18D-049 (3) BP-2023-1030
348 KING ST COMMONWEALTH OF SSACHUSETTS
Map:Block:Lot:
18D-049-001 CITY OF NORTH MPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-1030 PERMISSIO IS HEREBY GRANTED TO:
Project# ROOF 2023 Contractor: License:
Est. Cost: 12000 BRAMUCCI CONS UCTION
Const.Class: Exp.Date:
Use Group: Owner: D AR-RANDALL CYNTHIA G
Lot Size (sq.ft.)
Zoning: HB Applicant: BRAMUCCI CONSTRUCTION
Applicant Address Phone: Insurance:
17 MT WARNER RD (413)221-3942 656OUB1K70974321
HADLEY, MA 01035
ISSUED ON: 08/01/2023
TO PERFORM THE FOLLOWING WORK:
STRIP AND REROOF FRONT SIDE OF BUILDING
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:
• • >9 -
Fees Paid: $100.00
212 Main Street,Phone(413)587-1240,Fax: 413)587-1272 •
Office of the Building Commissi er
�� -deC�m rt � 1
RECEIVED
he Commonwealth of Massachusetts
Office of Public Safety and Inspections
t' - 1 2023 Massachusetts State Building Code(780 CMR)
Building Permit A lication for any Building other than a One-or Two-Family Dwelling
fFPT nF RUILDING INSPECTIONS (This Section For Official Use Only)
Buildingyprm W,TON.MA 01060 te Applied: Building Official:
�JA 073 - 1030 SECTION 1:LOCATION!.
No.and Street City/Town Zip Code Name of Building(if applicable)
3ia tl1V(. ,r, NOmni 4901PTO^-1 0/O00 A/APoe?
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here ❑or check all that apply in the two rows below
Existing Building R 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 SpecUy /2 oe%'i#v
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No.14
Is an Independent Structural Engineering Peer Review required? Yes 0 No 1 -
Brief Description of Proposed Work S T't' P E tr/3'?/N 6 sd/Al 6 L.6 3 arc DIE
6o^vT s/a& or ?I/E $ . ,ate REPL4cs wi-niJ ^/cc./
RCFII T Re 1-u7AL s I.I i A161.EJ
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) ❑
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 ❑ 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-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 D IIA 0 IIB 0 ILIA IIIB0 IV 0 VA0 VB
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 0 Indicate municipal W
A trench will not be Licensed Disposal Site Pa
required 1I 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❑ 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
i
Name and Address of Property Owner
NAVA 3411 W N 6 sr. -r A o 10 c,0
Name(Print) No.and Street City/Tow Zip
Property Owner Contact Information:
✓isJ Es34 TEFCE e4A-SV- L'S7 - - ✓coNe.5 q_ :EECF 8 4EmPT
Title Telephone No.(business) Telephone No. (c 11) e-mail address c o m
If applicable,the property owner hereby authorizes:
k r c d4R t7 8c?Al,e,u c c/ r'7 ,tin-. I. 441v A az> frig O L EV 1,142 0 is 3S-
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)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
ASRArnt/Cc( ao^/s-rR d c i oe✓
Company Name
t2ici.lc r 'BR4vv cci CS- (10831 C.EaPRAG Co Arne ACTo/t
Name of Person Responsible for Construction License No. and Type if Applicable
•7 AlT. WA2NEX . 2U I-4VLEV 0/02r
Street Address City/Town State Zip
413-22.1- sq 4Z 413 -e21- 3942 & 1,rarc/roius7AOCT, 0Ai (' 6,ms1c. .covi
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 B No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(fitful Item 6)=$
1.Building $ /2 , 0 0O. 040
Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)=$ .
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ ` (contact municipality)
5.Mechanical (Other) $ Enclose check payable to `
6.Total Cost $ /2r 0 00 . 00 (contact municipality)and write check number here 3 —
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.
a inucc/ it—.—.. CD 4(3 -22( - 314 2 7�31' Z023
Please print and sign name Title Telephone No. Date
17 , . (^/ARNa2 RD. t/AD L.C. y MA 0/03.E
Street Addratt City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: _____//eo-!- ZD�3
Name Date
The Commonwealth of Massa husetts
= Department of Industrial Acc'dents
a. 1 Congress Street,Suite 10
,l,.ir
=' .= Boston,MA 02114-201
', F_`' www.mass.got'/dia
1lutkers'('umpensation Insurance Affidavit:Buildersl('untractors/Electrician, I'Iunlherl.
f0 BE FILED With 7UIIE PER%*ITI'i\G Al'711(/RI I .
Applicant Information Please Print Le_aibls
Name(Business()r .in uatiottflndividualt 512.4M0CC 1 CONISTI¢t)CTI,04___
Address:17 MT• ',La 2 n)E 2. S2D. _
City/State/Zip:4L t Le µA 0I035 Phone#: 113 — 221 - 31142_
Art'MI a0 employee t hick tilt appropriate but:
1. fie of project(required):
Lisa am a employer with 7 cmpduyces Unit and or part-bail.• 7. D tieN construction
20 I am a side proprietor;at lunncr,htp and have no employees working for me in 8. 0 Remodeling
any capacity.No wutters'comp.Insurance matured.)
30 I am a hurnouancr doing all work myself No workers'comp.insurance required.]' 9. Demolition
4.0 lam a homeowner and will be hiring contractors to esunduet all work on my property'. I will ICI a Building addition
ensure that all contractors either have workers'eexnprnsztwrt insurutu or are sole I l.a Electrical repairs or additions
pruprietun with no esnptoycis_
12.E]Plumbing repairs or additions
50 I am a general cuntraetur and I has a hired the sub-contractors listed un the attached sheet 13.®ROOf repairs
MistThese sub-contractors Mistemployees and base workers'comp.insurance.: P
6.0 We am corporation and its officers have exercised their nest exemption per AMGL c. 14.0 Otherre
11(2.i 1141.and we have no employees.No w infers'comp.insurance requued.l
'Any applicant that cheeks boa=I mint also till out the section below showing their workers'comisensation policy information.
n ttomeo%nen who submit this alydas it indicating they are doing all aurk and then hue outside c tractors must submit a new affidavit indicating such.
:Contractors that check this bss must attached an additional sheet showing the name of the sub es tors and state whether or not those entities have
cinploy s cc, II the sob-con actinn bass cm'locc-.tiles taunt pro,, a m tdc th,:rr orkcrs'cop pulley' umber.
1 am on employer that is providing rt'urAers'compensation insurance for my employees. Be•lutc is the pulit'i and jab site
information.insurance Company Name: iiE 1.14 2Tpo ieD
Policy#or Self-ins.Lic.#: lc 5(op U$ l IC.-.7 0 9.7e4 322 _ Expiration Date /i - ile - 20 �3__
Job Site Address: 39 8 LING ST NJ 0 Rill A nnP ro IV iris CityiStateJZip:__a_t rx.ce 0
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a line up to S1,500.00
andlor 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
da against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
cco+:rate verification.
1 dr)hereby certify under the pains and penalties of perjury that the infi,rmution lrrovided above is true and correct.
st_•naturc i ',1 ^ CD I).tt- 7 - 3l - ioza
Phone. 9t3 - 221 - 3542
Official use only. Do not write in this ureu.to he completed by city or town official
City or Town: Permit/License#
Issuing Authoritc(circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
( (intact Person: Phone 1t:
-. __ __ _
City of Northampton
Massachusetts ^,
(W t
21
j
DEPARTMENT OFBUILDINGINSPECTIONS
`, 212 Main Street • Municipal Building -�Northampton, MA 01060 rst-�y. .�.����
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: ini_LFY Recvc Li NG 231 cASTAm!''roN R'D•
PJO ter A,tn-roIQ 044 010 (, O 113 - S$? - 427q
The debris will be transported by:
Name of Hauler: 8R4n7N cc i CoNS-T o C'7 • o 4
Signature of Applicant: C (� Date: 7. 31 - 2oz3
Initial Construction Control Document
't ii�1 To be submitted with the building permit application by a
Registered Design Professional
for work per the ninth edition of the
►�44 Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Date:
Property Address:
Project: Check(x)one or both as applicable: New construction Existing Construction
Project description:
I MA Registration Number: Expiration date: ,am a registered design professional, and I have
prepared or directly supervised the preparation of all design plans,computations and specifications concerningl:
Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information, and belief such plans,
computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780
CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my
designee) shall perform the necessary professional services and be present on the construction site on a regular
and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CNIR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the
progress and quality of the work and to determine if the work is being performed in a manner consistent
with the approved construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3_)together with pertinent
comments,in a form acceptable to the building official.
Upon completion of the work,I shall submit to the building official a 'Final Construction Control Document'.
Enter in the space to the right a "wet" or
electronic signature and seal:
Phone number: Email:
Building Official Use Only
Building Official Name: Permit No.: Date:
Note L Indicate with an'x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is
chosen,provide a description.
Version 01 01 2018
Appendix 1
Construction Documents are required for structures that must comply with 780 CMR 107. The
checklist below is a compilation of the documents that may be required. The applicant shall fill out
the checklist and provide the contact information of the registered professionals responsible for the
documents. This appendix is to be submitted with the building permit application.
Checklist for Construction Documents*
Mark"x"where applicable
No. Item Submitted Incomplete Not Required
1 Architectural
2 Foundation
3 Structural
4 Fire Suppression
5 Fire Alarm(may require repeaters)
6 HVAC
7 Electrical
8 Plumbing(include local connections)
9 Gas(Natural,Propane,Medical or other)
10 Surveyed Site Plan(Utilities,Wetland,etc.)
11 Specifications
12 Structural Peer Review
13 Structural Tests&Inspections Program
14 Fire Protection Narrative Report
15 Existing Building Survey/Investigation
16 Energy Conservation Report
17 Architectural Access Review(521 CMR)
18 Workers Compensation Insurance
19 Hazardous Material Mitigation Documentation
20 Other(Specify)
21 Other(Specify)
22 Other(Specify)
*Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified
must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the
authority having jurisdiction.
Registered Professional Contact Information
Name(Registrant) Telephone No. e-mail addre Registration Number
s�
Street Address City/Town State Zip
Discipline Expiration Date
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
Please follow this link for construction control forms to be used by Registered Design Professionals.
From:
A4rnurc/ con/ST� �c � log/
J4DLtY 01)A olo to 0 (4/ ) 21 . 394
To:
Jonathan Flagg
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, I request that you
grant a modification to waive the requirement for construction control of the project at
398 IL i N Cs 5 Nh 127 ILO rn19-7 s nJ r»a o/D G o
because the work is of a minor nature, will not affect structural elements, health, accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,