49-060 (3) BP-2023-0908
237 GLENDALE RD. COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
49-060-001 CITY OF NORTHAIVIPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0908 PERMISSIO IS HEREBY GRANTED TO:
Project# BASEMENT ALT 2023 Contractor: License:
Est.Cost: 2800
Const.Class: Exp.Date:
Use Group: Owner: NATH MOYER
Lot Size (sq.ft.)
Zoning: Applicant: NATH MOYER
Applicant Address Phone: Insurance:
21 WEST SCHOOL ST
WEST SPRINGFIELD, MA 01089
ISSUED ON: 07/14/2023
TO PERFORM THE FOLLOWING WORK:
BASEMENT WALLS
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: I Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
1' • yg .
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax (413)587-1272
Office of the Building Commissi i ner
flu° r/ea
R4 C
The Commonwealth of Massach setts
1., Board of Building Regulations and 'tand• ds JUL 1 1 F
rise
IC ALITY
Massachusetts State Building Code, 80 t MR SE Building Permit Application To Construct,Rep' Remo'; .lish a Mar 2011
One-or Two-Family Dwelling NoRTH.'PToc INSpecr,
This Section For Official Use Only
^1. 0o Ns
Building' Permit Number:�• 3— cog Date Applied:
I�c—:Utn�lIZ-) il/ 7-lN-ZOZ3
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.2 Assessors Map&Parcel Numbers
A 4anawlt c1aaLbtrt MA 810(12.
1.1a Is this an accepted street?yes I/ 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.
NI a e r 10 f ly Bays-r, FL eccce1` MA /o(02
Name(Print) City,State,Z11)
231 Cal e,4ide 0 330 fogs g07o AIayernRe yslia,.•,r..,
No.and Street Telephone 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 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
agaltleallien : Fin'.sL wa II S 4. two radyv6S ,n vv, aisliPal 4)'Sc AV,r /,
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 18 00 1. Building Permit Fee: $ Indicate how fee is determined:
' ❑Standard City/Town Application Fee
2.Electrical $ j 140`3 0 Total Project Costa(Item 6)x multiplier►r►i j . x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $ A'a
• Z8 Check No., 3fp Check Amount:42X.,'`Cash Amount:
$ .f0e3 0 Paid in Full 0 Outstanding Balance Due:
City of Northampton
vorer.i Massachusetts sr'fr
off
DEPARTMENT OF BUILDING INSPECTIONS
, '212 Min Street • Municipal Building
Northampton, MA 01060 rites .k,t�
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES,
FENCES, GROUND MOUNTED SOLAR, ETC.
I
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 SERVIC4S
5.1 Construction Supervisor License(CSL)
License Numbe Expiration Date
Name of CSL
List CSL Type( ee below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email ad D Demolition
5.2 Registered Home Improvement Contractor C)
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.
►� '( -1- '2-o23
•� ' ed 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 Q 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,finish basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable r count
Number of fireplaces Number of b rooms
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"
1
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
,r
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
•' Massachusetts -_ %..
5, c
DEPARTMENT OF BUILDING INSPECTIONS --, P.,
212 Main Street • Municipal Building
-��r Northampton, MA 01060 j'S p, 4
(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.
S .
I
The debris will be disposed of in: V t Ic,i •Rec., (J:,l
Location of Facility: 23 4 (a5-tL1111kv+ Rd , JJ 6 r-41,Lp4i p-)-,,
The debris will be transported by:
Name of Hauler: d6t41/.10 Aye/
r
Signature of Applicant: a/t-X. ,., Date: 47- /- Z3
4.,
The Commonwealth of Massachusetts
I=r....,..
L941-1,7-;.....
et Department of Industrial Accidents
7..tile= I Congress Street,Suite 100
- ..t.,. Boston, MA 02114-2017
%..C7:'''0>. WWW.mass.govidia
•
11 orkers Compensation Insurance Affidavit:Buildersi(
it)BE FILED VS fin TI1E PERNIIITING AE111011111.
Applicant Information Please Print I..egi his
Name 4 Dustarss,Orsonization l nil tvidualt:_a_k_qh,A M dy C /
Address; 2.-i 1 6 I ej,41e Kok
City FA.,eouz. Mtt, o1002 Phone#: 3 3 0- b g'S-4/0 1 3
r
Ate you 1411 VIIIII)kr.,rel Cheek the appropriate box: Type of project(required):
I El I am a employa with _,,,,,_,,,,,,,,,,_ cmployccs trail and-or part-time I." 7. 0 New construction
20 I am a solc proprietor or purmership and have nu crisployei winking fur gme in 8. C3 Remodeling
any capacity„[No wOrkers.cornp insurance ntgaired.j
9. El Demolition
03.211 am a honscowrict doing all work myself,iNo workers"coat ..nasumnee requital]
lo 0 Building addition
a4.c3 I am a homeowner and will bc twins contracturs 11.1 conduct all work on my property. I will
enure Mat all contractors either have workeru'eortirpeitsation insurance or are aole 1 1.0 Elt.-ctrical repairs or addition,
proprietors with no employees.
12.0 Plumbing repairs or additions
5 I Urn a emend euntractor ansl I has c hired the sib-untraetrs lished on the attached sheet.
repairs
Thcse sub-o.iiirrscior.liaise employ ccs and hose workers'comp.nistetam:c.: 13.0 Roof
14.00ther
lip We ama sir/pen:bon and its officers have exercised their right of exemption per 11646L r...
I 5.1,:,.I 1 4 i,and vve Lase no employees.[No workers'comp.insurance requoctil
'Any appbearti that ilteeks bes..1 most also till out thc seetion bckgiv showing then workers'convcrwation policy information
+Fioarieuwopers who strintul U12%Aida%a titan:emu duty are doing all work and then hire outside cm/amours mint submst a new affulaNit indicating such.
Itontmeturs that hock this box must attached an 3dilitiunni sheet showing the name of the sub-contraetor*and suite whether or not Ilitts.e enistin,lta%c
employees If the suls-contractors have employ t. .„tile',ratio provide their AurksTs°eonav polwy number.
1 um an catplover that is pro riding worAers'compensation insurance for tny employees. Below is the policy and job site
infarmation.
Insurance Company Name:
Policy*or Self ins Lie,#.... Expiration Date:
Job Site Address: City,'StateeZip:
Attach a copy of the workers'compensation policy declaration line(showing the pea, number and expiration date).
Failure to secure coverage as required under MU..c. (52, §25A is a criminal violation punishable by a tine up to$1,5000)
and or one-year imprisonment.as well as civil penalties in the form 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 forwarded to the Office of Investigations of the.DIA tbr insurance
coverage verification.
I do hereby eertIfr mode he pains and penalties of pa rituy Mu(the information prositfrd ohm e is true on earn:a_
i ..-1
- -'111111110- 4'1-79'107' Mlle.: i' f- L-..,)--,
Official use only.. Dv nut write in this area.to be completed bs,city or town official
City or Town: PermitiLicense*
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing inspector ,.
' 6.Other
Contact Person: Phone al
WI /,
City of Northamptont pie fi,
Massachusetts. �� `.
Imo,
DEPARTMENT OF BUILDING INSPEC IONS
�� c` 212 Main Street •• Municipal Buil ing
- Northampton, MA 01060 sy , Y,'`
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
,A S4VI .y 13, 1 of
I, NIA 6n 1 1 aV G r (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' • 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 const acted 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 licen.e and, except to the extent that I qualify for
and will abide by the Massachusetts State Building Code's requirem• is for the supervision of the project or work
on my parcel, I am not engaged in construction supervision in co nection with any project or work involving
construction, reconstruction, alteration, repair, removal or demoli,,'on 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 wit the aforementioned project or work on my
parcel,I acknowledge that I am required to and will act as the supe isor for said project or work.
Signed under the pains and penalties of perjury on this I day of v 2023.
�,7 —
(Signature)
Sectional Building Plan '
. alleles
•
Roo • •sc;mbty: elt
I
Pitch nlicr icellanier
Coveringor R Slag
Truss
Underlay it t,•
fee Barrier- w
Coning foist •,�
Sheathing- „
Truss-Cut She• Required el rSpan,to tho o le wpm
Or
•Rafter Size-
Rafter Sparing- 12" 6" 19.2" 24" _ . ._.... • . .
Rafter Clear Span-
Rafter Species-
Riche- Siding
Ceiling Joist Size- • 5ikn ing ..,..-,____ ,
Ceiling Joist Spacing-12"16 9.2"24"
Ceiling Joist Species- Insulation ,,,
Insulation-R • Wall Framing-.
• Interior Finish.- }
Attic Ventilation- • Interior Finish,
•
Walls:
Sites •
Sheathing-
-insulation- Zc4rtyyii;454Jt,4krr• o/ C-orKrele eh. sts CRi3 ). R-13 Fseed,Asvig ,,,
-Wall Framing- 24(1 w,ll 6e _,eU J will 4"r►•+(4 ,
!leaders- J
-,Interior Finish- Dry wet/ 4/2" . •
Floor:, 1 S`uls-Fluor
Finished.Floor- I'Ior-e (Cont G pA f J •
Sub-Floor- . .. �• __.' -- - _ ., ._ ..
Floor Joist Size- Floorlo1st.
Flottr Joist Spacing-12"16"19.2"24" of
Flour Joist Clear Span- �, t3caatowe
Door Joist Species- Char SPatt,to the oppoa11! _
Mum Type&Size- r '__• , "
Distance From Grade- •
Sill Plate ;a ;. ', 4,-•
Foundation: Fooudatittik Anchor . ?: •° . ``
Anchorage- __ _. -. r ��``-1-.
Sill Plate- sr Foundation Rail .-�..-. .• c ,. l',; .t�� ~
•
Wall Type&Size- .. • , 'rtea`+ ,,I s
Reinforcement- Ee[7Lorcetnoot • ', 1�t+rf1 f.q
TS h_�'•js• -: -"R
Concrete Floor Thickness- �. ' ,
Vapor Barrier Concrete Floor ;` e �'�„ .,x �'• R
nor s,rx f
Column Pad Size- X X • • a�`ar rIr"'``r'=
Column$pacing • ks.•'",--
• i`
Footing Width- Vapor Barrier ; r, i ~:
Footing Height-
Footing ,
Fooling Depth Below Grade--
38' 1.75"
26' 1.75" 12' 0"
Storage Library/Hom
11' 10.75" BASEMENT 11' .25"
19' 8.5"
14' 10" T�
14' 7.25" Exterior wall
Interior wall
Informal
Door
ml 15' 5.75" Ceiling 90.5"
18' 5.25"
Estimated areas
44A N. ebb ae#.R,xk4a4n4.N11 -4#
FULL FRANC
E p a A
51zf5lJiA OfMr1414:364 APPOWX1141Alt,ACTUAL NAY VARt.