24B-031 (3) BP-2023-0961
316 KING ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24B-031-001 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-2023-0961 PERMISSION IS HEREBY GRANTED TO:
Project# INT RENO 2023 Contractor: License:
Est. Cost: 99000 SHAUN KENNEDY 102493
Const.Class: Exp.Date: 04/22/2025
Use Group: Owner: LLC LAKE RENTALS,
Lot Size (sq.ft.)
Zoning: HB Applicant: KENNEDY CONSTRUCTION
Applicant Address Phone: Insurance:
609 COLLEGE HWY AWC-400-7040813
SOUTHWICK, MA 01077
ISSUED ON: 07/26/2023
TO PERFORM THE FOLLOWING WORK:
INTERIOR RENOVATIONS
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: 1111
l ice/
i!
Fees Paid: $693.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
The Commonwealth of Massachusetts
Office of Public Safety and Inspections'
Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number. BP-D3-43%I Date Applied: Building Official:
SECTION 1:LOCATION
No.and Street Ci /1'glwt 3,3i Zip Code Name of Building(if applicable)
Assessors Map# Block'#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below
Existing Building 0 Repair 0 Alteration ❑ Addition❑ Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No 0
Is an Independent Structural Engineering Peer Review required? 1 Yes CI No 0
Brief Description of Proposed Work: �C I1iQ e`k"1'e c'toi- wal\ ) ►ivsu Ie t Crop p nil:r9
ti1Q W Ile 10 4r c) Up�};tc'to1� ��s+ern
Ai i i ,Jof/r',-
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) ( kdt f F/0
Total Area(sq.ft)and Total Height(ft)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2❑ Nightclub ❑ A-3 ❑ A-4 0 A-5 0 B: Business 0 E: Educational 0
F: Factory F-1 0 F2 0 H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R:i Residential R-ID R-2 0 R-3 0 R-4❑
S: Storage S-1 0 S-2❑ U: Utility 0 Special Use❑and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA IBD HAD IIBD MA LIIIBD ND VAD VBD
SECTION 7:SITE INFORMATION(refer to 780 CMR µ05.3 for details on each item)
Water Supply: Flood Zone Information Sewage Disposal: Trench Fern*: Debris Removal:
Public laCheck if outside Flood Zone CIIndicate municipal A trench will not be Licensed Disposal Site CI
redPrivate CI or indentify Zone: or on site system 0 regmt is e or trench or specify:
permit enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes ❑ or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Lake Re_h-W5 LLf: 3+t--t*73y1 e fld. ;4.e.8'401( lv;1 br 41..a,. °lo qs
Name(Print) No.and Street City/Town' Zip
Property Owner Contact Information
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Pel-ex- 140c,5er Old racm Rd• lid cn\,Cl I�1F4 cat0g3r
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here D.
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State ip Discipline Expiration Date
10.2 General Contractor
•
Company Name
Sv\Rv1\ kti,(\.�c IC1.R3 u
Name of Person Responsible for Co truction License No. and Type if Applicable
t9O4t C Otl e_ hk+doon c frhw€a A O(Q77
Street Address City/Town State Zip
43 _(,3(e t(3 —7 _ - SXP KennOticalcii-r rri coM
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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
Is a signed Affidavit submitted with this application? Yes 0 No 0
SECTION 12 11 CONSTRUCTION COSTS AND YERMTT FEE
Item Estimated Costs:(Labor
and Materials) Total Constructions Cost(from Item 6)=$
1.Building $ 151 Gad _ op
Building Permit Feel—Total Construction Cost x 7'(Insert here
2.Electrical $ a..) t a n o appropriate mu ' pal factor —$ .
3.Plumbing $ 0, d oil // QQ Gd i
4.Mechanical (HVAC) $ a 0 nor) Note:Minimum f =$ WI,(cgrt`tact municipality)
5.Mechanical (Other) $ t '-�
Enclose check pay�'ble to
6.Total Cost $ y9 s 000 (contact municipality)and write check number here Cv
:............„....----'C414
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and^penalties of perju¢y that all of the information contained in this
application is true and accurate to the s of m wled d understanding.
jhRt,h ke-A,edr 6C- ' 40 126 _ sag 13a3
Please print and sign names Title Telephone No. Date
c� co/�
all -f h�. � co�a (mac of
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: 1� ' •r ` • • '. °' 7/a4/a3
Name 1 Date
I
City of Northampton
i : X Massachusetts
1 DEPARTMENT OF BUILDING INSPE OMB
y
212 Main Street • Municipal Sul ding `gyp
IN^" Northampton, MA 01060 rSN irDV\
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 frortf 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:
////
Col
Location of Facility: CO , Y /c' /1 A/., 9 - eJ
The debris will be transported by:
Name of Hauler: la, c„ IA SL,
Signature of Applicant: Date: 7" -4
231
"' The Common werrith of ilussrtc'husetts
Dgmrttnenl of Industrial.-1 c c•idents
"' / ('oat;revi Street.Suite I110
B(.1 tun. .11-102 I l 4-2 0l.,
. , . . WW sit us.s,.gotldiu
1l ul ker.' ( uutpeosat" Insurance.►ftidas it: lluilders+( untractttrs;Elrctrit•ian.:Plutnber..
Ill)ID. 111.1.1)S.1111 1 III.P1..Rxt FII\G Al [11UK)I' .
.knulicant Information Please Print 1 ettillh
Natilr 114u-is-:: t trS'anrrattota triaan Omit. ,e e",d,- GxlN JC'hP
Aikiress: 0`t. CO tk e%e._ w JJ
(it) Slate Zip:Sc3chw ,c,IC (1r.R Ot ol`) P11one : t4l3 te36. g S
r
Ara.un a emptuarr'.•t hact.Mr appruprtatr Iona: of project(required).1 f a/a"fit :t .,.n •vit9 r inty,lotic.,1tul:ina ii p n:unk t• g %. j \c as construction
=.,[3 1 am a xtl.prupiat-mt or tanner 4up and Isaac au cuipl..y.•.,a.miming h.t me in > II. 0 ReniOdehnp
am.vat-tt. INn aa.ri.ct,' ...r . ,rnuranut n eared i
I 9. fl 1X uiolitio l
wt 10 I am a lnm atw,dimly all a..et,mysal.I\, a
+ ..tt as-+ a.air uutaram.:au cut all'
100 Building addition
4 Q I au.a Ibt'£th`..M rA:t acid U.ill I. hat MO iilliaaitka.lu..etdu.t a1:N01'k;il U. IH.,Istt1 1 NII -
."rawrr that all COildri'&ui.•tilw.ha%i Nt.iLiT .aMnpitr+Jl Kto 111,441 JINX W ate xdi i 11.0 l:Ii:tl lcul I(pans or.lddltl.N1.
I 12.0 1 lumbilip tt:patrs or additions
'.4.0 I atu a t;:tsaaI.m u:t.1ur and I ha..hind tit..ut.-,.iit1:b.knm stated.x1 hie alla.h:d JI.-.L
11ta'.i.uh-iartrtta.lunha.c.intdry.i.and ha..a.Acta co.nya msurJm.:.' i 13.1'�Raulteit.ttt�
6EJ 1.a aae a.'tp.�ait.x.caul its niru.t.1W"CI-cr.ixll that ri'hi .acmptnln Par xtr:l... } 1 i. Offset
1,5:. 1141.amid N.haus no.apsl.ni.a.[No N Wil.a. :may.ausamur.umuaica.j ,
•Any applicant that clrail.s Ixu'•I imiat:dale till out du:aca:Man ladata*hula mg then aiontata e • . um podia na a istalt.'n.
li.`ut....Nu.i+,.h...,uhuut than ailsdsstt Indi.alaui t1a. ari doing all Nock and then lute uutat&,: •Ita.1i na Must%ulswt a 1104.111idaa tt nr:t.alkttr aucis.
'l".tnti-.1 ,that.h..k this 1..,a roust atta.h.d an addiu.'nal dual,h...mu dtc uarni.•I tls.aui,-cu .seta,.and.tat.u b.iliet in nut thou:Lamm-.ha..
.niplu}..s It th:.uh.or.tt.l.tot,ha.::nrpL's.i,.:h.}1titat pr...1.1:liras- .uni.r, annp.1%41,2, weber.
I am an employer that is prot•iding warner.'compensation insarnner for my implorers. Helots-Is thr stolid and jab site
information_ItuUrini.(ullipids'Milne.. '/�11, e `' V *VC-- —
Pohc-1 r.of Self 'foC.ins.Lie_St-. tq — LIM—?0 4006 C13 Expiratlan Date- (o)-aa -a-3
Job Sae: dtbe'.s. C'h State Lip. _
A11114 1 a cops of the workers'cutnpcosat. pulii1 declaration page(shooing the()folic) number and repiratiun data .
Failure to secure co%crapc as required under X1(iL :. i 52. 25A is a criminal violation punishable 1•1 a lieu up to S 1.50 0.O(1
and or me-\ear imprisonment.as udi as cis,d penalties in the form of a STOP W(1RK ORDER and a tine of up to S7.50 On a
day against the s,tolator.A eopo, of this statement mac be force arded to the Oily•e of InkesIwailons of the l)I A tits-insVr:mce
coscraee 1enfication.
I do hereby crrtifr••ne?e mins cute a us irs of per. r that the information provided abuse is tray and correct.
Stpn.ttur. y Date: 7--/3- =2-3
mitmc:. 1ff 634. - S 3
!4 Official use only. no not write in this area,to be completer)ln•city or town official.
I
( its for I oss it: Permit I.icense it
Issuing .tothurits (circle une):
I. Board of Ilealth 2. liuildinh 11epartlnrnt 3.( its limn(lerk 4. F:Ieetrie:d Inspector ;. 1'lunthii, Inspector
It.Other
('untart Person:___"_____ _ _ Phon4 iit: _.
i
lIA i
t
1
3
f
p 3
N 1 B a
f�v g}
A i
t
1 74
Z