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31C-057 (5)
BP-2023-0339 7 HIGGINS WAY COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31C-057-001 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-2023-0339 PERMISSION IS HEREBY GRANTED TO: Project# WALL 2023 Contractor: License: Est. Cost: 800 Const.Class: Exp.Date: Use Group: Owner: TRUSTEE ASLIN, PATRICIA J. Lot Size (sq.ft.) Zoning: PV Applicant: TRUSTEE ASLIN, PATRICIA J. Applicant Address Phone: Insurance: 7 HIGGINS WAY NORTHAMPTON, MA 01060 ISSUED ON: 03/27/2023 TO PERFORM THE FOLLOWING WORK: BASEMENT PARTIAL WALL 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: 161119/ Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner BP-2023-0339 7 HIGGINS WAY COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: • 31C-057-001 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-2023-0339 PERMISSION IS HEREBY GRANTED TO: Project# WALL 2023 Contractor: License: Est. Cost: 800 Const.Class: Exp.Date: Use Group: Owner: TRUSTEE ASLIN, PATRICIA J. Lot Size (sq.ft.) Zoning: PV Applicant: TRUSTEE ASLIN, PATRICIA J. Applicant Address Phone: Insurance: 7 HIGGINS WAY NORTHAMPTON, MA 01060 ISSUED ON: 03/27/2023 TO PERFORM THE FOLLOWING WORK: BASEMENT PARTIAL WALL 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: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner ; Rh'r-----N------- ; 1------,..„.„,t ,i , - -:, _____, ii -,-- ,_. ,, The Commonwealth of Massachusetts/ MA R 1 Board of Building Regulations and Stand4 ds 2023 FQR Massachusetts State Building Code,t780 � MUNICIPALITY USE Building Permit Application To Construct,Repair, Renovate 33eb cii:ic evised Mar 2011 One-or Two-Family Dwelling 01°60 This Section For Official Use Only Building Permit Number-6/1'. 3 3-37 Date Applie : id 19 n Building Official(Print Name) I Signature Da e SECTION 1: SITE INFORMATION 1, Propert 1.2 Assessors Map& Parcel Numbers 1.1a Is this an accepted street?yes 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❑ Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owne 'o d: l ic : i / -1(/a /VDe '704/ M/I O /06o Name(Print) City,State,ZIP g- 4/6-6/,✓J' CUA Y S Jr-- 36O— —321 fdtL.rlhtrhta..irce9/�-,. No.and Street Telephone Email Ad ess SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 ' Accessory Bldg. 0 Number of Units Other 0 Specify: fief Description of Proposed Work': ,� � SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.6Building $ t700 0O 1. Building Permit Fee: $ Indicate how fee is determined: ?.YElectrical_, $ Y� O� ❑ Standard City/Town Application Fee J 0 Total Project Cost3 (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All F �Check Amounn 6 6 6.Total Project Cost: $ ',ICU Check No.r ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name No.and Street Email address 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 0 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 to act on my behalf,in all matters relative to work authorized by this building permit application. 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. Thrx"JcjA A- S c �� aq — 2//17 a_ �rint Owner's or Authorized Agent's_Name(Electronic Signature): _.;$ 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,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" T1u Consinnn s'eulllr of.11u�:suc'lausetts ! =- _ Dc�/.rttrlinent of 1slrlti!►t►trrl:lc'cidents =_ =ttl= �, I Congress Sitec�t. Su to 1011 y•: = I:�_ Boston, MA 02114-201 iiii....., �,,i ... moss.govidia 11 miters'compensation Insurance:UNida+it: Ruilklerv"('ontructursiEketriciansiPlunthers. it)HE:FILED 1►till THE PERMITTING A1'TIIORIT%. Applicant Information Please Print ..eeihl►` Name(l;'IurJlksti tltp8n11.:LIIWWUNIiaidual) Address: CitvfStatefZip: Phone #: Are,nu an L'mpIl) r:'tlu+ak the appropriate bin: Type*,project(required): LC]I ant a ernpl°'4e'r with erttr1Juti.ees gtuli andot PII LIinel•' 7. 0 New construction +. 1 ant a suite pn Lnietur or pairthcasitip and blase rmmr ctuptel et>.w,urluu fur me in $. 0 Remodeling an!:latcaeit►.l slu a utters'Camp.orsun.nu n�yatind.l -- 9. Ei Demolition OI ant a lurrrwuwrset doing all wori inyselt'.i 1u w°akus`cony..iru°natoe nvluind..l' 10 0 Building addition 4. 1 am a harnrernwnwm and wiU Ise hiring cuaar cturr to eunduct all+soak un my plope�aty. I w ili or erttiun that all contractors either haw workers'contleits.otenL ur.uranc en an sole I I.0 Electrical repairs or additions pruprxtors with no eanpluyee's. 12.0 Plumbing repairs or additions i:3 I am a stow-tall cuntraclur and I franc hired the sub-euntaacturs Listed un the attached'shed_ ae s°btLxmacturs la+e ernpluycc.and hose workers'ennp.uura unce.= 13 Root repairs Thec 6.0 We a a corporation and its officers Lime exercised their right of esenspnun per Witc. I4.00ther air I ¢1(4).and ae It:+e nu emplertces. [Nu w err e'ts'comp.insurance required.i *Ally applicant that ducks bins ni mina ale IdII out the season below showing then wurk►rs'compensation policy iufounn shout. t II<IIMI'uw tees w hL+sLIl.1nit this altnha+it indicating rite),arc(king all work and then hire°outride contr.Leiucs must submit a net+aftnLa+it inttiu~wing such. 14 ontraelLtrs that eheck this bus.must macho]an additional sheet shun mu the'slue of the soh-contractors and.,late whether Ln not those%amities Lase empluycex. if the sub-cumraetois lime etnpknccs.die•} must provide their workers•crimp.policy number. I urn as employer that is providing.snrAers'compensation insurance fur my employees. Below is the policy job site in f tar►rrmaion. [n.'.ttatir:•e l cimpan)' Name: _ Policy#or Self ins.Lic.#:_ Expiration Date: Job Site Address: C it}''State,Zip: Attach a copy of the workers'compensation policy declaration page I shim ing the police number and expiration date). Failure to secure coverate as required under MGL c. 152,§25A is a criminal t iolation punishable by a tine up to SI,500.00 andeor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a dip against the violator.A copy of this statement may be forwarded to the Oflice of investigations of the DNA for insurance CON VI apa veriticatitbrt. I do hereby tertilt' the inns and penalties of perjury that the infort/Jailor'provided above is�ffrit and correct. 3// /j 2_*nature: Date•: !! ['Butte:=. t/Jlit iul use Wily. Der not write in this area. to he completed by thy or town official city or Town: PermitiLicen a fl Issuing Authority(circle one): I. Board oiliealth 2.Building Department 3.('0ii'ue►n Clerk 4. Electrical Inspector 5. Plumbing Inspector t,. Other t'induct Person: Phone#: City of Northampton (7- F Massachusetts •�• -- DEPARTMENT OF BUILDING INSPECTIONS yrR : >' 212 Main Street faMunicipal Building /- `, fr ,, Northampton, MA 01060 11,jti. .4,,1\v 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: Vrof ( LL r Rg( eCL/,J �---- Location of Facility: rolcot/ixiiire,,() ,eI The debris will be transported by: DNc, Name of Hauler: _„ e-E Signature of Applicant: Date: ) /A-� City of Northampton O ,H1M i Massachusetts I '• � w *1 L+ 4 idi) DEPARTMENT OF BUILDING INSPECTIONS 1 ` .,. �' �_ '1Seo 212 Main Street • Municipal Building v, \ `.�' Northampton, MA 01060 �s ii....,,^` ' I hOMEO/WNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, ACKL440 TTYL ✓V (insert full legal name), born (insert month day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners' exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than ore home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this /7 day of M 4 , 20 z 7 y.:#a",,i___ ___A (Signature) I- 9 ft I 19 ft I 19 ft I 6 ft -I electrical sink © El 4 TV water heater 4 El 13 ft water � �L Cdt L L main II t furnace 18 ft