24D-151 BP-2021-2330
,`14 CARPENTER AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-151-001 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-2021-2330 PERMISSIONIS HEREBY GRANTED TO:
Project# renovation Contractor: License:
Est. Cost: 65000 OAKDALE PROPERTY SERVICES 107356
Const.Class: Exp.Date:09/26/2023
Use Group: Owner: 14 CARPENTER AVENUE, LLC
Lot Size (sq.ft.)
Zoning: URC Applicant: OAKDALE PROPERTY SERVICES
Applicant Address Phone: Insurance:
51 RATTLE HILL RD
SOUTHAMPTON, MA 01073
ISSUED ON:01/04/2022
TO PERFORM THE FOLLOWING WORK:
REPLACE FRONT DOOR on unit 16,REBUILD FRONT & SIDE PORCH, REPLACE 3 TUBS
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:
V 51.41 •
10
Fees Paid: $455.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
( R
2021 `,
The Commonwealth of Massachusetts
trisPEc-I'L _3 Office of Public Safetyand Inspections
��{1.oi e, !� co0�� Inspections
` pEP-TIOFr��. ��� Massachusetts State Building Code(780 CMR)
__------Buiding Permit Application for any Building other than a One-or Two-Family Dwelling
el" (This f edion For Official Use Only)
Building Permit Number c l—a 3 W Date Applied: I db J stOj al Building Official:
SECTION 1 LOCATION
Nq.and Street City/Town Zip Code Name of Building(if applicable)
Cf St/7.
Ave Nor -to 10 C c?
Assessors Map# Block#and/or Lot #
SECTION 2 PROPOSED WORK
Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below
Existing Buildings,$. Repair t. Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy ❑ Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No'151:
Is an Independent Structural Engineering Peer Review required? Yes 0 o fa-Brief Description of Proposed Work Q tt c,ce 1 rO► DO(a r C?Y r\ lI n t} (�1. ke6u i l c
l0evioe IPocc,1,. Siete: rle -(uI�ra"a�cA3a-ve►�v►eVf) (s lcce • 3
U�k1. 4--0 bs Ldi 1 ( t w F )er,(c4 53, ►"f * ( flv It
clewr S
SECTION&COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) D
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA an
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A 1❑ A-2❑ Nightclub 0 A-3 ❑ A-4❑ A-5❑ I B: Business 0 I E: Educational 0
F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
Ii Institutional I 1 0 I-2❑ I 3❑ 1-4❑ Mi Mercantile 0 I R: Residential R 2❑ R 3❑ R-4 0
S: Storage S-1 0 S-2 0 U: Utility❑ Special Use Cl and please describe below:
Special Use Description:
SECTION&CONSTRUCTION TYPE(Check as applicable)
IA IBO HAD IIBD MA MBD IVD VAD VB�
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit Debris Removal:
PublicA trench will not be Licensed Disposal Site 0
req� Check if outside Flood Zone 0 Indicate municipal
Private 0 or indentify Zone: or on site system❑ u or trench or M R.permit is enclosed CI (�Gt�-e_
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable.l Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes❑ or Miles- Yes 0 No
SECTION&CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
f% Crew 1);Rti - :2k Cres -ii ( tLiki,k .0QQC-t .Ne, MA- 01 -, i
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
003 Y1QCon _)od_ '7707 cfl 7 _AO_ci 70 J, ru-zzAa --,(c.dc ► t,1•«
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,th9NpropeTty owner hereby authorizes
af',(-kjA\ c9.411 SiQ( 1Les Si QtAkF 1\
�.. ' ,l ,ak(irl e v1 AA 0 1 0
-73
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of endosed space and/or not under Construction Control then check herb
Otherwise provide construction control foms(see section 107 in the code)r as required
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) r
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Oa L dcAe Pro?Q( S kci ic eS
Com y Name
JOhcAA,CA� V:A c. C L - ) 01 3 -- `� kA3S CQ
Name of Pe Responsible for Constructi n License No. and Type if Applicable
51 C.- 1 e Ni l 1 4. So 0 i1,a wt -o A /P1 A di 0 73
Street Address r City/Town 1 State Zip
0)5_12G 4R-_� 9 31 ( - 4137S- 0,-,,k,ale\,,Ntbkr-HQ, 1c-Lto . co.�
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit f ut the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes I No El
SECTION I2:CONSTRUCTION COSTS AND PERMIT FEE
Estimated Costs:(Labor T
Item and Materials) Total Construction Cost(fruut Item 6)_$ '>, v
1.Building $ G 5; ° Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)=$ .
3.Plumbing $ ['
4.Mechanical (HVAC) $ Note:Minimum fee=$1.(contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ C.i� c i 0 0 c7 (contact municipality)and write check number here (61 G 7
SECTION 13c SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest ••. •• ,•'••and penalties of perjury that all of the information contained in this
application is true and accur to the best .f my . , ledge: derstanding.
J0V1C\-\—\\Qh ;`c Nil / • o)v'tc 9)3.7.2 /3 75 1 Q 1
Please nt ign name Ti 1 Telep ne;,. Date
S I -gG 1�:11 K1 �� k, 40 /✓� d I0
13 Oa�Cc1�1e op�( .(01
Street Address City/ in State Zip Email Address
e
Municipal Inspector to fill out this section upon application approval: s il)► , _
Name D ate
The Commonwealth of Massachusetts
Department of industrial Accidents
l; V^ I Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
11 pikers'Compensation Insurance Affidavit:Builders/ContractorsfElectriciansiPluurbrrs.
I()BE FILED V.I7 H THE PERNI'rriNG At'-hHORfl v.
Applicant Information cam/ Please Print Ixtiibls
Name 4 Business Organs ation Individual): QQ\k ``Ae S c ) �Ce
Addre.s : S 1 A k.. �� �� < 1 \'�C-
010�3
City/State Lip: 5s \\ �1 Phone#: 1413 0)-Cv IA
Are Cheek the
7+�a.employer? appropriate
Tt,prof project(required):
1 1 am a employer with employees(full and or part-time i_' 7. 0'�i�w construction
��J{L�I am a mole proprietor(Ni'itor or purtnerthrp and hate no employees u-Burrg for one in $. Rernodebng
(J capacity.(• 'worker;eiaup.union .
9. ❑Demolition
1 am a homeowner doing all work nnymi.lNio wurkors-comp.ueurmce rcydured.
4.0 I am a horneou rr-r and will be hung oorgrachors to conduct all work on my pnspetty. I w ill
100 Building addition
eiAun that all contractors either ins►vWlcn compensation insurance or are MAC I i.Q Electrical repairs or additions
pnlpncturs w Ith no cmplul,'c....-
12.a Plumbing n.patn or additions
;0 I am a central contractor and I hate hired the sub-contractors listed on the artashed sheet.
art
Them sult-contraetun hate eTnployi comp.
n and hate workers'cor .uc,uranec. 13.DRcxdf rep
o Q We are a corporation and its ofIceis haze estTeised then nrht of exemption per\K
14. then r)
152.4It41.and we hate no eTmrluyces. Nit workers"comp.insurance rnluued.
'Any applicant that eh,s ks bus r1 roust also fill out the section hcluw%bourne their is onleTs'compensation polk_t intrmnation.
*Ilonneu,t nets whoa submit this atfr'llat it indicating dies an:donne all work and then hue outside eiRtu-jetur-.must subuul a new aftittat it rndi.atiig such.
:t'untracturs that check this box must attached an additional sheet shouinir the name of the sub-eorttxact rs and stale whether or not those stratifies hate
employees. It the sub-contractors hate employees.they naist ruin ide their worker, sionip.policy number.
I am an employer er that is providing wortters'compensation insurance for my employees. Below is the policy and job site
information.
lntiuiattec(.otiiparis \aitle.
Folks or Self-ins-Lie.~: Expiration Date:
lob Site Address: CitytState2:ip:
Attach a copy of the workers'compensation policy declaration page(show ing the policy umber tmd espirathn date).
Failure to secure coverage as required under MGL c. 152,*25A is a criminal violation punishable by a fine up to S1,500.00
and ur one-year imprisonment,as well as civil penalties in the forth of a STOP WORK.ORDER and a line of up to S250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations oldie DIA for insurance
coverage verification.
I do here pains and penalties of perjury that the information provided abort.is t me and correc•t-
t
SiasnaSignature: t��),1� I)al�c. � �{ (?
Phone». ( (.
Official use only_ Do not write in this a completed tit•city or town official_
City or Town: Permit;'l.icrnse ti
Issuing Authorits (circle one):
I.Board of Health 2.Building Department 3.( its+l ties(leek 4. Electrical Inspector 5. Plumbing Inspector
6.Other
('intact Person: Phone#:
01111
City of Northampton
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DEPARTMENT OF BUILDING INSPECTIONS a. o G'
\*�: 212 Main Street • Municipal Building �Jk a�
Northampton, MA 01060 .rJJ 3O°``
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: /Di -t- 3 \ r''1 ', 1` R , \-cb\filse_ ,A A
The debris will be transported by:
Name of Hauler: Di1 R Ld,,,, -e_ . Cc,I 6\e /✓� A
1 1
Signature of Applicant: - Date: ID/0)042 t
r