12C-029 (3) I
BP4-2023-0711
296 NORTH MAPLE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
12C-029-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0711 PERMISSION IS HEREBY GRANTED TO:
Project# WINDOW/BATH RENO Contractor: License:
Est. Cost: 5700 BRANDT GOULD 118232
Const.Class: Exp.Date: 10/09/20,6
Use Group: Owner: FR• LAURIE A
Lot Size (sq.ft.)
Zoning: RI/WSP Applicant: BR i1T GOULD
Applicant Address Phone: Insurance:
34 CANTON AVE SOLE PROPRIETOR
AMHERST,MA 01002
ISSUED ON: 06/05/2023
TO PERFORM THE FOLLOWING WORK:
REPLACE PICTURE WINDOW, BATH RENO ON 1ST FLOOR
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: I i i
4 • f • )2 . 9- ,
r ,
Fees Paid: S65.00
212 Main Street,Phone(413)587-1240,Fa : (413)587-1272
Office of the Building Commis oner
Iftr
IRECEIVED cAJ hc si t—Pad-Y
• <%. JUN - 1 2023 ' Tl a Commonwealth of Massachusetts
I *tv
Board of Building Regulations and StandardsMUNIP R
Massachusetts State Building Code, 780 CMR E
.OF B Dt WStl CTIONS SE
��ORTHnl mar Application To Construct,Repair,Renovate Or Demolish a Revise Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
BuildingPermit Number: Date Applied:
Liu I,...) (Z.,
.// t-5-20Z.-
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Propert Address: 1.2 Assessors Map&Parcel Numbers
2-lei 1•kOOtt MAi Sit • , �w c�,v ce. r 2 O?ft- Co I
1.la Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
241 2.ee sqr-r I2-I
Zoning District Proposed Use Lot Area(sq II) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard '
Required Provided Required Provided Required Provided
911 2$ ' 101 '
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❑ On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
l-Au 2'( AAA 1< c- 1i-otar.NC G Ma G:A06 2
Name(Print) City,State,ZIP
2 lto ta0.m 011p.LS C-,:"\- 6o --755- `t6H5 1.,Atrttt:Fas..4k1-a16 i
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) 6' Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work': f-2 -j>1.--*ems Prc r 0lea 6✓,o o o w Ors I'51 rich A N
Pergov 4-re 7 4-r«+ a rl I 11 'Cl oak/ 12 p o olCc. w rrt 6.6 w Iv CA--►N Too
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 31P„6) 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
1,5r0 0 Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ / z dL 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire (V
Suppression) Total All Fees: $
Check No. Check Amount:
6. Total Project Cost: $ rj t)00• C c 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CA'' l 1 gal,2 to/9/7o26
1 S-( 65 0 v v License Number Expiration Date
Name of CSL Holder
��`1� List CSL Type(see below) "7
( z-0^l AO
No.and Street Type Description
'AA„ 1� ✓ U Unrestricted(Buildings up to 35,900 Cu.ft.)
444%04- R Restricted 14%2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofmg Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
S'325� i210 .1 etCCo(PANa - n Cows I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
-t��avD.-r G o �� 208�b �t/ /2oV5
I IIC Registration Number Expiration Date
HIC Company Name or HIC Registrant C.ArertY4 Atllt v1,va�+�cCL-�p.�A(ZC�w+A-�- chow.
No.and Stnett Email address
O-(00 Z 508-'91s-3Z1-o
ity/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 61 v v a>
to act of my behalf,in all matters relative to work authorized by this building permit application.
G ( i Loy
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 application is true and accurate to the best of my knowledge and understanding.
` �o a't / ,1_)2;72
Print wner's or Authorized Agent's Name(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/dvs
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
/ `, Massachusetts ��?S 3►_ �'c
N;
`d E ;h�' DEPARTMENT OF BUILDING INSPECTIONS y:.
t�.., 212 Main Street • Municipal Building vim.. Pa
t'° Northampton, MA 01060 'rsN�,, ,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: ——cc, us-eA—ran► 216, (4. M,P�
The debris will be transported by:
Name-of Hauler: Am+izeS-r 1r� "41
Signature of Applicant: Date: 5I3(5723
The Commonwealth of Massachusetts
t` = ;AN Department of Industrial Accidents
l'':R1111'= . 1 Congress Street. Suite 100
;fi'
1/4Boston,MA 02114-201'
,, www.ntass.gor/dia
11 Ili kers' Compensation Insurance \Hides it:Buik rr iContraeturstEiectricians/Plumbrrs.
10 Bt. I11_t:0%%I E11 1 Ht: PERMUTING At TH()RITY.
Applicant Information Please Print Leeibl4
Name (Business 0rganvattun Individual): rst);:s.''c 6---i DJ�T> '
Address: 474-\ l.rtoA ,kJt
City/State/Zip:,AAvk v.-4''. W'A1 Q %Dos Phone#: Cqo$— Z — ' iZ a
Are yea an employer?Cheek the appropriate b oi:
Type of project(required):
1.01 am a employes with_ _ ___employees(full and or part-Breese)_' 7. CI New construction
2.01 am a sok proprietor or putncrship and have nu employees working forme in 8. remodeling
any capacaty.[No workers'comp.insurance required.]
301 am a homeowner doing all work myself.[No workers'con,.insurance requited.]' 9. Demolition
4.01 am a homeowner and will be hiring contrwttorato meiduct all work on my property. I will
10 O Building addition
ensure that all contractors either have workers'compensation ansunuicx or are sole i 10 Electrical repairs or additions
proprietors V.nth no employees- 12.0 Plumbing repairs or additions
5C3 I am a general contractor and I have hued the nub-contractors listed on the mailed sheet. 130 Roof repairs
ra TIseae sub-contractors have employees and base workers'camp.insunce.• P
6.0 we are a corporation and its officers have exercised their nght of exemption per MA:iL c 14. Other
or
152,¢1)4),and we have nu cmpluyees.[No workers'comp.insurance required.]
•Any applicant that chocks box u l must also fill out the section below showing their workers'compensation policy information.
t Homeowners who stthrnit this affidavit indicating they weaning all work and then hire outside contractors mint submit a new affidav it iaadiriating suck
k'untractors 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 has-c enrgaluyees.they must prat ide their workers'camp.policy number.
I 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.Lic.#: Expiration Date:
Job Site Address: CityiState,'Zip:
Attach a copy of the workers'compensation polka declaration page(chewing the policy number and eipi Lion date).
v
Failure to secure coverage as required under MGL c. 152,§25A is a criminal olation punishable by a fine up t4S 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 S250.00 a
day against the violator.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.
stun: Date. / 3c 12 2,
Phone#: 5,D�, �ZS- "j 2 o
Ofcial use only. Do not write in this area. to be completed by city or town official
('its or Town: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2. Building Department 3.City,rI'own Clerk 4.Electrical Inspector S. Plumbing Inspector
P
i 6.Other
Contact Perwn: Phone#:
t'
aifyof
fi Fad Kevin Ross <kross@northamptonma.gov>
Fwd: U FACTOR
1 message
Kim Carson <kcarson@northamptonma.gov> Thu, Jun 1, 2023 at 2:02 PM
To: Kevin Ross <kross@northamptonma.gov>
This is for 296 North Maple St permit in your box
Kim Carson
Northampton Building Department
212 Main St
413-587-1240
Forwarded message
From: Brandt Gould <brandtcgould@gmail.com>
Date: Thu, Jun 1, 2023 at 2:01 PM
Subject: Re: U FACTOR
To: Kim Carson <kcarson@northamptonma.gov>
Hi Kim,
Please excuse the delay, been driving in circles!
The U-factor for the Frankl permit at 296 N. Maple St in Florence are:
Bath window- .27
Picture window- .28
They are both Paradigm windows. Please let me know if there is anything else I can or need to do.
Thank you!
Brandt Gould
(508)325-3270
Sent from my iPhone
On Jun 1, 2023, at 10:34 AM, Kim Carson <kcarson@northamptopma.gov>wrote:
Hi, Please email us the U Factor on the windows.
Thanks,
Kim Carson
Northampton Building Department
212 Main St
413-587-1240