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23A-146 (26) BP-2024-1209 130 PINE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-146-001 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-2024-1209 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est. Cost: 21980 YAMIL JR BRITO 115714 Const.Class: Exp.Date: 03/31/2025 Usc Group: Owner: FLORENCE CONGREGATIONAL CHURCH Lot Size (sq.ft.) Zoning: URB Applicant: B. ALPHA CONSTRUCTION Applicant Address Phone: Insurance: 29 DANIEL DR (413)539-8310 A9WC324145 CHICOPEE, MA 01013 ISSUED ON: 09/23/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZATI ON 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: // P Fees Paid: $165.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner FSEP 1 7 2024 .4 T e Commonwealth of Massachusetts Office of Public Safety and Inspections C,�T n`6UII Du , NooTF n. 7 ; INSPFCTip Massachusetts State Building Code(780 CMR) i e�ni Ap lication for any Building other than a One-or Two-Family Dwelling /� (This Section For Official Use Only) Building Permit Number. '1 O Date Applied: Building Official: SECTION 1:LOCATION 130 Fine S+ RRorer%ce ,tl,4 p/o6 g No.and Street City/Town Zip Code Nam.of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 4pecify: Z n S uicai on Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No Is an Independent Structural Engineering Peer Review required? Yes 0 No C� Brief Description of Proposed Work: UVt w4 U) be i�►SV( 1 K e p. //nlo jc �;M cese �,e h ti' i u p RIMUJa a;1l he do< Se04e ,e r►or Lua-I s uv;ft yr.') tea„l dosed l! C e 6 ova .a fi IA�-I �;re j e Sc s"4 ea i 1 4- . J 1 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) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) Total Area(sq. ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5❑ B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ 1-3❑ I-4❑ M: Mercantile 0 R: Residential R-1❑ R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IBEl IIAEl IIB 0 MA El IIIBEl IV CI VA El VBO SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information Sewage Disposal: Trench Permit Debris Removal: / A trench wil not be Licensed Disposal Site 0 Public Check if outside Flood Zone L� Indicate municipal required or trench or specify: 5 Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes 0 or No ID/ Yes 0 No SECTION 8:CONTENT OF CER 17FICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner L. g C .- tlalcter► 13O e.the $t' 'nor a oce 1 t4 fl- 0106 Nana'(Print) No.and Street City/Town Zit' Property Owner Contact Information: •...a q re A-.5 -_7?Col- - �►sso.mar,..(ti,Qtde.z@lwt;I :44 Title t/ Telephone No. (business) Telephone No. (cell) email address If applicable,the property owner hereby authorizes Y�m.:( 134.; 4,9 et.xitiel DI;de- -- -Mk O,a6c. Name Street Address City/Tow State Zip to apply for and act on the property owner's behalf,in all matters relative to work authori,rd by this building permit application. SECTION le CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building;is less than 35,000 cu.ft.of enck c'd spao and/or not under Construction Control then check here 0. ( ther►+iseprovi.k • t.,.•�•.iion107in the code)asnstuired. 10.1 Registered Professional Responsible for Construction Control wit,professional coordinating document submittals) Name(Registrant) Telephone No e-mail address Registration Number Street Address City/Town Sink' Zip Discipline Expiration Date 10.2 General Contractor S. amen 4' NC. COLSC YvG 1 (�Y► LbC \` ..;Tony I &,r. 46 CS' /f5 / / Name of Person Responsible for Construe t i License Na and Type if Applicable c Dewbviel t)*;,.e Cln:tc� re ,M)4. olu'3 Street Address City/Town State Zip — #/3 - $ 5 $3/V ` .t let,aCll>r,Try AI;so „waif t:t+N1 Telephone No. (business) Telephone No. (cell) a-ma>I.eeldrm% SECTION 11:w't 4:?.t•`,('t>N 'FNSAT i>NI INS ilt.-tic .>F I':V.'i 3 M.G.L c.152. • 25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be complete.)and submitted with this application. Failure to provide this affidavit will result in the denial of the .i uatx:O of the building permit. Is a signed Affidavit submitted with this application? Yes No CI SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE ItemEstimated Costs:(Labor and Materials) Total Construction Cost(from)tenth)=5 1.Building; a l,q VO Building Permit he=Total Construction Cost x (Insert here 2.Electrical S appropriate municipal factor)=5 . 3. Plumbing S I!, 4.Mechanical (HVAC) 5 Note: Minimum fee=S v.-- (contact municipality) 5.Mechanical (Other) 5 I Encloses check payable to 6.Total Cost 5 a1 !q"O (contact municipality)and write check number here 13 7 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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 +est of w knowle •,e and understanding. VAIN 1 i c1 40 dr4r e r /3ux Please print and si ,n nano, + Title I• Ii•phone No. Dote ;Ci VskAitl tire 1%co a M4_ g1O13 B.A11hacors4t,cfiono na: Sloss' Address City Town State Zih Eeliail A.l.lress • Municipal Inspector to fill out this section upon application approval: - Name Date City of Northampton ,101w.d4 �,� Massachusetts ���- �<, i t f. �\ DEPARTMENT OF BUILDING INSPECTIONS a.• ,z �r..�f„ 212 M• ain Street • Municipal Building yv� . Cam Northampton, MA 01060 `'BMW �'`.\O 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: 319 OAfa.,,ok.•) c4,, CI%ic—ree, MP 0(01 3 The debris will be transported by: Name of Hauler: ►' . Itl ka. rov.14ry e- Ti`On LGC Signature of Applicant. Date: 9 /;-/�'l _ \ The Commonwealth of Massachusetts �'R Department of Industrial Accidents .oar r �.S'r'✓rS t - .�� I Congress Street,Suite 100' Boston,MA 02114-201 7 _ www.massgow/dia 114lkers'('ompensation Insurance Atlids%it:BuildersiContractors`Electriciaus('lumbers. 1 o HE FLED N77H'111E PERMIfI`i'I\G At'I HORII l. .‘nnlicant information /i L Plccase Print L.e�,ihis Name(Business'Organization'Individual I. Z. file h� Cori-') 4 ii eik€,v1 LA,C, Address: a,°1 Oowt:e I Drive City/State/Zip: C t.ti tofete / M U)01'3 Phone#: _h/i 3) 531} Z�?) 0 Are yaw an employer!Cheek the appropriate boa_ Type of project(required) I. to a employer with I( employees(full and or part-tinet.' 7. O New construction 2.0I ant a sole proprietor or partnership and have no employees working for me in 8. Q Remodeling any capacity.(No workers'comp.insurance nyuired.) 30 I am a homeowner doing all work myself.Pio workers'comp.irsurance n iaand.l' 9. El Demolition 10 a Building addition 4.0 l ant a humeowner and will be biting ciwriraeturs to condtrea all work on my,property. I will noun that all contractors either have workers'eompensatiun insurance or are sole 11.0 Electrical repairs or additions proprietor,with no employees. 12.❑Plumbing repairs or additions 30 I am a general contractor and I have hind the sub-contractors listed on the attached sheet. These yrrb-contractun have employers and have workers'ecenp.insurance. l3.❑Roof repairs h.©W'e are a corporation and its officers have exercised then nght of exemption per hiGL 14.whet �,,t i i O n 152,yeli4l.and we have no enrsioyces.[No workers'comp.insurance rcrpiired.[ •Any applicant that chocks box'l must also till out the section below show Mg their w urkLT>'compensation policy information. t Homeowner who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit italicaling such. 1i'untr ctors that cheek this box must atached an additional sheet show ing the name of the sub-contractors and state w hether o not those cmities have employed. If the sub-cuntr tors have employees.they most provide their workers'comp_policy nwnber- 1 am an employer that is providing workers'compensation insurance for my employees. Below is they►lie;'and jab size information. Insurance Company Name: PCfr�1 o(t.ti' I r r' i I i P' \ �i to Policy#or Seit-uu. Lie. w: Act w/C 3-&H �S Expiration Date: * i aJet v Job Site Address: 1'50 ?Ire s4. City/State Zip: 00(*Ater-/till o,OCa Attach a cope of the ss orkers'compensation policy declaration page(show ilig the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,*25A is a criminal s wlattan punishable by a tine up to S I.500.00 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 certifp under the pains and penalties of perjure'that the in formation provider/above is true and correct. S:n iture: Date_ Phone:-:. Official use Only. DO not write in this area. to be completed by cite'or town ofcial ('its or Toss n: PermitJLicense is 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#: Building Permit Authorization Form I, Cassandra Holden , owner of the property located at (Owner's Name) 130 Pine Street, Florence, MA 01062 (Street Address, and City) Hereby authorize Yamil Brito of B. Alpha Construction LLC to act on my behalf and obtain a building permit to perform insulation/weatherization work on the above named property. a)4Likl 413 559.7752 Own: . Signature Owner's Phone Number August 22, 2024 Date Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-115714 Expires: 03/31 /2025 YAMIL JR BRITO -- 29 DANIEL DRIVE CHICOPEE MA 01013 . atti.:ds a• ' r �0 J V&Yatik, Commi ssioner �c;� � ��,0 CONSTRUCTION CONTROL WAIVER From: COri$IfVC11 oh bowai D,r>; ►•e , C h; c bre e , 0.414. ow /3 To: 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 13 Pi ne s ,lore nce 1 MA oro6a because the work is of 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. Respectfully, 825 vo.wid 8 (4