Loading...
37-080 (2) BP-2022-0268 54 PLATINUM CIR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 37-080-001 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-2022-0268 PERMISSION IS HEREBY GRANTED TO: Project# RENOVATIONS Contractor: License: Est. Cost: 30000 RICE ASSOCIATES 49847 Const.Class: Exp.Date:08/31/2023 Use Group: Owner: CHOQUETTE CAPITAL INVESTMENTS LLC Lot Size (sq.ft.) Zoning: SR/WSP Applicant: RICE ASSOCIATES Applicant Address Phone: Insurance: 64 BUTTERHILL RD 4134277505 PELHAM, MA Ol 002 ISSUED ON:03/22/2022 TO PERFORM THE FOLLO WING WORK: WHOLE HOUSE RENOVATION 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 10 9 cs-0 Fees Paid: $390.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner - I✓ce0 FL-00 2 RA-L.) fV _� u O W i 1..)1300..) it-f c /25 l . l a) �o The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR �'. ,;' Massachusetts State Building Code, 780 CMR MUNICIPALITYfRuilding Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 a One-or Two-Family Dwelling z i z This Section For Official Use Only futi Building-Pnt Number: P'..a•• .769 Date Applied: �� 40 /1/1 3•ZZ-ZoZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro 4ddress: 1.2 Assessors Ma &Parcel Numbers .54/pvio. tet/"r) C—t l� 3 7 oc - co ( 1.1 a Is this an accepted street?yes tr- no Map Number Parcel Number 1.3 Zoning I formation: 1.4 Property Dimensions: i Ree ( SEnge i (y OO /IC) Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required � i4 Provided Required Provided /IAm-L04 N4 A / m / /4 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public a Private❑ Zone: Outside Flood ? Municipal 1On site disposal system 0 Check if yesl SECTION�" 2: PROPERTY/� OWNERSHIP' 2. Owne>zl of Record:, 2irl�etr✓t-6 /Lc- /`'7►^'►1'l0S-1- /h A d(OO. Name Print) �'t� City,State,ZIP .5 4ve w naa 41-, /ho 1` D17 y/3-33S--ass 0,64;ooC.ss FreS110 G-i► e I k c(Lyn No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) / New Construction 0 Existing Building i, Owner-Occupied 0 Repairs(s) I Alteration(s) id Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units l Other 0 Specify: Brief Description of Proposed Works-2: re o' p I Ge m e oT �e s_ -RI it /S.Q— bC.in Q . 1,c4- -Sh (� Pam►to ►oi �Q(f3C.2 o 4t✓ � e. ec l lAto 6trS, rvto- / _SIcl h! , 1C� e.✓t, tcths Vot-furr,A. 0 Frac2.3 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 2 n evD 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ..5'(,,vdd 0 Standard City/Town Application Fee 0 Total Project Cost (Item 6)x multiplier x 3.Plumbing $ �'"©C)() 2. Other Fees: $ 4. Mechanical (HVAC) $ 0- List: _ 5. Mechanical (Fire $ ' Suppression) Total All Feek$ Check No\,O a' Check Amount: 14/5610 6.Total Project Cost: $ 3L r: ) 0 Paid in Full 0 Outstanding Balance Due: ell o ercgt I -- Ckerti)0 or,eo@ CAP,nu•sr-, he r 11.0 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) o c y7 Sr—31_Z 3 CIA 1-6� hey- l( R`� 4.sSOc.o4c License Number Expiration Date Name of CSL tiolder 6 y QVhI 11 nd List CSL Type(see below) No.and Street 1'� Type Description Description d 10 ' • VJJ Unrestricted(Buildings up to 35,000 Cu.ft.) Pei hrh>n /1 I R Restricted l&2 Family Dwelling City/Town,Stag ^,�/� ,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances V/13— 7 )5 ricc,cvtr i) Yah o.ccm i Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 1� /370/S //-/4—.2.2 eNNC e_ >��Gt 0 s HIC Registration Number Expiration Date GCo ny ame or1�IIC Registrant Name ice q r2 c Cow NPei d. Street ' A t D � Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.g 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 BUILDINGp PERMIT I,as Owner of the subject property,hereby authorize C�i.-1S�eke- f ,j ce- to act on my behalf,in all matters relative to work authorized by this building permit application. to ifto doge 3// / z Print Owner's Name(E ctronic Signature Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION 12( 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 m knowledge and understanding. .4t64-1451 c 1,o i, Print Owner's or Aut..! ized 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.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.) 3.W/0 (including garage,finished basement/attics, decks or porch) Gross living area(sq. ft.) /7'5 Habitable room count 3' Number of fireplaces l Number of bedrooms 1/ Number of bathrooms 3 Number of halflbaths air 7 I Type of heating system h-o Number of decks/porches Type of cooling system /1-fr Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts • ' =( Department of Industrial Accidents iek1 / Congress Street,Suite 100 Boston. ,MA 02114-2017 •',_4 i��`,t H'rt.'w.mass.,oi'/dia 111)rkers' (Compensation Insurance Afftdasit:Buildersi('ontractors ElectriciaosiPluo hers. I) tit. FILED N ITN TNF_PERMITTING Al I NOKffl .tnplicant Information Please Print l.l'Lih1� Name I liusincsts:tlr;anizalionr1ndividusl): P ice- -Sec e-s Address: l'o' 6, 4e)- 4,1( R4 City/State{Zip; Pell ( mff 6909?2 Phone #: 463 Y-Z 7 ^ 7 SJ5 A re visa as eaaaphyer'Cheek file appropriate boa: 1'yfx of project(required): 1.0 I ant a cngdoycr with empluyrca f11dL rnitut part-tiiii:t• 7 0 New construction 11 I am u'wit:proprietor or puAncrsbip and have no rmplaryvv-s working for me in 8. Eg Remodeling any capacity.[No workers'cunip.tnautunce regrtutnl_1 9. ❑ Demolition 101 ant a lairrAWwtier doing all work myself.!No w inkaTs'curry.rrnuranec required]' 10❑ Building addition 4❑I am a homeowner and will he hams omtrat'1ur'ato conduct ell wick on tax property I will ensure that all colurac`Wra either lralie workers'coor►pens:►trun inaurnner or aft rule 11.❑ Eleciriuil repairs or additions pruprrctort with no employees. 12.0 Plumbing repairs or additions 301 ant a general cunlraetor and I Wise hind the aub-cuntraetun listed on the anaehed sheet. Thew aub-cuntractunav he employees and kasc worker,'erinp.Insurance l 3❑Ruuf mpatrs n.❑we arc a corporation and its officers has a ckm ed then right of exemplum per ML L C. 14.❑Other n 15'.bIt41_and we ha>;e no rrnpluyeeir.(Nu xorkera'comp.insurance requncd. 'Any urn i..rut that ehe..•k.bay tit must also fill out the irection below show tag their w others'contpetuItiun policy,mlonnalion r Homeowners who subtntt this aflida n rnahealing they arc doing all work and then hire Outside coninietoe4 must submit a new affida%t mjre:ttmu.tw h :Curivaetors that check thi.bus must atta+l►ed un additional sheet show mg the name of the sulrevniraeturs and crate whether in nut those entitle.h i.e employers. If fire sub-contractors hair employ M.S.they mum pro+idc their workers'e'olnp 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: _ Policy#or Sell=ins. Lie. : Expiration Date: Job Sae Address: 54/ Ct rCtC City/StateJZip:Flout t, /yf 4 DCcv-z Attach a copy of the workers'compensation policy declaration page(showing the policy number nod expiration date). Failure to secure coverage as required under MGL c. 152. §25A is a criminal violation punishable by a fine up to S1,500.00 and or one-year imprisonment,as well as civil penahies in the form of'a STOP WORK ORDER and u tine of up to 5250.00 a day against the violator. A copy of Ibis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the in/irrmation provided above is true and correct. Signature: � Dale 3/13/ D�oZ.2. I'ltunc : 11/3 - Official use onir. Do not write In this area.to be completed by city or town official city or Town: Permit License Issuing Authorit} (circle one): I. Board of Health 2.Building Department 3.('ityflown Clerk 4. Electrical In±tpector 5. Plumbing Inspector 4i. Other ( outcict Person: Phone 0: City of Northampton �t HAMpT �` C'� Massachusetts 4, ee c �l E 4• DEPARTMENT OF BUILDING INSPECTIONS -.r. 281C212 Main Street • Municipal Building ✓j ��� Northampton, MA 01060 ssNp •Ii7%^S 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: � �1ejsS Lid 'l The debris will be transported by: Name of Hauler: G''°Qt�e; Capig°t _L✓ive`r-'"`' - - L L C Signature of Applicant: Date: 3/ I S/Z c ,7 E-, , ... „, . ..... ,.....e.- lir e 16,7- li . . _ __ _„... ,.. ,_,,„_. _ _ i v , i . I 1 3 i .- v) .;r i 1 0 } . ',E mow. E 1 1 1 j y , _ 1 „w 1 f D t \ 4..i i I cfs • ✓, • •