24D-003 (6) BP-2022-0356
231 PROSPECT ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-003-001 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-2022-0356 PERMISSIONISHEREBYGRANTED TO:
Project# SIDING/DOORS Contractor: License:
Est. Cost: 104500 HANS DALHAUS 101628
Const.Class: Exp.Date: 11/17/2022
Use Group: Owner: OHLENBUSCH HENNING W &LISA BEZO
Lot Size (sq.ft.)
Zoning: URB Applicant: DALHAUS CARPENTRY INC
Applicant Address Phone: Insurance:
11 CHERRY ST (413)977-6094
EASTHAMPTON, MA 01060
ISSUED ON:04/08/2022
TO PERFORM THE FOLLOWING WORK:
SIDING/DOOR REPLACEMENT
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 51-11 •
Fees Paid: $100.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
_�_ LA APRThe Commonwealth of Massachusetts
7 ?0Aoard'of Btilding Regulations and Standards FOR
ti r % �, assachusetts State Building Code, 780 CMRMUNICIPALITY
nofi - USE
-- l d€iig Pew_-Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
"`',".� One-or Two-Family Dwelling
This Section For Official Use Only
Buildin Permit Number: 6 P"��'" 3 6"Yi Date Applied:
55
//.& q-716ZZ,
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1..P e,LE Address S_ 1.2 Asses�o�rs.M p&Parcel Number o_3
1.1a Is this an acce'ted 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: PROPE TY OWNERSHIP'
1..1 L w, .- Record: j k M l
a..� t1 O 1-'•
Name(Pri Ci State,ZIP
3o_j
aY
A- , Ht)34ii 0 \csuke-ke,- cAtin, ,CO-1(V\
No.and Street \ Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply)
New Construction 0 Existing Building it Owner-Occupied VI Repairs(s) fib Alteration(s) ft Addition 0
Demolition I9' Accessory Bld . ❑ Number of Units Other 0 Specify:
B,ne jD scription ofPr..'sed Work2. J 0.-..kr (n .QX}P`�� 6� Af t
e� je e�- V�• • 1.1 N v) cx. .kS" y- U,,k-` a,m� S W ,-Cc. ,., �r.5 1,( 1 vre,w
s,d, k-r,� o 1Nwie. o. , e— . r ill ' „.0 -N4A-clew e_, Scer
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 1,00 00 O , ca 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ''ISI) , (, 0 Standard City/Town Application Fee
0 Total Project Cost (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression Total All Fees: $ (/�
L Check No.mo Check Amount: t" Cash Amount:
6. Total Project Cost: $ 10(-L 0_Os.) 0 Paid in Full 0 Outstanding Balance Due:
5, II111 'f'GW r,
SECTION 5: CONSTRUCTION SERVICES
5.1 Const tion upervisor License(CSL) 16+ /
G ` G` ,i License Number E piration Date
Name of CSL older
i' (V\ti\f\-) S List CSL Type(see below) U
No.and It et T Description
�,� � { U Unrestricted(Buildings up to 35,000 cu.ft.)
G
( `I\ 0,,0�� R Restricted 1&2 Family Dwelling
City/Town,State,ZIP
tyM Masonry
RC Roofmg Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
(� �7� 60! ! d)�I kC,�� C (� I Insulation
Telephone Email address S D Demolition
eP gl'b�st
5.2 JReistd H xne Improvement Contractor(H C) _CO .
/1 G , \Q/ C Re istration Number #1._
Date
HI Compan ame;HoIC�Registrant Name I I /
No.i S e . ' G� 6 , ,�G ..r'l +� {'ems,1 . l,�'1'\
cee- a
E it addres
.
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 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 bC1 1h°Ali>to act on m ehalf,in all matters relative to work authorized by this buildiçoxtk-ci
pernftt applicat on.
ril (i77 Date
Print Owner's Name(Electronic Si )
SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my e below,I eby attest under the pains and penalties of perjury that all of the information
con ' 'n ' a c is e and accurate to the best of my knowledge and understandin
7
nit 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"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
P, A m,,,
ry i .N C)1 ')' • ..Sic'.
` Massachusetts �q,, L 'rCC.
'. ; (, A'f'* DEPARTMENT OF BUILDING INSPECTIONS 1,
212 Main Street • Municipal Building yJt cb
Northampton, MA 01060 � W.:A
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, SS4, 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: AirkolAi\L- fv_x•I ( , , ,,
The debris will be transported by:
Name of Hauler: �' `�_ � \. A(,,Jiv•\.,
fi7
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pp
7
Signature of Applicant Date:
g
. .
The Commonwealth of Massachusetts
..
, ,---,
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
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...., -...,- -,.., wwmas.gov/dla
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SVPOrkers Comipassailata Insurance Affidas it: Iluilders/ContnictorsiEltetriciansilPlumhers.
TO BE FILED WITH 'I ilt: Pi.H.NIIITING AtITHORTI V.
Anulkant Information
7 Please Print t.teitils
Name ganizationi
Address:_)
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CityiState/Zip: , \N'i --Phone 1 1
Att 31411 SIN beipleyet?t:bweit the appropriate bore, Type of project (required):
I.C3(Ant a employer with ,_ ,,. enaphryhes(fah anti ea parverine):6 7. [3 New constructUxi
I AM a wile proprietor or pArtsiesship and have no terrplis,tres Mn tor I'M lft ' 8. e, Remodeling
Mly t'AfaCklY., as workers'terry insioranee required."
9. in'Demolition
31J I arn a hurratewner doing all wink riPoelf.fNo makers'coil%instiranoe required:I'
i 0[3 Building addition
4.0 I ant a homeowner and will bt hiring 4.-ontreit1ori to cialtioct all link on tir,.rnoperr . I will
CIIINIArl:that all contractors either haire workers'corupensattnan insurance et:tor wk.- I 12 Electrical repairs or additions
prop:it:tors with no empid.yert,
I 2.C:I Plumbing repairs or additions
SC:1 I run a ginietal contractor aril I ha,.e trinril the soh.contiesciers Iisteit tra the attached sheet.
13_E:1 Roof repairs
Tlicut sub-tuna-Acton.wive employees 4441 Liao.e*oriel*. 'WOW,ttc.vuswricir.:
6. ‘: •'t.,are a corporenan anti ihi tinkers hite.e.xerviairti there right of aseirinitavi per IOU e.
I 5 1.§IOW and we have no ivaplut.ves.[No workers'comp.Otani:awe moaned]
"Aril:airpticant that cheeks bra 4I stiva.t alio till trot the ieetion below showing cheer workers'i'.3.'orliffCLINI.11i41.41 policy interrnation,
t Rairieownerii who habil-zit[has atTietion:mist:aging the",are doing ail work*tail then hire outside contravt...r:i nuatd 3,ubratat a new a flitta,,it inthealing surelt
'';Curti/actor,that clack the bek mu s4 altaciva an adA.12ttona. Osext thk,e4 mg th...-aaint ot 1:12•L-val,-cuetttax:toc3 asmi.satc%holier tn.not those eunin..-4
cs-tplo:y4.:e., f(ila..!•,111b^t1,1171fili.ka.,-clarikt!!ian..do:'.,tiiti,1 pros id,they: vo,,tikets o.try eulicy nuralits
...../.../..fe, •• . 1.,,,,..n.........^,,,,,,,...K............M .IY"...1.1111..,
I am an employer that is providing wagers'compensation insurance for my employees. Below is the policy and job site
information.
Policy#or Self-ins.Lk. P.. Expiration Date:
Job Site Address: City/Statcliip:
Attack a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as requwed under MUL c.. 152. §25A is a criminal violation punishable by a fine up to N1,500.00
imdior one-year irriprisonirient,as well as civil penalties in the form of a STOP WORK ORI)ER and a fine of up to$250.00 a
day against the violator.A copy •f this siaternerit may be forwarded to the Office of Investigations of the DUI, for insurance
coverage verification.
I de hereby teed ,1 , • . , —do 0 1 1 7.of perjury that the information provided!thaw is true and correct.
.4*
iplir
Signature: Ifp- „ _.
Phone g: (3 (1-7., .- 0 q er---
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Ofiklal use only. Da not write in this area,to he compkted by city or town officiaL
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City or Town; .,Permit/License#
Issuing Authority (circle one):
4., 1. Board of Health 2.Building Departnient .3..t.:ityrileimi Clerk 4. Electrical inspector 5. Piumbing inspector
6.(In her
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t'ontact lierson: Phone
tors,••••...........r.•.70*,."....19.*”..4.,•,....*.tr.r..,•rn,pr.••••••Imr.".....R.T.J.11,...4.1.....M............e.`",...4............1••••••WIMI./..".11.........e."..,........1.M...10,0•Vv.o•••••••nit,., ••C.0
City of Northampton
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►3` Massachusetts ?� c- 'lac
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DEPARTMENT OF BUILDING INSPECTIONS o; naa
212 Main Street • Municipal Building Jd :Ca
' 1;4-
Northampton, MA 01060 j4 4'.
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, (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 day of , 20_.
(Signature)
231 Prospect St. Work Scope
Remove all existing siding and trim on the house and garage. Remove
front door, garage door, and bulkhead. Install new siding and exterior trim
on garage and house. Install new garage door, front door, and bulkhead.
Add exterior lighting and outlets. Add interior can lights to living room. Add
new electrical meter on exterior. Paint all areas on exterior that have been
replaced.