05-060 (8) BP-2023-1044
407 AUDUBON RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
05-060-001 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-2023-1044 PERMISSION IS HEREBY GRANTED TO:
Project# RENO 2023 Contractor: License:
Est. Cost: 52000
Const.Class: Exp.Date:
Use Group: Owner: GOODRIDGE, GEORGE L. III TRUSTEE
Lot Size (sq.ft.)
Zoning: RR Applicant: GOODRIDGE, GEORGE L. III TRUSTEE
Applicant Address Phone: Insurance:
407 AUDUBON RD
LEEDS, MA 01053
ISSUED ON: 08/08/2023
TO PERFORM THE FOLLOWING WORK:
UPDATE FRONT FACADE AND EXTEND LAUNDRY ROOM
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/
Fees Paid: $338.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
File #BP-2023-1044 -OR
APPLICANT/CONTACT PERSON:GOODRIDGE, GEORGE L.III TRUSTEE
407 AUDUBON RD LEEDS, MA 01053
PROPERTY LOCATION 407 AUDUBON RD
MAP:LOT 05-060-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $338.00
Type of Construction: UPDATE FRONT FACADE AND EXTEND LAUNDRY ROOM
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 Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
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
r
ic,„1/44,„
� S' 3 a3
Si re of BuildingOfficial Da
te
Da e
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 of
Planning&Development for more information.
gt) i tit(
r3(10'1
The Commonwealth of Massachusetts
Tool Board of Building Regulations and Standards FOR
Massachusetts State Building Code, 780 CMR MUNICIPALITY
USE
Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 6i' 3 q Date Applied:
!�� . T•619/ 46
Building Official(Print Name) Signature ate
SECTION 1:SITE INFORMATION
1.1 Pro er Address: 1.2 Assessors Map&Parcel Numbers
CD
rs/�
1.1 a Is this an accepted street?yes no Map Number Parcel I Tiber
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❑
2.1 Owner'of Record:
ELWIN&SUZANNE HERRINGSHAW LEEDS MA 01053
Name(Print) City, State,ZIP
407AUDUBON ROAD 413-563-5512 SAHERRINGSHAW@GMAIL.COM
No.and Street Telephone Email Address
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) la Addition El
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2:
UPDATE FRONT FACADE WITH GABLE. (ALL EXTERNAL)ADD PORTICO OVER FRONT DOOR. EXTEND
LAUNDRY ROOM APPROXIMETELY 36"
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ u Z100 O 1. Building Permit Fee: $ Indicate how fee is determined:
0 Standard City/Town Application Fee
2.Electrical $
-60C d 0 Total Project Cost3 (Item 6)x multiplier x
3.Plumbing $G,)0 G on 2. Other Fees: $
4. Mechanical (HVAC) $ bj List:
5.Mechanical (Fire $
Suppression) 0Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $52,000 0 Paid in Full ❑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.)
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 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 ❑ No ❑
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
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained' 's app' is true and accurate to the best of my knowledge and understanding.
• wn s or Author' d Agent's Name ectronic 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 ngt 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
SiCs
Massachusetts t�?• 3• '<<
d DEPARTMENT OF BUILDING INSPECTIONS y.
212 Main Street • Municipal Building i„•
Northampton, MA 01060 sd .....
CEO
(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: 90 (Ix dI ,),(
The debris will be transported by:
Name of Hauler: f / 7/P(i/ii &XC4..j
Signature of Applicant:
The Commonwealth of Massachusetts
F_-' =
r '
Department of Industrial_fccidents
t' =:l�!_ 1 Congress Street,Suite 100
si=il i,,,s, . Boston,'IL4 02114-201
. -x=jz ' wwra:ruass.gor/dia
ow
Wurkers'Compensation Insurance Affidavit' Builder&Contractors.E1ectricians.Plumbers.
TO BE FILED WTIH THE PERMITTING AUTHORITY_
Applicant Information Please Print Leglbh
Name ideal):
Address:
CityiStatei'7ip: Phone
Are gas as ems?Ciao the apprepriate box: Type of project(required):
i.p I an a eimpleysr with mopra yes ow algae part-tiiaac).• 7- ❑New cor tIucticn
20 I a a saspo4Riabrorparmariit aaiiave no employ's"smilont fur man L.m S_ ❑Ro nodiehng
nay opa .piovinei cam.asuam:s tsapa6sd]
9?.❑I , Ions l [No o4a en°comp.Imareas rectums.s' _ [:-.1 Demolition
10 El Building addition
cc 4. U to kit* arhacadrs to.aid sad eri
terra art di cemaacr oaRiaat a a�rkar 11.0 Electrical repairs or additions
12❑Plumbing repass or additions
5.❑I am a ipmaltemostear sad Dome kind tbs mihmiotacton Lamm oaiaattaarkri asst.
Tha -m owes kava empirpam and bars wai ammo.:
n&coal.am .: 13.❑Roof repaiThom i
CEia an sr#im mil its etc..bars saaaomai liar Right ofamapimpleIS it c 14_El :- _
112.El(11,mhos Imo an es ppiorsa.Ala loodrttr'asap.i mmamnrtaif
Mir awromtandsclos bon ill anal=Ai so do linaiMilisimir
5Itommassaiaaisaiaiist.isdtiiis titgaRoaiimtiam=ibcum sr-waaaiaitamaraiidt,n,,ialsach.
IC ommai tadrdiibsam et alledheiamailiimilam direap dr amm dile eilranammo ma gift ilia at sat Om maim bar*
employees.Pin solpammismalimmiployeek Amy met pstaiiririr woisfa's .paTaicyzlim
I am am employer that islwmafeapar s'caowpensaaote»+sat'for my aesgafyres. Beim is the policy andjob site
Insurance Company Name:
Policy#ar Self-ins_Lic.it: Expiration Date:
Job Site Address: City tei p:
Attach a copy of the workers'eompessation paficy declaration page(showing the policy number and expiration date).
Failure to swine coverage as inquired under hiK L c 152,125A is a ts®ma1 violation punishable by a floe np to$1,500 00
aodror one-yea imprisonment„as well as civil penalties lathe faun of a STOP WORK ORDER and a fine clap to$250.00 a
day against the vibe,.A copy of ibis statement may be forwarded to the Office of Investigniom,trite IXA for insurance
coverage wrificzlian-
.1do bar•, eon* the pains palm ofpetjuny that tie iefsrnmaioaaprosi lmiaaioreis mme tad llarlett
J2J'/ /V�G�t.J 8/2/2023
4 3-563-5512
neeiduseonly_ Da seat miss ii die monotobE completed by city or wow official
City or Tense PerunitLicense g
Issuing Ant mity(ale sae):
1.Board of Health 2.%Haag 3.CibtT..aG k 4.Hach*al Impeder S.Piribiag Inspector
S.Other
Contact Person: __ -.,.,4.-", Moo itis' .
City of Northampton
�oµYnnMf juh 5N5 ..- S,C
Massachusetts �?
t
`1J N:
j i---��' ' DEPARTMENT OF BUILDING INSPECTIONS
A,_
!` 212 Main Street • Municipal Building ,
Northampton, MA 01060 SdjY %'�
1 SUZANNE HERRINGSHAW (insert full legal name), born 05/27/1966(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. 1 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 one 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 2nd day of AUGUST 20 23
is-nature)
CITY OF NORTHAMPTON
AP:�Ftzc�-ems Q
LOT: 'P?C)
LOT SIZE: j .-2 C Ce4
REAR LOT DIMENSION: I GC-f2.j"
REAR YARD v U ' (Z u
SIDE YARD 2 ZS t (of V (04, SIDE YARD , enf`j()
FRONT SETBACK 3 a G r (q) k
FRONTAGE I% I cw c. l.� (uo
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, , ICERTIFY THAT THIS PLAN HAS BEEN RATESe /4
\• • -szs•-•.5r• PREPARED'N CONFORMITY WITH THE
' ..... ,
i/.'i • ....••••'';---- ' A RULES AND REGULATIONS OF THE
REGISTERS OF DEEDS OF THE •
ALMER HUNTLEY,JR la ASSOC IATE S, INC
Weill COMMONWEALTH OF MASSACHUSETTS .• '''' W' SURVEYORS- ENGINEERS- PLANNERS
''.° 5? "5 q'55•T ''' I mos:were.n4Y7A.1 \ ,
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D 125 PLEASANT STREET
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„ •.e,.. SIGNED AI.Az —.- ft,. NORTHAMPTON, MASS.
49E45 es o ,t, m JE. 4, 4, Oaf'
DATE_.-&-#.._.4.2,./9A., We //0-ax-/
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