17A-173 (14) BP-2022-1541
40 HOWES ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
17A-173-001 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-2022-1541 PERMISSION IS HEREBY GRANTED TO:
Project# ABOVE GROUND POOL Contractor: License:
Est. Cost: 10150 DOUGLAS GOODNOW 082188
Const.Class: Exp.Date: 10/16/2023
Use Group: Owner: S BASSETT THOMAS A& BEVERLY A
Lot Size (sq.ft.)
Zoning: URB Applicant: GOODNOW CONSTRUCTION INC
Applicant Address Phone: Insurance:
45 WESTVIEW TER (413)548-4561 CS0178654
EASTHAMPTON, MA 01027
ISSUED ON: 12/08/2022
TO PERFORM THE FOLLOWING WORK:
INSTALL POOL 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:
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:
Fees Paid: $66.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
Z—OK
File #BP-2022-1541
APPLICANT/CONTACT PERSON:GOODNOW CONSTRUCTION INC
45 WESTVIEW TER EASTHAMPTON, MA 01027(413)548-4561
PROPERTY LOCATION 40 HOWES ST
MAP:LOT 17A-173-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $66.00
Type of Construction: INSTALL POOL DECK
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Buildin l Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
X Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
I I I /Igl/ n
•
Si:J ature of Building Official I Date '
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Depa ent
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office f
Planning&Development for more information.
R E C IVY ,
14 The Comrionwealth of Massachusetts
lUit DEC 2 d of Building Regulations and Standards FOR
Massachtisettsj State Building Code, 780 CMR MUNICIPALITY
USE
rlikififiliBBNitiltsiWkiNdlon To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
o''THAm".1'?a.mA o1(3so-One-Or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 3P— 3.3 • 15*`4 Date Applied:
r�i ' ). \.. S, 6.241t
Building Official(Print Name) Signature l _L� e
SECTION 1:SITE INFORMATION
1.1 Property Addres • 1.2 Assessors Map&Parcel Numbers
#a r`��rMap 1N 4 --1 ?3 Parcel Number / 7/1—17 3✓a O I
1.la Is this an accepted street?yes no
1.3 Zoning Information: 1.4 Property Dimensions: /��'."-
O.3 4 Lt AC-0s —
Zoning District Proposed Use Lot Area(sq ft) /141 N 0 J$4 Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water S ply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private 0 Zone: — Outside Flood Zone? Municipal i3�On site disposal system 0
9 Check if yes �
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
?0M 6 dAf Grr Ow S4 aw f/oran�- fA o/ o b o
Name(Print) City,State,ZIP
go yow L S 5 7 tin-335-1836 9usAdw Io@J" I . coy►,
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition ❑ Accessory Bldg. 0 Number of Units Other ❑ Specify:
Brief Description of Proposed Work2: �^ ,_�—4( / O ,( p�K wl�-` h 0 ((n)f
4(4(.14/ 9 44-r-e.--
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building SA f2).0 0 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $
ii
Suppression) Total All Fees: $ ii (Q
Check No.Id f Check Amount: t,v Cash Amount:
6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS-- a��'I l0/l0 3
�.��b_c Gbo np1� License Number Expiration Date
game of SL Holder Li we s rvix— 1 To -r 4,c� List CSL Type(see below)
No.and Street
Type Description
1/9/eil.Ce /{/l g 6/D/b 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
` /J SF Solid Fuel Burning Appliances
$ 'i sC d tj 01/I,sGr Q '&L . I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) t I3
GOad �, q`S'y 3`( "
nQ �' SZ HIC Registration Number Expiration Date
HIC Company Name or HI Registrant Name
r Vick/ 1 4 Y4-cam- d 1) " }IPA . 64
tS`an T t{eetAil� -oil),‘ Aitt .cY 1-K3 4/ 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 47 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 D 0 / b 4) W
to act on my behalf,in all matters relative to work authorized by this building permit application.
�b 41, Q it/5 c4/17r / €v8L'i /2/( a
Print Owner's Name(Electronic ignature)
/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.
V LA flit //n\44
Print Owner's or Authzed Agent's Name(Ele is Signature) to
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
�'•.1 Massachusetts
DEPARTMENT
N
OF BUILDING INSPECTIONS 9
212 Main Street • Municipal Building vti o�
�_, Northampton, MA 01060 J f'Jy .3,')\'‘�
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:
/ r
Location of Facility: Vl�<f ( n
The debris will be transported by:
Name of Hauler: p 6.4d IN
Signature of Applicant: I Date: / �/ 2-�
tatt The Commonwealth of Massachusetts
,,,,_ Department of Industrial Accidents
1.
t =';, Office ofInvestigationsT , ,
ri
,.p— ri 600 Washington Street
II * enM rt
4�� �� Boston, MA 02111
`" www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information c Please Print Legibly
Name (Business/Organization/Individual): CG7 4")4 ft-EI C-' ✓
,, v _
Address: Lic hi/e-S.11 <v (kis/ r----se-n/.
cc_ti
oil /
City/State/Zip: �A-S�'L 1.Qaa # t 41 hone#: 11 3 —clf rJ etSb
Are you an employer? Check the appropriate bo Type of project(required):
1.❑ I am a employer with 4. am a general contractor and I T
employees (full and/or part-time).
have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling
ship and have no employees These sub-contractors have 8. Q Demolition
working for me in any capacity. employees and have workers' 9 Q Building addition
[No workers' comp.insurance comp.insurance. 10.❑ Electrical repairs or additions
required.] 5. Q We are a corporation and its
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs
insurance required.]t c. 152, §1(4),and we have no l 3.Q Other n /
employees. [No workers' f 1
comp. insurance required.] (I II
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees_ If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. _______--......-
Insurance i+
Company Name: 4 /- /if\ All ill-4/
Policy#or Self-ins.Lie.#:W 1 C 106 J 0 )416 .- d'0 a'2" c (t)Expiration Date: /0 o/? 3
Job Site Address: 7 We 3 St _City/State/Zip:A-Add AA Of d er
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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 fine
of up to$250.00 a day against the violator. Be advised that 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 perjuty that the information provided /above is true and correct
9 Signature: Date: /)// f' 2- �r
Phone#: ill ' t- cl 8 (f 6 / 111 `
Official 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):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
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Parcel ID 17A-173-001 n 1,-• � 1 a +� 1 t'•
Address 40 HOWES ST 'J •• }:� �a 1
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The information depicted on this map is for planning purposes only. tit' . 1
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interpretation,or parcel-level analyses. a
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