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32A-272 (6)
BP-2021-2258 21 MAIN ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-272-001 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-2021-2258 PERMISSION IS HEREBY GRANTED TO: Project# REPAIRS Contractor: License: Est.Cost: 4000 106527 Const.Class: Exp.Date: 12/23/2021 Use Group: Owner: CHAMISA CORPORATION Lot Size (sq.ft.) Zoning: CB Applicant: BEYOND BUILDERS Applicant Address Phone: Insurance: 117 SUNNYMEADE AVE 6HUB-2E676637 CHICOPEE, MA 01020-1780 ISSUED ON:12/03/2021 TO PERFORM THE FOLLOWING WORK: REPAIRS TO DRYWALL, FLOORING REPAIRS 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: �) ► '�' • 9I., I . r Fees Paid: S 100.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner r_ DEC - 2 2021Th Co monwealth of Massachusetts Of ice of Public Safety and Inspections W Ma sachusetts State Building Code(780 CMR) kufoot Per _ Ns catio for any Building other than a One-or Two-Family Dwelling _. ---,_____,(_This ction For Official Use Only) Building Permit Number: .% t-..)a 5 Y Date Applied: Building Official: �1 SE ON 1: CATION EE :Z1 J?7a/ /lnr,11uno 1 4/1)6© r e-'r !/ .� No.and Street / City/Town /Zip Code Name of Building(if ap le) Assessors Map#/7e l Block#and/or Lot # (/ SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0 Is an Independent Structural Engineerin eer Review re d? Yes ❑ No BriefBrgZcriptipn of Proposed Work:T s� SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq.ft)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5❑ B: Business kacir YS A Educational 0 F: Factory F-1 0 F2 0 . H: High Hazard H-1 0 H-2 0 H-3 0 H-4❑ H-5 0 I: Institutional I-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ HA IIB 0 MA CI IIIB ❑ IV 0 VA 0 VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Sup ly: Flood Zone Information Sewage Disposal: Trench Permit Debris Removal: Public Check if outside Flood Zone 0 Indicate municipal ____„' A trench will not be Licensed Disposal Site 0 Private 0 or indentify Zone: or on site system 0 required 0 or trench or specify: permit is enclosed 0 Railroad right-of-way. Hazards to Air Navigation: \I.\Historic Commission Review Process: Not Applicable 0 Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: City of Northampton p,Ft• ..,..y Massachusetts 14. DEPARTMENT OF BUILDING INSPECTIONS r xis`212 Main Street • Municipal Building y C Northampton, MA 01060 b PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR COMMERCIAL& MULTI-FAMILY NEW CONSTRUCTION/ADDITIONS/ALTERATIONS 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specification of proposed work(digital and hard copy). 3. Site Plan with location of proposed structure(s)and setbacks. 4. Construction Debris Affidavit filled out and signed by applicant. 5. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 6. Contractors must supply a copy CSL and proof of Liability Insurance. 7. Energy Conservation Compliance Certificate(if applicable). 8. Note any Conservation and/or Special Permit requirements (if applicable). 9. Driveway Permit(if applicable). 10. Proof of Water and Sewer entry fees paid(if applicable). 11. Trench Permit(if applicable). 12. Initial Construction Control Documents filled out and signed by the Registered Design Professional in responsible charge. I . SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Propffrty Owner ./..eaPe CO .23M7,4( 4,74- #.141-4?)77/7)-7/ A el/eve .. Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the prr�erty owner h reby authorizes: �/ 'Jz,`'6�a r //`7$a i /t 4�d [ ltcc a"Q- j Name Street,aiallress City/Town/ State Zip to apply for and act on the property owners behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 bd eneral Contractor .,2 C —/e16 7. .-^7 Name of Person Responsible fo o true on License No. and Type if licable pp / � 'Z Street Address City/Tw(vn Z / State Zip , lJ Vi,...- = 2--7 - - h, .'4vi k-IPCj ) �j�� r r Telephone No.(business) Telephone No.(cell) Or e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes 0 No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$_ _. 1.Building $ "' Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal for)=$ . 3.Plumbing $ 6� 4.Mechanical (HVAC) $ Note:Minimum fee $ [ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to ,1 6.Total Cost $ (contact municipality)and write check number here -f ' SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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 d curate to the b of my knowledge and understanding. t y eg7-3727 Please print d si m A cA,4.,,„A Title Telephone No. Date Street Addr C/ ity4'Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: I /3/ 1 Name Date CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton Massachusetts A DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 1:. 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: VALLFELI c r GL,1067 _ The debris will be transported by: Name of Hauler: Signature of Applicant: Date: 1 -e\ ,,z..,.. The Commonwealth of Massachusetts Department of Industrial Accidents ,- - I Congress Street,Suite 100 , . Boston,MA 02114-2017 .7-12 -: • --7-..-Q,, ' www.mass.govidia %Yorkers Compensation Insurance Affidavit:Boliders(2ontractors/ElectriciansiPlumbers. TO BE FILED Nall 111E PEILNItrrrsG AUTHORITY'. Applicant Information Please Pri t Legibly Name il i Bus ut.v.-..ss,t)rpritta lion.Ind 1 v idual): Vi ..., ex et Address: d.7 (.... el/17 •P City/State/Zip: Phone#: 'kre visa am tarp/Dyer?Cheek the appropriate hot: Type of project(required): 1. arrra trick"),ot with -..-danpi,..,,,..eN I tun=dor part-unte).• 7. 0 New construction _La am a sii.ile proprietor or partnership and hate no etickryees worknts for toe na B. % R , k b'ling an L-iimiciry.INu workers'ectrip.insurance itsfuiredi —„ 9. . Demolition 30 lam a lionicovviart doing all work myself.[No workers'comp.isisuranix rcquired_j" IC ci Building addition 4.0 i am a flontorwmta-arid*Al be hiring onitraciors tia conduct all work on my property. I bita ensure that all contractors either have w.orkers'ciAnirraaation insurance or axe sole I 1.0 Electrical repairs or additions proprictora with nu crapluyeta, I la Plumbing repairs or adttitions ',..1 I ant a general contractor and!have hoed the,sab-contractors. listed on the touched sheet_ 13.1:jRtX)f repairs " These sub-contractori have employries arid have workers'eornp.rnsiaraziee) 1400the1 elf]We are a corptirahon and its officers have eketVISed ihet?right Slf exeraphon per AKA.c. 1.12.§I i-I i.and we&site no entployera.[No workers'conap.insurance required.j *Any applicant that checks hot 41 moat also fill out the section below showing their wors....7.,‘'c.omperwation policy information. "Hornewithers who stibmrt this atraktvit indicating they are doing all work and darn hut Putiide contractors mint sotanit a new affidavit Militating such. Contractors that check this hot Into attatthed an adthhonal hot show inn the name,,f the stab-c.ontmettn3 and nate whether or not those entanci Katie irmployera... If the sub-triratratii,h.,...:oriployees.the!, mom provide their kvoik.c:, ,:,-rtip.policy number I am an employer that is providing worAers'compensation insurance for M y eniployees. Below is the policy and job site information. ..„...--i Insurance Company Nanie: //IA 1,14:e .. ,. -. — Policy#or Self-ins.Lie.#: - -7i -.7 Expiration Date: /2:2 31-gi ,,,,,..7_ Job Site Address:,2/ 1/ir r/2 t5t- CityStateZip Pie /49/2Yeir5 Attach a copy of the workers'compensation policy declaration page(showing the policy namber and ex ration ate). Failure to secure coverage as required under NIGL c.. 152.§25A is a criminal violation punishable by a fine up to$1.500.00 andior one year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day against the violator.A copy of this statemer:t !nay be forwarded to the Office of Investigations of the DIA for insurance - coverage verification. 1 do hereby rertifir at er the s penalties [per-fury that the rotor:nation provided iibov•is fru. nd correct. i IlL1..: 4:2 , .P./ --.,_•11.,-.are: Phone#: Q/35 3,g--7----. 777 Official ItNe only. Du not write in just urea,to be completed by city or town official City or Tut ri: PermitiLicense tt Issuing Authority(circle one): I. Board of Death 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector i. 6.Other ( intact PerNon: Phone 4: a Number C-20166 November 30,2021 PO#AF-36809 Gene Borowski Licensed&Insured General Contractor MA Ho CS-106527 117 Sunny Meade Ave, Chicopee,MA 01020 0 A.. ■ ' (413)687-3777 E3 L ,_. DE R S CUSTOM DESIGNS NEW HOMES•ADDITIONS•RENOVATIONS ESTIMATE/CONTRACT Submitted To: Job Site: Fitzwilly's Att. Fred Gohar 23 Main Street Northampton, Ma. 01060 Phone (413) 586-8666 E-Mail fgohr@fitwillys.com SCOPE OF WORK Renovate Tossed Owls basement bathrooms. Permits/Insurances/Protections: 1# Provide drawings and file pennits as frequired. 2# Furnishing a certificate of general liability and work compensation insurance. 3# Provide continuous supervision over workers and sub-contractors. Bathrooms: 1# Demolition of existing floor joist and damaged sill plates, 2# Install(2)ventilation vents one in maintenance closet and the other in liquor storage area, 3# Install new(2"x6")PT floor joist(16")OC with Simpson Strong Tie brackets. 4# Install MR gypsum wallboard tape,and apply three coats compound, 5# Primer and paint(2)coats latex. 6# Install Plas-Tex wall covering with trim over all walls accept brick wall. * Plumbing and Flooring to be supplied by Fitzwilly's Management Pennits/Filing Fee $ 375.00 Material $ 1,548.00 Labor $ 2,050.00 Total Bid $ 3,972.00 + M We hereby agree to follow all requirements specified in this contract as well as all manufacturers' specifications. The job will be completed in a substantial workmanlike manner. The site will be kept clean at all times and all material will be stored properly. The job will be completed within (1) Weeks; excluding conditions beyond our control such as: any material not provided on time by client. All labor guaranteed for one(1) year. Any alteration or deviation from the above specifications involving extra costs will be executed only upon written orders and agreed to in writing by client and architect will become an extra charge over and above the original contract. PAYMENT SCHEDULE TOTAL CONTRACT $ 3,973.00 $ 1,500.00 Required to start contract with the balance of$2,473.00 due upon completion of contract. ACCEPTANCE OF CONTRACT The above price, specifications and conditions are satisfactory and are hereby accepted. You are authorized to perform the work as detailed in this Contract. Payment is outlined in the above Payment Schedule. Gene J.B rowski, 1 Contr for Flient Si Gene Borow 11/29/2002