Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
36-259 (11)
131 MAPLE RIDGE RD COMMONWEALTH OF MASSACHUSETTS BP-2021-1925 Ma p:B lock:Lot:36-259-001 Permit: Alts Renovations CITY OF NORTHAMPTON Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-1925 PERMISSION IS HEREBY GRANTED TO: Project# FRONT ENTRY Contractor: License: Est. Cost: 10000 MILL RIVER DESIGN BUILD 106644 Const.Class: Exp.Date:09/25/2022 Use Group: Owner: MCGRATH JOHN E & NANCY T Lot Size (sq.ft.) Zoning: SR Applicant: MILL RIVER DESIGN BUILD Applicant Address Phone: Insurance: 6 HIGH ST 4133418893 WC2-315-624269-010 FLORENCE, MA 01062 ISSUED ON:09/23/2021 TO PERFORM THE FOLLOWING WORK: BUILD FRONT ENTRY 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. Signature: J1 y2 cgi r • i • Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of Massac sett _ (eC wt Board of Building Regulations an. Stan,.rds �1 ' FOR Massachusetts State Building Co• 781 C V/�` �ICIPALITY ` USE Building Permit Application To Construct, R-,air, 'enovate Orcemolish a Revi•-d Mar 2011 One-or Two-Family I .ell gl <949 j r This Section For Official � 2p, Buildin ermit Number: f�Q�o)fr 10 .5" Da A hed: roti s°if Fca Evio (t‘5 22'7o2) Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Addres : 1.2 Assessors Map&Parcel Numbers 13t t\P KviSn 3G, z51.-00I l 1.1 a Is this an accepted street?yes f no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Distnct 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 30 I i o r 1 J No/ go NA., 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' p p Check if yes❑ Municipal Q�On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Otrfnerl of Record: ,� 1 Mc(9 rr i -WixJt 'e /l1'0nc FIOceelcc t C7/Oc Z Name(Print) City,State,ZIP i 3 t at4re K.‘,cti e nn No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction IEK—Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition ❑ Accessory Bldg. ❑ Number of Units Other 0 Specify: tt�, Brief Description of Proposed Work2: 13. ,,d Vet n-1— RAt-J•. lii 0(`c-IA! (ef L:cG_ cJcx C SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ /?i r 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 Fees 1 ( 6 Check No. 1� Check Amount: Cash Amount: 6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Cs-`o66f(J f v + ✓C`� License Number l Expiration Date Name of CSL Holder List CSL Type(see below) (f �Q , No.and Street Type Description iMn Unrestricted(Buildings up to 35,000 Cu.ft.) F1 1'Qom— '" lk O(0 2.— Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding (- $p� _ SF Solid Fuel Burning Appliances J .f ' [ AKA,,vi v P��—� q l l,(AZ„ I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) , q".4 28.4- j/g/Z Z +t l HIC Registration Number Expiration Date HIC Company Name or HIC RegistrantName r No.and Street \\ Email addresi 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 No 0 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 M,`�k- -2 to act on my behalf,�pp in all matters relative to work authorized by this building permit application. aa�& 0\t,C6 1/ 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) 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 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.) (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 SETBACK PLAN MAP: LOT: 2-51 LOT SIZE: 1,,C REAR LOT DIMENSION: REAR YARD -3 C SIDE YARD 5 SIDE YARD f 3 A/ C� FRONT SETBACK ( FRONTAGE C-�C 1 s I 0 i\ --Dco,>viok\ 1!. f' xN-3- 'ate o� d%, Co-‘1%_\31Ace 1 L/4 5'1 X---0. ,1 t/- S \, 1 se_y 01hz aia✓)vo / I-7 © fir "- J or-, c ►, .;„,-„, i ' \ Sw 1/ D —I -- c-.,_„ cue )30k) \, '\ co i.......p-Dv , 1 i ',' ,v,,,yr-o sx-z Tint) L V rvw V/ULU Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH I His PERMITTING AUTHORITY. Applicant Information ` Please Print Legibly Name(Business/Organization/Individual): i { i 1 Jt - IC1 Address: 6 t-\:t gL . City/State/Zip: c-1,O(LALe/ MA O/c9 Z Phone#: (t 3.3 (-WI? Are you an employer?Check the appropriate box: Type of project(required): l,iam a employer with i employees(full and/or part-time)' 7. D New construction 2_D I am a sole proprietor or partnership and have no employees working for me in 8. ID Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doingall work myself9. ❑Demolition y [No workers'comp.insurance requited.]t 10 Q Building addition 4.0 I am a homeowner and will be luring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.nRoof repairs These sub-contractors have employees and have workers'comp_insurance.: 6_111 We are a corporation and its officers have exercised their right of exemption per MGL c 14_❑Other 152,§1(4),and we have no employees.[No workers'comp_insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information_ I.Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees If the subcontractors have employees,they must provide their workers'comp_policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: 1—:1 £t'r VAR O Policy#or Self-ins.Lic.#:WC 2-31 S- (p 2-y l(v t-O 1 O Expiration Date: #.`,/7-G/2r� Job Site Address: City/State/Zip: A D�fl /iV,n 0f(26G Attach a copy of the workers' compensation policy declaration page(showing the policy number and 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 and/or one-year imprisonment,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 violator.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 information provided above is true and correct. Signature: #1\k Date: 912Z/ 21 Phone#: 1) ) 4514 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: = ' ' ?' �� DEPARTMENT OF BUILDING INSPECTIONS Q-------:)- _,, ,'dam 4;;Y. 212 Main Street • Municipal Building Northampton, MA 01060 . ip 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: Flag�i C Location of Facility: V cA1, kg....,a, N5 The debris will be transported by: Name of Hauler: RA (k e_c . + h L ,, U S Signature of Applicant: i'll Date: 7 ZZ/2 i l