30B-083 (10) BP-2024-0426
35 LADD AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
30B-083-001 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-2024-0426 PERMISSION IS HEREBY GRANTED TO:
Project# BULKHEAD 2024 Contractor: License:
DOUGLAS B THAYER DBA
DOUGLAS THAYER
Est. Cost: 9600 WOODWORKING 107699
Const.Class: Exp.Date: 04/07/2025
Use Group: Owner: LLC 35 LADD AVE
Lot Size (sq.ft.)
DOUGLAS B THAYER DBA DOUGLAS THAYER
Zoning: OI/WP Applicant: WOODWORKING
Applicant Address Phone: Insurance:
P 0 BOX 60322 (413)530-4785 6HUBGR15002
FLORENCE, MA 01062
ISSUED ON: 04/10/2024
TO PERFORM THE FOLLOWING WORK:
REPLACE BULKHEAD
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:
/e/ Z-
Fees Paid: $200.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
, owate ra f. fir rti___Es.:::07-71-__ ---- --
C .„,,_
The Commonwealth of Massachusetts! I APR 1 0
. E. Board of Building Regulations and Standards i �R- FOR
;, Massachusetts State Building Code, 780 CMR _-._.,_„_�� MUNICIPALITY
�'. fU1 n, �, -,--. .,USE
Building Permit Application To Construct, Repair, Renovate Or Demolish a ' ;Reins' Mar 2011
One- or Two-Family Dwelling
p This Section For Official Use Only
Building Permit Number:c-7 �" l.,q.. ysZ 4 Date Applied:
K r3(Z5 ,i//, I -ID-z z
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Pro erty Address: 1.2 Assessors Map& Parcel Numbers
,S L-Qdd O f.1
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zonal g 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 ElZone: Outside Flood Zone? Municipal ❑ On site disposal system
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: AC.aa(ek �v--Q t-C. '61 S is 4-1-.-0-4
Pa h 0,-5)-
Name(Print) City, State,ZIP
/9A akv0
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work':
R ►I-s I . Miff/ Li
fM
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ Sr 000 .— 1. Building Permit Fee: $ Indicate how fee is determined:
�� ❑Standard City/Town Application Fee
2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ JGQ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees:
q 117/(5°
Check No.‘014C4 heck Amount: Cash Amount:
6.Total Project Cost: $ [ tad. — 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) c S to 76 ?e/ a i o7A5
1)060x11,) 'Dube v License Number Expiration Die
Name of CSL Holdkj
List CSL Type(see below)
'5 Sp S
No.and Street Type Description
ROAKCQ n 0((f„y 6 d, cp Unrestricted(Buildings up to 35.000 cu. It.)
City/Town,State,ZIP Restricted 1&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
(( 117 r e i o —�7 Go- c SF Solid Fuel Burning Appliances
J f I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 1 '7q 7 SS t 11� Z(/
1)O u `k'i T huy\2 r HIC{Registlration Number Ex(pi on Date
HIC Company Nate or HIC Registrhftt Name
No.and Street ?..,s U" S J- Fie-,ot„ 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 . ❑
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 VO Oft,q,)
to act on my behalf,in all matters relative to work authorized by this bllding permit appli do
5.
Jce ( }Lori so,,k 00Av
Print Owners Name(Electronic Signature) ate
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 a plication is + and accurate to the best of my knowledge and understanding
p' Ih.�.
Print Owner's or Au orized Agen s Name(ElEretronic 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"
City of Northampton
.�° . 4:,,, �" arc
Massachusetts ^� .. 't�
' '' DEPARTMENT OF BUILDING INSPECTIONS a
212 Main Street • Municipal Building 1.7� ""7'
Northampton, MA 01060 rS = a�1`�`
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: Va Icy
YPoc3Ity--
The debris will be transported by:
Name of Hauler: DC:1+S -nci e r
Signature of Applicant: ,zr:LbDate: 0/0Z St
1*-\
— - The Commonwealth of ifassachusetts
11.t- C:7111,,orh Department of Industrial Accidents
/ Congress Street,Suite 100
1111
Boston, MA 02114-2017
wwsv.mass.gor/tlia
11Orkers•r:ompensation Insurance Affidavit:BuiklersiContractors/Ekctricians/Plumbers.
TO BE FILED WITH THE PERMITTING At;IlltHOTV.
Aorrlica.nt Information Please Print I.etitilv
Name(Business/Organs zationAndividual): V (1110, 711024,,,z_ .......,_ . ,......._____
' o<
City/StateZip:_ 010 al _
Phone#: __YE—___s G
.......
Are,ow an enripkryer?Cheek die.appropriate bin: Type or project(required):
i.ia sin a erriphiyer with ,,,,,,,,277:eitiployees hull and/or partAinvel.* 7. E3 New construction
' 2 0 I am a sole proprietea or paellIMIllp and have no employees working fur ine in K. 0 Remodeling
any capavity,(No workers'comp.insurance tesprinadj
9,, 0 Demolition
3f:i i sin a bernerawner&ingot!wott.myself.Pio workers'COMF.,insurance nrquired.]'
I 0 n Building addition
4.0 lam a hinneowne7 and will be hiring emantetors hi conduct ail work on my property. I will
eilikUlt that all contractors either have workers's i ..., ,- . ortinuance or an sole . 110 Electrical repairs or additions
proprietors with no employees,
I la Plumbing repairs or additions
, 5f0 I am a general contractor and I have Wald the sub-contracton listed on the attached sheet.
l 3.C]Roof repairs
These soh-contractors Kase employees mid have workers'comp.insurance.;
, I 4. ther
th.ID Vie are a co n moratio and its officers have exercised their ngbs of exemption per MCA.e. W
1.52,§lt4i,and we have no employees,PM workers comp.insurance required...1
*Any applicant that checks box ttl must also fill out the NCI:6M tsclow showing their workers'compensation policy information.
t liorneowners who submit this atraimit indicating duty are doing sit wink and then hire outside contriwtors mat submit a new strain',it indicating such.
"Contractors that cheek this box must attached an additional sheet show mg the name of the ssib-contractors and state whether or not those entitim have
employees tithe sub-curnisetors diVe+411100!.CV",,Iltcy IlltW pro,kic-their *orktrrs'-,:omp polw. nu.intx'r
him an employer that is providing workers'c'orapertsation insurance for my enit4oyees. Below is the policy and jab Air
information.
Insurance Company Name: av eN q,lrt 7
Tv
-
Policy#or Self-ins. Lic.Ai: 14. F7 - 5C,t).)-- Expiration Date: 4,0 , 0,2
Job Site Address: / S /-add )(IA' City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under SIGL c. 152. *25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the OtTice of Investigations of the DIA for insurance
coverage verification.
. . ...
I do hereby certify under the pain: 'penalties of perjury that the information provided.a .e true and correct.
Signature: JO Date: (0 ay
Phone#: (//3— 5 3o --ci7i
gffIcial use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
. „ . .
Issuing Authority(circle one):
I.Board of Health 2.Building Departntent 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone 4:
_____................_.-- .
Douglas Thayer
45 Spring st Florence
CSL # CS-107699
35 Ladd Ave
30B-083
Scope of Work
Basement access and Laundry are
Remove existing bulkhead hatch and replace with wall and roof system.
Add 82" exterior door and interior stairs.
Install hookups for washer and dryer in the first room of the basement for tenant use.
4/10/24,7:50 AM Northampton MA,Web GIS
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From:
coili (Trlay24--
PC) 0o1C SQL _ __ .
To:
Jonathan Flagg
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts.Building Code, section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, I request that you
grant a modification to waive the requirement for construction control of the project at
LOOL(
because the work is of a minor nature,will not affect structural elements, health, accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration. .
Respectfully,
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