The URL can be used to link to this page

10B-038 (8) BP-2024-0188 44 FRONT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 10B-038-001 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-2024-0188 PERMISSION IS HEREBY GRANTED TO: Project# BATH RENO 2024 Contractor: License: Est. Cost: 13000 DAVID WOOLEY 119193 Const.Class: Exp.Date:04/12/2027 HAAR SAMUEL W&MAYA MALACHOWSKI Use Group: Owner: BAJAK Lot Size (sq.ft.) HAAR SAMUEL W&MAYA MALACHOWSKI Zoning: URA Applicant: BAJAK Applicant Address Phone: Insurance: 44 FRONT ST LEEDS, MA 01053 ISSUED ON: 02/22/2024 TO PERFORM THE FOLLOWING WORK: BATH 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: I ; ! T-#O • Fees Paid: $85.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner \ \ °A\ 42> Ix The Commonwealth of Massachusetts '�;.o., j m FOR Board of Building Regulations and Standards�ti,G.� c� w.____._ Massachusetts State Building Code, 780 CMR ''°'ti,,4 c3, IUSB` ' Building Permit Application To Construct, Repair, Renovate Or D `s.. 1 a i Revise/Mar 2011 One-or Two-Family Dwelling 'os'gr, This Section For Official Use Only Building Permit Number: t7"• .2 -/f/ Date Applied: jr 'J oo /'VJ— 2-2Z-Z.Z2V Building Official(Print Name) Signature Date SECTION 1.;;SITE:INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 1j r_� r/c';if Sfr't t f 1.la Is this an accepted street?yes V 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' /vi 4t if et 3( 2.1 Ow er'of Record: Name(Print)( City,State,ZIP AN Fi��-tf �¢-,-trf ( 1rfr3OI cock;f3�6.k&.5 a."l.eo� No.and Street elephone Email Address NI SECTION 3 DES TION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Owner-Occupied ' Repairs(s) pl Alteration(s)/m Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: A r vt v tic 1--,,, ti!A a/ S (.1r'r.''-%K e n c ,/ n< tiA19 avkop h'lt 5 v.((cAA-4-%41 I( +-I/t -FIa•y. Aft,,. bu-fti ic-Ael <:,p( f€ ;pit. SECTION 4 ES' TED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only .,.. `0, s,, taut,^, (Labor and Materials) 1. Building $ / 0 G c• er 1. Building Permit Fee: $ Indicate how fee is determined r 0 Standard City/Town Application Fee ' e-�s ;rx`; 2.Electrical $ f (u G / 0 Total Project Cost'(Item 6)x multiplier x <0:kit 3. Plumbing $ Zi du 02. Other Fees: $ • *4 •_ s .`. �F I MASol 4. Mechanical (HVAC) $ List: ' 5.Mechanical (Fire $ Suppression) Total All Fittcst Chitallo.1/ Check Amour `, ` z'' ,z - 6. Total Project Cost: $ / / i GUC` 0 Paid in Fu 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS—J I It i 3 °Lib2/2_027 bik✓i ./ hia l 7 License Number Expiration Date Name of CSL Holder List CSL Type(see below) r L f.Kk C v I k S iYc.< f No. and Street Type Description rAS �K 1 �ii 0/a.Z-7 TJ Unrestricted(Buildings up to 35,000 Cu.ft.) �p R Restricted 1&2 Family Dwelling City/Town,State,Z19 M Masonry RC Roofing Covering WS Window and Siding .j,�� SF Solid Fuel Burning Appliances (L14412-02 2) 1)e.J�.d� vUe,o l t!ij(oYtsv ( ,,,,•t,,CC*1'tl Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) , 7 3 c, )/© 7/z v z6 J HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name ' L- tvi[c•Iir, Sfie.eI- D„,v+r.1 C)(/1/coley (Gn)ir ric,,i.Cc'' I'( No.and Street • Email address EA_ ►vtpfi:� :Mh oie'Z 7 (t-�13) y 7L—C 2 23 City/Town,own, 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? YesfriNo 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT w I,as Owner of the subject property,hereby authorize ib A v tCJ W 0 o L. to act on my behalf,in all matters relative to work authorized by this building perm t application. Print Owner's am (Electronic Signature) P Date O Z� 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 ap . . is true and accurate to the best of my knowledge and understanding. 2I /ZoLk( 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 Massachusetic ..:-...-.....7....-.. _ ,A••••••"---... ............ fr, if-rf- Department of Industrial Accidents - ' 7 7.7...::7111%...._=-7 '•) 1 Congress Street,Suite 100 -.,. 7....-..-,!•:,........= :7 Boston,MA 02114-2017 www.mass.govidia Vt takers'Compensation Insurance Affidavit:BuildersiContractarsfElectrkiansiPlumbers. TO BE FILED WITH nilt PERKETTING At 11110RITY. Applicant Information Please Print Lodi* t' . , . Name(Butdriesittlkganization'todividual): "i ( ,...,r" .-‘1 C.(..+1 S'-171.-‘,..T7 es,/ i....t-( , ( ,4**:Mt-;.:VAt.4.00:43a4.04,t4.WfiWar4gAVOMAW:*****000.k$* „...,„...,,,, ... ,,,„ --- — -- City/Stateviip:...Er' tivorif 1744_0 11-u i!;z-7 Phone Any aaomodayer?Clitek d appesiptinte bey 'Or st Pinged(requ4re40t 2g. ,au a eitipkiyor with _,,,.....[ ellicknites.(fa and Perl-time)-4 7. CI Now construction inmasole propriehat or plettnership awl have no employees working forint in Ilitemodeling Demolition any aitnnity.[No waiters'cinnp.inaunteim mowing 9., 3/7.1 Taw ahomnowner doing all omit myself.iNo workers'comp insurance regnant'' t ' 14E]/kidding addition 4.0 lam a humnownin and will be biting coeuracturs to otmettert all work on my property. I will ensure the all to/mai:ton eadver have*oaken'claapinion unistance or an atilt ` tic]Electrical repaint or additions pieipaintans with no immloyeen Plumbing repairs or adtraions 1C:11 gotta spowat conettoor and I have Pinta the soh-contractors titled on the rinachedailmet These stinoonunciots haw employees mid have workers'comp.inianancec; 13,1:3 Roof ropairs ...: .....,...............„.....„,,..,.._..„.. ;. 0C1 we one a carporation and its officers bast exercised their right of extmptioit pet Wit.c. 14.1:30ther 02,11(4),and ins bane no employees,[No nutlet/a'comp.ins iumained_} *Any apphtent that degas box Itt moat also fill ow the incenin telow showing their workers'cmripemiation illicy information, f Harmiewatrs who submit this affidavit imitating they me doing all work and than line outside tors num submit a new affidavit roilll4(tnt4 NtA.11 ttontittetori that cher*this box nnaal attlithedan additional shed show iris the nate*of the suiroaestrattors and state whether or not those entitle.*have employee* If the sub•eontractort have •‘••• - they twit provide ituris IMAM'weir.policy niaribi:r. 1 am an employer that is providing'pothers compensation insametefor my employees. Below is the policy and job site information. , , „ .• ....... .,„ Insurance Company Name: 2_N.A.r i c let — ccK: X...An StAleillt.<- 61 e r.C''A-1) Policy#or Self-iris.Lie.#: (o 2 _vt Z---0 tA)K3,q(03—7-zy Expiration Date Of''''' Job Site Address: ti Li F revtk 4-,Vt.et 17 cayistatezip: ff-rthikmi) :4 JAI A 0 i ti r-.) 3 Attach a copy of the workers"compensation policy declaration page(showing the policy number and expiradon date). Failure to secure coverage as required under MM.c, 152,§25A is a criminal violation pemisbable by a line up to S?.500.440 arailor 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(MA for trisortince coverage verification. I.---s-t— . . . . A. Ida hereby certifY der thg ins rattles of pointy that the information provided above is trate an4 correct --e:Sivisture: .- Date: 2/2- )/2 ii Phone#,-..i,.:(11:13) 9 7 Z--c-r2 2 3 , , Ara'11"T"'" 4- •- b.. i I.. i , e , , ‘ , , ' ' k Official use only. Da at wile la Oaf area,w be completed by city or sawn offirial 4 Cky or Town: . PernsitiLitense h laming Authority(dr* I.Board of Hetdlit 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector ..:. Si.Other ,.......„,...„.....:....„........ :...„..„,::...,... :, ..,„.....„...,...„.. Contact Person: Phone#: — -', City of Northampton °`1, 5 ti Massachusetts ` f: 'Nie i i /I T DEPARTMENT OF BUILDING INSPECTIONS a +r i r' 212 Main Street • Municipal Building Northampton, MA 01060 ,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: Location of Facility: tick (I?I ( G if '' 2 3 E"stw,j}a4, Lei. l "-ex-it/0 e' / & . The debris will be transported by: Name of Hauler: Cx1 c 1-7 Cd s n'1~41704-t LCL Signature of Applicant: kg Date: Z/2 ,/ / / City of Northampton Massachusetts { ' DEPARTI0 NT OF BUILDING INSPECTIONS $ ;a 212 Main Street • Municipal Building r' eu : Northampton, MA 01060 -' r HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born (insert month, day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners' exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this day of , 20 (Signature) 44 Front Street • SketchUp r 8' ,r Linen Cabinet Skylight C i /__ Fan Tub • G6 • • 01, 2' 6"