24D-250 (6) BP-2024-0831
88 CRESCENT ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-250-001 CITY OF NORTHAMPTON
Permit: Ails Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2024-0831 PERMISSION IS HEREBY GRANTED TO:
Project# KITCH/BATH RENO 2024 Contractor: License:
Est. Cost: 91500
Const.Class: Exp.Date:
Use Group: Owner: THEODORE PARADISE
Lot Size (sq.ft.)
Zoning: URC Applicant: THEODORE PARADISE
Applicant Address Phone: Insurance:
88 CRESCENT ST
NORTHAMPTON, MA 01060
ISSUED ON: 07/09/2024
TO PERFORM THE FOLLOWING WORK:
KITCHEN/BATH RENO
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: tr/P
Fees Paid: $594.60
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
a
�ECEI
D
_ The Commonwealth of Massac sett
Board of Building Regulations and tan rdsJ(/N
j Massachusetts State Building Cod 780 MR 2 8 R
2024 IPALITY
Building Permit Application To Construct,Rep' ,Reli olra iz olish a evis Mar 2011
One-or Two-Family Dwel to N2�THA f ,t.N pperi� S
This Section For Official Use Only "�0
Buildingpermit Number: 0'0 9.Dn3 f Date Applied:
rut ary5 ///2-2 7. q a'Zy
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 roperty Address: 1.2 Assessors Map&Parcel Numbers
1.1a Is this an accepted street?yes`x�- no Map Number Parcel Number
1.3 Zoning Information: i 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 Private❑ Zone: _ Outside Flood Zone? Municipal On site disposal system 0
Check if ye
SECTION 2: PROPERTY bWNERSHIP'
2.1 of Record: +5 Ob / iv•A_ criA 60
Name(Print) City,State,ZIP
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Buildings,, Owner-Occupied Repairs(s) Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg.❑ Number of Units t Other 0 Specify:
Brief D escriptiI ,oo'n o Proposed Work2:
ittefitite-J
t ST-
t♦1.QyJ bra tl-�le.ors A..� ' 0 N. 'Se_ rL /
Oa4dje.d Se-1.-4'^� p6V' 6,�- 5 � 'xc,4S
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ c� cpp 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ Z pt to 0 Standard City/Town Application Fee
0 Total Project Cost (Item 6)x multiplier x
3.Plumbing $ ifs,'° 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $Suppression) Total All F sl qttett°
Check No. 11 Check Amount: ,
6.Total Project Cost: $ t L 4 0 Paid in Full 0 Outstanding Balance Due:
+ACV.
*to teki c
ern r,
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP 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 Y`
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.
1/11/4.L6 doter Q 0441(42
Print Owner's or Authorized Agent's Name(Electronic Signature) ate
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 areas .ft.) (includinggarage,finished basement/attics decks or porch)
g g , P )
Gross living area(sq.ft. Habitable room count 14
Number of fireplaces Number of bedrooms 3
Number of bathrooms Number of half/baths 020
Type of heating system G T Number of decks/porches Z
Type of cooling system v,,,,.Z .. Enclosed 1, Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
►' Department of Industrial Accidents
1 Congress Street.Suite 100
Boston.MA 02114-2017
www mass.goWdia
11 inkers'('ompensation insurance ARdas it:Builders/ContractorsiElectriciansfPlumbers.
tO BE FILED WITH I11t•.PERNIITIINt;At lHORfl't.
Applicant Information Please Print Lettihl%
Name 413usinrs ,'Organtzatiorulndividual►:
Address:
CityiState/Zip: Phone #:__._.__.�__
Are you an employer?Check the appropriate boa;
Type of project(required):
l.Q I am a employer with.__............employees(full ant ur part•tirntl.• 7. ❑New construction
20 1 am a sole proprietor or padnenhip and have nu cnnpkrycrs working fur roe in g. 0 Remodeling
any capacity.No workers'comp.insurance qutr i J
30 I am a homeowner doing all work myself[No works's'conc.insurance required.]' (-�
9. El Demolition
10 Building addition
4.01 am a homeowner and will be hump tuattracxora to i.unduct all work on my property_ 1 w III
ensure that all contractors either lure workers'compensation uu.urancz or an stale 11.0 Electrical repairs or additions
proprietors w ith no`mplu a_ 12.0 Plumbing repairs or additions
30 I am a general contractor and Iaas c hired the sub-contractors heated on the attached died 130 Roof repairs
These sub-cuniracton lute and late workers'comp.ursuranec-•
6.0 We are a eorpttratton and its officers hoe eaen:tsed then nghi of exetnptam per MCA.e.
14.❑Other
I{'?4.1(41-and we his c no anpluyces.[Nu workers'comp.Insurance requircd.J
*Any applicant that eherks box eI must also fill out the sectirm below show tng then workers'compensation pricey infonnatrort.
t Itotncowners who submit this alltda%it indicating)they are doing all work and then hate outside contractors must suhnut a new ahfidat it mak-alms su.-l.
1Cunrr etors that check this boa must attached an additional sheet showing the name of the uttb-cemtr:u'tor and state whether or not those unities Its.:
ernpluycrs_ if the sub-cuniracuus Iuse c rlu.ees.they must pro..idk r, c .t ,rkeri comp.policy nurnber
i am an employer that Is providing workers'compensation insurance for my employees. Below is the policy and job site
injorntation.
Insurance Company Name:
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: CityeStaterZip:
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.S25A is a criminal violation punishable by a fine up to 51.500.00
and/or one-year imprisonment,as well as cis it penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a
day against the s iolator.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 darer rho irrJrrrauurrnit lomrirlrrl uhrn a i.true and correct.
Signature: 1)at
Phone#:
Official use only. Do not write in this area.to be completed by city or town official
City or Town: Permit/License P -
Issuing Authority (circle one):
1.Board of Health 2.Building Department 3.('ihtfown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
City of Northampton
o4. SAS f/r
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
\.+► rAg 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, 554, 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: \.111 , 04c
The debris will be transported by:
Name of Hauler: 05k
Signature of Applicant: Date: 6 0
City of Northampton
f� J' Massachusetts �a+S' <<
* :a
' y! 1St_
+( • DEPARTMENT OF BUILDING INSPECTIONS a,°
3'"{ 212 Main Street • Municipal Building Crk
Northampton, MA 01060C
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
-(4I, Pci el ire --)1( (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. 1 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. 1 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 t(o day of 'vim ,20 (
( attire)