23D-187 (2) 91 HINCKLEY ST BP-2021-1144
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23D- 187 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Deck BUILDING PERMIT
Permit# BP-2021-1144
Project# JS-2004-001624
Est.Cost: $15000.00
Fee:$97.50 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JULIE PAVIA 085685
Lot Size(sq. ft.): 8058.60 Owner: MARCIE J O'CONNOR
Zoning: URB(100)/ Applicant: JULIE PAVIA
AT: 91 HINCKLEY ST
Applicant Address: Phone: Insurance:
594 LOOP RD (413) 743-1178 SOLE PROPRIETOR
SAVOYMA01256 ISSUED ON:4/9/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:RENO EXISTING 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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS. r
i
Certificate of Occupancy Signature: )2 , 0
FeeType: Date Paid: Amount:
Building 4/9/2021 0:00:00 $97.50
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
' l-fE - bdia 1
r-------,, 6-74-7,..„.. in
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R / zs o k
The Commonwealth of Massachusetts Q2� OR
l Board of Building Regulations and Statid)r� , MUN CIPALITY
�yy, Massachusetts State Building Code,784i: `n. N���cp� t USE
v,---_.
Building Permit Application To Construct, Repair, Renovate Or dliskT Ns Revised Mar 2011
One-or Two-Family Dwelling u _.
Thh�istS tion For Official Use Only
Building Permit Number: '` i i—f i`'( Date Applied:
I. . I 1 I, 441b ♦ 1 0_
Building Official(Print Name) Signature I
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers// I,/�reCKC.ty O i) 3.D 1 7 — De
1.la Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
R Jog x 775- / O Y
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft) Al A
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:
Zone: Outside Flood Zone?
Public 0 Private El Checkif yes❑ Municipal❑ On site disposal system El
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: i
'JV�NLI€ Con S'1C -- UCo"4(I- /' oaaen, C E rr() O/ 0L .
Name(Print) City,State,ZIP
9/ /* Pick L Ey 27 y(3-38E—ib8'1 mt;.ccrtconStcOconner e T .4',t.c4„,
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s)" Alteration(s) Addition 0
Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify:
Brief Description of Proposed Work': R i7 L(A c t Ex 1 S?Dr)0 7 ECK go n(_n S
7/ (AS/ - R
Posts Siti' S 31.9. Sq'Ci—
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ I. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: S
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $ 4
Check No.ZI 0?(heck Amount: 9/C'a Ti Kntount:
6.Total Project Cost: $ f S OU 0 ❑ Paid in Full ❑Outstanding Balance Due:
/
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Su ervisor License(CSL) (�g' b g S ,) e__z 2_✓ 1 A V(A _ License Number Expiration Date
Name of CSL Holder
..-c-p L/ i,U V n R D List CSL Type(see below)
No.and Street / Type Description
S/, v O�/ MA 0/Q S /V L 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
•
y/3 79 3 /17 g I�V I r,,Cor.St(vcf I a an SF Solid Fuel Bunting Appliances
i insulation
Telephone Email address ,5Ii Lf,„ D Demolition
5.2 Registered Home Improvement Contractor(HIC) /6 65 7Io 6 _ /V-a1,
HIC Company Name or HIC Registrant Name HIC Registration Number Expiration Date
No.and Street i)gVlgConStfvt*tN € 51v1q ``
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 ...J.)L,£ 1A y n
to act on my behalf,in all matters relative to work authorized by this building permit application.
MtUtti + Myra C'o�Sit u/COnnbt- .3--30— Z (
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 a lication is true and accurate to the best of my knowledge and understanding.
JLJL), 6AI, 0 310-D.
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.govidps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) 31 a S I %. (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-
Department of halustrial. aide
1 Conress Street,Suite 100
w a, Boston, 31,4 0211,1.2017
wanuc s?Ftli
Workers"Compensation is unitise Affidavit Roil&us,.EctittetheiturifElectrigthettelltotniters.
'+l)OE#II,ED WO II ERE PERMIT 1 I'VE;AtAV tilikitiTV.
Apt IikWirt Inter tiaras Print I e rftt%°
dott tl•t rsi z sai E °i atEi:
Address: 1 dz, 1 '�
`.ityst :t .a i S f1 u t M f 612..s Phone a �f/? `7 Y n
Art thm*t►entotththe r`ilwt k the*romp-kw hay �.,.
Type of project(requtretl)
014M er o s tit o or tttrs 4 r New coast# Ns fI
.$ I 0 as nee pinnate a t peas k
esship otter luau trt wopkwoos sotto* #tamo laa
cope:sty.[`tike workers'cssoo orart000r tss,pare$1
JO I AM A htittWAVONEVdoles tImath at tt l ea% "txc's Ir
l "tnCtititriJ
. I atat r hot a"ai *di be itattttr cast sav3atr a"•aastitAtt a i with are pay I II t tltliri iltttttit4tttt
theatre ThAt a!I esserrassers eahet hast saattetk totepostarses mousses ear ost tett la Electrical repairs or as ciitkuns.
panpottiata with an ettipittywk
I 2.0 Plitrobiam inform ar additions
J lara a gelainal eetittattee and i haw hated die stita-eataitentis bond on taia Ait3kikttd AtmI oftvp it
Thew anats�t:arrt�ar siei testa employee*and aa"c s` e0 r_
w 6 q e a t.Inlet ion asa ate€.gf as s tow tstr'zsed awe rightofa per A a .. I r L�► C C��.
1E1.Ota ?.sod we hoot ttCt its sta ass pita n "tea.anahutta s uns**
"AHD atppittant dun al xtts t Ai"att€s1I rB acw:tacera bkAt;;Pr a tom+ ss aat .a?ts"‘,0"19pAttlaittltlt pttiss a.axati mail a
w s Mast mat tilt illittilil tilililitil the"are thaingLtd*tut and theta kit 4Vtgittitt o ttt .wt+sssttet tahtsnat a as affidavit anlientnit t h.
tetwattadora tot whcck din bal attssat ate lt�sl an additional Anal ahonitit the:rause of the an*autaractors nor a ea r tar tuia thou!enigma.low
01.1piat t-. tithe seal.-e.erat sseues l v atttgaf t} they 1stwc gala&air*takers'camp.none( r: .
tato an onplaptthatCipigarseac Ana ° >rnrrn r for, inktstoyerx 8oluto h the policy stags*she
ihfarattlitirItt.
Insurance Company Name:
Policy# Sew ems..be.& Expiration
Job Sint Address. u_._..... t ate State .ip
,
Attach a copy at ea woken'e*usp tion pokey declaration page tabooing the policy tinsiber tatingdrailan date).
Failure to sty tare coVerAge r nplited wader'ttS .c. 12,Vfok is a Ot t tinatl violation punishable by a fin up to Si.5430,tat
andor tt€ ye r inimismunent,as well as civil penalties in the fora of a S"COP WORK ORDER and fine dap to S25 .00 a
day against the v'it4 atur,A copy of this staWrneul nay be forwarded to the Office,of hays ., pattsuats of the DIA flit insurance
coverage lea station.
Ids hoots, ttitil),sir tom" IR* poialati afordary'that Ike inftssuatts provideitaboreisamettamicasitoot
SiA ttttax = .f:'i /J ` Date:
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Phone
tsar only. Do sot eta is lM area to iv cornpkted city or own u t
City Town: Pertnitotieentie
boning Author (circle one)
I.Hoard of litaith 2.Budding..Deparbme*t 3.City/Town Clerk i.Electrical Inspector .Plumbing Inspector
m Other
€onta:t Per Phone it:
CITY OF NORTHAMPTON
SETBACK PLAN
MAP'3 6 LOT: / 7 - cab
LOT SIZE: J O y x 7,S
REAR LOT DIMENSION:
REAR YARD
1-3
\ DI 1.—
\ C
SIDE YARD r DECAr-1 SIDE YARD
i ovsE
36)
FRONT SETBACK
FRONTAGE I V y
City of Northampton
Massachusetts _ .
A
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 '111r W`.1%'s"r�
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: t'S ' P t" MIN U / " Z�
The debris will be transported by:
11 G
Name of Hauler: ��l � r` S ) 11 0
Signature of Applicant: • �� __ Date: -S �/
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