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32C-357 (2) BP-2024-0460 34 HENRY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-357-001 CITY OF NORTHAMPTON Permit: New Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2024-0460 PERMISSION IS HEREBY GRANTED TO: Project# NEW HOUSE Contractor: License: Est. Cost: 650000 TIMOTHY STOKES CS083602 Const.Class: Exp.Date: 02/06/2025 Use Group: Owner: BROWN, NORA A. & ALRENGA, PETER O. Lot Size (sq.ft.) Zoning: Applicant: TIMOTHY STOKES Applicant Address Phone: Insurance: 20 TURKEY HILL RD (413)695-2264 SOLE PROPRIETOR WESTHAMPTON, MA 01027 ISSUED ON: 07/08/2024 TO PERFORM THE FOLLOWING WORK: NEW SINGLE FAMILY HOUSE 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: 6/2. Fees Paid: $1,034.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner cr1l!t_ - ZG D rioe;_ 1 N r-o — <,tau-r--t ;,c 5- w 5 Amu. Coe Cu.? The Commonwealth of Massachuseis % APR 18 2 Board of Building Regulations and Sta idards _ �24 FOR Massachusetts State BuildingCode, 780`CMR�r Qr.fU�.`� MUNICIPALITY JHrya Cb�,1,r Vc. USE Building Permit Application To Construct,Repair,Renovate Or Demolish a,„, R ised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: h"A A el" V(e Date Applied: eEt) 72)s 7 8-zt z Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 34 Henry Street 32c 357-001 1.1a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information• 1.4 Property Dimensions: URC Residential 6240 s1 52.1 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 10' 40' Left-10' Left-10' Right=0' Right=2'•6" 20' 20' 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public El Private 0 Zone: Outside Flood Zone? — Municipal I81 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Nora Brown,Peter Alrenga Northampton, MA 01060 Name(Print) City,State,ZIP 34 Henry Street 618-207-8197 nabrown78@gmail.com No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction ® 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: Construction of new, single-family dwelling per attached plans SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 560,000 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ 38,000 ❑ Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ 26,000 2. Other Fees: $ 4.Mechanical (HVAC) $ 26,000 List: 5.Mechanical (Fire $ Suppression) Total All iesl• ✓ n� $650,000 Check Noll ►deck Amount: r Cash Amount: 6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 083602 2/6/2025 Timothy Stokes License Number Expiration Date Name of CSL Holder 20 Turkey Hill Road List CSL Type(see below) U No.and Street Type Description Westhampton, MA 01027 U 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 413-695-2264 stokesbuilders@gmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 175925 4/3/2026 Timothy Stokes HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 20 Turkey Hill Road stokesbuilders@gmail.com No.and Street Email address Westhampton, MA 01027 413-695-2264 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 . E 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 Timothy Stokes to act on my behalf,in • 1 matters relative to work authorized by this building permit application. Nora Brown 4/5/2024 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. Timothy Stokes 4/3/2024 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.) 1700 (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) 1700 Habitable room count 6 Number of fireplaces 0 Number of bedrooms 3 Number of bathrooms 2-1/2 Number of half/baths 1 Type of heating system Forced air, heat pump Number of decks/porches 3 Type of cooling system Forced air, heat pump Enclosed 2 Open 1 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 City of Northampton Massachusetts :t DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 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: The debris will be transported by: Name of Hauler: Amherst Trucking Signature of Applicant: Date: 4/3/2024 ' \ The Commonwealth of Massachusetts =or— Department of Industrial Accidents MONO 41111/11111. : . 1 Congress Street,Suite 100 16:' '= Boston,MA 02114-2017 4% wow:mtrs's:govidia %%oskers'Compensation Insurance Affidavit:Bnilders&ContractorsfElectriciansiPlumber . CO BE E'1LEU Willi THE PERM l-i'l't\C Al l'tlO1UTY, Annlicant Information Please Print Let ibis Name 1nusinest�` )r ntzatiovIndrvidual): Address: • City/State/Zip: Phone#: Are you tea employer?Cheek the appropriate has: Type of project(required): l.Q I am a employer with uyeex!full anab'ur part-time).* ?_ 0 New construction 20 I am a sole proprietor or pwtnrtship and have no rnrpkr'yeert working for me in 8. a Remodeling any capacity_[No worked'comp.utsumance required.' 30 lam a hua►orswisr cluing all work myself.[No wxtrkras u cony.u wonne required.) 9. 0 Demolition 4.0 I am a hitmoowiles and will be biting contractors to conduct all work on in poverty_ I will 1©0 Building addition imsure that all cxraaradiurs either bs a wxsrlacn'crrtnpenaiation insurance or arc sole 11.0 Electrical repairs or additions proprietors Re ell au rrbplayo ate. 12.0 Plumbing repairs or additions 50 I ant a►gcmm al connecter and I have hired the sub-contractors listed an the attached sheet. 13 Q RCKDI'rst{rSirs These sub-contractors have employees and have workers'comp.uaxumncc.• _ b.®we ate a corporation and►r offic ers have exenised then nght of-exemplum per MCI c_ 14. OtI er 152.§It A).and we have no employees.[Nu workers'camp.insurance required.' "Any applicant that checks box a 1 must also tilt out the section below show ing their u takers'compensation policy information +Homeowners who submit this at1'xlaeit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating stact fCuntracioe that cheek this box must attached an additional sheet shvwtng the name of the subcontractors and state whether or not those entities have rrnplovec-s lithe sub-euntractors laxew ernpluyise.they must prow ide their .e takers'ctam�a.policy number. l 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: City'StJte Zip: 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 e:. 152, §25A is a criminal violation punishable by a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 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. 1 do hereby certify ant the pains and penalties of perjury that the information provided above is true and correct. Si tune: Date: 413I2026 Phone . 413-695-2264 Official use only. Do not'a rite in this area,to be completed by city or town official C'its or Town: Permit/License'4 Issuing Authority(circle one): !. Board of Health 2. Building Department 3.C'illy/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector fi.Other contact Person: Phone#: City of Northampton Massachusetts ; DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building 9J r�s Northampton, MA 01060 i44 �;�0 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT (insert full legal name), borfr312917(gisert month, day, year),hereby depose and state the following: 1. 1 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. Sided under the pains and penalties of perjury on this 5th day of April , 20 24 (Signature)