25C-097 (4) 193 NORTH ST BP-2021-1544
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25C-097 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-2021-1544
Project# JS-2021-002566
Est.Cost: $14500.00
Fee: $95.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BRAMUCCI CONSTRUCTION 110834
Lot Size(so.ft.): 7492.32 Owner: HEATHER L McLaughlin
Zoning: URB(100)/ Applicant: BRAMUCCI CONSTRUCTION
AT: 193 NORTH ST
Applicant Address: Phone: In.tirn•ance:
17 MT WARNER RD (413) 221-3942 WC
HADLEYMA01035 ISSUED ON:6/29/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:REMOVE PT DECKING AND RAILING AND
REPLACE WITH NEW COMPOSITE 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 NO!'THiit PTO UP IIOLATION OF
ANY OF ITS RULES AND REGULATIONS. , . i' . 'I •
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 6/29/2021 0:00:00 $95.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
eL,0" The Commonwealth of Massachusetts Q
Board of Building Regulations and Stan rds c% R
Massachusetts State Building Code, 780 CMI AT 'v� A. • LITY
Q
Building Permit Application To Construct,Repair,Renovate 0 ,-s $lish a evised ar 20 7
One-or Two-Family Dwelling g2,,00„.
cl
This Section For Official Use Only o4,�;so
Building ermit Number: 6I oil• 1 s�! Dat Applied: Qo'os).,o�s
K6))11/4) a / ***-Z- - , 6 zcrzozi
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
IQ3 moix-r0 s?. .2 Tel aA ?
1.1a Is this an accepted street?yes K no Map Number ParcelNumber
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 kik Private❑ Zone: — Outside Flood Zone? Municipal II On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2. Owner'of Record:
146A-lIJER McLAti&gLlu) Na,2744m,P1-0^1 WM o/d40
Name(Print) City, State,ZIP
1613 NO1QTIl sr. 413- sir- :41t Wf.F '6 r4'.. ea✓N
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) a.. Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other IQ.Specify:
Brief Description of Proposed Work,: RGolevQ grtiSTt$6 p.T. Dec,i i'4 ghip 2,416,1 NC,
4' > Qgp444 E wiry N6 to CQ,»ftosrre oN 4 gGgrt Dace.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ /4, To 0. DO 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee S oQ
0 Total Project Costa(Item 6)x multiplier(p.' x/it
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ oa
Suppression) Total All Fees: $6I5 —
0 Check No.,31 , 1 Check Amoun� Cash Amount:
6. Total Project Cost: $ /4, 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
GS- 1tO934 9- l- 2022
R,C tIAR D $1241 W1uCC I License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) V
17 saT. wf12N c R. ED.
No.and Street Type Description
0 Unrestricted(Buildings up to 35,000 cu.ft.)
I A t L B Y MA 01 OgS R Restricted l&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS .Window and Siding ,
SF Solid Fuel Burning Appliances
413-221-39'4 2 8/Pgrnucc/a o�.is rR ticrI e NJ( I Insulation
Telephone Email addressG 1L fopy) D Demolition
5.2 Registered Home Improvement Contractor(HIC)
I3i 4ry C c L cows-rauc np 14 HIC A`�08 S/t7/�t3
Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
i7 NAT Wq&MGk. R . $49101ICCtC0 toc'-l/onl a b e`
No.and Street Email address CD/y►
M At.tom'/ met of 03S 413.221 .3g42
City/Town,State,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 IX No 0
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 Ric II4121> Bea m J c c I
to act on my behalf,in all matters relative to work authorized by this building permit application.
ttl tAT ll E It.. Plc Crib 0 Fig 4 (dZ.l/2 I
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 ap lication is true and accurate to the best of my knowledge and understanding.
4/zi f z E
Print Owner's or Authorized Agen ectronic 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.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"
The Commonn'eaith of Massachusetts
• e Department of industrial Accidents
1_ 1 Congress Street,Suite 100
t: =
- = Boston, MA 02114-2017
www.mass.go►•/dia
11 utters'Compensation Insurance Affidavit:Builders/Contractors/Eketrkians/rlutnbers,
'1 o BE FILED s IT11 711E PERNIIITI\(:AI THORITY.
Applicant Information Please Print 1-ra ibly
Name(Hiusrncs.Organization!min tduall: &QcI UCCI CO1%3S1 -UCT to►J
Addles: 17 MT. WAS NG/e QD•
City/State/Zip:isAD I. y IAA co 105s. Phone #: '{ 13 - Z21 - 39 4 2
Are y in an rmpinyee?tiled[dor apprapriele teas:
Type or project(required):
I.�1 ant a employer with S__— cmrlutres(full and or part-[titre a• 7. New construction
2.0 I am a sole proprietor or puuncnhip and hate era emplulteca wutl.tnr; for me in S. Remodeling
any capacity.[Nu wuricrs'conga-uuurana- mmieeL_]
10 I am a humeuuner Jawing all wall myself.[No%anus comp.rn,uruaae rcutural.)
9. Demolition
10 0 Building addition
4,0 I am a lwno-turn and will he huirg contractors to conduct all w al.on my paaitwrty. 1 sill
e'ruurc that all cunir•.r-turs either hate awaken'a`unpemation ut uranc.:u arc Mlle I 1 a Electrical repairs or additions
pn pneturs with no cmployca_
12.0 Plumbing repairs or additions
I am a venial contractor and 1 kit c hoed the wh-camtraclurs last,dun the attads-d sheet-
13.0 Roof repairs
ibese wbauntracturs lute ctmployccs and hutc wurla:rs cannp insurance.:
6.0 We arc a corporation and its officers has exercised then nghi of etcnptiun 11ttiL 14.❑Uthct
po
1 y_!.;1441.and we tease nu employees.[So wothers'cum.unto[anae rcyuindl
'An*applicant that checks fait n I*Host atw fill out the sedum bcluw s6 rng then war►cr cump-ruatiun ruin.)rnfunnaitua,
lluineuuncn who submit dos aluidat it uiahcatun dreg arc dant(all we rk and then hue uutsiak contractors must ablaut a rw-w afl-ialat it malicaimg suck
:tent/actor,that check this hot must attached an additional slam show ar c the n:une of the sub-caaatractens and staie nix-titer or nut those entities hate
employees.. If the sub-contractors have employees.du,must prutidc thtiir amity.'amp.paled number.
I am an employer that is presiding worAers'compensation insurance for my employees_ Below is the policy and job site
information.
Insurance Company Name: i 6- /IA'?Fot2.D
Policy#or Self-ins.Lic.i#: IO$(0 0 l)6 I kl O q 7 4 3 2 0 Expiration Date: ////b/2OZ 1
GYJ rrlA 0/410
Job Site Address: I q 3 NOQTIA ST• City,istatezip:/fogni4NP7
Attach a copy of the workers'compensation policy declaration page(showing the policy number and espiration date).
Failure to secure coverage as required under 1MGL c. 152_ 25A is a criminal violation punishable by a line up to S1,5001/0
andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a line 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 ventication.
I do hereby certify tinder the pains and penalties of perjury that the information presided abate is true and correct.
Signature: e' Date (p/ZI
Phone#: A 13 -221 - 3qy 2
Ofcial use only. Do not write in this area,to be completed by city or town official
('its or Town: Permit/License#
Issuing Authority (circle one):
1. Board of health 2.Building Department 3.City Jona Clerk 4.Electrical Inspector 5. Plumbing inspector
6.Other
Contact Person: Phone#:
City of Northampton
?0.-H M SAS . • S4,
t �' �` Massachusetts A. - '<<,,
el
, ' sic . w
DEPARTMENT OF BUILDING INSPECTIONS , z
F "' s
\ w "'T 212 Main Street •• Municipal Building Jti� ``Ca
�w y7.{f Northampton, MA 01060 sbh�, T.�\'‘
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: VALLEV REcyc (-1 .16 / Noarr0Aw►P-rpv..I
The debris will be transported by:
Name of Hauler: 812A7v1 0 cc i CO N SI-RUCT1 D J
Signature of Applicant: 'C Date: b/al /2/