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23A-120 (5)
BP-2023-0155 8 MIDDLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-120-001 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-2023-0155 PERMISSION IS HEREBY GRAN ED TO: Project# 2023 DECK RENO Contractor: License. Est. Cost: 8500 JONATHAN SOUTRA CS-1 12317 Const.Class: Exp.Date: 10/25/2023 Use Group: Owner: ABKIN TAYLOR ROGER COLIN& I I Lot Size (sq.ft.) jONATHAN SOUTRA dba SOUTRA OME Zoning: URB Applicant: IMPROVEMENT Applicant Address Phone: Insurance: 5 MUNSELL ST 413-977-3212 BOP 0100741636 BELCHERTOWN, MA 01007 ISSUED ON: 02/09/2023 TO PERFORM THE FOLLOWING WORK: REBUILD EXISTING DECK IN SAME FOOTPRINT 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 (NT Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts l' Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY l I USE co Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 o One-or Two-Family Dwelling w This Section For Official Use Only Building Permit Number: P 2ol3'O I S:1 Date Applied: evi I-) tZ, 1/1%G-- 2.9•ZDZ3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1_Property Address: 1.2 Assessors Map&Parcel Numbers Mdd it S4- 2.3A - 12o-Op 1.1 a Is this an accepted street?yes I/ no Map Number Parcel Number 1..3('�Zoning Information: 1.4 Property Dimensions: ,2/04 acre 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 SewageDisposal System: Public w Private 0 Zone: _ Outside Flood Zone? Municipal m/On site disposal system CICheck if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Fc )v Tall ioc 4c(i-he,m"t0^, i MA, Di&,'-.)- Name(Print) City,State,ZIP Z' M;c\cllt, 51-• Op -ss„/-01010 rvic,cca.,Avilor ii Grua l.Lom No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 12/ Owner-Occupied Id Repairs(s) Ilil Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. D Number of Units Other 0 Specify: Brief Description of Proposed Work': gC bti.Id:ni ah Gx;S};Ai 1o1X iq ()cur.,. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ con 00 1. Building Permit Fee: $ti -5 ' Indicate how fee is determined: 0 Standard City/Town Application Fee 2. Electrical $ 0 Total Project Cost' (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ a Check No.)3(' Check Amount: ]5 Cash Amount: 6. Total Project Cost: $ c t„:;-0 0 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) GS I Id-30-7 aS *.3 Jon k-hgh S00 j-CCt License Number Expir tion ate Name of CSL Holder _ List CSL Type(see below) 5 M J i s (k �+No.and Street Type Description i Gilt( 1.. ,,^ A nI DO') U Unrestricted(Buildings up to 35,000 Cu.ft.) To . R Restricted 1&2 Family Dwelling City/Town, State,ZIP M Masonr y RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 13-ql -14.0. SoJf-ctihomc imecct,•t'rnG14"�oem' COO) I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 01503 To Svo*c HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name cJr1S- S+- 5co k-rri homLtm prod,ntrr1/2- I.CAn) No.and Street Email address Fx ICher-k)btin (1 . o; 001 413-'177-3,?,I� 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 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 `)D r%tit-I^a r\ SO 04-(�� to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owners Name(Electronic Signature) Date SECTION 7b:OWNERS 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. -TO r‘ ctE-ky S. S0t)* ,A/t f X0?-3 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 1Q 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 V 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton Massachusetts * ' mk DEPARTMENT OF BUILDING INSPECTIONS tiw 4. "'r "' 212 Main Street • Municipal Building yeti QD` Northampton, MA 01060 sl'Ay 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: Vot k\C1 FCC I((i rnt The debris will be transported by: Name of Hauler: Toro: (\ Sci-*"i Signature of Applicant: 91,7eA A A-106 Date: ,Atip0 3 THE COMNIONWE ALTH OF MAS:ACHU SETTS Officf3 of Consumer Affairs and Business Regulsation 1000 Washington Street- S Jite 710 Boston, Massachusetts (12118 Home Improvement Contractor Registration Typ?: Inaivi lual JONATHAN SOUTRA ftegistratio r 19181)3 5 MUNSELL:$T. Expiratio r 01,14/2025 BE'.CHERTCWN,MA 01007 Upilate Addre;s and Ret on Card THE COMMONWEALTH OF IMASSACHUSETTS Office of Consumer Affairs&Business Regulation 2egistration valid far ndividual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return t3: T`IPE:In 3i4iaual Office of Consumer Affairs and Business Regulation Registrar! - EmSration 1000 Wash ngton Street -Sure"10 19180:3 0 /14112025 3oston,MA 02118 JONATHAN SOUTRA JONATHAN S.SOUTRA f 5 MJNSELL S"I j ..��L.`�'�r,k' �ll/ �C t k(&1). BEL.CHERTOWN,MA 01•.07 ,� Undersecretary slot valid without signatur3 POLICY ISSUED ON THE CO-OPERATIVE PLAN NON ASSESSABLE POLICY Policy was prepared for: JONATHAN SOUTRA COMMERCIAL POLICY Preferred Mutual Live Assured Preferred Mutual insurance Company One Preferred Way • New Berlin, NY 13411 1.800.333.7642 • preferredmutual.com Policy BOP 0100741636 effective 01/23/2023 to 0 1/23/2024 Preferred Mutual representative: AQUADRO & ASSOC INS AGENCY INC /RAIS 413 586 7373 020129900 COMMJCKT(10-14) Insured Copy The Commonwealth of Massachusetts -=' Department of Industrial Accidents LIE_' ':1-7..... 1 Congress Street.Suite 100 w„ , Boston, MA 02114-2017 it :der — www raass_gov+/dia Workers'Compensation Insurance Affidavit: Buiklers/ContractorafEbectriciansiPluothers. t)HE FILED V. THE Pi.ItvttI '1NGAUTHHORITY. Annlleant Information Pleats• Print t ellitik Name tBustncs8 Organization lndividuatt: r\tick-hC:ri SU t(CI ____ ekdidress: C AU n SU 1 5A-, City/State Zip: gOciiltcAT:on /AA. CiO07 Phone #: / 3-177 --3 iD. Art ynw an employer?(link dor apprupriatr bet: T",pr of project(rtegtti#rd):, 1.©1 ante cmpiayeer wiTh,. _,_,„ aarployessAtoll anike pan-newt° 7. a New c wt 2 aai a stile psupne r or pain ►up and haw no employe es winking fur are in remodeling an slipway INa makers'comp.assonance mite red.) 30 lam a homeowner doing all mittm}elf.(Fier workers.roar.tasu et torstr i i` 9. j Demolition 4.3 I am a lrimiawwner and will be hums oontrar irs nr. i all work on my praparty. I will 10[3 Building addition mum that[all tnatratl tits talker have workers' or as raik i 1. Electrical repaint or additions pruprieton with no employees. 12.0 Plumbing repairs or additions 5C1 l am a oaf ccatnatior and I best hired the sib-ccnitract0rrs hated on the attached Aiwa Meow roab,rutnatctoss.Co.a tts recsaxtS%*,c*a**a' saga.teramamc. 13 Rrw1 rtpalss 6.0 We air a ctixpornl to and its uffa.ers have est./coedthat right of mare tion per MOGI.r_ 14 thdt_.. 152_;kit dk and we base no employees.(No workers*of mp inaarancrtregnant) 1 "An.applaeittn that chocks boa$l ratio also fill ma the stt'tw*below show inn then rctuiut+'.ontpretaation pulse,udirtntatwn I ' ti4 rrecowncrs who submit this affidavituidieadm outsideg they are doing all work and then hire utsile co ntracior,nitro anoint a new atldarR u idiAaahpg such :l oral—actor:that cheek this boa must attached an alehtionai sheet Aiming the name of the suti-euetttae•toi.and,tare...honer to not those entities have oririv': tf the aub.uanraeo*shas e ei lo)ce.,.the tmum met rd..then 4erl.rra'etgnctpointynimth:1 I am an employer that is providing warAers'compensation insurance for my employees. Below is the policy and,jab site information_ Insurance Company Name: T r-C C'G r t'C,d fV 4'VOA fit'►Su ra nCh GO. .— Policy#or Self-ins.Lie.#: &O e o t 0o 7 -I 1 (0 3(D Expiration Date IM-Vd-1 Job Site Address: 7 M e"d d It. S+-' citynt* izip__(iv,coke MA, a j of Attach a copy of the workers'compensation policy declaration page(showing the policy number sad expiration date). Failure to secure coverage as required under h4CiL c. 152,#25A is a criminal violation punishable by a fine up iti SI.SO0.0 0 andfor one-year imprisonment,as well as civil penalties in the form of a STOP WORT(ORDER and a fine of up to S250.00 a day against the violator.A copy tsf tin .tatemcnt may be forwarded to the Office of Investigations of the DIA I.Ir insurance coverage verification. Ida hereby eertify tti ter thepartas mad penalties o/perjure that the information provided abate is true and correer. Signature: A r ken-- I)t;, ,�/ /� 9,04 C'lsunc v. y l 3 el T 7 3 a-va. Official use only. Do not write in this area. to he t omple'h'd by city or rosin official N . City et Tow,: PeranittLieense b Issuing Avlhoritt (circle one!: I. Hoard of Health 2. Building Department 3.(,it i ossn Clerk 4,Electrical Inspector S.Plumbing Inspector 6.Other ( ontat.t Person: Phone 4: __ 31 �.. ; Rii , MEMM MIV--- - MEM. LAMMEMMEMEM M MEM' II \ City of Northampton Building Department MEMEMIMMEIMEMINEME Plan Review i �� ° 23. Northampton, M A 01 060 111111111 iiiIiiiiMill ER - ................................i..m. V- ammommumummaimmainimm immiummommummiggill m 1421N111111 . MI MINI imm mommommilm mom _ , NNAI mmammommimmommi milimm _ , loll 1111111111111 :mi. IEII1IilhIii.ui.iau..a. i.=------ :eiN sI •HIN•inuimminms.• maw— wog t • . mommummummummommaiMMITIMA mumnimmummommommumnimmo - ummommorammommommummi mom m �11■milmumm IIiIIIIiiiiiiiiIIhh" II un0 ■�IIlO■ IA.� fps 1.11Ailiontlarlaillammor1111111.111•11 111 IIIIIIIiIIIIIIIIIIIIIIIIIIIIII II II II 1111111111111111111111111111111111MimillIM NM IMMO EMI LIMINEEPRILLIKEILIC mi MIEN 1111111EMEMMINEIMMINI ilibrarililliiiiiiiiiirtf im Nii 4xy