24D-045 (5) BP-2022-0753
18 STODDARD ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-045-001 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-2022-0753 PERMISSIONIS HEREBY GRANTED TO:
Project# GARAGE Contractor: License:
Est. Cost: 21500 JAMES PHANEUF 011632
Const.Class: Exp.Date:01/31/2024
Use Group: Owner: DOHERTY DEIRDRE ELLEN
Lot Size (sq.ft.)
Zoning: URB Applicant: JAMES PHANEUF
Applicant Address Phone: Insurance:
74 Old Stage Rd (413)247-9993
W HATFIELD, MA 01088
ISSUED ON:06/30/2022
TO PERFORM THE FOLLOWING WORK:
12X20 DETACHED GARAGE
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 VIOL TION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
• j' )I .
Fees Paid: S140.00
212 Main Street, Phone(413)587-I240,Fax:(413)587-1272
Office of the Building Commissioner
Z-OK
File #BP-2022-0753
APPLICANT/CONTACT PERSON:JAMES
74 Old Stage Rd W HATFIELD, MA 01088(413)247-9993
PROPERTY LOCATION 18 STODDARD ST
MAP:LOT 24D-045-00I ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building it Fille ut
Fee Pa'd $140.00
Type o o,L►structio . 12X20 DETACHED GARAGE
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN O ATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
MajorProject: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Appva 1 Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
•
\Us., 21, ' 10/3 0
Signkture of Building Official i
Date /
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
RECEIVED .
The Commonwealth of Massac use s d�UN 2 3 FOR
° Board of Building Regulations an :Stan r ICIPALITY
Eit.i).,
� Massachusetts State Building Cod 780 CMRUSE�� Rev ed Mar 2011
Building Permit Application To Construct,Repai ,Rabr IL cno s
One-or Two-Family Dwe NORTHAMPTON,MA 01060
This Section For Official Use Only _
Building Permit Number: -34~ '74' Date Applied:
c-...en.gekr*, g T 6 330 c2a.
Building Official(Print Name) Signature Dane
SECTION 1: SITE INFORMATION
1.1 Property Addre AAle() 1.2 Assessors Map&Parcel Numbers
1.1a Is this an accepted street?yes SI 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) T1ZgA( .
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
01 `f'' 4_1. '+3 g"!
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public ll( Private❑ Zone: _ Outside Flood Zone? Municipal hJ On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
''Pe►R-DIt& VO HUrrtil dd itTWAM TotJ
Name(Print) City,State,ZIP t
e, �14,› gqarde�eiclo��{.cow�
I
`l!3-` 7,5-0(ol/ deFesidwaierseyeehoo,mw‘
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) 0 Alteration(s) 0 Addition ❑
Demolition 0 Accessory Bldg. lid Number of Units Other ❑ Specify:
Brief Description of Proposed Work': / 7 T/ e!',-U=. n
ts I
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 213 6o(� 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ I 0 Standard City/Town Application Fee
❑Total Project Cost (Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:Au
Check No.a�lv ` Check Amount: ` Cash Amount:
6. Total Project Cost: S al cr(( ) 0 Paid in Full 0 Outstanding Balance Due:
City of Northampton
r/`�1 , .0 ....„,,,,,,
Massachusetts mW2 p G't�.
: DEPARTMENT OF BUILDING INSPECTIONS t
212 Main Street • Municipal Buildingy a*7
Northampton, MA 01060 .'sN .. '�3C*
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES,
FENCES, GROUND MOUNTED SOLAR, ETC.
I. 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. Site plan with location of proposed structure(s) and set backs.
4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance.
7. Energy Conservation Compliance Certificate (new / replacement windows).
8. Home Owner's License Exemption Form filled out and signed by Homeowner (if applicable).
9. Note any Conservation and/or special permit requirements (if applicable). 10.
Driveway Permit (if applicable).
11. Proof of Water and Sewer entry fees paid (if applicable).
12. Trench Permit - public land by DPW / private land by Building Dept.
13. Stretch Energy Code - all new construction will require a HERS Rater Affidavit to be submitted with permit
application before issuance of permit.
14. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton.
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) M la 32— i 31
V iA,1 4 65 171.114 �il t JS Licensece Number Ex 'ration Date
Name of CSL Holder t 1
--pi, c�- �� List CSL Type(see below) VI
No.and Street Type Description
` � yy.�� �,�w • U Unrestricted(Buildings up to 35,000 Cu. ft.)
l �k�.{✓1 , Vag R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
v,�� � .,, `�a Cr?"' SF Solid Fuel Burning Appliances
d7l q q/3 -pk(, Qi f t7) Ql I'+- • I Insulation
Telephone Em address D Demolition /
5.2 Registered Home
Improvement Contractor(HIC) P 0$- �,q �./i k/7_3
TA `'k HIC Registration Number Expiration Date
HIC,qmDany am or` 4 egtstr/YJ�I�jame
No. tree a� Email address
City/Town,State, IP 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 1T tk NS 141441
to act on my behalf,in all matters relative to work authorized by this building p application.
AIIL,� a�, aoaa
Print Owner's Name(Electronic Signature) / Date
SECTION : WNER'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.
ipt,,f,s P#AN a/ !"L2---
Print Owner's or Authorized Agent's Na ie(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
i I
Massachusetts At �` .
DEPARTMENT OF BUILDING INSPECTIONS 2
212 Main Street • Municipal Building
Northampton, MA 01060 ss-h,
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: V Pt-eV C. .�
The debris will be transported by:
Name of Hauler: Jo4,41.&
4u
Signature of Applicant: Date: 1/244-2.7
The Commonwealth of Massachusetts
11'2 i46 Department of Industrial Accidents
I Congress Street,Suite 100
Boston, MA 02114-2017
, . •=,,4.-,,,
www.mass.goWdia
-.._..,
Workers'('ompensation Insurance Affidavit:BuilderuiContraetersiElectricianstPlumbers.
TO BE FILED WITH THE PERMITTING AtTHORITV.
. nnlicant Information Please Print Leeiblv
1 Nittne il3us1nessorgAnization individual) ,
' Address:
Cily'Stalc'Zip: Phone#:
Are stir an employee!Check the appropriate hot:
Type of project(required):
3.C3 i AI71 a employer with employees!lull imam min-lirriel'
, 7. j New construction
2C;ri ant a auk proprietor or partnership and have no etnployees worlang for me in 8. CI Remodeling
an opacity.[No workers'comp.Insomniac roomed]
! 9_.0 I am a hoennowner doing all with,myself,.[No workers'comp.insuranix so:mired.]' El Demolition
l 0 D Building addition
4.0 1 am a homeowner and w irl be hiring coattnietors it conduct all work.on my property. I will
ensure that all LAYIstracion.either hate workers"cornpensation insurance or arc sole 3 l.C] Electrical repairs or additions
proprietors with no employ-tan.,
12.0 Plumbing repairs or additions
.!,(3 lam a general eontnanor and 1 bate hired the sub-et:mar/actors listed on the attached sheet
13.0 Roof repairs
Three sub-contractors hate employees and hat e workers'comp.insurance:
6.0 wt are a consortiums and its officers have men:tied then nett of exemption per hit,I. ,. 14.CDOthei
152.,§1441-inid we have no employees.[No workers'comp.insurance requited]
`Any applicant dug checks box Pi must also fill out the section be lov.showing then a oricrs'compensation NLI..,, I:dorm:mem.
" lloineownets who submit this affidavit milicaung they are doing all W.ork and then hire outside contractors must submit a ilex affidat it indiLating suck.
tContractors that cheek this box must ittus:hed art additional sheet show sng the name of the sadi-cmaractoes and Nr.11:e V. IL lilt': or nut tilos,:,itt al.:,h c
croplo-,ees It:Is:sets,:ontractoes hilii.V OW 1...:,4....!,..iht.::, MUNI NO,id e their N.,misers"1:Arnip policy nunibet
I am an employer that is providing wailers compensation insurance for my employees. Below is the polio.anti job.%itt•
information.
' 1
Insurance Company Name: —
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: CityiStaneZip:
Attach a copy or the workers'compensation poke) declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL e. 152. !;25A is a crurunal violation punishable by a tine up to 51,500.00
ari&or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine 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 4 , A..,.der tie paini.and 1 n ' o-fperittry that the information provided above is true and correct.
Signature: %Ay 1)31--/( "
11 1W7d-'..2-----
Phork. - .A4=7 9 p.
Offi(ial 4i i'oak. Do slot write in this area, to be completed by city or town official.
City or Town: PermitiLicense#
' Issuing Authority i circle one):
I.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
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