Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
38B-066 (18)
BP-2023-0693 251 SOUTH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38B-066-001 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-2023-0693 PERMISSION IS HEREBY GRANTED TO: Project# ADD STAIRS 2023 Contractor: License: Est. Cost: 7500 Const.Class: Exp.Date: Use Group: Owner: S. MALINOWSKI, REBECCA Lot Size (sq.ft.) Zoning: URB Applicant: S. MALINOWSKI, REBECCA Applicant Address Phone: Insurance: 251 SOUTH ST NORTHAMPTON, MA 01060 ISSUED ON: 05/26/2023 TO PERFORM THE FOLLOWING WORK: ADD EXTERIOR DETACHED STAIRS 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: tu& Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner II V IlAY 2 5 The Commonwealth of Maslach efts 2 023 7 ° I7 Board of Building Regulations/and g FOR ICIPALITY �fi ` Massachusetts State Building Code;-78' [pt�/pry.Mg° gFpTip�Ns USE Building Permit Application To Construct, Repair, Renovate Or Delirc_____ -- vised R Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 9jI1 a%3- Date Applied: Building Official(Print Name) Signature Dat SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers So.rI S1 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 Recor ©��` v kb)GGL� r ►1.elowwsk i kioiAl,♦ l.or { Name(Print) City,State,Z ?sI So..44% 5.4 pip ;3 11.16 ba.,6 014l;nnrrsh:* ,N,,,:�cow No.and Street Telephone t Email Address 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 ❑ Demolition ❑ Accessory Bldg. 0 Number of Units Other 0 Specify:�� Brief Description of Proposed Work2: A) 1,1� S '!fit ,;••S— Kik b*ktit/'J SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost' (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ Check No. t Check An"ount: U6Cash Amount: 6.Total Project Cost: $ 6—� ❑Paid in Full 0 Oitstanding Balance Due: City of Northampton IC Massachusetts ° J. I DEPARTMENT OF BUILDING INSPECTIONS - .' s ,. 212 Main Street • Municipal Building ` Northampton, MA 01060 '1, T. ?1k )1L\ 1 PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW 1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES, FENCES, GROUND MOUNTED SOLAR, ETC. I. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specifications of proposed work. (Digital and hard copy) 3. Site plan with location of proposed structure(s) and set backs. 4. Construction Debris Affidavit filled out and signed by applicant. 5. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance. 7. Energy Conservation Compliance Certificate (new/ replacement windows). 8. Home Owner's License Exemption Form filled out and signed by Homeowner (if applicable). 9. Note any Conservation and/or special permit requirements (if applicable). 10. Driveway Permit (if applicable). 11. Proof of Water and Sewer entry fees paid (if applicable). 12. Trench Permit - public land by DPW/ private land by Building Dept. 13. Stretch Energy Code - all new construction will require a HERS Rater Affidavit to be submitted with permit application before issuance of permit. 14. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton. • 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 Mlasonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I 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. Re'bGGC,,A. M..1:„0 'd4; s=Xs--).3 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.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 SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD 251 t-1-14.1 s-r FRONT SETBACK FRONTAGE City of Northampton 1 1 '" lit Massachusetts DEPARTMENT OF BUILDING INSPECTIONS t 212 Main Street • Municipal Building Northampton, MA 01060 _ ` 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: `' /16i'r ,/2.-FG y 6L /AJIt, eti5LI PAJ1 Z yll T /2,0 A ' PiO/Mtt/P ) The debris will be transported by: Name of Hauler: Ju ZAA-1"/ AZ' Signature of Applicant: Date: 495' 2 S. 2.3 The commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 WW1V.ina..vs.goledia natters"CcimpensatIon Insurance Affidavit:Builders'ContractorsiEleetriciansiPlunibers. lir BE FILED WrIll nu PERMIT')\.r;At'TIIORI Ili, Antrlicant Inforniation Please Print Legibis Name(ansthess;Orguntiationindtvidual i &bee,44" PI*I1A/5 14.4 Address: .2.s.--1 so,....ik, s4, city/State/Zip: ikID flit st,,Np 4 a AIMone#.PoOP _ h '. Wbli — ‘ S.5 — 1-2-14 Ate)titi an emplitytt?Cheek the apprapriatt,b4s: Type or projtet(required). 10 I am a.aniptssysa.sloth „„ , ,, employees i fail amior pat-tinsel,' 7_ CI Nett.'cottstrtictitni 1E11 am a sole pettprieus or ptettatashtp and!lase no en:ph/etas workiam for ma in 8. 0 Remodeling any L.-area:Ay [No anninra'comp.nourance remineiti 9. C:1 Demolition 30 I ant a homeownet thsing all work myself.fbm workers-tetimp antitaanal natotatcd.]' ddition 0 a 4.1yrant a betneowner arid wall be helms oentractur,in conduct al work on my Foil:telly. I Will i 0 Building , mature that all contractors either haw workers'conspemattott nourarice ot are wit, i i,C3 Electrical repasts or additions propsushas nab no employees. i 2.Cj PiUrnbing,repairs or additions 31:73 I am a general contractor and I/tot-.hiard the mbimonatetur.listed ma the attached.sheet 1 Roof repairs These wth-tatnithetor.have employee.and has e It other.'comp.insurance; 30 i 4.0 Othei &El kit't an:a evaporation and in taffaatts have tsar...had their nght,,t,fits.e.rtzparim par MU c. 15.1,§..11.t I.,and WV ltaVn tan ottapItt)vas„.[No workers'tannta.pastantraVtatiatintli *Any applicant that cheeks boa al must atso fill out the sw-ctunt below showing then workers,'compensation pulley ntformatteet Homeowners who submit trams altidas it inthcauna they are stomp all la mirk and then hire outside contracters mind sutanut a new atfulasat mai itainng sauCh, tentattaatara that check Inn box must attached att saftlinonal sheet show ma the name ache tnin,-taittrataall and state whether or not those xatittic has e employee. II the subsenutractors Luse Lariploy cm,they mum pow idc ItIca or oaten"ettarip.pelecy ntanber lull,an employer that is providing workers'compensation insurance for my employe., Below is the polity and job site information. Insurance Company Name: Policy 4 or Self-ins.Lk,#.,• Expiration Date: Job Site Address; City,State Zip; Attach a copy of the workers'compensation policy declaration page(shossing the policy number and expiration date). Failure to secure coverage as required under MOE,c. 152,§25A is a criminal violation punishable by a fine up to SL.500.1)0 andior one-year iinprisonsnent.as well as civil penalties in the foam of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator..A copy of this statement may be firm ardcd to the Office of Investigations of the DIA fist insurance were verification. labo hereby eertilr under the pains um!penal:ries Of peritliy that the infatuation provided u hove is trite and eurrecr ' Signature fk 1,14440(1...-40 itit41;7'°••• Date. T." 7-r••2.-5 Plsocc ::, i ii t4"5, 1-3.14 Official use only. Do not write ill this arca.to be completed by city or town official City or TONktil PermitiLicenst# Issuing Authority(circle one): 1. Board of ilealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone it: . ,.. „... • City of Northampton Massachusetts h4,%t/ DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 3 pM-e` HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, C4,6CCA. (insert full legal name), born _ (insert month, day, year), hereby depose and state the following: '.� /p_ P 1. I am seeking a building permit pursuant to the homeowners' e emption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.;.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 seekin: the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings cons ,cted 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 •etached structures accessory to such use and/or farm structures.A person who constructs more than o e 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 I4la day of M. 2021 INLItaiAltitt-/ (Signature) / n /Z s ....-7-Ks\y„,(-7 L.Liit_ii 1 j Ld. / /` n 4/1 ft• r '- a I ) $Pfr.ibLig.S i0✓cr14 3 L1 r pl&+✓O /i4 I,2— OW `- i /i 144y ,or, pdst 4t ` Q (,, . , / // C pr D 'Lam,: -/ii47i1 .Ny-,,Nv/7-.0 ?-X 4 ,r F �-'Jviir! W/DP PAAJOrZit-s /ell G' 'G° 'Ili I , &x. 4 of Pelt-5 wirnl 0A-d 1 g T.5" olV I An 0/4 . critie. Pdsa<<kvfAS zi-I 0,E P (A//r - 2 l "-maw i it- pl: Sr' 1- STX`Mrf,t lei, O L‘ wi . . vAc/ r 4.05 S'rOf it/tSE = 7 `' caLe � ' '- ! ' 5 7k'00 /L u 1 1 Z"" 7,5 I S a 11,1-41 S-7 5r/5 p i-$ . Cf ' 1SA . A- sp ,�