32C-021 (13) BP-2023-0552
25 PLEASANT ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
32C-021-001 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-2023-0552 PERMISSION IS HEREBY GRANTED TO:
Project# REPAIRS 2023 Contractor: License:
Est. Cost: 136500 DAVID OSIECKI CSL089376
Const.Class: Exp.Date: 01/05/2024
Use Group: Owner: J-BARC INC
Lot Size (sq.ft.)
Zoning: CB Applicant: WESTERN MASS MASONS LLC
Applicant Address Phone: Insurance:
383 COLLEGE HIGHWAY 413-527-1800 4283978
SOUTHAMPTON, MA 01073
ISSUED ON: 05/02/2023
TO PERFORM THE FOLLOWING WORK:
REPAIRING AND LENTIL REPLACEMENT
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
I/
Fees Paid: $956.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
'01,u, / Gt/ w 4a f-iECE D
7
tThe_� :,,,i
Commonwealth of Massac uses - 1 2� 1
i � Office of Public Safety and Inspectio
Massachusetts State Building Code(780 C '— Ui-----
rs• 'Building Permit Application for any Building other than a One-Po ng
(This Section For Official Use Only)
Building Permit Number d /" /75al Date Applied: Building Official:
SECTION 1:LOCATION
AS--g-1 QIe4:S•;m/ S��• A,r j/'i"- t c,fU
No.and Street �" City/Town Zip Code Name of Building(if applicable)
Assessors Map# 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 E7 Repair 0 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 Engineering Peer Review required? Yes 0 No ❑
Brief Description of Proposed Work \ `
Ara.•1o1^tt a-t.[. (jj C%//1/
pepf<cc.�
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 0 B: Business 0 E: Educational 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❑ M: Mercantile 0 R: Residential R-ID 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 0 IIB 0 IIIA ❑ 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 0 Check if outside Flood Zone 0 Indicate municipal 0 A trench will not be Licensed Disposal Site 0
required 0 or trench or specify:
Private 0 or indentify Zone: or on site system 0 permit is enclosed❑
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❑ Yes 0 or No 0 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?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Addressh of Property// Owner j a
3oe_ 81UMat( i,l)r'o�7piecJ . i,J ^ 8/04
Name(Print) No.Ind Street Ci /Town Zip
Property Owner Contact Information:
0 L`'/1`r - - 763s210_MO 0/o jok"joe.gh J/ir../eO
Title Telephone No.(business) Telephone No. (cell) e-mail address a1(cr..,
If applicable,the property owner hereby authorizes:
Name Street Address City/Town 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❑.
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)
,'0 0-Sie c i4. `I/3 _D7- &&'vim' 6&l i1',ev ,lf,,-,-f1_ /77490P
Name(Regis ant) T lep ne No. a-nfail address A4 1''. Registration Number
P3 C I(j.. /17 so A- io- Q1021 /—/1 A 5"
Street Address Ci /Town State Zip Discipline Expiration Date
10.2 General Contractor
IA)es 1 t't- 4 %i&'i.
Corn y Name
Name of Person Respopsible for onstruction 'ce a No. and Type if Applicable
3CP3 rdl , ( Soo/ N- Al- al0?1
Street Address / City/T n/ jf State Zip
/3-.5.7 (0P 94 .S50Lr_ 6..3// Qt / f Ie uved!/,v/ AA/04J' (a,i
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 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 cipal fac =$ .
3.Plumbing $ qr,�
4.Mechanical (HVAC) $ Note:Minim fee=$ ` (co act municipality)
5.Mechanical (Other) $ Enclose check paya e 6.Total Cost $ a‘SUG• v- (contact municipality)and write check number here g6-Nf,(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
application is true and accurate to of my wledge and understanding.
Please rint and ign nam Title Telephone No. Date
3 '- �(!CC /#7 ‘� c'a7)
Street Address v City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: I ' v v ' 6 F 5 d aa3
Name Date
City of Northampton
AN`-r"4rl. `S s�
` _' Massachusetts �w}� x_ r��,
_4000
l 1. * c,
' ,t DEPARTMENT OF BUILDING INSPECTIONS
_ "` 212 Main Street • Municipal Building yp� O�a1
-''� Northampton, MA 01060 'frj 3 {�
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:
(j - i 1 RC( l
The debris will be transported by:
Name c- (�
a e of Hauler. �� /14
Signature of Applicant Date: � � �/ �I
v The Commonwealth of Massachusetts
vk f Department of industrial Accidents
A '+� 1 Congress Street,Suite 100
r=
r�;a Boston, MA 02114-2017
V1,YJ wwtt:mass.gov/dia
Ua,kers'Compensation Insurance AtTidasit: Builders/Contractors/Electricians/Plumbers.
7O BE FILED 11.1I.II THE PERM TTI G AlTHORTTI'
Applicant Information 4 Please Print L.eeibh
Name(Business()rganization'Ind vidual): Kit,.)7CIr _ / 2____yAt G/- —
Address: ] _ _ ` 447
City/State/Zip: S-c-.17 t'i^ 2 7 Phone#: /3 aV./tI C C'
Are you an employer?Cheek the appropriate bot:
� L Ty pe of project(required):
1.[E " n a employ a.with V empl tidal it oyees rud`or part•tim.1.• 7. 0 New construction
20 1 am a sale proprietor or partnership and have no employees working forme in S. D Remodeling
any capacity.(No workers'comp.insurance required.I 1
30 i am a homeowner doing all aurk myself.(No workers'comp.insurance mir gud.)'
9. ❑Demolition
10 0 Building addition
4.[3 I am a homeowner and will 9+e hiring cxmtractors to conduct all work on my propxrty. I will
ensure that all contractors either have weaken"compensation insurance Of an:sole 11.0 Electrical repairs or additions
proprietors with no employees. 12.0 Plumbing repairs or additions
50 I am a general contractor and I have hired the subr:ontractors listed on the attached sleet.
These sub-contractors hail"employea in r and lave wters'comp.insurance.: 13.[jRoof repairs
6.Q We are a corporation and its otiieerr have et ercired their right of exemption per MGL c. 14. they /r r J
152,r)1(oll,and we have no employees.(No workers'comp.insurance required.) /
'Any appliont that checks box xt I must also till out the sittings below show ing their workers'compensation policy information.
+Homeowners who submit dui aflitiatit indicating they are doing all work and then hue outside contractors mint submit a new affidavit indicating such.
:Contractors that check this hot must attached an additional sheet slowing the name of the sub-contactors and state whether or not those entities have
employees. If the sub-contractors base employees.they nuua preside their workers'wisp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the polio.and job site
information. __
Insurance Company Name: 2 A-/4_X ,_/v1 _
Policy#or Self-ins.Lit:.#: 4,1d-S s _ Expiration Date: e 'lf/ZY
Job Site Address: 2J —4)-7 . (f of/ :�✓, City/State/Zip:Jac/ A ,.'' r C7"c�C
Attach a copy of the workers' om nsationpolicy declaration page(showingthe policynumber tfad expiration date).
I� Par pl
Failure to secure coverage as required under MGL c. 152.*25A is a criminal violation punishable by a fine up to S 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$250.00 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 certifi'u e pai a nahies of perjury that the information provided above is true and correct.
Signature: Date: J ' / ;3
Phone 4: e//3- S-')-7- /c CC%
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):
I.Board of Health 2.Building Department 3.('ity/Town Clerk 4. Electrical inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
ERA►
383 College Highway
QUOTE
Southampton, MA 01073 N LICENSED • REGISTERED
(413) 527-1800 INSURED
(A"
WesternMassMasons.com '4 i i B 0 if@ ACCREDESSITID
BUSIN
quality@westernmassmasons.com
SO
JOE BLUMENTHAL Date: 2-25-2022
To: 25-27 PLEASANT ST. Quote# 893298
NORTHAMPTON MA Project: FRONT OF BUILDING
Phone: 413-210-1654 E-mail: �O�AT�No
Description of Work To Be Done: tJ /g1
The entire front of this building will have scaffolding set up the full length and height and will
have fall protection in all necessary permits with the city in order to complete this job.
The top four windows will have the existing exterior brick removed and replaced with new
stone lentilles to match as best as possible to the likeness of the stone lentil's on the 1st
floor.
All open mortar joints will be addressed and new mortar will be installed throughout the
entire front of the building as needed.
The most amount of grinding and tuck pointing will consist in the upper section
approximately 3 feet above the new stone lentils that will be installed on the second floor.
This section will be grinded out the full length across and new mortar installed. Clean as
needed.
a red dye will be added to all the new mortar. Relay any falling or loose bricks as needed.
The scaffolding will still allow for the business to be open per usual and protect customers.
TOTAL PRICE: $ 136,500.00
This quote may be withdrawn from us if not accepted within 30 days. Quote Prepared By: David Osiecki
Thank You For Choosing Western Mass Masons!
383 College Highway •
QUOTE
Southampton, MA 01073 N LICENSED • REGISTERED
(413) 527-1800 INSURED
1
WesternMassMasons.com I 0 ) at ACCREDITED
BUSINESS
quality@westernmassmasons.com
4so
TERMS:Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and
above the estimate.By signing this quote,you agree and understand all the above terms and conditions that apply to this job.Any changes that are to be made,must be
discussed prior to construction and agreed upon by contractor and may also affect to the final price.
PAYMENT TO BE MADE AS FOLLOWS:One half of quoted amount is due when job construction has begun.Remaining balance of bill will be paid in full when job is
complete.A Finance Charge of 1-1/2(18%annual rate)per month will be added to any unpaid balance over 30 days.
ACCEPTANCE OF PROPOSAL:the above prices,specifications and conditions are satisfactory and hereby accepted.You are authorized to do the work as specified.
Payment will be made as outlined above.
Sig Date: Signature: Date:
9
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Thank You For Choosing Western Mass Masons!