25C-040 (3) 212 NORTH ST BP-2019-0161
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C-040 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Categorv:window replaced BUILDING PERMIT
Permit# BP-2019-0161
Project# JS-2019-000269
Est Cost$14983.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: STEVEN ZUCCHINO 021356
Lot Size(su.ft.): 6577.56 Owner: GOLD HOWARD J&JENNIFER INNES
Zonine7 URB(100)/ Applicant: STEVEN ZUCCHINO
AT. 212 NORTH ST
Applicant Address: Phone: Insurance:
70 Gleason Road (413) 584-3878
NORTHAM PTONMA01 060 ISSUED OM81"018 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL 16 REPLACEMENT WINDOWS
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.
Certificate of Occuoancv signature:
FeeTvpe: Date Paid: Amount:
Building 8/9/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
w( NPOW
_9
- T v m Department use only
�- 111 Cit of ton Status of Permit:
Y Northampton
Building Department Curb CutDdveway Pe.0
-L ,l 212 Main Street Sewer/Septic Availability
l r ' Room 100 WaterMell AvailabXily
m - Northampton, MA 01060 Two Seta of Sbuctural plane
P♦
phone 413-587-1240 Fax 413-587-1272 Plot/Site plans
w Other Specify
TO CONSTRUCT,ALTER REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION (,b 0— 19- ` (.L /
1.1 Property Address: This section to be completed by office
Map 1�- C- Lm G 40 unit
zone Owrlay District
0m SL District CB Disbkt
SECTION 2-PROPERTY OWNERSMPIAUTHORIZED AGENT
11,
of Riec/o�rtl: 1 i,
�� v,.rol l�dd 1 �6rkh S i-ti+
Nam(Pont); ��/ ��/J Currwd AlaRrg Atldresa:
[I— ry`K NI-',ponce e
Tele
Sensitive
2.2 Authorized Aaant: I�
u Zucth'an_ ,n �agS6h Rw1 k/Dr4lA -ptpl.L]A
Name Cume�nt Maing Address:
'-Ili- S7S-a,3SQ
Sig Wre Telephone
SECTION 3-ES MATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit app,licant
1. Building (a)Building Permit Fee
2. Flai (b)Estimated Total Cog of
Constmction from 6
3. Plumbing Building Permit Fee /�
4. Mechanical(HVAC) 4f
S.Fire Protection
6. Total=(1 +2+3+4+5) Q Check Number
This Section For Official Use Only
Building Permit NumDate
ber: Issued:
Signatu '.
9uildin missbnerllnspectta of Buildings Date
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING All Information Must Be Cornpleted.Pemit Can Be Denied Due Tp Incomplete Information
Existing Proposed Required by Zming
M,column to M filled in by
Buadwg lk}erm®t
Lo[Size
Fronts e
Setbacks Front
Side L: R: L: R:
Rear
Building Height IV
Bldg.Square Footage
Open Spaee Footage
(Uu aces minus bug a pavM
#oFParkin S aces
Fill:
wlunw a Locelion
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES O
IF YES, date issued:
IF YES: Was th ermit recorded at the Registry of Deeds?
NO O DONT KNOW O YES
IF YES: enter B k Page and/or Document#
B. Does the site contain a brook, bedFofter wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or ne toed from the Conservation Commission?
Needs to be obtained at d O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, /size,
a and location:
D. Are thereanges to or additions of sign intended for the property? YES O NO O
IF YES, pe and location:
E. Willthemisturb(clearing,grading,excavation,o Ilirg)over t acre orb a part of a common plan
that will disturb over 1 acre? YES O NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION S DESCRIPTION OF PROPOSED WORK(chaek all aoolicable)
Nev,House ❑ Addition ❑ Repacemen 1tyl Indoors Alterations) ❑ Rooting ED
Or Dourer �]S
Accessory Bldg. ❑ Demolition ❑ New Signs 101 Decks M Siding"I Other 101
Brief Description of Proposed —r yI 11 n ,y^
Work: r3A " P.,x i 7t wih�A�wS w -� Vlkt/I JoA Lw
Alteration of existing bedroom Yes—No Adding new bedroom Yes No
Attached Narrative Renovating unfreare d basement Yas No
Plans Attached Roll -Sheet
Sa.If New house and or addition to existina housing corndete the Tollowina,
a. Use of bustling:One ily Two Family Other
b. Number of rooms in each f ' unit Number of Bathrooms
c. Is there a garage attached?
d. Proposed Squarefootage of new cons then. D' ensione
e. Number of stories?
f. Method of heating? eplaces or Woodstoves Number of each
g. Energy Conservation Compliance. eck Energy Compliance form attached?
In. Type of construction
I. Is construction within 100 R.of wetlands? Yes No. Is sbucticn�AMin 100 yr. floodplain_Yes No
j. Depth of basement or cellar floor below fished grade
k. Wil buddirig conform to the Buil Zoning regutabahs? Yes No.
I. Septic Tank_ City S Private wen_ City water Supply
SECTIONTa-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNE•,RR�S/AGENT OpR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, IJUwotrwl GoMras Owner of the subject
property
hereby authorize J 1
to ad on my behalf in a`ll ranters relative to work authorized by this building permit application.
C (i( v
Si mturreeofoxnw /- Dole
I, ) � 'l 1� as OwnedAUNonzed
Agent hereby declare that the statements and Information on the foregoing application are true and acoumte,to me best of my knovAedge
and belief.
Signed under the pains and peneltias of perjury.
qTilo, 2
Print Na /
a0 O(
Sign re fO.nwrlAg D01e
n
The Commonwealth efMassaehusetfs
Department of Industrial Accidents
I Congress Street,Suite 100
t maw iii Boston,MA 02114-2017
_ www.mass.govldia
' Worken'Compensation Insurance Affidavit:Builders/Coutractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information -'') PI ax Print L 'b
Name Busineas/Or mizatum/ atividua0: n n Lv
Address: '10 �eaSo� Rti'cX
City/State/Zip: Vj tI" ibp6, I A Phone#: S7S- 501 (
Are yon an empi"ae?Chwx the sppropnate bin Type of project(required):
I.�I am a employe wiW_mployem(full and'arpn-time)• 7. ❑New construction
441 me a sole pmpdera oe mostship end ha,e so employees waling far me w 8. ❑Remodeling
any caped,[No womna'wrap.imwm« mamwd.] 9. ❑Demolition
1❑I.m a ha«o.doing all work myself[No workers'comp.wommes,tapunaLl
4.❑ aowma
1 am a houner d win be hinny oontmchea m cooduer all work on M ptopealy. t will 10 E]Building addition
emvn mm.n eonumra.ndasm loo.ww cos'conpa,mhon inane.ar veaole ll.❑Electrical repairs or additions
pmpnemrs with W amlo,,e.. 12.[]Plumbing repairs or additions
5j]1.ma central«alf.caxami l have hitM the sadcoms ias lismi on We amsebad sheet I3.0Roof ira
naso sublonmacmrs hwe,,aploycos and have warkeo'comp.ins ame,J
6,C]We are a cam000km and in ofi5—e Mee eaacwrd fiam,ROL ofessmarioo Per MGL
Ib.�Other K Wv"�✓�"�
153,pl(4),and we love m em aorem.INowotkmi ax W.iawrm«mvm osi.l
'Any Wphesm t va ehedu bon#1 miry use foil an the saloon heath showing Weir wales'em parawtiun poary id'm®,ion
I Haxownm who.ubimt thu affidaen iMi .ting Mcy am down,all avrk and dao M1ire mnidc«nuances sins astern..nw.f5davo habeas,such.
Tcommemm that chxl now bin mss ansered an aaana rinsed snowim the Dame aWewbmnmems and come wourer or not tame entities have
employees. IfiM1e sub-moms tus M1ave employaec tM1eY rmot pwide Meir workers'.wq,policy number.
an an employer Thar is providing warliers'compensation imoranee formy employees. Below is the po0cy andjab sire
information.
Insurance Company Name:
Policy#or Self-has.Lic.#: Expiration Date:
Job Site Address: City/State7.ip.
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure an secure coverage az required under MGL a 152,¢25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well to civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violacr.A copy ofthis statement may be forwarded to Be,Office oflnvestigations of the DIA fm insurance
coverage verification.
1 do hereby ceder doe poll=
and penalties ofperjury thin the information innovated above is hue and correct
S' t Dae Ou ;10
Phone# 1-10-
Official
'I0-OA9cial use only. Do not write in this area,m be completed by city or town official.
City m Town: Permit/License If
Issuing Authority(circle one):
1.Board of Health L Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
SECTION S-CONSTRUCTION SERVICES
.1 Li n n rvt Not Applicable ❑
Narrc of tfceneB stager - cs- aa(35L
h A License NumBar
�� �ettsav 1/°lluoo'ly 6r1T'1v� .�!„J(• _—f3t�2at�
Atltlress Ezpim oa
Sign u Telephone
1412� -suS-
0.Ret Contracty Not Applicable ❑
Comoenv Name "���til
S Registration u r
Address ` VYl*e Erb /a•Jr�l
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(KQL c.152,§25C(5))
Workers Compensation insurance affidavit must be comgated and submitted with this application.Faium to provide this alfldavit%MM result
M the deraal of the issuance of the bull"pornut
Signed Affidavit Attached Yes....._ O NO...... ❑
City of Northampton
tr
Massachusetts
O MTaBaT OF aVZZOZW ZNSpS=WS t
r212 Mein Btraet •Wnieipal Builai .°m
Y��Z Worthgt , W 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c40, S54, I acknowledge that as a condition of the building
permit all debris resulting from the construction activity governed by this Building Peri[shall be disposed
of in a property licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
11 g, klsr& S+ ';�t
(Please print house number and sheet name)
Is to be disposed of at:
1/" f( i RQ-wc(tmx
(Please pnnt name and locato of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
w-)l ajl�
Sigfia ure of PfV
it Applicant or rDate
If, for any reason, the debris will not be disposed of as indicated,the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
City of Northampton
}"•"
Massachusetts ,
µ OSPAR14atw1' OF BUILDING IaBP3CTION3 �®/1
313 Nein atzaat • W icipal Building
Borthu ton, M 01060
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to fore family homes.Prior to
performing work on such homes,a contractor must be registered as a Hume Improvement Contractor("HIC").
M.C.L.Chapter 142A requires that the"reconstruction,alteration,renovation, repair,modernization, conversion,
improvement,removal,demolition,or construction of an addition to at,pre-axotirg ownerocc itned building containing
at least one but not more than four dwelling wits....or to structures which are adjacent to such residence Ofbuilding"be
done by registered contractors.
Note:If the homeowner has cantraded with a corporation or LLC,fhat entity roast be registered
TypeofWork: !t��NcfP^�,, Yeh�a ce-MLLewl Est.Costo ls,om —
Address of Work:Date of of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law(explain):
_Job under$1,000.00
_Owner obtaining own permit(explain):
Building not owner-occupied
_Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 14M SUCH OWNERS ALSO ASSUME THE RESPONSIBH.ITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit astheagent of the owner:
S as ,;Cc�.ko 1wlmlc�
Date Contractor Name HIC Registration No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
8/7/2018 Steven Zucchino
70 Gleason Road
Northampton, MA 01060
413-575-2258
Const. Supervisor Lic.#21356
HIC# 100199
steve.zucci@comcast.net
Howard Gold
212 North Street
Northampton, MA 01060
413-320-3037
hgold(dsmith.edu
Work to be done-
Replace 16 existing double hung windows with new replacement windows.
The replacement windows specifications will be as follows-
Paradigm double hung vinyl replacement units
White exterior with factory applied dark oak(wood grain) interior.
Glazing to be insulated, low-e coated argon filled. U value- .28
No grids or divided Ines.
Single, oil-rubbed bronze sash lock.
Full screens with white aluminum frame
Replace 2 double hung bathroom windows with new replacement windows.
The replacement windows will have the same specifications as above except they will
be white on the interior and have white sash locks.
Work will include removing and disposing of existing sashes,window weights,aluminum
storm windows and all other project related debris.The interior trim and window weights will be
carefully removed to allow
for the air sealing and insulation around the jambs.The existing trim will be re installed.
All permitting and necessary inspections will be included.
No painting, clear coating or staining is included.
Cost of replacement windows- $10,343.00
Cost of other needed materials- 330.00
Cost of obtaining permit- 90.00
Cost of debris removal- 120.00
Cost of labor- 4100.00
Total project cost- $14,983.00
Payment schedule
In advance of ordering windows- $9000.00
Upon completion- 5983.00
lid
( Ce
Howard Gold Ste+ Zucchino