24A-209 (5) BP-2022-015.5
24 ADARE PL COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24A-209-001 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-2022-0155 PERMISSIONIS HEREBY GRANTED TO:
Project# staircase Contractor: License:
Est. Cost: 29000
Const.Class: Exp.Date:
Use Group: Owner: BODDY JAMES P & EMILY E WEBSTER
Lot Size (sq.ft.)
Zoning: URB Applicant: WEBSTER BODDY JAMES P &EMILY E
Applicant Address Phone: Insurance:
24 ADARE PL
NORTHAMPTON, MA 01060
ISSUED ON:03/01/2022
TO PERFORM THE FOLLOWING WORK:
add staircase from 2nd to 3rd floor
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:
.)2
Fees Paid: $189.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
The Commonwealth of Massachusetts— �
---
Aibe
Board of Building Regulations and Standards FOR
Massachusetts State BuildingCode, 780 CM MUNICIPALITY
1 6 ?(?2 USE
Building Permit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling "T
This Section For Official Use Only
Building Permit Number: AR^al d-'/`J"'S^ Date Applied:
0 ; 77.2p406 3
Building Official(Print Name) I Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 2 4 A-PA-e E PL 1.2 Assessors Map&Parcel Numbers
m-00-14,44ki P T D'v/v4 )/Ob 6
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❑ Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes
SE : 111PDPERTY OWNERSHIP'
2.1 Owner'of Record:
I L Y WE a STEW, TAm ES 150.NDy ORTh I N, dadO
Name(Print) City,State,ZIP
2.�} ,4-pAI ,E Pb 'oa szei J' 5& eMILY eau ILY t3ODPY.(0M
No.and Street Telephone Email Address
RIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building I]' Owner-Occupied [B Repairs(s) 0 Alteration(s) d Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2: We- a.Y e a d Olt ► a. S+-ti 2C Awl -f-n, S Cvn a( fa
-frt ire( -Hook , lll.rrc i S AP -ems i)lr i 4 a46 C/ 1 r-e(f
So ur( tth 1J (re cL.?) z yt y
1' '1
J
SECTION 4:ESTIMATED CONSTRUMMININIMIlle
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 2&, 600 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ fi pbo 0 Standard City/Town Application Fee
0 Total Project Cost (Item 6)x multiplier x
3.Plumbing $ 0 2. Other Fees: $
4. Mechanical (HVAC) $ b List:
5.Mechanical (Fire
Suppression) $ Total All Feers: $� 'q t
Check No. 1J.J Check Amount. b_I
6.Total Project Cost: $ Za I C7 06
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.)
City/Town,State,ZIP R Restricted 1&2 Family Dwelling
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)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street 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
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 this application is true and accurate to the best of my knowledge and understanding.
04I I LY wa5slt`x__ 2/1d/.202,2
ner' 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
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
1` -rah!/ Department of Industrial Accidents
I Congress Street. Suite 100
•
Boston. MA 02114-2017
wwwmass.got/dia
- 11 ur kers' ( ompensation Insurance:Adidas it: Buildersi('ontractorv'ElectriciansrPlumhrrs.
10 Bt. FILED wnH IIlk PE.RM1111 USG.st IHORIfl.
:Annlicant Information 'l Please Trutt Le�_ibl%
Name tlivatncs.Orilanitatton Inds.t.luall' E M ( �� 3o )V y
Address: 'L 4 A4) e Ft--
City/State,'Zip:_ 1�02 t Ar pro v'M,� Dlbi'�tone 80Z
5rr'.tier as cumin!.re!(heck the appeapr air bus: Type pr of project(required)
31 ant a arnplu.tt with empkoyues(full and or part-turret• ]- Net construction
l am a s.ik proprietor or purtnt-rship and have nu etrpttytt,worlmg for me in Remodeling
an)capacity (No%inters'com rc comp insurance yuutxl.) L-/
Obi a humeuu nt-i darn►all work mtadl.[Su wurltxs'compmsur.im x requiredJ.
9- p Demolition
to 0 Building addition
MD a&intim%net and%ill he hiring,anuracturs to cuatduel all work on my pruturt', I w ill
ensue that all Loner:sours either ha%e workers'euenpen,antin nnsurantti or an sole I la Electncal repairs or additions
prupnetors w rth no employ it's
1 2.0 Plumbing repairs or additions
5C3 li ant a item-tat tundra-to,and I ha,c hin:d the soh-contractors listed on the attaehal sheet
These sub-contractors base einpluyccs and ha.c w w workers'tnp.insurance. I3 Roof repairs
6.0 We are a tutpuratrun and exemplumotrcer,ha.a exercised their nght ut exemplum per\tt,t t
14.❑Other
152.4 it i.and uc haw no trnployecs.INo vs utters'cutup insurance rcyutn+d.I
•An.applicant that thaxka lox a t must also till out the section Milo%show m►their....Luker,':a'nipcnsalton pulacs tnlurmaturn
t Iionecow ners who submit Ilus attrda%it indatatinc the arc doing ail work and then hoc outside cu ntrat-tor,must submit a new attida%it uxlit-atmg au:h
:C-ontrattots that thcck this boo must ananhcd an additional sheet show mg the name ul the sub-:untr-a:tura and state whether or not huts-entittcs has.:
cmplonccs It the sub-contractors has:etripluytes.they trrual pros idc their wt'rkers t'.nnp,to ire.nwnhcr
1 am an employer that is proi•idinx woriterx'compensation insurance for m 1.cmplo)Yes. Below is the polity and job site
information.
Insurance Company Name.
Policy#or Self-ins.Lk. is: Expiration Date.
Job Site Address: CityStatelip:
lttach a cups (lithe norkers'comp nsat' policy declaration page(shots ing the policy number sad expiratdoa date,.
Failure to secure coverage as required under WA_ c. 152. .2:A is a criminal s iulation punishable by a tine up to SI.500.(X)
and or one-year imprisonment.as well as cis II penalties in the torn of a STOP WORK ORDER and a tine of up to S250.00 a
day against the violator. A copy of this statement stay he torts aided to the(Mice of Investigations of the DIA too insurance
cot er.1L'e .er►ticatton.
I do he•rehi- ' of i•under the par and penaltie•8 of perjury that the information provided above is true and enrrect.
l0 /z �
Phone=: 62 Z I Sz
Official use only. Du not write in this area,to be completed by city or town official
City or I uss n: Permitll.icense p
Issuing.kuthurits (circle ones:
I. Board of Health 2. Building Department 3.City `I unit Clerk 4. Electrical Inspector S. Plumbing Inspector
G.(hher
( (intact Person: Phone u:
City of Northampton
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° _R Massachusetts ��?� �'�
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'DEPARTMENT OF BUILDING INSPECTIONS
l%i ;70, 212 Main Street • Municipal Building 4s
—.4 Northampton, MA 01060 ';,ti. -I',\\'
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: �U�� bar.) �'" "7'Sk�' c,' �''e,� i 1�"--
OA- d/1--tiv-rAAP-ai -6-44-- /A/6de(c,/- d-t-ei_A.A.09,--.
The debris will be transported by:
Name of Hauler: Bud r 7)-i`xstey-- LLc-
. #'
Signature of Applicant: h Date: a �� /a�
City of Northampton
OPS H�M�TO
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`' Massachusetts ?� .._ '
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DEPARTMENT OF BUILDING INSPECTIONS
`.�' �£ 212 Main Street • Municipal Building 9vk a�
! '�y`_ Northampton, MA 01060 sd�y ��C
HOMEOWNERS'EXEMPTION ELIGIBILITY
E/Vl I L I"/ �� s Y� #Sle2(insert full legal name), born sert
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 / day of 1 bn4ai , 20
(Si ture)
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