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24D-312 (2) BP-2022-0858 70 BANCROFT RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-312-001 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-2022-0858 PERMISSIONIS HEREBY GRANTE TO: Project# kitch/basement reno Contractor: License: Est. Cost: 75000 BRETT SAHARCESKI 110761 Const.Class: Exp.Date:01/16/2023 Use Group: Owner: BARBARA TAKAHASHI Lot Size (sq.ft.) Zoning: URA Applicant: FINE LINE BUILDERS LLC Applicant Address Phone: Insurance: 29 TAYLOR HEIGHTS (438)342-9831 PLA5026-PCCM374846 MONTAGUE, MA 01351 ISSUED ON:08/15/2022 TO PERFORM THE FOLLOWING WORK: KITCHEN AND BASEMENT RENO 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: • r A - ''1 • Fees Paid: $487.50 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildine Commissioner The Commonwealth of Massachusetts `� I Board of Building Regulations and Sta rds Jut 1 n 2 I IOPA ITY Massachusetts State Building Code, 780 MR Q `' USE Building Permit Application To Construct,Repair,Re vatStIf lie • Revis d 417 2011 One-or Two-Family Dwelling _-°FAT 1/44,4o2.N!ASS, cr n This Section For Official Use Only n ono s ' Building Permit Number: 4 P-'4.).--1 Cr2 Date Applied: 1 . • il .>\ V.. Ige Building Official(Print Name) Signature to SECTION 1:SITE INFORMATION 1.1 Property AddresE. 1.2 Assessors Map& Parcel Numbers 7n tincro ci b 3/'°/' 1.1 a Is this an accepted street?yes x 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: Outsi Public Private 0 Zone- Check f Flood yes❑Zone? Municipal�'On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1. Owner'of Record: bck-r Ook.c-ems 'C-0,v-cor\okShh, Al n t' mo w,p4v4-• /1Ac O lC LQ C) X, Name(Print) City,State,ZIP 70 ccncic4t- _ 8'17-7?8-3 c2 . ? 1.B g0. n•a\ic.0 No.and Street Telephone Finaff Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building' Owner-Occupied pr Repairs(s) 0 Alteration(s) pr. Addition 0 Demolition pi Accessory Bldg.0 Number of Units Other 0 Specify. Brief Description of Proposed Work': fst Se trv2 n-1- c\rck. 1�,-1-c-N•tx� Rc rz v c„ o.-- 1�c-w C�tAtAS Ck & kJt. i) \ V k-d-•-v\_ 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: 2. Electrical $ 0 Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ 1f,( g7 Check Nobble' Check Amount: `'! 6.Total Project Cost: $ lc-WO ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C,S- t(0 7 61 Up 23 - SkINnorti2SI License Number Date ame of CSL Holder List CSL Type(see below) V 7 A i k Sired No.and Street Type Description nn • �� © ``��1 U Unrestricted(Buildings up to 35,000 cu.ft.) l 1 lt?(� �l� R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding ,J �/ - SF Solid Fuel Burning Appliances -i 13� /-2 /e t ,{- 6 l_.,'neBu►kapW,u-Gen I Insulation Telephone Email address D Demolition 5.2 Registered Home Improv''eme//nt Contractor(HIC) HIC Registration Number 'on Dale HIC Company Name or HIC Registrant Name '?s( cat- \\-#-S ,.et#0,_ ' lal-�6v i ic sW o No.and S t Email address rests .Nt,� 11A C. o%3sl ur3$3y-23`tg City/Town, ate,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 Pr 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 auth6nze to act on my behalf,in all matters relative to work authed by this building permit application. a(bc.. c��.a.h�' h,i. • 7 .16 .. 22- 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 is true and accurate to the best of my knowledge and understanding. oi(�G "raLaV)civGv 1 -7 • I R •"22 Pn- er's or Authorized 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.) (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 Commonwealth of Massachusetts - ' f Department of Industrial accidents ?lei I Congress Street.Suite 100 V: . :is Boston,MA 02111-201 -i www.macc gov/dia 11 urkers' Compensation Insurance:tffidas it:Bui dertd("ontracters/EiretriciansTlumbers. i0 NE(ii.ED 1%I"I II 7111:PERMITTING Al ille)RI I1. Applicant information I Please Print Legibly Name(Business Organization Individual): c(�ve.. `-. Z V►, LL C.._ Address: 2°( *t (f cam- Wk , City/State'Zip: ,kC,u- Mc. O l35 k Phone*: cf 1 `e,3d -23e7 i Art sou an employ tr'l'hccI.than appropriate irsn: f,,I pe of project(required): 10 I am a employer swath marls+ ec.purls and of part-true!" 7. jJ New'eonstructi'n am a.talc pnrpratitx'or p:utncr.hip and haw err Crnp&n.xa scruiura tier me in S Remodeling airs capacity_11Nn%miens'comp amuran.x required.' 9. Demtalitttrn ,.j I car a licrntctrttnct doom alt work myself Ito rstwkara camp_ansuratii.required"' '"� 10 3 Building addition •1. I t am a trnnc.'uvmm m and swell l"c hump rxn*ractors Its conduct all work tin row propet'ty. I a ill cruaue that all c'nrtnwtorw other hate sandaers"ctwnrcnsatitrtr firer uramnn ter are Nob: 11.0 Electrtt::tt repairs or additions propnctwa swath no casplrryecti. 12.D Plumbing repairs or additions I am a general contractor and I hoe hued the wM-eontrackrn hated ern aka:attached died- lhcae sub-contraeturx hoc anplo .v ea and ha►c worker.'comp.nourance_- 130 Roof repairs 14.r1()thet 6.0 Wit arc a et,rpirraturn and it,o tiew ra hate exeres..-d then rapist sort excimpanin per 011:1.c_ 152.(ICI t.and uc lapse rat,ctriplo+.ee'..[No*oaktm.'s..maip.m us:ince reyuarcsl.f ".li.m applicant that check%box- I shut also till out the sodium tu.ltww.law.mp then sa Oft......- 'cwmtpeaeaturn pedw.y urtk rraatmen. + I known nee who%l1 nht thin attrtla+at na.3tcating they are sluing all sots rk and then laic+iit.ule ctntreettu.nand!Album a mu.allidas it itdilaillg ateciu. t.,nir:uk,rs that.beck this how.muwt attached an additional sheet'lowing the name.4 the wed•-s.ontractot,and-.sate 0hcthcr.,not[term:at11WYxe lItl c inpl,rp.:,,,._ It time sub'e.rnalt tr .ris lue t cir#illrw'ees.the!. masa plow ale their warkcrs'cramp.la4m nuuiler. l am an employer that is providing workers'compensation insurance fur nay employees. Below is the policy and jab site information. Itp.tir.uttc( trot{r-true Nam e: Y_�� .r— Ptrlrtq#or Sett=nts.Lit:.4: Expiration Date:_ Job Site Address: City Sutter Attach a copy Mille nerkers"compensation policy declaration page(shooing,the policy number and owl date). }-adore to secure costa q e as required under 1NGL c. 152.*25A is a criminals rotation punishable:by a tine up to 1,500.00 and or one-year imprisonment,as well as civil penalties in the hens of a STOP WORK ORDER and a tine oi'up $750.00 a :l,s against the s ioiator.A copy of this statement taws be forwarded to the Office of Investigations of the DIA for insurance ti.us t:ta;e weriticatian. . I do hereby certify- nder the pains and',enables of perjury that the injnrmation proridfe labare is true and rarre:I. ' tonal DDate:m Phone#: 6/12 ypr'i -J V -Z- ✓ r G✓ .rr Official use only: De,not write in this area.to be completed by city or town official ('it,. or Tuna: PerrnitlLicense tr Issuing.tuthoritr(circle one): I. Board of Health 2.Building Department 3.City/ own Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone-: City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: -7b cc The debris will be transported by: L ,A The debris will be received by: Ueklly Building permit number: Name of Permit Applicant g,„k6t LLC. 7/jig ,14., • Date Signature of Permit Applicant 8/15/22 10:23 AM City of Northampton Mail-70 Bancroft rd Northampton c 3 # c F _ G 1.1 tYA. J D C<( 1 V C>r h w1 �� ��:.' P4 iI} 722t k wm(1.c4v% .1 e x h ► t-f Yit 1 u \— - _ t / s y Aik Iv k ir i Lk; � ,,. + ,e-, •z ,)-tc‘ 1 hops://mail.goog le.com/mail/u/1/?ik=e5d 1685713&view=pt&search=all&permthid=thread-f%3A1741236660795912847&simpl=msg-f%3A 1741236660... 2/2