24D-266 BP-2022-1451
6 FRANKLIN CT COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-266-001 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-2022-1451 PERMISSION IS HEREBY GRANTED TO:
Project# 2022 RENOVATION Contractor: License:
Est. Cost: 52000 STEPHEN SHELDON 092810
Const.Class: Exp.Date: 09/21/2023
Use Group: Owner: SHELDON, STEPHEN&KELLY, MAURA
Lot Size (sq.ft.)
Zoning: URB Applicant: STEPHEN SHELDON
Applicant Address Phone: Insurance:
1 ADAMS ST (508)232-8790 SOLE PROPRIETOR
EASTHAMPTON, MA 01027
ISSUED ON: 11/07/2022
TO PERFORM THE FOLLOWING WORK:
Interior reno to kitchen,bath,add full bath
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:
riejlai,,_ 2 . 7 11v,
Fees Paid: $338.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
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The Commonwealth of Massac usett.Board of Building Regulations and tan.• dsNOV R
IPALITY
Massachusetts State Building Cod:, 780 MR �22
SE
Building Permit Application To Construct,Rep' ,Rom: `- •lish a revis d Mar 2011
One- or Two-Family Dwe to• Nog1H.aa nirvc INSPFCT,O
�L C1A 0 i o6p S
/� This Section For Official Use Only "``-- i
Building Permit Number: tom"-•.Z 1-• / 't/ Date Applied:
l �%,i : •• , .2 ► '+
Building Official(Print Name) I Signature to
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
6 C A Kt;vk CA z,41)- Co I
1.1 a Is this an accepted street?yes ✓ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
5�R -3cR t6 Acie.s 3O
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 Private 0 Zone: Outside Flood Zone? Municipal ..,On site disposal system 0
Check if yestk
SECTION 2: PROPERTY OWNERSHIP'
2.1 gw er'hoIfv` N A i t
N No �� CA A1"1, cg ILA 6�)
Name(Print City,State,ZIP
ft- v av, C - d08-2.32 v sS‘‘Q K4q p I
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building ak Owner-Occupied 4e Repairs(s) 0 Alteration(s)/4 Addition 0
Demolition 0 Accessory Bldg.0 Number of Units 1, Other 0 Specify:
Brief D� iption of Prop sed Work': �w� AizA t iA V\Q,Iti/ ( 1ti �2 WOtk' = NG
itt\wea
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ Lip t 460 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ (Klan!� Cl Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 6,041.CO 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Feese�+$� �j
Check No.2( OU�heck Amount. `
6.Total Project Cost: $ S 1( /� OO ❑Paid in Full 0 Outstanding Balance Due:
C„q„ , oQdv /t _i 1,4 rh Plu ,7 S t tumor,„.J c4u, 4
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
Q � Lis,o4tzg 10 A=2t'23
ktV_V License Number Expiration Date
Name of CSL older
r k.I) t C4 List CSL Type(see below) U
No.and Street ` I CO
�` Type Description
Na ���a �✓ V
1•� V1 Oi fk 0 l� — U Unrestricted(Buildings up to 35,000 Cu.ft.)
Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
'fin `, \ SF Solid Fuel Burning Appliances
5 V\Q\V l.4 ualt` I Insulation
Telephone Email address D Demolition
5.2 Registered Home HIC Im rovem t Contractor(HIC)
< k-��I�.e- o [85 3
Registration Number Expiration Date
HIC C pany ante or HIt R strant Name r
cpct_Avi
iAeu
_
No. StreetEmail addr5!s
10a ikCl AVO VK ivVk ut060 Sze 232 81-gU
City/Town, State,ZIP I 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 ❑
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.
sc_o5 ' -'Z2-
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.
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.govidps
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 hall7baths
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
OQ"i.i A4:Y
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�` DEPARTMENT OF BUILDING INSPECTIONtw
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r 212 Main Street • Municipal Building J� a
Northampton, MA 01060 r 44 it,
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: V Ct,�, QQ_c_ijC.,CivIL
Location of Facility: Iv)() A1V011/1. v1 2- �664-L.ktA10 rk V('
The debris will be transported by:
Name of Hauler: AQ_ \QA4ct ii A Lsic
Signature of Applicant: ` Date: ( <' 4 -ZZ
..,
... or m nw+ alt of Massachusetts
1.s
, Division f Occupational Licensure
Board of Building Res ulations and Standards
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Atiswitv5' tP I
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CSO9281O- es : � '
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STEPHEN L v EL N
891 ASHIN �r : SON STto
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HAVERHILL 10 ,
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Commissioner di - k y - .
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer AffairBusiness Regulation
1000 Washing .IK - Suite 710
Bosto .-.; .'. ------: - ...; 118
Home Imro - _ , tfite egistration
"'" Type: Individual
_
STEPHENe• 'fration: 191853
SHELDON
PO BOX 829 "� *� E piation: 10/07/2024
EASTHAMPTON, MA 01027
C
se'i c '~
Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affaftla,8,Business Regulation Registration valid for individual use only before the
HOME IMPROV ONTRACTOR expiration date. If found return to:
,• Office of Consumer Affairs and Business Regulation
1000 Washington Street -Suite 710
Re•i t `s s: i•n 9
€g ...i . ' Boston,MA 02118
STEPHEN SHELDO f
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STEPHEN SHELDON , t'. .' �?
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1 ADAMS ST �; ` 41'. ,,,, C{ ?Q
EASTHAMPTON.MA 01 ^",,*
Undersecretary Not valid without signature
The Commonwealth of Massachusetts
Deportment of Industrial Accidents
‘1--_ _---7 '.
,.,. 1 Congress Street,Suite 100
• Boston,MA 02114-2017
.., = ..?.,= ..
.z. , .. www.mass.gov/dia
Workers'Compestation Insurance AMdavit:BuiklersiContractors/Electricians/Plumhers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
ADDlieltei Information Please Print Letilas
Name aiusinaniarainizetiarnadividney •\-t.eke-AIN -.Ake.-tatO Y\
Address: 1- 04CUAA_ 'Sk • _ , ... „
,...--__
City/State/Zip: t Gl.t. ." " AR-Vit G`1.,\ Phone#: ---Ocg..
Art yogi iut empioyer?Cheek the appropriate box: Type of project(required):
1.0 lam a employer with _ __employees rfilll ands'or pari-timei.` T. a New construction
2131 1 am a sole proprietor or partnership anti have 00 employees working for rde in 8.Wemodeling
any capacity,(No workers comp.insurance required)
9. 0 Demolition
30 I am a homeowner doing all work myself.[No workins'war.,insurance mowed]'
I 0 0 Building addition
4.C3 1 am a 1100140Wilitf and will be hig0716 04101000e'S to CM:dad Alt WiZi.00 on property. 1 V.011
ensure that all contractors either haw workers'compensation insurance or 01V sole II a [1%h:trico1 repairs,or additions
proprietors with no mnployees,
i 2.0 Plumbing repairs or additions
50 I am a general contractor and I biare hued the sub-eontrac tors listed an the anachod sheet
134:1 Roof repairs
These itils-contractuni have employees and haw voiatiums.comp.outunincti,
14.C:10ther
61:1We area corporation and itS officers have exercised trier right of exemption per!VIOL c.
152,§1(41.and we haw no employnes.(No workers'comp.insurance respired)
'Any applicant that clusits box WI must also fill out the wection below showing then workers'compensation policy information.
'Homeowners who submit this affidavit isulicating they an doing all work and then hut outside contractors must Yuktfait a ht.*affidavit intidating such.
;Contractors that check this box must:niched an additional sheet slanting the name of the ints-contrimors and state whether or not those entities has,
employees. If the sub-cordiaekes,have employees.they must provide'their workers'wasp.policy 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.Lic.#: Expiration Date:
Job Site Address: City/StatelZip:
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$1,500.00
andkir one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains a ,penalties of perjure that the information provided above Is true and correct
Signature:
2_.2.
Phone#:.'"R%rg '-2a. -
Official use only. Do not write in this area,to be completed by city or town official
1 ('it' or Town: PermitlLicense a
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3.City rfown Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
. .