31A-087 (8) 18 VERNON ST COMMONWEALTH OF MASSACHUSETTS BP-2021-1740
Map:Bloc,k:Lot:31A-087-
001 CITY OF NORTHAMPTON
Permit: Temp Structure
(Tents)
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1740 PERMISSION IS HEREBY GRANTED TO:
Project# Contractor: License:
Est. Cost: 800
Const.Class: Exp.Date:
Use Group: Owner: ROBERT BARBER
Lot Size (sq.ft.)
Zoning: URB Applicant: ROBERT BARBER
Applicant Address Phone: Insurance:
16 VERNON ST
NORTHAMPTON, MA 01060
ISSUED ON:08/18/2021
TO PERFORM THE FOLLOWING WORK:
TEMP HANDICAP RAMP
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.
Signature: I i_
rr • � �,Q
•
' '
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
/ /9<(\
\/9G, .
The Commonwealth of Massachusetts ^,
pTi(('
WBoard of Building Regulations and Standards'o°� 6'
,
�ti Massachusetts State Building Code, 780 CMRV U% / I
SE LI
Building Permit Application To Construct, Repair, Renovate Or D4 Rev' ed Mar 011
One-or Two-Family Dwelling A«���
This Section For Official Use Only o s
p'�1' 17 Building Permit Number: Date Applied. _iniictA,,-,. �a�• 5 i
Building Official(Print Name) Signature D to
SECTION 1:SITE INFORMATION
1.1 Prope ty Address: 1.2 Assessors Map& Parcel Numbers
tip IS £R f•t o t4 5'�• ,3(A -•0 87 —O O I
1.1a Is is an accepted street?yes V no Map Number Parcel Number
1.3 Zoning Information: 1. Property Dimensions:
5'SIM Ca? so
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft) .3 facl.t- r-u_c c_t i— --, 5 t d-A, y&4f
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
I
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private ID Municipal Outside Flood Zyne? Municipal i2 On site disposal system ❑
Check ifyes
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Ro8•E/tr E. ISPrit.SER 4 Ci4cC-L- E-0=Ls-r i nt N(NL?}e Alm PTdNi
Name(Print) City,State,ZIP A. 0 I Cia 6
l 4) 1 a vten4 Si 414-585 - v ✓5 3 a aie v'4-eloa rix.v 47- e
No. ancliStreet Telephone Email Address C&j-0• C�1
SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply) (JA
New Construction 0 Existing Building B/ Owner-Occupied Itri Repairs(s) 0 Alteration(s) 0 Addition IKI
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: +-t', 0O . -( 1
Brief Description of Proposed Work':
T -PO A Pr14Y H.Pt-Ni P t c--Pt-P (ZftA P I\LAt TH s1 O E-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor an Materials)
1. Building $ @ 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ / 0 Standard City/Town Application Fee
0 Total Project Cost3(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ /
Suppression) Total All Fees: ICheck No.a(0 Check Amount. Le
6.Total Project Cost: $ e0 0 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
N License Number Expiration Date
Name of CSL Holder
OW'' ^1 ^ n List CSL Type(see below)
No.and Street ,V 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)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
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 0 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 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(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.) itS 51. f f . (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count 0
Number of fireplaces Number of bedrooms
Number of bathrooms / Number of half/baths 6
Type of heating system / Number of decks/porches f
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Common vealth of,tlassachusetts
—4--a= Department of Industrial Accidents
=:..,..111111 a.- •
1 Congress Street,Suite 100
Boston, MA 02114-2017
WNW.mass.gov/dia
ri utkers. ('ompen*ation Insurance AMdavit:Builders/ConlractoratElectriciansiPlumbers.
'11)BE FILEO is II THE PERMITTING AUTHORITY.
,knolicant information Please Print LatiblY
Name 1 li LI itls Onantzmwil Incti‘iduith' tR,A6E.i2-..r 6prizzEtz....
/Address.,,_1 Cc, 8 \I ef2÷1 6 t•.1 ,5—r NI,CSY41-14 Pc14/le it-3/4
C'ity State Zip: /A,lik <::::•(0(p 45 Plume #: 41 • S.55__ _ ... . .
emplin.er?Cheek the appropriate box: ' Type of project(required):
1.9 I am a ernployer wah employee*(full again part-timrt." 7. 0 New construction
20 I am a sole proprietor or partnership and have no employers working for me in 8' 0 Remodeling
any cathicrty.[No workers'comp insunince required
, 0
C]I am a homoowner doing all work myself.(No weathers'comp_Ilwuranct required„)' 9. Demolition
10 ';', Building addition
451iiia s honwowner and will be Nang contractors to cooduct all work on my property. I will
ensure that all coritraciont either hove workers'compereconin insurance or are sole 1 1.0 Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
I am a general contractor and I have hired the sub-contractors listed ori the attached sheet
Thew sub-contractors lus.ve employees arid have workers'comp.insurance. 130 Roof repairs
14,0 Other /ZAN,'
ka We are a corporation and rts officers have exocised then nglit of exemption per kkil c.
152,§I On,and we have no employees.[No workers'comp,insurance required]
. ..
'Any applicant that checks bin ttl mint also rat oat the section below showing their sionliers'compensation policy information.
Itomeowners who*Wenn this affidavit indicating they are doing all work and then tare outside contactors must submit a new affiars it abdicating stack
zContractorii that check this box moot attached an additional theet showing the name of the sub-ColliTilCUM and state whether or not thole entities have
employees, If the sub-contractors have employ ecs.they min*provide their workers'comp.pillicy number.
I am an employer that is providing workers'compensation insurance fur'sty employees. Below is the policy and job site
information.
Insurance Company Name: ____
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: CityiStateiZip:_ _
Attu*a copy of the workers*compensation policy declaration page(showing the policy number sad expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
andior one-year itriprisotorient,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the%iolator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of perjury that the inform attmon provided above is true and correct.
Signature: 12-041)-(1.--4-t (2-J a-AID--tir Date-. P /l ( /2i.
Phone#: 41,3 - 5 8 5 - 3 5 30
Official use only. Do not write in this urea. to be completed by city or town official
City or'f0Vt a: Permitilicense
lase*Authority(circle one):
1. Board of Health 2.Building Department 3.('ityr-town Clerk 4. Ekctrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone 4:
City of Northampton
r°Y �, °� yes 5!c
f Massachusetts �� °°,,
c
Pr(DEPARTMENT OF BUILDING INSPECTIONS
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: Vkl....LEA. I.... CHcLt--
�-C" (O 2 EA5T1--t et-ixtP 127
P - & IPA t O cots
The debris will be transported by:
Name of Hauler: (iJi\_.[ E_1e--
Signature of Applicant: Date:j ( /2- I
City of Northampton
1,'. sr
Massachusetts
w it
y _° DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building `3 ,/C1
Northampton, MA 01060 �10
.t.
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
l Ra8hr gz 1 4147.
I, � �tnsert full legal name), b r 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 I ( day of Ah f' , 20 2(
(Signature)
Borrower: Robert Barber File No.: 13761492
Property Address:16 Vernon street Case No.:030912-01
City: Northampton State:MA Zip:01060-2862
Lender:LS-TD Bank NA-Mount Laurel
Doc: 980021476 OR /5 /0346 08/05/199814:00
EXHIBIT "A"
The land with the buildings thereon situate on the corner of
Vernon and Jewett Streets in Northampton, bounded as follows;
Beginning at an iron pin at the corner of Vernon Street and
Jewett Street; thence North 533 10' East Fifty (50) feet along said
Vernon Street to stake; thence South 42P 26' East One Hundred (100)
feet to stake; thence South 533 10' West Fifty (50) feet to stake
on Jewett Street; thence North 410 26' West One Hundred (100) feet
along said Jewett Street to the place of beginning; containing Five
Thousand (5.000.00) scuare feet. more or less.
Y /� yi
t _r
' '41t,'"41:t4Liklii.'•••',::•.::::':•• ' ':''-•-:•-;":''.'"' - •",,i‘ ,"/
2 s - '., It iP 9i ''vb
..,.411-441$AV.c.,filOPW,.... ..•
.
4 �
F3 O
e
• r8 f 'g,
;.
Y
7
k 9
II 3P, {W14,
4 4 :"4 n rib IM4333II .
°1811/416/faib,•40/1
elk;, ?. -..-.... •.10. ii, •
. ''''.3...11”,.., ii• 0 0
I 'I
416S
410 ,,
- -ip
•
_ . i
.• * -a I
*
.... ....- s
I * i, Ai ,'
- a
<�0 S.
Je
tx # ��0
�, JQ
-kic:.:;.,1,..4r,--.- ... 4.-Alf.,',..4- sip , . - :,.......--f -,..fr., ,=„-... :,',-,-,
x
U�
gJ ':".'''''''''‘I
�n
�� book publisher - a
- `(�K Gallery of Readers ; G •
•
,,,,,,,,,,,:le
; � 6 Vernon t, �
ff
_. � .;:� �� � Northampton MA 01060
. ....,
1,''' .....-e, -,11.11.11111•11,c- • -
�� Hof
Z a 140 ,,,,..4rf 1 0*
.." t fix. ...,f �� a �* � ,-:�a
R
•
-<. ., ', ' <
404144
e •,:: y `. `1 , 't sue` ' 4
Si
- fib
1\, .
34 '
, 0 -7---
\ '' F-1-E \I 6C71'‘C1/1 t
{ 3 fx 30
I -----\
1 .. 1
0.
3o f
ply[
r�
. Cd�
-2
f II
te6w)-e-
pnr c)A