31B-030 (8) BP-2024-0481
43 SUMMER ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31B-030-001 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-2024-0481 PERMISSION IS HEREBY GRANTED TO:
Project# ROOF 2024 Contractor: License:
Est. Cost: 20000 NU-WAY HOMES INC 013693
Const.Class: Exp.Date: 07/20/2025
Use Group: Owner: INC NU-WAY HOMES,
Lot Size (sq.ft.)
Zoning: URC Applicant: NU-WAY HOMES INC
Applicant Address Phone: Insurance:
10 WHITE AVE (413)563-0085
EAST LONGMEADOW, MA 01028
ISSUED ON: 04/19/2024
TO PERFORM THE FOL L O WING WORK:
STRIP AND REROOF
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: 1/1/2.
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Buildine Commissioner
______._ .... _ ;;TT___,_
IP
The Commonwealth of Massachuse s APR 1 9 2024
AEI, ) Board of Building Regulations and St ards t FOR
Massachusetts State Building Code, 780 CM MUIyYCIPALITY
."�Y DEPT.OF BUILDING INS ECTIONgJSE
Building Permit Application To Construct,Repair,Ren vate OPDitiMI "^°o Mar2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: P . '/. yg/ Date Applied:
ean ki 4 //12._ Log_ZD2
Building Official(Print;ame) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
5/3 t L 7•►M 1 ��
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'
2.1 Owner' Record:
-.Wit
: G0-7 --- _A Moi- 0 I DVS-
Name
(Print) City,State,
le toin,R./4 v4 N(9363_6015— ivow/q,1—"icAp.p.e.SCov e
No.and Street Telephone (mail Address 6.ors A,y.0017
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 2(..Alteration(s) 0 Addition 0
Demolition ❑ Accessory Bldg. 0 Number of Units Other�❑ Specify:
Brief Description of Proposed Work': R ,) ,a Zgs,,?a ! Oa>C f- /3roc .ti ta.w-
I",144)0,1 4 A s Pluat- 51,Arlea_•
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $�(5) alci--- 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fee
Check No.(11 V�heck Amount: "(-0 Cash Amount:
6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due:
T.
City of Northampton
•'" Massachusetts 'r
d .�DEPARTMENT OF BUILDING INSPECTIONS T.
212 Main Street • Municipal Building ;;5; -��'
Northampton, MA 01060 '51- -)ti1:''
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES,
FENCES, GROUND MOUNTED SOLAR, ETC.
I. Building Permit Application signed by legal owner and filled out by owner or authorized agent.
2. One set of plans and specifications of proposed work. (Digital and hard copy)
3. Site plan with location of proposed structure(s) and set backs.
4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance.
7. Energy Conservation Compliance Certificate (new/ replacement windows).
8. Home Owner's License Exemption Form filled out and signed by Homeowner (if applicable).
9. Note any Conservation and/or special permit requirements (if applicable). 10.
Driveway Permit (if applicable).
11. Proof of Water and Sewer entry fees paid (if applicable).
12. Trench Permit- public land by DPW/ private land by Building Dept.
13. Stretch Energy Code -all new construction will require a HERS Rater Affidavit to be submitted with permit
application before issuance of permit.
14. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton.
J
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 5-0/ 3/ (�.3 ��I,
License Number la 7 Exp. atio ate �/
Name of CSL Holder
List CSL Type(see below) U
No.and Street ` ( Type Description
/•I 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 Expiration 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 0 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 information
contained in this application is true and accurate to the best of my knowledge and understanding.
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
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
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
r
City of Northampton
`s "" sty
Massachusetts 'e.
"i *M t
DEPARTMENT OF BUILDING INSPECTIONS '
212 Main Street • Municipal Building ,.
Northampton, MA 01060 }t=py 10
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: U S / PJ-//
The debris will be transported by:
Name of Hauler:
Signature of Applicant: �'`7 Date: V447/A0-2
' ... \ The Commonwealth of Massachusetts
Department of Industrial Accidents
4 -
1 Congress Street,Suite 100
Boston, MA 02114-2017
-.....:.-,. w!vw.mass.goi,Vdia
-- 1Vorhers'Compensation Insurance A ffida%it:Builders/Cont ractorsfElectriciansiPlumbers.
TO BE 1.11.11)S' I tit I lit,„PERMIITINt;A t itiORIIV.
Amilicant Information Please Print Leeihlv
Name 4 Busints,,,,(>r,..1:inu.ation Individual t. tt)(-)
Address: /0 174 LA( ,
CityiStateiZip..-1;:::• &Pio/14,644-v-4-- $44 Phone#: Ccii,3 j -5Z —0-0,P,5
Are pati slat Mpg*,st?titre I.the a No ul trim,hi,t.. Ty pc uf project(required)
1,[31 gun a employ a Atilt ,_„,,„, „,,,,_ employees 1 full=dal pan-Lima* 7. D New construction
2..n I am a sole proprietor or ixinnerstup and have nr.)employee working tor me.in 8. CI Remodeling
any capacity., Nu workers'camp.mat/ranee nAtilman
9. 0 Demolition
1 am a hornomturet doing all Work myself.[No workers°tun v insurance rey tut,..n:I
10 C:1 Building addition
40 I AM a homeowner and will be hams contractors tu conduct all work on tny property. 1 w ill
mute that all contractors either haw worker,'compensatton insurana.or are sole ii.0 Electrical repair's or addition,
Mupne WTI a ith no employee,
i 2.0 Plumbing repairs or additions
30 I am a snmeral contractor and 1 Ism,e hired the aub-contractors hated on the attached sheet
I . oo repairs
Them:,kik.--tuntracturs ployee-a and kin e workers'emnp.imam:we;
h. k:" an:a l-orporab a n and its offteera have exat their?
1 nght of exernpinXII prr MGL 4.2c‹...**-
51,§1 i 41,and w o e have n employees.[No workers'comp.inturance required.' 4,0 Oth
1er .....__
i
-1,1,L.mi that dials but tt1 mot Mau till out the teetion belu 0.tituv.In..;thn muticrt'compmation pk,1 ie....,inforrattnat
' t knueoo.nen who submit this affidamt intheannu,they are doing all,,,ink and then hue noble emu-Jewel mutt tabnut a new at f:d.m,16 walscalmg,,t.. h
lContnictors that check this box muss art bed an alitiminai slwihn how in the name of the sub-eoutractors and,tare u.'holier or not those came-shawl
If the tult-euturaetms lute clorlo:.,:e,they mutt pro%ale their lo.t Uticr;vmnp.pulm'y number.
_________ _
1 am or:employer that is proeiditte tworAers'compensation insurance for my employees. Below i9 the policy and job site
information.
Insurance Company Name.
Policy#tar Self-ins.Lie.4: Expiration Dale:
Job Site Address: CityStateiZip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00
and one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a line of up to 5250.00 a
day against the violator..A copy of this statement may be forwarded to the Office of Investigationsof the DIA for insurance
coy eruge vc ri tication.
1 eh,larch cer 4, •o toter the pains pcnaltieN . perjury haul the information provided above is true and correct
C--4-
Sigp.1; .. Illif /•- Date: Y7/7/Xel n v
)
Official use only. Do nut write in this area.to be completed by city or town official
(it) or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
(,.Other
('on I Act Person: Phone#:
f
City of Northampton
944
��,4:cry ep. vv. s
_� Massachusetts Ka�� '
•
DEPARTMENT OF BUILDING INSPECTIONS ,,
1.
,‘ ,r'" 212 Main Street • Municipal Building �';.`
:" Northampton, MA 01060 S j4 CIVv:'
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 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 homeowners'exemption,
does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.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 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 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 or work on my
parcel, I acknowledge that I am required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this day of ,20_.
(Signature)