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38A-021 (10)
BP-2022-0941 35 RUST AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38A-021-001 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-2022-0941 PERMISSION IS HEREBY GRANTE TO: Project# WINDOWS/DOORS/SIDING Contractor: License: Est. Cost: 32000 Const.Class: Exp.Date: Use Group: Owner: PENGELLY FRITHA A& PAMELA T ACEWAN Lot Size (sq.ft.) Zoning: URB Applicant: PENGELLY FRITHA A& PAMELA T ACEWAN Applicant Address Phone: Insurance: 35 RUST AVE • NORTHAMPTON, MA 01060 ISSUED ON:08/10/2022 TO PERFORM THE FOLLOWING WORK: REPLACEMENT WINDOWS AND DOORS, SIDING 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: • tI Fees Paid: $100.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Please email permit,when ready,to Robin MacEwan at robintm©earthlink. et:-- - The Commonwealth of Massachus s l Board of Building Regulations and S dar AUG Q FO'ICI ALITY Massachusetts State Building Code, 7 0 C R _is 2022 U,E Building Permit Application To Construct,Repair, enoflitto. olish a R ised ar 2011 One-or Two-Family Dwelling NORrNAMto%�,iNsP coo'S This Section For Official Use Only MA.4060 Building Permit Number: to— @-// Date Applied: �E1!ICU 55 / L 8- /0" ZOZ Z Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 35 Rust Avenue 1.2 Isgs4s Map&Parcel Numbers 1.1 a 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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Pamela("Robin")MacEwan&Fritha Pengelly Northampton,MA 01060 Name(Print) City,State,ZIP 413-586-2524(landline) 35 Rust Avenue 413 27-a7-371{ecll) robintm(a)earthlink.net No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building® Owner-Occupied ® Repairs(s) 0 Alteration(s) la Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': On single side of house(west side):Remove existing siding,backdoor and single-pane windows;install air barrier,2"rigid insulation, WRB,rain screen and fiber cement siding;install replacement backdoor and double pane windows(new window U-value:0.27). SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 32,000 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $0 ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 0 2. Other Fees: $ 4. Mechanical (HVAC) $ 0 List: 5. Mechanical (Fire $0 Total All FebSuppression) 4 1U� Check No. ' Check Amount: I 6. Total Project Cost: $ 32,000 0 Paid in Full 0 Outstanding Balance Due: City of Northampton ate_ Massachusetts - _ �r t A, R t' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 .,,�‘" 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 specification 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. Homeowner's License Exemption Form (if applicable). 8. Note any Special Permit requirements (if applicable). 9. Energy Code—all new construction(Gut/Rehab) requires an HERS Rater Affidavit. SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35 000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) • HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name No.and Street Email address 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,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic 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 applicationca is true and accurate to the best of my knowledge and understanding. Pamela MacEwan 6�v� r 8/4/2022 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" The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 1 — - .4,it,:z. ..,-....i.. Boston, MA 02114-2017 wwwmass.govidia Vl'orters'Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING Al.'THORITV. Applicant Information Please Print Legibly Name iBuNiaLts 1ir, 11./.4.tion Individual : Eamela Llobin)• Addre : 35 Rust Avenue City/StatelZip: Northampton. MA Phone#: 413-586-2524(landline)413-275-7371 (cell) _ . . Are!inn Ill einployeal Check car appropriate birs: Type of project(required): I ID I am a employes with LITITAllYtt.•(full and os r+un-tifor I• ' 7. C3 New construction .10 I am a Nth:proprictla or partnerthip and have no empleyeth workinE for me in X 8, c3 Remodeling ,.capeeity,[Nu workers'comp.insuranix require:11A ' 9_ 0 Demolition ...1-1 1 arn a homeowner threaF all work royiell. [No%..,orkcrs'comp_znamance reg lined. 10 El Building addition 4.71 1 am a homeowner and will ha:lin-mg contractor5 to conduct all work on iro.propert,. I witi L/I.Slitt that an cosuractors either hare workers'ceemensation tnantance ix arc mJ1c i i.0 Electrical repairs or additions prippriettm with no employed, 12.0 Plumbing repairs or additions '-..71 I arm a pampa'contra:tor and 1 have hued the sub-curitnieturs listed un the aired:Had sheet I 3C1Roof repairs Thew sails-eontrrietuts have employee%and Mist wcrticers'comp.insunince; 6.0 We are a cumin-shun and its offieers have exercised they Neu of europium per MGL c. 14.CD Othei 1:4 2.t'I i 4 i.and vie have Do employees.[Nu workiPs'comp insurance required] 'Am applicant that ch,...x.-Ls box 4 i MIMI also fill OW lik:iiiktian below showing their workers'eettimeraation policy information. *Flitwowners who t21111:14 tin%affidavit indicatine Dal an:doing all work and then hire outside contractors must submit a mew affidavit iisantatig such. 4.:oritsaelors that diet.*the boamusa artached an additional sheet showing Livr name of the iab-canitacton,Ind stars:utother or nor those iisitities have eariployees. If the soh-eirearseturs favor employed they cnno provide thee v.orkerN,'o.snip,pulik-..monk! I am an employer that is providing ovorAers'compensation insurance for My employees. Brion-is the policy and job site information.. Insuratii:e Company Name: _ Policy-it or Self-ins. Lic.#: Expiration Date: Job Site Address: Citv,'Statelip: Attach a copy of the workers'compensation police declaration page(showing the policy number and expiration date . Failure to cure coVerage as required under MGL c. 152, §25A is a criminal violation punishable by a tine up to$1.51X).00 aml'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 Invevaigations of the DIA for insurance co..cr.i!.,;.- ‘critic-Ilion. I do hereby certify under tire trains and nenaltie.s of perjury that the information provided oho'c 11/4 true fin tf correct Signature. Pamela MacEwan ‘,;"."./1,.,Z Date: 8/4/2022 413-586-2524 (landline)413-275-7371 (cell) Official use only. Do not write in this area to be completed by city or town official City or Tow n: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing litspectnr 6.Other ('Iintaet Person: Phone 4: City of Northampton .406214, Massachusetts - `t. . N st DEPARTMENT OF BUILDING INSPECTIONS , 212 Main Street • Municipal Building Jf4 4> Northampton, MA 01060 Sp 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: Abatement debris facilities(per abatement contractor): Temporary Storage:TransWaste Inc. 3, Barker Driver, Wallingford Ct. 06492 Location of Facility: Permanent Storage Facility: Minerva Enterprise Inc., 9000 Minerva Road SE, Wanesburg, OH 446; General construction debris: Greenfield Transfer Station The debris will be transported by: Abatement debris(per abatement contractor): TransWaste, Inc. and Minerva Enterprise, Inc. Name of Hauler: General construction debris: Scott Belanger Signature of Applicant: Date:8/4/2022 City of Northampton kfarl Massachusetts * � �j4c DEPARTMENT OF BUILDING INSPECTIONS 44,1; r i' 212 Main Street • Municipal Building -^cam pig Northampton, MA 01060 p•f �._> ti y HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, Pamela MacEwan (insert full legal name), borrPl�snqinsert month, day, year), hereby depose and state the following: 1. I 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 4 day of August , 20 22 . (Signature)