30A-032 (113) 320 RIVERSIDE DR BP-2021-1292
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:.30A-032 CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS.
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: REPAIR BUILDING PERMIT
Permit# BP-2021-1292
Project# JS-2021-002138
Est.Cost: $2500.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: MATTHEW BEAUDRY 108605
Lot Size(sq.ft.): Owner: BURTON SAM
Zoning: SI(108)/WP(38)/ Applicant: MATTHEW BEAUDRY
AT: 320 RIVERSIDE DR
Applicant Address: Phone: Insurance:
117 FERRY ST (413) 320-1348 WC
EASTAMPTONMA01027 ISSUED ON:5/6/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:REPLACE STAIRCASE
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 Signatur; 53-11
1
FeeType: Date Paid: Amount:
Building 5/6/2021 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
t
The Commonwealth of Massachusetts MAY - 6 202i
.i,, I Board of Building Regulations and Standards FOR'
y T Massachusetts State Building Code, 780 CM a �- —MUN CIPALITY
USE OF BUILDING INS PE TI N
�
Building Permit Application To Construct, Repair, Renovate{� ��^Et�sno Rb'sr d Mir 2011
One- or Two-Family Dwelling
2 Q This j�e�ction For Official Use Only
Buildingpermit Number: Ur J;,I" /' % D to A lied:
�ewo Q, 5-6-202.1
Building Official (Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 P o ert ddress 1.2 Assessors Map& Parcel Numbers
KVer51 fir• 3v7sl- n 32-
1.1a Is this an accepted 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 0 Private CI Municipal^ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Ownsc'of Recor
7A,w` iatirArlan Afo 0,101�p 0, / ow d o
Name (Print) Cit Stp t ZIP
-o g',v�.r5i fir, 9b c.—A 7 Saw)_spalit &1w.
No.and Street Telephone Email Addres
SECTION 3:DESCRIPTION OF PROPOSED WORK' (check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other Specify:
Brief Description of Proposed Work': rQphtif Lueye), krl) Al)11 beiGk Deck
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
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 $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Ftt
rA\ Check Nb Check Amount: Cash Amount:
6.Total Project Cost: $ cv0 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction SupervisorLicense (CSL) , /` /� �Qc �23
License
llNumber Expiration ate
Name of CSL Holder t
(� RY List CSL Type(see below) �JI
No.and Street J Type Description
,�r� �,\ U Unrestricted (Buildings up to 35,000 cu.ft.)
0 )'iU � '"r Restricted 1&2 Family Dwelling
City/Town.State.z M Masonry
RC Roofing Covering
WS Window and Siding
(� n5 V rid, I �(�,j '� SF Solid Fuel Burning Appliances
1I�� (� �`� � i 1 Insulation
Telephone Email addregS Demolition
5.2 Regere�Home Improvement Contractor (HIC) I l l lit �) �Z
'�l Q.t4. rr��1l.„vY►�_„, YLvikr.irVi" HIC Registrationai umber E pira on Date
HIC Company or HIC Registrant Name
I 7 /stir }4%LI 1;1( i dregs
t.twt
t1sd. witt'k,Q NIA 01077 ��13�3�G''13 Email dre s
City/Town,State,Z1P 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 ?SCNo 0
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIESfl47
FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize 6-1 NJ
to act on my behalf,in all matters relative to work authorized by this building permit Ipplication.
CC( pi 6 yi, ,
Print Owner's Name(Electronic Signature) ate
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 understandin
1/14/4—
Print Owner's or Authorized Agent's ame( 'lectronic 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 tinder M.G.L.c. 192A. 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
r•.'p �" Massachusetts
1 DEPARTMENT OF BUILDING INSPECTIONS
wi :,r,�
,� 212 Main Street • Municipal Building
Lt..+� Northampton, MA 01060 �SNh 3�L1`l
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: Vk J! 1 4CC(/cithj
The debris will be transported by:
Name of Hauler: fill
Signature of Applicant: Date: V )-9 �—F-
The Commonwealth of Massachusetts
N- Department of Industrial Accidents
1 Congress Street.Suite 100
..`Yw Boston. MA 02114-2017
www.mass.go►/die
))ui hers'('unrpens►t' Insurance Affidavit:BuikIer J("ontractor ifI kcsrici*nstrPlumbers.
ID HI. tit I:I/11.1111 I IIE PERM)IitN(::Al I t1UR111.
Applicant Information (,�� !�I,,' Please Print Legible,
Name(Duane,• +ht:antratt n lndrstd l,1Vual0: � __. _ Orm/e'1 „'
Address: \1 Rolf .5 - huwtp411 .htAA c)y 0');
City State Lip: Phone 0: V 13" j)M ' i
Are you am rripk er":'t hark the appruprlaic toss.:
!'�Pe of project(required):
igl am a aulpIusiT with ( employer:,tiu0t and..r pail-tin►'i• 7. New construction
20 I gin a sole proptetul or peritonitis and hate noanrf+lr}at.otnii,rig. for m.in $. jJ Remodeling
am capacity[No wuticr.'comp.insomnia: rimmed.]
9.Tig lhutolition
LD I ant a h.lnev.wnei doing all work ins sett.l\u watt ai.`comp. in,aratice nwtulnri.l r
4.D 1 am lw.nevwtlat and will Ia 111r mg contractor,r+.curnduti alt w a on ins rowdy. I w�
10 O UUrWing addition
.Tuute that all contraction.either tote woti en'conilw'rlsatt.nr ln.,lama:tot an sole I 10 Electrical repairs or additions
pll.pnat..r,mall is.erur.luyo.s..
12.0 Plumbing npatrs or additions
3C3 I and a tY7letal a..11rlact..r as d I Iute hated the suts ntsactals hi.1 on Ihlo auaclrsv[sheszt
ewsub-contrjsl.n hale amptayar.and Iwo to, ..comp.nr.unukei 13 Raul repairs
Thew
t..D Vi w an a aptratu.n and it.eat*nxn.base etercis then tight theght ut csam pet et Mt.L r. 1 ()their _—
132 t§1(4).and wc haw nu onipkyocs.(\sr n.urlat.*comp.us%watec ra pottJ.1
•iAn)applicant that chocks(oar 41 lnu.t ate till out Ilk:.a.nJll IRtaw sh.n inn thalr oinks:vs'n'4 in s resat pule.}intimitutum,
+•I1.nm:owna %bu mahout tin. oolt An nrJi alijii Iles 41l'.t t,aft wink and then hoc outside 4ltltra.t.t.must.omelet t two.atyibasit indicating.u:h
C'onti:soo.ts that check tht,h os anon arta,led an additional,hest shooing the name 01 the sutsconiracto.and state wli.'tlm of not Mo.,:,317iht has,'
carpi.%:cs. it th.c sub inn:ac tot s fuse curio!.ccs.the, ittu•t 'is'idcthcir a.t:.ticr.'.r.rtit. r..it.ti nuinh.i
I am an employer that is providing NorAers'rlmpensation insurance fur my employees. Below'is the polity and job site
information.
Insurance Company Name:-- —
Policy #or Sell-ins.Lie.*: (PS ID O ) E (0 3 0 0 O I
Y a}
1 ttailttn Date
Tub Site Addre»:___ ; Rif Y ti y' ('its Suit:J.t1, 1M _ jg d l U ci-
Attach a copy'of the sorkcrs'compensation policy declaration page(shinning the policy number and tpiratron date).
Failure to secure Coverage as required under WWI_C. 152.+25A is a criminal violation punishable by a tine up to$1 500.00
anther one-year imprisonment.as well as.lvil penalties in the hewn ot'a STOP WORK ORDER and a tine of up to$250110 a
dad against the siuiator.A copy uttltis statement may be Ions aided to the Otlice of Investigatixtm of the MA for insurance
eo►etage 1.cniit:atton.
I do heretic certify under the xsins and penalties of 'jury that the information provided a re is t e and correct.
: 1c
gnatu : + 1)ji. 1-9 47-1
hone». L113 32-c)- )3 V
Official use only. Do not write in this area,to be completed by cite or town official
City or limn: PermittLicense k
Issuing;.tuthority (circle one):
I. Board of ilealth 2. Building,Department 3.City Inuit Clerk 4.Ekclrical Inspector 5.Plumbing Inspector
G.Other
( ontaCI Person: Phone(t: