Huntington Building Inspection

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1 Huntington Building Inspection George W. Peterson Building Inspector PHONE APPLICATION One and Two Family Dwelling (Residence) Only For ALL other projects use Other than One and Two Family Dwelling application The Commonwealth of Massachusetts Board of Building Regulations and Standards Massachusetts Building Code 780 CMR, 8 th Edition (effective Feb. 4 th 2011) All applications for New Dwelling building permits must include: ASSESORS TAX MAP AND PARCEL NUMBERS Contact the Huntington Board of Assessors for Tax Map and Parcel STREET NUMBER Ask the Building Inspector if you don t know it. SITE PLAN Clearly Drawn show distances from all lot lines Existing and proposed buildings, Septic system, Well, Driveway Any wetlands (stream, pond, marsh, ect.) Front Lot lines are usually not at the edge of payment. DRIVEWAY PERMIT Copy of permit received from Highway Superintendant PROOFOF POTABLE WATER Enclose a copy of water test results from a registered laboratory or permission to connect to the town water system. SEPTIC INSTALLATION PERMIT Enclose a copy of the permit received from the Huntington Board of Health or permission to connect to Town Sewer CONSERVATION COMMISSION SIGN OFF Contact the Conservation Commission for project review. THREE SETS OF BUILDING PLANS Clearly Drawn to scale including Floor Plans, Elevation, Framing Cross sections, Window and Door sizes, prefab components with engineers stamp, location of smoke, heat, fire and CO detectors. ENERGY CALCULATIONS Use for Massachusetts Building Code energy calculations. OWNERS SIGNATURE Must be signed by OWNER OF RECORD. DO NOT send a permit fee with your applications at this time. The fee will be assessed during application Review, you will be billed for the fee. When your payment is received your building permit will be activated. Completed applications may be submitted during office hours, or mailed to: Huntington Building Inspection P.O. 430 Box Huntington MA Office hours at Huntington Town Hall Wednesdays 7:30 pm.

2 The Commonwealth of Massachusetts Town of Huntington Massachusetts State Building Code, (780 CMR) Eighth Edition Building Permit Application To Construct, Repair, Renovate Or Demolish a One- or Two-Family Dwelling This Section For Official Use Only Building Permit Number: _ Date Applied: Revised January 2014 _ Building Official (Print Name) Signature Date 1.1 Property Address: 1.1a Is this an accepted street? yes no 1.3 Zoning Information: Zoning District Proposed Use 1.5 Building Setbacks (ft) SECTION 1: SITE INFORMATION 1.2 Assessors Map & Parcel Numbers _ Map Number Parcel Number 1.4 Property Dimensions: _ Lot Area (sq ft) Frontage (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 30 feet/9.15m 20 feet/6.01m 20 feet/6.01m 1.6 Water Supply: (M.G.L c. 40, 54) Public Private 2.1 Owner 1 of Record: Name (Print) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Municipal On site disposal system Check if yes SECTION 2: PROPERTY OWNERSHIP 1 City, State, ZIP No. and Street Telephone Address SECTION 3: DESCRIPTION OF PROPOSED WORK 2 (check all that apply) New Construction Existing Building Owner-Occupied Repairs(s) Alteration(s) Addition Demolition Accessory Bldg. Number of Units Other Specify: Brief Description of Proposed Work 2 : SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ Standard City/Town Application Fee Total Project Cost 3 (Item 6) X.006 = 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire _ $ Suppression) Total All Fees: $ 6. Total Project Cost: $ Check No. Check Amount: Cash Amount: Paid in Full Outstanding Balance Due:

3 5.1 Construction Supervisor License (CSL) Name of CSL Holder No. and Street City/Town, State, ZIP Signature Telephone address 5.2 Registered Home Improvement Contractor (HIC) SECTION 5: CONSTRUCTION SERVICES HIC Company Name or HIC Registrant Name Adress Signature _ License Number Expiration Date List CSL Type (see below) Type U R M RC WS SF I D Description Unrestricted (Buildings up to 35,000 cu. ft.) Restricted 1&2 Family Dwelling Masonry Roofing Covering Window and Siding Solid Fuel Burning Appliances Insulation Demolition _ HIC Registration Number Expiration Date address Telephone SECTION 6: WORKERS COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c C(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. No.. 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. Owner s Signature Date SECTION 7b: OWNER 1 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. _ Owner s Signature or Authorized Agent 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 Information on the Construction Supervisor License can be found at 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

4 TOWN OF HUNTINGTON BUILDING INSPECTION DEPARTMENT Construction Debris Affidavit In accordance with the provisions of M.G.L. c all debris resulting from any work covered by a Building Permit shall be disposed of in a properly licensed disposal facility, as defined by M.G.L. c A. Address of work: The debris will be transported by: The debris will be received at: Signature of Permit Applicant Date Building Permit Number: _ P.O. Box 430, Huntington, Massachusetts 01050

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7 For Office Use Only Permit Number Date: AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application Huntington Note 142A, requires that the reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal or demolition or the construction of an addition to any pre-existing owner occupied building containing at least one but no more than four dwelling units, or to structures which are adjacent to such a residence or building be done by registered contractors, with certain exceptions, along with other requirements. Type of work: Estimated Cost Address of work: _ Owners Name: Date of Permit / Application I hereby certify that registration is not required for the following reason(s); Work is excluded by law Job under $ Notice is hereby given that: Building not owner occupied Owner pulling own permit Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Other (specify) OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND M.G.L. C. 142 A Date: Contractor: Reg # OR: Not withstanding the above notice, I hereby apply for a permit as the owner of the property. Date: Owner: Tel. #:

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