30B-004 BP-2022-0801
54 NORWOOD AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
30B-004-001 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-2022-0801 PERMISSIONIS HEREBY GRANTED TO:
Project# 2022 ENTRYWAY STEPS Contractor: License:
Est.Cost: 8000 JESSE RYAN CS-117083
Const.Class: Exp.Date:0I/16/2026
Use Group: Owner: FONG HERMAN J
Lot Size (sq.ft.)
Zoning: URB Applicant: JESSE RYAN
Applicant Address Phone: Insurance:
985 FLORENCE RD (413)858-9760 SOLE PROPRIETOR
FLORENCE, MA 01062
ISSUED ON:07/08/2022
TO PERFORM THE FOLLOWING WORK:
REPLACE 2 ENTRYWAY LANDINGS, STAIRS & RAILINGS
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:
)9 CS-°
! I
Fees Paid: $65.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 •
Office of the Building Commissioner
The Commonwealth of Massachusetts
'— Board of Building Regulations and Standards FOR
_ 1 P Massachusetts State Building Code, 780 CMR MUNICIPALITY
cmUSE
N ram, Buil iig Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
N.) i -, One- or Two-Family Dwelling
�� This Section For Official Use Only
Building Permit N er: -Zoe?-OS a/ Date Applied: 07/0 L/20 22
eu,� /SS ./// 2 7-72OZZ
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
614 NI orOots,1 AvG . 3o, - oo'/--00 1
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
U/Ca Rest 4v-.k WSW C•fo° Acre)
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 b Private❑ Zone: Outside Flood Zone? Municipal ISI On site disposal system 0
Check if yes
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: ❑
o.reta" 1'01n berefD T 1or cis 1/1(11,
Name(Print) City,State,ZIP 1 0 1 0�0 2.
57/ 4)0( Ale, L( .2/ .377/ - )COA 100 • Y4No0 a
No.and Street Telephone mail 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 0
Demolition 0 Accessory Bldg. 0 Number of Units Other Specify:
Brief Description of Proposed Work': V ep tac.t►'t ►fo0 erv4 N0o...l 14,1cJ t t'k�S) 5' akcS
Ounc1. �'0.k.`1fl 5 •
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ $- 000 1. Building Permit Fee: $ Indicate how fee is determined:
i
2.Electrical $ 10 1� 0 Standard City/Town Application Fee
0 Total Project Costa (Item 6)x multiplier x
3. Plumbing $ ((A. 2. Other Fees: $
4. Mechanical (HVAC) $ N I A. List:
5. Mechanical (Fire ^
Suppression) $ I vt IX Total All Fees: $(0 5 °=
Check No.2ag Check Amount: 4.,� -'Cash Amount:
6. Total Project Cost: $ (')OD° 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS-((7co 3 /-!4.2 d 26
JeSSt, 2t(0ik License Number Expiration Date
Name of CSL Holder
curs cLc�Rc oc,� Z List CSL Type(see below)
No.and Street TA Description
\ (U J Unrestricted(Buildings up to 35,000 cu.ft.)
N� ��� �� ��d VI-- Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
,�-`Q SF Solid Fuel Burning Appliances
Le tit-611W ��Esseitk(e ) IJftk I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) /LO 576D 6-20.2 0Z`f
Jesse_ 2y HIC Registration Number Expiration Date
HIC Compan Name or Registrant Name
R 8-s rtOre e CE i2 D J112.�es'S��� �, t l .cam►
No.and Street Em 1 address
oArN API PTV , '14 610CZ 5"5-8. .17.60
Ci y/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 F No...........❑
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 J-CSSC
to act on my behalf,in all matters relative to work authorized by this building permit application.
Eo 7/2/001a
Print Owner's Name(Eledmfiic Signature) 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.
2 . 22
Print Owner's or Authorize d Ag t 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
(nonregistered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142k 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.mastgov/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"
The Commonwealth of Massachusetts
zwr,=e
,.....1 Department of Industrial.4ccidrttts
l `
, incii .:I=__ 61
1 Congress Street,Suite 100
' =le;�s.__ Boston. ;tI A 02114-2017
t,; .s'ii'w.mass.gorrdui
• 1l rakers'(watt►ensalion Insurance.ltfndas it: Buildersl'ontractorsfElectricians?Pluuthers.
10 HI-. I-l I I.l)V1 rr11 l iii:1't:R%ll i IM Al-IHOI(1 i1.
Annlicaut information Please Print Letihls
Name al
Name r}.tnv.uum Inditidualt _ e554.- 2_
Address: 14'S rrL OrL6-,vc - 2
CityfStatr Zip:._ /Je C - el/NI 4,4 cal PIionc L/! ? i _..7-7 Cs
Arm gun an emplirstel('limb the alrpnrpriat"hot.
Ty pe of project(required):.
1.0 I ant a eiriplotcr with employees thrill and or part-tin::.' 7. C]New construction
yoiaI am a AIlc proprietor or partnership and hate nu employes working for me in R. a Remodeling
ant'capality-[No workers'ltln M p.tnraniY liNiltgtll_I
9. ❑Demolition
401 ant a filmy-warm donne all work myself.!Nu wurkar,'comp_imusance ret;ttrrcd.l
4.0 I am a homeowner and will be huurt contraetursto conduct all week on my property. 1 will IQ Building addition
ensure that all contractors either fuse worker.• nitpeit.nii.rr ilistlinteCt Or are ttulC L L.fJ Electrical repairs or additions
prupnetura with no cmployc.s.
12.0 Plumbing repairs or additions
I am a general contractor and I lute hind the sub-cunu:rtun listed on the attached short r
These srth- urtracturs have artrplu_t'es and lute workers'ctanp.uouranee.^ I Roof repairs
14. then `ptlVor nq r 5T41 i S
61:1 Vi'e an:a corporation and its officers have ea.reisead their nglit of exemption per Wit t:_ 1
15_.,s 1141,and we have no employees.[No worker'coup.insurance requurd.[ F0 it .e."i'r'c/ 4.)A S .
Mist apphcant that checks boa at ist also till out the section below showing their worker ert'eompsatiun pole}rnlurtnaliun. l b
r Huenc owners who whims this atl'itlasit indicating they an:doing all work and then hue outside contractor,mini%%ki ut a new affida%it indicating such.
%t'untractors that check this bra must attached an additional sheet showing the name of the sail►-etmtractoes and state wh.7h ccr of not those enlitics base
anplo+,ees. tithe soh-contractors hose eartflotees.thce tnu+i ru+didc their wvukcis.comp.pudic!, i uira s'..
I am an employer that is pro►'iding workers'compensation insurance fur my employees. Below is the policy and job site
information.
Insurance Company Name:
Poliev or Self-ins.Lie.#: Expiration Date:
Job Site Address: C'its State-Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and aspiration date).
Failure to secure coverage as required under MGL c. 152.*25A is a criminal violation punishable by a fine up to SI.500A10
and'or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.O0 a
day against the violator.A copy of this statement may be forwarded to the Office.of In estigatiwu of the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: 24 4 /2 Date 7 e2" -02-Z.
r , 8" - g D
lhtnr:: �(!3 �� 7,S
Official use conk Do not write in this urea.to be completed by city or town official
( its or I'utsn: Permit/license i1
Issuing.•uthurits (circle one):
I. Board of health 2. Building l)epartinenl 3.(•il, limn Clerk 4. Ilectrical Inspector 5. Plumbing Inspector
6.Other
(•ontact Person: Phone#:
City of Northampton
Massachusetts ti+ '(�.
A.
�� DEPARTMENT OF BUILDING INSPECTIONS N y
`a.� ' 212 Main Street • Municipal Building Jti ^D'
Northampton, MA 01060 'rsN,i, 17''"
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: I 7 I al4G/1 la,/ ,ed. F/rence. /14, 1710- 2._
The debris will be transported by:
Name of Hauler: )e-SS2 24 _
Signature of Applicant: l jA/fei Date: 7.2 ' 2Z
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CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE