12C-052 (17) BP-2023-1363
20 CLOVERDALE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
12C-052-001 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-2023-1363 PERMISSION IS HEREBY GRANTED TO:
Project# FRONT ENTRY RENO 2023 Contractor: License:
Est.Cost: 5800
Const.Class: Exp.Date:
GRIFFIN ANNETTE &SUSAN D REARDON
Use Group: Owner: TRUSTEE
Lot Size(sq.ft.)
GRIFFIN ANNETTE & SUSAN D REARDON
Zoning: RI/WSP Applicant: TRUSTEE
Applicant Address Phone: Insurance:
20 CLOVERDALE ST
FLORENCE, MA 01062
ISSUED ON:10/06/2023
TO PERFORM THE FOLLOWING WORK:
REPLACE AWNING WITH SHED ROOF AND ADD 1 STEP
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: y9I
5)-,1 •
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
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RECEIVED
(Ireic/GarGU
rsEP
2 9 2023I r `
The Co on ealth of Massachusetts FOR
DEPT.OF nun DIN ing egulations and Standards
� NoRTHAmr-rqt4dgaairtiesetts Stat Building Code,780 CMR MUNICIPALITY
USE
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Tiro-Family Duelling
This Section For Official Use Only
Building Permit Number: •. 3-- I."31 Date Applied:
/0-4-za,,3
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Pro• rty Address: 1.2 Assessors Map&Parcel Numbers
6 ' love. 4et f e 54-re-C"..1'
1.1 a Is this an accepted street?yes t/ no 1 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❑ Private El Municipal_ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Su Teo Rto ral..1./. G-r i' f"n a to r r. c e ':1�114 .._ o i 0‘, L _..
Name(Print) City.State.ZIP
bCIofr'rottta S(-rYe- (113)943-e393 sveolrer.r,@ apt .corn
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apph�)-
New Construction 0 Existing Building Ill/ Owner-Occupied IR' Repairs(s) 33' Alteration(s) Ili Addition 0
Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify:
Brief Description of Proposed Work': fze�Ic►r L d ts4 'y rd( 4j., h t`v►�c 0/t�1-(.t S {�t ral reef 3
Rr y 14cr_ 1-Ste�I i evr{,-r AeLf<
SECTION 4:ESTLMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 5 g')0.d 0 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
0 Total Project Costa(Item 6)x multiplier x
3.Plumbing 2. Other Fees: $
4.Mechanical (IIVAC") S List:
5.Mechanical (Fire $ /�
Suppression) Total All F J
Check No Check Amount: Cash Amount:
6.Total Project Cost: $ j$Q 1),0 1I 0 Paid in Full 0 Outstanding Balance Due:
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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(HI(')
__ _ .. _ HIC Registration Number Expiration Date
HIC Company Name or I I k 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 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.
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZEDAGENT DF,CI.ARATION
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.
SG/...5 R e e rol O v1 7/1,4/40
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
wtivw.massiov: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 halfbaths
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"
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City of Northampton
Massachusetts . .., ,.
tid
DEPARTMENT OF BUILDING INSPECTIONS ti .r'
212 Main Street • Municipal Building x, ,•
-�' Northampton, MA 01060 Tp �,�t1`
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL I:)I.'.MOI..,II'ION ANI) 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:
''�� 11 �, �/ c ,
4. Location of Facility: �4- W l 4 —S r, ✓1 ��
� r
The debris will be transported by:
Name of Hauler: i vre'tct 11 YJ ,Peke c
Signature of Applicant: I�,vtti'►k. Date: // ifiLvZ3
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•.\
The Conttnottivealth of 11assaclueSettS
Deportutettt of Industrial Accidents
,;•/,
' 1 Congress Street,Suite 100
Boston,31-1 02114-201'
11.1$/$:ntass.gar/dia
ompen non Insurance Affidasit:Builders`Catarrsc torvElectriCians Plumber:
TO BE FILED MITH t ti PERMITTING AITHORITY
.A.pplicaut Information PI. :t F'iint Legibl:k
Name
Address.
City/SteiatZip Pie
Art rote eraplot egt.item We t Type of project required :
piaaaa amp.:-4:A 4:44:101 I'Lid:MA es part-tow:• 7. D :ew:-oiaLtruction
I:c:*propnetm:c:parzer:41p lad lave mc ompl.orio: :Alma for e:6 8. U .31411r76::PiTn.
az, skor.',:C=f reccatil
D Demohnon
3 I=a h=o,vm n*:lamp at.work:myself[Nc woliocs :moor mut:macs rscrarol:
10 El Builintlf addloon
4 I ma,zbatoowmor :rill b.t innag contractors to caackla wcW =:•'prcpartA:
esatre that 2-1 cOAVICCOTS scrbar tura)woriar:'compamawma aura:awe a are Imle 11E111:ectrical epu 07. 3d•dIt1OZr.4-
pmens=-. to:arpkyos: - 12.E]Pug repr oi
•El I=I guars:ccatcactt:as.1:ar-e t.:--64 sufro-ccazactor,1::rod aro:I.:41;4w
13 El
Tto:6 lat-ccvsoasol Itr,w ccopl:o7e4: tato wake:: cc =a:tax:a;
14. Otheg
t •
its a camporomcz sza tato asexclaW tau rip.it ciezactracm par MGL c
152.11(4).and we kat:: earployaas [tic'MAWS'cm", z,-.7auc::Kama
'Aar&velum that docks box al maw alio fill oar the wt.=halm"awing mbar viviiisil•coupes:at=paw,-adramaamica
lioarowain who salmis mkt.44.4r,n Laiscattm tsay us dczaa a wort sod thee luso wcwala roormractca amrt mbar::I mow :Hilo,• such
:Coasacton time CAM:irks:bcar maw rtmccod aatcoa::toy Iltowiname3.11:41i±1sub-:ea:rut:II and:we whoWe: tc: cum oe:c‘ca
-
:5 to -CO:r.batracar:tr. 7.14, IS:14:L: ::=7. F.:
/ern en employer-that is providing,4otkm compenscnon insurance for iu emploiees Belom !s the polio.and job site
information_
ILurarce C ouvany Name:
Policy Oi Self-1m.Li A7 E...vuation Date
Iob Site Address:
Attach a copy of die worker- conapenatior poky declaration page(showing the pohey number and expiration date .
Faixne to secure coverage a iequn ed=der MGL c. 152.125A is a terminal violaton purathable by a fine up to S1,500 00
and oi cne-year ualpri:cumett,a.:well 3:zlvd the form of 3 STOP WORK°Ma and a inf.of up to S250 C4 a
agair. t the violato: A copy of dar.-,tatenaent may be fonvarded to the Office of In-ye:ligation:of the DL%for msurance
:overate vertfizanoL
I do her*certth'u et the pains and penahies ofperjur)that Ike information provided aboiv is nut and con ect
S1=1.1tUre: tre41101.412197A Date 9-1Z /IV. Z.-3
1/13) 9Z3 *—V.3 q3
Official use anis. Do riot 1177te in this area,to be completed by city or town official
City or Town: Permit.Licesse
I-:tung Autholir !circle one!:
1 Board of Health Building Department C zr Town Clerk 4.Electrical limpet tor Plumbing InTectot
Other
(cur t Per Phone a:
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City of Northampton
Massachusetts =s sue_
i
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 cf �j�Q
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, Su Sat4 bra h a e v-ot°t (insert full legal name), born 1//1O/f94qr(insert
month,day,year),hereby depose and state the following:
1. 1 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. 1 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.L2:
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 A 9 day of t w(4 e!-,20 Z3
/et-A/VIP\
hJ�
(Signature) •
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I of 2 9/29/2023, 11:37 AM
Subject: Quote for Front Porch Project
Susan and Annette:
20 Cloverdale St, Florence Ma
S:ope of work
Demotion of existing porch structure
Construction of new 5)(5 ground level deck
2x banding to be used with 2x6 joists
S,mpson strong tie joist hangers will be used.
Deck surface will be comprised of 5/4X6 deck boards.
Ali materials on deck will be giound contact pressure treated
Construction of porch cover
Porch will be framed with Cedar dimensional lumber.
Roof decking will be 1x6 tongue and groove pine
Felt drip edge and shingles will be installed
Cleanup and removal of all debns included.
Total for labor and materials - 55800