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24C-064 (13) BP-2022-0072 88 MASSASOIT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24C-064-001 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-2022-0072 PERMISSION IS HEREB YGRANTED TO: Project# BASEMENT RENO Contractor: License: Est. Cost: 18600 Const.Class: Exp.Date: Use Group: Owner: EPPSTEINER ERIN E&ROBERT W Lot Size (sq.ft.) Zoning: URB Applicant: W EPPSTEINER ERIN E&ROBERT Applicant Address Phone: Insurance: 88 MASSASOIT ST NORTHAMPTON, MA 01060 ISSUED ON:01/26/2022 TO PERFORM THE FOLLOWING WORK: BASEMENT RENO FOR FAMILY ROOM POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumping Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I >2 . Fees Paid: $121.00 212 Main Street,Phone(413)587-1240,Fax:(413)5 87-1272 Office of the Building Commissioner JAN 2 1 2022 The!Commonwealth of Massachusetts FOR Biz(and odf Building Regulations and Standards MUNICIPALITY M4ssaclusetts State Building Code, 780 CMR nor. „�r,,.,,., ��,�. . USE BuildingPermit'Npplication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: arz j ,«7 Date Applied: I 66 D, Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 88 Massasoit, Northampton 01060 24C 24C-064-001 1.1a Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: URB 17,028 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 KI Private 0 Zone: _ Outside Flood Zone? Municipal la On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Erin and Robert Eppsteiner Northampton, MA 01060 Name(Print) City,State,ZIP 88 Massasoit 508-479-6293 erin.eppsteiner@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building l Owner-Occupied Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: X Brief Description of Proposed Work2: Basement remodel. Framing out basement. Drywall. Flooring. Intended use:family den/rec room Plan attached. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 17,400 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 1200 0 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 $ Total All Fees: $ Suppression) Check No. Check Amount: 6.Total Project Cost: $ 18,600 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street 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) HandyHumans LLC 203608 11/03/2023 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 73 Mount Tom Avenue No.and Street Email address Easthampton,MA 01027 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 Girl 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 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 ' application is true and urate to the of my knowledge and understanding. I \ -' ,k,4 z , (Li\ t f (') 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" Proposed Plan.png 1/20/22, 8:15 AM I. 20 4 *= t I ; 4 (s } 1 to A I 1p 21 1$ C ,s is 771 a I 4 https://mail.google.com/mail/u/0/ Page 1 of 1 City of Northampton j .icl , Massachusetts t _ V( _1 �ft DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building / �1r+►-. Northampton, MA 01060 , 1..:/ 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: Valley Recycling, Northampton, MA The debris will be transported by: Name of Hauler: Handy Humans LLC l ,` '7 �� /� of Applicant: A �'� Date: Signature pp G City of Northampton / O(HA: S ... S j��'• ' Massachusetts a? k_ e I - Ilk tG � 3 it;� I ;F ' DEPARTMENT OF BUILDING INSPECTIONS y - • 212 Main Street 4, Municipal Building Jb OD \. �`. Northampton, MA 01060 f,Yw Tov``� HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT 11/30/82 I, Erin E.Eppsteiner (insert full legal name), born_ (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 19 day of January , 20 22 (Signature) The Commonwealth of Massachusetts Ir l ammo of Industrial.Accidents Inat: gyp_ 6 1 Congress Street. Suite 100 Boston, MA 02114-2017 ,.� _ www mass.got/dia - 11 urkers'('ompensation Insurance Af idas it:BuiklersK'M ions.Plumbers. 10 BE. t H.1 U%%1'11i I Ht. P1:K111-1-1•ING AUTHORITY. Applicant Information Please Print l.r_ihh Name IHusttn'ss(iriramtisttion ludo ialitall: Erin Eppsteiner Address: 88 Massasoit Street City/StatefZip: Northampton, MA 01060 Phone#' 508-479-6293 AreRiau an tziiplo iui?Clerk tht apprgrrtatc tart: Type Sr pnjeet(required): 1.❑1 am a curio►cr uaka cfl luyrea(full and or part-bench.• 7. 0 New construction 2.01 am a sok p,uprntor or panncmhaverp and hae no err,h ', corking orking for me inS. D Remodeling and capacity.(No wothers'comp.a amance ray ura 9. Demolition 30 I am a Iromc�trwnr doing all work myself.(Ni,work,T,c:Amp_imuramx ar nayucal.1 ❑ 10 0 Building addition 4.0(am a mevw nor and u in i11 he hiring►nnlrn tun to conduct all work on rm pnrp►Tty. I will cnaun that all contractors collier his.vomit-b.vomit-b.compcmatrun uuuranca ur are ok 1 l.O Electrical repairs or additions proprietors w ith no c-nploycca_ 12.0 Phtmbmg repairs or additions Sin I am a gametal contractor and 1 has hutd the sub-ciwrtracto.,n lined two the attached sheet 130 ROOf repairs 71xsc sub-contractors has employees and ha..e wor►crs'comp.►nsurancc.: 14.ElOther 6.Q N c arc a corporation and its odd ors has c es.eTerxal their nth(o(cecmptwn per Nt(:l_c. 152.t It 41.and we has.:no arrpkncca.[`o worlcra•comp.insurance rc iurn-d.I 'An)applicant that clictks bus.=I mud also till out the%octane lobo showing then wurkcrs'compensation pintos m wo fonnatn. 1. n- Borneo% rs w ho submit tins att ik*t at riida atin:the!,at.dormg all work and then hare'outside contractors mull submit a nen strides it itiibcatrnt such. :Contractor,that check this tyre must attached an additional shoat showing the name of the sub-contractors and state w bother ui not those e011t1cs hate etriployccs. II the sub-a:mirac1 r.hate employees.titer must monde them workers`caimp.police number. I am an employer that is providing workers'compensation insurance for my emplorres. Below is the policy and job site information. Insurance Company Name:_ Policy or Self-ate.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 MGL c. 152,§25A is a criminal s wlatton punishable by a fine up to$1.500.00 and or one-year umprisomnent,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for in ::rice coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above i8 bete and correct. .S12y"natuie: c.- t / Mao_ A` /2 2 Official use only. Do not write in this area,to be completed by c ii)•or town official ( its or Town: Permitil.icense 1t Issuing authority (circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other E ontact Person: Phone#: 1/26/22, 1:51 PM City of Northampton Mail-88 Massasoit r . ,‘-• -111c, tt .---'.-- t tA vt.ktics t'. c31/4-i2-- 64: .. •• i; t..,,,, ,i.....i,05.,,,,,, _.4..-4,,,,,,.,e_gt„, 10, i .,..alle..).". Y; 5(1-t‘vii , . i ___ oroe-- I: 41114 , r . / ., .,„<,,,,k, lopvieit sT r f .1 ie. ,.., ‘ eA . { , , i„v, i,rP h „„\," otil ‘„, , as s4 C toye [ , �- y 0 1 ><.. , •, . .. , _ . ,,,,:s.,,,' ,*1-------'''''—* 11 '''!C.:;.) .,,)cs.IA, t--.,""t1A. 5 . r 2 �� 'P p'`' z , ,�s �'°,!te r Y �:� �„i,q t ` I a - i . https://mail.google.com/mail/u/1/?ik=e5d 1685713&view=pt&search=all&permthid=thread-f%3A1723042230869192135&simpl=msg-f%3A1723042230... 2/2