38C-043 14 SOUTH PARK TERR COMMONWEALTH OF MASSACHUSETTS BP-2021-1791
Map:Block:Lot:38C-043-
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-2021-1791 PERMISSION IS HEREBY GRANTED TO:
Project# Contractor: License:
Est.Cost: 18550 WESTERN MASS MASONS
Const.Class: Exp.Date:
Use Group: Owner: OEN, LEANNA and BRYAN COMER
Lot Size (sq.ft.)
Zoning: URB Applicant: WESTERN MASS MASONS
Applicant Address Phone: Insurance:
383 COLLEGE HIGHWAY 4135271800
SOUTHAMPTON, MA 01073
ISSUED ON:08/25/2021
TO PERFORM THE FOLLOWING WORK:
REPAIR FOUNDATION
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.
Signature: • l
ir • y2 3-11 •
I0
Fees Paid: $120.25
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
RECEIVED
T - Co nonwealth of Massachusetts
AUG 2 3 20oar. of B ilding Regulations and Standards FOR
Mass. hus is State BuildingCode, 780 CMR MUNICIPALITY
USE
_ oF NT,Sf ll r`, :: _ 9 icati n To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
b1A O1oso, s O or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: '! k 17-`/ Date Applied:
‘,2 7 6
Building Official(Print Name) Signature 14te
SECTION 1: SITE INFORMATION
1.1 ['grtA Addy: povi jc,71,2A,, 1.2 Assessors Map&Parcel Numbers
1.la Is 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 0 Private 0 Zone: Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: �f ,.^
le annc4., 0En lw01 M7 •
Name(Print) City,State,ZIP
/4 Sower pc4-1( W. ( - ays',771
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) ❑ Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work':
tidti
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: 2.
Check No. $1 tiOCheck Amount: (20` Cash Amount:
6.Total Project Cost: $ lP, U w ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
DIA 0 Os:c-A, License Number Expiration Date
Name of CSL Holder
3P3 ccid {J`7 List CSL Type(see below)
No.and Street Type Description
`� 2 U Unrestricted(Buildings up to 35,000 cu.ft.)
So y^ 'h / IV0 O GO 2J R Restricted 1&2 Family Dwelling
City/Town,State/ZIP M Masonry
RC Roofing Covering
WS Window and Siding
4//
/t �^) SF Solid Fuel Burning Appliances
5-,J d`)'l(/' ' Oc.,1.% ct.,ore i�/f/ s/44'ir -'- I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
�, " /33 / /-y-
t) ,• &kJ arty HI Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
S
No.and Street Email address
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 Issuan f 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
to act on my behalf,in all matters relative to work authorized by this building permit application.
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 application ' true and accurate to the best of my knowledge and understanding.
1)44 a ok-„id-kol /
Print Owner's or Authorized ent'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.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"
City of Northampton
/�..-j Massachusetts 4Qy'j`' L '''I
a
:X
DEPARTMENT OF BUILDING INSPECTIONSr212 Main Street • Municipal BuildingJ4rrO
-- Northampton, MA 01060 rs'6yft--° j°
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: D/A)/ t - _
The debris will be transported by:
Name of Hauler: Ce JA- le,A, 1 '
Signature of Applicant: Date: F---2-1--;
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
F. Boston, MA 02114-2017
»r)t+w mass. ov/dia
.rr�i.'a 1l wkers' ('ontpensatiun Insurance:Ursdas it: Builders Contractors Electricians/l'Iuothers.
I U BE FILED I.F:I) ,n H THb:PERMITTING AIITHORITt".
.Applicant information Please Print Lettibls
Name(Bus tnrss Ori;a ton lnd (tris Anal): t tt T 4,440 ,2
Address: 3(P 3
City/State'Zip: je7a • Q4i?j Phone#:
Are you an employer?Cheek the appropriate box:
Type of project(required):
1. 1 ant a employer with employees(full andkor part-tinny* 7. Q New construction
201 am a sate proprietor or partnership and base no employees working forme in 8. Remodeling
any capacity.]No wutkers'comp.insurance respired.]
�3,�I am a homeowner dumb all work myself.]No stinkers'comp.insurance roomed.] 9. Demolition
4.0 ISM a hom rr evwn and will be hiring contractors to conduct all work on my property. I will 1 O Q Building addition
ensure that all cotton toes either have workers'compensation Insurance rev arse irk 11.0 Electrical repairs or additions
piepnetors with no employees.
12.0 Plumbing repairs or additions
5rl I am a general contractor and 1 have hired the sub-:unuueturs listed on the attached sheet. 130 Roof repairs
These sub-contractors have employees and have workers'camp.insurance.:
6.0 We are a corporation and its officers have exercised their right of exemption per MCI c. 14. Other
152, 1(4).anti we have no employees.[No workers'comp.insurance required.]
*Any applicant that cheeks box 41 mint also till out the section below showing their worker's,'compensation policy information_
*Homeowners who submit this arltdasit indicating they are doing all work and then hire outside eon tra tors mint submit a new affidavit indicating reach.
:C ontiactors that check this boa must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. It the sub-contractors base employees.they must pros ids their ssorkcrs-sump,policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. //
Insurance Company Name: ‘rc, C 4-Ad
Policy#or Self-ins.Lie.#: '7t> 'I(0 6 Expiration Date: 41-4
lob Site Address: Al JO'I c r /k /(�' CityfStateiZip: AZ u'a6U
Attach a copy of the workers'c pensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S 1,50().00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine 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 DR for insurance
cos cr,tgc verification.
I do hereby certify der the pa' . and penalties of perjury that the in/arnu:tion provided above is true and correct.
Signature: Date I -0Z)
Phone K: -/(4(ll �1`�—
Official use only. Do not write in this urea. to be completed hy city or town official.
('it) or Toss n: Permit/license to
Issuing Authorith (circle one):
I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector
6.Other
Contact Person: !'hone 4:
RN
383 College Highway
Southampton, MA 01073 ln' N LICENSED • REGISTERED
(413) 527-1800 �' " INSURED
WesternMassMasons.core
quality@westernmassrnasons.com
4so
} LEANNA OEN
Date: T4-12-2021
To: 14 SOUTH PARK TERR. Quote# 7832788
NORTHAMPTON MA Project ; FOUNDATION WALL
Phone: _ � s^'p�-�7f ,_. I-
I ...._.__...._. _.._...._..._.__.._.._...___--_.__r.,
E-mail:
Description of Work To Be Done:
THE FRONT LEFT SIDE OF THE FOUNDATION WALL WAS INSPECTED AND IT WAS FOUND
THAT IT IS VERY UNSTABLE AND NOT STRUCTURALLY SOUND.
THE FLOOR JOINTS ARE ALSO BEARING ON THIS SIDE OF THE FOUNDATION.
THE ONLY WAY TO CORRECT THIS IS TO REMOVE AND REPLACE THE WALL.
SUPPORT THE FLOOR JOIST AND EXCAVATE DOWN TO THE FOOTING OF THE HOME FROM
THE INSIDE FRONT CORNER TO THE INSIDE CORNER OF THE RETURN WALL. REMOVE ;
AND DISPOSE OF THE FOOTING AND WALL.
FORM AND POUR NEW CONCRETE FOOTING WITH REBAR AND VERTICAL REBAR EVERY 6'.
POUR 4'X 10" WIDE CONCRETE WALL AND REBAR TIE INTO THE CORNERS, OR 8" BLOCK.
INFILL WITH 8" BLOCK TO THE SILL PLATE.
TAR EXTERIOR.
BACKFILL WITH OLD MATERIAL.
CALL DIG SAFE.
PULL BUILDING PERMIT.
I *** NOT QUOTED HERE IS ANY AND ALL CARPENTERY. ELECTRIAL OR PLUMBING IF
I NEEDED***
Thank You For Choosing Western Mass Masons!
,,- .-Alr\---!17
383 College Highway / ` %
Southampton, MA 01073 / V} LICENSED • REGISTERED
(413) 527-1800 I'' INSURED
WesternMassMasons.com 411r_&r_i_. 0 , etz-zao
qualityitwesternmassmasons.cotn `� '
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WE HEREBY PROPOSE TO FURNISH MATERIALS AND LABOR- = 18.550.00
IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS,FOR THE SUM OF: I
This quote may be withdrawn from us if not accepted within 30 days.Quote Prepared By: David Osiedci
TERMS:Any alteration or deviation from above specifications involving extra costs wit be executed only upon written orders,and will become an extra charge over and
above the estimate.By signing this quote,you agree and understand all the above terms and conditions that apply to this job.Any changes that are to be made,must be
discussed prior to construction and agreed upon by contractor and may also affect to the final price.
PAYMENT TO BE MADE AS FOLLOWS:One half of quoted amount is due when job construction has begun.Remaining balance of bill wit be paid in full when job is
complete.A Finance Charge of 1-112(18%annual rate)per month will be added to any unpaid balance over 30 days.
ACCEPTANCE OF PROPOSAL:the above prices,specifications and conditions are satisfactory and hereby accepted.You are authorized to do the work as specified.
Payment will be made as outlined above.
Signature: Date: 'Signature: Oate:
Thank You For Choosing Western Mass Masons!