32A-255 (164) BP-2022-0574
36 KING ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
32A-255-001 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-2022-0574 PERMISSIONIS HEREBY GRANTED TO:
Project# REPAIR STEPS Contractor: License:
Est. Cost: 10000 PIONEER CONTRACTORS 017890
Const.Class: Exp.Date:01/19/2024
Use Group: Owner: MANANTO HOLDINGS LLP
Lot Size (sq.ft.)
Zoning: CB Applicant: PIONEER CONTRACTORS
Applicant Address Phone: Insurance:
PO Box 1 145 (413)626-7267 WCC--50059570120018A
NORTHAMPTON, MA 01061
ISSUED ON:05/23/2022
TO PERFORM THE FOLLO WING WORK:
REPAIR FRONT STAIRS
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
I
I'
Fees Paid: S 100.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
RECEIVED
s, e Commonwealth of Massachusetts
1: ,11 ), MAY 2 0
lI 2022 Office of Public Safety and Inspections
Massachusetts State Building Code(780 CMR)
bFPT OF R „ Pe 't Application for any Building other than a One-or Two-Family Dwelling
v _ t1 OINK INSrtC PIONS
NoaTHaMr ToN Ma olnsn i (This Section For Official Use Only)
Building Permit Number: .. r7''f•_. -bate Applied: Building Official:
SECTION 1:LOCATION
3b YInI vkp c'tir Kk O(L? b , Yo.` L
No.and Street City/To Zip Code Name of Building(if applica le)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State CCode used If New Construction check here 0 or check all that apply in the two rows below
Existing Building® Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other Specify:ev�
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No IV
Is an Independent Structural Engineering Peer Review rered? Yes 0 No ILK
Brief Description f�/f Pr ose opd Worik: P--e, , "`oy"4 0"`g•
/>
Tlo-rs?...., CA,
" TIAL, - Sa cttort,
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) J
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 VA-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business.❑ E: Educational 0
F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional I-1 0 I-2❑ 1-3❑ 1-4❑ M: Mercantile 0 R: Residential R-11" 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 0 HA 0 IIB 0 IIIA d IIIB 0 IV 0 VA ❑ VB 0
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information / Sewage Disposal: Trench Permit: Debris Removal:
Public Check if outside Flood Zone Crl Indicate municipal A trench not be Licensed Disposal Site 0 �,p
Private 0 or indentify Zone: or on site system❑ required B or trench or specify Ai
-
Private is enclosed❑
Railroad right-of-way Hazards to Air Navigatio • MA Historic Commission Review Process:
Not Applicable Is Structure within airport ap. each area? Is their review comple ?
or Consent to Build enclosed❑ Yes lD or No n Yes 0 No
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction
Does the building contain an Sprinkler System?: le% Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address.f Property Owner
t C q ' i 3� *' i Ntf► O1060
Name(Print) No. Street City/To n Zip
Property Owner Contact Information:
3:risk (-Ve55 0a1(5 y t3 ? - s(12-- - -
Title Telephone No.(business) Telephone No. (cell) e-mail address
If ap licable,the property owner hereby authorizes:
I wteese' COArLeisiS Q-U) (3v c i 144 ^- PVC b i*t
Name Street Address City/To n State Zip
to apply for and act on the property owner's 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 ProfeeQional Responsible for Construction Control(the professional coordinating document submittals)
- •- - H-3-- -- - I
Name(Registrant) Telephone No. e-mail address Registration Num}---
rt
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
.Q j OlA,eeir $ad11 rS
ComL/ )
ame
C14v^ CAS— ,)17k0
Name of Person Responsible for Construction License No. and Type if Applicable
.Q,t, 1�vd i \ 4J-- rt. `ik. - d/D(9(
Street Address City/Tov.In State Zip
'{14- C ib - 12,41 - - I t G�+,twe. €ti� ,6%14-
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the• suance of the building permit.
Is a signed Affidavit submitted with this application? Yes No CI
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ (.d 1 M.•L Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)=$ .
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (7 (contact municipality)
5.Mechanical (Other) $ Enclose check payable to Gt
6.Total Cost $ i 0I b,vy•P7 (contact municipality)and write checknut
u ber here of l 30
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 and accurate to the best of my knowledge and understanding.
►& 61a PI t1 - 624- 72-17 -12612-47 -
Please print and sign name Title Telephone No. Date
f v , i iy 11(44 ��o�/ c0' "- a lob 1 Pz 4500.tcip t Q,treat., 6s-1--
Street Address City/Town State Zip 1 Email Address
, • • ✓
Municipal Inspector to fill out this section upon application approval: •� ' �
Name • . ►Date
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The Commonwealth of Massachusetts
'}_ l Department of Industrial Accidents
n::aav 1 Congress Street,Suite 100
lii�ilar Boston,MA 02114-2017
www mass.gov/ilia
11 ui kers'Compensation Insurance ARidasit:Builders!('ontractorslEkctriciansfPlumhers.
10 BE FILED%%FIB THE PERMI"t'f1M:ai'11101 11.
.tniilicant Information Please Print I.ceibis
Natnc t tiusinrs.t kganwatxxt Individual): Si)I 1 -��
Address: -Q _ bG)- ily
City/State/Zip: Phone #: 103
Are y.m an empla)er?Cb.rk tie appriagaste hex: Type of project(required):
t.Erain a employer with 3, employee.(full arid«pan-Arne)-' 7. 0 New construction
201 am a sole proprietor or punnenhip and have no empleyctis wonting for me in 8. O Remodeling
am capacity-t`u workers;comp.insurance moved"
301 am a homcsownT dun+ work myself. workers'c ieurrkr n 9- ❑Demolition
S ally [• imp. matured. .
4.0 I am a hoowner and will be hiring contractors to conduct all work on my pompons. I will I Q Building additionxn
ensure that all contractors either have wurken'compensation Minn:woe or are WIC' 110 Electrical repairs or additions
propncton with no employ c a.
12.0 Plumbing repairs or additions
50 1 am a general contractor and 1 hoe hued the sub-contractors listed on this attached shed 13.QRoof repairs
These sub-contractor.lease employees and have winters'ceatp.nrttoaaae.:
60 Vie are a corporation and its officers hate exercised their right of exemption per M(iL c. 14. of v---
1 t 2. It 41.and vie base no employees.[se workers'comp.Itrtmo t required)
•Any applicant that checks boa al OMM she fail out the section below show in theft workers'compensation policy inlimcatuas.
o Homeowners who submit taicatini they are doing all work and then hire outside contractus must sulnmat a new atfidas at udradisg su:h.
untracturs that check thia b.ltttaa alafeheda.additional shod show ing the name of the sub-contractors and state whether or not those cohti es hale
employees It the.ob-crulhaalia VMe enployds.they must pros ode their workers'ovcnp policy ntanbcr.
I am an employer that is providing wor*ers'compensation insarane a for an employees. Below is the policy and job site
in/urination.
In�ut.ut.e Company Name: s =`t-y 1 Pd`-S ' ' °`^'CA'.
--l/—St?
— -- —
or Self-ins.Lie.#: U IGG- " —STD�a57 132 2./4 Expiration Date: (ca 1 4z3.
Job Site Address: 3/, - t'1 6"— City;�'State'Ztp:
Attach a copy of the workers'ction policy declare page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152.425A is a criminal violation punishable by a tine up to S1.500.00
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 DIA for insurance
coverage verification
/do hereby certify a e the pain t l 'es of perjury that the information provided above is true and correct.
Signature: 'el1 1
Phone#: 41 .CV42 � e
Official use only. Do not write in this area,to be completed by city or town°Meant
('ity or Town: Permit/l.icrnse
Issuing Authority (circle one):
1.Board of Health 2.Building Department 3.('ity."lasso('lerl. 4.Electrical Inspector 5.Plumbing ltrsltrttiir
6.Other
Contact Person: Phone is:
City of Northampton
``''''' 'lirli, S`5 sir
r� t Massachusetts ..4
6/ _ ' µ. all ;
Y y:
;,t 1 s DEPARTMENT OF BUILDING INSPECTIONS y'
=�' 212 Main Street • Municipal Building vp,, D�
* �- Northampton, MA 01060 f ._,. �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: An cA
t/.,
The debris will be transported by:
Name of Hauler: V5&
Signature of Applicant: �/, ,l Date: s'� j/Z-v