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31B-231 (9)
BP-2023-1700 57 GOTHIC ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31B-231-001 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-2023-1700 PERMISSION IS HEREBY GRANTED TO: Project# BATH RENO 2023 Contractor: License: Est.Cost: 27000 ERIC PAYNE 086442 Const.Class: Exp.Date: 01/22/2025 Use Group: Owner: SAMUEL B.STEPHEN B. &JULIA C. WHITNEY Lot Size (sq.ft.) Zoning: CB Applicant: ERIC PAYNE Applicant Address Phone: Insurance: 32 BURTS PIT RD (413)218-4276 NORTHAMPTON, MA 01060 ISSUED ON: 12/06/2023 TO PERFORM THE FOLLOWING WORK: ADD SHOWER TO 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: ' ir I rI Fees Paid: $176.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner RECEIVED The Commonwealth of Massachuse s DEC ' 5 20?.3 FO ), Board of Building Regulations and Sta dar IC ALITY Massachusetts State Building Code, 78 C T OF GUIL DING INSPECTIONS US HAMPT A010 Building Permit Application To Construct, Repair,Renov�E NO WairO ISC ob _ d ar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: (I7. A 3-J? el?, Date Ap lied: 2-3 Building Official(Print Name) ( Signature Da SECTION 1: SITE INFORMATION 1.1 Property Address: , 1.2 Assessors Map&Parcel Numbers =a`l �ca-kAN . Z.. 1.1 a 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 system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' w�',tne,, -rho.M e�o�, N n t o 60 Nt e(Print) City,State,ZIP 57 041N; c S fi gog. 635-Z 5c\N1. ,rt o.1 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) ❑ Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': A ca c3 cs h e vi' i SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ Z) t,,. 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ K ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ ' K. 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ - Suppression) Total All Fees:$ Check No. 62. Check Amount( 1� Cash Amount: 6. Total Project Cost: $ 'Z 1 "'- 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) it TeS-1 License Number Eipiratioh Date Name of CSL I-lolder �Z 4.(\��: List CSI,Type(see below) No.and Street Type Description J �cA, ` �� U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,Z �� R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances �i 172 tg yZ.1 h et t6 v►.�e. Va,; •, I Insulation Telephone L.4 mail address D Demolition 5.2 Registered Home Improvement Contractor(HIC) t g bq 1 I" uf HIC Registration Number Expir ion 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 E f c ?6\`/ nRe. to act on my behalf,in all matters relative to work authorized by this building permit application. C. S o,t,N UJ k Pfint Owner's ame(Ele is 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. Print Owner's or Authorized Ageit's Name(Electronic Signature) e 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 «ww.mass.gov'oca Information on the Construction Supervisor License can be found at wwww.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"maybe substituted for"Total Project Cost" City of Northampton Massachusetts ��t5 4*., 41✓i{ it l' "4. ° t„tt DEPARTMENT OF BUILDING INSPECTIONS 1; ., 212 Main Street • Municipal Building 0 , It. Northampton, MA 01060 �#% ,.�41 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: l� ,\� ` l The debris will be transported by: (. Name of Hauler: k. N,/ Signature of Applicant: Date: I --- . . The Commonwealth of Massachusetts , _ Department of Industrial Accidents :, 10,... . A 1 Congress Street,Suite 100 Boston, MA 02114-2017 t ,; WNW.mass.gew`dia %linkers (°ompensation Insurance Affidavit: Ilitildersofontractorvtlectricitins•Plumbers. IA)111,Ell.../3)111111 Tlik. PERM i I I INC AlITHtilti 11 ADDlitnant Information Plcdsr Print 1.1.oililt vc Name(Business tkganizationlIndividual): Address: 3 2 \ 4 1 City/StateZip: tv. b,---ir i Phone #: Are;ilia so eireployert tiled'the appropriate boa: ' 1. pe of project(required): LEI I am a employer with , ,employers(full anti or purt-titrIC I* 7. 0 New construction .1311 I am a sole proprietor in partnership and have tio employees working tor ase 3r1 S. 0 Remodeling any capacity [No workers'comp.insuratiet nrcputed.) 9. E.] Demolition 3rj I am a homourvfnet Joint all*nth myself.[No*otters'comp insurance required r to 0 Building addition 4.0 I am a homeowner*rid will be hiring oontraciors to conduct all WiAiL on my property. lain CILIUM that all imam-tun either have workets'compertsrmon trEsurrirtee or Are soie 11.0 Electrical repairs or additions proprietor,sh ids no employees I 2.0 Plumbing repairs or additions kCil I am a general contractor and 1 have hired the sub-contractors listed on the attached sheet th I 31:1 Root repairs These sub-contractors Fait employees and have%oers'von".froaffarice); o.D 0 Other Yoe art a LorporArun And tts officers have exercised Mere right of exemption per Mt&4:-. 14. 152, 1141:and we have Ito emplorets,[No workers'comp,nominee requived.1 *An)applicant that checks boa 41 must also fill out die motion below showing then%otters'vompensistion pAtcy trliortrutuvri *Homeowners vvho subetut data affidavit theating they are doing all work and then hive outside eontractots must submit a new affidai it indicating such. ;42vratteetiirs that cheek this boa must atto:licd an additional sheet show ing the name of the sub-contractors and oat,:whether an nut thust entities have a loyces It the sub-rooters:tors has,:at. 'key crs.they nutsi rroside their workers'comp policy nurniser I am an employer that is providing workers'compensation insurance for my employees. Below A the policy and job site information. Insurance Company Name: Policy a or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the polity number and expiration date). Failure to secure coverage as required under MOE c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 525(1.00 a day against the violator.A copy of this statement may be forwarded to the OtTice of Investigations of the DR for insurance ,is‘erage t,erification. ,... ... /do hereby certify under the pains and penalties of perjury that the information provided above IA true anti correet. . .. ,--- Stundturc. ' '\ • Date: rt..-y 41 ......,. Phonc l' .. Official use only. Do not write in this area, to he completed by city or town official t'ity or Town: Permit/License a Issuing Authority(circle one): I Hoard of Health 2. Building Department 3.CitylTown Clerk 4.Electrical Inspector 5. Plumbing Inspector (s.Other Contact Person: Phone 4: x F u x f • • • On Dec 5, 2023, at 9:31 AM, Kim Carson <kcarson@northamptonma.gov>wrote: [Quoted text hidden] Eric Payne <elpayne@comcast.net> Tue, Dec 5, 2023 at 12:57 PM To: Kim Carson <kcarson©northamptonma.gov> Hi Kim Let me know if this is good enough for you. If not, I can make something more professional when I get home. There are no windows. Thanks! On Dec 5, 2023, at 9:31 AM, Kim Carson <kcarson@northamptonma.gov>wrote: [Quoted text hidden] citY of it ) ' y' Northampton Kim Carson <kcarson@northamptonma.gov> 57 GOTHIC ST APPLICATION • 3 messages Kim Carson <kcarson@northamptonma.gov> Tue, Dec 5, 2023 at 9:31 AM To: ELPAYNE@comcast.net I forgot to ask...is the floor plan changing at all? If so please email me over one. And is there a window in the bathroom that may need to be tempered? Kim Carson Northampton Building Department 212 Main St 413-587-1240 Eric Payne <elpayne@comcast.net> Tue, Dec 5, 2023 at 12:55 PM To: Kim Carson <kcarson@northamptonma.gov>