17A-089 (8) BP-2023-1323
296 BRIDGE RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
17A-089-001 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-2023-1323 PERMISSION IS HEREBY GRANTED TO:
Project# 2023 SERVICE Contractor: License:
Est. Cost: 15600
Const.Class: Exp.Date:
Use Group: Owner: STOWE-THURSTON LISA R
Lot Size (sq.ft.)
Zoning: R1/URA Applicant:
Applicant Address Phone: Insurance:
ISSUED ON: 09/27/2023
TO PERFORM THE FOLLOWING WORK:
KITCHEN 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:
I e, , If, ''1► •
Fees Paid: $101.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
&c R
EVE
sFp
The ommonwealth of Massachusetts
2 2023 :oard of Building Regulations and Standards MUNIFCIPALITY
tit�1' ass. husetts State Building Code, 780 CMR OR
USE
'' yqfit a
Mn. • ("Tit :kkgit Ap,lication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
•44 o,soloNS One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number:Nu� / �j^ 13 A 2, Date Applied:
410 j:'o75 // 7 ?-27.20Z5'
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
Z1 , Z•RItm E ,20
1.1a 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 0 Private CI Municipal Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
LISA .S OWE N00Q. 14-0, P MBA 0ioc2
Name(Print) City,State,ZIP
if 3R 4 Ro 4+I s cm-IR _ L.Rsromld P Cori C.AV: r
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK' (check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) fd Addition ❑
Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ Specify:
Brief Description of Proposed Work2: 05411l-rC44 pJ CA //dT - Hobtv./.IZa #bT aiLJ
JAM 0%1 r 101864 t.I- SIS T-11c+-1 'D)Al1.J4 t' lit-r6.0.6+-1
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ '-/*WO 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ n►/ 1 ❑Standard City/Town Application Fee
//,�,� ❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ '�'6W 2. Other Fees: $
4.Mechanical (HVAC) $ r— List:
5.Mechanical (Fire $
Suppression) Total All Fees: $
N /�\ Check No. Check Amoun v J
6.Total Project Cost: $ J56crj ❑Paid in Full 0 Outstanding Balance Due:
et/Rai l I i'ar 5rnar w`uy (ialy
City of Northampton
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/��- oti S,,S.........SIC
/��•�' Massachusetts �4?�` ._. `,e
w! !4 DEPARTMENT OF BUILDING INSPECTIONS ,/
..iE , a: �` 212 Main Street • Municipal Building '.),. fi1
y Northampton, MA 01060 rt"•—••wl%
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 specification 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. Homeowner's License Exemption Form(if applicable).
8. Note any Special Permit requirements (if applicable).
9. Energy Code—all new construction(Gut/Rehab)requires an HERS Rater Affidavit.
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
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name belo ' I hereby attest under the pains and penalties of perjury that all of the information
contained in this applica� is true and accurate to the best of m knowledge and understanding.
Print Owner'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"
•
,.'s` The Commonwealth of:'1assachusetts
i t Department of Industrial.Accidents
��
5� 1 Congress Street.Suite 100
:"_=' gr
MA Boston. 02114-201 7
,,� �� ovisle.mass_iolr'dia
V niters' ('ompensalion Insurance:lffidas it:Builders)("ontractorsi'Electriciansil'luutbers.
'Ill HM:t1LE1)U 1111 1 11E t'ERNIII IING Al'1l t)KII 1.
Applicant Ittinrntatiutt Please Print l.e■gibls
Maine it3u-sitwesvOrganizatioitindividuaI):
Address:
t'1tyr'SiateZip: .__ Phone :
.:ire%rto an cnarpkn ter't heck the apprupriatc box,. Type of project(required):
t.❑1 amt a cmrpta!g'c4 4sIdh taunt.,:ec.t1Ilt anti or part-ti■meI..• 7. O New construction
".:'..D i amt a sale Fri:Trit'tt.'a or lfalriner'19ap mJ haw all camp■*■ WorLims.. for ow art & tJ Remodeling,
tart eaapactty.INu r4orktrs'ccanp.ml mranlx w:{uonti1.1
g
a lurmomimiu-r tloinr all u.oall lnka�l1--.[No merJ.ass'conalr..iraalurmrcu requiretl..� 9. Demolition
ion Building addition
a lwrlrrnFr►trlrand it ill Ise kLnl i aYFlttra Surf tU:num urct aft v LM-'ten n14 l*PV i7II. 1•'i.ft
re alhat all eawlY7itton ritlucr It ea a av aFal.a n eamrrJriar atiii at nuwranir or arcade I IC Electrical repairs or additions
pi L.prwskim5.utthnoihmpluAcc...
12.0 Plumbing repairs or additions
S.0I ant a-immoral contractor mid 1 km:.hand the sut6-cumtaactr:rrr.lishul mu dm:attadh1Yl alhCau.. ^
These iamb-c/rntracti r.kale ean :rklic4.,anti ha Ix urllcrs mta'eourrp. wrartce..;' 13J 1 Roof repairs
14.00Otheei
rh.0 We-are a cr rtreicathun anti IN uffseera hate exercised their richt aFl oweteptitm per MIL e.
I5'_y Il1I.artrl At:have nu ati,Iu cc c.[Nu u lit kcal,'cvvnp inatmarh Iuercall.I
*An%appticartt that elvtxls box''I nimbi alai till out due acctwmt LILrxa 4111:r44 ins their•ta orl elm:cunr{rcnsafiumi policy information_
+lWant'tattwt.mho aukinalt dUs attuIaait indicating[l c}arc tithing Al Stall.amid tlona iliac aaa,ide emaraetarn mina submit a new 4til4 at it i tlitaina stack.
^r•i:rnLraetor%tat dim:U.thin box must artaclscd an adahrtunal shwa Awry:-inte die mane aFf du:,IIb-,coutrae:tur l:m1ut yeate r,411.011er as nut these tattities hale
trnplu_4cc3, if the sub-ccmtrachirs Isar:ctepJtipa:s.toy nuts■par',itic their 'LLorl.m cmanp.pert r3 tnaunbur..
I am an employer that is pruriding Workers"compensation insurance for nay employees_ees_ Below is the policy and jab site
information.
Insurance Company Name:
—
Policy#or Self ms.Lie..:: Expiration Dale:
Job Site Addres ('ity eSt tteiZipc�_
.:Attach a row, of the ssorkers"compensation policy declaration page(showing the policy number and expiration date).
l a i ui e to secure coverage as required under MGL c. 152.*25'c i,:r c ritrrittanl Violation punishable by a fine up to$1.5(X1.00
and kV r.•rrte-year imprisonment,as well as civil penalties in etc fOrnL of a STOP WORK ORDER and a fine of up to$250.00 a
d ik a1,2uittA theem viola or.A copy of this statement may be forks arded Ito the Oflice of Investigations of the DIA cur insurance
cuAa:r.lr'c' 4c'rtficatru .
I riff hereby certify der the pains and penalties of perjor-rhai the information prusVded above is true and correct_
-L2-z-5
Phonic±: 9as- l(.°c i
Official use only. Du not write in this area,to be completed by city or lawn official
('its or Town: Pertnitl.icense 4
Issuing.1.uEIifirit", (circle oncl:
I. Board of Health 2. Building 1)epatrluteut 3.(-it"Nossn Clerk 4. Electrical inspector 5. Plumbing Inspector
(t.Other
Contact Person: Phone#:
City of Northampton
oQSM M To
;„
Massachusetts
1 DEPARTMENT OF BUILDING INSPECTIONS (�,
',•r' 212 Main Street • Municipal Building A- C��
Northampton, MA 01060 .rs •
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: "Q '\ �1'1/J6 - 10 zior'1P7 ?J
The debris will be transported by:
Name of Hauler:
Signature of Applicant: Date: f.2.2-23
City of Northampton
4%': Massachusetts
1,1
! DEPARTMENT OF BUILDING INSPECTIONS 7•
• 212 Main Street • Municipal Building 'a;., �
:". Northampton, MA 01060 •r 1;1'1'+ �'0c
r
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
LI54 '1TC (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 pai and penalties of perjury on this 2-Zday of S CP , 20 Z2
(Signature) \'
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( • 'h ' a Northampton Kim Carson <kcarson@northamptonma.gov>
APPLICATION
Lee Anderson <leeicr@gmail.com> Wed, Sep 27, 2023 at 7:10 AM
To: Kim Carson <kcarson@northamptonma.gov>
The brand is Paradigm. Model is 8300 series the U-factor= 0.28
Thank you
Lee Anderson
Manna Community Kitchen
V 413.887.0500
C 413.533.2866
On Sep 26, 2023, at 2:43 PM, Kim Carson <kcarson@northamptonma,gov>wrote:
[Quoted text hidden]