31A-268 (9) BP-2022-0153
47 DRYADS GREEN COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
3 I A-268-001 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-2022-0153 PERMISSIONIS HEREBY GRANTED TO:
Project# BASEMENT RENO Contractor: License:
Est. Cost: 35000 KUEL MCQUAID 051394
Const.Class: Exp.Date: 12/1 1/2022
Use Group: Owner: ZUCKER ADAM L& HEATHER K ABEL
Lot Size (sq.ft.)
Zoning: URA Applicant: KUEL MCQUAID
Applicant Address Phone: Insurance:
131 FERRY ST 41335375063
EASTHAMPTON, MA 01027
ISSUED ON:02/16/2022
TO PERFORM THE FOLLOWING WORK:
BASEMENT 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 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 . Tit •
i
Fees Paid: $228.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
1 ., The Commonwealth of Massachusetts , FEB J
Board of Building Regulations and Stan �rds 6 �Q IR
Massachusetts State Building Code,780 .1 --_._ F E�ITY
�t� r.Building Permit Application To Construct,Repair,Rcriovati; l4l �c oo evisdMar 2011
One-or Two-Family Dwelling
This Section For Official Use Only _
Building Permit Number: 1609.' .? "I 53 I Date A plied:
n
A; • f i v„ •WI
_j246/a_.D.,
Building Official(Print Name) Signature Dat
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
y7 )1L/A ,( 3 C
lk �. c i
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
' Ai M Sv Cic£.n_. A4oa_ M 4 0 I D�>o
Name(Print) City,State,ZIP
L el D(-Y d D S G-R-E E N 9!7"S 7 —0312- AbAuvwc ca.-Q.Cr+-+a 1 .c
" No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) of Addition ❑
Demolition 0 Accessory Bldg. 0 Number of Units " Other 0 Specify: '
Brief Description of Proposed Work': ir;1,t,;5t.t, e l3ct_sew.e,^4 -1-o 1.-:v;44, Spa`ce_
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 3 1. Building Permit Fee: $ Indicate how fee is determined:
r'G�� _ 0 Standard City/Town Application Fee
2.Electrical $ f U 00 ❑Total Project Cost3(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees 0
' Check Nod IA Check Amount: /»Cash Amount:
6.Total Project Cost: $ 3 s t v00 1 ❑Paid in Full 0 Outstanding Balance Due:
City of Northampton
0 o 'ss " s1
f'�•'"� Massachusetts ��5 e,
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building yeti C
s 1
�. . Northampton, MA 01060 �W ar)
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 &2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES,
FENCES, GROUND MOUNTED SOl AR, ETC.
I. Building Permit Application signed by legal owner and filled out by owner or authorized agent.
2_ One set of plans and specifications of proposed work (Digital and hard copy)
3. Site plan with location of proposed structure(s) and set backs.
4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability insurance.
7. Energy Conservation Compliance Certificate (new/ replacement windows).
8. Home Owner's License Exemption Form filled out and signed by Homeowner (if applicable).
9. Note any Conservation and/or special permit requirements (if applicable). 10.
Driveway Permit (if applicable).
1 of Water �r paid applicable)
l 1. Proof and Sewer entry fees (if
12. Trench Permit - public land by DPW/ private land by Building Dept.
13. Stretch Energy Code - ail new construction wiii require a HERS Rater Affidavit to be submitted witn permit
application before issuance of permit.
'4. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton_
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
,n r-4`-6 S l 3q'f- i 22
Kt/ J r►L G2vcc!,4 License Number Date
Name of CSL Holder
3 ��.� c S List CSL Type(see below) U
No.and Street L Type Description
s wl1Ol U Unrestricted(Buildings up to 35,000 cu.ft.)
CitylTown,State,ZIP \ R Restricted l&2 Family Dwelling
M Masonry
MA 0 1 0 Z.7 RC Rooting Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
y/3-537-5063 /IC�v4;tJr, r ve I G4(A,k4,(, I Insulation
Telephone Email address c.o+H D Demolition
5.2 Registered Home Improvement Contractor(HIC)
we I GQ /0 6 70 0 n
23 ZaZZ
M . Q�c ` HIC Registration Number Expirati Date
HIC Company Name or HIC Registrant Name
/3 cc ��- MCQvgki.tiC�LI 6) iMc�.l •�
N and Street C Email addr
0.w
CLS-i-kkAeL ekik MA 13-53?_So6'3
City/Town,State,ZIP L (O 27 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 .. . l27- 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 Kti e—I M a c A_
to act on my behalf,in all matters relative to work authorized by this building permit application.
. Z IA 2/I6/Ze 22
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
7' , contained in this application is true and accurate to the best of my knowledge and understanding.
r4D1 ?Al Lkat 2116 f-lo22
Print Owner's or Authorized Agent's Name(Electronic 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. 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
t 3. "Total Project Square Footage"may be substituted for"Total Project Cost"
-an-OF NORTHA PTON
SETBACK PLAN
MAP: LU I
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
SHAM
p
jJ?'"A•'� Massachusetts
•,• ( ‘ DEPARTMENT OF BUILDING INSPECTIONS 9
� 212 Main Street • Municipal Building Jti
.. "i. Northampton, MA 01060 rsMarpW `'‘OC�
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
in accordance of the provisions of MGL c 40, 554, 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: A.11421 f?ec J t etNnr4fiv\ M,
The debris will be transported bv:
Name of Hauler: , tee. I / c
Signature of Applicant: //t Date: lb 22
The Commonwealth of Massachusetts
Department of Industrial Accidents
= I Congress Street.Suite 100
Boston.MA 02114-2017
s
N•wn ntass.go►*/ilia
�1 iuker.'('unlpensation Insurance.UTydavit:Builders)("ontractursftaectricians!Plumbrrs.
10 HE FILED N Ii I1 TILE PER)111r1 lt(:Al 1110R1 tl.
1pt►licant Information Please Print fxt_ibh
Name(Business.Otsarkitatton Indic i.Ettal): , I al e) frt c, t/c+`l
Address: )31 r z cc
City/State/Zip: Ec1/454kcomerrovk frak otc27 Phone#: 413 = S3 7-Sow
Are'us an c er?('heck the appropriate thdx:
Type of project(required):
11.01 ant a curb.*ea with 4.-mployees(till and tot part-roan?-' 7. New construction
_".1t Jul a molepimp-limn ur putince.hip and hate no employees wurkuiF kir Ilk:in S. (�RL•rntrilt:ling
auto capacity.iNti wadi, co
mp.nnurrncl RYpiiad_I LLL���JJI
D 1 ant a honk--.ttnt doing all t+udl ny.rht_Fittut'uthux'comp..hzaur.inc n quited.1
9. Ell Demolition
loci Building addition
1.0 I ants Ie f Ltnttr-t and will he hiring contractors W xvudtatt all autk on my itrttleetty.. 1 i ill
cotton:that all contractor.either hate wotken'cump►ittatitut tinurtnce.n arc mule l 1 Ekci tea)repairs or additions
pruprictors vetch no ettrplayec%.
12.0 Plumbing repairs or additions
50 I ant a goicral contractor and 1 Iaate hind the wbctnrtractors fisted on the attached sheet..
thew hate employee%and hate not er,'comp.m uratne. 13 Rtlut repairs
,t
14.0Othci
6.0 Wean a amputation and its officer.hate cu.-wised then night of exemption per
132.11(0).and we have nu cuiplo_VCCS.INu nutter,'comp.nnuaaace rexluited.I
'Ace!,apl.lecsnt that checks thin 41.met 360 till ow[the.cetxne IRiuu.hi.tsthat:thotir trurkcr.compensation pith.:}mleantatnui.
lloincott net.Alto suhnnht this allidusil indieLarirtgthe.}" arc doing all wank and then hue outside contractors nuns.mites'a new Aid %it indicating mach.
C On :ttt tion cheek.that the.box vaunt attached 22*hilt.).IKet.he mina the taste Oldie sub.-aantractuts and state tthKteh7 to not these tatlriic%(late
ciiipl.tt.cs It the suit-coniirackn%hate curiutce..th i ay must proeide them wutkcr.'comp.whet.number..
um an employer that is providing iding workers'compensation insurance for m► employees: Below is the policy and job site
information.
Insurance Company Name:
Policy.e tar:kit-ins.Lie.#: Expiration Date:
Job Site Address: ("its 'State Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy sumber and expiration date).
Failure to secure coverage as required under NICE c. 152.r25A is a criminal s ttilritwn punishable by a fine up to S1.50 0..t1U
andior one-year imprisonment.as well as civil penalties in the Wrin of a STOP W't!ILK ORDER and a line of up to S250.00 a
day against the violator.A copy of this statement troy lac timswarckd to the Office of Investigations of the DIA our insurance
cos craw verification.
I do hereby certify under the A
pains d peaaltie of perjury'that the information provided abore is true and c orrec t_
t, '/ (�'l.L %' Date: tZ/16 I Zo 2Z
St•riatur+r: i
Plume
Official use only. Do not write in this area.to be completed by city or town official
('its or Town: PermitiLicens#
Issuing Authority (circle one):
I.Board of Health 2.Building lhpartmrnt 3.City/town Clerk 4.Electrical Inspector c.Plumbing Inspector
6.Other
f i'intact Person: Phone#: --
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