37-022-013 BP-2023-1497
600 FLORENCE RD UNIT COMMONWEALTH OF MASSACHUSETTS
13
Map:Block:Lot: CITY OF NORTHAMPTON
37-022-013
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2023-1497 PERMISSION IS HEREBY GRANTED TO:
Project# deck 2023 Contractor: License:
Est. Cost: 15500 STOKES CONSTRUCTION LLC 094609
Const.Class: Exp.Date: 05/17/2024
Use Group: Owner: BERMAN ROGER S& TRACY PERKINS
Lot Size (sq.ft.)
Zoning: SR Applicant: STOKES CONSTRUCTION LLC
Applicant Address Phone: Insurance:
270 CHAPMAN ST (413)834-1170 2001 W9265
GREENFIELD, MA 01301
ISSUED ON: 10/24/2023
TO PERFORM THE FOLLOWING WORK:
REMOVE AND REPLACE 12X14 DECK
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: I
1' , yd
O 1, •
• •
I
Fees Paid: $101.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
7 `1.61 rf PI Fi( rfi�s
Ic? C ,V 7�t,urs / ?
S., The Commonwealth of Mass hus= s ��
Board of Building Regulations d S . i dater FOR
0 / Massachusetts State Building C de 7:0 CMR c'4 CIPALITY
'ac 2023 USE
Building Permit Application To Construct,R ir,Klt®y. - • Demolish a R vised Mar 2011
One-or Two-Family Dwel in °RTy,4t rim r/tv
This Section For Official Use Only r��'ft'44 o�5n°AiS
Buildin Permit Number: 60`�3 — I y q 7 Date Applied:
l euIN)&,5 17 10•Zy-ZOZ3
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
13 ruL Ictu re) * k'
1.1 a Is this an accepted street?yes 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
15- Ibo 4 2C too +
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public CI Private CI Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
(loser ( rry $Iorevtc. .fr& 0tobb
Name Print) City,State,ZIP
1-3 4.4-W Laure) ?1 ^ N1S-58g-88W4 rriy1SCLol -cow
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) 12r, Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: DGC,k.
Brief Description of Proposed Work2: (Le vvioV>; Cw Act 9.e.p 1„ ,Q l2 x 14' S IC
U5 v}c�u9x f-�'o vni ik 1 2- " r..Soo .tvtac.S out erc SS LA-e- -}--r- 1
.-St.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 15 30 p 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 $
Suppression) Total All Fees:..§,
0 Check No. l Check Amount. 1� Cash Amount:
6.Total Project Cost: $ 15,E 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) (;S l(b0`! 05117 r'a y
Onih( ny 3 N,S License Number Expiration Date
Name of CSL'Holder , p
,97c Ckt p � 5� List CSL Type(see below) lil
No.and Street 6M Type Description
6r„_ 't of MA 013 o 1 U Unrestricted(Buildings up to 35,000 cu.ft.)
�f, R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413 834-(17 0 co--(topic.((_5tb le S t d ec .C6lM I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
Chr;5-bke r )o-k! 9e,4 $y3 3/a81ay
HIC Company Name or MC Registrant Name HIC Registration Number Expiration Date
CIS Nvey-lk S4 04-1C.e.@ 5+01/6 . cow,
No.and Street Email address
5a o-HA Par Par&kl I-I13-Saa -(475
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 .❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize Ayt{-Igbam c l-42-4 64- SkI(Ces CS)r131YVC-11v\A
to act on my behalf;in all matters relative to work authorized by this building permit application.
ge4 7.43fxw V - to 'i31-207—
Print Ownes 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 accurat to the best of my knowledge and understanding.
Ao n �} s ue-S io/av/dJ
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 halfrbaths
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
'' •� Department of Industrial Accidents
=�= 1 Congress Street,Suite 100
►-? Boston,MA 02114-2017
•_,,. www.mass.gov/dia
I1 urkrrs'Compensation Insurance Affidavit:Budders/("oatr'actorsiEketriciansfPlumbers.
to BE HEEL)W'I I IHk PE RMI'I'II%(:Atrutoltl"ht.
.tnthcant Information Please Print Legibly
Name(Busancss'chganincwo�l�tadividual): J Io dke c CO t.S _0.--
Address: 70 GiAatcx14,24.4 S -f _...
City/State/Zip:Care 4 C1 tfrtlit C13C k Phone#: LI13- S 3'4-(/"] D
Are yam as ulster!Cheek tie appaspthse ham:
'l Type of project(required):
(. I am a enaptuycr with 1 tseployces(full amber 1-•
p� 7. D New construction
20 I am a sole ptupnctor or pa imechip and have no employees wurkin5 for to in 8. ❑Remodeling
:up capacity.!No workers'camp.iaauranca nrgmairrat.l
9. ❑Demolition
31-:3 I am a hagtvwnet Jaang all work myself lNu workm'comp.mtawrancc required.I
10 Q Building addition
4.0 I am a humans net and will be hiring coseraaturs to eoaduat all wort.on my property. I will
noise drat all cinanrctur,either loose%uden'crampcnaaman ur.urarm:or are role i I.0 Electrical repairs or additions
prupeaaaars oath no employees.
12.0 Plumbing repairs or additions
:Sri I am a enteral contractor and I hays hand the rub-caanractoaa hared on the attacked sheet. 1 Roof airs
These subc lime
ontractors Laic employees and ste workers'comp.aasnunce.E repairs
60 We are a corporation and us officer:ha+a racYcaaad then nein of exemption pet M(iL c. i4.�Oth _ e 1
152.i 144).and we have nu empkryatiti.(?Nu workers'comp.maritime ragasodl
*Amy applicant dim checks inn MI min also fall out the%eetiun below%bowies hair workers`compensation pobcw inf ornaatiaan.
•li maownnm two admit die allidsvir inaiL-ating they am doinj all work and than hire uutudc euramractot.mans!whnnt a are%aff.dav ii walacaiinde suck
lCooaraemn that c he elk this boot mat altarlted a•addiriatal dial slaw mg the name of the aul*suaractors and state w babe/or nut those amities have
employees It Mc.ub-cur tracmra bar owls/ask dory road provide dear %oad&comp policy mamba.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.Insurance Company Name: iq n eat vt I�Ct-1bvkc.( ' 4 i vo -Pt 144 Ill CaS HAS S CO —
Policy tt or Self-ins.Lic.X: 900 i W 9 a (0- T Expiration Date: PP1 h b/a003
Job Site Address: /3 /'VT& 4urn/ fregliA City/State/Zip:##ce i4/,1 0/060
Attach a copy of the workers'compensation'poky deelaradon page(showing the policy number and expiration date).
Failure to secure coverage as required under Mil c. 152.*25A is a criminal violation punishable by a fine up to S I.500.00
andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine 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 ender the pains and penalties of perjuty that the information provided ism is true and correct
Signature' l 1)ate: aV/00
Phone t: V/3 83V //70
' Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License iX
Issuing authority)circle one):
I. Board of Ilralth 2.Building Department 3.('ityifown Clerk 4. Electrical Inspector 5. Plumbing Inspector
b.Other
( unisex Person: Phone#:
A
City of Northampton
?oatr+�Mp ti; ♦ +a-
S
rye • Massachusetts �'�!�G
} DEPARTMENT OF BUILDING INSPECTIONS
Y
!. + 't 212 Main Street • Municipal Building
�_.� Northampton, MA 01060 why,' t♦10Q
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, 554, 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: `)Oii a3 ( act p/bN
►U p ox-A o
The debris will be transported by:
Name of Hauler: 5-DYIP,S CO✓1*L thOr\
Signature of Applicant: Date: l0/PV 4 3
A
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