38B-068 (4) BP-2023-1574
243 SOUTH ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38B-068-001 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-2023-1574 PERMISSION IS HEREBY GRANTED TO:
Project# FOUNDATION REPAIR 2023 Contractor: License:
Est. Cost: 19850 DAVID OSIECKI CSL089376
Const.Class: Exp.Date: 01/05/2024
Use Group: Owner: LUNDQUIST FELICIA R
Lot Size (sq.ft.)
Zoning: URB Applicant: WESTERN MASS MASONS LLC
Applicant Address Phone: Insurance:
383 COLLEGE HIGHWAY 41 -527-1 800 4283978
SOUTHAMPTON, MA 01073
ISSUED ON: 11/08/2023
TO PERFORM THE FOLLOWING WORK:
REBUILD FOUNDATION
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:
I • • - T-56i1
Fees Paid: S129.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
0VRECE
- $ .7).
The Commonwealth of Mass hus s2Q23
Board of Building Regulations St dards FOR
CIPALITY
Massachusetts State Building Co e, 7110 c�u *Ih�INSPECTION USE
a ,IN
�Building Permit Application To Construct, Repair, Renovate-flFlri& Re ised Mar 2011
One- or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 5/9- 2- 3 /5-2 V Date Applied:
it
Building Official(Print Name) Signature
SECTION 1:SITE INFORMATION
1.1 Property ddjs: 1.2 Assessors Map& Parcel Numbers
1.la Is this an accepted 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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Name(Print) City, ZIP
P
al 4/3 so�,3- 3/. ��/s-?. - op),
No. and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORD(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
RC.6 t....U Oar/ of-
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 $ ❑ Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $
Check No.'Mb7Check Amount: Cash Amount:
6.Total Project Cost: $ r 7�$ ) ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) cv Lj C
04(,( 0 a,-
c:c g, License Number Expiration Date
Name of CSL Holder
3 r`_ d( f/47 List CSL Type(see below)
No. and Street ( T5 Description
6ULP `)2 to-- AIA' (O� u)3 R Unrestricted(Buildings up to 35,000 cu.ft.)
City/Town,State/ZIP �U1 Restricted 1&2 Family Dwelling
h M Masonry
RC Roofing Covering
WS Window and Siding
r, SF Solid Fuel Burning Appliances
7-
l d" ' 011,,f.,17e,..JeJler,-/tveyJmiiyo I Insulation
Telephone Email address et.,/‘ D Demolition
5.2 tRegistered Home Improvement Contractor(HIC) /7 7 (-odd `�)y
w t J/(r, " i .44 vn-3 HIC Registration Number (Expiration Date
HIC Company Name or HIC Registrant Na e
34') CV fiL`^? 64 tt,%"*J6l'r '4M7-j.4 4IA4j C..,.
No. and Street Email address
City/Town, Sta e,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 the building permit.
Signed Affidavit Attached? Yes No . ❑
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
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 and accurate to the best of my knowledge and understanding.
PA,,0 ,d- 4-
Print Owner's or Authorized Agents 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 C'nnlnton it'enith of Massachusetts
Department of Industrial Accidents
1 Congress Street,Suite 100
': Boston, MA 02114-2017
tt'►v►r.ntass.gov/dia
%Yorkers'Compensation Insurance.lfftdasit: Builders/ContractorsJElectricians/I'luntbcrs.
TO BE FILED SSIill I Hi: PERM!ITINGAtT11Olt i .
Applicant Information Please Print I.e�t ibls_
Name(BusitMcseK rganiratiat>'Indnidual): kJ i e/V7- ✓ a _Adi_ h
Address: 3P3 ce,/l/j-c-
City/State/Zip: .5.1--✓ ► /& ., » Phone#: N2 l4"c'`
Are)111 II eatpturyer'('heck the appropriate Mrs:
Type of project(required):
t. a employer with... __._employers(full and/or part-time).* 7. 0 New construction
20 I am a sole proprietor or partnership and have nu employees working for me in tl, 0 Remodeling
any capacity.(No workers'comp.insurance required.]
3 fl lam a homeowner doing all work myself.(No workers'comp.insurance required"' y ❑Demolition
1
�w�r 0 0 Building addition
t.! ,I am a homeowner and will be blimp e.on work to conduct all w on my prop.ity. I will
t•_J ensure that all contractors either have workers'emnpensation immix*or arc sole I I.o Electrical repairs or additions
proprietors with no employees. 12.0 Plumbing repairs or additions
t
I am a general contractor and I have hoed the sub-contractors listed on the attached s&ct,
These sub-contractors have employees and have workers'cone.insurance.^ 1 Roofrep /
14. Other s--
6.0 we are*corporation and its officers have exercised their rigM of exemplum per SAGE e. .._
1S2.11(4),and we have no employees.No workers'coop.insesanee required.]
*Any applicant that chocks but a I must also fill out the section below showing then workers'compensation policy information.
t Hot wuwnrs who submit this atlukivit intheating they art doing all work and then hire outside contractors trust submit a new affidavit indicating such.
:Contractors that check this box most attached an additional sheet showing the name of the sub-contractors and sta:c whether or not those entities have
employ cr. If the sub-contractors lose employees.they corm pros ode their worker,'comp.pit.nunttm
1 am an employer that is providing worilrrs'compensation insurance for my employees. Below is die policy and job site
information. iin
Insurance Cody Name: /rt.t� Sri
Policy#or Self-ins.Lic.#: 41 3?C/'G"/ —_ Expiration Date: y/1--d y
Job Site Address: 01 l 3 SG=-11-- S/' CityiState;2ip:At e4- X co t
Attach a copyof the workers'compensation policy declaration page(showingthe Pnumber 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-year 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 verification.
I do hereby certify r the xtin and penalties of perjury that the information provided above Ls true and correct
Signature: Date /7 i/ t%2 J
Phone x: 5—,)-) `ttLc/
Official use only. Do not write in this area, to be completed hi city or town official
('its or 1 oss n: Permit;License#
Issuing.'uthority(circle one):
I. Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
( on tact Person: Phone#:
City of Northampton
C
.i i..I,yr1 ,Massachusetts may'' I <
GDEPARTMENT OF BUILDING INSPECTIONS a= /4';i�, 212 Main Street • Municipal Building y6; .�a`� Northampton, MA 01060 '"—k31%0
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, 554, 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:
N.
Location of Facility: / ,' St 41 il.--''
The debris will be transported by:
p
Name of Hauler: -=� /4,
(, ‘-\7,
Signature of Applicant: Date: ii-01-3
ERN
383 College Highway - ` '
Southampton, MA 01073 i` ` N LICENSED • REGISTERED
(413) 527-1800 , INSURED
WesternMassMasons.coni rs �.� rR are FO
quality@westernmassmasons.com ' "`SS
S4
FELICA LUNDQUIST Date: 6-08-2023
To: 243 SOUTH ST. Quote# 7842378
NORTHAMPTON MA Project: FOUNDATION
Phone: 413-222-6922 E-mail:
Description of Work To Be Done:
The front foundation on the home was inspected and it is found to be extremely structurally
unsound. The remaining foundation can collapse at any minute because there is no
support or structure left to the front left corner underneath the porch and on the side of the
home.
This area will be temporarily supported and excavated out along the driveway side as
needed.
Form and pour a new concrete footing with vertical rebar.
Pour new concrete walls or concrete block whatever is accessible because of this area will
be installed.
Attached to the existing foundation and backfill with clean material. Tar the exterior of the
new foundation below grade.
Call DigSafe and pull the building permit required.
*** we will come out and temporarily put two lally columns up to support the floor joists
before the work can be completed***
Thank You For Choosing Western Mass 11; :;:
•
ERN _
383 College Highway "
Southampton, MA 01073 (4" u) LICENSED • REGISTERED
(413) 527-1800 INSURED
� � WesternMassMasons.cor `
quafityt)westernmassmasons.corn T45;%
of 4
4
S 0
WE HEREBY PROPOSE TO FURNISH MATERIALS AND LABOR- $ 19,850.00
IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS,FOR THE SUM OF:
This quote may be withdrawn from us if not accepted within 30 days. Quote Prepared By: David Osiecki
TERMS:Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and wit 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 bit will be paid in full when job is
complete.A Finance Charge of 1-12(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.
Signature' I
A Date: Signature. Date:
•
Akn,u o..Vir t4w13 5/27/23
•
Thank You For Choosing Western Mass Masons!