23D-156 (7) BP-2022-0315
150 MAPLEWOOD TERR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23D-156-001 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-2022-0315 PERMISSIONIS HEREBY GRANTED TO:
Project# 2022 NEW DECK Contractor: License:
Est. Cost: 10000
Const.Class: Exp. Date:
Use Group: Owner: JOCELYN ALVORD, CALEB &
Lot Size (sq.ft.)
Zoning: URB Applicant: JOCELYN ALVORD, CALEB &
Applicant Address Phone: Insurance:
150 MAPLEWOOD TERR 413-645-3577
FLORENCE, MA 01062
ISSUED ON:04/04/2022
TO PERFORM THE FOLLOWING WORK:
NEW 18'X 36'DECK OVER EXISTING DECK FOOTPRINT WITH NEW FOOTINGS. REPLACE SIDING AT DECK
LOCATION
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: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
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i The Commonwealth of Massachusetts
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Board of Building Regulations and Standards
`� MUNICIPALITYF
j" Massachusetts State Building Code, 780 CMR
USE
luildifig Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
__., _. This Section For Official Use Only
wilding PerPfit Number:3P-7-7Z2- 031S Date Applied:
1eClJ I l...I (ZSS /7/g q- Li-Z ZZ_
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Number
Aso M4�►t,�,o��-rc�r- �_ ��, a. Q - isb-Doi
1.1a Is this an accepted street?yes V no Map Number Parcel Number
1.3 oning Information• 1.4 Property Dimensions:
u r3 V-t 5i a A',, 1 �3,O 7 c 2- fa I . B
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 Sewagepisposal System:
Zone: _ Outside Flood 7pne?
Public Private❑ Municipal dOOn site disposal system 0
Check if yes
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owperl of ord•
CAW" Moor--EA. �Iore1'—( A4,4, DI06 7
Name(Print) City,State,ZIP 1 SO ! fi 1,Jva01, I DMAtG-C 'I 1;645�3 577 al ebe Votile t,o ,-y,ro,c-.A-4 '6,
No.and Street Telephone Email Additot
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)`
New Construction Existing Building 0 Owner-Occupied 0 Repairs(s) El Alteration(s) l Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: }
Brief Description JofPropose8 Work2: 1 0 —cs.t)" 1Att, flat 1i lrft' ;s1 at/�1 ..) Cr,r�r4, %%+,
Px;v— \A ' : '•'• )J i .0(-). `.,`�S n,,..1n , ;l,L(�I.�.v-Y, ev,,A. r( -Ai 6)-4,
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ \0 DOD 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ElStandard City/Town Application Fee
_ -.___ ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ Total All Fees: $
Suppression)
Check No.2.37 Check Amount/P(0, (?,--5-? Cash Amount:
6. Total Project Cost: $ 1 D ()Imo ❑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)
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 T� No........... ❑
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.
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 I
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton
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' t DEPARTMENT OF BUILDING INSPECTIONS �. ry`
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212 Main Street • Municipal Building t. e"�
` ms� Northampton, MA 01060 ' 'o''s
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: .)/2k11-e c.(LA CA1‘.^.,)\
\\)
The debris will be transported by:
Name of Hauler: Celleb trI,0„1 �D.n-a�Q.���(f
Signature of Applicant: 24Z"--.:1;-:
Date: oZ -
The Commonwealth of Massachusetts
.t Department of industrial Accidents
�' 1 Congress Street,Suite 100
`; ,�- Boston, MA 02114-2017
;, www.mass.govldia
_.- 1%others'Compensation Insurance Allidasit: I3uikIers1Contractors/E:lectricianx/Plumbers.
TO BE FILED WITII THE PE:RSII rl'IM.At I lIORI i'1.
Annlicant information /� i L �j I 't Please Print !.wills
Name(l3usincatsfOrgan;�tiaafladividnat):_ t <G(6i)___..J�l cvT- �
Address: A s--c) iti cipl ,„...6.40.,,,t --r-(1-r.4--c,
C'itylStatc:'Zip: LvvS-r-4.f- /V - c d5 .Phone :._ t2s. ls-- 5 ,. ..
Art yen an einisksyerl Cheek the appropriate bay:
Type O Oject(required):
LEI lamae employer
mp x.emphtyres(fall anifor part-timel•' 7. *':.: w construction
ICJ 1 am a sole proprietor or partnership and have no emrployeei working for me in 8. `► 'emodeling
jny rapacity.[No workers'comp.insurance required.)
3 lam a hotrasowner doing all work respell.{No workers'comp.i requited.]' y 0 i?etnolitioo
4.01 a a homeowner and will he hiring aantrartcm to c odu,.t all work on my property. 1 will 10 l3uikling addition
m
emtan:that all eanfracturs either have workers'compemation utuuance or are cute 1 10 Electrical repairs or additions
proprietors with no employees_
12.0 Plumbing repairs or additions
30 lam a general contractor and I have lured the a uba-ontraetctre listed on the attached sprat. 1 3.Cj Roof repairs
These subr:rtmtractors have employees and have*otters'camp.insurance.;
1ti.Q We are a e�urp{xadtaa and its atYrears have eae�rriat-d t}r�cir right u[exemption pc
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132*UAL and we have no employees.(No workers'comp.insuranee required.'
'Any applicant that cheeks boa at must also fill out the section below.stowing their*takers'corwpentation policy usformation.
t Borneo%nem who submit this affidavit indicating they are doing all work and then hire outside eontraettxs must submit a new affidavit mdkatutg such.
;Contractors that cheek this box must attached an additional shoat duetting the name of the 3ab•contr a.tors and hate whether in not those ontitic%hate
employees.. If the sub.euntraetors hate engsl ryees.the!,must provide thee workers'comp p. hc:.r..miser
1 am an employer that is pro►iding woriters'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.': � _ Expiration Date:�___�
Job Site Address: CityiState/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,§2SA is a criminal violation punishable by a fine up to S 1.500.00
and?or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certi rid t pain a d pr ' . of perjury that the information provided above istrue and correct.
Signature: A Date. 3/�8/ c77?"
Phone g: /Zj Q-3..
Official use only. Do not write in this area.to be completed by city or town officiaL '
('ity or Town: Permit/License it
Issuing Authority (circle one):
I. Board of health 2.Building Department 3.("iiy/1'own Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone a:
City of Northampton
Massachusetts <7 J.--
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DEPARTMENT OF BUILDING INSPECTIONS Z tom; NJ
212°` 212 Main Street • Municipal Building
` a Northampton, MA 01060 j'sPh
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HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT S i)--S79`i
I, Caleb AIvp (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.
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Signed under the pains and penalties of perjury on this day of J 464-c,h ,
(Signature)
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Propertytz:,Information X.. ,,..
Parcel ID 23D-156-001
Address 150 MAPLEWOOD :;i 'F`� a` ;et
Total Value undefined ,
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The information depicted on this map is for planning purposes only. r
It is not adequate for legal boundary definition,regulatory
interpretation,or parcel-level analyses. G 1 P ``
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CALCULATED BY DATE
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