17A-188 (9) B -2022-1077
21 KIMBALL ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
17A-188-001 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-2022-1077 PERMISSION IS HEREBY GRANTED TO:
2022 COVERED ENTRANCE
Project# DECK Contractor: License:
Est. Cost: 11000 DOUGLAS GOODNOW 082188
Const.Class: Exp.Date: 10/16/2023
Use Group: Owner: H BELL ROSS J& ERICA
Lot Size (sq.ft.)
Zoning: URB Applicant: GOODNOW CONSTRUCTION INC
Applicant Address Phone: Insurance:
45 WESTVIEW TER (413)548-4561 CS0178654
EASTHAMPTON, MA 01027
ISSUED ON:09/01/2022
TO PERFORM THE FOLLO WING WORK:
REPLACE STEPS WITH 8'X8'COVERED DECK ON FRONT ENTRANCE
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:
• f1 • Tv-
Fees Paid: $72.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
z_Ok
"' The Commonwealth of Massachusetts
WI (-`1 Board of Building Regulations and Standards FOR
MU
Massachusetts State Building Code, 780 CMRNICLP
USE�I
TY
LD Buildin Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Num :3P 2022—( 0"77 Date Applied:
„J
.CSAA51/ —1.;_)
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
alKim ball s�r ��� 1'7A - tg8- 0t9 i
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
U i i3 .3 4 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 0 Private❑ Zone: Outside Flood Zone?
_ Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 owner'of 811 Record: .� ..Cs; b ! o L
b5S �
Name(Print) City,State,ZIP
al u;M6al( s-rr y(3�/o — bsbs rj bet/7yir► 1frNt
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied 0 Repairs(s) DI Alteration(s) 0 Addition 0
Demolition ❑ Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work': j -1 A i( D2 G k. a r+X- P-Ov� ar- Fr.,.y ircr�
g74_b
eu4r4nCIro9 r.r)tic(orc.- - ""/ 34-4,
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ kigad 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
�1 �� 0 Total Project Costa(Item 6)x multiplier x ( .
3.Plumbing $ /li/A 2. Other Fees: $
4.Mechanical (HVAC) $ N//A List:
5.Mechanical (Fire / o 0
Suppression) $ �( Total All Fees: $ 72-.
u
Check No.,(A Check Amount:72. Cash Amount:
6.Total Project Cost: $ it)do 0 Paid in Full 0 Outstanding Balance Due:
pi , ) 000
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) a a ..1 :le /p/A1?3
Do J 6 f 6. ) (}a-d no w License Number Expiration Date
Name of CSL Holder
'r c wt$41/ w Tyr 6-Le-- List CSL Type(see below) V.
No.and Street / Type Description
E o-Sk -)CLAY CLAY'Co n ( MA 17`O?' Unrestricted(Buildings up to 35,000 .ft.)
1- R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry _
RC Roofing Covering
WS Window and Siding
1113 ,Syi,y s/ d b'0 4 aw /0400` SF Solid Fuel Burning Appliances
( v I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) / f i f 3 4 It 3'
`'va�n HIC Registration Number Expirati Date
HIC Company Name or HIC Registrant Name
qS We'f vco-L. Tarrttc.— d 4 ,,sdinoti �y4_/wa. 4 iA,
No.and trees kill-6I O�7 q85- g- Ica(
Email address
E�5 A,�P7o� J J I 1
City/Town,Slate,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 . Itr''' ' No .0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of th-1
ubject property,hereby authorize
to act on my b- • in all matters relative to work authorized by this building permit application.
Print Owner'. :, e(E • 'nic Si ) 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.
A05 5 gill 00/?..2___ ,
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 1
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"
r �
The (•onunonwealth o/ .Nus uchusetts
Department of Industrial.ccidents
b I Congress Street.Suite 100
Boston.MA 02114-2017
Mww.n►ass.go►/dia
t t� 11 ur Lers" ( unipensation Insurance. f1iidas it: Builders/("otatractorr/Eketrieiam Plumbers.
It)Bt. F 11-1.1)%%11 H 1 11F. P1.10111"IING AIrIHOHtITY.
Applicant Inturmalion // Please Print l�ibir
Name(Business(lrganvstion Indn'tual): 6 oc4c,o1?
Address: 111 e-5-eGce/ rr. a eft_
City/State/Zip: (i 3 CA&Apt ( CC Q)7 Phone#: Ltd! Y-vst
Are pan a.i-mptus no?CUM trapprupnarbut: p.of project(required):
1 ^
am a.trpk'LT Nab O'• cmp0.+►.c.tluil Jed of pa it-Via i.' 7. New construction
2C11 1 am a sole pn.prrwwr of punnenhrp and hale n..Tnpk iecii s.rkutg tot nc m B. 0 Remodeling
am captac11'. [\..%o.tLrs'warm.irbiitancl minima
9. Demolition
30 I am a&mammner doing all soik mull Ito%% a tea'coup.ntewraici mywr.il.l
10 Q Building addition
4.0 I am a IMin s sn or and w ill Ise hiring.ultra ours to conduct all w otk on no,mix-tn. I%ill
L-toute that all contractor.either has worker."tonne"nutio n m utane ON arc sale 1143 EicoricaI repairs or additions
proprietors w tilt no.Tiplo,,ees.
12.0 Plumbing repairs or additions
I our a general contra:tot and I haw hied the auks-contractors ItsiiJ on the attache.'sheet.
13.0 Roof repairs
the.:sub-contrackors hale e'alpl.iites and has c%etk.T.comp Insurance
14.0Other
6.0 N c an:a corporation and its otffear hale et.Tcts.d then nght of etrnpti n per 1t(.L c 152.f 1(4).and we host ni dui.Iost s. tit+%oiler% o n p insurance minted.I
•Ans appli.att that chock%brit l initial ahoy till out the s.t1.m IR'kns showing theft workers .attitp.Tn.rtion polo.)in orinatin,
i Il.Mn.t,w nets%dto subunit this attMIS%it udncating Iles ate.loin,'all work and Men hue outsr.k.orttra.trrs must mahout a nest atlicia,it n.huitmg such.
•(ontractors that cheek this hot must atta.lacJ an additional sheet shim mg the name.rt the snbcontta.t.rs and stair nhrfh.T in not thus t.lYNes halt
.Ttrp.lo�e.•. If tie sub-..mira.r.rs lint cn skms.rs.the,.must pro,.,..1,their %oiler,"comp
p potli..nu+nhti.
I inn an employer that k providing workers' compensation insurance for my employees_ Seinvb fie pelity rid job.site
information. -
Insurance Company Name: CA n ((n n 0tt � n -Cam.
Policy "or Solt-ins.Lic.=• / Lia6 I ,-11- I:.xpiratum Date: f( //Wd?--
Job Site Address: g { k``•1 b6.-k( ✓Irs'r ('lty State'Lip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and espiratloa date).
Failure to secure cos erage as required under M(iL c. 152.§25A is a criminal violation punishable by a title up to$1.500.00
and or one-year imprisonment.as well as cis d penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a
day against the violator.A copy of this statement may be forwarded to the Ounce of Investigations of the DIA for insurance
coverage verification.
I do hereb; certify under the pains and penalties of perjury that the information provided above is true/ and correct.
Signature: �� ►)ai ����1
Phone»: _S 4 ( - ('L
Official use ant: Do not write in this area.to be completed by city or town official.
( its ur-town: Permitil.icrnsr
Issuing:authority (circle one):
I.Board of Health 2.Building Ikpartmrnt 3.(•its"Town( leek 4. Electrical Inspector 5. Plumbing Inspector
tic Other
( 'intact Person: Phone n:
City of Northampton
OaYH M. 0.... ,-
P:y `� � MassachusettsP.
1,iii '
/� DEPARTMENT OF BUILDING INSPECTIONS.L... i,, 212 MainStreet • MunicipalBuilding 77� Northampton, MA 01060
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 n` I l
c-1;v`,
The debris will be transported by:
Name of Hauler: B A. 6L t n
Signature of Applicant: li,(iff (11--04(-^-- Date: �/l °/�2
{7Al I
0.100 1 174475.001
101 li! O.tBs
i
1 W
tJ l
17A-173-Oil
17A-1 0.344
0.10) 1 N - 40 17A-100.111
in I 17A-174-001 ! 0
J
0.170
_______ 0
KIMBALL STREET
I —
I
17A-186-001
17A4
02 17A4
. 0.34
n / 17A-100-001
17A401-001
'\ 0.330
\ p
r
17A-196-001 lf: 1_
--- 1�-'95-001
1 10.1 [1 17A404M1
14 0.17t
11A•103M1
j_______,_
12A-197 001 0In 17A401-N1
0.'r i 0S q
P I It
r7A-198-001 POWELL STREET _---
0.172
Tighe 8 @cnd
8/24/2022 11:28:39 AM i( �'
of , 1 140. k
Scale: 1"=50' ' at:>y' -r. s
Scale is approximate � ' � --N.
The information depicted on this map is for planning purposes only.
It is not adequate for legal boundary definition,regulatory
interpretation,or parcel-level analyses.
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: ` 7 A LOT: f rr"6
LOT SIZE: O "74
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
fr
aAJN- ) SMd(
qi Giza,
3 6
FRONT SETBACK
FRONTAGE
,f ,i
, � .. :..
' r • '•fig .
r r
` o ' '� 1 ` 4 A° J�y�:, JJh� .�Cr 'fir ..,f` {
4• .pi..1 i • 't
t {1•.
+ •'� `e'
,��[[[!��_ s'' '4,f. iim_sac h
— _ — _ -_____.�>< ____ -, ..ter �._' _
-_ _ __ ,s, ��.
f
r ,.
-1 ' ,,T • -,'". •-- '-_s,-. .41`. f ,,;.. -'•— i _ i ______I L_ -_..--.-
. .JI •. ��yy��• _y��{ , �1y� �' • T syt ' :. J�;t
-_ w s,, %.r - v 4• ��i —_- l;, %; '4G ... ems:%A.24-
_ -
s4 t 1 - y ,BSc•`" d. -sA` ' �_
t :y - s I
_ diary.= s °T g
4 lt. '
1_`..`L�' 1 H die:. h_ '• ,'..�yr tw.: 'a.
"" .� Mee - - ,.
r-y`-" r r to .e.{ .,�
a
� � - S ` P s -
tzr Y' tiled
;Iir..sse_.
011r.,&.
', ;> ?,
•
fi
- 1.4i . - - y 1
ram_ --
¢
•
-. .
a a� r• r .� "�t *fir- r 'ds' •r-a,- Y. h r �1 s.,..
-. ,. 1,, `'-� i ^ - .,tip;
•
/,--1 ,‘,.
/ , .,„,
„, 5..„,,d v., I mt,
, , ...„,, ,•,,,
, ,
/ ...,,
,, ,,,,•,.„
., ,,
i
.. „.
I, .,
, ,
y �!� \
�� :/,'„,"' \ \ ,, '> ,.,- .-....,
i
i
,1
c v 1--17)-qr /c°'--)-k
v1)1-OJ
14Lll