31C-001 (3) BP-2023-0841
52 WARD AVE COMMONWEALTH OF M SSACHUSETTS
Map:Block:Lot:
31C-001-001 CITY OF NORTHA PTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2023-0841 PERMISSION IS HEREBY GRANTED TO:
Project# CHIMNEY 2023 Contractor: License:
Est. Cost: 5800 PAUL KORPITA 25671
Const.Class: Exp.Date: 10/01/202
Use Group: Owner: CREI HTON SARAH L& JOSEPH P LAWRENCE
Lot Size (sq.ft.)
Zoning: RR/URA/WP Applicant: KORPI A MASONRY
Applicant Address Phone: Insurance:
PO BOX 263 WCP1753F
DEERFIELD, MA 01342
ISSUED ON: 06/26/2023
TO PERFORM THE FOLLOWING WORK:
DEMO AND REBUILD CHIMNEY
•
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 NORf THAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
• • >2 . Ti .l
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax (413)587-1272
Office of the Building Commissi'ner
AFC
ret ern et/ZP (Aik.i 11
Via 'SUN .1)ga The Commonwealth of M cl 6
Board of Building Regulations an ,c1 FOR
(174
Massachusetts State Building Code, 780 �n'Nr, CIPALITY
` oti Ns, USE
Building Permit Application To Construct,Repair, Renov to Or Coic sa evised Mar 2011
One-or Two-Family Dwelling
ff��,,�� This Section For Official Use Only
Building ermit Number: '�"'�"?i - PP Date Applie :
►o O loos, 6 Z6 ZOZ3
Building Official(Print Name) Signature Date
wa ea SECTION 1:SITE INFORMATION
l.l�operty Addis n�: Ail.' 1.2 Assessors Mai&Parcel Numbers
1.1 a Is this an accepted` J�street?yes 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:
Public❑ Private CI Municipal Outside Flood Zone? Municipal❑ On site disposal system 0
Check ifyes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 wner'of Record:
13
P
4At - �4 _ 0 fa�
Name(Print) City,State,
6 z L'`' jii—U&— 96 S.76 93'y 604;`l n-gg.ce-y 6 tom(,
No.and Street Telephone , Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑
Demolition 0 Accessory Bldg. 0 Number of Units Other Speci . `
Brief Description of Proposed Work2: D.e,'no (uVyt,rail
1-- at,
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 Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $ �/
Suppression) Total All F s� jU �.l
Check No. ' V' Check Amount:
6.Total Project Cost: $ A) 0 Paid in Full Cl Outstanding Balance Due:
„„ City of Northampton
7
tt( �� Massachusetts _.
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 ..
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR WINDOWS,
DOORS,ROOFS,RENOVATIONS,ROOF MOUNTED SOLAR, ETC.
1. Building Permit Application signed by legal owner and filled out
by owner or authorized agent.
2. One set of plans and specifications of proposed work(Digital and hard copy).
3. Construction Debris Affidavit filled out and signed by applicant.
4. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance.
6. Energy Conservation Compliance Certificate(new /replacement windows).
7. Home owner's License Exemption Form (if applicable).
8. Note any Special Permit requirements(if applicable).
9. Energy Code—all new construction (Gut/Rehab)requires a HERS Rater Affidavit
10. Please provide the appropriate fee in the form of a check made payable to: The City of
Northampton.
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
1 > C5D ZSG7/
lV
&1\ License Number Expir 'o ate
Name of r `�
� �A� List CSL-ype(see below)
h e hl t o t_ 1�_a
N Type Description
r , r/ Q t �L U Unrestricted(Buildings up to 35,000 Cu.ft.)
�1 u/ R Restricted 1&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
(y `27Y yLCJjyQJj �p - I Insulation
e E ail address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
5 4 c� 7
Ir Y•ri� HIC Registration Number xpira�on Date
HIC Rent N�mf /
Itree- 40.G44,,N . eem--
mail address
'_Ale, 77v-4' O
C�,SS te,P Telephone JGo1 p; fa..
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 0 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 authorize CO-e- ti tire
to act on my behalf,in all matters relative to work authorized by this building permit application.
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.
0 . 2b z3
0010
■ MIL N „ 1 INN.._• —
. _
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 Cbst"
________ The Commonwealth of Massachusetts
......*,—,—
Department of industrial Accidents
t4) I Congress Street,Suite 100
• ..,•
Boston, AfA 02114-2017
.
..,,,..4.ir...i, ...c., wovw.mass.gor/dta
1Vorkers Compensation Insurance:‘ffid 14%it:BuildersiContractorsiElectricians/Plumbers.
IC)Bk.i II.ED WIT11 I Ili_P1_1011 IIING AVIIIORTIN.
Applic anti nfornimtion Please Print l_egibls A
Name illuatnessiOrgantzabonilndaxidua0: Ki94. :39t....4,01eael
Address: 1 (js..._ Fi/A,4_,,kinle,k, AI
City'State!Zip: tp a fl>,r _ t414 e- Phone ,:-. qk.,-, -7-7 44,,,,yD
Are you an employer?Cheek the appropriate box:
Type of project(required):
1.211 am a employer with Z.- eimgoyoux(full=dor part-tirrief.' 7. cj New construietion •
10 1 am a xok pruprictur or partherrhip and have rlaa errapkryee%working Int the in g. fl Remodeling
any L-aixacity..[No wuriterx'comp.enaurance required[
9. El Demolition
3.0 I am a horocoVinet dying all Kush myself'.{ mioas'comp..iltaUratiee texplaretk)' la
I 0 Ci Building addition
s 0 I am a larissrevencr and will be hairy contractors to oirtidnet all wart on My property_ I will
otxure that ali contra:Tuts Millet hare Markers'coMpeltaaairl Malaranee Or are aole I 1 Ej Electrical repairs or additions
pruprpeloca.1.,ab no employeca,
I 2.0 Plumbing repairs or additions
SO I am a nera ontra:tut and 1 hate hired the aub-contracton.listed on the attached sheet
l I 31:1 Roof repairs
lises•.:sab-Luearaeans.Isask:easistayees am uxe workers'tamp.Luxor-ante.:
14.0 Other 4 i /A,A,, U/On/iLer
0.0 We are a omporanon and it otlteems have exercised their right of exemption per Mt&c.
1.2,§1(1.1.,and we ium:no employees.[No wortcra'Luny.Maur:ince regurroill
'Any applicant that eheckx box=1 moat also fill out the xection below above mg their worker,:connwrouti,11 policy utharmaltoct
'i kmatro%arra I.hi.;submit tho aft-id:v.1i indicating they;re doing all work and then hay outAdc contractor,mint sahnot a new affid.e.it indicating xuch
:Contractor%that check tho,box alma attached an addatiunal sheet shooing the mune of the tors and,arc v.hethea in not[hum:tmlaticalial.e
,mployee, if the alab-eoraira,Eur.,bat,'emplosee,.,th...y•mina provide their u.orLer,'comp.poli,...?;nwribo
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Nan : tri eV
Policy#or Self-ins.Lie.#:____ .(1C..e1) I-1.S.--- ' '... Expiration Date:
Job Site Address: SZ._ (44111e4 14t)*— CityiStale/Zip:
Attach a copy of the tsorkers'compensation polity declaration page(showing the policy number and es lion date).
Failure to stek-Coverage as requirett under MOIL c....1$2.425A.is a criminal violation punish.sbie by a lino up tv41.50(1.04•
iutd/or one-year imprisonment.as well as civil penalties in the formula STOP WORK ORDER and a line 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 DR for insurance
coverage verifieation.
I do hereby certif. on er the p in anti Ilene:file+ of perjury that the information provided above it true and correct.
Signature: s/tes,
Phone f•-:
Official use on!;'. Do not write in this area to he completed by city or town official
City or Toss n: Permit/License#
1 Issuing Authority(circle one):
' I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Insist:coo-
6.Other
Contact Person: Phone#:
trLT 7i+
City of Northampton
fr
Massachusetts � -
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 .yy 1z\"�
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:
l^ �t
Location of Facility: I /1A-cJ .1 (�� e9
The debris will be transported by:
Name of Hauler:
Signature of Applicant: Date: 6/ 247
City of Northampton
Massachusetts -_
DEPARTMENT OF BUILDING INSPECTIONS i
111444
212 Main Street • Municipal Building
Northampton, MA 01060
HOMEOWNERS'EXEMPTION ELIGIBILITY FIDAVIT
I, sert full legal name), born_(insert
month, day, year), hereby depose and state the following:
1. I am seeking a building permit pursuant to the homeowne exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 C 110.R5.1.3.1, in connection with a project or
work on a parcel of land to which I hold legal title.
2. I am not engaged in, and the project or work for w ch I am seeking the aforementioned homeowners'
exemption, does not involve the field erection of ma factured buildings constructed in accordance with
780 CMR 110.R3.
3. I qualify under the State Building Code's defini in of"homeowner"as defined at 780 CMR 110.R5.1.2:
Person(s) who owns a parcel of land on hich he/she resides or intends to reside, on which
there is, or is intended to be, a one-or o-family dwelling, attached or detached structures
accessory to such use and/or farm stru,tures. A person who constructs more than one home in
a two-year period shall not be conside ed a home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I
qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of
the project or work on my parcel, I am not engaged in construction supervision in connection with any
project or work involving cons ction, reconstruction, alteration, repair, removal or demolition
involving any activity regulated any provision of the Massachusetts State Building Code.
5. If I engage any other person or rsons for hire in connection with the aforementioned project or work on
my parcel,I acknowledge tha am required to and will act as the supervisor for said project or work.
Signed under the pains and penalti of perjury on this day of , 20 .
(Signature)
Yd9/,S
KORPITA MASONRY
P.O Box 263
Deerfield,MA.01342
(413)774-4640
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Commonwealth of Massachusetts
111 Division of Professional Licensure
Board of Building Regulations and Standards
Consf, t t rvisar
CS-025671 Aires:loioir2on
PAUL KORPflA,
PO BOX 263/PIN
DEERFIELD IAA
jahl
Commissioner �� I. i . nck ,
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street- Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Individual
PAUL KORPITA Registration: 104540
D/BIA KORPITA MASONRY Expiration: 07/13/2G2fi
P.O. BOX 263
DEERFIELD MA 01342
Updatb Address and 1=letus n(Are.
IF COMMONWEALTH OF MASSACHUSETTS
co of Consumer Affairs&Business Regulation Registration valid for individual use only befon*±P i
HOME IMPROVEMENT CONTRACTOR expiration data ff found retum to:
TYPE:Indvidual Office of Consumer Affairs and Business Regulation
Registration itgairfisan 1000 Washington Street -Suite 710
104540 07/13/2024 Boston,MA 02118
1PITA
IPITA MASONRY
•
3PITA,JR.
1OOK RD �„f
D,MA 01342 �✓�
Undersecretary o v id ut mature