24D-145 BP-2023-1239
225 STATE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-145-001 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-2023-1239 PERMISSION IS HEREBY GRANTED TO:
Project# RENO 2023 Contractor: License:
Est. Cost: 350000 STOKES CONSTRUCTION LLC 094609
Const.Class: Exp.Date: 05/17/2024
STATE STREET NORTHAMPTON PROPERTIES,
Use Group: Owner: LLC
Lot Size (sq.ft.)
Zoning: URC Applicant: STOKES CONSTRUCTION LLC
Applicant Address Phone: Insurance:
223 STATE RD (413)834-1170 2001W9265
WHATELY, MA 01093
ISSUED ON: 09/14/2023
TO PERFORM THE FOLLOWING WORK:
INTERIOR RENOVATIONS
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:
Sl-Li 5,2 .4"tvi
Fees Paid: $2,450.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
225 ^mug t` 72.
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The Commonwealth of Ma ac set
Office of Public Safety and In i'ec ''i a 2023
: ti Massachusetts State Building Code( :; M ' RT 8til
Building Permit Application for any Building other than a One- rwRi-re,t► I we ,ing
(This Section For Official Use Only) Mq o7 Ono
Building Permit Number: 33 ^/L 3?Date Applied: Building Official:
SECTION 1:LOCATION
aa5 si4 sf A)or*thany n dA 0/o(oo
No.and Street City/Town Zip Code Name of Building(if applicable)
AFP
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 Repair)7l 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 RI, No 0
Is an Independent Structural Engineering Peer Review required? Yes 0 No &
Brief Description of Proposed Work:404 K. Ch4v►S . 60.AvtrWvvt S , Avid Cai\wi geg S , ia.c �x
�`n�s(�cll r1Rl L� �Glnc L& , V rc71'fil,C , L� wr..0 ti l\ J vl c{��v c� pA.,fL-f P_t47f re
tkTjuS.c. T,ng. 0v+
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❑ 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 0 I-4 0 M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0
S: Storage S-1 0 S-2❑ U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 0 IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV 0 VA 0 VB 0
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone Information: Sewage Disposal:sLicensed DisP osal Site❑
Public' Check if outside Flood Zone 0 Indicate municipal$ A trench will not be
required 0 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 ocess:
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 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 Address of Property Owner `'�
,' 1aw''K �k V+t.Wis 113 VOINA4Pel S4 -Pto Ir41.NCA- 04.9t O60L2
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
R-ic a71 ciS - nX4,64440H. fkt. .u1SCac,roa,,1. W►^.,
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
.SSf-oi k.a2 S co n, }r o ciim L l.c 2'O Ch0A-p rIAQ,14 5-1 ( ree v\ to c1 try /A 3 0 1
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
,clib theS C0VL 1006 blk LLC.
Company Name
+ 4wu VA 5--1-t) S Cat 1-1bL7
Name of Person Responsible for Construction License No. and Type if Applicable
6770 Chu w vtO In 54- &Y\cc-Ake id L 4 6l3U 1
Street Address City/Town State Zip
cf(3 -'31- 101 O - - PM-hp w1/4,1 Sioikx S.c df2 a S . C OvtA
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 $ 2 go,Oo v Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ 140 i Orb appropriate mu ' ipal factor -$ .
3.Plumbing $ ;)DO , O OD
4.Mechanical (HVAC) $ Note:Minimum fee= 2 j q ontact municipality)
5.Mechanical (Other) $
6.Total Cost $ 350) C�O od Enclose check payable to t
0 (contact municipality)and write check number here
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.
0rt-\c9 A 5Abl(-I2- S Con sh-,c it c5 /r/,,43 ay- 1170 _1_Y-63
Please print and sign name Title Telephone No. Date
G9 20 c/iap rily 5/ (9ne7✓ � ( CA30) r1/7 vr/y&rsk /o!e 5. cok-t
Street Address City/Town State Zip Email Address
I1
Municipal Inspector to fill out this section upon application approval: i a t lil`1. I q,i 94 Li/d,3
Name Date
Z-25
City of Northampton
�, „.
'* Massachusetts �4t�s !<<
It ywg ;S
ti. DEPARTMENT OF BUILDING INSPECTIONS Zt7V i+^' 212 Main Street •• Municipal Building ��,
t "� Northampton, MA 01060 8 �V0
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: ,3V r`57 kI f' I'? ri--L✓
VQ/,tey /4cy�`/J ,
The debris will be transported by:
Name of Hauler: 4/71hOrty e c_`a'1J7 1
Signature of Applicant: Date: 9/7/,3
,LZ 5
The Commonwealth of.Massachusetts
'' 'l Department of Industrial Accidents
—FillL. '� I Congress Street,Suite 100
ii= Boston, MA 02114-2017
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wwtv.mars.gou/dia
11 ut kers'Compensation Insurance Affidavit:Buildersi('ontraetorsfF kctricianslPlumbers.
t O DE FILED N u'il THE PF:Rsui rl7Nt:AIiHORIT1.
ADulicant information Please Print t.eeihty
Name(Ilusincs Organization-individuai): ) .___Cf2054 rtx Ur Lk,(.
Address: 9--)O Gnec P V .vx. 3
City/State/Zip: &vrcevt-(t;ic` t O lJb[ Phone#: L((3 - g?.3 y- 1/-2 6
Are yew as employer`thick the appropriate box:
Type of project(required):
IQ)am a employer with y _,. employees(fuit and oe pan-dine).• 7. CI New construction
2LJ I am a so!r prop-sewn or partnership and have ear employees working for me in 8. Remodeling
any capacity_[No workers'comp.insurance required.) Jo
30 I am a humouwnrr doing all work rispelf.[No workers'coal insurance rrgui,tti.)`
9. Demolition
4.0 lam a bona*WWI and will be hiring ourittaRtlfi sominduci all work on my property. I will 10 Q Building addition
enure that all coatracton rubor have mitten*oarace satiar insurance or are ante 1 Electrical repairs or additions
proprietors with no employees.
12.E)Plumbing repairs or additions
50 I am a gee cal coafactot and I have hired the sub-contractors lsstcd on the attached sheet. 13.QROOf repairs
Thew aub.coaten:tor%base employee%and have winters'comp.insurance.:
613 we are a corporation and its offsets have exenined their nght of exemption per tNtiL c. 14.0 Other
152,+1(4k and we have no employee*.[No winters'comp.insurance required.)
"Any applicant that checks bet*1 must also fill out the section below showing their winters'compensation policy information_
°tk,.n tiers who submit this atlidas it indicating they me dams all work and then hire outside euni ariats mast submit a new affidavit wdiming such.
:Contractors that check ibis box must attar.-tied an addrti nun sheet shins ing the name of the subcontractors and stale whetter or not theme entities have
cniplosess. It the sub-d iscs have ens'us ci's,they MYt pms idc their workers'unnp policy number.
1 am an employer that it providing workers"compensation insurance for my employees_ Below is the policy and Jab site
information.
Insurance Company Name: .4 unreflCG,I/n ["\Jrj-4 uicj lT�+om+' ✓ik WVik� Ce-1 [(A, t1`rcc.✓t.c.e CC
Policy#or Self-ins.Lie.#: aCC)(W 7 9( 5-- Expiration Date: 11/1b!a 3
Job Site Address: .Pas- S/ CitytState:rLip: iUOi" heiiniy/.lvn lei Ol06O
Attach a copy of the worker"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 fine up to S 1,500.00
and/or one-ytar imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine 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 DIA for insurance
coverage serification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: 7, Dale 2/7/C3
Phone#: --/7)0
Official use only. Du not write in this area.to he completed hr city or town official
City or Town: Permit:Licenve p
issuing Authority (circle one):
1. Board of Health 2. Building Department 3.('itv'Tossn(lerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
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