01-001 (10) BP-2022-0104
710NORTH FARMS RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
01-001-001 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-2022-0104 PERMISSIONISHEREBYGRANTED TO:
Project# KITCH RENO Contractor: License:
Est. Cost: 58000 ERIC PAYNE 086442
Const.Class: Exp.Date:01/22/2023
Use Group: Owner: BRIERLY-BOWERS KEITH W&PATRICIA E
Lot Size (sq.ft.)
Zoning: RR/WP/WSP Applicant: ERIC PAYNE
Applicant Address Phone: Insurance:
32 HURTS PIT RD (413)218-4276
NORTHAMPTON, MA 01060
ISSUED ON:02/03/2022
TO PERFORM THE FOLLOWING WORK:
KITCHEN RENO
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:
Gas: Final: Final: Rough Frame:
Rough: Fire Department Drive way 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
• r .
Fees Paid: $377.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
JQEIVE -;
JAN 3 1 2022
•� t:Fp-r OF GUILDtNG IN r :ott1't O11wealth of Massachusetts
--n. NORTHAMp1ON,t, 'IglAktuilc ing Regulations and Standards FOR
• 1 �^" <_s< tsState Building Code. 780 CMR MUNICIPALITY
'� USE
Building Permit Application To Construct. Repair. Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Duelling
This Section For Official Use Only
Building Permit Number: 6,".a.), oti Date Applie :
i Ii 'i
rt , - ► --;s_ a 3as
Building Official(Print Name) Signature II D to
SECTION 1:SITE INFORMATION
1.1 Property Address: `
R 1.2 Assessors Map& Parcel Numb••ti
-iIC 1`: • tiN i\\ s. tti Q t Q
I.Ia Is this an accepted street?yes no Map Minter Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed t ik Lot Area tsy Ill Frontage(lb
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.(i.1.c.40.§5a) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private CI7°nr. Outside Flood Lone? Municipal 0 On site disposal system 0
Check if.rs❑
SECTION 2: PROPERTY OWNERSHIP'
2,1 Owner'of Record: , .
sed '-&/ir,.:,I4 b_c,'coley-&t,de" f-/0-Dy1c el i.41_ C Io L---- -
Name(Print) Cite.State.ZIP
2/C 41, A r WW0 _yri'_ ,;27y Abi, .Le &'y;A4.•. . CO-xi
No.and Street telephone Iimail Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alterati n(s) 0 Addition 0
E Demolition 0 Accessory Bldg. 0 Number of Units Other j:44 1 Spccil irt." 44.
Brief Descriptione1 of Proposed Work': K �t<H .F 4.` L yy b%. ..c ` al, _ _ v. ,>L
._.LAYS thAmi. :e GeyVhA 4
f SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ .r d 6 p p I. Building Permit Fee:$ Indicate how fee is determined:
2. Electrical $ ` el b D 0 Standard City/Town Application Fee
0 Total Project Cost'(item 6)x multiplier x
3. Plumbing S 2 0 0 O 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees 1 �]
Check Net/ Amount: 3� Cash Amount:
G.Total Project Cost: $ 5" 1?O 0 U ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES /
5.1 Construction Supervisor License(CSL) r_1 Z- 7i3
?O•h '' - license Number I.x irafion I).te
Name of CSI.I folder
32 So J N4 P• list CSI.Tt,>L(ice le lrn,)
No.and StreetType Description
l\ 1' l Inrestrictrd(Buildings up to 3;.11111)eu. h.)N ' two,' R Restricted 1&.2 Family I)aclling
City/Town.State.ZIP M Masonry
RC Rooting Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
q 13 ?XVI I". ell.Ili C6 y, .1.14'
I Ins,dation
Telephone mail address I) Demolition
5.2 Registered Home Improvement Contractor(HIC) 'Pro k
• C��� - I IIC Registration NumberIsp alion Date
CompanyY� v
1 I ItCompanyName or I IIC Registrant Name wA�y,�
No.and Stmct L) '
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 0 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 6 Y t C /?f
to act on fmfy behalf in all matters rei. ive to work authorized by this building permit application.
2/4-t-C7f:
Print Owner". 1'iame(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.
?&rut.-
Print Owner's or Authorized Agents Name ttilccu-onic Signature) Date
NOTES:
I. 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. I42A.Other important information on the HIC Program can he found at
Information on the Construction Supervisor License can be found at
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. If.) 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 ofcooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost'
City of Northampton
f •
Massachusetts
'1ri K DEPARTMENT OF BUILDING INSPECTIONS 5 _
;- k-P"+ 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:
Location of Facility: 4 ) ‘\\\`'\-\11/41\V
The debris will be transported by:
Name of Hauler: `\qd\NS
(-, — ,i: ,E----,
Signature of Applicant: Date: I f3t( 1
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