31B-232 BP-2023-1458
12 ALLEN PL COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31B-232-001 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-2023-1458 PERMISSION IS HEREBY GRANTED TO:
Project# PORCH REPAIR 2023 Contractor: License:
Est. Cost: 4000 JAMES MAILLOUX CS-081694
Const.Class: Exp.Date: 10/16/2025
REYNOLDS, DONALD A., JONATHAN D., &
Use Group: Owner: TERRENCE R. TRUSTEES
Lot Size (sq.ft.)
Zoning: URC Applicant: JAMES MAILLOUX
Applicant Address Phone: Insurance:
221 PINE ST SUITE 160 (413)585-1592 WCT0721Q
FLORENCE, MA 01062
ISSUED ON: 10/20/2023
TO PERFORM THE FOLLOWING WORK:
FRONT PORCH REPAIR
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: n �`?
I` . v . ycC11�( . Cr
'1 •
I
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
RECEIVED
The Commonwealth of Massachusetts
; Bot rd ofBuilding Regulations and Standards FOR
OCT 7 2O Matsachisetts State Building Code, 780 CMR MUNICIPALITY
\+°/ USE
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
DEPT.OF BUILDING;INSPECTIONS O1ne-or Two-Family Dwelling
NORTHAMPTON.MA01000
This Sjition For Official Use Only
Buildin Permit Number:,S A..3""/4157 Date Ap lied:
e-i,iJ I D}S I / 10-2O-zoz3
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
12 Allen Place 31B 232
1.1a Is this an accepted street?yes X no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
URC Residential 2,502 40
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
10 >10 10 >10 20 4
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❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
John and Marlyn Reynolds Irrevocable Trust
Name(Print) City,State,ZIP
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) XI Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2:
Front porch repair to replace footings and rotted decking as needed.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building _ $ $4,000.00 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Firett____ tc)
$
Suppression) Total All e
Check N ,I,o heck Amo .
6.Total Project Cost: $ 4,000.00 0 Paid in ull 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS— 041694 ppgz5
S ',LLakx License Number Expiration Date
Name of4-,One
,"lHolder
2; e�11a n- /� f/f List CSL Type(see below) �—
No.and Street .! �'/ Type Description
y U Unrestricted(Buildings up to 35,000 Cu.ft.)
Ives " "1 J */ MA 0102.7 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Rooting Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
V's rec /f,, I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
tujL---- H1C Registration Number Expiration Date
HIC Company Name or HIC Registrant N me
No.and Street
f!'�', 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 R 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 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 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"
The Commonwealth of Mas.Nachusetts
Department of I ulustrittl.I e ritlt'rtts
1 Congress Street,Suite 100
Boston, MA 02114-2017
I1'It'w.mnss.gor/tlilt
- 1lurkers' Cornitetiscolon Insurauc'e.‘flidatit: Builders/ContrAt-torkEleetr►cians1Plumbers.
I(1 HI-i FILE!)\%I III I!IL t't:R‘tl I1I t.:At I11()k1.11.
Applicant Information Please Print I.t iltl.
Name IHu in Or ne;,:.,ation lnd iduutt: NT-71ieiES (1/)ILL ut/
Address: 2-2 11(le 5'r re I O
C'ity?St�tt� /.ip: �v✓?6KtCE , AAA 0104Z Phone F#: Sys ) rs2
1rr 1Vtr• s rml,1noc r: Cheek Liar apprstttrtate Inv,: I s Itt of project(required):
1. I mat a employ er with employees hull andur part-time).• 7_ l New construction
201 am a wile proprietor ur partnership and have no employees working forme m $_ ' I Remodeling
any tapacrty.[Nu workers'comp.ueturancu required.]
30 I ant a horneowner doing all work myself.[No wurkrrs'Bump.insurance required.)'
9. Demolition
I
4.0 I am a homemi w-s and will 1,hiring c igraclurs to conduct all work on my property_ I will
0 Building addition
ensure that all contractors either have Sl.rker;cmimen i.aison insurance or are sue 11.l Electrical repairs or additions
prupnetan with nu employees_
I2.®Plumbing repairs or additions
50 1 am a general contractor and I I1a412 hired the nib-contractors listed on the attached sheet_
13.:Roof re airs
ei These sub-ceuatractura base npluyees and have workers'comp.nuurarux.° p
14. Other
6.0 Vt* am a t_omma:nun and its officers has c exercised then right of exemption per MCGL c. —
111,¢lt4)_and we have no employees.[Nu workers'comp.insurance reyuired.l
*Any applicant that chrx:6,box of must also till out the section below show ing their workers'compensation policy information.
t l-tuarwvawncrs who subunit thus aftlilmn indaeaune they arc dung all work and then hire o iitside contractor,r•ur>t',about a new aftidat it Indi...t it su..h.
fCuturactu a that check this box must attached an additional sheet showing the name of the sul-,ontract.•s.and,rate vvheiher or not those en! leave
employees. If the sub-camr:.' .- 1 t:1, crust pm%ni..
I am On employer that is providing►torAcr.►'r•unrtrerrc,rrr,.“ ;it+rrrrrrrr r for Hi employees. Below i.4 the pulit.►•and job site
in formation.
Insurance Company Name:_ A I A/ S r
Policy#or Se11-ins.Lic.#1: h/C Y 0 7 A.I 61, Expiration Date_ /0 F 2-14
Job Site Address: 1Z„ A EA/ P City.State lil. N0/6.
Attach a copy of the corkers"compensation policy declar.etauii page(shouting the l>itlic, uuutlttrr-and expiration date).
Failure to secure coverage as required under!AGE c_ 152. §25A is a crinunal violation punishable by a line up to SI,500_00
andlor one-year imprisonment,as well as civil penalties in the fin of a STOP WORK ORDER and a fine of up to$250.00 a
dati against the violator.A copy of this -,'„itunent may be forwarded to the O11ice of Investigations of the DIA for insurance
cc' Cr i.IUC verification.
I do hereby r•ertif and Sky Irtr 'tenrrlties of perjure that the information provider!above is tr u. ,roil t Leant 1.
iunaturv: I 7/2-3
Phone#:
official use only. Dv Hatt wive in till%area.to hi ranrpietrel bt coy ur(awn official_
( its. or I inn: Permit License a
Issuing authttritw (circle one):
I. Board of Health 2. Building Department 3.("its[limn Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
( intact Person: l'lir>nc
City of Northampton
0rrr4
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�r Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
�y 212 Main Street • Municipal Building
Northampton, MA 01060
f
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:
--
I L /
Location of Facility: 3 4- Eltii ta,,_ �� p 1 -
1
The debris will be transported by:
Name of Hauler: $12 ) F
Signature of Applicant: Date: /(1/17A)
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 0118
Home Impro -e ept C *tractor Registration
z
f" - ';,Type: Individual
Registration: 210033
JAMES MAILLOUX . Expiration: 10/17/2025
221 PINE ST.
SUITE 160 i01
FLORENCE, MA 01062
N •
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:Indiv dual_ Office of Consumer Affairs and Business Regulation
Registration 1,,=Expiration 1000 Washington Street -Suite 710
210033 " T z10/17/2025 Boston, MA 02118
AMES MAILLOUX
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DAMES MAILLOUX 4t1 ,
I76 SOUTHAMPTON RID' 14 Cf" 7. 4 .�; t,x,
VESTHAMPTON, MA 0102
Undersecretary Not valid without signature