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10B-056
BP-2023-1370 24 MULBERRY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 10B-056-001 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-2023-1370 PERMISSION IS HEREBY GRANTED TO: Project# REPAIR HANDRAILS Contractor: License: Est. Cost: 2000 JESSE RYAN CS-117083 Const.Class: Exp.Date: 01/16/2026 Use Group: Owner: HUNTLEY HUNTLEY ALMER M JR &SANDRA J. Lot Size (sq.ft.) Zoning: NB Applicant: JESSE RYAN Applicant Address Phone: Insurance: 985 FLORENCE RD (413)858-9760 SOLE PROPRIETOR FLORENCE, MA 01062 ISSUED ON: 10/02/2023 TO PERFORM THE FOLLOWING WORK: REPAIR HANDRAILS 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: .TAV Fees Paid: $100.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ,,...._ 8rrfai w ,..,... bn ir' 'd///V� e Commonwealth of Massachusetts 'r' ,„ .-('---.��0 Office of Public Safety and Inspections 1`�� OCT Massachusetts State Building Code(780 CMR) 1 © Builai> erm' Ap 1 'cation for any Building other than a One-or Two-Family Dwelling h ',, ,3•/3 (This Section For Official Use Only) Building Perini . s�niNr,Ng �►"ate Applied: Building Official: 4"io6°Ns SECTION 1:LOCATION 2-Li /Mk/her//5 r .=i ' is 65 r O (cE No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION Z:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building❑ Repair p Alteration 0 Addition❑ Demolition 0 (Please fill out and submit Appendix 2) Change of Use ❑ Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No iS Is an Independent Structural Engineering Peer Review required? Yes 0 No VI Brief Description of Proposed Work f lF"l AL 1(4AI/)1 4I/_. /:Pik/de S SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 ❑ F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 1-2❑ 1-3❑ I-4❑ M: Mercantile 0 R: Residential R-ID R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2❑ U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IBD HA IIBD MAD I11BD IVD VAD VBD SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit Debris Removal: Public 0 Check if outside Flood Zone CIIndicate municipal CIA trench will not be Licensed Disposal Site 0 required 0 or trench or specify: Private Cl or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes 0 or No 0 Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Prope Owner (tl -T 0,46' 2 2.I S� 0-0E(2. 1 t l� 8'�3 Z-, Name(Print) No.and Street City/Town Zip Property Owner Contact Information: C3iti9 nl 2 3- ClZI- C 17 - - Pl$FC a% /OTfr.W(L-C Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here G. Otherwise provide construction control forms(see secn the code)as inq tion 107 i uired. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Jesse_ g( r-\ () GA- icoiscicce AieL oboq Company Name ,_ss'a 12,11 -`/70 F- 3 Name of Person Responsible for Construction • License No. and Type if Applicable °'�c cza,eAJ(& enae e-✓CC _M4L arla a Street Address City/Town State Zip lea -15r Ci 7‘0 - - 7f/A1F0 rtorL E r)(•v6_c t i t Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.$25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes 0 No 0 SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1. Building $ Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ . 3. Plumbing $ _ 4. Mechanical (HVAC) $ Note Minimum fee=$ 0 (contact muni . ality) 5.Mechanical (Other) $ aa/t6 6.Total Cost $ !.,- '� ,.. ^� Enclose check payable to U v 0 . V (contact municipality)and write check number 1 �e SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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. Please print and sign name Title Telephone No. Date Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval• P 4 " ►.l (0 a' Name 1� Ik The Commonwealth of Massachusetts t' �_!i Department of Industrial Acci4'ents ? = 1 Congress Street,Suite 100 1��= Boston, MA 02114-2017 www mass.gov/dia Workers'compensation Insurance Affidavit:Buildersl('ontractors/EkctrkianslPlumbers. TO BE FILED WITH THE PERMI1TING AUTHORITY. Applicant Information /i�Please Print Letibis Name(Btuiness,'Organt�tiotu'Indtvidual): { ,j9 _I/1} O(Agl / JE6 W=1t_ ^a Address: q rs- ��e-- ta 0 City/State/Zip: !"l4 td Phone#: 4/3 gJ d 1 7 a� Art you on employer?cheek tie appreprWe boa: Type of project(required): t.❑I am a employer with amployant(hWl*Woe prey-time)•• 7. CI New construction 'Ziffa auk proprietor or prnner�hip and have nu employees working for me in K. Q Remodeling :a any capacity.[No workers'comp.imuran x required.] 301 am a homeowner doing all wink myself.[No wisdom'cone.insurance required.]' 9. Demolition 4.01 am a horoauwner and will be luring cuniracw cvo all rs to dw.K work on my property. 1 will I 0 a Building addition ensure that all cvruracton either have*tickers"compensation insurance ur are sole I I.Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 50 I am a general contractor and I have hired the cob-contractors listed on the anae6ed sheet These sub-euntracwn have employees and have workers'comp.insurance. 13.0Roof repairs � I 6.ate co We a a corporation and its officers have exercised their nght of exemption per PNGL c. Othei )Lt LlD( ' _-' - e 152,41(4).and we have no employees.[No*utters'cusp.Insurance required.] *Any applicant that cheeks bus al MUM also fill out the section below showing their workers'compensation policy information. +Homeowners who submit this affidavit indxallng they are doing all work and then hire outside contractors must submit a new affidavit indissttng such. :Contractor that check this box must attached an additional sheet showing the none of the subcontractors and state whether or nut those entities have employees. If the sub-contractual,have erapluyc+cs.they maw provide their workers'cutup.policy number. I am an employer that is providing workers'compensation Insurance for my employores. Below is the policy and job site information. Insurance Company Name: _ Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: CityiStateJZip: 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 violation punishable by a fine up to SI,500.00 andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. . I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct St nature: Date: 'T771l i 3 Phone#: 375.d /71v Official use only. Do not write in this area.to be completed by city or town officiaL City or Town: Permit/License I Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone I: City of Northampton Org Massachusetts 4? '~ - 0'<< DEPARTMENT OF BUILDING INSPECTIONS S �, 212 Main Street • Municipal Building J. 'a• Northampton, MA 01060 1 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the ptoviStons of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this wdrk 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: v�.(1 e G 6/t)y C7 The debris will be transported by: Name of Hauler: Signature of Applicant: Date: Z Your Confirmation number is 20231002464029 Date of Confirmation: 10/2/2023 NOTE: When paying by ACH (Checking) it will take two business days for the payment to be debited from your bank account. Your account number is not verified until this payment is presented to your bank. They have the right to return this payment if unable to process this transaction against your account. Your request for payment(s) of$105.00 has been received and is subject to approval by your financial institution. No email was entered so a confirmation was not sent. Account Information Payment Information Name: JESSE RYAN Payment Type: Credit Card Note: QUICK PAY TRANSACTION Payer Name: JESSE RYAN Card Number: Transaction Information Transaction Quantity Amount Fee Payment Type City of Northampton - Building 1 $100.00 $5.00 Credit Card Department Misc. QP Permit Option: Building-Zoning-Sheet Metal Permits Full Name: JESSE RYAN Phone: 413-858-9760 Property Address: 24 MULBERRY Notes: Total: $105.00