am a Z6yer witb r. New coustniction 201 am a mk proprieuw or pArWerAip and have no eaVk"m wo*iyt for res in Remodeling wr�aarwaN_[NO W . rasa -*WkL1 30 I am as bo"W VV"doing*t3 VU Mytat£INo Wa&dm'cam.ani rowiihid.j 4&19trl rmsou and will he Eaten wautders to roaduci alhwotk on nay piaperty. I wiU Inane that all cowr;xio s either lit Awrktrs"cxxnpta3,AUM awdm m tv ftV i i Eleetrual lVaits or addit o prrspsiaU*M With t",-06"- 1repairs or adtlttiAM 501 amt a xal euxaromw and i bava hind the ub-evausruws fiaued an Aw anadd sbee Thbw have ono"oft aat warkeW suesap,. warms.' fi. We are a aorpoert am and a.ot'la r.have ewvi"their rift orttetrrptioft Pitt AlK`,L r. 14 vc— and Wr 6W,00 xxMsWV".[Nd wadcm'cuaap,i"Agan""iand.l ��O *,;.ax} pht w that eho--Ls t el snu t a6u fin am f*Relies+boicrw of aivia dwe tares'i u��re polity WorwAcka.. H wa ft,%wbo iia th«s atTidvk i4 aW44m.atir g tMy aft"ns ad**A aeml alien We xwtairk cwztYaewo nom suit a rmwaftiwik indkating kowtactots twat a to bssa msast Amvhol as W&kcmal%heed rhowiag 6a nAme id&t a311.vwrwton sadsww Mwdw ar nA*Lmt tawks leap ics+ rc_ If dw Marx F**,c imiplu�mn.,dwy masa pwv-it+c thrix rtsxrtcen`totap-policy naaobitr. !am an employer AW is protddfng workm rompenwdon fnswru"fat my e*WAoh w . Below Is Me pWiq and job sett Insurance C,o+ntpany`biatxee. Poli #at Self- .Lie..#�:. ireas Doe Job Site Address� Cit�r`Sistc . Attack a+ 7 of the morkes�s'caoip•�n policy dee1k radar (�R the poUty another and ezphsOm dsftj. F"ure to secure coverage as required under MOL Q 154§25A is a caiminal violation punishable by a fine tip to$I Sdq.W oullor aroe,-yca imprisonment,"well as"penalties its the form of a STOP WORK ORDER wW a fcoe of upx to$250.00 a day agaitst the violator.A copy of this somment may be firms;arded to the Office of Investigatiotaa of the DIA for insurance coves Verification, I din hereby crr#fy`arutl v Mw pdas axdpeni&Wes afpe9%ry AW Ike ln,fvrmaden prow;ded abiove fa cad rarnrrr. &w only. M not ate In Mis area,to he iromplemd 0 ch)-or tm m aj City or Town: AAutlsWfa _t__ Pertuit/Licence� M__ (drd a Out), 1.Board of Health 2.RuMng Department 3.City/Town Clergy d,Electrkal Inspector .4.Plumbing Inspector 6-othe.r taxntaet> r a; pbout#t City of Northampton Massachusetts ' l DEPAR!?ffiIV4' OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 HOMEOWNERS'EXEMPTION ELIGIBILITYAFFIDAVIT CI, J ?c)- J h J (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 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. 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 J day of `�'�_, 201q� ignature) CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: S REAR YARD Q Sal I� 1 q wSh 0�- SIDE YARD SIDE YARD 2� L oLk, FRONT SETBACK FRONTAGE