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30A-042 (3) BP-2024-0230 13 LEXINGTON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30A-042-001 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-2024-0230 PERMISSION IS HEREBY GRANTED TO: Project# garage floor 2024 Contractor: License: Est. Cost: 3800 Const.Class: Exp.Date: PARKER, JEFFERY MOYCE ELIZABETH MARY Use Group: Owner: GRAY Lot Size (sq.ft.) PARKER, JEFFERY MOYCE ELIZABETH MARY Zoning: URB Applicant: GRAY Applicant Address Phone: Insurance: 13 LEXINGTON AVE FLORENCE, MA 01062 ISSUED ON: 03/04/2024 TO PERFORM THE FOLLOWING WORK: REMOVE AND REPLACE GARAGE FLOOR 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: Allee Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner _ ��a, / fir'' f ` __ The Commonwealth of Massachusetts FOR ►1, Q 202� Board of Building Regulations and Standards MUNICIPALITY �n� v1assachusetts State Building Code, 780 CMR USE L EPr Bualdit Pertt Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011 N R7HA OF BUILDING;INSPECTIONS i One-or Two-Family Dwelling _ -,4.MA(-wino 1 This Section For Official Use Only Building Permit Number: SP.° .2 9'3l — Date Applied: Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 13 Lexington Ave. 1 1.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) r Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.O.L c.40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Jeffrey M Parker Florence.MA.01062 Name(Print) City.State.ZIP 13 Lexington Ave 603-721-1261 jeffreyparker25©gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check alhthat apply) New Construction 0 Existing Building I21 Owner-Occupied 0 Repairs(s) lit' Alteration(s) ❑ Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work': Remove and replace the concrete in two bay garage i 1 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ $3800 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical 0 Standard City/Town Application Fee 0 Total Project Cost (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All F �J�� Check No. Check Amount:11 6.Total Project Cost: $ 3800 0 Paid in F 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 15.l Construction Supersisor License(CSL) License Number Expiration Date I 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 T&a Family Dwellmc_City/Town.State,ZIP M ' Masonr. RC Rooting 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 Citv/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...........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 I to act on my behalf.in all matters relative to work authorized by this building permit application. i f IPrint 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. Jeffrey M Parker 3/1/2024 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 riot 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 Information on the Construction Supervisor License can be found at 2. When substantial work is planned,provide the information below: 1 Total floor area(sq.ft.) 440 (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count I 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" They C'orrlllttltt►tietllth of i1u%S lehusettl: Depart/trent r1(Inth4.1trittl.-1ccidettts 1 congress Street. Suite 100 Boston. MA 02114-201 ti'N+It.rnus..got►ilia 11►,kers' (-ontncnsatinn I11%11rsnce.1Rdasit: Builttera+( t►ntractor.Ele trikianr Plumbwr�- ttl HI FU.t:11 U.I t 11 1111..PENNI(I I 1 (. tl t 1OR1 . .Hnlicaut htforniatiurt Please Print l.et!iltl>+ Name )12.;fl.i.01 .l, 1 •.: ,•.i,,: Jeffrey M Parker Address: 13 Lexington Ave (_'itv State.Lin: Florence/MN 01062 Piton': 603-721-1261 i Lry ruts an cuiptsitaar.'t ba-vl.tiu'appiuprcatc!Milt: ['pc of project(required): t i 41/a:ni'k'... Ann c717t'irret:%f u}t:a:id:yltat1411SW!• _ :71 Ness ;:c.n4lrnction --�i stu a,.tia rcvprut+.i i+r iairtsio.,kup arta ha,c ti.•ouc,i„Ycc,wt tnp ;et u.it 1 �- �^f 1 Ra'ttttKlC ini air.;cat+acio.',4 ili+taan.c Ngini.ti; 1 y-11111. Dcinuiltt in a:tiyt.'.`wt&t L O1t1t x itiii iiIVx II.INe.%.rtltr:'comp ir..vrata:rt.:0 had I(l j Building a,fditu+n aKmia•wniiused+aalIN: tuui, ei:kintatit,Su.s,uatt�taI!a+vi.t.nmyrnarat). I wilt , .nwtt that all iOti.ta.t.i: .ttlkr h;:sc WV:1i 0.74 k.xtipi l'aia•n uimaazi.e in ate.safe I IC LkI~trtt;al repitrt.or addition:, i+tar.n..M-,with noctr>ta,.•.r,r.• 1? Plurnbinc rtiritir,ul .lilchram. sflI..i i a e'i7l.tai corns art..,anti 11-..ra hthJ the fJtf,.culiUa.ttu.h\I:,;ot.tb.arta.htJ,:1.t1 I t `� ti*"I Ii¢s.,ul+•cat trar?.n. hi- J IS]Li,.ra omen' i!MT. rt:n.lftr ln,ul:lti:a' 14 Ot.)thi, Concrete h,r 1 t+.all a so-mot-Awn and Fa.+ ru..:'ia7.►eal tl'au:4-111 'I L-a.ert Miles p►t tr.rt... i I i 41.and i i.tu,.°n.'iii ptu.:c {Na.xvt i.:^':voli!.uhtY-.rnct `itm-apnii aott that.-h+vk.box. tnt:,t,I..a+hi ut i the -.tt.Ni i'.i..ia vivo,.In-:the:t •.0 l.s+'i iii S1.411 11:r•i l:.nli.:ri:m;: , :,iit/e.i,h Oat*Mil+,lit. ali iru,arri.i:i.11 111.ii.alnii•.tiii :ua 441*:!i413 a i aa.yl&anal thin true..`utltdc:t+nird:t.s-,ORA,ut1tn4 a ri.,a at.tiiiJ,tt indt.utirai:r t..I. .•aira:U,r-that:areal ltto hit nn.+S Als:i.:1::i.r.#.1JtIi.+:iat eii:..:.io' in.tI..Dank:.st Un Mh.tiii Ir,tld rlu ka.'►dirt.-info. It11P R.• 11 .Sx.'Ut,•ia,ltracttc+fm,;:.ta"n•'-.i..Idea ni L1,J i,n.,tat uIt-r 'satle:, .v t:14, i'• '.F: taro+_k l rim an rrspfrt►-e•r that is proiiding corkers'compensation ittrurnnice•(Or ar.t'rn►ptnree-,. Berens-i.. the Iat,'ia t rusd trii►,:ft' intetrmittent. IrEstanince Catnttt;tns- tts*la, »to Sili•ma. Li.. kit,Site.tiara►►, r i.:. Vlach a e•utrt of the Aorke•r,'cun►!x'n,ation nettles drelarirtiun pare(thiKint:the!italics number and ct.piratittn datel. I ,ii. ttuutli d undir Mt it. i 152. _5.\is d cullin-1;11 stoiaticii tatilsilahtc ht. .l 11::4. lir to.' iNt tat and or time-vicar utrl rt-tntnrint.as Aril .e'i it rl l+en.iltlr> in the turn►vita s-r()i'Zvi tRh (tRI)1 R and is line of up io S2 0 iWi das asatn,t the tu-iatt•r. '. .•.r"t .,lthi. - it:_snira en hi :. i•,.died iv the tltticc utlii'. Iu.ttt.tn.of the I)l,t for m.uranic i t`'•i�d1i titltii.ttt I Je,hereby e'erdl't under lire pain.A and peaalliea el perturi that the inlortnalinn provided above IN true and eor'rr't- 1/2024 io/u,e oak. Do not write sr:t/rr•urea.to he romoleted he eel or to►cn oltictal i! ( it% tar luo ri: I'crnmt-I.icru a !' h,uinf+..tuthurin tcirirk tract: ii i. Board of Uralth 2. Building Item►twilit 3.(•it% ToNn clerk •I. Electrical Inspector 5. Plumbing Iiispectoit t� 6.Other t ioitact Fermin: Phone Si: i` City of Northampton ;slit, . . f , Massachusetts t DEPARTMENT OF BUILDING INSPECTIONS r,: 212 Main Street • Municipal Building �, Northampton, MA 01060 spy, .M"D‘' HOMEOWNERS'EXEMPTION AFFIDAVIM Jeffrey M Parker (insert full legal name), bornl18/1(in 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 int 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 qualify 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 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 1st day of March , 20 24. El / a.2, A. ( ��r re City of Northampton �� Massachusetts (J ''% 9. r DEPARTMENT OF BUILDING INSPECTIONS f x ;" 212 Main street • Municipal Building $ ►- Northampton, MA 01060 'J'Yy�,, �,_�� CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Fermi; 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: _ocation of Facility: The debris will be transported by: Name of Hauler: ? v1 Z r-0-0L LOLASca()-€-5 Signature of Applicant: Date: 3/ acl