18C-141 3a Gclib BP-2024-1134
680 BRIDGE RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
18C-141-001 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-2024-1134 PERMISSION IS HEREBY GRANTED TO:
Project# RENOVATION 2024 Contractor: License:
Est.Cost: 28000 BONDE CONSTRUCTION 67758
Const.Class: Exp.Date:01/02/2025
Use Group: Owner: LATHROP COMMUNITY INC
Lot Size(sq.ft.)
Zoning: Rl/RR/URB/WP Applicant: BONDE CONSTRUCTION
Applicant Address Phone: Insurance:
205 PARK ST 413-529-2176 UB4K0538A1842G
EASTHAMPTON, MA 01027
ISSUED ON: 09/04/2024
TO PERFORM THE FOLLOWING WORK:
INTERIOR RENOVATION
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 NORTHANIPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: 7.
Fees Paid: $210.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
RECEIVEI
The Commonwealth of Mass hus s P - ?02� FOR
Board of Building Regulations an Sta dar
Massachusetts State Building Cod , 780 CMR M IUSE LITY
_/.
Building Permit Application To Construct, Repai�, RonoMate Or Derttmljgtf 1°t'SRev ed Mar 2011
One-or Two-Family Dwe . era. a;a»°�,o
This(Seection For Official Use Only
Permit
Building Number: 6/l0� 7 y/ I�3 Date Applied:
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
t7 COLA 1Pj Ac PPtE L-A
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 Private❑ Zone: Outside Flood Zone? Municipal 12I"Zn site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
1--P+1-1 ).'fr a' 11Wu'ku IS t►"-f ViOt 1/ A?a 1 )/ NAN OtTo (AD
Name(Print) City, State,ZIP
t j►..I C L ) e- rZov V< 1 _N cg b -Ooe b
No.and Street Telephone Email Address
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. 0 Number of Units Other 0 Specify: ��MC�i7EL,
Brief Description of Proposed Work2: 1.j V Eu..s hot n�T'wS
or t M z a— ru -4--
03 n.t CJ ►V EIS I, `DArt/ , k 2t•M,V.
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ C94/000 1. Building Permit Fee: $ Indicate how fee is determined:
�D 0 Standard City/Town Application Fee
2. Electrical $ /
i ❑Total Project Cost3 (Item 6)x multiplier x
3. Plumbing $ 3 O bO 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees:
Check Nocict‘tuCheck Amount
6. Total Project Cost: $ rev,^ 0 Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
A License Number Expiration Date
Name o CSL Holder
List CSL Type(see below) t)
aa5 i71=.el<
No.and Street Type Description
U Unrestricted(Buildings up 35,000 Cu. rt.)
�As' 'C'4-iA�1�_I 4-4 CA Z.7
� R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
Mi3 5Z9 -Zit vvx56 to-).. c.1-1tt2c Q,&tt-r I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) (eC122 6,- -2_5
ra15Nr ` •
�v ON g l-ue l 1,„A.! HIC Registration Number Expiration Mate
HIC Company Nsmt or HIC Registrant Name
�rs k mS'tJ ,2 etcrdifett_TEV,NE -
No. t t Etna'
Ec.-,--►-1644 tw i .i . 1�p< 4413 5za-21-74,
City/Town,State,ZIP 6tO L 1 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 Issuanc 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 . AR►< p=,1
to act on my behalf,in all matters relative to work authorized by this building permit application.
1.471-ttzol> c 5'-.tNL K) iT c1.3— 2'4
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 and accurate to the best of my knowledge and understanding.
1' 3— 2‘i
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 Q 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"
City of Northampton
Massachusetts �ve
DEPARTMENT OF BUILDING INSPECTIONS L ,
' z
212 Main Street • Municipal Building yJh a0
Northampton, MA 01060 ssNy �)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: VaLL,.? } Lk--
Location of Facility: N0- T - A M c b1•.3 I
The debris will be transported by:
Name of Hauler: E �—� ►S�4.uC'�T613
Signature of Applicant: Date:3' 4
The Commonwealth of Massachusetts
alliale "al=e. Department of Industrial Accidents
►E -1 1 Congress Street,Suite 100
i, IL:m .1=ii►_ rj Boston, MA 0211 d-2017
... -t wwit:nfass gov/dia
11 ui kers' Compensation Insurance Affidas it: Builders/Corn ractorslElectricians!Plumber..
10 BE I li f:t)W 1111 I Ill: FERMI rI I (: 'I I HURITl'.
Annlicant Information Please Print Letibls
Name 4 Business()rganization'indi idualY (&r•-,t)�_--C.Z>KI -' - }01•N
Address: a-os ?Actie, 'b
City/State/Zip: O% Phone#: 4t3 SLcr- zc ii
e re for an employer?('heck the appropriate h►s:
Type of project(required):
: Dai nt a ciupkiscr with 1 employees(full andlur paratimel.' 7. 0 New construction
2:3 lam a uk pn,ptsetur or partnership and have no employees working for me in K. 2 odehng
any capacity.[No workers'comp.insurance required.)
9. a Demolition
iCI I am a homeowner doing all Murk myself.No workers'comp.insurance requited.)'
4.0 I ant a homeowner and will he hiring contractors to conduct all work on my property. 1 will
10 0 Building addition
ensure that all ctntraelurs either hate workers'compensation iisutanet or Inc sole I I.a Electrical repairs or additions
proprietors w nth no employees.
12.0 Plumbing repairs or additions
5{:1 1 am a general contractor and I hat c hired the sub-contractors listed on the attached sheet. 130 Roof repairsThese sub-contractors hate einpluyees and hat c workers'comp.insurance.;
&CI PiC arc a corporation and its officers have exercised their nglil of exemption per Wt. 14. Otl►er
l�1.;1141.and we hate no employees.[No wurters'comp.insurance rcquinsd.[
'Any applicant that cheeks hot uI must also fill out the see below showing their workers'compensation policy information.
' ihonteownets who submit this atlidatit indicating they arc doing all work and then hire outside corttractors must submit a new affida%it indicating such.
:Contractors that check this kis must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities hate
cmplocecs. lithe sub-contractors lute c-npk.y ees.they must pros ids them workers'curry.polls'.number.
I am an employer that is providing►s•urAers'compensation insurance for my employees. Below is the polity and job.site
information. //
Insurance Company Name: 1 tJEL-E 41;�j. v4,I . Ve'3
Policy#or Self-ins.Lic.#: jJ 1K<Q S3 86A 4 f_r Expiration Date: 5--j- Z5
Job Site Address: cam) CehelikVfte- Lp. 1g-- City/State Zip: ]sorrtTl-(IU4 PTC)iJ, MiA
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.g25A is a criminal violation punishable by a tine up to S I.5(t).00
and-or 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 the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of perjury'that the information provided above is true and correct.
Signature: 7 ,/) c�<? b Date: -- .3 f 2Phone:: 4/ - 5 2cr-217 b
Official use will.. Do not write in this area.to be completed by city or town official
Cite or Town: Permit/License P
Issuing. uthority(circle one):
I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
it. Other
Contact Person: Phone#:
KITCHEN: Remove Cabinets, tops and plumbing.
Install new.
I I
BED 1
8'X10'
KITCHEN
EXISTING GARAGE
BATH
Remove
Toilet. 0 3 PORCH:
Vanity. Raise floor 2' w/
Replace BATH EXISTING 2x4 and install
all. /y)
DINNING 3/4' plwood,
New pocket door.
BED 2 8'X12'
LIVING ROOM: EXISTING DEN
Remove 2 existing windows.
Reframe opening.
Install 4 andersen
picture windows.
Caulk, tape and foam.
u vALUE. , 27 5I -L . 51`
11 I I III I F II
BONDE C❑NSTRUCTI❑N / 30 CRABAPPLE LANE, LATHROP C❑MMUNITIES 8-25-2024 413 535-9529