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32A-101 (12)
B -2022-1225 12 MARKET ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-101-001 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-2022-1225 PERMISSIONISHEREBYGRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 33500 YAMIL JR BRITO 115714 Const.Class: Exp.Date:03/31/2025 Use Group: Owner: TRUST MARKETSQUARE CONDOMI IUM Lot Size(sq.ft.) Zoning: CB Applicant: B. ALPHA CONSTRUCTION Applicant Address Phone: Insurance: 29 DANIEL DR (413)539-8310 A9WC324145 CHICOPEE, MA 01013 ISSUED ON:09/30/2022 TO PERFORM THE FOLLOWING WORK: INSULATION!WEATH ERIZATI ON 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 VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: i `�>t Fees Paid: $234.50 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner \\ L " I tr / C14 r�vi�— 0021 The Commonwealth of Massac sets /L 5 E0 Office of Public Safety and Inspeec`6. Massachusetts State Building Code(78Q.0 c" � �,/'`) Building Permit Application for any Building other than a Os •k; , o-Fan*y Dwell. g Qfhp,� c� (This Section For Official Use Only) ��,SGS Building Permit Number: .3,1 - iA)-6 Date Applied: Building Official: ‹p'O SECTION 1:LOCATION �7 so/(41,s ) --i6 i c.aKe- 541 Nc,f-k1N6,, 4- ( i ( • 1 No.and Street City/Towp Zip Code Name of Building(if ap. 'cable) Assessors Map# Block If 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 I Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other pecify: A.cut t^'t i rs ll Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No i Is an Independent Structural Engineering Peer Review,p required? 'r Yes 0 No re Brief Description of Proposed Work " v‘S U 1 CkA-,04 I h a-,Irk-A C� i t�c4 1 1 o'-v1 a ftlioct5 c1ta.evl1- , _ _ 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 0 E: Edpcational 0 F: Factory F-1 0 F2 0 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❑ I-3❑ I-4❑ Mi 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 0 IIA O IIB O IIIA O IIIB O IV 0 VA D V B 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: A trench will not be Licensed Disposal Site 0 Public 0 Check if outside Flood Zone 0 Indicate municipal 0 required❑or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation MA 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&CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction Does the building contain an Sprinkler System?: Special Stipulations: I Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION i Name and Address of Property Owner 5-05CelA M iAlun IC Mu✓ke-I- s-1 . No rJ ti ip- r. ii a 6 I 0.60 Name(Pnnt) No.and Street City/Town Zip Property Owner Contact Information OwAelr - 413-;}.1O- 1‹aa- S . M .n i A.G,y Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: \/(AAA l (3{t Pi 00,4irl Or. Ow ref 0(613 Name Street Address City/1 wn tate 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 111 CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of endosed space and/or not under Construction Control then check here , 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 General Contractor B• 14II0I,a Con S trda iovt L LC Company Nattne Y aim; I Dr k CS - 115 . 719 _ .„ Name of Person Responsible for Construction License No. and Type if Applicable gq \)cclni r c)r (. vvco ee 4 0/013 Street Address Cit /Town State Zip __ ��3 S3G if310 Yawl; l� N,jl}IpI�taGv.s�r�c��b,n , (oa.t Telephone No.(business) Telephone No.(cell) e-mail address SECTION11 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 eti No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ 3 3 560 Building Permit Fee=To nstru o t x (heart here 2.Electrical $ appropriate unicipal factor =$ . 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minim fee 4 ;3 4, co ct municipality) 5.Mechanical (Other) $ 3 3 Enclose check payab 6.Total Cost $ 0 (contact municipality)and write check number here /¶i)/`] 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 ap lication is true and curate to th best my know ge and understanding. yOv1M1I Bt'1 Po/TY..er y/5-539- 31O icf "):as 3 Pl � vt i e. ill1nnt and sign name Title ``I aTel�hone No. ate c k Of. Ck.coo ee - V 1,...,-,1 %At fifickeb,1-ir k,(4;04, o,,, Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: / �% ct '�ZZ Name Date The Commonwealth of Massachusetts 1, Department of Industrial Accidents =fit'= 1 Congress Street, Suite 100 _ �f= Boston,MA 02114-2017 ' www.mass.gov/dia AX,sakers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annliennt Information ,/� ) Please Print i.ettihly Name(Business/organi7ation/Individual): . 7"\if) 11 c:,_ Co vx S /-(U C 1-1 OKI 4- L C Address: d-dl D ck ;v e 1 D r, City/State/Zip: C 11,1 ( o r e r (4 4 Oi 0(3 Phone#:6l/3 5 3 Q - (3/0 Are you employer?Check the appropriate box: Type of project(required): 1. a employer with l employees(full and/or part-time).* 7. :New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.pI am a homeowner doing all work myself.[No workers'comp.insurance required.]' 10 0 Building addition 4.ElI am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs Or additions proprietors with no employees. 12.ElPlumbing repairs or additions 5.EI am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs / These sub-contractors have employees and have workers'comp.insurances 6.❑We are a corporation and its officers have exercisedtheir right of exemption per MGL c. 14.�ther ✓1 S(I (�T /Q�I 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. / I ` f ? Insurance Company Name: 1�10-�1'I O r(t al t.—%0-`�\11‘ {'I i c I o �1 �'av1 C e l p f 611 Policy#or Self-ins.Lic.#: r1 CI W C 3 e2 4-) 1 7 5 Expiration Date: 4 3i 9 6)- 3 XP Job Site Address: I —I in r' v l eik r.k e k-- 5•\-, City/State/Zip: f-�-V\ ,11 A V"`4 Q 1°66 Attach a copyof the workers'compensation policydeclarationpage(showingthe policynumlfer and expiration date). Pe Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$2.50.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under epains and penalties of perjury titat the information provided above is true and correct: Signature: Date: q f?q1)-a- Phone#: (L(13) 5 3 -- '1510 Official use only. Do not write in this area,to be completed by city or town official City or Town: permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton r •• Massachusetts t * `G Y I DEPARTMENT OF BUILDING INSPECTIONS Z 212 Main Street • Municipal Building Northampton, MA 01060 f4. 4 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: v,\Ie ReC ci i� - a 3y Ca5-�1 �A Rd �a,r�tiz,„�0 4 � P The debris will be transported by: Name of Hauler: Vosom; of • • pP Signature of Applicant: -4 Date: 6) ) i g g1^44.tilt8,0+t city c)f orthaptt rnpe$t • ortgf,ort.10 hai*e'811.11"Yer,Pt,,IL ,31 t17.‘,s .4.1tittgdtht.P,IVit','OttY L'`.1 CA,eatfar....11x'sigtvR1ofe „ Ctaie B . ALPHA CONSTRUCTION LLC 29 DANIEL DR. CHICOPEE, MA 01013 (413) 539-8310 Building Permit Authorization Form I, .A4 k . D , owner of the property located at (Owner's Name) AMA- vi It ave C &,x, (Street Address, and City) Hereby authorize Yamil Brito of B. Alpha Construction LLC to act on my behalf and obtain a building permit to perform insulation/weatherization work on the above named property. Ow s nature Owner's Phone Number Date Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration • Type: LLC Registration: 201875 B.ALPHA CONSTRUCTION Expiration: 05/03/2023 29 DANIEL DR CHICOPEE_,MA 01013 7 W, rM p,i T •e Update Address and Return Card. SCA 1 0 20M-o5.'l7 // ( ele.Y''!/( /2. //�/•i•i�/r//,i/. �1 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: RegiOrajion .4Xpiration Office of Consumer Affairs and Business Regulation 201875 05/0312023 1000 Washington Street -Suite 710 B ALPHA CONSTRUCTION Boston,MA 02118 YAMIL BRITO 4 29 DANIEL DR * Not valid without signature CIIICOPEE.MA 01013 Undersecretary POLICY NUMBER : A9WC324145 Basic Polic Information Named Insured Transaction Information Firm Name: B.Alpha Construction LLC Term: 8/3/2022- 8/3/2023 Address: 29 Daniel Dr Last Update*: 8/3/2022 Chicapee, MA 01013 Business: (413) 539-8310 Carrier: National Liability & Fire Insurance Company Cell: Fax: Email: b.alphaconstruction©gmail.com Workers Compensation Employers Liability WC & Employer's liability Each Accident Limit: S1,000,000 Disease Policy Limit: S 1,000,000 Disease Each Employee: S1,000,000 Deductible/Type: Applies To: Commonwealth of Massachusetts it . Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-115714 Expires : 03/31 /2025 YAMIL JR BRITC) I ....� :r. 29 DANIEL DRIVE CHICOPEE MA 01013 j - '` .• 7 Commissioner ,= c } /' E,yibik., , Li ,