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34-024 (13)
BP-2023-1229 119 TURKEY HILL RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 34-024-001 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-2023-1229 PERMISSION IS HEREBY GRANTED TO: Project# BASEMENT RENO 2023 Contractor: License: Est. Cost: 26000 DEGRAY CONSTRUCTION LLC 106199 Const.Class: Exp.Date: 05/24/2025 Use Group: Owner: W. REITER,BRETT J,&CAROLYN Lot Size (sq.ft.) Zoning: RR/WP Applicant: W.REITER,BRETT J, &CAROLYN Applicant Address Phone: Insurance: 119 TURKEY HILL RD FLORENCE, MA 01062 ISSUED ON: 09/07/2023 TO PERFORM THE FOLLOWING WORK: FINISH PORTION OF BASEMENT FOR PLAYROOM 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: I 1 • 1 i yQ Fees Paid: $169.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner E'yi ^ RELEIVED 1 .c./4/09___ eayaL The Commonwealth of Massachuse SEP W Board of Building Regulations and Stan ds 7 2 IFoJ Massachusetts State Building Code, 780 M M ICIP LITY r US Building Permit Application To Construct,Repair, Ren vate uK j��NS E led M r 2011 One-or Two-Family Dwelling MA 1060 This Section For Official Use Only Building Permit Number: 10' A 3-0 l,A...1/ Date Applied: WEt;it-irer53 / 9'72tz3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 1 lq Tlitirk, RI 1l 1Z.00,A 1.1 a Is this an ateepted 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 0 Private Zone: Outside Flood Zone? Municipal 0 On site disposal system K. Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: ct and SA R N or-ftam�v►� HA. o i o(P 1 Name( t City,State,ZIP iio1 TurtecJ NO ZocAd 4{3-' 3T--3P' T1 avow(Ai hoffevicul.c.0-► No.and Street Telephone vEmail Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) tg. Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': fjy j ts-V1 11 f or-h on 0 f- -t h . b O.S nn€.4'T SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ ( 20 ©D'�7 6161 1. Building Permit Fee: $ Indicate how fee is determined: / 0 Standard City/Town Application Fee 2. Electrical $ 0490 . a rt 0 Total Project Cost3 (Item 6)x multiplier x 3. Plumbing $ f/ ' 2. Other Fees: $ 4. Mechanical (HVAC) $ �//(� List: 5. Mechanical (Fire Suppression) $ NI4 Total All Fees: $ Check No. Check Amount; 6.Total Project Cost: $ ?4 Dom'¢ ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) .� J / ��6�zz/ License Numbe Expiration Date Name of CSL Holder List CSL Type(see below) 3( G4 4-)ei1/4/ 64//- No.and Street Type Description 9e- v / �'/ k'J���Gn ©1077 /fT? Unrestricted(Buildings up to 35,000 cu.ft.) Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding ,� SF Solid Fuel Burning Appliances LI(2—(4d 7-5 c8 J r2-C42/1 y @. YY1 -COM I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) �1,© ?4i1-r i1 /efev I`�L1r,-( C;p,t5'' C I10,0 L�L HIC Registration Number Expiration Date HIC Company Name or HIC RegistrantName l C ���� N � � _ P G24-i C)?Yr-f co nj .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. COtrUl�n V.e i-e.r' C—Qe t - 915123 Print Own s Name(Electronic Signature) 1 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. COwotgi ��rter' C • 11603 Print Own 's or Authorized 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 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" [WeAtoorr ei_A-15frqijon ,__ _7_c____, c)1 )'.4, ---) Ihod, — 1 ) --Z C, Z -:E- ---72 --T3 N , 7)09a 1 ) „---- , ,--L- __Dvooc 1 1 1 ) 1 The Commonwealth of Massachusetts leli.- 'WI e Department of Industrial Accidents ......, ,1= vigil. . =: I Congress Street,Suite 100 Boston, MA 02114-2017 ., www.mass.govidia II,otters'Compensation Insurance Mild a%it:Builders/ContractorstEttetricianstPlumbers. 'TO Bk.TITLE)ii,S Intl IIE,PERMITTING AVT1101111V. A ti MICA tit i n form a tion Please Print I..ed bh Name titosniess,`organizariontodividual):: )17F ,11-ii (0-A)9----vzoe:1 l&,,,t) Address: 3 iq t.) 6_,() LA/1.)E-- CityiStateiZip: ,.,p"-T.,(.- I .(C___ (UM- Phone Are you ari eriephryer?Check the appnipriate hire! C.)te57 ? Type of project(required): .D I am a ereepti4er with_ _,cialtiloyech(fail imileerpartAimek* 7 D New construction LA 1 am a sole grope-tette or patemerahrp and leave air ineployeda woriciag the me m X. ri Retnodeling [No workers'comrE ixisiiihnee ravened I i 9. a Demo ti ail ,...j I Am 4)/1011300WItel doing au i work layette'.iNee wherkets",echnr.. um riediariaij' 10 0 Building addition 4,0 I am a homeowner and win tietionig hadtrimaurs to oadehaetedi wlerk oft my patigerty, 1 will LMAITV lila all watractora either haw workers'coengoviatime ihataarthe rar are aide 1 1 a Electrical repairs or additions propeettora with no employeo, 1 ID Plumbing repairs or additions 1,C3 i sto a gelbt.71111:untr2ctur and I ha i e hued the aide-corstractors hated on the attached sheet 130 Roof repairs These witi-Luraraeiors iivoe otuaieyeesora hat e tvorkees*exhale.macrame:, 141.0 Other 6.0 We are a COVOISZT1011 and ih.officers haat cacreised dater eigha of ekirolption par 152,§10.),and we Itteole titt CTIVILIYV.Ch.[Nie workers"e.-otem eaamanct reepekrail4 *Arty appticam that checks box it 1 mast alaci fen act the iaretrim below stehia mg their workers"-chimperaishila poiwy mtermantere_ 'itteneoweicrs who soldrit tins affidavit neihcat%they are doves all work and then here 4muide coideacteita,mum iarhitut a new ittlidaii a tradecaureg hilek reConteseturs that check this box.moat attached an additiemal sheet%hi:awing the name of die autaecateraetore and at whether ier not those entities have employees ft the sul'oettortzia... Los:,.irrpioy et:...,rioky rout pr.o.ide their worked,'comp.policy drank' ,. . .. , . .. i am an employer that Ls providing workers'compensation insurance for my emplosvek Below is the policy and job site information. Insurance Company Name: ___ Policy#or Self-ins. L . #: Expiration Date: , p.../ Job Site Address-, / I -rt)4-e —j /4/ c,c... g_b City'State:Zip:/T/4/11'i f 04) Mfr Attach a copy of the w orken*compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under NIGL c. 152.*25A is a criminal violation punishable by a fine op to SI_500.00 and/or one-year impriaonment,as well as civil penalties,in the form cif a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be Forwarded to the Office of Investigations of the DIA for insurance co%erase verification. 1 do hereby certify tinder the pain ad of perjury that the information provided above Is true and eorrect Signature Date:Sr' p-r -2 1 020a. -5 • ., . .. Official use only. Do not write in this or .to he completed by city or sown official City or Town: Pertnit/License# Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5-Plutithing Inspector 6.Other Contact Person: Phone 4: SECTION 5: CONSTRUCTION SERVICES '5.1 Construction Supervisor License(CSL) License Number 'xpiration Date Name ,f CSL Holder List CSL Type(see belo No.and St et Type Description U Unre• icted(Buildings up to 35,000 cu.ft.) R Re•I icted 1&2 Family Dwelling City/Town,Star,ZIP M asonry RC 'oofing Covering WS Window and Siding SF Solid Fuel Burning Appliances Insulation Telephone Email address D Demolition 5.2 Registered Home provement Contractor(H IC) HIC Registration Number Expiration Date HIC Company Name or HIC ' -gistrant Name No.and Street Email address City/Town,State,ZIP -lephone SECTION 6:WORKERS' OMPENSAT 4 N INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affi .vit must .e completed and submitted with this application. Failure to provide this affidavit will result in the denial of,i e Iss . ce of the building permit. Signed Affidavit Attached? Yes 0 No ❑ SECTION 7a:OWN'I • UTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT s ' C O NTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property, i ereby autho ' e to act on my behalf,in all matters ' lative to work . thorized by this building permit application. Print Owner's Name(Electronic..ignature) Date SEC ' ON 7b: OWNER'OR AU S RIZED AGENT DECLARATION By entering my name b ow,I hereby attest under the pains an, 'enalties of perjury that all of the information contained in this appl. ation is true and accurate to the best of m knowledge and understanding. Print Owner's or A horized Agent's Name(Electronic Signature) Date NOTES: 1. An Owne who obtains a building permit to do his/her own work,or owner who hires an unregistered contractor (not reg'.tered in the Home Improvement Contractor(HIC)Program), 'll not have access to the arbitration progr, or guaranty fund under M.G.L.c. 142A. Other important infor .tion on the HIC Program can be found at www mass.gov/oca Information on the Construction Supervisor License c. be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finishes .asement/attics,decks or porch) Gross living area(sq.ft.) Habitable room ••unt Number of fireplaces Number of bedroo 's Number of bathrooms Number of half/bath Type of heating system Number of decks/por• es Type of cooling system Enclosed Open _ 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton rf ti JP*f 4 .,, k. Massachusetts _ re-a, 1---." , „ # 4 DEPARTMENT OF BUILDING INSPECTIONS r ` 212 Main Street • Municipal Building =g_ .� a Northampton, MA 01060 3SPIT if. 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: k- 4 (-0 i jCV)4. (AS ` 0u « / The debris will be transported by: Name of Hauler: 1) G014-- y Signature of Applica Date: 2 7 /"''' a City of Northampton "\ Massachusetts �. t; g �rw tit DEPARTMENT OF BUILDING INSPECTIONS `" � �.` 212 Main Street • Municipal Building ., - . Northampton, MA 01060 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (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 ,20_. (Signature)