30B-024 (2) BP-2021-2068
21 LIBERTY ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
30B-024-001 CITY OF NORTHAMPTON
Permit: Addition
PERSONS CONTRACTING WITH UNREG1S71:RED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-2068 PERMISSION IS HEREBY GRANTED TO:
Project# ADD FRONT PORCH Contractor: License:
Est. Cost: 7500 IRA CURTIS 113741
Const.Class: Exp.Date:04/18/2023
Use Group: Owner: CURTIS IRA& HILARY CURTIS
Lot Size (sq.ft.)
Zoning: URB Applicant: IRA CURTIS
Applicant Address Phone:, Insurance:
21 LIBERTY ST 413-270-2336
FLORENCE, MA 01062
ISSUED ON:11/01/2021
TO PERFORM THE FOLLOWING WORK:
REMOVE DOOR OVERHANG AND ADD FULL WIDTH PORCH ON FRONT OF HOUSE
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 QT
.)2
I
Fees Paid: $65.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
File #BP-2021-2068
APPLICANT/CONTACT PERSON:IRA CURTIS O I G
ZvaK
21 LIBERTY ST FLORENCE, MA 01062413-270-2336
PROPERTY LOCATION 21 LIBERTY ST
MAP:LOT 30B-024-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $65.00
Type of Construction: REMOVE DOOR OVERHANG •'I ".:0 FULL WIDTH PORCH ON FRONT OF
HOUSE
New Construction /1
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
intermediate Project: Site Plan AND/OR SpecialPermit With Site Plan
Major Project: Site Plan AND/OR SpecialPermit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
n ff//��//
/
• mg l� i a l
S ;+ ature of Building Official b Date
J
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
te,_ o The Commonwealth of Massachusetts
.. Board of Building Regulations and Standards FOR
14 MUNICIPALITY
Massachusetts State Building Code, 780 CMR USE
I— Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 .
o One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 6P-off 1- 2.0(,i Date Applied:
r
Building Official(Print Name) Signature I ate
SECTION 1:SITE INFORMATION
1.1 Property Addres : 1.2 Assessors Map&Parcel Numbers
2 I LI b St 1616 82.4-DO)
1.1a Is this an accepted street?yes X no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property
.13 Aors-s Ibi..2c
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
I0 15' 2O
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public CIO Private 0 —Zone: Outside Flood Zone? Municipal On site disposal system 0
Check if yes13►
•
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owne 'of ecord:
I r2.A C,vt ,4 I ►kit1 Cent;\5 f l Otvb-N tk- A()A 016L.2
Name(Print) City,State,ZIP
z-1 G,b1; * 411) 21-0 233 b In.a.Ctticks 6 6."PA I• -
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building'& Owner-Occupied Cr Repairs(s) 0 Alteration(s) tli Addition 0
Demolition tii, Accessory Bldg. 0 Number of Units Other ❑ Specify:
Brief Description of Proposed Work': IZ etvoyC %v%A 118X I ST1 I� -9onv 0 veyz,1 AN ii Ar(
1►d A 14 cy w rv-
II cH- ¶Ot2-614 alrI fr+-*,�. cif +t ►sm. 1 -Tvltit-A
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building S1 06 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: S
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire
Suppression) $ Total All Fees: ,
Check No.I I Check Amount: rt1(44 Cash Amount:
6. Total Project Cost: $ 1 c oZ, 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CS ) CS—I 13 1/111312023
lri.ott ,\PC)n)t -) 1 S License Number Expiration Date
Name of CSL Holder
,2( t I17614-1C-A List CSL Type(see below)
No.and Street Type Description
O p� Unrestricted(Buildings up to 35,000 cu.ft.)
1 1 V�j 2_ R _Restricted 1&2 Family Dwelling
City/Tbbwn,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
/ SF Solid Fuel Burning Appliances
7- 6 233,v. 11-A . 141U--k Sty 6 M Pd I •CY 1►� I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
/��� �.bs81
I�� h�'�� HIC Registration Number Expirati Date
HIC Company Nam or HIC Registrant Name
21 LIb -h- So- In-Pc .C,Ar��40,6w1All.Cer-
No.and Street Email address
f lore- m A Mao- ti ri 21-0 23'3 '
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 triA l/i
to act on my behalf,in all matters relative to work authorized by this building permit application.
1 �,A. Inl1'I 15 a(q �,r3�1
Print Owner's Name(Electronic Signature) I Date
SECTION 7b:OWNER1 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.
A 4i5 ib111-(76'2-1
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.) (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"
11,.. The Commonwealth of'11assachusetts
ill=WM, 0.1
Department of Industrial Accidents
1.1—gz.,71**ctr
' e 1 I Congress Street,Suite 100
Ibk wril&or )
Boston, MA 02114-2017
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wwwmass.gov/dw
IS orkers'Compensation Insurance Affidavit:Builders/ContractorsiEkctricians/Plumbers.
11)BE FILED Wait THE PERMITTING AUTHORITV.
Applicant Information Please Print Letihh
Name IBUSUICis Orga ntia lica,Endi v hi ua 4.
- 6 InA
... A........,
Address._11_L.l_AlzEftki '91-
City/State/Zip rigt),-Ckf(Z tyjA al 0,b--1,- Phone#: if Ir.- 7:9"° . "-....4 3,1 '
Are yam ea tstiptit:k er?I'heck the aptimpriale is,s: Type of project(required):
1.0 i am a cuipkoy er'.§.Lib enqiloyei:s(full limier patiginkt• 7. 0 New construction
_'ati i am a soak proprietor or partnership and kave no employ LV3 working for me in K. 0 Remodeling
any tamacity.No workers'comp.insurance required
9. D Demolition
31:11 am a honscoutter doing all work myself.[No winters'eurnp.insurance required,'°
10 c3 Building addition
4.0 hint a lionscov,tic/and vial be hiring...ontracturs,to conduet all work on tny property 1 will
ensure that all contractor either have workers oacupetuabon.inaurafter of are aolc ILO Electrical repairs or additions
proprietor,.with no employees. 12.0 Plumbing repairs or additions
SO I am a general contractor and I have hired the sub-corttrackus listed on the attached sheet
130 of repairs
These0k-cunt/wars.have employees and have workers'comp.insurance.;
14.0Other I..it—ifq 'Porz-ab
ha We arc a corporation and its officers have exercised dam tight of exempbaci per MC,L c..
152.,*101.and we have no miployees.[Ni workers'comp.insurance requimill
An Applicata that chocks boa a 1 most al,o till out the section below show ifISZ their workers'cornpensatiun policy information.
+I tortkowncr.who submit than Aldus a cadicaling they are doing all wort and then hire outside contra:tors Inthl submit a new aliadit indicating such.
;Cofaractor's that check this boa must attached an additional shect%how mg the name of the sub-covaractors and state w 10..tiler or not those croaks have
cmployccs If the sub-contractors luise cireplo:.ces.Lilo;mum pu,.hie their °A orker,"oonir.ponc:., numbe.r.
I ant an employer that is pro-riding workers'compensation insurance for my employees. Below is the policy and job site
information.
' Insulance Company Name: —
Policy#or Self-ins. Lie.#: Expiration Date: .
Job Site Address: City/State'Zip:__
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under NiGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00
andlor 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
cos erase verification.
/do hereby certiff under the wnins penalties of perjury that the information provided obore is true and correct
vz‘T2_,.. _ 1)alt: Il 5 1--÷(^7-41'2—)
Signature:
Phone : 1 i-2, 213 ic,
I Official use only. Do not write in this area.to he completed I city or town official.
('its or Town: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
t nntact Person: Phone#:
„ I
City of Northampton
. rO�, ,.._-
,,../_a, tiff. � x _ C srr''
Massachusetts
.t' w v
II DEPARTMENT OF BUILDING INSPECTIONS S
212 Main Street • Municipal Building ti3', a
Northampton, MA 01060 fj's'1 .;lt\'``
' 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: VAI(*6-1 TieZy O r 2 1-1 at9THAw 4ON 12-1)
Merct14Am M4 00 0
The debris will be transported by:
•
Name of Hauler: IAA e},,,ni-,-
c
Signature of Applicant: h-"\___ l �> Date: iD I1- �d �
CITY OF NORTHA.MPTON
SETBACK PLAN
MAP: , ' LOT: C i{ '0(.) 1
LOT SIZE e w'x Iry,•
REAR LOT DIMENSION: =.�E.._t' '":.._.
REAR YARDrr,
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SIDE YAKD )
SIDE YARD____._ __
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FRONT SETBACK BAC K
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FRONTAGE • . ' , 4.µ' h:-