29-354 (4) BP-2023-1208
14 AUSTIN CIR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-354-001 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-2023-1208 PERMISSION IS HEREBY GRANTED TO:
Project# KITCH/BATH RENO 2023 Contractor: License:
Est. Cost: 18775 KEVIN NETTO 001317
Const.Class: Exp.Date: 10/02/2023
Use Group: Owner: S LEARNED RAYMOND H&BONNIE
Lot Size (sq.ft.)
Zoning: WSP Applicant: KEVIN NETTO CONSTRUCTION INC
Applicant Address Phone: Insurance:
90 Southampton Rd. (413)527-3168 WCC-500-5008057
WESTHAMPTON, MA 01027
ISSUED ON: 09/27/2023
TO PERFORM THE FOLLOWING WORK:
KITCH/BATH RENO
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:
1. •
Fees Paid: $122.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
-z-(*
File #BP-2023-1208
APPLICANT/CONTACT PERSON:KEVIN NETTO CONSTRUCTION INC
90 Southampton Rd.WESTHAMPTON,MA 01027(413)527-3168
PROPERTY LOCATION 14 AUSTIN CIR
MAP:LOT 29-354-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $126.00
Type of Construction: KITCH/BATH RENO
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 Wa ter Ava ilability 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
0 ► ; . C g 7 a
Silature of Building Official / Date
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.
IZ., The Commonwealth of Massachusetts
Vii=.
Board of Building Regulations and Standards F/o `
Massachusetts State Building Code/780 a ME NIUIPALITY
1 Building Permit Application To Construct, Repair, Ke3ta „ olish a ISevisei Mar 2011
One-or Two-Family Dwelling yA�'"'oti'"is.c
(JD This Section For Official Use Only 4110,„ o
ivs
Building Permit Number: 6P }.3 . 14Q 9 Date A plied:
Building Official(Print Name) ( Signature I Da
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
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}8 Private 0 Zone: _ Outside Flood Zone? Municipal® On site disposal system 0
Check if yes®
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
.144;:k.y X-etecc42. 6 H,or`$3N N N\P. c»oeo
Name(Print) City,State,ZIP
\4 Pva.�,�x. Cvcc._ e
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building® Owner-Occupied RI Repairs(s) 0 Alteration(s) El Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work':\-tAlu cers'Oe\IwEus icy w14.-%
-Yn ace.. , Niu,
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ \e.-`15, 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fee : $ L
Check No.Ilh21 Check Amount: • Cash Amount:
6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
00V'S\1 �o-�►-ay
\t C,tote` License Number Expiration Date
Name of CSL Holder
q0
44 List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
City/Town,
N 010 oZl R Restricted 1&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
C2tWv.�C"� OL'S\•COS I Insulation
Telephone L Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 1012aQyS _Q-WA
\IIIIZV\'c1 C 1+1:J HIC Registration Number Expiration Date
HIC Company Name or HIC Re istran Name
No.and Street 1. Email address
\ze."Ak ck.aOo-,,MA'y% _' 5a►�-3\\ag
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.
-"Xitlyfrt(0,0) Ligi iC 17/S1a.3
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.
‘Z. C_,()(1? bd /5Z 3
Print Owner's or Authorized Agen 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"
The Commonwealth of Massachusetts
Department of Industrial A ccidents
aiza rF� I Congress Street,Suite 100
S z1 i . Boston, !11A 02114-2017
0.1 www mass.go►/din
11 ur leers' ( unipensation Insurance atTdus it: BuildersIContractors/Electricians/Plumher .
TO RE FILED WI I'll THE PER%IITTING AIITHORI I'i.
Applicant Information Please Print Ir•Lihl%
Name(Husincss-Organtzation'Indts-idual►:‘16e.4%'c C.•h�!`{e ,,kc-ve‘uNN
Address:__ qb �u.
City/State Zip: 1N1)10,b'1 Phone#: L1/4ti3-6% .-‘-%\‘0IES
.‘re yew an employer!Cheek ree apprepriare loot:
Type of project(required):
I.01 am a cngdover with employees(lull:aid-or paw-turef• 7_ CI New construction
:L I am a sole prophetic in partnership and hate nu employees working Cut rive in S. ® Remodeling
any capacity.(Nu workers'coop.uuuranc- n u,rcd.)
,O I am a lionn cr vwn doing all work myself.[Nu workers'cony,.I uruua nquir.d.l
9- ❑Demolition
10 I am n a lion on t and will be hiring contta.iun to conduct all work on nn w property I ill
10 O Building addition
ensue that all.wrttactun either have worker,'cam i.-9aatt n uuuranci cc an sole I I D ElectnCal repairs ur additions
prupnetun w ith no errtpluyecs.
12.0 Plumbing repairs or additions
lam a cencial contractor and I hate hind the sub-contractors listed on the attache!Acct.
3.❑Rout repairs
These susub-contractorshas e cmpluyce-and have worker,'
cop.insurance.•
1
1-l.❑Other
h.�we an a corporation and its officer hate denied their nght ut ctenipinnI per ik,l e.
I52-§ll4l.and we have no empluyaes.(No wurkcn'eo,np insurance reyuind.l
•Any applicant that sharks ho.s cl must also fill out the section below showing their workers'eunrpcnvatiun pulls information
} I omeownen who suMtut this at ilmit indicating they are doing all wink and then hue outside euntraciun must submit a new affidavit Indicating such.
.unt/acton that check this but must attached an additional sheet showing the name of Ile sub cuntta.iun and slate whether or not those ailitics late
einpl..te. If the sul.cumractos hate triauy ces.they niu.t prat ide their wurkcn'comp policy number
I out an employer that is providing wurlie•rs'rompensutiun insurance Jttr my employees. Below it the police and job site
information.
Insurance Company Name: b\- 1•1 1\1\11 3i \ — —
Policy z or Self-ins.Lie. g: WCG- Cjqt2Q=5k►Q'gQ%-t• Expiration Date:.-o,--2i. \
Job Site Address:VA A ! \h _vcN City/StateJZip:Nip, ,�1 O\Obc)
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152.§25A is a criminal siolation punishable by a fine up to SI,500.00
and-or one-year impnsonmcnt.as%yell as civil penalties in the farm of a STOP WORK ORDER and a tine of up to S250.00 a
day against the s tolator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coserate serttication.
/du Hereby tertili•ander the pains and pen hies of perjuty that the information provided above is t
n C true and correct.
St ature ►C �n�� Date 97
Phoneg: II
Official use only. Do nut write in this urea.to be completed by city or town official
( its or Town: Permit/License#
Issuing authority (circle one):
1. Board of Health 2. Building Department 3.City/Town('lerk 4. Electrical Inspector S. Plunihiiit Inspector
6.Other
( ontact Person: Phone rt:
City of Northampton
` yiJ!-%#.1 :
Massachusetts
,�1)
DEPARTMENT OF BUILDING INSPECTIONS
Ste / _. 47
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: \\Ip..\v..ye.c. c\\h , INIp -flRv.�n MP.
I 1
The debris will be transported by:
Name of Hauler: Y.-r... 4\r,C. . ,e Ct \\ _ Npc. C'r�.
Signature of Applicant: ' C Date: __4222
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given tire nwbiect.»p verification*n not beo,lcmmtc!wr copied unless Printed:
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