32A-079-005 BP-2024-1313
30B GRAVES AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
32A-079-005 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-2024-1313 PERMISSION IS HEREBY GRANTED TO:
Project# 3RD FLOOR REPAIRS Contractor: License:
Est.Cost: 51000 DOUGLAS GOODNOW 082188
Const.Class: Exp.Date: 10/16/2025
Use Group: Owner: TRUSTEE CAREY, ALLISON VIOLET
Lot Size (sq.ft.)
Zoning: URC Applicant: GOODNOW CONSTRUCTION INC
Applicant Address Phone: insurance:
45 WESTVIEW TER (413)548-4561 WCC-500-5026062
EASTHAMPTON, MA 01027
ISSUED ON: 10/10/2024
TO PERFORM THE FOLLOWING WORK:
3RD FLOOR REPAIRS
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:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: 17-°.
Fees Paid: $382.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
REcEivEr)
cams ( I Y- ite'if Card
, The Commonwealth of Massachusc s OCT
8 ?024 Fo
� � T
. Vt. '. Board of Building Regulations and Standards;
MUHICI LITY
Massachusetts State Building Code, 78 CNI- US
Building Permit Application To Construct, Repair,Re fisli a,:A �' ledMar 2011
- g Cr, mr�c�t�i a.� '
This Section For Official Use Only
Buildin Permit Number: 419 ).C/" / _I 3 Date Applied:
aii,,—) /�!� Ip 9 zozz
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
)V, G raUPs 14 u e
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. Owner'of Record:
R
k ;ion ( 6 fe-9 �V ua?ha.rn 1(►'l I o t of o
Name(Print) City,State,ZIP
1-33 3 Arta-vec AUL qi3-�1 �-3g1b to tolet l tDgmcu1• Ull
No.and Street Telephone Email Addtess
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work2: 3r ct. - i2,,. S Ft_a6Ri►x ,NL{Tarmac
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building S ID, D
cip 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ j- an ' 0 Standard City/Town Application Fee
0 Total Project Cost (Item 6)x multiplier x
3.Plumbing $ 6;WI D 2. Other Fees: $
4. Mechanical (HVAC) $ O List:
5.Mechanical (Fire $ 0
Suppression) Total All Fees: $,,,
Check Na 4 f/7 Check Amount: 38 Xash Amount:
6.Total Project Cost: $ 61/ b A 0 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
_�,�,� fei9 ( a (O-/6- .S
b ua\- '^ham License Number Expiration Date
Name of C of er
J lAY4U.14 TeC List CSL Type(see below) U
No.and Street Type Description
�'c ,N� ' U Unrestricted(Buildings up to 35,000 Cu.ft.)
.17� l rn 1' `�(�l �u� • R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
�7 Jp — SF Solid Fuel Burning Appliances
13-9 d — tp) dII oc 1 iw �.( I Insulation
Telephone Email ad (,( D Demolition
5.2 Registered Home Improvement Contractor(HIC) 1611341
A 13,tiI ,`r_ r� _
( n�—
OLY.4 Lt1�Qic, uLf itn-t-1�� IIIC Registration Number Expiration�+Daatte
HIC company Name or HIC Registrant Name
1-15 totet0 -ice ( h OOdrn 1i Z t,a ha) l!(
No.and Street Email Address
ra&ti-arnpfrm ?YIN a(oo-4 1413 c-a SbI
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 Issuan 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
to act on my behalf,in all matters relative to work authorized by this building permit application.
Day Kos 1100 to F-Vi
Print Owns 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 t is appli• ion is true and accurate to the best of my knowledge and understanding.
/ 9/ g/)-At
*i`rint 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 dccks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton
e.Lf_f_1�14
Massachusetts
. .
y 1 ;1'
DEPARTMENT OF BUILDING INSPECTIONS
y. Ilt a ree • un pa u ng 212 Min Street • Municipal Building
Northampton, MA 01060 J;r,- ;,..'
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: -[rrI fo,f s {1 C
Signature of Applicant: Date: jU'R--o7.4
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street,Suite 100
=ati{ Boston, MA 02114-2017
.�' www.mass.gov/dia
II orkers'Compensation Insurance Allidas it:Builders/Contractors/Electricians/Plumbers.
TO RE FILED WITH THE PERNII rl'IM(::U'"hIiORCI'1.
Annlicant information Please Print Lecibis
Name(I3uslncss;Organixattonlndiv:dual):
Address:
City/State/Zip:�ti lhpkt_ Phone#:413^q- _q5-6 J •
Are you an employer?('heck the appropriate box:
Type of project(required):
I.Vam a employer with a„_.__enrpioyties(full anddor part-timel.• 7. Q New construction
201 am a sole proprietor-or partnership and have no employees working for ere in 8. (remodeling
any capacity.[No workers'comp.insurance required] U.�/
30 tam a homeowner doing all work myself.[No workers'eump_insurance required.]
9. Demolition
10[] Building addition
3.0 1 am a honwown r and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'comlorsatron insurance or are sole 1 a Electrical repairs or additions
proprietors with no errtpiJyees. 12.0 Plumbing repairs or additions
5 I am a general contractor and 1 have hired the sub-cuntractots listed on the attached sheet.
These sub-contractors have employeesinsurance.:
and have workers'comp.insunce. 13 Q Root repairs
6.0 We are a corporation and its officers have exercised their right of exemption per lefts.c. 14.0 Other
152,¢l(4).and we have no employees.[No.s orkers'comp.insurance required]
*Any applicant that checks box 01 must also fill out the%tenon below showing their worker,'compensation policy information.
r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-cinitractors and state whether or not those entities have
employees. It the sub-eontracucs have ermpluyces.they must pros idc their workers'comp.policy number.
I am an employer that is pro►iding workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: f'cLm
Policy#or Self-ins.Lic.#:1i)GG_ Expiration Date: i(.- IQ -'
Job Site Address: 30 CD G-tro.tips e City/State/Zip:ja(12,thO 11 \D1:U
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MI_c. 152.t25A is a criminal violation punishable by a fine up to Sl.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 for insurance
coverage verification.
I do hereby eery 'under the pains and penalties of perjury that the information provided above is true and correct.
Siunature: ��_ Date:1
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone t#:
City of Northampton
OaK H!1MP)04, S 'S..
Massachusetts
*
DEPARTMENT OF BUILDING INSPECTIONS
r � $ 212 Main Street • Municipal Building ' . •t.
Northampton, MA 01060 ss:6
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.
CONSTRUCTION CONTROL WAIVER
From: 64.Shc/Lo� , ( h J `
•
145 ((,le y7�!(�
a.5 &-"Aplb. A4 of°- 7
To:
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, I request that you
grant a modification to waive the requirement for construction control of the project at
because the work is of a minor nature,will not affect structural elements, health, accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,