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29-380 (3) BP-2022-1108 179 FLORENCE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-380-001 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-2022-1108 PERMISSION IS HEREBY GRANTED TO: Project# 2022 SIDING &WINDOWS Contractor: License: Est. Cost: 19600 Const.Class: Exp.Date: Use Group: Owner: EFRAIN DIAZ Lot Size (sq.ft.) Zoning: WSP Applicant: EFRAIN DIAZ Applicant Address Phone: Insurance: 179 FLORENCE RD FLORENCE, MA 01062 ISSUED ON:09/08/2022 TO PERFORM THE FOLLO WING WORK: SIDING &WINDOWS 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: y2 3-''I • Fees Paid: $100.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner 4 itk `- >> rand-)0d l a Z 2o2o eyhe-vc C 0 Mn - aR The Commonwealth of Massachusetts `� Board of Building Regulations and Standards FOR E f I c-,.,' ,..3..)I co MUNICIPALITY Massachusetts State Building Code, 780 CMR USE tit 1#uildin&mit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 u., E L One-or Two-Family Dwelling a� M r Cl) z This Section For Official Use Only Building P_n� eer: 2D2Z' I I 0-2 Date Applied: 4i/J ` JCoyy ,�� q-7-ZDzz Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1. Pro arty Address: CD(0(a 1.2 Assessors Map&Parcel Numbers kFlZ)fex>cA CO Flom.ncQ.( W 2 1-34©—0.0 1 -- 1.1 a Is this an accepted street?yes J 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 caner'of Record: l4\ 1C)‘ ok.2 cto-rQ.,-, c.o. rn.rc; - 0k0(0a, Name(Print) City,State,ZIP `'°\ T_1. 'e.nc R 'Rev . 1413-q a3-a4/0.1p ?b lActAc•aoo8.0,\(a.hoo.c,awN, 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) [i' Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ Specify: Brief Description of Proposed Work: S\da TN%_c91/4,1/4...0'NI 0-FAcmit. .2q 4- . Zt'_ SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ t vl Leo,O 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee `-'Id/' J G a 2.Electrical $ ❑Total Project Costa(Item 6)x multiplietl-'3"�4°'^)* '- D 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fees: $ [O O — c 0 ( ^ ��,QC Check No.)!23 Check Amount: (O0iCash Amount: (/6. Total Project Cost: $ i 0 Paid in Full 0 Outstanding Balance Due: fir city of Northampton Massachusetts1,q( ;it '. 7 AA it DEPARTMENT OF BUILDING INSPECTIONS tlt 212 Main Street • Municipal Building Northampton, MA 01060 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. r 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.) •City/Town,State,ZIP R Restricted 1&2 Family Dwelling 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 1 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 application is true and accurate to the best of my knowledge and understanding. caner s or ut Bonze gent'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" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton Massachusetts i��' 1. -r{,_ * '\ f % . DEPARTMENT OF BUILDING INSPECTIONS S 41" i w }�• 212 Main Street • Municipal Buildings j' - _ Northampton, MA 01060 ��yyi I.�\' 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: Cl Cl, F l Off\ co p\A - VA 0 ')ncQ -01 dcc) The debris will be transported by: Name of Hauler: A. v_OmSt al ' a-c--P- i Loorr S ,_K)i 1, 14 . ���- 5'5 -q,> > 1 ' • IN i Signature of Applicant: Date: .1 .. The Commonwealth of Massachusetts it._......... ,=.—....,et Department of Industrial Accidents 1 Congress Street,Suite 100 Boston. MA 02114-2017 4> ,;,-,,,s4:': www.mass.govidia . Waiters'compensation Insurance Affida‘it: Builders/ContractorilElertrieiansi Plumber . I()BE FILED%SI I'll 1 III PERM!rf INC AlTHORIT8. Applicant Information Mast! Print 1.1.1libl% Name(BusinessiOrvinization I netivaluall: Y\ Address: '1-1 Ol RPTn42SA C Q. 'RCA City/State/Zip:EILMICIR bib iYa Phone#,:, 4 t 3 - Cil, 3 .9,44/(0120 .s,re you iill eMplilile ex?Cheek die appropriate bee: Type of project(required): 1.D i am a e.mr.10es with .,entrt.loyeeit dull=ier part-tura:0 7. CI New construction 2.1:3 I am a sole proprietor or partner and have no employeet working for the m 8. c3 Remodeling any capacity [No workers ccertp.that/mice revived.] 9. 0 Demolition , 10 t sm a hot:tweak/ter doing all work myself.[No wockers'comp.inhuranee revvirea]* 4. 1 int a homeowiter and will be hums contratetera to otaadtiet all wink Ott eny rope:To. 1 will ge 1 0 El Building addition ensure that an corium-mix either have workers'CultriptilAation insurance or art sole 1 1.0 Electrical repairs or additions pry/Orietata with no employemi 12.0 Plumbing repairs or additions 5.0 i am a Remold contractor and 1 base hired the solr-contractors listed on the autatinat shoe_ I 3.Cj Root repairs These sub-contractors have employees,and haw workers'comp.insurance.: 14.0 Other 6.Q we are a evaporation and in.officers have exercised their right at:exemption per MCIL c. 1.12..§114 1.and we have no employct%.[No workers'comp.insurance required.] *Any applicant that chocks birt ni must also fill out the acclaim MOW showing their V.arik..1,4.sa)Mpemildlimi pulley LiiiiirMalitleL itomeowerers who submit tilt affidavit indicating they siedvang all work and then hue outside Cu tractors meat submit a new affidavit Militating such. teuntracturs that check this but must attached an additional sheet showing the name'Ache anta-eutairactora anal state whether or not those eoliths have empluyeea_ lithe sub-eutitraeitir%ha..e empltry ee....they mist pro-ode their winker,'.comp.poke!,number I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: _ Policy#or Self-ins.LW. #: 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 MGE c. 152,§25A is a criminal violation punishable by a fine up to S1.500.00 anAtor 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 fort' rdal to the Office of investigations of the DIA for insurance co‘era,„..,e 1.critication. I do hereby certift under the pains and penalties of perjury that the information provided above is trtte and correct. Si enature: Date: Phone r": (Vidal use only. Do not write in this area. to lw completed by city or town official (Its or Town: Permit/License# Issuing Authority(circle one t: I. Board of Health 2. Buildinv, Department 3.City/Town Clerk 4.Electrical Inspector 5. Pluinliin Inspector 6.Other Contact Person: Phone*: City of Northampton Massachusetts hL a 40 tt. s DEPARTMENT OF BUILDING INSPECTIONS + 212 Main Street • Municipal BuildingN.Jy� Northampton, MA 01060 "Kok ."'' HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT T._,kI, (,K� \ 0\7,, (insert full legal name), born kIkb insert 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 saidproject or work. Signed under the pains and penalties of perjury on this (c day of c�� — 0 (Si Fwd: 179 Florence rd Efrain diaz • Remove this label after final insRectton;SAVE for future reference Pella Corporation ie .0 • 250 Series wi Nh9tC Double Hung Annealed One Wide ".laticnai Fenestration Adved low—E dating Court! I Argon ancGas CERTIFIED (PEI-N-211-00057-00001 ENERGY PERFORMANCE RATINGS U-Facror Solar Heat Gain Coefficient 0.29 1 1.65 ' 0.28 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0.53 • Mm 4ctodaotpaufatesethat half ratlt ings,cnnFo•l to eretidllarbeeflied prafeduyesof or unmentaleaondftlone and a tpealro prndue etre.NFRC done rnl reoommend eny produetde and doom net Werrant ` "' tht chi o 1°y al ary product tnr any onetMt une.F ar more Inlo'matior.call(611))6at-3114 CO rut+ Palk,,ea l'a et WCW Pell,oem or yiep the NFRC web site al WWiv.nfre.orp ak ENERGY STAR`` Certified in Highlighted Regions a 4 • , -- ir.,, :,,,,.....„.......„ t ...., , , I v��1 4 certin9d em 4ttg4+p�R2 a"away eaaaae StLicinfe:`ea—Double Hanel r Qr,SwA t..lS ?tNa_b H P---&ze`lned a.�"a' a :. ____. z1Wat1R POS Strl'Ilia 1-4T81ammr74-"'1t: z —__ Ct6a:8DammL.'4�6nt_t o d p2:" %Natant Inset, _ — ., —"nth;41,1W9a C[ 1F1a7titlit 1 M q%di""aaq a1!e!Wet li ■Mg tte pee9aa spY�::�:e: da ttr Rilx Hq t_p17uuu,Z. 11,,r4r4N/ k :1' sUeM* a t*Pr"�a e 4 , ht XPVeofktm ;Id r P t * a Pattw : WFcrASIVI iyn e rtap fir J6t!t:a 3 of 6 9/7/2022, 11:44 AM Fwd: 179 Florence rd Efrain diaz • 4' tat r 1n:hCedMt:.5,tYf tnr hflrtre C1PTPfiP@ fre rtic teilt��a`tin''l'Inintiimn tenate 84{R Cotpotatton 250 Senes Reed FrameiSpecial Shape 1 anaai d One Wide advanced Low—F argon Sat � ►1 PEt-R ?Di—00049-00001 ENERGY PERFORMANCE RATINGS._ . rac r Solar Heat Gain Coetficieni 0.26 1.48 0.31 ADDfTiOliAL PERFORMANCE RATINGS 0.60 - - h r Okulov,tin inxs.lomx �-to epuhttilAt NFst_Irued.rea Is dxtermineeg attain orndie Gx 1 R'..r1tm,r,rankestBert predate one 1.2.not rrr.nte..leNa. o..n' Ur'1 lore I .ann tel(MII621-3114 x ue i°'a wr.+�.p.t4,tort or-es ehe Ora et Ye It;Mr niro.rp ENERGY STARS Certified in Highlighted Regions • AI P !fl na 6 i fnd $d 3r„! ,' tam tabF .ia>e Cx; Y tax Nauxf ri11!!d'h >ite rpr y YK .c>S A ttsratz Ynt 1�rs�t�k 0et7rmr RxMlo and �S Pr�.�Slift -is a ree flhS wHM tea d,u rN n ex.xs x.Mre ,M1C .: a n. E,�dtC wm RiN'�Lx'rU aiff,E•;5...... :.-In;F� tttrd • • w".n.em�i ...... x • t I 4 of 6 9/7/2022, 11:44 AM Fwd: 179 Florence rd Efrain diaz ... WE , r,---- kerneve nun&IV rfin fin. PetPella Corpotalton \i Ri ' Double Hung Annealed °'' One Mlle ,,,, ,,`x ','a. Advanced Law-E Argon Gas ''.. I CERTIFfED , ..k, ''' f, FEL-h-VI-MOP-Wiltil __ENERGY PERFORMANCE RATINGS \li t,t.,•-•,',,°v 0 ,, u-Ficin Sake;Hut Gain Coebleisof ° '4 ',.- .29 1.65 0.28 ADDITIONAL PERFORMANCE RATINGS k ' ' f 14c,e Frinimetaice ,, ,;,,•''', 0.53 ma. ... r:iti, ' \ k, ENERGY&TAW'Certrfied In ileghlighted Regions ;° A I 1 ; WitE,11! l {!. ; i ,. ...4. ., .' t'l, -——--_-_:,T,1: ___ _ '-- ',,, ,;:,*°,, • '-,' ''' :At'-'"1,:'..131.'w'• .'"*.r4 '''' ' \. 1-Z,':: e..'; I $ A . _ 9/7/2022,11:44 ANI 5 of 6 Fwd: 179 Florence rd Efrain diaz Sent from Yahoo Mail on Android Kevin Ross Local Building Inspector 212 Main Street 587-1240 Northampton,MA 01060 Fax 587-1272 kross@northamptonma.gov 6 of 6 9/7/2022, 11:44 AM