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31A-240 (10) 55 KENSINGTON AVE BP-2021-0140 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 3 1 A-240 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING P E RM I T Permit# BP-2021-0140 Project# JS-2021-000231 Est. Cost: $15000.00 Fee: $105.0 PERMISSION IS HEREB Y GRANTED TO: Const.Class: Contractor: License: Use Group: LEARY BUILDING COMPANY 104806 Lot Size(sa.ft.): 5096.52 Owner: TORRES MARIA Zoning: URB000)/ Applicant: LEARY BUILDING COMPANY AT: 55 KENSINGTON AVE Applicant Address: Phone: Insurance: 13 GLENDALE WOODS (413) 336-2611 SOUTHAMPTONMA01073 ISSUED ON.81612020 0:00:00 TO PERFORM THE FOLLOWING WORK.-DEMO 1 ST AND 2ND STORY DECK 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: Uate Paid: Amount: Building 8/6/2020 0:00:00 $105.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner p)q P7 o F RECEIVED AUG - 4 2020 The Cot--:•:u_nayralth Board of Building Regu4atians and tart&W BUILDING.MA 01 6 NS F© THAMPTON,MA 01060 ICTtFAItUSE JtTY Massachwelis Std RWTdirr.g Code,`7 ElluMina P& t,Aar)]ieation T6 Com—t t.,Rep*.,Renovate Or.DeffL twish-zv-. J?Lz sed-m4r, 2017 One or TwoFamly,Dwelling This,Section I?or OfciA Use Only, R.,si dint.Permit Vumll(-.r oG �0 ai-e .Arinfied, CU 'Building Official(Print Name) Signature )Date CFCTff)1# 1 S:tT�.< fi r' r1`ION 1.1 Pie rly Adore 1.2 As wrs Map&P.arleel Numbers 1.1a jc thiG an accented stcret?ves� M) Map N�r PaxcelNumber 1.3 Zoning fullwwatien: 1.4 Property Dimension: Zon*District Proposed use Lot;Pew(sq ft) Frontage f- 1.5 Building Setback&(lit). )Frani,Yard, Sidi Yards: Isar Its Required Provided Required Provided Rem Provi ckd 1.6 Water:S.uwly —G-L c.40,154) 1.7 Flood Zone lutbrmation. 1-8:S,ewaw Dis"al system: VoMic43 Ptivae l Zone: Outtiide Mood Zone? Mmo"pa-10 -On s,ire posal system -0 Check if yes❑ SECT ON 2: PROPERTY-01TVXWERSHW 2.1 Owne��g.-d: N�27�r�1�-T�.� 'Aliq 010(01- Name(PPrrint)�,r /� � Matta 71P © T �J '�-GN.S11,3�tUl j4w:: Kq3. - �( P41mgIg C/ 5mkRt CbU No.and Street 9releoiaw Ernail'Addrem SECTION 3:DESCRIPTION OF PROPOSED WORK 2(check all that apply) New C'onstrtiction D Exis ong Building ET Owner-Occupied Q- 1 Repairs(s) ❑ 1 Alteration(s) 11 Addition 0 Demolition: 0 Accessory Hldg;0 Number.of Oiits: ©th:er SPeciffly p a-k— &&U.6 Rrief Description of Proposed Work: ��►S7 d � SiD" nr%1x l L EAw57 306 S 1oq-1 D�ZiL "ItJl- Zrti SFU%&15� !611o,u1 SECTfON 4:ESTIMATED CONSTRUCTION COSTS Estirnated'Cests: Official Use Only a�bt�a'aid tri�i l s) 4.%ilding 1. Building Permit Fig 'S indicate how fec is determined: 2.Electrical' S 0 Total Prorect JCost"(Item 6}x multiplier x 3.Plumbing 2. Other Fees: S 4. Mechanic (.HVAQ S List: Suppressim) .Mechanical (Fire S 1 T''etsd:Ablj'Fem fir. ,?�� 1 l, l 11 S i_.Hfll(tl lllt- i .ii\Ii Amiii_m ! 6..TotatProifttCost S 000 0 Piid in Rei11 ❑"Outs tanding HaIaneeDue SECTION 5: CONSTRUCTION SERVICES 5.1 Construcdi Supervisor Lieeeee �- CS - lOtfFOu 2• l� -22 /M ldceme Number EViiration.Date r Name(if CSL Hcrldcr List C3L Type(ow W 1 (ALWALC &JCVb S 6T7_ Nw and StFwt l ype :12escription T3 UUreed"MK &0 j3,4 f!CU_ft.) City/Town, �U State,,ZIP roh�, Nil (.171 R r�tRestricted 1&2 Family Dwelling SStaM Masom- .,w loofwg Covering ws Windows and:Siding _ ;.SF I 601W fuel Burning Appliances I-6ZncrTlatitm ane Emat address D " Demolition 5.2 Retboemd H=w-I mprovemni Cc ntracur - Hid 'eegistration-Number Expicatiori Date H�Eos: i or l�giatr�l`Iamte ' (Joebs be u� � UiGO��� ' •� No.and Street Tail address ,ScU TbtAKPTco.0 MA Otol'� l City./Town_-!%te_7TP T elenhi�ne SECTM 6. WO RKE RS',COMPENSATION IMURANCE AFFIDAVIT�M.G.L.c.1.53.§ 2SC(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to:provide this affidavit wf=1i-result in the denial of the Issuance of the'building permit. Signed Affidavit Attached? Yes ......... No........... ❑ SECTION 7a: OVVNMA17MORTZATIONTO'BE COMPLETED V HEN OWNER'S&CENT tO CONTRACTOR APPLIES FOR BEAT D LNG TERNIIT i t 1,as Owner of the subject property,hereby aud"ize �N to act,on my behalf;:in aH'matters relative-to work authorized.by this.buil ' g permit-ap meati. Print Owner's!Marne(Elceft is sig) omit- SECI,M1 7b-:OWNER!OR AFTHORI7,F,D AGFNT DFC•I.ARATION By entering-my name below, i hereby attest:.order thepRins w d�pmalties efTrjury haat all of th e,infom. AM contained'in this-application is true-arid aecurate'to-the-bekt of y'knowledge.aodwderstaxr&ng. - ::�� / 9ATJ :2.ki Prim Ommw s Bei Authari !Agent's.Naime,(O wtreair.6ignature) Taaw 'NOTES: 1 An Owner vvhn obtain-- a h,I,A3inrt nrrmit to An hielhrr numwork,or an owner who hircE an umremstercd co.... �t�m Owner ... .....»....,».,.... ..b pe........, ........., ...... ......., ... ..b........... (not registered in:the Home Improvement Contractor(HIC;)Program:),wiff nothave access to the arbitration program or gimanty fund wide M.G.L.c. 142A. Ott im"twa infra asaEim owthiz MC PIV09 aM can-be.fob at wwwmass.gov/oca ItrfowmatiowowthwCousuwation Supervisor Lic nse:can,be.foun&at.www.mass. og y/dps 2_ When subs work is plazl ccl.provix t}! i t trorr b cri Total floor area(sq.ft j (includmg gprage,finished basement/attics,decks or porch). Gross living area(s+ ,it.) Habitable room count Number offirepia , Number ofbedrooms I Ar W,—.'b)�.r of L)aILIt C,C, _ *v viii�iCT ief ii cis routs i� l "Type of heating syeteixi - tY1 JEY of' @CIES✓porches -- Type of coohngsystem Eneiosed Open 3. "Total Project Square F000ge".may be-substitut©d€or"Total NvjootUos(" c - L U oj. LI%J l;.ii33ll�.c+tl>Edii Massachusetts DEPARTMENT OF BUZZZING 1ZNSPE£PI a� 212 Main Street a Mttnscigsf &ttileiinq No=thaz[tpfAn; MA Qi060' f"+f%'kTC1rVT')T i='1rrTfll\T "IPT)"]TC A IMPTT A i 7TT 3io 'JUPIN!L-11 r,&L,Z•SA-iny e s �FoR ALL DEMOLMON AND RENovA N'PROJECTsa In .accordance of the provisions of MGL c Q,S54,,, condition.of Building Permit Number is that�aII debris resultingfrAm this wwkshall be disposed of in a properly licensed waste dispoSsi fzetitty, -astlefinted`by M- ,GL-c'111,'S 1S0A. Ti.... .J..1...:. .:11 L... .I:. �.. . ...J ..F I Ile ueurls vvlll 'we uIsposeu o1 111- L t of:f.adflxty: live Ueb is YY111 Ive - al-Ispo 4041 4,- Name of Ra er:, &IC,01AZ, algnature of Y!}dp lcan4t: a,t'., Tber�'emroswc tk,of:4l�r.� hewvrAt� DepmMwW of h"vsftiW.-fir€ideffts E f ares&Sxee Sem 10 WAIIA- M7 �(CoaWe mewd"lmmanmw Afffda*>;f3tra de r '�a �lecttracis nstPturt fys . !'ORF FILED WMI THE!' RMITfING At{TH{ WTV. :apli��t:lxr,Cerxuatiwu l'k�c i'riat 1.epibl+ css' Cityt° p c z i / - 3 Phone-V; .Y.rw ww.Nw aM.wM.:wr'►t''pwwtr r�P w�aeawaeareaNw lenr� M _. .. . - - ,._..... -.... q 9 i Ix of project treyuiredy i hsps v wider �+a►a ta:rw7.• �68:tV,Ctl�tt!R1YiLC�tt3Xt .. lam mi+t papa atia uc pt ►a�a• a�&s��tu�u,rktis,3uerrr;ax� :+am�-ap�trI�r q+�v'..+mxcrx'�x .iarcwraa�a;+•c�%� t`-`] ��irest:l,�+a.,sntsawa��ai:W!ttsini+hw�ii�. �'usiM>pi+,.itc^�ets�glitt�tri,j,` r 40 1 m'n a}u:aaeuwi'arer and will bL huuw cnmuclon to cauaitis.•t a!'t rrtarttc rn my meugacxxv- A W%td 100 BuMing addition enwiv Tha alk coawwwn CWOCV l*Vc w erre wase Ito Ek-am"L ropmrs oM ys di9ditefts r"N°Prirt:>ra�i�Yn.�tar�ala^r,_•ea_ a I am a vmrul coutrwt ax;awl 1 fu%A:bvW the 419Wd-taw the u#MW%h»i`d. TlcrRw,s�+«e,estz�trai��m�:+�ssk�au.a►tii-l ;uizr�'a� caxzsla.a�rit�Mu_, p `e usu'aEetsuin7l�ui'lLss . vF7tnrvliiebtrri$.iEtf+Sehptum`A4sI 1 '_4114).Datil M;¢l►s4Kna��tgalw�uea�:;[�ka wF+rl eae:`:uunp,irxtauMrC r+c UitWA j a 'Atm.appfxumt:$tM ►,b,aa,s3 AW All Oui-tba s�aar► �i6�r'awat�rv'�aus�:a.rtx+r,iF���. .�'HV3r�a�x;ua:rr:��t'Fav�atts4'ratati�[lua�1lE"��avtrataQaca�taa:�ilc�vaux�os(r¢�eltt�mdc.:ark.3l�ee.�ere.+x �:�•wani�:t�t<,cw ar,r�xt+ t Y -:ssct ergg auu�. ��Cce�•,r�lux.tt+i[ 2lazs�saaaxst�Rir�b�8 sw xtw+ >lba�tttw�fagg#ble d�'%tlae;:�fMrtti:k'!a A�fiifi[Yklttl�lL1C Mllf awed' �tiipRCY laY►7t mtiluyr::s IS Ylae wika a�nstraa se,r+ltK,.•�rarukry 'kms' tress ii4�AU-9 W434rt4'(XMUP txtlrot V aaaxat+rr Alli!&v eAV&yer that i+ w&vW8xgn w orke n"coxvpe& v6om&.wrewe.or wy Vis. Below is d#v pafi*y attd j&b siW W Imurame Ctnnpatt'y .tttb2: JobI Site Addr tE7v'�ataf 7ajr .;x a roev offlu, ;w1,•rs :3rr3e:stiuv paW ,.....u.ug t3ir pat•ry r<umtsrr ins:Cipir:stian:lit;. t'W' 1 a umc ctrd' ►'� tx1 l:�s ci a e4'.ici&c of-aS %XMWO DCA ands fiar,of up to ISM M a clay x;itntst the violator.A rc)pY of this StdttSttt,~ttt tntty!te fosunrcit-ci to the Office of in, tittgatims of thL t)i�� t o� �murauce ;es�ter��tt:'�xsr#'iitatina� X40'LerArCNW). H xe+;t=t�tuF l�rc xa�arra�iwav�r�aadc�rrlwnr..ix i�ixs;exarxl twrrnrt }ate ,#: y/ L 11 !?�Fcla# vxtl,4: �v/tf#'1vfAN`iiRf�t'S"tFI�All7�"�K►llt 'lk'[f'�1'Cr?t�'a7#'/ +ttUf}?ctuf' C t 1 City or Towsr. Feralit{Licenst 1. Haard"OHeaft L'. ft£f{lC,�. Department d:i.HS•'fmmC fCiR 4, i.li4ctrZ`ciaa .-. au0jeicue'i ry �3 �('gsti6edCaillilYf: -P `#: t` C-1 fir,. -- 5I� l.t�}Il`ttIlt'}I1Wt~di �l O li+i55A�'�li1S� t ' ---._--� �. in iii.A Lse mill DepaErtraent of Industrial Accidents Office of favegtrptions,-Dept. 153, I Congress Street,Suite 100,Boston,Mass&dews Its,02114-2017 http/tww r.umm.gov/dia, Invest lSViVO.ID#: AMWAVff OF EXEMPTION FOR CERTAIN CORPORATE �%",A XER215. OR DIRECTORS C&».pfer 169 >r.�,f;the Acts of 2.002 amended M..G.L. c. 152, X1(4)by add ng bhe follo wing parograph: "This chapter shall be,elective for an officer or director of,a corporation who owns at least 25 percent of the issued and outstanding stackQftthe oiporation.Not-Withstanding section 46,these provisions shall apply only if ft corporate macer provides the conunissioner of industrial accidents with a written waiver of his rights under this chapter. Said commissioner shall promulgate regulations to carry out the purpose of this paragraph.Violations of this paragraph shalt subject the corporation.to,the penalties set forth,in sectim.25C." P tulsuam to -Wtx-L1, c� .152 -6r(4)a lexr; ,tl; Tfwe.dl- ov?&Ies o+frrcers oil Leary&A&V�kw- 1039 East Mountain (Road, Wt d,AIS. 01M. (Name of Corporation and Address) each hflld*at beast 25%,of the issued vid outstuding stock in said corporation,do Hereby invoke the right to'be-exempt from the provisions of M.G.L.,c. 152,;'§25A.and therefore are:not required to twq a workers' compensation policy covering the undersigned corporate officer(s)or director(s). I/We the undersigned do also vaiive any and all rights to make claims for benefits as.defncdiin MG.L. c. 152 for any injuries thA maybe vustained while-in 1be employ•of the.ab:ove-name corpcwtion. Further, T/we the undersigned do understand that, should the ihnve-nanied corp oration hire nr haver in its employ army employee(s),in addition to the undersigned corporate off:cer(s)or.dir�tor(s)T said corporraboa is.required to obtain workers compensation coverage for the emlaloyee(s�,as prescribe ed.by M.G.L. c. 152, §25A. I/We the undersigned have real and understand the statements and obligations as delineated abwve and 1/we have checked the appropriate box below€mylour name(a).indicating,mylour desire to be eMnpt-or not to be exempt from the provisions o#:.M.C11 . e. 152. .Sigel #&r a Paim. andyenatfin if are_.. T imnfhy.A.Leanj,President 13y91:5t�t9"I� �, Signaiure - ftirrtNameXPi Tile Date( yyyy)�- I Wf6h to CUK& nay righyAexemptian or F! I wish NOT to exercise my right of exemption Signature Nat Name&Title Date(rnsnrddly jc 7 1 wishh to exercise my right of exemptibrr or El F wi!h L aTr to exercise my r*n ofexemption Signat url Pristt Name 8s:Title Date(mmiddfyyyyr) Q` i wish to exercise my right ofexemption or 0 t wish NOT to exercise my right ofexemption Swiatrme WistName&Title 'Daze(trmldd/yyyy) FI I welsh to exercise.my or E]A wish NOT to txvrcisemy ri4,t rof:xemption Note L "E�I,�f rflL E'C�(9RFORA'1'E UC£11RS MUST SIGN. THERE CAN BE NO MORE THAN 4,S1GNAT'4WY-& [caous on btrt*. Fame 153—712010 vi , i t { I tit / t 4 j , + —�rVM✓Fbyr.... - , i i i i E 1 .,.,,.. . ... .�..._.. 9 ....,._....- ..{. ....,. .i. 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