32A-153-005 BP 2022-1035
32 STRONG AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
32A-153-005 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-2022-1035 PERMISSION IS HEREBY GRANT I TO:
Project# RENOVATIONS Contractor: License:
Est. Cost: 82000 DANIEL DACRI 105989
Const.Class: Exp. Date:05/07/2024
Use Group: Owner: CENNERAZZO ALVERT J& KEVIN ROY
Lot Size (sq.ft.)
Zoning: CB Applicant: DANIEL DACRI
Applicant Address Phone: Insurance:
247 RIVERSIDE DR (617)543-2843 R2WC 121938
FLORENCE, MA 01062
ISSUED ON:08/23/2022
TO PERFORM THE FOLLOWING WORK:
RENOVATIONS TO KITCHEN AND BATHS, CREATE OFFICE
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:
2 . 1 1 f
Fees Paid: $574.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
/ 1-1-&-C /V ,,
The Commonwealth of Massachus•_ I s 6 3 2022
C , Office of Public Safety and Inspections. N�oT������
•y Massachusetts State Building Code(780 CMR) --�i4i7,,,'I /A,
Building Permit Application for any Building other than a One-or Two-Fa1n I . ings /
(This Section For Official Use Only)
Building Permit Number:1,1:2 (() .) Date Applied: Building Official:
SECTION 1:LOCATION
3� s�-( AS S iyor- tplor\ / 14 •,cCo
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK j N
Edition of MA State C e used , If New Construction check here 0 or check all that apply in the two rows below
Existing Building ar Repair 0 Alteration ENe Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify: ,
Are building plans and/or construction documents being supplied as part of this permit application? Yes B� No
Is an Independent Structural Engineering Peer Review� ]S
required? L • Yesi 0 �No �f
Brief Description of Proposed Work: t w�c�,}.� riv, Lt S iv, 44tL Cl iO 2 t (OOMII -
Z.P.Mt, - 4a1-5kdc-c/(4 a.%ll sit k'+(kv? ) Add pjri-/-tba M }n44 (i>, cAt im( Are:,:c .
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): 1, Al) R.- Proposed Use Group(s):_gn cIic ?r t..,
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) 3 3
Total Area(sq.ft.)and Total Height(ft) /5 C13 7 o) /54 3 410 l
SECTION 5:USE GROUP(Check as applicable) i
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5❑ B: Business Er. E: Educational ❑
F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 H3,101 H-5 0
I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 12K R: Residential R-ID R-2 R 3 0 R-4 0
S: Storage S-1 0 S-2❑ U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as app • able)
IA 0 IB ❑ HA 0 IIB ❑ IIIA ❑ IMB IV 0 VA 0 VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Suppl . Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
A trench will not be Licensed Disposal Site Id
Public g Check if outside Flood Zone Er Indicate municipal required 0 or trench or specify:
Private 0 or indentify Zone: or on site system 0 permit is enclosed 0
Railroad right-of-wyf Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable Is Structure within airport ap oach area? Is their review cotnpl d?
or Consent to Build enclosed 0 Yes 0 or No Yes 0 No Er
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: 7 Use Group(s): 441 Type of Construction: 33
Does the building contain an Sprinkler System?: (�5 Special Stipulations:
Design Occupant Load per Floor and Assembly space:
fr
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
K--v i n) TZ 0' -' 3 Srtr x c R st.)v 01'()
Name(Print) No.and S eet City/Town Zip
Property Owner Contact Information:
- - 1-1t3 . if.,_ a)-1`67 Cennct Q 1- r \•(,
Title Telephone No.(business) Telephone No. (cell) e-mail a ress
If applicable,the property,owner hereby authorizes:
----D C-` -I - 1 WCS wASZViN. l o(42/ CQ 1lf\ ) i''b C j
Name Street Address City/Town State Z.p
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0.
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Exj iration Date
10.2 General Contractor i
rb aV �-�C r) Co'r`f}"1ic J On
Company Name
V• Cr) CS` 105 IE'cl
Name of Person Responsible fo Construction License No. and Type if Applicable
(-i — �).)-(I—s)o Dr rlo<voct / 61,—
Street Address City/Town State Zip
/
- 6') .,1-F93 choeick,c r) l
Telephone No.(business) Telephone No.(cell) e-maiNtiddress
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the
��_�' ance of the building permit.
Is a signed Affidavit submitted with this application? Yes No CI
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE j
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$ 'Z1 a`Z)Q
1.Building $ OJ 4.7J1--)
Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ 44 o,. o appropriate municipal factor)=$ 54r
3.Plumbing $ 3§31M06 .)v6)
4.Mechanical (HVAC) $ .. Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to C1 OC �1 OIdJI�J
6.Total Cost $ r..)1 7 (contact municipality)and write ch number here I9 3,j
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereb ttest under the pains and penalties of perjury that all of the information contained in this
application is true ccur to st of my knowledge and understanding. 1
+" l�c() Ow-/G-C Q s1/3 -A'y3 034
P,lase print and signme Title Telephone No. Da
Y R)VWS Pr F/brc.vlc4__ /hA. 0/06,1_ o/Sti /(:cr,'Ost4c!(I.ear)
Street Address City/Town State Zip Email Address'
I
Municipal Inspector to fill out this section upon application approval: : ;TV; , s8• �' r i''
Name Date
City of Northampton
/ �p 1 Massachusetts 1?�' - .
(�[V�/ '�!?�c
i• DEPARTMENT OF BUILDING INSPECTIONS �'. b,�,°
212 Main Street • Municipal Building y%Y.., /cs`
Northampton, MA 01060 '...•^"'t
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: 7
V1i
17'tc ) o( o/,/
"" o
i
The debris will be transported by:
Name of Hauler:`) 1 Old (D'io
Signature of Applicant: �"` _ & - ��
Date:
The Commonwealth of Massachusetts
n
L=:1i Department of Industrial Accidents
II „ 1 Congress Street,Suite 100
;iiE"-' `1 Boston,MA 02114-2017
•:,..—„4' www mass gov/dia
II urkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
ro BE_FILED W'11-11 THE PERrtrrt11SIG AllliOltrrY-
AnDiieant Information t� Please Print Lefibls
Name(Rustness�'{hpanir tnralndnidualt: \ V\ \ Gk.( f
Address: q l g)Vtitc---5)614--
City/State/Zip: cip ke.R_ PA C71O(0, Phone#: 6l1'—5-4-i3-0)-g4/3
Are yam sin earobeyer?(linen the appeopdate boo:
Type of project(required):
1.0 I am a emphpket with employees Mill sadder part-time)" 7_ D New construction
L-.- 1 I am a suk proprietor or pwtn.,ship and hate no employee%welching for air in 8. eNemod lint;
m comp.
a eapacitt.INo workers'ru .insurance rammed"
v
9. ❑ Demolition
10 I am a homeowner doing all work myself.INo%tra s"corm).insurance implied_]
10 Q Building addition
den lama homeowner and contractors he hiring contrauls to iuniuhi all work on my property. I will
tom—++cmun that all iontr a1ors either hat.worm. cunpp►-n aiam irk.uraarx VC art VAC I I.o Electrical repairs or additions
proprietors w oh no employees. 12.0 Plumbing repairs or additions
5lat'am a general contractor and I have hired the subsuntra.turs lifted on tine attached shirt.
The subcontractors hate employees and kcomp.
Irate workers' unwanrc. 13.0 Roo f repairsw
6.0 We are a i:orporatnon and Its officers hate exorcised their right of exemption per hkit c 14. Ot et
15I$14•1l.and we hate no♦aiikiyccs.[Nu won tors'cutup_insurance required.]
•Any applicant that cia ck%box o?1 must ako fill out the section below sbniva heir wotkas'compensation nation policy indorw atinn_
+Homeowner,who submit this atYnIa it dassi tt they oar doing'nave ad das kite ma i&contractors sit submit a men atfniaa it MAW*such
Co tractua that chick this[nix mud atittatimai an aiiiand time arewina the inns aim sb-aarrxwra and stalk whether or nut thoac mimes bate
employees, if the sub-cumraci.ers have etoployees4 they and peayide their wnekas'comp.policy number.
I awn an employer that is prodding worAers'compensation Insurance for wry employees. Below is the policy job site
information. J
ln.urancc Company Name: 6(farc2 13 C-0 __—
Policy#or Self-ins.Lie.#: I`D-'
W C 5"3 5.;) Expiration Date:/OM
lob Site Address: 3)- S7T l is(� � City/State/Zip:11bf 4701 4 l'1 QJcC V
Attach a copy of the workers'caalation policy declaration page(showing the police number and 4 4 I date).
Failure to secure coverage as required under MGL c. 152,¢25A is a criminal r,iolatton punishable by a fine up to. 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 I $250.00 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 c •on the penalties of perjury that the information provided abo7c1rve and correct
Signature: Date: e-/-- .Z
Phone#:6/1--5'13-c /3
Official use only. lb net milt in ik area,to be completed by city or town official
'. ('its or Town: Permit/License#
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#:
CONSTRUCTION CONTROL WAIVER
From:'` )a
)01C
ace- e(s)cJL rek1 CL, IIA 01o6. 2
To:
Jonathan Flagg
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
3� \ , 1w A/or 1)0mo7 n 414 0/060
because the work is'ff 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. a���9
Respectfully,
Dc v\. CK )
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