38B-109 (3) BP-2022-0365
29 MUNROE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38B-109-00I 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-2022-0365 PERMISSIONIS HEREBY GRANTED TO:
Project# KITCH/BATH RENO Contractor: License:
Est. Cost: 58000 JASON GRAVER 103229
Const.Class: Exp.Date:06/27/2023
MCCLUSKEY MARTHA T &CARL H
Use Group: Owner: NIGHTINGALE
Lot Size (sq.ft.)
Zoning: URB Applicant: ELEMENTAL CARPENTRY & CONSTRUCTION INC
Applicant Address Phone: Insurance:
118 HAWLEY ST (413)320-6427 UB-43619853-21-42
NORTHAMPTON, MA 01060
ISSUED ON:04/11/2022
TO PERFORM THE FOLLOWING WORK:
KITCH& BATH 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:
oak C•
Fees Paid: $377.00
212 Main Street, Phone(413)587-1240,Fa x:(413)587-1272
Office of the Building Commissioner
j'`�.r4,&-
The Commonwealth of Massachusetts /f '4/0/910
W
Board of Building Regulations and tan 8 OR
Massachusetts State Building Code,7$0 CI Fr 49 M CI ITY
US
Building Permit Application To Construct,Repair,Renovate � ' a R ised ar 2011
One-or Two-Family Dwelling oN P, spc
This Section For Official Use Only q°'o�Ns
Building Permit Number: t5v .E 07 . 0 ��Djjate Applied:
Kl=, � i7, Li- II•ZbZZ
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
1 AAA rei St. 3I8 /09
1.1 a Is this an accepted street?yes X no __ Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Las
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone?
Public( Private❑ Check if yes Municipal$ On site disposal system 0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: .I
/►1mrfl , ft)c.Lla.Ley /( rIit)3M'jaIe A orfAMpian I Nip 0/0b 0
Name(Print) 1 City State,ZIP
al /1/0nr0e Sf . (71.) 4'S- "It carol,,; h+ini�jth e yfio��. um.
No.and Street Telephone '.mail Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building{ Owner-Occupied 0 Repairs(s) 7:1 Alteration(s)yf Addition 0
Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify:
Brief Description of Proposed Work': geplat.E k;kkln [abietil} �d
1:10rl +ior wall iz [rtoe hell /1 • Qefllcr 1 Jaen' ► rr...eJs1
brlkrdon. Dal 'Ilea 'l leer s Aar) SIi)ialo dear.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ y0, 4`00 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
goo° 0 Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ ttam 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$f $ 7
Check No.q/A I Check Amount 7
6.Total Project Cost: $ 'S2, 006 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
� CS• (03aag G a, a3
.J Graff' License Number Expiration ate
Name of CSL Holder
List CSL Type(see below) u
Ill NAWky
No.and Street I s}• TypeDescription
�dlr1�A A�}OA M A Q/d`U U Unrestricted(Buildings up to 35.000 Cu.ft.)
r1� R Restricted I&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
3ab•414�1 fientrtirx1arpOm1cj Q V ;.1 D Demolitionon
Telephone Email address V
5.2 Registered Home Improvement Contractor(HIC)
Ekmerjal far enfr for f. 1'nt. /719to x1 3 Al
p y S HIC Registration Number E era ion Date
HIC Company Name dr HIC Registrant Name
1/f owley s+- desienfol corIpm4r �nutrf•
No. d Street I Email addre tip,iItir+6,11 A !t'lA Oat. 1413.3ao•6 y a 7
City/Town, 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 l 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 34S0n Org1Mr
to act on my behalf,in all matters relative to work authorized by this building permit application.
6
Cdae, anifisimai
Print Owner's Name(Electronic Signature) "10 f.f-h0. / 'G&Iu,s ke•/ 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.
�ASQn Grav[r - 1 der- 'y�/41
Print Owner's or Authorized Agent's ame(Ele onic S''i e) 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"
,..Z\
....._ - The Commonwealth of Massachusetts
MI'•iii-=--
-- tillIE
, ..„
1
im Department of Industrial,4ccidents
1 Congress Street,Suite 100
Boston,Af.4 02114-2017
v, 714'
=,..
,,,........
www.mass.govidia
II others'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
lit BE FILED WITH THE PERMM'ING A1114tHtt IA.
Applicant Information Please Print ',rends
Name ii4ustnesalnantzation'individual i: Elenlenc I „..../Arpedr 1 (iAstLpitc1-4, :in, .
Address: IN thtriky 5/•
City/StateiZip:__ A)0140,,,,htx e14 0/040 _ Phone#: L113.
Are you an employer?t heck the appropriate hot: I Type of project(required):
I. I am a etryluyer with, ,4).i errophiyeeli k Nil and in part-tintel.•
7, 0 New construction
2 I am a uric getynttor Of partnership and have no employeea winking: iin me S. •70 Remodeling
any captetty..[No workera'coley inaurance regional 3
9. Demolition
..t.0 I am a hot/WOW/WV doing all work myaelf.[No wortraa`cony.inionnice ronuared 3'
10 0 Building addition
4 0 I am a himre4*iimer and ii oil be hiring ocausackirs to Conduct all ii ork on my poverty. I will
enaure that all coraracton either have wortem'CAImpermatatin insurance ix art aole I la Electrical repairs or additions
porn:lots widi no employee,.
12.0 Plumbing repairs or additions
5C)I am a general contractor and I hav e hued the inb-cinattaciora listed on the altaidlod Nitetri.
I 3E:IRoof repairs
Thew:vuh-citturactorN bait employee,and have workers.'',Vim.inainsoor;
14.0 Other
rtE3 We ate a corporation and na otin:era have eIrttimAlthetr ng61 of exemption per WA c,
i:S2.f.14.41,and we have rio employeeu.[No wirriera'einrip.man:ranee required 1
•.try Joy(1,..ini that chock,.bo%al mini alao tilt out the section below*hawing then worker. compensation putt...)information
' t loom:ow net-,who subunit rho.allaliv.it Itlthcatirqi they*redoing all work and then hire woad*:ei.estraeloci mug Altana a new affidav it natinating iuck.
t ontraeroni 01.811 cheek thii bov must attx-lard an additional Alva saw%mg the Ilktirle or the sAii,s,e,ontic tor v and.itate whether it nit theac addle,tie
cmpli)y1.....", if the Ytill-ik)Itir14.11.1%.licj'.I:kitiplOyet:N.thi.. inut4 pro',id c theiX A orlicri'komp pone:,
I am an employer that is providing workers'compensation insurance far my employees. Below is the policy and job,ite
infiirmation.
Insurance Company Nan : 7i-oveler3
Policy#or Self-iris.Lic.#: 08- /43 to Of S 3 JI - 1 gl- Expiration Date: 4,///3 X
Job Site Address! al M RAC& CityiStaterZip: /1.hrfilAmpillf , iiiif 0/0(r0
Attach a copy of the workers'compensation polky declaration page(showing the policy number and tspiration date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to S1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250110 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
etwerage Ncrt licat ion.
...
I do hereby eerrifi under the ins and penalties of perjury that the Information provided above is true and corrett.
Signature. I}2.1„: it/liyiid-
Phone T: 11/3, 30)0 • 6/0?
Official use only. Do not write in this area.eta be completed by city or town offieint
City or Town: Permit/Lieense 14
e e
: Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Taws Clerk 4.Electrical Inspector S.Plumbing Inspector
6.t)ther
'i. t'oni act Person: Phone 4:
m
City of Northampton
S - 4
Massachusetts .c�� -- �'r
-:
DEPARTMENT OF BUILDING INSPECTIONS 1,,
q,; _, 212 Main Street • Municipal Building vk ,a
Northampton, MA 01060 'xrN g���\
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: liAlteLt P(Ctfcl% - d 3'1 ( 4 hipte1ln Pd.
IV Orl4AaroPiiik I /t'1'A — Oi0b0
The debris will be transported by:
Name of Hauler: 5/1/nOdO/ CUcp2N11 i 1 C dAJirit&Prrl
f
Signature of Applicant: Date: 4I�I)
96"
1 „ 18" -46 z" --- 30"
21" 438,' 31 B„
s„
s „ t6 " 5"
100 a„ 14,6 5 23,a 23;6" 29,ia 75 a"
17„",e 81" 1' 26 e' 33" 18" 18" 19" 56 8"
Q
c �- WF:W 1836-L W3036 WF336 2 ,
-- �O Iv �- WFETP-R WFE$P-L WFETF-R 8 ,
AFPDT715SYNF B18-R B18D2AF35-L
Ce
0
,� ,
v - is.) N
j 0) � v v
0
1058' W ,
j ir
r� (n -.
�sr O w co W
,,°. F• .. %,_ � _ O O CO
O K O
M
r
m n
W W
_ - _" r 0
N
rn _ O N (J v
`t
N v CO r"
a a
p II
w '---1/CO r rn _y m 'n 45"
N
i
17)
All dimensions size designations This is the property of Kate McKinnon and Designed: 1/14/2022
given are subject to verification on 4 must not be released or copied Printed: 2/15/2022 l
job site and adjustment to fit job CVS unless applicable fee has p
conditions. been paid or job order placed. l
Fi&lllin c
S`IPp1Y
i
I'
Nightingale,Carl 1st fl or.kit = ___ JAll __ I Drawing#: 1 LNo Scale.
96"
2 18" 46 "
2 30"
1j) WEW1836-L W3036
or)
I
111
Lo
AFPDT715SYNF SB33 B18-R B18D2
26 5
6 33" 18" 18"
16
1 4 28 " 533"
All dimensions size designations This is the property of Kate McKinnon and Designed: 1/14/2022
given are subject to verification on „It must not be released or copied Printed: 2/15/2022 ,
job site and adjustment to fit job COWLS unless applicable fee has
conditions. "ilF been paid or job order placed.
PIM DING
SUPPLY
Nightingale,Carl 1st floor.kit [El 1 I Drawing#: 1 I No Scale.
. . •.. -• - - _- -- ---- - - --
96"
2 27" 30" 27" 11
2
N i
N {
I-.----
1
a0 1 W3018 it 1
1 '11[11 1 ,
cna - 736
- WF, W2736 � � W2
"�j '�� CVM517P2MS1
I
a I _,,
N11
L — —
't AF 1 B27-SD CHS900P2MS1'' BCLST3636-R R.OSS
I
-lam
I I
L__
i
__ - 27" 30" 36" 244.
1 7 7"
42�6" _ _53,6
All dimensions_size designations This is the property of Kate McKinnon and Designed: 1/14/2022[j
given are subject to verification on I must not be released or copied Printed: 2/15/2022 I
job site and adjustment to fit job C unless applicable fee has
conditions. been paid or job order placed.
mot.mu
SUPPLY
Nihtin
g g kit [Drawing
-- g
ale Carl 1st floor kit [El 2 Drawin #: 1 No Scale I'
192"
928" 30" 458" 12" 12"
N
N
00 W301824 /,iiiiiiiir4Nor 4r
CO /. V L
el I
N /
TEPU242490-1-L ;1 '190 4 /
If
GIE18GSNRSS
0
Lo ,O
B15-L PDT715SYNFS
0
r /
•
i
51 j„ 15„ 1 z 24', 99 8 It
108 4
59 4,, 24" I !,
All dimensions_size designations This is the property of Kate McKinnon and Designed: 1/14/2022'
given are subject to verification on ,4, must not be released or copied Printed: 2/15/2022
job site and adjustment to fit job $ unless applicable fee has
conditions. been paid or job order placed.
PIIIT()NC
SUPPLY
Nightingale,Carl 1st floor.kit LEI 3 Drawing#: 1 I No Scale.
r•..-.r _ . . •..- ---..¢- `---.ez_.—_t= —. _ --__— art-- ` ---- _