24A-119 (14) BP-2023-1352
26 CALVIN TERR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24A-119-001 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-2023-1352 PERMISSION IS HEREBY GRANTED TO:
Project# WINDOWS/STEPS 2023 Contractor: License:
Est. Cost: 9700 THEODORE TOWNE JR 000722
Const.Class: Exp.Date: 08/20/2025
Use Group: Owner: BETH HABERKORN MARY
Lot Size (sq.ft.)
Zoning: URA Applicant: THEODORE TOWNE JR
Applicant Address Phone: Insurance:
PO BOX 153 MP151046
SOUTHAMPTON, MA 01073
ISSUED ON: 09/27/2023
TO PERFORM THE FOLLOWING WORK:
REPLACEMENT WINDOWS/ REPAIRS TO FRONT STEPS
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: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
RECEIVED
gt ., The Commonwealth of Massachuse s
Board of Building Regulations and Stan rds S E P 2 7 7 FOR
Massachusetts State Building Code, 780 CM 2IUM
' CIPALITY
USE
Building Permit Application To Construct,Repair,Re ovatrFO Demo y4,; -�, i�' dMGr 2011
One-or Two-Family Dwelling .__ -----"''_'°r; 1
This Section For Official Use Only
Building Permit Number: 13P-23-1,3 6 . Date Applied`.
w ,5 ____i2 9-27-zoz3 -'
Building Official(PrintTsiame) Signature Date 1
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
2-6 CAL IW -7 -E.� J i N -Ito • 4 I q
1.1 a Is this an accepted street?yes no Map Number Parcel Number
C
1.3 Zoning Information: 1.4 Property Dimensions: t.
v
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) -/
1.5 Building Setbacks(ft) t
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided d
s
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❑ --t-
SECTION 2: PROPERTY OWNERSHIP' V
2.1 Owner'of Record: ...0
H Nt leirt.i 4-44,42,ttitE. tcoRN Na psnir-t.A.Picy Pik o1d6Gs .1
Name(Print) City,State,ZIP t,
2to CkLVl,N -lam---.AGE 1 el13 Svdil-e)1&'1
No.and Street Telephone Email 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)Ili. Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2:
P2E.Ply c N ts.t- T l vi f.-►b 6,,i sc R C -S c..t R-f'Ptc.S
fiz.xy 1.3-T -STrp%j 1?Pal 1.— V-FoctoR . Z7
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ ei ti O0 — 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ Total All Fees: r
Suppression) I �
�. Check No.1Uv Check Amount: l� Cash Amount:
6.Total Project Cost: $ 6A 1 Qom, ❑Paid in Full ❑Outstanding Balance Due:
City of Northampton
rl 014
Massachusetts` DEPARTMENT OF BUILDING INSPECTIONS212 Main Street • Municipal Building%INorthampton, MA 01060
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES,
FENCES, GROUND MOUNTED SOLAR, ETC.
I. 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. Site plan with location of proposed structure(s)and set backs.
— 4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
--6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance.
_7. Energy Conservation Compliance Certificate (new/ replacement windows).
8. Home Owner's License Exemption Form filled out and signed by Homeowner(if applicable).
9. Note any Conservation and/or special permit requirements (if applicable). 10.
Driveway Permit (if applicable).
11. Proof of Water and Sewer entry fees paid (if applicable).
12. Trench Permit - public land by DPW /private land by Building Dept.
13. Stretch Energy Code - all new construction will require a HERS Rater Affidavit to be submitted with permit
application before issuance of permit.
14. Please provide the appropriate fee in the form a check ade payable to: The City of Northampton.
i
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) C 5 Ge>67 2 2 2-G
I i.ij g , "cc. License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
P./ .tx 15
No.and Street Type Description
Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
z —I - 21
11'D RC Roofing Covering
1 WS Window and Siding
SF Solid Fuel Burning Appliances
—a K6L,Ccs t-i Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIc ompany Name or HIC Registrant Name
1 3• ' 'ri�wlt a-a r l..60
No.and Street Email address
x -1-t A-t-Airrdki P• 1413 -29 t b
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 Issuanc of the building permit.
Signed Affidavit Attached? Yes 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 D_T a t�NTrl VL.
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 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.
Print Owner's or Authorized gent'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"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
The Commonwealth of Massachusetts
w=? '' Department of Industrial Accidents
I.'.= 1 Congress Street,Suite 100
R
�; le- Boston.MA 0211 a 2017
.rl_ wily•mass.gor/dia
11 1)1 kers'('ompensatitin Insurance.tffdas it:Builders/CoatracturstI kctrkiaavi Plumbers.
It)BE F ILL l)V.1 I H I HE PER%II1i'ING AUTHORI 11.
Applicant Information Please Print Lrribls
Name tau.incss(hitaniratiun Individual) Tiii, '1?t— - 011>'yof4 r...le._.
Address: P0•3o 1S3
City Start:zip: fl1'km P't 14 IX Z3PPhoonne#: `i 13 29—1 — Zoi l b
Air!tin an e'enpbsrr'(heck 11111 approprIsmie has: "I s pe of project(required):
I.a I am a employer with cntpl.'sers dull and or part-torte)• 7_ D New construction
IiiI am a tole proprietor or pusinership and hate no employer.viol-Low ton me in S. u Remodeling
am.ap..rty.[st sat►eA'cownp.ammonia: requital.)
9. Iknitihti nt
3.0I ant a hsonw,i.snet doing all work m)selt [ro wofk.rs'comp.ammonia:mowed.)'
F.0 I ant a Iron us nor and sill he lin
ing contractor.to conduct all stork on my pn.ps-rts. I sill
10 O Building addition
eratute that all contractor.cutter late awaken'columniation naturist/man are sole i I.O Electrical repairs or additions
propr iois*till rho crrgokoyce..
12.0 Plumbing repairs or additions
'0 I am a general contra.tot and I have bond the wb-eaotrxtan Kited am the arlw-h►nl sheet_ 130 Roof repairs
These subticmtractots luse employee.anti hoe sow►.r.'comp.i nwarce t
6.0 We a a cowpwatum and its tinker.nker.hate ex rooted then nide of exemption per Wit.c.
14.pOlhet ' - , .. C,._ m l
n
152.y Its).and we haw flte.ttiplos.es.[fro worker comp anslmarReiequimill '(,y1 tot V-J1---,5
-Ain applicant that check.boo"I must alto till out the iectton halos showing then sow►its'comlensatioon policy mfunmation.
'llomounn-rs s ho submit that attnias at indicating they are doing all sunk and then hue outside rualraclhws mina submit a neviattirdas it indicating ouch.
;('on tractor,that check that boo mutt atta i-al an additional ilea showing the mite sd floe tnlo-o.vottao.tts'and skate whether in not these unmet lust-
einplosces It the soh-contractors hate cn,ioseocs.thes mu.t pros the their .'rkct.'Lump polies numh t.
l am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: mho U
Pubis or Sell-ins.Lie.#: Hip t 518 146 Expiration Date: 06 1 2.c 1 2.07.J-4
Job Site Address: 24o r'>*t LV)hl 1 P-04t C•( _city/state/zip: T (4ryh(o01-3/ &k Pt
Attach a cope of the workers'compensation pocks declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under M(iL c. 152.§25A is a criminal violation punishable by a fine up to$1.500.00
and'or one-year imprisonment.as well as civil penalties in the fume of STOP WORK ORDER and a fine of up to S250.00 a
day against the violator.A copy of this statement may be tiirssarded to the Office of Insestigatiuns of the DIA for insurance
coverage veritication.
I do hereby certify sand r the pains and pen is of perjury that a information prosided above is true and correct
SSignature: — / c t ten. Dale: i '. / ' 1 3
Phone#: Lit ? ..3-'I 1 - 2ei 1
s II Official use only. Do not write in this area.to be completed by city or town official
( its or I won: Permit/License b
Issuing.tuthoriti Icircle one):
I. Board of Health 2. Building Department 3.( its I own('irk 4.Electrical Inspector 5.plumbing Inspector
6.Other
( intact Person: Phone#:
L- �1,- - -' i 6
City of Northampton
�o: 70,,, S, s,,
/ •' S :'�Massachusetts �4, x_ '<<
� a t DEPARTMENT OF BUILDING INSPECTIONS
F x
�'. -�: ° 212 Main Street • Municipal Building vti •.
\ 011511:�`_lif Northampton, MA 01060 ssNw TO,1a�
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: Vtc'U-r-`f (� y�i 4p JG
Location of Facility: IJae I i 'zrc 1 , '
The debris will be transported by:
Name of Hauler: 4cA.4.4 JP— L.441) T2-k.1l—Ei2_,,
Signature of Applicant: )//.......ADate:'2-6- 2
Coownorwwisagttt► of ltlaetlt.tli;husofts Constru :lion Supervisor
ti DMS4On dif Occt lonat Lkonsafni UnnstrlcRsd • Aulktings of any use group wttk.h cordmo
Y Blood of Building R ; Uons sod Stondsofs
kips lhsti 35.000 cubic feet I901 cubic motors, cr1 sr►ekased
space
CS 000/22 4 elpIrcts. 4i1l2Of20R i
TT�'i//���t1000011E,0j T
. ,. ,
it t'?UrTsmoris It, A ,.., t;'
i-- ' -'' ''
P� 03
clibt.tkij F elluru to possess s curr,rnl edition of lhs tll}assuchistotts
5trie Budding Cod* is cauw* lot rrvocatiun of this bowies
C1Stt
, .,,,4 i0,444,........., For information about this ikons.
Call ($171 727-3200 of visit www mass.govdpl
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Individual
THEODORE TOWNE JR Registration: 132751
P.O. BOX 153 Expiration: 06/20/2025
SOUTHAMPTON, MA 01073
Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Individual
THEODORE TOWNE JR Registration: 132751
P.O.BOX 153 Expiration: 06/20/2025
SOUTHAMPTON, MA 01073
Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE:Individual Office of Cnnmumer Affairs and Business Regulation
Registration Expiration 1000 Washington Street -Suite 710
132751 06/20/2025 Boston,MA 02118
THEODORE TOWNE JR
THEODORE TOWNE JR
14BGUNNRDEXT �, r ~1� 1 —7)
gn IT!IAUPTON,MA 01073 Louvr"
:.�.� ;teiary ivut valid witho t signature
------N ® DATE twluDolYrrYi
Ac Ro CERTIFICATE OF LIABILITY INSURANCE „D
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1:OLE• '..T":t,
CERTIFICATE DOES NOT AFFIRII•.,'.T.: -- ^NEC-ATIYEi_Y ANcc:r 1•.r-.:7 _:_. .r-€r.THE CC-TF.P.SE?a'Q c.:7.777^.• -__-7 7:.:_
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A COIL i RAC i�SE.1- z€H THE ISSUING I1113iII-: :_l;, _'
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PRODUCL:: NMMEt w..w.......,G"
Alera Group,Inc. PHONE (413)586-0111 1 fAA (413)586.6481
Webber&Grinnell Division ADDRt_ sherin r.�gewsbbendy .co.n
ADDRESS:
8 North King Strcct pest �•.__.=Yrors+r^•<T.w.:rz NIJCe
North3f.1rt:l MA C` A.suREKA: Main't;cotA.rnoriimi'MJn 29S39
INSURED INSUREP.E:
Theodore Towne,Jr.
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P.O.Box15? I._.
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Southampton MA 01(i. IN+I 1K�-
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