Loading...
38B-117 (7) BP-2024-0341 17 EAST ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38B-117-001 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-2024-0341 PERMISSION IS HEREBY GRANTED TO: Project# ADD BATH 2024- 19 EAST ST Contractor: License: Est. Cost: 20500 CLAUDIO GARRIDO CS-089458 Const.Class: Exp.Date: 08/24/2024 Use Group: Owner: GUIDOTTI ALICIA Lot Size (sq.ft.) Zoning: URB ;applicant: CLAUDIO GARRIDO Applicant Address Phone: Insurance: 140 NASH HILL RD 4132195906 SOLE PROPRIETOR HAYDENVILLE, MA 01039 ISSUED ON: 03/27/2024 TO PERFORM THE FOLLOWING WORK: 19 EAST ST -ADD BATHROOM 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: 4/72- Fees Paid: $133.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts' W Board of Building Regulations and Standards r''�1( 0FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY FOR ,'USE Building Permit Application To Construct,Repair, Renovate' fp rQolish a Revised Mar 2011 One- or Two-Family Dwelling :: This/Setction For Official Use Only ..,"`r<-r"tis / Building Permit Number: 4 A V' �-- / Date Applied: ii Aeu0,, % 5,5 // 3-Z7-ZDZii Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Pro erty Address: 1.2 Assessors Map& Parcel Numbers ice( FT STr l.1a 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: Zone: _ Outside Flood Zone? Public Private 0 Check ifyes❑ Municipal l On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: , / 1— tic— u GLcia-F--c—i Nv!fti 0vin V h.)-NC, ti tik b I bGb Name(Print) City,State,ZIP PI r a sA- 5' 3�2 1t a 5 2 3 r (.4 6 4 (Co.5 n ,-t,,. � -1� ' No.and Street Telephone d Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s)Jit Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': 0 4Tt'-/ &Gt/ 6/1-5( 4-`2 4r-w SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ ' `( aU,9 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ ❑ Standard City/Town Application Fee I� c)v Li 0 Total Project Cost' (Item 6)x multiplier x 3. Plumbing $ , 50 J 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 1 5. Mechanical (Fire $ Total All Fees: Suppression) Check No.5( heck Amo IF 6.Total Project Cost: $ • �' C11 cot Cii-I 0 Paid in Full 0 Outstand g Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor Licensee (CSL) CS—c? � ' 0 1 1 c AI O ®e( t O License Number Ex irati Date Name of SL Holder 1 k tl 11 !7`�( j I 4� List CSL Type(see below) 0No.and Street 7 // Type Description // V 1 l�` (/r C� U Unrestricted(Buildings up to 35,000 Cu.ft.) GbEr �f ! ��� (�� ( R Restricted l&2 Family Dwelling City/11 own, State,ZIP / M Masonry RC Roofing Covering WS Window and Siding 4tVi(7 � A^ SF Solid Fuel Burning Appliances ��,,�'1 C".6/-�� t o 061, 17.CC / I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) c 4CJIVO G .4i'' I 'iO (s$��/ Q o �" "`� HIC Registration Number xpira ion Date HIC Cpjnpany Name or HIC Re i5t ant N r7o f/4 ti lL<// / " c� � �`'d eg No.and Street En Ail address � fr'Vi`L1� ti 0/65 '(/1p7 S-off' 0 Gt4q(1.celr City/Town,State,ZIP elephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes No .. 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize CLG-q L/o(e [vL�c�2( UJ Q to act on my behalf, in all matters relative to work authorized by this building permit application. 3 //,, P not Own 's a e(Electronic Signature) D e SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below;Yhereby attest under the pains and penalties of perjury that all of the information contained ieppk. . atn is truganti�ccurate to the best of my knowledge and understanding. - 3 /$/2 Print Owner's or ACuthorzed Agent's Name(Electronic Signature) Date NOTES: I. 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 i' ,,;;_., 1tf Department of Industrial Accidents 7.11:11V / Congress Street, Suite 100 "Mil"•��= Boston, MA 02114-2017 • e, www mass.gor/dia )%outer,' ('utnlarn,ation Insurance Affidavit: Buildersi(ontractorsil lectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annlicant Information Please Print Legibly Name 4Busincss`Organizationlndnadual): Address: ( / 7 ,/K-s(1 /1(11 K City/State/Zip: Fi l t9(D� Phone #: ( - ��( yrc you an employer?Cheek the appropriate has: Type of project(required) l.©l ant a employer with_ ecarpbo}ees(flab autos.part-time).* 7. © New construction =.j23"1 am a sale proprietor or partnership and have nu engaloyees worsting for me in8. 0 Remodeling �Yny capacity.[No weaken'comp.insurance required.] 9. ❑ Demolition I am a homeowner doing all work myself.[No workers'comp_irnurimee required.)' 4.0 1 am a homeowner and will be hiring oonarae urs to conduct all work on my property. I will l0 O Building addition ensure that all contractors either have workers'conaptmaatr+art insurance or are sole 1 143 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions InI am a general contractor and I have hired the sub-contractors hated on the attached sheet_ These sub-contractors base employees and have workers'asap.insurance. I3 Q Roof repairs ti.®We are a corporation and Its officers have exercised their right of exemption per Wit_e. 14. Other 152.§1141,and we have no employees.[No workers'comp.insurance required.' *Any applicant that checks box++I must also fill out the section below showing their workers`compensation policy information. Homeuwnen.who submit this afft<ktvit in heating they arc doing all work and then hire outside contractors mot submit a new affidavit indicating such It'untra ctors that cheek this box must attached an additional sheet show ing the minx:of the subcontractors and state whether or not thus:enitie'^s have employees_ If the sub-contractors have cutrlusces.Ihr:y muss pruv ids their workers'comp.policy number. I am an employer that is providing rvorhers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City+'Statc.'Zip:___ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,*25A is a criminal violation punishable by a fine up to SI.500.O() and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine 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 certijjE under the1, nd pcnolties,afFeriaty that the information provider)above is true and correct. Stenuture: � `�... L "" Dale:6L.3 /r—/K r Phone K. Official use only. Do not write in this area, to be c oinpleted by city or town official City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone i#: City of Northampton s� �.`� Massachusetts �� **%, DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building r`� Northampton, MA 01060 jst ,^^�j�'1� 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: L/& iJ/ CyaN,tC� The debris will be transported by: Name of Hauler: c% c/e ( 1 0 Signature of Applicant: Date: �'2 �S j �L_ L f � 4 n I Ti i ... „sr_ . i f -\j ,-.„ w , _ T ,...... r L__. R m K Cc i, ,1 17 r IIIa 4 Z rco i O ei O i -1,- _ • ' i :g ,fr., ®Uo, T, ; ,^le , _ IZ Y, , '� x „ ,,,,,,,„..., _.,.... xcx;rr;s& ;3+ . ,'rx 1T B��THROOM 1719EASC S[. DESIGN NO101ELMSTBUILD Er :{. O 2"p C; REMODELING NORTHAMPTON,MA01060 r�N re• ,ORT AMrroN.MA010B0'6I 0 I ..0 ; ........