Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
32A-044 (7)
BP-2022-0976 13 CHERRY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-044-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNRE ISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUA ANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0976 PERMISSIONIS HEREBY GRANTED TO: Project# BATH RENO Contractor: License: Est. Cost: 9000 ROBERT GOULD 90940 Const.Class: Exp.Date:02/19/202302/19/2023 Use Group: Owner: EDWARDS, DANI EL & EDWARDS, SU'ANNE P. Lot Size (sq.ft.) Zoning: URC Applicant: ROBERT GOULD Applicant Address Phone: Insurance: 62 LYMAN ST 413-531-1391 SOLE PROPRIETOR GRANBY, MA 01033 ISSUED ON:08/12/2022 TO PERFORM THE FOLLO WING WORK: 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: 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: (t; ,r • ''1 • ' Fees Paid: $65.00 2l2 Main Street, Phone(413) 587-1240,F.x:(413)587-1272 Office of the Building Comm ssioner RECEIVED IIi The Commonwealth of Massachusetts AUG + 1 2022 •14I ' Board of Building Regulations and tandards FOR ' i' —MUNICIPALITY Massachusetts State Building Code, 780rcP nuaoiNC;INSPECTIONS USE ` C1RTHq�iP�ON.M�01060 Building Permit Application To Construct,Repair,R to rry�-rriel ° Mar 2011 One-or Two-Family Dwelling a This Section For Official Use Only Building Permit Number: 61-y)-- - 1 (4 Date Applied: 1 � .91Ar6 apa, Building Official(Print Name) Signature -- SECTION 1:SITE INFORMATION 1.1 Prop Address: 1.2 Ssselsrds Map&Parcel Numb ct 1.1�a Is this an ac street?yes no Map Number Parcel Number —J 1.3 Zoning Information: 1.4 Property Dimension Zoning District Proposed Use Lot Area(sq ft) Frontage(II) 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: ( / �, " DAN 5 ko 11 Name(Print) City,State,ZIP J /3 aevvy'I" (<3 37if 5-‘0-0 clKe S L® No.and Street Telephone E ail Addre SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building)la Owner-Occupied 0 Rrepairs(S) Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed WOrk2: SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ PO 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ! /O ©� ❑Standard City/Town Application Fee 0 Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 0 CAS 2. Other Fees: $ 4. Mechanical (HVAt) $ List: _ 5. Mechanical (Fire Suppression) Total All Fees: $_ (n. t3° 6.Total Project Cost: $ O Check No.606S)Check Amount: Cash Amount: Wahl in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) -0!!e'i C. }5 o c to License Number Expiration Date Name of CSL Holder l ` Q� List CSL Type(see below) No.and Street Type Description /_ �` /0 3 3 U Unrestricted(Buildings up to 35,000 Cu.ft.) Cit et-e• ,Mate,ZIP R Restricted I&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances if(3 c3(—I3Q/ 6 C4 ( '*l@LkVe.COv-1 I Insulation Telephone mail address D Demolition 5.2 gi tered Home Improve ent Contractor(HIC) f 3 g/ r(.�z2 6 C �V` HIC Registration Number Expiration Date HIC Copa y Name or MC Registrant Name 0 0444 4 5f b,3cawpe - ®Li Imo,c -t. No.and Street Emil 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 Ill No . 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRA 0 .^-T 0 /" C C. APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize61)-0 Kt to act on my behalf,in all matters relative to work authorized by this building permit application. ilk A,L-e,L gd a-45 /( 2.,0-7—z. Print Owner's Name(Electronic Signature) i / Date SECTION 7b:OWNER1 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 ap. won is true and accurate to the best of my knowledge and understanding. /' y tit�-� iowner's or Aut orized Agent's Name(Electronic Signature) Date NOTES: I. 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 l Congress Street,Suite 100 Boston,MA 02114-2017 : #' www mms..gov/dia 11 tuners`Coaipensatiuu Insurance Affidavit:BuildersI('untractors/Ekctricians,''Plumbers. TO ttI:lFll IJ)a lilt'ruE PERM)ii IN(;AI7110R1.I.1'. Applicant Information �� Please Print Leaibl. a:il Name(Husincsrganizauonilndniduall: d le'�"t�t (�` t.)/CI Address: it Z. CtY t/ "4 City/State/Zip: this fAAA. ota3 Phorto: tf(3-5j /3?/ Are yam air etttelayer't'Meth the apprapriate has: T.pe of project(required): 1.❑I am a employer with employees!fill and or part-time6` 7. New construction 2 a uk proprietor or pratnermhip and hate no employees working tar ma:In am any capacity.[Na nutters'comp.imurante required] lt_ CI Remodeling 30 I am a iwarw mmtT doing all work myself.[Nu workhns`tromp.imuraa,c roptittaii' 9. ❑ Demolition 4.0 I am a humansriT and will be suing aaaraatnrs ie conduct all wtrrk on my pnpl tty_ i will 1 U© Blrildlnb addition ¢tame that all codrtetun►it cr have warners'cueopeuwriun uururance or are sole 11-0 Electrical repairs or additions proprietors with nu employees_ 12_Q Plumbing repairs or additions 5C t am a general contractor and I bate hued the sub-cunuatturs listed on the attached sheer_ These nab-euntractur.lose onpluyees.and have�rrur►ers'coop.nw rrance.= I Roof CO We are a cwporatitin and its officers hate exercised their right ul eaarrptioi per MCiL c. 14.0 Ott t: (Q/,•.h#i/ IS? 1(4)4,and se hate no niployeaca.[Nu wurken•comp.insurancereyuuetlj 'Any applicant that checks hoc as mint also till out the section below slam ing their workers'compensation policy information_ 'I umneo%nen who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new atYtdat it indicating such. t ontraetun that check this bus must attached an additional sheet showing the name of the wb-coaraciurs and state whether or not those entities lane ci,tt'loyce's. If the sub-twtlraetos have!mils.ce.,they must provide their workers'vamp.pulpy nunher. I ant an employer that is providint;wurlhers'compensation insurance for my employees. Below is the polity and job site in/ormutinn. Insurance Company Name:, Policy#or Self-ins_Lic.#: Expiration Date: Job Site Address: City:State.+Zip: Attach a copy of the workers'compensation policy declaration page(showing 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 S1 50U_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 S250.00 a day against the violator.A copy of this statement may be forwarded to the Oftice of Investigations of the DIA for insurance coverage verification. I do hereby cer - •under the pain%and penalties of perjury that the information provided above is hue and correct Signature: �S l� 04- ,/ Datc1•it'2z Phone#: t i!'33(- r59/ Official use unit•. Du not write in this area,to be completed by city or town official (it) or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City?uwn Clerk 4. Electrical Inspector 5. Pluniliinu Inspector 6.Other jt{ Contact Person: Thane 4: City of Northampton +AM Massachusetts w .�s DEPARTMENT OF BUILDING INSPECTIONS C. i 212 Main Street • Municipal Building .) Northampton, MA 01060 N 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: / jc t.e The debris will be transported by: Name of Hauler: Signature of Applicant:A-. � - �� Date: ��'i-