24C-028 (4) BP-2023-1420
98 NORTH ELM ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24C-028-001 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-2023-1420 PERMISSION IS HEREBY GRANTED TO:
Project# KITCHEN 2023 Contractor: License:
Est. Cost: 64500 ALLEN GUIEL CS-054248
Const.Class: Exp.Date: 04/12/2024
Use Group: Owner: SULLIVAN CRAND JOHN D& SUSAN
Lot Size (sq.ft.)
Zoning: URB Applicant: GUIEL CONSTRUCTION
Applicant Address Phone: Insurance:
63 CHESTERFIELD RD 412-268-9200 6S6OUB-9F66069
WILLIAMSBURG, MA 01096
ISSUED ON: 10/13/2023
TO PERFORM THE FOLLOWING WORK:
KITCHEN RENO
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:
ich a .
)2
Fees Paid: S419.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
-7r /emom/'! �. RECEIVED
)t° I,us I wJu et Viedy
ocT , 2 _2073
The Commonwealth of Massachusetts
Board of Building Regulations and Standards FQR
Massachusetts State Building Code, 780 CMR DEPT.OF 6UILDING Irotibl LI. Y
NORTHAMPTON MAOt06
Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building P rmitNumber:6, A3- /ya(0 Date Applied:
EUkJ 14 /// l0-IZ-ZOZ3
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
9'S IJORT.I ELitil
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
ue
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 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 O S of . U `I ,gip 6
Name(Print)u ��y� City,State,ZIP ` G�O
93 (U, 316... S/ 4(3-gb- in 5 ac so( @ C vc I. (CY i
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building Owner-Occupied 101 Repairs(s) 0 Alteration(s) ill Addition 0
Demolition X Accessory Bldg. 0 Number of Units f Other 0 Specify: T Jd(�
Brief Description of Proposed Work': Grj ZI,�peel-6 kt C t4 c� Y�-G�-Ib0CZ... V -
- 6,i�l o i )!C�� '►L 0 - Pik) v.)l a qt)q , /NG,(19.n0,) , DAM)mac.- /
t-Coo I
?Jc ,
Tu.)c) jJt`ZU W 1 Jl06uj c- ,,, �i�l6 Sf?� $ faC/9 70N `1:
ft troi
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ (PO t 000 1. Building Permit Fee: $ Indicate how fee is determined:
0 Standard City/Town Application Fee
2.Electrical $ "Z�
0 Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 1 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees:$
Check No. Check ount: ` h Amount:
6.Total Project Cost: $ 0)q �D ❑paid in Full 0 ance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 C struction Supervisor License(CSL)iiGil //m �� - 0
FDC L �U f t L License Number Expiration Date
Name of CSL Holder t J
6.; List CSL Type(see below) l/
6j6 i izFl EZO Pap
No.and Street Type Description
W f CC I nius qUe
/14 Of p U Unrestricted(Buildings up to 35,000 Cu.ft.)
!"I (Q R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
/J SF Solid Fuel Burning Appliances
qG °t/Q? "j J +t to ft i U i eI - Cf.W' I Insulation
Telephone Entail address D Demolition
5.2 Re steredHome Improvement Contractor(HIC) l0 yWIN '7 ,.' .'1
ne.(�N11 0 1I:Z HIC Registration Number Expiration D
HIC Company Name or HIC Re istrat�Name
(0; C 7,TEr F(Ett ►Ve.0190 L't.e0 0,90l{'1 ` CeN�(.'�
No.ap(`1 i t.FA,t� U24 ,q4 Q/ao ql 3 n I ' 970/ mail address
City/Town,State,ZIP Telephone
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 No ❑
SECTION 7a:OWNER UTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
CkiLCCVN c.1 \li U(,...- _ lbIit la-),
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 and acc lie to the • of my knowledge and understanding.
AVM4u \Print Owner's uthorized Agent's Name(Electronic Signature) Date
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 Cost"
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE:Individual Office of Consumer Affairs and Business Regulation
Registration Expiration 1000 Washington Street -Suite 710
104444 07/13/2024 Boston,MA 02118
ALLEN R.GUIEL
ALLEN R.GUIEL '`
63 CHESTERFIELD RD ;'./.�^^'a.,' h
WILLIAMSBURG,MA 01096
Undersecretary Not ah without signature
lotcon
Divio°nM'ealth of M n
°ard of a(ilding RcuPatidoal lac use
Cons�l�Gons a�lure
CS-05g24g y� WI i Standards
ALLEN GU �%. 14 * .+�_ tF
Sor
W►LL gESTE Ems : f��res:ru,
MsBc , :, ., 2024
j1
rSsia)er
City of Northampton
Oat NAMpjoH, S`` • S/r
Massachusetts
Lv
DEPARTMENT OF BUILDING INSPECTIONS
moo0111'H:—/i:OAP212 Main Street • Municipal Building
Northampton, MA 01060 J"t 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:
II
Location of Facility: t4 `l 6 c 410 d
The debris will be transported by:
Name of Hauler: 7/2Je-
Signature of Applicant: Date: 10 4 ��
_ \ The Commonwealth of Massachusetts
11, Department of Industrial Accidents
=ail= 1 Congress Street, Suite 100
_ 79 Boston,MA 02114-2017
* www.mass.gov/dia
Workers'Compensation Insurance Affidavit: General Businesses.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Business/Organization Name:Guiel Construction
Address:63 Chesterfield Road
City/State/Zip:Williamsburg, MA 01096 Phone#:413 268 9200
Are you an employer?Check the appropriate box: Business Type(required):
1.0 I am a employer with 2 employees(full and/ 5. ❑Retail
or part-time).* 6. ❑Restaurant/Bar/Eating Establishment
2.❑ I am a sole proprietor or partnership and have no 7. ❑Office and/or Sales(incl.real estate,auto,etc.)
employees working for me in any capacity.
[No workers' comp.insurance required] 8. Non-profit
3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment
their right of exemption per c. 152,§1(4),and we have 10.❑Manufacturing
no employees. [No workers' comp.insurance required]** 11.0 Health Care
4.❑ We are a non-profit organization,staffed by volunteers,
with no employees. [No workers'comp.insurance req.] 12.0 Other Building and Remodeling
*Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information.
**If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an
organization should check box#1.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information.
Insurance Company Name: Hartford Underwriters Insurance Co
Insurer's Address: PO Box 4614
City/State/Zip: Buffalo, NY 14240-4614
Policy#or Self-ins.Lic.# 6S60UB-9F66069-2-23 Expiration Date:04/27/24
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby ' under the 'ns and allies of perjury that the information provid ab e is true and correct.
Signature: � ,� Date: U
Phone#:413 289 9200
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.Licensing Board 5.Selectmen's Office
6.Other
Contact Person: Phone#:
www.mass.gov/dia