44-112 1170 FLORENCE RD BP-2021-1542
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:44- 112 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: KITCHEN&BATH RLNO BUILDING PERMIT
Permit# BP-2021-1542
Project# JS-2021-002564
Est. Cost: $195000.00
Fee: $1268.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BRAMUCCI CONSTRUCTION 110834
Lot Size(sq. ft.): 645733.44 Owner: SCHAEFER PETRA
Zoning: Applicant: BRAMUCCI CONSTRUCTION
AT: 1170 FLORENCE RD
Applicant Address: Phone: Insurance:
17 MT WARNER RD (413) 221-3942 WC
HADLEYMA01035 ISSUED ON:6/30/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:RENO KITCHEN AND 3 BATHROOMS
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department 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.
• y� .
Certificate of Occupancy si��natnre: I . T-°1 .
FeeType: Date Paid: Amount:
Building 6/30/2021 0:00:00 $1268.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
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g4 The Commonwealth of Massachuse 14,i-Gk
Wt Board of Building Regulations and Stan rds ✓(/N M PC.
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Massachusetts State Building Code, 78 CM 4 SE Building Permit Application To Construct,Repair,Renotet olish a 1Revi d M 2011
One-or Two-Family Dwelling tif4 o,Nr
This Section For Official Use Only JON Mq p'ct
Building Permit Number: 411-.l l-(6-4.4-- Date Applied: 7n6o s
/CUiu/S-j 11 - 6-3o"zoZI
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assesso s Map& Parcel Number
if
1.1 a Is this an accepted street?yes ✓ no Map Num Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 / Zone: Outside Floode?_ Municipal 0 On site disposal system l�
Check if yes
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
pCrQp sc PAX FOR_ Atot 719r *la# 6104 G
Name(Print) City,State,Z[
1170 FLO RING< RD. 94q - bgq-a31z PinScIIACil`4291G.co+r)
No.and Street Telephone mailAddress
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) 6i Alteration(s) jo Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units / Other 0 Specify:
Brief Description of Proposed Work2: vP 041"E k.4 i'41/LA1 AND 3 847/)AOO sr$
Wit} &KV twidiNCTS /c&uN-rdKToPs, t2.»'e Alvt, tt.Doi4C
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ f(o p , 0 0 0 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 1 S, 00 0 ❑ Standard City/Town Application Fee
❑Total Project Cost (Item 6)x multiplier (0, x I
3. Plumbing $ ape 000 2. Other Fees: $
4.Mechanical (HVAC) S List:
5.Mechanical (Fire $ /
Suppression) Total All Fees: $ lJ; r e -
Check No NO deck Amount: Cash Amount:
6. Total Project Cost: $ / 9S, 00 co 0 Paid in Full ❑Outstanding Balance Due:
•
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS - 110834 9-S•2022
R0 44QD 812A wivcc 1 License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
11 WIT WAQ JEl2 R9.
No.and Street Type Description
Unrestricted(Buildings up to 35,000 cu.ft.)
I1A D I-B y n+A 01 03 S Restricted 180 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-221.3g42 ZgArAUCC IC "Kilia u rnoni 6/'1'it4 Insulation
Telephone Email address CO m D Demolition
5.2 Registered Home Improvement Contractor(HIC)
,To 408 sh Vas
8 R.Ari1 oC C I C om s7t t!c ri O/s/ HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
17 eftvr. ,iA"Dv rr►2 ito. 04'9MoCrI CQN STD dcT/ONQr
No.and Street Email address
$144)1...ey ,A nto3S 413- 221 - 39'2
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 • 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�s ai erv) dec./
to act on my behalf,in all matters relative to work authorized by this building permit application.
PQT 124 Sid 4AGP et. & 2. /2_02/
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 at)daccurate to the best of my knowledge and understanding.
(SW tot1
Print Owner's or Authorized Agents ame(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"
The Commonwealth of Massachusetts
r_.v c
Department of Industrial Accidents
=N �_ 1 Congress Street,Suite 100
=;',•= Boston..CIA 0211 2017
' � +l.mass.gorr•/dia
Vs niters'Compensation insurance Affidavit:Builders/Contractor ''EIectriciansfI'lumbers.
TO BE FILED WITH THE PERM17T11t;A1r illORlT1.
Annlicant Information Please Print Leiibh
Name I Business organuation1ndisidual►: 81 AMVCC.I CON5T QC"( ION
Address: 11 ,jr. w^RN6R Ate.
City/State/Zip:$..AD 1 6 Y MA 010 3'6 Phone#: 413- 221 • 341 4 2
Ate!ion an cmpktsrr°t hook the appropriate hot:
T}pr of project(required):
I.®I am a cnipl i)et with Ss cntplutccs hull and ur part-turn 1' 7. 0 New construction
20 lam a sole proprietor or puslnclslip and hate it emplutcc,winking fur me m 8. ®Retnodeling
any caipacits.(No wurLcrs'comp.insurance required_(
9. ❑Demolition
30 I ant a humans net doing all work rnsxli(Nu worteri comp.insurance nquir►d_J'
4❑1 am a hon ines and will he huui imam-tors all tt irk on nit, I still
10 CI Building addition
w
anon that all ctiHutrr-iurs either has stutters'compensation insurance or arc sole II a Electrical repairs or additions
llritctofs with nu emplu}ees..
12.0 Plumbing repairs or additions
30 I am a ccim:ral contractor and I tease hind the suhtamtractars fisted un the attached sheet_ 1 3.E3 Rnofrepaus
Iltesc sub-contracture kite tlnplutce-s and Iusc outlets'comp crtsumanl:c'.•
14.00ther
h Q w c an a corporation and its officers hate exercised then ncht of ca<.ntphut per Pail c.
1<_s.;1141.and we hat,no cmplosces.[No workers'comp.*limn ancerequired(
':\nt applicant that checks bun ni must also till out tic section beliao,shooing their wooers'cutnpensatni,n rolic-t information.
' Itcwrrcvw nets whim submit this atridasit nisticaumz du..-y arc doing all stork anti then hire outside co ntrsctors must submit a nos afftdas it indicating sack
(',n tacturs that cheek this bun mug attached an additional sheet show ins the name of the sub-contractors and state w ltctbcr in nut thusc rttitres hate
.onrh)acs. If the makeastsaliatsbasettTto'ytxs.tux}must prusideduct worker..'euingi.pubes nunnkr
I ono an employer that is providing workers'compensation insurance for an employees. Below is the policy and job site
information.
Insurance Company Name: ENE h1gRTF oil
Pokey g.or Self-ins.Lie.#: (OS b 0081 K.7 0 9 74 320 Expiration Date: i1/14 /20 2/
Job Site Address: 117 0 FL O4ii IC9 CPO . r.IORT Vlgw)PT'd4ityiStatra'Zip: m4 0 t o Coo
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,§25A is a criminal violation punishable by a tine up to SI.500.00
andkor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of tie 131.E 1.ir insurance
coverage verification.
I do hereby certify undr the pains and penal - of perjury that the information provided above is true and correct.
Sigmature:� S; . Date'. 1,r/21/20,i
Phone a: 413 ' 221 - 3942
Official use only. Do not write in this urea,to he completed by city or town ofcial
C"itt or Town: PermitiLicense a
Issuing Authorit} (circle one):
I. Board of health 2.Building Department 3.t'it}(town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone h:
City of Northampton
T 1.:
rti#S.._<�I�rl,\ SAS . .SAC
Massachusetts �k? ._ '•..i.
C.iti yy w .
I N
R DEPARTMENT OF BUILDING INSPECTIONS jb°
212 Main Street • Municipal Building yJd :.1,
e IS—'•� Northampton, MA 01060 'r� '' N'‘�
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: JAt-LG 4 REcycl,INCs / No AvvtP-ro►.
The debris will be transported by:
Name of Hauler: 3Romucc I CONS-rxoc- t onA
Signature of Applicant: (/ Date: 6 . 2! - 2 I