24D-251 (4) BP-2021-1991
94 CRESCENT ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-251-001 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-2021-1991 PERMISSIONISHEREBYGRANTED TO:
Project# BATH RENO Contractor: License:
Est. Cost: 28000 JULIE PAVIA 085685
Const.Class: Exp.Date:08/01/2023
Use Group: Owner: PARADISE THEODORE
Lot Size (sq.ft.)
Zoning: URC Applicant: JULIE PAVIA
Applicant Address Phone: Insurance:
594 LOOP RD (413)743-1 178
SAVOY, MA 01256
ISSUED ON:10/06/2021
TO PERFORM THE FOLLO WING WORK:
RENO 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:
Driveway Final: Final: Final: Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
(� • r >9 . cfro
Fees Paid: $182.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
-%.,--
The Commonwealth of Massach setts t.
r411, Board of Building Regulations and Stan �� I`q ICIP ITY
Massachusetts State Building Code, 78 e90
Building Permit Application To Construct,Repair, Renovat tn'~`ty ish a evised ar 2011
One-or Two-Family Dwelling o.,,`.--
This Section For Official Use Only )'°6o6Nis
Building Permit Number: 60—Z/i i 447 Date.Applied:
. r i tk,, ,2, � jpeJ lea ' a1
Building Official(Print Name) Signature D
SECTION 1:SITE INFORMATION
1.1 Property Address: I 5 y C A Es C c, r S+ 1.2 Ass sor lap& Parcel Numbers _ O i
1.1a Is this an accepted street?yes k no Map Number Parcel Number
I
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
iv IV ( NFt
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Zone? Municipal 0 On site disposal system 0
Check iff yes
yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Ownert of Record:
774E00JRL IA RCA ois E AiOR PO""eTo ,..) lvifl
Name(Print) City,State,ZIP
q `f C1 c( 7\5-- S1- y/3 aaa O 21, tjparaolis¢ Q m4C• QJr,,�
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) 111 1 Alteration(s) Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:__
Brief Description of Proposed Work-: R Ern,a p C t ,E K 11 Tin/U KrIf.N �J r,,_
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
item Official Use Only
(Labor and Materials) t)_
1. Building S 2 01 UUU I. Building Permit Fee:$ /g Indicate how fee is determined:
2.Electrical $ uV v 0 Standard City/Town Application Fee
i ❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ S V U _ 2. Other Fees: $
4.Mechanical (HVAC) S / List:
5.Mechanical (Fire $ --- —
Suppression) A
Total All Fee
Check No. `rC.heck Amount: I Cash Amount:
6.Total Project Cost: $ 2 c D 0 v 0 Paid in Full * 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
Jut-YE
0$S6�S �/ "202 3
V U L/C Fl V if}} License Number Expiration Date
Name of CSL Holder u
5 / List CSL Type(see below)
Na and Street Description
S V O y M P d �, U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
IP? 7 9.? /"7c? V IAC O N1 (v Lt ,I SF Solid Fuel Burning Appliances
I 1, I Insulation
Telephone Email address �° " D Demolition
5.2 Registered(Home Improvement Contracto (H1C) /6/o C7 / 6_/c�.a Z
"' 7� — 3LA,E V HIC Registration Number Expiration Date
HIC Company me HIC Registrant Name
91/or La..)Vp0.V1gCo(Nsin.al) 50A411.00f,,,`
No.and Street (N1( ,
( — 'i3 7 t�� //7 e Email address
Sf2IVOCity/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 Issuance of the building permit.
Signed Affidavit Attached? Yes �d 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 J U L r t PR / /�-
to act on my behalf,in all matters relative to work authorized by this building permit application.
—7-1:1E'0DO(L I1Lf ,sE 1012121
Print Owner's Name(Electronic Signature) Date
SECTION'lb: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 true and accurate to the best of my knowledge and understanding.
JU � t£ Pr4Vift i0_1 / 2- I
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"
City of Northampton
Ato
Massachusetts rr�,
t1 it # .'e DEPARTMENT OF BUILDING INSPECTIONS 3s '
14
212 Main Street • Municipal Building `3'w
Northampton, MA 01060 41,4
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: V '°L L y <CC y C L &—
The debris will be transported by:
Name of Hauler: Dv1CCc 1,-v cci-i cp,.►(a(, cMz ,�3
1 c�
Signature of Applicant: Date:
The Commonwealth of Alassaehusehs
Department of Industrial Aceitkitts
I Congress Street.,Suite lett
:14)
Boston,MA 02114-201 7
onoettonssigneldila
(ormirasation Instirance Affidavit:BuilderatContrsirturstEleetrietinstPlunthers.
TO HE 111.111)WITH THE PERMITTING ACTIKIRITT.,
Annlicant information Please Print Loailth
Name ottoillesta;Orvolizationtridivideatt: 1./1 (c,N,14, „„,„„„
c -
Address:
City/State/Zip: -SY-) V y /71 4)/2 C Phone y/3- 7v_.? /17r
Aer***testployeel Cheek the appoilaritatte hoc t. Type or project(required):
1.0 I ein intapkvyar with that&altar pait-tritink. 7, 0 New construction
y4I am 3 343.1.3 proprietor or pannership and have otopktryeen work*fin rot in 8."23 Remodeling
ittlY C4p11433Y.[No workers°event,.tationower hopseredi
9, Ci Damian:4
3.0 I sot a 1131433001311.3t doing ail work myself(No workers"comp,itennotore ristptinad..)
i CI Building addition.
41.0 I itot a homeowner and will be hiring notattartara tat oxidant sit work on say property wilt
ensure dam rinoracteso tither lust workers*3V33413333.133[31t ilE33111t4=3: 3331C 110Electrical repairs or additions
preprirturii with ermikiyets,
2:Ej Plumbing repairs or additions
SI am a Sottitethi coat:nowt and I hove bend the ontstorotractrits totted on tha attached shoo
. Rind`repairs
'Moe ma-osatiscrisis hoar oriployees and iusii ussisis!coup,issuntsor
; 14. Other
6.1:3 We ant a earporatisei and its tinker*have exerensert their right of exemption pin MCA,c
Vilt bit%and we have no etrolowerk[No workers' an iroinnsicereipaitotLI
*Any applicant twat giktk*btngi raw spas fill twit the inettoo Oaken showing their*mhos'rotannensstien pointy infornotion„
lowirossonts who othont this*airiest'tosticattrig they 33V 413333t ad work and data hoe monde contioctori ovot schwa a new ianitsii tiroheatioi soar
ontractors that cheek this box nand winched an,UtitliiiMA sheet showins the name of the tattottaintraritan and state whether as not those entities&INV
employees. If tin solsorrairractors toot teripkink they mot rotide their workers*sou, policy nornbor
tam an einpioysT that is providing WO:1W?COAVAtitiattiOft insurance few my ensplopets. Below Is the potiey and Joh site
information
Insimince Company Name:
Policy or Self-ins,Lie,* Expiration Mite:
soh Site Address: CitytStato'Zip,
Attach a ropy of the workers toniptetsation policy deektration page Ishowitig the policy nunsher and expiration date).
Failure to seinee covemo a required tinder MGL USA is a criminal violation punishable by a line up to SL,500.(X)
turd one-year imprisonment,as well as,civil penahies in the hum of a STOP WORK ORDER and a tine or up to$25000 a
day against the siolator,A copy of this statement may be forwarded to the Office of Investigations of the IMA fir insurance
coverage verification.
I do beventsyeertifya r the in and •amities of perjury then the istfirratotion provided above is true and correct
/ — -
Signa Date:
Phone 7 4'
Official use only. Do not write In this areas to he rompterod by city or town offkiat
City or Town: Pertithilicerist
Issuing Authority(circle ono:
I.Board of Health 2. Building Department 3,ChyiTawn Clerk 4,Eleetrietil Inspector S. Plumbing.inspector
6,Other
`Okittett Person.: Phone 0: