35-164 (7) BP-► 022-1371
809 RYAN RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
35-164-001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-137 I PERMISSION IS HEREBY GRANT D TO:
Project# WINDOWS Contractor: License:
Est. Cost: 3500
Const.Class: Exp.Date:
Use Group: Owner: KENNEDY SCOTT K& SUZANNE N ',TRAUSS
Lot Size (sq.ft.)
Zoning: WSP Applicant: KENNEDY SCOTT K &SUZANNE N RAUSS
Applicant Address Phone: Insurance:
809 RYAN RD
FLORENCE, MA 01062
ISSUED ON: 10/27/2022
TO PERFORM THE FOLLOWING WORK:
REPLACEMENT WINDOWS
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 VIO ATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
yiZT1n
'
The Commonwealth of Massachusetts '• ,
1‘17
Board of Building Regulations and St4ndardyr 2 4 9(122 FOR
Massachusetts State Building Code,780 CMR MUNI IPALITY
j SE
Building Permit Application To Construct,Repair,Ren r; ish .)N N' Revised Mar 2011
One-or Two-Family Dwelling ' - , '
This Section For Official Use Only
Buildin Permit Number: 4 0—d4, "I3 7/ Date Applied:
4sulA.-) 4Z5
.)/12 0-75-2621
Building Official(Print Name) Signature j Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
4j 04 Rykea 1-1,t i FLo rh4Gt 19 (1 1
1.1 a Is this an accepted street?yes )A no Map Number Parcel um r
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 Lkl Private❑ Zone: Outside Flood Zone? Municipal 0 On site disposal system a
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
$c-c r k-- wcak64 y pLoP-ckt.e. t 1,-'.4 a to6}
Name(Print)5 i.L,4 u x e F[• 57 it it a 55 City,State,ZIP
go n.ykL< lam. LII3-3C0-54G3 5co7T, k. kt:kit£D &ci..,til_Go4..
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building In Owner-Occupied IA 1 Repairs(s) Tig Alteration(s) ❑ 1 Addition
Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify
Brief Description of Proposed Work': fic k'✓ 1 Id Q o- 1.1� p_ I p L.he-♦ tw-- £ ra T
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official UseO
(Labor and Materials) Only
1. Building $ 31 5,,„ 1. BuiIding Permit Fee:$ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
D Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) $ Total All Fees:S W. k0
Check No.65P—Check Amount:
6.Total Project Cost: $3 i 50 v iR Paid in Full 0 Outstanding Balance Due:_
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
_ License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
City/Town,State,ZIP — R Restricted 1&2 Family Dwelling
M Masonry
RC Roofing 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 Exp 'on Date
HIC Company Name or HIC Registrant Name
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 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
to act on my behalf,in all matters relative to work authorized by this building permit application.
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 informati
contained in this application is true and accurate to the best of my knowledge and understanding.
Sc.aIT 1:4y / -P jJ)
Print Owner's or Authorized Agent's Flame(Electronic Signature) Date
NOTES:
I. 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"
iN The Commonwealth of Massachusetts
_..ter ..
-= Department ofIndustrial Accidents
sµ/1 b I Congress Street,Suite 100
.SSA It, Boston,MA 02114-2017
waft:mass.got~/dia
114,lkers'Compensation Insurance Affidasit: BuiklerstContracteratElect,ir)ansiPlumisers.
fl)111.. FILED W I i'II THE rEl1MITfl1G AIT'HORITY.
.%nnlicant Information Please Print I.t-sihh
Name(Business•Organization,Individual: 5 L O`1"T- • i< E N g E o
Address: 5 a I 1)- y,i M L
City/State/Zip: r 1-0 P a cr c j >`"i_ es- G i of -P- Phone#: I-I 13 3 ts7 —5`14 3
Are yea aseitepM er?Cheek the appropriate boa:
Type of project(required):
t.Q t am a employer with employees r I all and or parttirn).• 7. J New construction
2.Q I am a sole pniprictur or partnership and hate no employees working for me in8. CI Remodeling
• any capacity [No workers'comp. insurance reywnsl.) 9.
V
30 I&homeowner dome all work myself.(Tao workers'cone.tp r required ' ❑ Demolition
4.�1 am homeowner and uf11 be home contractors to c'+ortduct ail*ink on my property 1 will Building addition
croon:that all ctmtraeton either hair titiorkers'csrrntre`rnatiat uaurance a are sole 11.Q Electrical repairs or additions
proportion with no employees
12.0 Plumbing repairs or additions
301 am a general contractor and I hate hired the sub-ctmtraetara listed on the attached sheet
13These sob-contractors base employees and hate workers'comp.unurance Roof repairs
6.0 We are a totp ration and its officers havecarn.ised then right of euemourn per WAe. 14. Other w/H A‘ '•^
I S;..yt ean 1141.and we hate no pkryaces.III workers'comp.inaurantx nvl reyui . 11 E t 41-6 Ps FikT
clay applicant that checks hot n I must also till out the section below show in then woshera'compensation policy Informative
t Humans nets who submit this a alai S it indseaun}they are doing all w ork and then litre outside contractors mint submit a new affidavit Indic'ling such.
CContrsciors that cheek this hot must attactsed an additional sheet show inc the name ols the sub-contractors and state w tether or not those entit es hate
aseis=2tire sub-contractors hate s.-mplotecs.the must pigs ide their v.orlters'comp.pubes,number.
I am an employer that is providing worAer.'compensation insurance for my employees. Below is the polite and job site
Information.
Insurance Company Name:
Policy tt or Self-ices.Lic.#: Expiration Date:
Job Site Address: (-tts State`Zip:___________.
Attach a cope of the workers'compensation policy declaration page(showing the policy number and ties date).
Failure to secure coverage as required under MGL c. 152,O2SA is a criminal violation punishable by a tine up to 1.500.(X)
and-or one-year imprisonment,as well as civil penalties in the farm of a STOP WORK ORDER and a tine of up S250.00 a
das against the tiolator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct
Signature: V- Le -„ Date: I 0 ! 7-y I -.)-
Phone r: tr! I) `7 - 5 "i 6 3
Official use only. Do not write in this area,to be completed by city or town official
('icy or Toss a: Permit/License#
Issuing.authority(circle one):
1. Board of Health 2. Building Department 3.City.Town Clerk 4. Electrical Inspector S. Plumbing indpector ff
6.Other
Contact i'erson: Phone#:
. _
City of Northampton
oaYHeMP,o `��r
s ? Massachusetts 4, x_
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t `40, DEPARTMENT OF BUILDING INSPECTIONS cu
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w i�r� �y` 212 Main Street • Municipal Building yJy. ^D7
. Northampton, MA 01060 ssNiii i 01:N..S"'
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 in, S 150A.
The debris will be disposed of in:
Location of Facility: Q4 t-h 4>~ trlrG-1- R ILL: c-yLLruyLa
The debris will be transported by:
Name of Hauler: 5 6 i—t I� I, i-I N E JJ y
7-
Signature of Applicant: ,cam- lc' �-r Date: 1° /yy 1 ->-
City of Northampton
��o0.tH�Mf�To `s w-- s'
Massachusetts �Q? '
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A ., DEPARTMENT OF BUILDING INSPECTIONS
w
r *: /` 212 Main Street • Municipal Building yeti
fir: Northampton, MA 01060
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
C. Tt } E a u s h 7' (insert full legal name), born y(insert'1
month, day, year), hereby depose and state the following:
1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requi ents of the
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 meowners'
exemption, does not involve the field erection of manufactured buildings constructed in acc dance with
780 CMR 110.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 10.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 tent that I
qualify for and will abide by the Massachusetts State Building Code's requirements for the pervision of
the project or work on my parcel, I am not engaged in construction supervision in conne ' 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 proje t or work on
my parcel,I acknowledge that I am required to and will act as the supervisor far said project work.
Signed under the pains and penalties of perjury on this ""Y71 day of bc- lG F i2
(Signature)
(, °f 4: :I Nor it o Kevin Ross <kross@northamptonma.gov>
ipton
Window installation
1 message
Scott Kennedy <scott.k.kennedy@gmail.com> Mon, Oct 24, 4022 at 12:03 PM
To: "kross@northamptonma.gov" <kross@northamptonma.gov>
Good morning Kevin. I submitted a permit application for the replacement of some windows on our house and was told
you needed the U-factor. The windows are Marvin windows from RK Miles with a U-factor of.28.
Cheers,
Scott Kennedy