30B-002 (9) BP-2023-0584
60 NORWOOD AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
30B-002-001 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-2023-0584 PERMISSION IS HEREBY GRANTED TO:
Project# DECK 2023 Contractor: License:
Est. Cost: 12000 BEAUDRY HOMEI PROVEMENT CSL108605
Const.Class: Exp.Date: 03/20/202
Use Group: Owner: HINT N,CLARENCE W. III TRUSTEE
Lot Size (sq.ft.)
Zoning: URB Applicant: BEAUDRY HOME IMPROVEMENT
Applicant Address Phone: Insurance:
117 FERRY ST (413)320-1348 6S6OUB2E863000
EASTAMPTON, MA 01027
ISSUED ON: 05/16/2023
TO PERFORM THE FOLLOWING WORK:
ADD DECK
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:
. At-
Fees Paid: $78.00
212 Main Street,Phone(413)587-1240,Fax (413)587-1272
Office of the Building Commisso
ner
2- o.l<
File #BP-2023-0584
c=04
APPLICANT/CONTACT PERSON:BEAUDRY HOME IMPROVEMENT
117 FERRY ST EASTAMPTON, MA 01027(413)320-1348
PROPERTY LOCATION 60 NORWOOD AVE
MAP:LOT 30B-002-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $78.00
Type of Construction: ADD DECK
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
Driveway Grade%
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Spec' 1 Permit With Site Plan
Major Project: Site Plan AND/OR Specia Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Va • nce*
Received&Recorded at Registry of Deeds Proof Enclose
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
I/& 5-1i0-Z62.3
Signature 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,Department
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 df
Planning&Development for more information.
The Commonwealth of Massachusetts C / ,
wt W Board of Building Regulations and Standards `--� R
PALI 'Y
1 tJIVI
Massachusetts State Building Code, 780 CM Mqy SE
Building Permit Application To Construct, Repair,Renpvat Demolish a 204vise Mar%2011
One-or Two-Family Dwelling j r o,%fl
,
This Section For Official Use Only 4 >nu mNsp-`
Building Permit Number: 6- ,R 3-5 d q Date Applied:
a
i
4„-) S // 5- )(,-2025
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Prpp�rty AddIrvJ: Aue 1.2 Assessors Map&Parcel Numbers
1.1 a 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 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. eco ,�y�,`` A r� Ni-
�t Q
v` �d l'11v� !V/d'I'ifs ll�
Name(Print) I City,State,ZIP �T
�Q0 A,jj�O '4 (ysy, sis-94) t,lcoatO»)-i-on w,Q,1.camp
No.and Set Telephone i Email Ad resgs
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 ❑ Specify:
Brief Description of Proposed Workz:
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ ' 000 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ` ❑ Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ Total All Fees: $
Suppression)
Check No. Ch Amount: 7 i ash Amount:
6.Total Project Cost: $ )3/000 0 Paid in Full 0 Outstanding B ance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction upervisor License(CSL) I U !_0c 3 c
eaurI License Number Ex iratio Date
Name of CSL Holder
11 e 5� List CSL Type(see below) u
No.and Street ( Type Description
-C�f� p_j,,,f , NIA- O I O)-7 U Unrestricted(Buildings up to 35,000 Cu.ft.)
�{J 1 J \ 1 �/-� R Restricted 1&2 FamilyDwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
''JJ j -� �l `,� Old)
(/ SF Solid Fuel Burning Appliances
-113--1 -v I3y� ►• 7d)i54(tclh(fo , 1M\ I Insulation
Telephone Email a dress D Demolition
5.2 egister d Home Improvement Contractor(HIC) )77(0)'I 3
e N F )Y) L YJe'' it HIC Registration Number pirati Date
HIC21
`,an NNa e or MC Registrant me
>fi o1 Cb I S y of v all on, Coin
No.aold StreFI 1 Email Oldress
City/Town,State,Z P 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 X 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 111Ia)l" L 'C1(AJ
to act on my behalf,in all matters relative to work authorized by this building permi application.
Woo 141 Y\ C ; �>
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.
wood 14-in3in s g �3
Print Owner's or Authored 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"
City of Northampton
,oaYH_nMyTo\ `S S,
` Massachusetts ��5 x_ 6>
14
+
�r DEPARTMENT OF BUILDING INSPECTIONS
4t 212 Main Street • Municipal Building J6 cD�
Northampton, MA 01060 �SNjy ��`�
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: Val\I k9. )-;q EaciAa h +nfv06604-41,m .
�J
The debris will be transported by:
Name of Hauler: dk"i l)Y1 IA ^,� ,�vrp04_ v►� -)-vlAc C P Y�Ue�Yr
Signature of Applicant: Date: C 2 3
The Common rvealth of Massachusetts
1, __ �__!l Department of industrial Accidents
_ _:at-. r I Congress Street,Suite 100
'I i= '` Boston. MA 02114-2017
•' 'r=tytt, www.mass govr✓dia
Workers'Compensation Insurance A1fida'it:Builders/Contractors/Electricians/Plumbers.
1A BE t71.t:11 will,1111:Ire:Rn117-IIM;.AI 1110KI 'Y.
Antdicant Informatics Please Po ds Print Lreit
Name(Hustnr s h-ganwatic►nindividua ff: Ple,Q U1 J V l I Trii y
p r U 14401 f
Address: 1 _I 7_._F- .,rye.' 5 i- fi-.0 h60)4.}-o 114 NA- d J 6a7
. City/State/Zip: Phone#: ` )3 - 3r2 ^ i.3 7 F
Are ymia air eapleyert Meek re appropriate hoc Type of project(regrired):
i I ant a cusp foyer rids eiapttgrecs(fldl andew part-tiac).• 7. 'd New construction
20 I an,a sole pniprictur ur ptrrncrrhip aid haw no employees.wanking fur nee in I. 0 Remodeling
aury capwdy.l`o pothers catmp_itrrtwacc rcquircd_1
9. ❑Demolition
AO I sire a huitteY1Ninx Joint all vont myself(No workers'can insurance t eirireil]
a.❑I ant a hanrcvr t ncr and pad be hiring curaracirrs to taada work of rk UN say property- I will 10 a Building addition
tmurc that all coutt actors older haw rtarkm"Cer•pelMYiep ilallraael WSW lalt 110 Electrical repairs or additions
pteiprteta+rs tt ith no entroloyeet.
12.0 Plumbing repairs or additions
sO I ant a metal contractor and'hate hind eke st,h-cuntraciiret lasted tam the altladhcei ALM.. 130 Roof repairs
Thew s-contractors}us
e tlavice*anti'use urtCers cutup.uaaerattel.t �� ^
We a a cngatratitnt anti its uflira-'n has c cm:rri.cril their right of irseinotiort per MOIL c.. 14. Other , �1
t"tJ re —
152 11(4).and t►c hose no eturktycc..I No patters'cutup_insurance nyasred.]
*Amy applicata that Anti hoe al rmrst also till out thy sc+etiun Mon showrug their poi kits'compensation policy itIuniratioe_
+ttrtrtretw acts who sltbrrt this affielae it unlicatitt}ths.-s arc doting all work and then here swots,&carttrsekas rated sultarit a aen affidavit irt1ua1mg such.
:Contracwrs that shade this box must attached an additiotsil shes.i shin+inc the name of the sub-ctaaraetursad stare whether tit nut diosc entities lose
ensphkwttlr's.. It the ttthrcaraturs blase cis rio)...'..titc4 inir.t prusidc.their Warrkerti strap.pokey ntanitrr.
I anti an emrplot"er that is presiding~hers'compensation insurance jar my employ eel. Below is the policy and job.site
information.
Insurance Company Name: 1*- 14-ro
Policy#or Self-ins.Lim tF: 6 5(o o u R LY(6 3 0oO 3 Expiration Date: 5 '1 l
Job Site Address: (00 A/grV OCIC1 Ave_.. City/State Zip: 0 i o 620
Attach a copy of the workers'compensation policy det:brafiett page(showing the policy number and er date).
failure to secure coverage as required under MGL c. 152,1125A is a criminal violation punishable by a line up to$1,500.1K1
•util or one-,1:ear imprisonment,as r+,ell as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a
eta ae ititst the'iulatur_A copy of this statement inlay be forwarded to the Office of Investigations of the DIA for insurance
ct,tciage%critic-anon.
1
do hereby certify under the Inrinr and penalties a periled•that the in furnnation provided above is true and correct
Signature: —7 Date: ..,5/�6 j
Phone#: 7/l' 3 - 3rr7
Official use only. Do not write in this area,to be completed by city or town ofcial
("ith or"loon: Per aiitf'Liceaee ate
Issuitt2 Authority (circle one):
1.Board of Ilealth 2.Building,Departlnent 3.('itm,Tiown Clerk #.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: new#:
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