23B-080 BP-2022-0341
58 SOUTH MAIN ST COMMONWEALTH OF MASSACHU$ETTS
Map:Block:Lot:
23B-080-001 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-2022-0341 PERMISSIONIS HEREBY GRANTED TO:
Project# STRUCTURAL REPAIRS Contractor: License:
Est. Cost: 21470 DALE HAWLEY 055048
Const.Class: Exp.Date:08/29/2022
Use Group: Owner: WILL VENTURA DARRYL & WENDY
Lot Size (sq.ft.)
Zoning: URB Applicant: DALES STRUCTURAL & CARPENTRY
Applicant Address Phone: Insurance:
P 0 BOX 273 (413)667-3149 WCC-500-5008253
HUNTINGTON, MA 01050
ISSUED ON:04/08/2022
TO PERFORM THE FOLLOWING WORK:
STRUCTURAL REPAIRS
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:
j i >2 . TAIT
Fees Paid: $140.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
Alt, lit-GD DP A - 0 N-3 0 4c ..
C4u -1) Li-(.-ZZ __ ! __- -
The Commonwealth of Massachusetts
Board of Building Regulations and Standards APR - 5 �Q��� FOR
Massachusetts State BuildingCode, 780 CMR I Mf IICIPALITY
�h _ USE
Building Permit Application To Construct,Repair,Renovate Or)Sdrt4el i,474,,,r`^R'visedMar 2011
One-or Two-Family Dwelling - _,,,; H.,,.,,F.,,,
This Section For Official Use Only
Building Permit Number:6,'? ?-•'• '4/ Date Applied:
/1-.5i),...) t'Z, //'/ y-8-ZoZ2
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessor Map&Parcel Numbeks
ss Sov+k al S , aaE5 of a
1.1 a Is this an accepted street?yes Nic no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public' Private 0 Zone: Outside Flood Zone? Municipal*On site disposal system 0
Check if yesk
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
0 a P / 11e,ociv1z,t rito/2eA)c e ; )'Y1 A • o/o Go 2.
Name(Print) ci City,State,ZIP
5 Soar • Mi �� - AF(3-5 -2)-iL$ daRay/ve /DRp orm4;/. C
No.and Street Telephone mail Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building Owner-Occupied , Repairs(s). Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:SrROC¢Upu4 I lQ e f i IR S
Brief Description of Proposed Work2: AP p too to fix, PT ,cT 4 d ?" I
' / i' '�', eA h l
//�� t4 e(( j-J C'P//flie . Rt p (car a /• -h6 /(Sty re7- t ,,-r S% // 6-e ,
e A i Ale ( ®p e-6 i.1)p� •-i^i A. , e& i' LO i0 1t y
MXMc -/ e ; P Nf 41
Ie C42 " pro k. RP p/�Le 7 . t ., -94 in *rp,, k 2 Xi
SECTION 4:ESTIMATED CONSTRUCTION COSTS -
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ i , r)o, €P-v 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
4
Suppression) Total All Fees:
Check No.iitati Check Amount: f q°Cash Amount:
6.Total Project Cost: $ 6/ ,q�m et 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
• CS - OSSo1fB e o2a
fie,fie, �� 1�—u License Number Expi 'on
Name of CSL Holder
List CSL Type(see below) kk
P,-o ' 8 0x s T Description
No.and Street
p U Unrestricted(Buildings up to 35,000 cu.ft.)
it i lk�/� �� �� (��� SD Restricted 1&2 Family Dwelling
ity/Town,State IP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
k/3'-676,?- 3►Al if ii Cif,k pe-.)4- 4611f 41Vi I Insulation
Telephone Email addrt 6o04 D Demolition
5.2 Registered Ho a Improvement Contractor(HIC)
b4e1J{AG)le i /r 40RAl Y-- � 113a Ov1/OpS aa3
/ q S �71'R!/ ' �� +►7'y HIC Registration Number x it ion Date
HIC Comp a yI e or HIC Registrant Name
P.O' Aox Zs ,J_ /` ( . c 0 m
No. d Street �, Email ad
v/n ' " _r mYjit= c�' "-s -t€ -31
C ty/Town,Sta e,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 .❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as ier the subject property,hereby authorize Pot)e p l/A i if 'l i/e 5 51-W ok/Ad( y`C n Rq t''J 1
to act on my behalf,/in all matters relative to work authorized- by this buildi gg it application. i
qi f� ( ki iv l`� S� ZZ- ✓vI
Print er Tame(Electronic Signature) Dat
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.
,.(.. 4 44 4 .---5-- 27-
Print Owner's o on e s Name(E ectronic ignature) 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
Massachusetts 44,
'<
w; L
i .0 DEPARTMENT OF BUILDING INSPECTIONS y,
212 Main Street • Municipal Building QD
^��-� Northampton, MA 01060 rsj:Pg 3;j,'O
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: J(e aer;y1/47) , / ,c c '7 2 A- 9/4,0
c .v^4- , V\O in 1A - r3 - 57 7 - '(
The debris will be transported by:
Name of Hauler: t- , ,¢ 0177
Signature of Applicant: 1 47►'/ - (V Date: 22
• _ The Commonwealth of Massachusetts
I*_ t,, Department of Industrial Accidents
+'till
1 Congress Street,Suite 100
ll t= Boston, :MA 02114-2017
'�. WWw.mass.go►r/dia
II vskers'('ompensation Insurance Allidasit:Builders/coatractorralectricians'Plumbers.
I 0 Bt.tll.t.1)%%I III IIlk PI:R%lI'ITIM(:AI'7'Ill)R111.
Applicant Information / C Please Print Lrribls
Name 1 Ilusintcss(>rganr rttun Indtwdtcal): )7 /to 1 J w L e L/ j/lam 1 �-p,-/ f C. ig r�e"—✓7
./JG
Address: A 'X 2 7 3
City/StatefZip:Nch071;JJ� ,ur /)- `(/0.--e Phone#: 1/S -ce6,? ` a- J'-N
%re you an employee Cheek the appropriate bus: Type of project(required):
I I am a arc,kilt ar with cnipfo►ees tlidl and or part-tire 1.• 7. O New construction
II am a sole proprietor in partnership and haft:nu employ.1.--,ot.rlmg for me in S. O Remodeling
IA
capacity.No oorlars'comp.insurance rrywted.I
9. 0 Demolition
aI am a huncuwnt Jung all work myself No w oilers'comp.insurance required("
4.0 I am a lentnet and will be burnt contractors to conduct all work on my pn.party. 1 ss di lop Building addition
wvw
ensure that all contractors amber Nor worla-n'cunipamsatwn uuuranr or are sole I in Electrical repairs or additions
propnetors with nu employees.
12.0 Plumbing repairs or addition..
50 I am a tnnral contractor and I has c hired the sub-.cuntraaton fisted on tlic attadiedAiel. 13 Roof repairs
Ihesc sub-contractors fuse employees and lssc outlets'comp.uuurancc
EEO a c are a corpaorinm and its ot►reen has r w exercised then nth(of esrmpia per Wit.C.
14. other -62L �R,¢�
152..144).and we hose no emiployccs.(No wu►en'comp insurance rcyuinvl.I e pat A5
•Arty applicant that cheeks bat 2:1 must also till out the section below shooing then workers'compensation pulc'y information.
i hornvw ors who submit this Arida%it indicating they are Joint all w oil and then hue%outsi d►contractors must salami a now at'wfas it indicating such.
.t ontractors that check this hod must attwcfcrl an adtfitional sheet showing do:nave of the sub-contractors and state whether or not those entities lose j
employees. It lbw suh-cunttactot.lease ciriplosics.the rnusi rwsidc their A orlon ..•rip role,!I.rrwnhr
I am an employer that is providing workers'compensation insurance for my employees. Below is the polio'and job site
information.
Insurance C'umpany Name: . ���AR) - 4 9cecI 4 . ..)fr. URA.L e C a ..
Peslit:s x or Self-ins.Lie.#: 1 _ - Expiration Date:
. _ r,�. cc s�..s� R�s3 ao p 5'—a 2o as
Job Site Address: 58 S0C) 1 101 f-)Al ' +a City State.Zip: rIOjP4,te.i 1914 = O fO ec2
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coseragc as required under MC&c. 152.*25A is a enrmnal s relation punishable by a fine up to SI.500 0()
aode or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Ins estigatlons of the DIA for insurance
cos crags ventication.
I do hereby ceolly under`/the pains a�nnd penalties of periuty that the information provided above is true and correct.
rrec t.
W171--' .... — ). -' 'Lk:
Phone-. 41 1) - LaCe 7- ' 4/1/7( -
f Official use only. Do not write in this area,to be completed by city or town officiaL
('its or Tussn: Pernik/License b
issuing Authority (circle one):
I. Board of Ilralth 2.Building I)rpartment 3.City:Town('leek 4.Electrical Inspector S. Plumbing Inspector
6.Other
(contact Person: Phonra:
Darryl Ventura
58 South Main Street.
Florence, Ma. 01062
413-288-2468
Roof
fir Existing Top
old door New Door Plate timber
Location. I Location.
7" x7"
" ll 11
New
Grade ' x 8" x 12' Sill Timber.
Brick&Rubble Stone Foundation.
Brick & Rubble Stone Foundation
= New Sill Timber 6" x 8" x 12' Or 16'
= New wall studs 16 o/c & Double Jacks& Single King Stud For Entrance Door Framing. Double 2" x 6" Door Header.
= New prehung Factory 32" x 80" Kitchen Entrance Door.
Note; The existing door will be moved three feet to the right and the void set with wall studs. The framing for the new
door will be performed as in the drawing above.
/ Darryl Ventura
58 South Main Street. �� , - r
1``'' Florence,Ma.01062
'
4�, � 413-588-2468 � `
ifs — s 4'
A
ir '.
lik
.,.
_ —17______--...—"":7-•`-:-_____al_ ° ,.,' It:'•1:' '. '
rf 1
xb New Location For Kitchen Door.
y R. t•
i
3 -
6 Feet.
ti
t
\\. ,
Darryl Ventura t
58 South Main Street. -
Florence,Ma.01062
410
,/ rr; a. Aro
413 588 2468 '
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Imam
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3 Feet.
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04/ 07/2022