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16B-048 (2) 221 NORTH MAIN ST BP-2021-1251 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 16B-048 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:REPAIR BUILDING PERMIT Permit# BP-2021-1251 Project# JS-2021-002077 Est.Cost: $11000.00 Fee: $72.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: MICHAEL PHILLIPS 082683 Lot Size(sq.ft.): 10149.48 Owner: LACROIX NEIL Zoning: URB(100)/ Applicant: MICHAEL PHILLIPS AT: 221 NORTH MAIN ST Applicant Address: Phone: Insurance: PO BOX 514 (413) 250-79900 WC GOSHENMA01032 ISSUED ON:4/28/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:REPAIRS TO BACK WALL OF HOUSE AND 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: 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: 4 • V , • ,'I • FeeTvpe: Date Paid: Amount: Building 4/28/2021 0:00:00 $72.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner M., �C C`r 44.._ 'The(:;ontr: nw € alt , \il s;, ,i is '� 2 8 Board of Building Pcbu i a S rcis 202/ OR XUSE Massachusetts tt; State l t tkii ' 1 it.i CCVP L.[T ' C Building Po-mit App1icalion"I'c>Construct. Repair,Rena E ' g 7, Reva ed Mar 201.1 One orTwo-Family Dwelling 7060 0 This Sect For Official U Only 3a,, 1:-' ' r gOr— 1"/� 0r I)9e A. lied: I LVifJ /.7 GCJ 7> �Z, I .. ........ bu.ru uJ s :Print N,atnEI �s .<afta, Date t ! SE.C1 ION 1', SITE INFORMATION I 1.l rpe y ;'l.ddress. I I ess Map Si Parcel e1 Number), Nita /IQ/ U7 9 I tI,la Is this an accepted no 'oar Number I' ''cei'tiai 7tf`cr i i 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Pt ;,..red t sc I t Area tsq ii) f r nr�age t,ft) 1.5 Building Setbacks((I) i Front Yard l Side Yards Rear Yard i Regnimi Provided tt usrecl Provided Rc 1t ,: l'uo%tdetl i 1 1.6 Water Supply:NAIL c:.4Q§+43 1.7 Flood Zane Information: I.S Sewage Disposal System: ZOiltr {)ua rk,Flo d 7one? Public 0Private I t 1, t \Iuricipeil a On,tic �:..r,=s<il system 0 J SECTION ION PROPERTY Y I AN NF RSHIP' 2,1 Owner . -I' 3-Iv r 0 0(4 . -- - ,, Nam.,i rim', i.',1„ .j',ITV.Zi' No.and Street .der, ,i,c. Email f l.taraaii:Ydciry _..__ SECTION 3: DESCRIPTION OF PROPOSED"WORK` tehevk all that apply) ` Ness Construction 0 , Existing,Building 0 I Owner-I kse4.,ied 0 a Re.p art t v„44 a?t t iii in) ©j Addition 0 Demolition 0 i Accessory Bldg.0 Number of I rats _,, Other 0 1 f3 et D scrrpti of Proc-t)",e- , posed Work ..„ „3,.._ c. i s 4� ---ra - .-). , , - 3,0„.„,,,A1.,... 4,<-,,,torrr , g 'SEC.SECTION ESTIMATED CONSTRUCTION COSTS Item I: Official( cysts: O iat Use Only (fat r and Materials) I.Building. 1. Btu t'in Permit Ice. Indicate how fee is determine: Electrical 1 ----1 D Stan hart; CityI own Application Fee .••••. . ...«._ j i 0.l out Project Cost' iItem iS)x {multiplier X. 3,Plumbing , :S i 4. Mechanical ti 'AC;i 1 $ I ict: 1 } i ' g Mechanical (Fire —— _ S9pprrssionj 1:=i at 4 t I G:c.. _ .` 1t'he k N P. IV 2 Check Arnow: ("ash Amount: j Total Project cost S t 0 Rini ni Kati_ C Outstanding �_•._ Balance Doe: SECTIO 5 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor ' ense(CSI.1 1\ti\[ 1 t tY Lieen .mr-k; E.xpi utIon e Name of CS,}colder j� [ fist a, St :p Cd;e ce below) } aDiitription ii S t ttt ii 0 t nrestrietc i i Buddin 7 up o a.5,000 cu.ft.) . kt\k t Oko-az) _. __. _.-._.._. I R Rex actekt ISO t`uttii 1›.:sensing City, .vn..,te.ZIP ; N-1 . Ma:.xmry , RC r Rootin;Co , \1'S Window and Siding • 4 t -771969 0- SF Solid Fuel Burning Apphanc .� ` � .... . y P _ n tnsutati«n ____j 7c1 i)rtc [mud uidrts D Demolition 5.2 Register home em?!.Contra r(HI ')r Iii �_ _ _ � _� . .. lal( RXr� isn Vutnt�ez ptratrtta Data amipanv Nauwitior HI eg t Nsmk. r Na d`sire 1 mail ad retie 0 f..\- ntl wa glYna-7P20 1 1 C i own ,.t` e,ZIl ._......__..____ � teleOwiirc _ ,.....,,. ...... .... .._,�...... SECTION h:WORiCERS'(O IPI'\SATION INSURANCE AFFIDAVIT S\IT(\i.C:L,c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must he 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 0 i SECTION 7a:OWNER lid"IIORl1.111ON TO BE COMPLETED kVH};N L OW SU`R S AGENT OR CO"I RA(-TCSK-tf'Pt IE S FOR BUILDING DING PI R\ fT I,as Owner of the subject property,hereby authorize j to act on my behalf. in all matters relative to work authorized by this building permit application. c. 116.1_. ,1_. t'.0i ' , -s Lam' y-a/--t /_ I u t?wvaer.s Name 4 ilectronic Signature) Date SECTION 7b:OWNER' OR A[Tli()RIZED AGENT DECLARATION Vl ION I , By entering my name below,I het by attest under the pains and penalties of perjury that all of the information contained in thi .plicatio an i Lurate to the best of my knowledge and understanding. iin Print Dwner's Of Authorized Agen _:'ant. ,.;tannic Stunutiart Date NOTES: �.... �... _ 1. An Owner who obtains a building permit to do hisTher own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(H.IC)Program).will not have access to the arbitration program or guaranty fund under'ul.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.vovloca Information on the Construction Super%iSi)f I icense can be found at vw\+\V.ma,s ov dos 2. When substantial work is planned,provide the information ,<loww. Total floor area(sq. ft.) (including garage,finished basementrattics.decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces_.-_..... .___. Number of bedrooms Number of bathrooms Number of half'baths (-ype of heating system Number of deckor porches Type of cooling system Enclosed .w.__. ..._.. _.__.Open 3. -Total Project Square Footage"may be substituted filer"Total Project Cost" .. • City of Northampton 1" Massachusetts i,f DEPARTMENT OF BUILDING INSPECTION'S 212 Maln StraQ°' 40 Munacipal Building Northami. t:,n, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, 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: I ' IN i It tit,,," Location of Facility: \,„,.) lik.',-,€ 41-/fr\i [ i The debris will be transported by: 4, Name of Hauler: , I 1 NV, , Signature of Applicant: _ _ 3-4 k Ay(„zie - 1 Date: -I, — - The Comma/rover:1th al ilaisachirsetts Departnit'Ill if Industrial I rr.-illents - I (-6argreA.s Street, Suite /Of/ Ba.ston, II 1 112114-201- ., . It'It'It.in a ss.govrdia s‘or kers.' tompeusation I ttsttr,tth,- tifola%it: Btilideril'oatractors Eleetricians,<Plumben. It)RE fit}.1)%t I Ill I 111:.PERM'ETINt; %I lift AM\. .1aPitliCsiilt In141111$(11}11 PIVANV Print Lei/alit. iti,. Nam :i3„:..,,,.----.(A:..it.-.V....1 1 Ilkt. k%'... N\ --C,\Yiek, ' \\3p.s ‘. -- ,11c.. .... Atitircss: ',h . Lt11) 6- p, ,... '-i,c_ -i,c key'Mai AU VItipetritil t'York thr a mar boa. i Type 0 project trequit ed i 1 j I tun s stnpioycs atzth ..___empialocea that!antiAat prt-tats#0.• 7. j"slew e.ortstruction -D i....,..ii,=,ituPuNifn'.3-PaniVet,illit raa hare au Cittiri...,'4V,4 Will* $.>t nie in 8. c3 Rernitkume .....,‘,...„......,„‘„ ,,,,,Atari/1ra"sump.frestlrince reCprrai 9 0 EXtistohtroin 10$iwz a tavatast-ta.rws deal.;al Aateit ntyis)f.INo AAA.en:"itn14, astattowe ro4ano.i I i 0 D ilitiklinit&Moron 4 0 I.,Ks-n*16411ff AnJ la SI hr:hang-.'IltrAkVzs.£4".•‘A'alth4d ail work,r,tvy Imola oy I ss-iti ! olayst.that alb.ANotrai.'a'ss aultet/tsar ionitketa'c,thpenastetso In.-Atrant‘v‘tt we•-A 4e t i 1 a Eloirre-al rerairs.-or :AM:Licht& propttetaha A id t M.wassr4o,,,eaa 12.0 Plumbing trepans or attlittiotIN I:an fie!cot:rat;Amens,lot And 1 har.r!illvii th.,.:.0.1b-owsintr tam toted on thes Aaitale.-:,Iart-1 i 3 - Roof repair, 'these Ash,covttao.vaa cur.,:,autaltsaval.arta hat.:Aori.esa'caotals tgliklittlek4' , 'A,Ara s,....sralastosts 4.441 as.4:S.:rt.., .t•t'e Vkacl.....d*on 7•Arlst of sterol:44m pes mt..: i. Il.god a,Isa,a ma trzs44#,avat,..iNt4 atortss4*tlZsrVi3 VINLIMIS:-‹'1.1/Latra-',' 1-./ . Oth<, ,as •An4 as,,ris..se t that cho.:4.#boa#i toms twat tili out tha archaatt helara,strioirria Iwo W,ilia.... ,i,Mp.CIVP•it:44.Ali?AU.y ra.1,:iuglau 3120alot,..mts Mat tadassat this st144.e.11 sittigshha they 3ft dKntri'AV*AAA and Ixtt ittla‘,,,,ttattie voottwtort matt atttaittl 4!t64 arliAistir • :4,Clitrai:t4 MI MAT tiara dies his haws.Itladlird AU tatalahonta abets shtaa uss la:topic,4 ilia.thb-4:41911i*VECT,et..4 v. if Ar*141.),-.0,44.nn:qqrt,4.,0.,,,,,.Itiri,,,.',:tne,,.he?11i,Ita 130,.Ws.thas A,A,:n,":..rip I am an tomplarre that is prarldin.z ii-orikers'(<01,1pr:tin:ion inNurance jar mr rnsplalrrA. Belton iN thc indit r and lab Nile information. Insurance Cornpart) Nam: (....r' 1"\i T2P0 ..,....-- i _1,1"NCO rW-1 CO — Polic% 7,:or S elf-ins he •: LC")(a.at —01,116T-14(; 0 N,--, 7 i,,,„..,,,,,I: if". .; (c)\11'.6 \a) 01. A./ () I I ( Job Site.tilii;tn.., „I,.,.))(40._fi\b lk, (._,1_ t:It.i Sta%1,,, Twftce it, /, Icit - , t -ii , .tttach ti cops of Ihr Ns orkers•romps:minion policy tketaratios page(showing the peke,% an:fiber art; eAptration dart., secorc.....i cr.rt‘:as icci.uo::wider Nit;I_c 1 5:.. .,‘is 11 enniinal t.rotation ptintslat :. try a!int. up I. •1.5,'. , ,1114.1 llt tX14-',"Car tMctriSanItt/tnt.as well as coif penalties in the hwur Of a STOP WORK ORDER id A fink,Of up IQ days a..tsrust the violator A copy of this Qtatenient may iic tivrwIrditi to the()Iirt....v of Ins estraattores of the DIA fin-;astir:mice cv:eravi: ,.cri fieation. /dr;hereby certi,fr under 11 -twin.al i ,ilqr ertars that the in tr?rmaiton//roc/der/a rev:• /rat- a St;dlix.: I).,:-... , ; — — — Official UN!Moth% Da Hot write ill MA arrii,to he completed hi city or town ofiii-jot ( it, or Town: Perraltoticensr 1 lvtuiriu A utborit% i t II de oar): I. Board of IleAlib 2. litiilding Department 3.("its:Twist,Clerk 4. Electrical Insprrtor 5. Plurriliinl:Inspector h.()1 hes Contact Persaa:_. Ptsour!:: ... — —