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24B-072 (12) )3Lb6.21 UNIT/ z BP-2022-0680 80 BARRETT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24B-072-001 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-2022-0680 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: Est. Cost: 4000 67026 Const.Class: Exp.Date:03/23/2024 Use Group: Owner: ASTER ASSOCIATES LLC Lot Size (sq.ft.) Zoning: URC Applicant: CHET MITCHELL RENOVATIONS Applicant Address Phone: Insurance: 2 PATTEN HILL RD 4135357457 COLRAIN, MA 01340 ISSUED ON:06/10/2022 TO PERFORM THE FOLLOWING WORK: REPLACE DECK 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: 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 . ' s Fees Paid: $100.00 212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner E1 The Commonwealth of Massachusett. Board of Building Regulations and Stan..rds JU FO' Massachusetts State Building Code, 780 M' N _ 8 20, ICIP. LITY US: Building Permit Application To Construct,Repair,Re ova, !- • ish a Revi.ed 'r 20,11 One-or Two-Family Dwelling n,00T a IL DWG INSF;CTIONs This Section For Official Use Only Building Permit Number: 3i°a-}� G"© Date Applied: ea Building Official(Print Name) Signature D e SECTION 1:SITE INFORMATION 1.1 Pro erty Address: 1.2 Assessors Map&Parcel Numbers go ceiT sue— Posiac) a- 2.4 .u7 2 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 PI Private 0 Zone: _ Outside Flood Zone? Municipal L5P On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2/1 Owner'of Record: ,/�' At ,Ztt -�0 5 /49Ley A/XL d70 Na (Print) Yro9 City,State,ZIP cto /1NQ 02is `'-d oLS— No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: ' "- Brief Desccript of Proposed Work2: 'C [Ce Cd Loi-t`5`h; De c.`g.©IA t ivae tp41A Sa µ+e SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ t!/ .00 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical ❑ Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fees: $ boo•a' 6. Total Project Cost: $ Ow, Check No.l3'7e, Check Amount: lPaid in Full 0 Outstanding Balance Due: City of Northampton Massachusetts �. . sI'e{ DEPARTMENT OF BUILDING INSPECTIONS a ; 212 Main Street • Municipal Building Northampton, MA 01060 D‘., '' PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR WINDOWS, DOORS, ROOFS,RENOVATIONS, ROOF MOUNTED SOLAR,ETC. 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specifications of proposed work(Digital and hard copy). 3. Construction Debris Affidavit filled out and signed by applicant. 4. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance. 6. Energy Conservation Compliance Certificate (new /replacement windows). 7. Home owner's License Exemption Form (if applicable). 8. Note any Special Permit requirements (if applicable). 9. Energy Code —all new construction(Gut/Rehab) requires a HERS Rater Affidavit 10. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton. J SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS cG 7O22 3fz- )Zy Cttec ( D . kt-trIzt ( License Number Expiration Date Name CSL Q0 ``e(A tit. t(HolLi Rc List CSL Type(see below)No.and treet Type Description +� C l Oil (�) U Unrestricted(Buildings up to 35,000 Cu.ft.) C/l 1 D R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry D13L1 6 RC Roofing Covering // tt l/ WS Window and Siding -}�u c SF Solid Fuel Burning Appliances &-irr °536----79;-7 (�ut.l � e `(tee(to-, I Insulation elephone Email address D Demolition 5.2► Registered!Roomre Improvemen Contractor(HIC) /f`I//�q -Z( (24 1 -tk . ►) `C"""t U u O 0 t)` s HIC(Registration Number Expiration Date HIC CAmpany Naiirie of I C Registrant Name i / r ` ed IAAA co— No anStreet Email address COLt PI 0[5C10 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 a o e subject property,hereby authorize ct n alf, in 1 matters relative to work authorized by this building permit application. 174. apter�s Name j,>*lectronig ign real Date T�"� �-! /�S/ECTION 7b:�O%WNER1 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 3. "Total Project Square Footage"may be substituted for"Total Project Cost" ' k ,46.... The Commonwealth of Massachusetts Department of Industrial Accidents 7.., it I Congress Street,Suite 100 ,I Boston,MA 02114-2017 14 www.mass.govidia Workers Compensation Insurance Affidavit:Builders/ContractoriElectriciansIPlutnhers. TO HE FILED WITH THE PEIEVIITTING AETHORITV, Applicant Information Please Print Leitibl% Name tflusiliess)Organizationdindividual): C --t- 1\tc,4-Aket( V?..ettoveL--(-Or-A-L5 Address: Q Pcx4rA It 1( ..----, ---- City/State/Zip:m1 Phone )`")-ra-t vl 1) 0 D(31-10 #: LI( "--,_) 19 ---)C1 D C.0 ..---7 Are you an employee?Check the a ptimpriate tort: Type of project(required): I in,a enykryer with cmpireyecs Mali arti&or ptinset..* ' 7. 0 New construction 2 1 am a sole port:thaw or partneratim and have no entpltryees work= for me In p any cnpacity [Nu workers'comp.inatuntrum niquiredij 8 Remodeling. c3 . 0 Demo'ition ICJ 1 ma a honsoawner thing al my l work self{No workers'curry.imatraruse reituired."'' l a c3 Building addition 4E3 I sun a homeowner and will be inruly cuntracturs to xamidiret all work on my property. 1 will elitare that all certhachars either have workers'compensation rusuranue cc am sole i 10 Electrical repairs or additions propriemes with no ernploytaN, 12.0 Plumbing repairs or additioris 50 I ant a aerteral contractor and 1 tune lured the satbAtoritractors hated on the;studied sheet . 131:3 Root repairs These sabsmsurseioes have mtaployees and have vitatitera'comp.instirance. 14.0 Other 0,ec.- iyiik • 6.0 We are a oerparatioa and its oilmen,have exercised their right el exemption per NMI.e. 112,§1441,and we have nu anpluyees.[No workers'comp.insurance require&I it:A.,t-v 1.=1 rtiLna.11,,,ril old dIL-..-ca,'n i;,,..1,,,, ,a,,,,,11.91:their worktias*compensation potivy sadmrsatanti, *ifamintralania.who:...untant[ha atridak It mencating they are doing ail V4 Urk and then lure estrarde contractors mina taihniat a new af(tda it intlic-ating such. :Contractors that check that box must atuelwil an additional Meet showing the name of the suls-euraracturs and date,ain,-1,1nr, ot nor those..M.t1t10* emit-402,c,-. If the suld-contratiturs lame cirrptir LI:N.they must puwide their workers'eninp.polley number /am an employer that is providing workers'compensation insurance for my employees. Below is the polar and jh site iriformatioit. Insurance Company Name: _ Policy#or Self-ins,Lie,rk Expiration Date; Job Site Address: City StateZip Attach a copy of the workers'compensation policy declaration page Ishossing the policy number and expiration date). Failure to secure coverage as required under MGL c, 152, §25A is a criminal violation punishable by a fine up to SI,500.00 arittor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S2543.00 a day al,inst the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage vent ..tion I do hereby . ii y v,r th ' 0 ' monies of perjury Mat the information P melded above is true and correct 1 i P 4 ,....10). i. . Date, Tove e 2-2. &patine: r a0 (-7)) '53 5-s-- -29 5-7 , . Official use only. Do not write in this artd,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Lam, _ --- City of Northampton fi.� Massachusetts k � � DEPARTMENT OF BUILDING INSPECTIONS � 0 f.- ' - 212 Main Street • Municipal Building ' Northampton, MA 01060 �� �"•;� ;.j ' 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: kr,->-114-c'4z}'`. 0-1- Cot ret'c`1 P) # The debris will be transported by: Nameof Hauler: )cutc7Po(L4or 4,-(,olit c"----'(„)eJ 3 DZ Signature of Applicant: ' Date: �`��' ,2 City of Northampton Massachusetts * $ c, ° DEPARTMENT OF BUILDING INSPECTIONS r 47 212 Main Street • Municipal Building '. `tr, Northampton, MA 01060 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert fill legal name), born (insert month, day, year), hereby depose and state the following: 1. 1 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_. (Signatu re) Prop05,c_ i n is`t becic ov, Irak/ tu v e)'-1-P 1 / -' Se t°i` y Fool S 2,. 8 . / t ¼o iwt 15 .frkwei-sA,,,,y-eut ts/Pe 1-- 6 okc < 1 Z ,, . ,lp,es di\ 7_4_ 1 .. _______T___ ___ __,, 6,t - 9 `;‘dkck- ! , ' i► , , 1 ; , I ( CD i i, I : , . i ; , . , 1 ! 1 ! tcJr.,,,..1. (0,,1 , . coptiAtetk-i-N 11(0e, 4 4 ( rvio-ti-oot) , i ; , \(. (-6: 5&11' )-L(' �J l3 r TrST . BD are as P t ad"P`vI/N At A