25C-085 UNIT A BP-2024-0124
238 BRIDGE ST UNIT A COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
25C-085-001 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-2024-0124 PERMISSION IS HEREBY GRANTED TO:
Project# 2024 UNIT A RENO Contractor: License:
Est. Cost: 82700 THOMAS BACIS 070061
Const.Class: Exp.Date: 03/06/2025
Use Group: Owner: MICHELLE RABOIN
Lot Size (sq.ft.)
NEW ENGLAND REMODELING GENERAL
Zoning: URB Applicant: CONTRACTORS INC
Applicant Address Phone: Insurance:
75 VALLEY RD (413)478-5272 WCC500601501
SOUTHAMPTON, MA 01073
ISSUED ON: 02/09/2024
TO PERFORM THE FOLLOWING WORK:
INTERIOR RENO TO OFFICE SPACE
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: �T
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Fees Paid: $579.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
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The Commonwealth of Massa chu C i --
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Office of Public Safety and Inspections
Massachusetts State Building Code(7801CMR)
Building Permit Application for any Building other than a One-or Tror,FamilyI wellin f
(This Section For Official Use Only)
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Building Permit Number:)9-/1 I Date Applied: Building Official:
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SECTION 1:LOCATION i JcI3cC�iV
76 38- G rI q c rr ia74/11,0i,1 6(o60
No.and Street City/Town Zip Code Name of Building(if applicable)
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 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy ❑ Other Ot Specify: h e Cede To,7t/'tfr--
Are building plans and/or construction documents being supplied as part of this permit application? Yes 'yt No 0
Is an Independent Structural Engineering Peer)Zeview required? e Yes 0 No ❑
Brief pescription of Proposed Work: �[ 0 GQ�en-ter al Q r / /�n"j Lea �L
C4 Oft m C re, aw.+ Q F 1`a czA2d tit eC1rr
vrJ g rati , 7
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 0 Nightclub ❑ A-3 ❑ A-4❑ A-5 0 B: Business la E: Educational ❑
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) 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 0 IIA 0 IIB 0 IIIA ❑ IIIB 0 IV 0 VA 0 VB
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Sup ly: Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
A trench will not be Licensed Disposal Site p
Public t Check if outside Flood Zone"' Indicate municipal 15requiredilli or trench or specify:
Private❑ 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 0 Yes 0 or No 0 Yes❑ 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
m;t6 eile-V-611C041 i5c4in)e, S7- SAOiey /4Q, Dvo7r--
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
ou,.,i e r 413 % gssii iiii.6yc B S r hcfk&/oP 4 J rearAer.,'
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
1 r' gal C,'I 7 c iai/e y U,, Snytha pfo'1 n1( a r 6 73
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)
Chris NOVe lI i Se4_372 3 S61 Chfi'S4OVArCh%Teelare c0YS0
II�tt�o(r�,�gistr n) T e-mail a ress ' W�' egis r tion Number i/
'sd .4n7�jpr� �j �di jflephoyNo.
0e Cia,C 0i7� r. 1r°C� .-31�27
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
/ 'ems C 5Iati) et'clod e Iikij G 6 , ...,( 4 c
Company Name
a eacfr LI-—0700 6 i
Name of Person Responsible for Construction License No. and y e if Applicable
-- Valley S'at.74a ply. 4 0/0 7 3
Street Address City/Town State Zip
4►3 _S)-q Ojai yl3 'l? 5d'7„L l gac,1-7J(� Cj j'^a,' 1 / C,4'1
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? Ye0 No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ 7 Di VGd Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ s .f o O — appropriate municipal factor)=$ .
)
3.Plumbing $ (3‘;‘)
4.Mechanical (HVAC) $ y i i?-‘'V °^
Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $
Enclose check payable to
6.Total Cost $ ' ?, 7a a (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 knowled e and understanding.
: ' 7lirf1 di I C,� o w r ate- Yr 7g S) . - S- yl
Please print and sipname Title T ne No. Date
Va1ey �� Ov4ari f1n /ha Ole'7. c.s._71 pma,.i!,Co,4
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: 2-q-ZDZ4
;
Name Date
City of Northampton
Kr;A �r s
Massachusetts w *_ e
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060x,:n
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 7 '1 l y NC. e -y 61/'n a' / E4/7hiinf 7:1n fed I
/VA{711 d ,p/es) I /mac?,
The debris will be transported by:
Name of Hauler: A4r6n r `1/-7 (�l� i j + (� I/
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Signature of Applicant: � Date:
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••••••••011111•01••••101 The Commonwealth of Massachusetts
Department of Industrial Accidents
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-* SI.Fin= 1 Congress Street,Suite 100
.':Sq!ii—'7'—'1 Boston,MA 02114-2017
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www.mass.govidia
Workers'Compensation Insurance Affidavit:BuildersiContractorsiElectriciansfPlumbers.
TO HE FILED WITH THE PERMITTING AlrtHORITY.
Applicant Information Please Print Leitiblv,
1 /\ L.,
Name(Husinessforganizatiodindividuan: N tA..) _lt a nd ()15'?061.f , i R) Gfzn ern r Loo r facto(. . In
Address:7 5 \J Ct k 1 t E, a_Dct
J City/StateiZip: 1, 0 107• Phone#: 11)3 7 R-_ 5 2 7
Are silt an employee Check the appropriate ban: Type of project(required):
t. I ant a employer*sal,., LI_ employern(MI anther part-timo*
7 New
g . 0 on
2I am ask proprietor or rennershap and hare no employees working for Erse re 8. 0 Remodeling
any capacity.[No workers'comp.insurame rerpated_]
9. 0 Demolition
: 30 lam a homeowner doing all work myself_[No workers'comp_nano--owe a .eapnreell*
4 I 0 0 Building addition
{:i Ilan a homeowner and will be hiring rostranors to cordial ad work on rtre promty. i will
emote thft all ecooes-trits either have&rockets*compensation nnalrance Or am aole If.0 Electrical repairs or additions
proprittoes with no employees,
I 2.0 Plumbing repairs or sititilions
50 tam a general contractor mad I bare kited the itib-tOntractOr%hated on the anathed sheet_
1 3.Ei Root repairs
These sethartamances have employees and hare workers comp.ins'IrrZner.)
I 4_0 Other
61:1 We are a&seventies and its IIfacers have mortised then risk of eXemption per MCiL c.
I$2,§1(4),and we hereto employee&INe*otters'comp_insuranee requital]
*Any appilmt that&eat beat UI must who fill out the%tenon below showing dseir WOrieera:alinpenintion policy infonnairon_
t ilem.000nien who submit this afro:6re indicating they are thing all work and then hire nitwit contractors mud Albeit a new affidavit andantino nteh
Contractors that check this boa must enamel an seklitional sheet showing the name of the sub-connictets mid state whether or not those trollies hare
employrer lithe aub.nomacters have employee&they nuts provide their rankers'owes_palmy number.
I ant an employer that i s providing workers'compensation insurance for my employees. Below is the policy anti/oh site
information.
Insurance Company Name: PCI: H .. A
Insurance ,n gt)ca n re (10 , _
Policy#or Self-ins.Lic.#: V/O,C" 610-" 600bOIS- ,2 01;k3 A Expiration Date: Ci•Y' ')0 ) il
Job Site Address: 2-1 an ),9c. 5 (,, citrszawaip: °lobo
Attocis a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as requited under'MOE c. 152,§25A is a criminal violation punishable by a tine 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification
1 tio hereby certifr the pains an penalties of peppery shot the information provided above is trot and coma.
Signature: ---- : 1 'l,f-- Date: A-S-raoaLA
phne#:(k-i 3) .to g - ..,
41-ia
. . ,
Official use only. Do not write in this area,lobe'completed by city or town official
City or Town: Permit/License h
Issuing Authority(circle one):
1.Board of Healds 2.Buileksag Department 3.City/Town Clerk 4.Electrical Inspector 5,Plumbing inspector
6.Other
Contact Person: , Phone h:
' THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affa#%,,&Business Regulation
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Reqj
ONTRACTOR
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ns VALLEY ROAD
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Undomecreta9
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Commonwealth oxMassachusetts
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~~ Board o,Building Re qqla ions and Standards
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VALLEY FWAD �
Commissioner
From: Christopher J. Novelli, AIA
N3 Architecture
30 Anthony Road
Hopedale, MA 01747
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
238 Bridge Street, Northampton, MA 01060 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,