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30A-042
BP-2024-1149 13 LEXINGTON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30A-042-001 CITY OF NORTHAMPTON Permit: Demo PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2024-1 149 PERMISSION IS HEREBY GRANTED TO: Project# demo 2024 Contractor: License: Est.Cost: 8500 Const.Class: Exp.Date: PARKER, JEFFERY MOYCE ELIZABETH MARY Use Group: Owner: GRAY Lot Size(sq.ft.) PARKER, JEFFERY MOYCE ELIZABETH MARY Zoning: URB Applicant: GRAY Aaalicant Address Phone: Insurance: 13 LEXINGTON AVE FLORENCE, MA 01062 ISSUED ON: 09/05/2024 TO PERFORM THE FOLLOWING WORK: DEMO BACK HALF OF HOUSE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Sere ice: Meter: Footings: Rough: Rou,< h: 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: 772_. Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner R E C el f------_. ---. Please Email Permit. ) -7 '% SEP _ 7 sa Commonwealth of Massachusetts _, k 5 �024 : rd f Building Regulations and Standards FOR j'"�� as husetts State Building Code, 780 CMR MUNICIPALITY USE NoprkA Q1fli+ng•' ��sApp ication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 = f a°7 oso One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: (J/91,04*"//q 9 Date Applied: Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 13 Lexington Ave. 30A 42 1.1a Is this an accepted street?yes ✓ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: URB Residential-No Change 11,456 70.07 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 10 15 15 20 —35 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public lit Private❑ Zone: _ Outside Flood Zone? Municipal tlifOn site disposal system Cl Check if yes SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Jeffrey Moyce Parker/Elizabeth Mary Gray Massachusetts, 01062 Name(Print) City,State,ZIP 13 Lexington Ave (603)-721-1261 jeffreyparker25©gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK"(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition i7 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': Demolition of the back half of the house.Remove exhisting basement and excavate for new foundation. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs. Official Use Only (Labor and Materials) 1. Building $ 8500 1. Building Permit Fee: $ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire Suppression) $ Total All Fees`$ t r� Check No. Check Amount: 11° Cash Amount: 6.Total Project Cost: $ 8500 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSI,Holder List CSL Type(see below) No.and Street Type Description LI Unrestricted(Buildings up to 35,000 cu. ft.) City/Town,/Town,State,ZIP R Restricted l&2 Family Dwelling hM Masonry RC Rooting 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. Pnnt 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. Jeffrey M Parker 9/4/2024 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.) (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 /etH�• M � Massachusettsd I. DEPARTMENT OF BUILDING INSPECTIONS w I " 212 Main Street • Municipal Building s a 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: 6 W State St, Granby, MA 01033/40 Perry Hill Rd, Westhampton, MA 01027 The debris will be transported by: Name of Hauler: 413Dumpster/ Marion Excavating Co., Inc. Signature of Applicant: 1e,47..-N/°S A- Date: 9/4/2024 City of Northampton Massachusetts �4?: .. ..'e i•elk � DEPART NT OS BUILDING INSPECTIONS SI a, j„212 Main Street • Municipal BuildingyS. a, ... P ti P r ' ' �''y Northampton, MA 01060 �SY'-'.. ,:•0 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, Jeffrey M Parker (insert full legal name), born 181 (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 thisAlb_day of September , 2024— •, . ' ?yl GOit. (Sim' //� / The Commonwealth of Massachusetts Department of Industrial Accidents = rl� 1 Congress Street,Suite 100 4' Boston, MA 02114-2017 _,.mop www.mass.gov/dia U orkers'Compensation Insurance Amdavit:Builders./Contractors/Electricians/Plumbers. "r0 HE:FILED WITH THE PERM1rrlN( At THORI"i"1'. Applicant Information Please Print Legibly. Name iBusincss-Organtzatton7ndiv"iduall: Jeffrey M Parker Address: 13 Lexington Ave City/State/Zip: Florence MA 01062 Phone #: (603)-721-1261 Are you an employer?('heck the appropriate box: Type of project(required): 1.0 1 am a employer with employees(full and'or part-timc1. 7. D New construction em a sole proprietor or partnership and have no employees working forme in g. Remodeling any capacity"[No workers'comp.insurance requinal.} 321 am a hors a wner doing all Nark myself.[No workers'comp insurance required.)" 9_ ® Demolition 10 O Building addition 4.0 I am a humeow net and will be hiring contractors to conduct all week on my property. I will ensure that all contractors either have workers'etenpenuation insurance or are sole 11 a Electrical repairs or additions proprietors with no ertrpluyees. 12_0 Plumbing repairs or additions 5n I em a general contractor and I have hired the sub-contractors listed on the attached sheet 130 Roof repairs These sub-contractors have employees and have workers'comp.insurance.; 6.0 We are a corporation and its officers have exercised their right of exemption per MI c. 14.ElOther 152.,1141.and we have no employees.[No workers'comp.insurance required.} 'Any applicant that checks box QI must also fill out the section below showing their workers'compensation policy information. t Homeowner.who submit tins affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :conuactrrs that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those a iies have employees_ If the sub-contractors hive employees.tin} must pnhidc their Norkcm'comp.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. Lie.#: Expiration Date: Job Site Address: Cityr'State,'Zip: Attach a copy of the workers'compensation polka 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 tine up to S 1.500.00 and'"or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA fur insurance co%eragc verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: • Pa I)ate 9/4/2024 Phone (6101.)- 1-1'61 Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitlLkense# Issuing Authority.(circle one): I. Board of Health 2.Building Department 3.City+Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: CITY OF NORTHAMPTON SETBACK PLAN MAP: 30A LOT: 42 LOT SIZE: 11,456sq.ft. REAR LOT DIMENSION: 63.97 REAR YARD 10' See Attached Document for Site Plan. SIDE YARD 15' SIDE YARD 15' FRONT SETBACK 10 FRONTAGE 70.07