24C-010 BP-2023-0359
15 ADARE PL COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24C-010-001 CITY OF NORTHAMPTON
Permit: Addition
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0359 PERMISSION IS HEREBY GRANTED TO:
Project# ADDITION 2023 Contractor: License:
Est. Cost: 130000 HANS DALHAUS 101628
Const.Class: Exp.Date: 11/17/2024
Use Group: Owner: MEADE LAUREN B
Lot Size (sq.ft.)
Zoning: URB Applicant: DALHAUS CARPENTRY INC
Applicant Address Phone: Insurance:
11 CHERRY ST (413)977-6094
EASTHAMPTON, MA 01060
ISSUED ON: 03/23/2023
TO PERFORM THE FOLLOWING WORK:
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:
•
Fees Paid: $845.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
File #BP-2023-0359
APPLICANT/CONTACT PERSON:DALHAUS CARPENTRY INC
11 CHERRY ST EASTHAMPTON, MA 01060(413)977-6094
PROPERTY LOCATION 15 ADARE PL
MAP:LOT 24C-010-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $845.00
Type of Construction: ADDITION
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
X Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
IP fit
-1 , 3/?3/ 3
ature of Building Official ' Date
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Depar ent
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office o
Planning&Development for more information.
..z.f2e t Cat ?I‘ekt-s ._ _ _
The Commonwealth of Massachusetts ; MAR ,,,�
W
Board of Building Regulations and S ' dar s 22 20 f' F
Massachusetts State Building Code, 7 0 Cl C ALITY
n� T U E
Building Permit Application To Construct,Repair,Renovate- r rn N. ,ecnorvsised ar 2011
One-or Two-Family Dwelling --_Ma o10so
This Section For Official Use Only
Building Permit Number: 60- A-3- b•9' Date A plied:
. a — • 7)vatir 3 a<3 3
Building Official(Print Name) I Signature Da to
SECTION 1: SITE INFORMATION
1. Propc� Address: \ 1.2 Assessors Map&Parcel Numbers
moL
1.la Is this an accepted street?yes N 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❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2,,t,Owne,of ec
•-•i•rekk, /1‘..\\)(AK-, )srittr
6gkiv\45 OA, A#r 0\06 0
N (Pint)
City,State,ZIP
lb*. er e.,. 0316,1 coal 5acAAm4i4uvn ef a�k,1aw.,
No. and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction 0 Existing Building It Owner-Occupied tit Repairs(s) Ili Alteration(s) if Addition
Demolition G" Accessory Bldg. 0 Number of Units Other 0 Specify:�c- `
Brief Description of Proposed Wor .. d p aft Ct clie � 044' ' /t.
M a Le, room er n�, rc'e ,. te,'�b d
1 ,4p A ,.) t , Aep .� 1Jrr e. ,tt*“ek� r ►AS
c,
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 100,01Y) 1. Building Permit Fee: $ Indicate how fee is determined:
0 Standard City/Town Application Fee
2.Electrical $ \,01 V0 0 Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 1),O* 2. Other Fees: $
4.Mechanical (HVAC) $ t 0101.4 List:
5. Mechanical (Fire $ Total All Fees: $
Suppression) C(,j
Check No.jj,i})Check Amount: 6 Cash Amount:
6.Total Project Cost: $ I ��' ', 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS t o`6a L?p i k i-� I r�4
-kAft S \ L) License Number Expirationl Date
Name of Holder
k, SA\ List CSL Type(see below) j
No.and Street [ Type Description
AS k n\ � R Unrestricted(Buildings up to 35,000 cu.ft!)
�,/� Restricted 1&2 Family Dwelling
City/Town,State,Z M Masonry
RC Roofing Covering
WS Window and Siding
[ SF Solid Fuel Burning Appliances
VS 1 ( o1� �\ I Insulation
Telephone Email a dress D Demolition
5.2 Registered\Home Improvement Contractor(HIC) 1 /0aC ! 1iesiagl
�� c c S HIC Registration Number xp tionti Date
omp y Name or HIC Registrant Name '
No.and Street S 6E A 'NV V ��s ca E ail ad ess�—
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 YS 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 De._, ‘Im AAA C....ct.4"
authorized bythis buildingperm application
to act on my behalf,in all matters relative to work pe pp
1C33/a3
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
co tained in this applica*on is true and accurate the .-. o • knowledge and understanding.
AuthorizedY\ 1)a\\ 4- ,',. ''' /IV
Agent's Name ectronic nature i. itant
Printt Owner's or g _ ) ate
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
y' Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building "3G.
Northampton, MA 01060 stgy .'
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: VCR-t,I C.A1
The debris will be transported by:
Name of Hauler: yitark_
.41,1110
psir,;77 -
Signature of Applicant: ��. Date: ATP ���
The Commonwealth of Afassachusettc
t Department of Industrial Accidents
1 1 Congress Street,Suite 1C10
,v,'•,,„ '4911Boston, MA 0211 d-201
www.macs.goyr/dia
Win Compensation Insurance:Altidas it: luilde.r iC°ontractorsiLkctricisuvIPtumbcrs.
1'()BE f'tLI D W1111 THE PkR.YMI`ITI14C.AtJT1R.)Rl'l"V.
APtttica►nt Information Please Print Lenlihtv.
Nilttie gEiuststsaa.C.lm ani:attctt indetitctust): a.l.;a p �f
Addre-ss:__\A__GC\IA .7..."- --r ,
City>/StaterZip:. G... !( Ill it_ Phone#:.L11.3 6c214
Are you an employee Cheek the appropriate twat: Type of project(required):
1 am a employer with .,anaq trysts t ftrAt aa,d'ax pan•timuJ•' , (3 New constmetion
20 I am a role proprietor or partnership aad have no employees*urtcingr for nw in Remodeling
any t'atpart:ity.Itch workers'comp.inataritntx• tequwed.l \i Demolition
3 1 am a homeowner riding all wutk n cli:iNa workers'comp.itawrtanv twinned"•
4+i.t..t I am a hormeow ner arid will ire hiring w aa ct atraoaw to etibsct all*uric on my property. I wilt
Building addition
atone that all wrattrat:t.rw either lunar*writers'tvtoporsatsrat marerance ry are aura Electrical repairs or additions
proprietors u ith no mplo e ..
Plumbing repairs or addition
5.0I am a intro:al contractor and I traY'e hired the sub-contraettaa listed on the antrefrel sheet Roof repairs
Cheat nib-cotatra:tors have employees and brave workers'wimp.ratxrntaxax.•
6.0 We an a iatporotiun anti its oaken.have arcane.:iated dam nit of estersrtxn per h,4(il.c.
let,tb if AI..and we have nt e-mpkrytiea.[No workers'warm insurance rcyuitett 1
Arty a}ptitant that Awls boa+I must also till out the%wh rl below showing theirworkers'cormien..:ttiucr pahey iirlrmmation.
*iicrrneowracrx who eulrtntt tans:atrial:inn indicating they are dawag all wt,rk and then hire ouhride ersrtrraaters trued aubratrt a tlink of#'*lava witicattantr ara:it.
e:untractuh that check ti'w bor,must attached an additional shod A boo iarg tItc mots:of the aub-soeuractuts and irate*holier m trot dwae eimtrt-s km:
r+npi"ncc'', li t!: rtib- ri0r1.1c',1:, LW,:e rz nh.rs CC,dt,.,u1.u.t Va,cad,:thtri7 A,t.fkeV. cAnrnrp ruliAy number
».i..r..A,,. ....,,.MCM,,MPO.Mter...,.** MT,. P,.M.M.r.,,.,M—,.,,,,, ,M,f .«„in,mn,
1 am an empla s`rr that is providing workers'compensation insurance fir my employees. Below is the polity and job situ
in formation.
insurance Company Name: C A.!
Polity#or Self-Ms.Lk.#. 6s590 - S ).Y 46-1" l Expiration atc:_6 I 1 / ''j.____....._.__
Job Site Address:_ __ _yCity/State/Zip:.___ ..__
Attach a copy of the warners'compensation policy declaration page(showing the policy number and expiration date).
failure to secure coverage as required osier MGL c. 152. §25A is a criminal violation punishable by a fine up to$1.S00.00
:tnt:l,ar one-you 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.1
1 do h rei7yr seal& der th,e pains and penalties of perjury that the information provided hove is true.and correct.
`irgrt:at Date.: 3 49c3Ii
Official use only. Do not write in this area,to he completed by city or town official.
("Ity or Town:_ _,___ Permit/License Ai _
Issuing Authority (circle one):
I.Board of Health 2.Building Department 3.City.+`Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.t°hher
('contract Person: !'hone#:
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