08-012 (5) BP-2023-1517
836 NORTH KING ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
08-012-001 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-2023-1517 PERMISSION IS HEREBY GRANTED TO:
Project# REPAIR ROOF 2023 Contractor: License:
Est.Cost: 7300
Const.Class: Exp.Date:
Use Group: Owner: PATRICIA STOWELL MARSHALL L&
Lot Size (sq.ft.)
Zoning: HB/RI Applicant: PATRICIA STOWELL MARSHALL L&
Applicant Address Phone: Insurance:
836 NORTH KING ST
NORTHAMPTON, MA 01060
ISSUED ON: 10/26/2023
TO PERFORM THE FOLLOWING WORK:
REPAIRS TO GARAGE ROOF CAUSED BY TREE DAMAGE
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:
• + '
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
ECEl VE1
The Commonwealth of Massa hus- s OCT 2 5 2023
Board of Building Regulations an S . •dards FOR
W Massachusetts State Building Co 7:.t IP'i' M CIPALITY
ORT tUII-CING INSPECTIONS USE
Building Permit Application To Construct,Repair;Rem4ate�isbs Revi ed Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 'Oa. d 3 - /c '/ 7 Date Applied:
053 /7 /D-26 zoz3
Building Official(Print Name) Signature Date
B 3 l g SECTION 1:SITE INFORMATION
1.1 o�,ef�'A dress• l 1.2 Assessors Map& Parcel Numbers
3b 6 �;r5 4,r-e_e f
1.1a Is this an accepted street?yes K no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public CI Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2. O ner'of Record:
rerr,'c.•;c. ,M. jell ..r ?6 14Vk
Name(Print) City,State,ZIP
q3, Neekt. IC c f- I- Why 336s t c.FStA ll 13 6d cn�a,l. &Ai
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 1$ Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Descri tion of Pro osed Work':
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ _ 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire ‘D Suppression) $ Total All Fees: n
Check No. IN./Ott-beck Amoun Cash Amount:
6.Total Project Cost: $ '1 'llCt . ' 0 Paid in Full 0 Outstanding Balance Due:
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 .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 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.
�GZ . /07.Z Z 3
Pram Owner's or Authorized gent' Narfie(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 Massachusetts
IRE rg
Department of Industrial Accidents
1 Congress Street,Suite 100
Boston, MA'02114-2017
..ii li—....
wwwmass.gor/dia
1Vorkers'Compensation Insurance Affidavit: Builders/ContraetorstElectricians/Pluinhers.
It)BE HEED W1111 1 Ili:PERM I IIING AtA'HORIIA,
Annlicant Information Please Print 1A-Eihli
Name 4 H ustili;c3s;Organtzat tort lndst:'dual :
Address:
C ity/State/Zip: Phone#: .
,tre you an employer?Check du a pprapriatv box: r
T)pe of project(required):
I 0 I am a employet witia ernpioyous(fa sandimr part-timer' 7. 0 New construction
:.0 I am a ank proprietor or purloin-ship and have no employee*Nmicmg fur reic in 8. rj Remodeling
arty capacity.No*utter;comp.Mannino: required)
. El;....D I am A humaiwner doing all Wthi ropelf.{No aoria* 9 Demolition
*comp,srausance mama!"
100 Building addition
yam a horoorwacr and will he hump contrketura to conduct all tt urk on my property. 1 will
wore that all contractors eitlarr hose airdicrs'Cvalpotsation Marano=or an:sole 11.Ci Eloetrical repairs or additions
proprietors with no employm.:
i ID Plumbing repairs or orliiitions
SCI 1 am a cV111:Tai contractor and I have hind the sub-contr./it:tors listed an Ilse attached stick.i
Theme sub-contractor,haw cresployee-s and luvt woritrs•‘..uania.snaur.mor..: 130 Roof repairs
14_0 Othet
na Yee arc a ompuranon and its officers hake exercised them ngin of exemption per Wit_c.
1....1.§lj 44,and we have no ermiklyees.[No*takers comp,in an require/4
'Any applicant that ciwvka box 4 I flans'ako till out the aection below show mg then wadi:era'compentairun policy'mformatrow
lionseowners who submit this aftidatot tntheatsne they Ate cluing oil work and then hoc inthide contactor,moss submit a new affi.davir mil'Latina i.i.....i'.
:Contractors that cheek this b&a.must lathe&A an additional abitt showing the nasne of the sabeeontractor*mid soil whether or not those allifies hike
If the sub-contracsort,fut.e emplLoy ec,.they mu.l.rr id.their worLers'comp.r Li c:t number
I am an employer that is providing workers'compensation insurance fur my employees. Below is the policy anti fob site
information_
Insurance Company Name:
Policy#or Self-ins. 1. 1,.. : Expiration Date: .
. .,...i.„.,
.--
.
Job Site Address. S 3C0 N K-t, OJ , city/StateeZip:
Attach a cops of the workers'compensation policy declaration page(showing the polies number and expiration date).
Failure to secure coverage ati required under MGL c. 152. §25A is a criminal violation punishable by. fine up to S1.500.00.
and/or 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 or Investigations of the DIA for insurance
cos erage verification.
I do hereby certify under the pains ;old po;;;Iiies of perjury that the Information provided above is true and correct,
%I:mature Date:
Phom...t:
Official use only. Do not write it;thi.N urea. to be completed by city or WWII official
t'ity or Town: Perndt/License 4
IsNuitig.Authorit) (circle one):
1 1. Board of Health 2.Building t)epartinent 3.Citv/Town Ckrk 4.Electrical Inspector 5. P11110).114;Insiscctor
6.Other
Contact Person: Phone#:
City of Northampton
st
•,' Massachusetts
c
DEPARTMENT OF BUILDING INSPECTIONS y
;+r ' 'jv qr 212 Main Street • Municipal Building
Northampton, MA 01060 4:P Too'
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: yu ( T ( L_-
The debris will be transported by:
Name of Hauler: Aws� �
Signature of Applicant: Date: \b\zt(e,-92
City of Northampton
s s,
f " Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building �p• �.�
Northampton, MA 01060
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, (insert full Iegal 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 qualifj 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 rant required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this day of , 20_
(- )44 jte'_44 C
)41.4V/
(Signature)
1/2"x2'-O x2'-0"PLYWOOD GUSSET ATTACHED
TO(E)TRUSS TOP CHORD&WEB MEMBERS
W/(2)8d NAILS @ 2"o.c.(TYP.)
(GUSSETS REQ'D ON 1 SIDE OF TRUSS @ TOP •
CHORD PANEL POINTS-REATTACH EXIST.
NAILER PLATE ON OPPOSITE SIDE OF TRUSS
WHERE POSSIBLE W/4 MIN.SCREWS) •• '
-SEE NOTE#8BELOW FOR ADD'lINFO. j� ��•
'>\ �` (E) 2x4 WOOD TRUSS®2'-0"o.c.
i
5 gt
W A el.
\�\ '^ c erg
24'-0"
(E) W000 STUD EXTERIOR WALL---...„
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NOTES: 2
1.) (E)INDICATES EXISTING,OTHERWISE NEW.
2.) G.C.TO NOTIFY THE STRUCTURAL ENGINEER IF THE ACTUAL FIELD CONDITIONS c 4—
DIFFER FROM THOSE SHOWN IN THE STRUCTURAL DRAWING. > O
3.) FIELD VERIFY ALL EXISTING DIMENSIONS AND ELEVATIONS PRIOR TO CONSTRUCTION.
4.) VERIFY ALL NEW DIMENSIONS AND ELEVATIONS WITH EXISTING CONDITIONS. w
5.) G.C.TO RELOCATE EXISTING CONDUITS,INSULATION,ETC.AS REQUIRED TO PERFORM To' IIDa 5
THE WORK INDICATED(NOT SHOWN FOR CLARITY). cr 03 d
6.) G.0 TO JACK THE EXISTING ROOF TRUSS TO ZERO DEFLECTION PRIOR TO INSTALLING N co i
PLYWOOD GUSSETS PLATES. 2 Vr $
7.) DETAIL IS APPLICABLE FOR ALL EXISTING ROOF TRUSSES.
8.) PLYWOOD GUSSETS TO BE 3'-0"MINIMUM LONG AT LOCATIONS WHERE THE TRUSS
WEB MEMBERS HAVE CRACKED AND/OR ARE BROKEN. I
o
TRUSS REPAIR ELEVATION -8
SCALE:1/2"=1'-0" o
U)