The URL can be used to link to this page

36-234 (4) B -2022-1396 24 DIAMOND COURT COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 36-234-001 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-2022-1396 PERMISSION IS HEREBY GRAN D TO: Project# 2022 ENTRY Contractor: License: Est. Cost: 11000 LEARY BUILDING COMPANY CSL10480.CSL104806 Const.Class: Exp.Date: 02/17/202402/17/2024 CARLSON-SHAW CAROL A&CAT ;ERINE M Use Group: Owner: SHAW Lot Size (sq.ft.) Zoning: WSP Applicant: LEARY BUILDING COMPANY Applicant Address Phone: Insurance: 13 GLENDALE WOODS DR (413)336-2611 SOUTHAMPTON, MA 01073 ISSUED ON: 10/28/2022 TO PERFORM THE FOLLOWING WORK: NEW ENTRY WAY 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 VIO ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: •R I • y2 Tgl •I Fees Paid: $72.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner m 1C� n Z0 o v O T E 1 ,c. The Commonwealth of Massachusetts i? .i Board of Building Regulations and Standards 71 FOR '•• Massachusetts State Building Code, 780 CMR Fa MUNICIPALITY \�' = USE c N o Burg Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 UrN One- or Two-Family Dwelling Lvti This Section For Official Use Only tuildir_ • • - ber: g p .z�-'./ Date Applied: / EV►L) (Z51 /lZ 16-26-2cZ Building Official (Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 24 Diamond Ct y 1.1 a Is this an accepted street?yes ) no Ma —...__ Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: N/A N/A 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 N/A N/A N/A N/A N/A N/A 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: Carol Shaw Florence MA 01062 Name(Print) City,State,ZIP 24 Diamond Ct 413-977-1247 carolshawesq@live.com 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) 0 Alteration(s) IR Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': Build 2'x 8'entry overhang over existing front stoop • SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building S 10,000 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical S 1 000 ❑ Standard City/Town Application Fee b� ❑Total Project Cost (Item 6)x multiplier r f,r x to . 3. Plumbing $ 2. Other Fees: $ • 4.Mechanical (HVAC) S List: 5. Mechanical (Fire — $ --Total All Fees: $ 2 Suppression) Check No.piA Check Amount:22 c" 51 6.Total Project Cost: $11,000 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License (CSL) 104-806 2/17/24 Tim Leary License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 13 Glendale Woods Dr No. and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) Southampton R Restricted 1&2 Family Dwelling City/Town, State,ZIP M•' Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-336-2611 Tim@learybuilding.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 181065 6/14/24 Leary Building Company HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 13 Glendale Woods Dr Tim©learybuilding.com No.and Street Email address Southampton.MA 01073 413-336-2611 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 No . 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BLH.DING PERMIT I,as Owner of the subject property,hereby authorize Tim Leary,Leary Buildng Company to act on my behalf,in all matters relative to work authorized by this building permit application. Carol Shaw 9/14/22 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. Tim Leary 9/14/22 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.govioca Information on the Construction Supervisor License can be found at WWW.mass.s?ov!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 halfYbaths 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" .da....., The Commonwealth of Massachusetts ,......_ Department of Industrial Accidents 1 Congress Street,Suite 100 . . , Boston, MA 02114-2017 4 ....°' WWW.m ass.go Wdia Workers' Compensation Insurance Affidavit:Builders/ContractorsiElectriciansliumbe TO BE FILED WITH THE PERMITTING AllrillORITI'. A, .licant Info r , ti 1- Please Print .ibIN Name 4,BusincsseOritanizationIndividual): Leary Building Inc VV Address: 13 Glendale Woods Dr City/State/Zip:_ Southampton,MA 01073 Phone#.: 413-336-2611 Are aa au emplov er?Cheek the appropriate box: Type of project(required): I.C3 I am a entrobayer with employves OW1 and,or part-timer' 7. CI New construction 2.173 I ant a sole peOprielOr of pliertnersittp and have no employes working for me to 8, c3 Remodeling ally capacity.[No workers'camp.ntsurume required.) ElCI i ant a huirsoowner doing all work myself.[No workers'cony) insurance aquavit)' 9. Demolition 10 c] Building additi n 4 a Iam a haJ(raw winer and will be hiring wawa:Inn to conduct all work on my property. I will =Akre that all contractor's either have workers•conipetnatiOn ritiLlittlfu:t 1St are it)le I LE] Electrical repay V'or additions proprietors with no employees 12_0 Plumbing tepa' or additions I am a general contractor and I have hired the stab-contractors listed on the attar sheet I-CI Roof repairs mege sub•contracturs kae.t.employeei and have workers'conip.insurarice:,. o.E:21 we dire a eimsoration and its officers have exercised their righn of excavator)per MGL c. 14110ther Entry oLQ(erVbar. VV 152_§I(41.and we have two employees.[No w,iiikets';:tialp.insurance required.] 'An) applicant that ehrelts box#i must 1115,0 fill uw.it,.s..e;:UJr,tat:kro,N hawing their workers'cotripensation po. ,.-.;, ild.*4.It la ,xi. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contrwaors Inuit submit a new affidavit indicating such. :Contractor;that check this but must attachred an Witwind sheet showing the name of the suh,eontractoes and state whether or not those entities Ju% employees. lithe sub-contractors have cotrloccri.they Intls1 provide their worker's',..-orip.polic,. nornher I am an employer that is providing tvorikers'compel:so:ion instrance/or my employees. Below il the polity and job.site in,forination„ Insurance Company Name: _ Policy#or Self-ins. Lic. ••'-': Expiration Date: Job Site Address: CityiStatelZip: Attach a copy of the ‘i o r kers'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 1,500.00 and!or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER Liid a fine of up o$250.00 a day against the violator_A copy of this statement may be forwarded to the Office of Investigation of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and corect. Signature: Tim Leary Date: 9/14/22 Phone#: 413-336-2611 I! Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License A Issuing Authority(circle one): I. Board of Health 2. Building Department 3.Cityfrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone it: City of Northampton Massachusetts .4? '.,r;. /W w t -`- . DEPARTMENT OF BUILDING INSPECTIONS �� _`�''� 212 Main Street • Municipal Building S ° Northampton, MA 01060 s$ i1`` 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: Valley Recycling Location of Facility: Easthampton, MA The debris will be transported by: Name of Hauler: Leary Building Company Signature of Applicant: Tim Leary Date: 9/14/22