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18C-057 (4) 142 PROSPECT AVE BP-2021-0130 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18C-057 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:REPAIR BUILDING PERMIT Permit# BP-2021-0130 Project# JS-2021-000208 Est. Cost: $9633.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: BRYAN ALOISI 073513 Lot Size(sq.ft.): 39900.96 Owner: CZELUSNIAK JAY Zoning: URB(100Z Applicant: BRYAN ALOISI AT: 142 PROSPECT AVE Applicant Address: Phone: Insurance: 107 ROCKY HILL RD (413)427-2457 O WC HADLEYMA01035 ISSUED ON.81312020 0:00:00 TO PERFORM THE FOLLOWING WORK.REPAIR FOUNDATION AND REPLACE BULK HEAD 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 Occupancy Signature: FeeType: Date Paid: Amount: Building 8/3/2020 0:00:00 $65.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner ECEIVED AUG - 3 2020 fk P� 11tnINC;INSPECTIONS The Commonwealth of Massachusetts FOR i !# PTON.MA 0,060 oard of Building Regulations and Standards MUNICIPALITY Massachusetts State Building Code, 780 CMR USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling s ection For Official Use Only Buildin Permit Number: f Date Applied: L-wo g-3-Z020 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property A dr s: 1.2 Asses rs Map&Parcel Numbers 42 ( c- 1.1 a ts 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❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 caner' ecor ova Cze.(u sv� it/r�l D ,R 4/w62 Name(P int) City,State,AV l//Z Dktkr1913 ln:-,938 No.and Str et Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORKZ(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) JW Alteration(s) ❑ Addition ❑ Demolition ¢§ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Desc>;iption of Proposed Work': SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ 14B,S'Q 1. Building Permit Fee: $_&T.00 Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier 9.6335 x�-,5r 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Su ression Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C5 673V3 g Zozo License Number Expiration Date Name f CSL Holder // 07 / List CSL Type(see below) Vl No.and treet Type Description O f��� U Unrestricted(Buildingsu to 35,000 cu.ft. 1 R Restricted 1&2 Family Dwelling City/Towli,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances yr3 y�2�/v7 GLG�JIC//l lyG Hleyi"�.�'M I Insulation Telephone EmbIl address D Demolition 5.2 RegisteMsltvd�#% Home Improvement Contractor(HIC) /J/ 772 *t te. HIC Registration Number Expiration Date HIC Cow x Name or HICAggisp—trt ame Q 61 S J oh 54 r✓c�vmolMat 1.Lom No. Email ess I 01035 �3 5��� d /Town,S ate,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...........❑ 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 At51 4tJkV&kV% Ca 4c- /,�rfyrm to act on my beehh'al/f,in all matters relative to work authorized by this building permitlapplication. JA11 CC I lSN Ict. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNERI 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. A415 l 3 logo Print ner'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 not 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. ovg /oca Information on the Construction Supervisor License can be found at www.mass.gov/dpss 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" The C ommonweafth of Massachusetts Depurtment of Industrial.Accidents ��9� 1 Congress Street,Suite 100 �° Boston,MA0211 4-2017 W'., www.mins gov/dia 11 t,a icer.' t ,uupersatios lu%urance Affida.it:BuildeWt°ontracter.,'EleetricianslPlumhers. TO IW FILED wiry( i i i v rERNn*i*i'Ih(�AI'I IIOR I11 i tiic•Ant 1n6rrnr;tlitrn Fkmw Prim Name I13ta%tdii4.+it,aaat�ttr,rt tndt.idusl} lT 1 'I il7�rV G �h NC_ Will Ad C itylstatcJZip:_�it�1 0i Phone Are roe alt affigibyte('here the apprepriatc ern. TM of pmjM(K9aired): 1.5g t am a employer>r Nth ' crnpiarrcc%(dull and ar part-turn t.' 7. Q Netl'constructicmn a[j lain a%ol.:pn}prictor or lmancrship and haec rnr employee%%orktnlr lar me m 8. Renrcxlriinf aril c3lway.[No workcrs'eaxnp.us%utrno: w4uircd.) 3�l ant a IxlttKletiartcr d�urnit all vi Insxtd.l'.4v tsrarktiY�'colr�.rttaarrnec n:yw9. Demolitiontctl.l' Q 4.�1 am a lr<inrcxtwur irtg land ssttl lrc htrswnr:ectort to ea«nduet all w%ttk on my prrt{+t .Tty'. l will Building;addition Ip lT"m that all contrucet.n.Littler hast IMM&Cm'conyr%ro%atnxt rn%uraMU 01'arc%isle 1.1.0 Electrical repairs or additions pmjnzcku,with no tmplvr vc%.. 12.©Plumbing repairs or addition., Sin I am a general contractor and I lsrsc hired the tib LLuitraclot%Ir%tewl un the atMAcd Ax-cf. I3.a Rwf repairs 7`tre%c wb.eurrirxttin hwsc�Talplovee%arwl hose xorlcn'coonp.wt%nralnr.^ 14.C)Othci 6.[J weare ac%trprxarim sett it%officers hu%c c%crci%cd t}reu nght of e%cmptiar per Wit-c. 152.�jl(4t.aral we base Ixa%Trrpluyc-ce.I'k,ssirticr%'cwltp.rn%uralnc rcyuureJ.j "Any appliawi dirt clot k%!v%1:1 nruae a6v fi l oxrt dw%rctum helotr.%bossing rMirnrtrk%T%'cOmPLnxalit n Fk41&Y ut(r r matw m. *Ilontrxn%ntn who submit the%:atttslastt utr}i uttng they arc tkmnF all work sad do&Trust outside contractors mut%(%ulwunl a r1t:%UtfidJa rt rmttyLt4unc*a:h :Contractu»that check iht%txr%trims attacked an adahttonrl%hect%htxsIng die trirtrt elle aulr ontrectora utJ.tyle ss lrcttxr is cxat tlu%e�tittrc. lug e crtitloyec% [f t}re%uh contractax%}rase�Tmpluycc%.l>ts rrwsA prosidc¢herr utitkcr%`cimnp..polt%y trurntvr. I am an empit rer that is providing worAers•rompensarion insurance for my ratplolwr%- Below is the polity and job. 7r information. r lnsuranc:e Coniftany Nang !! � �G� �/i /C� lo-.,.foa �*6,ecltv X74,�IezwTcJ Policy#or Self-ins-Lica.#: &VC1" 52-S-3j Expirrtion Date: (p1 �2pZf Icrh Site Address- I'7Z &1 Pi me —CityiSWt+crzip..-A-1 7�/At, lba{+Z Attach a copy'of the wo�pen%ation poBey decla ratloo page(%howisg flat policy somber and :pie). Failure to secure coverage as w4uired under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 an&'or erne-year irnprisorin ent,as well as civil penalties in the form of STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of thi,,tatcment may be forwarded to the Office of Investigations of the DIA for insurance coverage Verification. I do hereby cercift under the ins and penaldes ofperjury that the information provided above i.%true and comet Si mature: Dalc: Phone#: 1413 qZ - Z5-7 k Official use only. Do not write in this area.to be completed by cit),or town uffi-riat City or Your n: Prrmitl'Licen%e t( (suing Authority(circle one): 1. Berard of Ilvalth Z.Building Department 3.t:ity/Yown Clerk 4.Electrical Inspector 5. Plumbing Inspector G.Other Contact Peron: Phone#: City of Northampton Massachusetts {S �{ DEPARTMENT OF BUILDING INSPECTIONS . ; -s: 212 Main Street • Municipal Building vs% Oa Northampton, MA 01060 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: The debris will be transported by: Name f Hauler: �/ �¢i(/ /4e`J/ Z'V `� �i 1.4"- a C • Signature of Applicant: Date: Zob A►C RfJl1 CERTIFICATE OF LIABILITY INSURANCE � ` ' I THO CGP"WtCA"IS ISVIVD AS A WATTF R OF""FORMATION ONLY AMO CONFlPM NOR T3 UPCw TWE CERTIFICATE NOLOER.T}6S CERTIFICATE DOES NOT AFFIRMATWELY OR NEGATIVE'Y AMEND,EXTEND OR ALTER TME COVERAGE AFFORDED by TII!POLICIES SCLOW, TMS CERTTITCATE OF INSWANCE DOES NOT 0003TITUTE A CONTRACT BETWEEN TK ISSUING INSURER(S1,AUT"ORIZED RVWX "AyM OR PIIODUCCK AND INC C.tIMOICATt HOLIXR. IWORTAmr ff vo Com6caft hoMw N on ADDITIONAL WSURM Ow Poftyllaisl=he"ADD" t MAL INSURED amVie of or M wndonad. 11 SLON00ATION r1 WAIVIEM WA II010 to the Matrw Ond i:.pndflM/ns osvie popsy,tenon pcoves ryr r�TrAn sn axeQO/NIMM. A Hon thb giifti1Kato Oars not tortMr h%to ON cwbfomts holds#In boo of wah MidcrowmaNT i5, AQ-Jo r,dAwcrGa rcw di4 ►b11biT73..._.....-�. (41� 35b 9r"p FSI O O fiat 35' OIIII NI'ORdNB 1 Harenreplhlft IAA ptrS61 MldtloislA+I.�kiMMrs*a 26684 wsulr ALOIN CQM'.TT'#UCTION CO.INC _._ 187 ROCKY HU OW o, HADLEY MA 8148""2 F_ COML'qA ATE NUM1qfR: C1.IW46 mNUMSIER: a3 IS TFTO CERTRY THAT T1,19 POLICIES OF INSW MCE ustED/FL$W"M*tN JWAD TO THE'MSURED NAMM ADM FOR ►-'AJCV VVMQQ INWATED NOTWT"$TAAIONN)ANY R€OUIREVIENT,TEJIM 00 CION 0FAFm C*rtRAGT Of OTHER DOC;6MENT WOO PWAPICT TO v**CH TM +;E1tltf40.'L&I"W 14040 0R MAY 09"AlM "li"SuMM.St AIF`d 011b ow TIH FOL.IgI:S DE.uxAsL`1?+C*ma 111ba6CT TOALL TM6 Ts"ims EXtLIiS; AND CONOF 10MS OF SUCA t--%CAS LIFTS SHCM MAY HA%f 9EEN 6t0UC=BY PAID CLAMW WFI9R �� t14r11fllpat.8011011MILaMMNITY 6tCH eX:A/I ,YIAp6 AOCr4r^ memoiIl0.A08 mogwong-op'll"n— Isom A T O ;om ,,„t ,r to".000 e Lj we a Ati16wlom LOWTt Alit-W'0 SOOLVftwirlowpn 1658,840 A OMr M1TS253J 9326=20 06/34OUl ftMkV MAWM sxiuwp I i48.No amyg464rav AArrD..W It MOM IAIirM1APw11>llolallfltr P f0.000t+QQ.4IM 1111plaXu tr/l� CICCt,nl Ixcaaa errs low AaoNf1AOwolticaPY6- TMwI,W61 m Pru '1x74.000 wrN10FIgETdRF14tI X60RNE j'”} MeA IIYCT','S3f SRI�iGID1fi 06t28I1Y9Q1 a 4.$0,000 �.. ewr ro.r+r,soar �.. ares• -P4'L+CY LW Dt}tNl'fltllr OF OR M""rLBCATNMM NNEN N 00M am"a"RIrMY Yrwa.aav M Ms+>ros!won aloe+N wWrWi CFFtTIii ACA uAl"O" iMOrAD AMY4F TIK Aa1CI!0l0GRIBEA/OL�r@S 66 CAMCEL.ED BEFORE TM GCMNATION 6MTE n4*9}F,IJOTIC!WILL tM OEtMRED M Fait w Ooky ACCOMANCE vmrl4 THE FOUCY MOVIS10"t lt�tlPi W tYY'IIr�! 131 UL� 0 JfS& 4 AICCIRO CORPORA~ AN"Oft MW-109t ACORD 25 121116431 TMACOM rrlw and 1po an rpM6wod NurMs sFACD10 Commonwealth of Massachusetts j Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-073513 Expires: 09/23/202 BRYAN D.ALOISI 107 ROCKY HILL RD HADLEY MA 01035 Commissioner Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the MassachusettE State Building Code is cause for revocation of this license For information about this license Call(617)727-3200 or visit www.mass.gov/dpl Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts- State Building Code is cause for revocation of this licensE For information about this license Call(617)727-3200 or visit www.mass.gov/dpi