24D-206 (2) BP-2023-1777
228 STATE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-206-001 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-2023-1777 PERMISSION IS HEREBY GRANTED TO:
Project# ROOF 2023 Contractor: License:
Est.Cost: 8000 JAMES ROBERTS 099404
Const.Class: Exp.Date: 01/21/2024
Use Group: Owner: HIGGINS MARY CLARE
Lot Size (sq.ft.)
Zoning: URC Applicant: JAMES ROBERTS
Applicant Address Phone: Insurance:
30 Edwards Rd (413)527-6078
WESTHAMPTON, MA 01027
ISSUED ON: 12/26/2023
TO PERFORM THE FOLLOWING WORK:
STRIP AND REROOF
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: t
1 � �
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Fees Paid: $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
780 CMR: STATE BOARD OF BUILDING REGULATIONS AND... https://northamptonma.gov/DocumentCenter/View/1
1
The C,o on ealth of Massachusetts
SEC 2(BR rd of B ildi Regulations and Standards MUNICIPALITY
t'i\ 1VI�ahus Us S to Building Code, 780 CMR FOR
USE
t..
A plica on T Construct,Repair,Renovate Or Demolish a Revised Mar 2011
`- R`_L,TroN�p.A-1 Cr1 e-o Two-Family Dwelling
4 O1u60
Th. Section For Official Use Only
Building Permit Number: " /7 7 7 Date Applied:
'. , gig. �. 4 3
Building Official(Print Name) Signature
SECTION 1:SITE INFORMATION
1.1 Property Addre 11------ 1.2 Assessors Map&Parcel Numbers
l.la Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 /one: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 0 e 'of Record �'
Name rint) City,Stator(
No.and'Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify:
Brief Description of Proposed Work': ...erf
14- -ftkilef-44-1;1...--A
SECTION 4:ESTIMATED CONSTRUCTION COSTS
stimated Costs:
Item (L or d M vials) Official Use Only
1.Building 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical I 0 Standard City/Town Application Fee
0 Total Project Costa (Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ Total All Fees: $
Suppression) a
Check No. "Check Amount:
6.Total Project Cost: Op 0 Paid in Full 0 Outstanding Balance Due:
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OARD OF BUILDING REGULATIONS AND... https://northamptonma.gSERVICES ov/DocumentCenter/View/15553/Residentia...
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SECTION 5: CONSTRUCTION
5.1 Construction Supervisor ' se(CSL)
License Number Expiration Date
Name o Ho der
`�a LA' /�PPList CSL Type(see below)
No.and St �!/ '' Type Description
/ 77f q �rai v U Unrestricted(Buildings up to 35,000 cu.ft.)
City/Town,State,ZIP R Restricted 1&2 Family Dwelling
M Masonry
Roofing Covering
S Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone - Email address D Demolition
5.2 Registere e Improvement Contractor(HIC) /` `c5 ,
HIC Registration umber Expiration D e
HIC Company Name or Re istrant Nam
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 0 No ❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES OR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authoriz y this building permit application.
t _
Cap ( .0' /k)q , 3
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 application is true and accurate to the best of my knowledge and understanding.- /
V 4! Autho �hfn (�Signature) ��`1'q ��
Print Owner's or Autho zed Agen a Electro Si afore 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"
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780 C4,4R: STATE BOARD OF BUILDING REGULATIONS AND... https://northamptonma.gov/DocumentCenter/View/15553/Residentia...
I
City of Northampton
ors' s'-
-- 1 - Massachusetts v, 't�'
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building f �.'
. Northampton, MA 01060 ssy1 �'``'�,
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:
4
Location of Facility: 0
The debris will be transported by:
Name of Hauler:
Signature of Applicant: j e ���/ Date: 0 / �`
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