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34-008 (10) BP-2023-0132 164 TURKEY HILL RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 34-008-001 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-2023-0132 PERMISSION IS HEREBY GRANTED TO: Project# 2ND FLOOR RENO 2023 Contractor: License: Est. Cost: 40000 RICHARD LABOMBARD 055340 Const.Class: Exp.Date: 10/20/2024 Use Group: Owner: JR MAI JOSEPH A Lot Size (sq.ft.) Zoning: RR Applicant: RICHARD LABOMBARD GENERAL CARPENTRY Applicant Address Phone: Insurance: 102 CLARK ST (413)537-6139 SOLE PROPRIETOR EASTHAMPTON, MA 01027 ISSUED ON: 02/06/2023 TO PERFORM THE FOLLOWING WORK: DEMO 2ND FLOOR AND RECONFIGURE SPACE TO INCLUDE 3 EDROOMS AND 1/2 BATH 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: $260.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner 4111 The Commonwealth of Massachusetts I 'r Board of Building Regulations and Standards FCR I Massachusetts State Building Code, 780 CMR MUl`IICL'ALITY USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 wOne-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: a--) 3.2 Date Applied: 4/1/.-.) 420,5 2. 6 ZOZ3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro e Address: 1.2 Assessors Map& Parcel Numbers r �,E-Fy�i�� �� Leo. 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal syst@m ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: \JDs - P4 q /vim \l4— -FLo I NG / M o/06 Z Name(Print) City,State,ZIP ! , r✓ ti1 HI wP-4>_ fi3-s38-gl?� No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 I Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: &""v 1 jr-Lode f Odm S. /Z6' C8IVP/o�d t'$ riTd7 ) E'57>M 4/3- 3 4 EEd m 5. Ave Go.•f MEcEss .ey cELG A't ivSdL 1eNTfict S' der. .yi�8U. CtN� M i7 $1. /E ' 6 .10`ls( , ' i ,� SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 3 a p e o . 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ OW. 00 0 Standard City/Town Application Fee 0 Total Project Cost'(Item 6)x multiplier A000 x 3.Plumbing $ Q"d d, d d 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fees: 24 D a, Cost: $ d Check No.410 Check Amount: 240, 6.Total Project U! �� 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor Lic se( L) QS-s3 YD /a/0 tt l(, i Zedo,14 / License Number Expiration Date Naive of CSL Holder /Q C 6 pL 57. T List CSL Type(see below) ii No.and Street !�/n�l Type Description C9157) Q7 i / , ©0 ^t U Unrestricted(Buildings up to 35,000 Cu.ft.) F,/"// !�/v �7 d / R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonr y RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 0'937•4(..39 g/Z.Dgw7LG / I Insulation Telephone Email address D, Demolition / 5.2 Regist r,d Home Improveeme Contr etor( C) /Q crd A 6 f e ,0 ,r Z 6of r- HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name ^-�/`�?`!/we���/C.GB� No.and Street (�y 7/(/Emaiail 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 . f� No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES,,,,��/ FOR BUILDING PERMITI,as Owner subject property,hereby authorize /f t c l 4b Lq 64NT IQ'7 to act on my alf,in all matters relative to work authorized by this building permit application. / ;1333 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my below,I hereby attest under the pains and penalties of perjury that all of the information contained in thi401 •lication is true and accurate to the best of my knowledge and understanding. a./.3 Print Owner's or •uthorized Agent's Name(Electronic Signature) Date NOTES: I 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 Hound at www.mass.eov./oca Information on the Construction Supervisor License can be found:at www.mass.Qov./dps 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) (including garage,finished basement/attics,decks or poach) 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" . I •1111111111111111111111111111111116 The Commonwealth of Massachusetts =1„...,:.—...- Department of Industrial Accidents —'-......., , \s: 1 Congress Street,Suite 100 „ Boston,MA 02114-2017 www.mass.govidia . . M'or ken'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. ill RE FILED V1 ITH IIIE PERMITTING At THORIT4'. Applicant Information - Please Print I.etili I Name i Husniess,Ch-ga nira two,Inds dual : //CM/CP I , Le-A4/44.‘i 4772 Address: /a 2. 6 uM ir- 97-.- City'StateiZip: ,7//f)., /l'i 0/41)2Phone ::: W3—5-37-6479" 1 • Arevisa an temple:grit.?('berk the appropriate but: Ty pt of project(required): LC]lam a employer*ith employees t tail:miter par i_.i' '. 71 New COEIStrl1070t1 .2.1Zrarn a 4ok proprietor or ixtrtnership and have no employees'sulk:v.. for me in S. . "z.erriotieling any capacity.[No workers'coitip insurance reportill 9. 0 Demolition 30 I on a homeowner doing all work myself[No winters'comp,ireoirani.e rouurred,] i 0 Ei Building addition 4.E3 I am a 114111124V VG,ner and will be home soiuractorA to L-unduct all work on my propiaty. I will ensure that all ceranwturs either have winters'i.vottrensation insuranoe or are sole itC] Electrical repairs or additions proprietors with no einployees. 12.0 Plumbing repairs or additions 5.C3 I am a ionierat ntractor and I have hired the anh-contractors listed on the attached sheet. l 30 it434)1 These sub-contractors Issee employee'and have winters:eurnp.insurance.; repairs 14.00ther IS.C1 We are a corporation and its officers lecke exercised their night of exemption per SIGL e. !...2.§114t,and N 1.:1124V MO irritiployees.' [No workias•comp.Insurance required.' . An.applis-sm dud checks but.i most also fill out the f101:1414111 bduw slams my then wiliterl _,,,r7n,:a IOU policy informatUnt. Homeowners who submit this atlidasit indicating they are doing all.aiori:and then hire ituitale,:onini. r.:r,must submit a new affid4.a indicating such. 4..um f a lnli that check this box must attached an.addinorral sheet N how Inn the mune of the*ub--etwitractur8 and state Yr lumber or not those< /1.11.1C1.11.3't C OtIrlk1:71,....',.. lithe...4.4hi-euniraeli.et.itio=e eliirio:...szs.iii,..1,1M1,1 rt1.1,1.1:chen, ,...,,t-Leri'..--,trir.pie:,number 1 am an employer that is providing workers•compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: _ Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: CityiState2ip: Attach a copy of the workers compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under NIGL C. 152,*25A is a criminal violation punishable by a tine up to$l,500.00 andior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to'41'i0.4:00 a day against the violator.A copy of this statement may be forwarded to the Office of Ins.esti,!ations of the DIA for insurance coverage ventleation . . i I do hereby cer ,•a der he pains 1 d petallies perjury that the information prortded a tre true and correct. Signature: A' 9 Date: e- 3 ? i- - Phone#: W3 5 7,7 —--0'751 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): I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone 4: City of Northampton Massachusetts ? DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building yir Northampton, MA 01060 1st 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: V /Gk/ gE6 Z//V6 The debris will be transported by: Name of Hauler: sid'er f �UL Signature of Applicant: Date: 3 13 City of Northampton r ,i.na,i.r� `` Massachusetts; 'iC.,frf '', tt i DEPARTMENT OF BUILDING INSPECTIONS "" 4', ' 212 Main Street • Municipal Building rya, ,?�` ..-.4 pg..* Northampton, MA 01060 4 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born— (insert 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 the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a roject 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 ho eowners' exemption, does not involve the field erection of manufactured buildings constructed in accord nce with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 11 0.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, do 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 l 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 • work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or ork. Signed under the pains and penalties of perjury on this day of , 20 . (Signature) / y r,e,cfy ,i/LI, . y y (o ,J 7 If(t/ SECOND FLOOR PLAN SECOND FLOOR PLAN 10rNM MIL / A a BEDROOM 0 X.—I -XLAV CM DEWY ON I 1 YI, 'DOOR` �` C/ MASTER BEDROOM OF ICE/OMOUT aaw — IOU 1110/LP SECTION SECTION AldlAlbl\'A Allh.. A EAT., ihti, 11°"011011 0 EXISTING JOE MAI'S HOUSE FLOOR 11170117.14LL ROA0 AORMAMPTON VA PLANS • • © -'-- -- Mu:fll.,'< --E 000,7 /0IAfl7MPMONT, Aw.Ar ON,-�, Ewrw. rt 'elacarl.xo0�ru*roe+o�