24D-067 (10) BP-2021-2034
32 PERKINS AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-067-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2021-2034 PERMISSIONIS HEREBY GRANTED TO:
Project# WOODSOTVE Contractor: License:
Est.Cost: 8000
Const.Class: Exp.Date:
MCKAY WILLIAM F& DANIELLE J & DENISE A
Use Group: Owner: MCKAHN
Lot Size(sq.ft.)
MCKAY WILLIAM F&DANIELLE J& DENISE A
Zoning: URB Applicant: MCKAHN
Applicant Address Phone: Insurance:
32 PERKINS AVE
NORTHAMPTON, MA 01060
ISSUED ON:10/15/2021
TO PERFORM THE FOLLOWING WORK:
REMOVE PELLET STOVE AND REPLACE WITH WOODSTOVE
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:
• III t •
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
RECEIVED
1
ea 142021
The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
Y u BUILDING INSPECTIO MUNICIPALITY
f HAMPTON,MAotoso Massachusetts State Building Code, 780 CMR USE
Building Permit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Buildi/LE
g Permit Number: itL I'' Al. ci to Applied:
U) ZSS _ >D-15-20Z/
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
32 Perkins Avenue 24D-067-001
1.1 a Is this an accepted street?yes X no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
URB Residential .14 acres
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 l Private 0 Zone: _ Outside Flood Zone? Municipal ® On site disposal system ❑
Check if yes®
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Danielle J&Denise A McKahn&William McKay Northampton,MA 01060
Name(Print) City,State,ZIP
32 Perkins Ave 413-320-7208 danimckahn@gmail.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2 (check all that apply)
New Construction 0 Existing Building 1N Owner-Occupied ® Repairs(s) 0 Alteration(s) Ell Addition 0
Demolition El Accessory Bldg. 0 Number of Units 1 Other 0 Specify:
Brief Description of Proposed Work2: Remove pellet stove,exploratory demolition,reinforce existing wood floor
framing,extend hearth floor beneath planned wood stove insert with 4"thick stone slab to 16"beyond existing
fireplace opening at front and to 8"beyond fireplace opening at sides.Build additional ember protection extension area
extending 22 7/8"behond existing fireplace door opening with 3/4" stone surface.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 8,000 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2.Electrical $ None ❑Total Project Cost' (Item 6)x multiplier x
3.Plumbing $ None 2. Other Fees: $
4.Mechanical (HVAC) $ None List:
5.Mechanical (Fire
Suppression) $ None Total All Fees: $
Check No.II 1 Check Amount L4 Cash Amount:
6. Total Project Cost: $ 8,000 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) t
CS-114308 06/01/2023
Danielle J McKahn License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
32 Perkins Avenue
No.and Street Type Description
Northampton,MA 01060 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
413-320-7208_ danimckahn@gmail.com 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 . 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.
Danielle J McKahn it� ;rr;F''��. 10/13/21
Print Owner's or Authorized Agent' 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.) (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
h. t a r:
DEPARTMENT OF BUILDING INSPECTIONS S
i
so.= 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: Valley Recycling
Location of Facility: 234 Easthampton Rd, Northampton MA
The debris will be transported by:
Name of Hauler: Owner, Subcontractors
Signature of Applicant: 1 ,' `i' .._. Date: 10/13/21
The Commonwealth of Ifassachusetts
Department of Industrial Accidents
1 Congress Street,Suite 100
„NM*
41 Boston, MA 02114-201
'•0` www.mass.govidia
i,rkers'IC'enipensation Insurance Milli it: linikler1iContractorsiElectriciansfPlumbers.
TO BE FILED WITH TIIE PERMITTING AUTHORITY.
Applicant Information Please Print LeteibIN
Name fl3UsiniCs.0. t Danielle McKahn
Addre : 32 Perkins Avenue . .
CityiStatc.zip: Northampton, MA 01060 Phone#: 413-320-7208
Are t nu an employee Cheek the appropriate hat:
pc uf project(required):
. /am a employer with entployees(full andior parttime)... 7. 9 New construction
.1.0 I au a sole proprietor Of rmainaship and have no enployno working for trie M. El Remodeling
an capacity[No workers'comp.earnx rixtutrail
4.. X E)erriolition
.10 I ani n:fii,trami.kner doing all work myself.[Se workers'comp.insurance reqinnill
10 El Building addition
4.2 lam a homeowner and will Se hams coestracor%to conduct all wrok on my preipkip... 1
einure that all contractors either have*twit ers coinpensatum insurance or are sole 1 1 LIcatrical repairs or additions
proprietors with rio employees,
I2D Plunibing repairs or additions
I ant a gerimal contractor and I have hired the sub-contractor%hibaii on the altathieJ I :
I 3 Roof repairs
Ttiem:sub-euratmetors employee,and bove workers'comm. .E]insure:1mi
14. Other
60 We are a eorporatheal and 1T.4.officers ha v e exacised then nab/of exemption per WI.
11‘1, It4t.and we have nu ernploynes. wurktms`comp.insurance requrred.]
appl wacit that checks boa al mad 11641 fill out die section below shoth Mg their workers'compensation policy informatiort
• kiOineowners who submit tAni.affidavit 111.41.11:'sting they are doing all work arid then hire outside contractors mint submit a aelw affidavit Indic-Jill-le such.
:Comr=tors that check ilia box must attsc...bed an additional sheet%bowing the none of the,:ab-contractors and mate whether or not tkaav rntauin.hAtt
o.• If ttu•suh.coriarnetors have employees.thc!, mua pnwide their wt.r TrIp.Ixrip,:y UM',Cr
4,0II
I ton an emplr,rer that i providing worAers•compensation insurance fur my employees. Below is the indicv told jab.%itt.
information.
Insurance Company Name:
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: City/StateZip:
Attach a copy of the workers'compensation polkv declaration page(showing the policy monsber and expiration date).
Failure to secure coverage as required under.N1GLi.... 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 st,:iteinent itrdy he forwarded to the Office of hi estigations of the [MA for insurance
coverage verification.
I do herd)) tern:1i.,water lire pally and penalties of perjury that the information,ororiilcar a/;at e i /r.ue anti correct.
/I ,t
Syznaturt: ! Flaw. 4/30/21
413-3201-7208
Official use only. Do aid write in thi.N area. to be toruphqcif by city or town officiaL
City or TON n: Permit/License
Issuing Authority(circk one):
1.Board of Health 2.Building Department 3.Cky/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
( tutisct Person: Phone It: