25A-133 (5) BP-2023-0898
21 GLENWOOD AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
25A-133-001 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-2023-0898 PERMISSION IS HEREBY GRANTED TO:
Project# BASEMENT WINDOW 2023 Contractor: License:
Est. Cost: 3500
Const.Class: Exp.Date:
Use Group: Owner: ADAM BYRNE SARAH &
Lot Size (sq.ft.)
Zoning: URB Applicant: ADAM BYRNE SARAH &
Applicant Address Phone: Insurance:
21 GLENWOOD AVE
NORTHAMPTON, MA 01060
ISSUED ON: 08/28/2023
TO PERFORM THE FOLLOWING WORK:
BASEMENT EGRESS WINDOW
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:
r le
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
p cc LS-1�4r 1-0 C. Roz. U t',a Ix
RECEIVED
., 1 020aThe ommonwealth of Massachusetts
rr ? Bard o Building Regulations and Standards FOR
M the
setts State Building Code, 780 CMR MUNICIPALITY
�, .OF BUILDING IN PECTI
`NORT -f _ 0� ^ppli i ation To Construct,Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only _
Building Permit Number6P)-3- 4/f Date
Applied:�fw Q
l��7z �/� `. (J Zs-zoz
Building Official(Print Name) !! Signature Date
SECTION 1:SITE INFORMATION
1 Prope�'Address: 1.2 Assessors Map&Parcel Numbers
.21 &`Pni.vO /9L'e.,
1.1 a Is this an accepted street?yes X 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❑
P SECTION 2: PROPERTY OWNERSHIP'
6.1 Owner'of e ord: A�
�✓''h C / ae4 watt Atte /U. hia 1 A n/(),oName(Print) City,State,ZIP
//3•3,i2a,31a6ad444h4f6�vrne a0ic%4d, ,iii
No.and Street Telephone Emil 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:
Brief Description of Proposed Work': 6G4 4".5e
SECTION 4:ESTIMATED CONSTRUCTION COSTS
em Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
0 Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: *1)1,6
Check No 14 V Check Amount:
6. tal Project C $ 3 S� 0 Paid in Full 0 Outstanding Balance Due:
J
City of Northampton
PZ'b
Massachusetts •
' DEPARTMENT OF BUILDING INSPECTIONS
k
�' 212 Main Street • Municipal Building
Northampton, MA 01060
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR WINDOWS,
DOORS,ROOFS,RENOVATIONS,ROOF MOUNTED SOLAR,ETC.
1. 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. Construction Debris Affidavit filled out and signed by applicant.
4. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance.
6. Energy Conservation Compliance Certificate (new /replacement windows).
7. Home owner's License Exemption Form (if applicable).
8. Note any Special Permit requirements(if applicable).
9. Energy Code—all new construction (Gut/Rehab) requires a HERS Rater Affidavit
10. 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.)
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
I elcphone 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: OWNERI 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.
2/ie)l013
onic-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/dns
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"
,-0 The Commonwealth of Alassachusetts
11
,,........,
Department of lndustria1.4ccidents
.....,iiii.
Ilk 1 Congress Street,Suite 100
Boston. AfA 02114-2017
11/4.
W IV W.mass.gotldia
It.or kers'Compensation Insurance Affidavit: Boiklers/Contractors/Efectricians/Plu milers.
'11)HE }ILED WITH l'HE PERNIITTENG AtrIHORI1 Y.
Applicant Information Please Print l.egiblv
Name iliu.sinicss,Organizattort Individual 0:
Address:
CityiStatelZip: Phone ..., .
•
Art yam an tin ninyer?ClItturk the I pprepriate box:
Type of project(required):
LC]I am a employer with employees(fun andor parmitnei.* 7. E3 New construction
2.0 I am a auk proprietor 13t puthershm and have 1117 employees workuts for Erie us Ji: 0 Remodeling
aro,capacsty_[No*utters'ii.vmp insuralso: requireal j
9_ 0 Demolition
a—mot]1.11111a lionaeovinct doing all*uric inyaelf.{No wurkias'comp.unurance required"'
4 1101 I am a hinnoo-v.n.a.mid wail be haring contractor-3 to tondoet all work on trty ptoperty_ I will , 10 0 Building addition
".=sure that all coil:tractors eithia hate%others'L'OCIITIL-mation insurance or an.soh: : II C Electrical repairs or additions
proprietors%kith no employees-
I ID Plumbing repairs or additions
sip I am a general contractor aqui I 1...••%.e.hsn:d the 3ub-contructon listed on the attaLted sheet.
i 30 Roof repairs
These aub-contractori haw onployees.and Kai c workers,'comp.inaurnace.:
I 14.0 Other
elti We an:a cmpornson and ILA officers have exercised their right of exemption px-r NMI r.
1.111.§1 NI},and Ad}Law no ernploynti.(No workers'comp.insurance,required'
An applicant that check,l.,...1 must al..)till out the action hdow show in52 then to.urierr:eontpermanon rAilu..),tnioututhon
/ [Loma),"nem*too...whim;tlu,a tridd,..11 moileating they are doing ail work and then hoe,outmtle.:mom:tors most..ithntrt a new.11114.r.rd inJ tem mg six+.
It'onGricior%that check this box mum attached an Additionalsheet Au.),,,,Ina the mom of the sub-eontracksr3 anti gate Whether or not those,mhti...- li.v.r
I utdo',Li.5 II the sob-conir a,tor,l.....,,, epic lo:,cc,.OIL) must pool&their A urk.en'c.,,M1r.pk.II,:).number
1 um an employer that is providing rearAers'compensation insurance for my employees. Below is the policy and fob site
inform I Won.
insurark:e Company Name: _
Policy#or Self-ins.Lie. #'. Expiration Date:
affinifiliiii I K7e. i waed Ate City/StateiZip:1(4 Arlo 4 4/1 a/000
Attach s copy of the workers'compensation policy declaration page(showing the policy number nd expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1.500.00 .
andior one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a line of up to S250.00 a
this against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA tar insurance
coverage ,crification.
I do herehr e'er*under the ins and penalties of perjury that the information provided above is true and correct
iiiplat in e: VIVI., ;- f)3 fir
Official use only. Do not write in this art a.to be compkted by it, or WWII official
City or Town: Permit/License#
Issuing Authorit, (circle one):
I. Board of Health 2.Building Department 3.City/ oin Clerk 4.Electrical Inspector 5. Plunthing Inspector
6.Other
Contact Person: Phone#:
.._ -
City of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
�� ..�, 212 Main Street • Municipal Building ,'
Northampton, MA 01060
d
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: Ci `14/ kii-cl4//
The debris will be transported by:
Name of Hauler:
Signature of Applicant: , y-- ,/f Date: ,//D a?
City of Northampton
t4 Lt-*/ a,�
Massachusetts lr
p . ,
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DEPARTMENT OF BUILDING INSPECTIONS i
€ "�-f,. 212 Main Street • Municipal Building '3f;<Ur
5`
--'°e�^^-^". Northampton, MA 01060 "` >>ti`
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT i
I, Ai air'Pt ala.ahl (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'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. 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 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 day of Ail/ /0 ,20.13.
(Signature)
PAGE NO: 1
VERMONT MASSACHUSETTS SINCE 1940
Manchester Center. Middlebury. Morrisville Williamstown. West Hatfield
Stowe. Barre. Montpelier. St.Johnsbury. Waicsfield rkmiles.com rk 11l ,1II I L E
BUILDING TRUST. DELIVERING RESULTS. BUILDING MATERIALS SUPPLIER
CUSTOMER NO: JOB NO: PURCHASE ORDER: REFERENCE: TERMS: CLERK: DATE/TIME:
*6 000 PARADIGM CASEMENT EGRESS NET ON RECEIPT CH 8/24/23 3:02
SOLD TO: SHIP TO:
TERMINAL: 574
**** CASH **** ADAM BYRNE DATE EXPECTED: 12/25/23 ORDER: 369513
21 GLENWOOD AVE RESALE NO:
ADAM 413.320.3926 SALES REP: CH
NORTHAMPTON MA 01060 TAX: 040 MASS TAX
SPEC ORDER: 369513/4
SHIPPED ORDERED UM SKU DESCRIPTION LOCATION UNITS PRICE /PER EXTENSION
1 EA ZZ004369513001 8 SERIES NC CASEMENT SO 1 510.24 /EA 510.24
8300 Series, Casement, NC SO
RO: 32"x 40" SO
TTT Overall Size: 31.5" x 39.5" SO
TTT Unit Size: 31.5"x 39.5" SO
Left, Performance Level: SO
Standard, SO
Glass Options: Double Glazed, SO
LowE, Argon, Annealed, SS SO
3/4" IG Thickness, Clear SO
Opening: SO
24.245"x 34.5", 5.809Sq ft SO
Ratings: U-Factor= 0.28, SO
SHGC = 0.25, VT = 0.47 SO
Continued...
When delivery is made inside the curb line,Customer agrees to accept full responsibility and assumes all risk for any and all damage caused to driveways,sidewalks,buildings,vehicles,lawn,trees,shrubs,utility wires,or any other items on
property,real or personal located at the delivery site.Customer agrees to indemnify,defend and hold r.k.MILES,Inc.harmless from and against any and all damage,loss,cost or expense relating to or arising from such deliveries.