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25A-155 (4)
BP-2022-0643 WOODBINE AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25A-155-001 CITY OF NORTHAMPTON Permit: Demo PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0643 PERMISSION IS HEREBY GRANTED TO: Project# 2022 DEMO&NEW BUILD Contractor: License: Est. Cost: 10000 LUIS BUILDERS INC 085424 Const.Class: Exp.Date:08/16/2024 Use Group: Owner: TRUSTEES MUNSKA DAVID J&CAMILLA J Lot Size (sq.ft.) Zoning: URB Applicant: LUIS BUILDERS INC Applicant Address Phone: Insurance: 37 WESTBROOK RD (413)246-0604 AWC-400-7026979 SOUTH HADLEY, MA 01075 ISSUED ON: 01/11/2024 TO PERFORM THE FOLLOWING WORK: DEMO GARAGE AND ATTACHED SHED 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: D�Smoke: Final: OR 001 �2 a 30!e. THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION "'At act,2 ANY OF ITS RULES AND REGULATIONS. Signature: I '' , ' I '. I Fees Paid: $30.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner File #BP-2022-0643 ') APPLICANT/CONTACT PERSON:LUIS BUILDERS INC ' ZOO(jJC, `© Imo, 37 WESTBROOK RD SOUTH HADLEY, MA 01075(413)246-0604 PROPERTY LOCATION WOODBINE AVE MAP:LOT 25A-155-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM I D OUT Building P it Filled o Fee Pai $30.00 Type o n DEMO GARAGE AND ATTACHED SHED New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Perm it With Site Plan Major Project: Site Plan AND/OR SpecialPennit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Penn it Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Perm its Required: Curb Cut from DPW WaterAvailability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Con - .tion Commission Permit from CB Architecture Committee ermit from Elm Street s •1 ission Permit DPW Storm Water Management Demolition Delay ir 19/0/9% ature of Building Official I I Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. ( RECEIVED y Tf e Commonwealth of Massachusetts „ ',,,, , JUN - 6 20oard of Building Regulations and Standards FOR 'kWMassachusetts State Building Code, 780 CMR MUNICIPALITY USE • Z-AgliiffigNsigq8Voication To Construct,Repair, Renovate Or Demolish a Revised Mar 2011 NORTHAMPTON.MA 01060 One-or Two-Family Dwelling Ths,Section For Official Use Only Building Permit Number: g 0- 3- ' Li �.J Date Applied: • V ; 2 . 1' ., 0 J/ y Building Official(Print Name) Signature bate SECTION 1: SITE INFORMATION 1.�P :7 (AA9 rgts: t 1.2 Assessors Nap&Parcel/mb o`-� (�lbt ks. ^avI 1.1 a Is this an accepted street?yes X 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 CI 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: L-Fe.tdel• flct a,y r l. OlOGe Name(Print) City,State,ZIP t( I "f8 5' 3,`i :ro C e/7d e1te e1,y 4,3,coPl No.and Street Telephone Email Ad s SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 r Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition A Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: (\e,o.o� (3pe.rot a(e.`6 �., � 'e ;5►—(,• (Cif A.!(-0 �J 5arZ5L) SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ /O�©'d( dr 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ l V 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ V 2. Other Fees: $ 4.Mechanical (HVAC) $ 9( List: 5.Mechanical (Fire $ Suppression) Total All Fees 9�1ti Check No. 41 teck Amount: rlCash Amount: 6.Total Project Cost: $ 1 (�, u 6 (1 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) /1 _`g5424 8_//0 Z 2 n P )V/� License Number Expiration Date Name of CSVolder 37 K ,,, • , List CSL Type(see below) No.and Street �[(� Type Description (kV 111 M*i Q: Y mil ©)6 75 U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 1&.2 Family Dwelling M Masonry RC Roofing Covering AlI /' WS Window and Siding S413 2V1Q 060 Las. 8uf/d, I Sold tioelBurningAppliances I Insulation Telephone Email address\Iglu D Demolition 5.2 Registered Home Improvement Contractor(HIC) 1, �/ Q 7 76 —2 I,� gc1,r Am. a S �,vy f'. Lus (J HIC Registration Number Expiration Date H C Company Name or HIC Registont Name` b L lei VU ers c'�hoo coydStee 1, ► A a� �f'13 2Y 1o�nOl - Email addre 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 Issu ce of 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 Lt.(, , au t'/de-f-S to act on m ybehalf,in all matters relative to work authorized by this building permit application. kl der►6er 5•25,21- 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 lin this application is true and accurate to the best of my knowledge and understanding. Print Owner's or Authorized 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 "_ Department of Industrial Accidents =: t� _ 1 Congress Street,Suite 100 ';1if_� Boston MA 02114-2017 \' www mass.gov/dia ..,.a r Workers'Compensation Insurance Affida%it:Builders/ContractorsfElectricians/Plumbers. 'ft)BE.FILED w'ITIi'HIE PERW.111N(:AIr1I1ORIT1. Applicant Information ` Please Print Lenibly Name(livainess�C)r aniration/Individual): L U/J 8(ji,� ..„'j / C - Address: 37 . W gSivgooK R4 m '� j ,�} 01075 City/State/Zip: JO Vi7f J Phone#: 41(.3 246666 4" Are,uu as ea tick yeM Cheek d!e appropriate box: J rx Type of project(required): Intl am a employer with V employes(full and ur part-time).• 7. 0 New construction 2r3 I am a aule proprietor or partnership and hay c no employees working forme in S. 0 Remodeling any capacity.[No workers'gip.insurance natured.] 30 lam a homeowner doing all work myself.[No workers`comp_insurance required_]' 9. demolition 4.0 I am a homeowner and will be hiring contractors to ou nduct all work on my property. I will 10 Building addition ensure that all ecwtracwrnt either have workers'coraperoation insurance or are sole IIa Electrical repairs or additions proprietors with no employees. 12E1 Plumbing repairs or additions 50 I am a general contractor and I have hired the sub-euntraclors listed on the attached Aces. These sub-coctors have employees and have workers'comp.insurance.: 13❑Roof repairs ntra 6.0 We are a corporation and ita officers have exercised their right of eatrmp1acm per MGL c. 14. Othet 152.§1(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box.1 mint also till out the section below show ing their worker,'compensation policy information. *Homeowners who submit ilus atlidaait indicating they are doing all work and then hire outside contractors mast submit a new affidavit indicating suck :Contractors that check this lox must attached an additional sheet showing the name of the sib iraracturs and state whether or not those entities have employees. If the sub-contractors have employees.they must provide their workers'Dump.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: /—1 ,Q., Policy#or Self-ins.Lic.#: /J W e.,-%O& 7iv tog 9 Expiration Date: ( `/-"'day 3 Job Site Address:C9 / /4.,666e/ /V C City/State/Zip: ,JO ra v/ 1 frO Attach a copy of the workers'compensation policy declaration page(showing the policy number and espli ation date). I Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a tine up to S1,500.00 � and or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of ln>.c'i igations of the DIA for insurance coverage verification. I do hereby ce'r i i'under the pain%and penaltie.,,or periury that the in) rmutiu,r provided above is true and correct. Si nature: Date: g—gn-c2 Phone.r: 3 C9 lL C)11M Official use only. Do not write ire tlri..,urea,to be completed by city or town official City or Town: Permit/License# I4vuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6,.Other ('untact Person: Phone#: —,—R Commonwealth of Massachusetts Division of Professional Licensure ��// Board of Building Regulations and Standards Construct tkpervisor CS-085424 ;*- Expires:08/16/2022 DANNY P LUIS 7 37 WESTBROOK RD j SOUTH HADLEy MA 01075 Commissioner i/0• K. FY& AZ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Corporation Registration Expiration 154318 02/26/2023 LUIS BUILDERS INC. DANNY P.LUIS %? 37 WESTBROOK RD. 0(' L SOUTH HADLEY,MA 01075-2173 Undersecretary City of Northampton C P4AMp `5 .o,.. S� Massachusetts ��s c• (W •' DEPARTMENT OF BUILDING INSPECTIONS �' M �•" r 212 Main Street • Municipal Building wb., ...1r1A141f Northampton, MA 010603rD ss , I1� 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: V t ,t 1Ne C t 1\4 The debris will be transported by: Name of Hauler: M tv‘V(,-e r S•t- 262Signature of Applicant: Date: � � if\ $A-152-001 022 4 o 254.14534/84 25A-155 0.185 \\„ 7\\\\> 25A-1511 018 27 N.,,,Ny WIN Vj+ Fq 44. 5C4440111 r OP '" ,'. , . rr_ . 4-4 .tit2114,6 : 't *01 ''' '- a 1 - 4 , . ,_ ._ joie, 4, • • .30:-. ....,„,e, . . : . t . ...., , , _. • ICI b + 4. 0. • i y + t " .may - .v *rob ""'"k a h. y Zt s s 4 r. • %iYA # ; 4 ' 'el..'..''I:,.-';'''. '''', '. ,.:**, Ali!4.101,4 11'''" lif *0.1*4 ir r VC':. W n 4iteillillilik' . it ,� # R djj' ipp• .t OP All NI, ' .r 0 _ Mr • 36 Woodbine Ave 4