38C-029 (5) BP-2022-1653
316 SOUTH ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38C-029-001 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-2022-1653 PERMISSION IS HEREBY GRANT D TO:
Project# RENO 2022 Contractor: License:
HAYDENVILLE WOODWORKING &
Est. Cost: 109065 DESIGN INC 116208
Const.Class: Exp.Date: 04/13/2025
Use Group: Owner: S STEWART ROBERT G&ENDAMI
Lot Size (sq.ft.)
Zoning: URB Applicant: S STEWART ROBERT G&ENDAMI
Applicant Address Phone: Insurance:
316 SOUTH ST
NORTHAMPTON, MA 01060
ISSUED ON: 02/06/2023
TO PERFORM THE FOLLOWING WORK:
KITCHEN AND BEDROOM RENO, BUILD MUDROOM ADDITION
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:
5r)S1W
Fees Paid: $715.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
OFF, ``..,
The Commonwealth of Massachusetts ��
Board of Building Regulations and Standards'op ��� r�OR a
W r opt, 'MUNICIPALITY
Massachusetts State Building Code, 780 CMR�' �,.;,. n,, , US�
Building Permit Application To Construct, Repair, Renovate Or Demolish cT -Rimed Mar 2011
One-or Two-Family Dwelling �5 i°Ns
This Section For Official Use Only
Building Permit Number: 6/l .1'1' /653 Date Applied:
ri; ) ' �1 % a
Building Official(Print Name) Signature 1 D to
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
1 to bOUFI- � T
l.la Is this an accepted street?yes >C 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:
Zone: _ Outside Flood Zone?
Public V Private CI Municipal K On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
/?tab Sir I4 -1 V-(!)a in i� 0t. j- 'V �,4 At ip(oJJ , Ma O1OI/)
Name(Print) City,State,ZIP
i6 ST -p �cr l6 ress
rli'lC-1 .CcA 1 ,No. dStreet eri e Email a�
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s)ag Alteration(s)1 Additiod'c
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work':
eroYLL42 P✓, rhTxvt_- al/,Q jmGrct t-hi,,,,,
14 1 wl\l .l4-tic, /z 1 -oZ 2 --
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ (1a5 1. Building Permit Fee: $ Indicate how fee is determined:
I �� 0 Standard City/Town Application Fee
2.Electrical $
i 0 Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 1/, /ic-- 2. Other Fees: $
4.Mechanical (HVAC) $ - List:
5.Mechanical (Fire $
Suppression) er Total All Fees: (
Check No.d heck Amount:"r] 16-Cash Amount:
6.Total Project Cost: $ log l O4' , ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 13
IVN/) S1SDI`1 License Number irati n Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
JJ Th-AM 77 3 ,M-A Melo0 R Restricted l&2 Family Dwelling
City/To State,ZIP ' M Masonry
RC Roofing,Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
9IOZ "7nth o6 ?l1 vI lie ho‘ 1I Insulation
Telephone mail€d ess D Demolition
5.2 Registered Home Improvement Contractor(HIC) /�v �
HIC ipaerty Nam) itCrr HIC �strant N 4' 12I0r� Ind' IHIC Registration Numberb� xp ation D to
3S Cc .l2- sr- zi.vi O-erwiI'le ,cOM
No.and Street 1 address
kIar Avyr a'tv VIA dlcyzo oZ
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AI F1DAVIT(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 2( 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 Ayief 1{.// �� y�� yL o V)J�
to act on my beha ,i all matters relative to work authorize y this building permit applicati
Pri er' ( lectronic 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.
• pia is $467 orized 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.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,fmished 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
�oQi H�Mp,>'oti SAS
y � Massachusetts �? A- <<
%` < <I. `� DEPARTMENT OF BUILDING INSPECTIONS �'.
212 Main Street • Municipal Building yJti Cb�
•'fir Northampton, MA 01060 Est y� -j,'`'
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:
The debris will be transported by:
Name of Hauler: Pim
Signature of Applicant: 7 ,4 (5)-- , Date:
U
The Commonwealth of Massachusetts
It,_ lam Department of industrial Accidents
.;3--�;;I_ bl 1 Congress Street,Suite 100
1iqs :' Boston,MA 02114-2017
',.;,.�—� www.mass.gov�/dia
%lin ters'Compensation Insurance Affidavit:BuildersK'ontractors/Electricians/Plumbers.
'it)BE FILED Willi 771E PERMITTING'All'1'11ORITY.
Applicant Information /� ` Please Print` Legibly.
Name(Business or ganixationilndividual):_ i l .�d iki6_ L-4 r) (e,v
Address: 3'L6,4-� s,-,' j
City/State/Zip:_gOar f O Phone#:2fi3--k s- -2--
Are you an cmplsyer?Check the appropriate but: Type of project(required):
i at:t:t culF!.` Cr .,ttkt Cetployttitt(field and"c►r po1 titer).•9
7. New construction',
L.._1 1 ant a st.c -n,,t.ct�,:,t atIncrshi and have no c twork for err in
tp �a+v n'g 8.iy Remodeling
anS capacity.[No f ofkcrs comp.insurance required.]
9. El Demolition
0 I ant a Mote)\t%Ma loang all work myself.Nu workers'comp.insurance minimal.]'
4.0 I ant a honkc,w ter and v.ill be hiring contractors to conduct all work on my properly. I will
l0 a Budding addition
casurc thrat all contractor,miller haw%vie as'compensation insurance or an:sole 11.o Electrical repairs or additions
ptopneton tilt no crtrplo.eo_
12.0 Plumbing repairs or additions
S17i I ant a glIkaal contractor and I have hived the subret rtracton listed on thrc attached sheet_
these sob-ccmtr.M tun have doyen-s and have workers'coop.insurance; 13 Q Roof repairs
6.0 We are a corporation and its officers have exernisal then right of exemption per M(iL c. 14. Other152,51(4).and we have no employees.(No workers'coup.insurance required.]
'Any applicant that dtc,k%box#1 must also fill out the section below showing their wcxkcri compensation policy information_
Ilointon rkwr%olio submit this affdkis it indicating they arc doing all w ark and then hire outside contractors tricot submit a new affidavit mdicatinF such.
:Conttaewn that cheek this but most attached an addttixral sheet dross mg the name of the sub-contractors and state w h atter or not those entities base
employees. It the sob-e aa,actoxs late employee,.they must pros ide their workers'comp_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: A.). /. I 1t
�f VT UA V J NS AcitiC6 /
Policy#or Self-ins.Lie.#: W4/1..--gam —j00�4/2.3r— Z) Z A Expiration Date: /2/ ( PO
Job Site Address: ?3) Se) 5tiIt S ,f City/StatelZip: A b1Q()
Attack a copy of the workers'compensation policy declaration page(showing the policy number and pin ion date).
Failure to secure coverage as required under MGL c. 152,*25A is a criminal violation punishable by a tine up to 1.500.00
and/or one yc r imprisonment.as well as civil penalties in the Circle ofa STOP WORK ORDER and a tine of up $250.00 a
day against the violator.A copy of this statement may be forts arded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the t , ,s and penalties of petjury that the information proiided above is true and correct
Signature: _ i i . 9 • Date:
Phone#: � ,Lp 02—
Official use only. Do not write in this area.to be completed by city or town official
('its or Town: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.Citytrf own Clerk 4.Electrical Inspector 5.Plumbing inspector
6.Other '
Contact Person: Phone#:
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SOUTH STREET
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15'-0" / / co
front setback -1
side setback
~ / /Charles Street 1 Setback(inside
II curb)
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Site Plan -- CURRENT
SD1 .0 Scale: 1" = 20'-0"
0 10 20 30 FT
February 1, 2023
Proposed Additions and
Renovations to
316 SOUTH STREET
Northampton, Massachusetts