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17C-029 (8) BP-2022-1068 1 BARDWELL ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-029-001 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-2022-1068 PERMISSION IS HEREBY GRANTED TO: Project# 2022 PORCH REPAIR Contractor: License: Est. Cost: 5468 JOEL BIAS CS-115346 Const.Class: Exp.Date:07/03/2024 Use Group: Owner: POLLACK STANLEY B&JOANNA VARADI Lot Size (sq.ft.) Zoning: URB Applicant: JOEL BIAS Applicant Address Phone: Insurance: 250 HENDRICK ST (413)658-8215 SOLE PROPRIETOR EASTHAMPTON, MA 01027 ISSUED ON:08/29/2022 TO PERFORM THE FOLLO WING WORK: REPLACE DECKING, HANDRAILS &SUPPORT POST ON FRONT PORCH 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: YU Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner N The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY USE puilding Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number:I3"(P-2,022- / 0(o Date Applied: /Evie-) ` KOs) //�Z �9 Z13ZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro erty Address: 1.2 Assessors Map&Parcel Numbers 1 bard,wCrt1 Ste• i7G—d24- Oo / 1.1 a Is this an accepted street?yes k no Map Number Parcel Number 1.3 Zonin Information: 1.4 Property Dimensions: Ukg , 33acres Zoning District Proposed Use Lot Area(sq ft) Frontage(II) 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 Er Private❑ Zone: Outside Flood Zone? Municipal B"On site disposal sysiem 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owne 'of Reco d: S.rare v01tac►-, Flor $ ee, c ; 0 l o b d Name(Print) City,State,ZIP tfd Locl1 L(13-S?S--90 i o sfan+htgx 1-mein,egrnwl• No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Eff Owner-Occupied Repairs(s) lir Alteration(s) l Addition 0 Demolition Et/ Accessory Bldg. 0 Number of Units I Other 0 Specify:_ Brief Description of Proposed Work': I e p t'Q k iKs J 5c.epv`� i7v0- ak leot,4- F Orc%, Sarrx- p r,n N SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ Sy 108.y o 1. Building Permit Fee: $(a = Indicate how fee is de ermined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ — 2. Other Fees: $ 4.Mechanical (HVAC) $ -- List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ �4, Check No.0 -71 Check Amount: faS•— 6.Total Project Cost: $ (3i.((Q8.,i.(0 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 11531-I(p 7 3-2,4 o`[ pj i3 5 License Number Expiration Date Name of CSL Holder List CSL Type(see below) 60 \enac i C.k & No.and Street Type Description Unrestricted(Buildings up to 35,000 cu.ft.) a.J vn , 0k0 ar R Restricted 1&2 Family Dwelling City/Town,State,ZDP Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances (41 (OS2J_ I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) �io�S % (QWI5 5-25 zy HIC Registration Number Expiration Date HIC Company Name of HIC Registrant Name �5O !-itc-1L1c gk-. m S&iCCQSe 9m&i No.and Street Email address EaSkAlarA Cnn , 6`(11't ©10Y) City/Town,State,ZIP1 Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C )) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to rovide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes $1. No . SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 32 f-� I,as Owner of the subject property,hereby authorize ..,/O� t a--"5 to act on my behalf,in all matters relative to work authorized by this building permit application. 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 in this application is true and accurate to the best of my knowledge and understanding. g 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/421 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" �- S The Commonwealth of Massachusetts Deportment of Industrial Aceidents Congress Street,Suite 100 Boston,MA 02114-2017 Tan: www.ntass.govitha %%takers'Compensation Insurance Affidavit:Huliders/ContractortiEtectricianstPluntbers. 10 RE,FILED WITH THE PERNITITINGAUTHORITE. A ilicant Information Please Print lb Name gasalessiorroulizatimanaiviaaat): j-ne_„\,, Address: .P 50 0 e.S1 ...0 City/State/Zip: Eas-liam on fon-,0‘04-7 Phone#: (--1 13-(Dsg- a S A re yaw*a eanitioyee t hot%the appropriate boat Type of project(required): 1 ant a sonnoyer with employees(Nil ot Pink* 0 New construction 2,017ant a VAC'prOptlettO or punnerthap and have no ealtployte%wanking for tant K. 0 Remodeling any capacity No winters`contp.mairanee resputoil 9, El Demolition i Ara a ilartsetrWner iluati#ail Avon:myself. vitirkera'conga.ineonanes required.14 10 Buikling addition tti lout a hoineownet and waU himag a:millet all wink on my plopenty, 1 will emote that all C&Vartli-lOtS either hta winters'cola4klmia1itat ittsittitt.V ire kik I 1.0 Electrical repairs or additions prophetess with no eimployetai_ 12,0 plumbing itpairs or additiore. • ! iarit.a peal avratraettat and1 have hard the aohmontractors had on die atiaciord abet i 3E:1 Roof repairs rheas stah-coratractoria hake employees and tiave workona*comp,stasmanee..", 14.1ather 1701r-414 kr:8 fra Wir art a c4krixbradwn and as ofticess hays exennsed thew ngin of exemption pet Wit c. 152,§1441,and we has no employees.[Na workers'comp.tiourance requared.1 *Any applicant dna chawka beat o I mans also fill out tke traction below ithetwang then workers'comperwmion policy infomattion, ihniniowtiets who itibian dui,affidavit aratheating they arc&nag all mirk and Inca hire ontinic cosaisetift must manna rowaffitioni indicating such ono-actor%that the&thia ISM ianal ititatliad an 1diana .tutd ShOkilis the name of the auh-coatracters.arid Wale1ntthat or not thaw satiate haot eitioloyerv. If the sotaworaractors have earvloyees.alto mug mosaic dam workers*amnia.polo:).number I am an employer that is providing a,orAers compensation insurance for my employees. Below is the polity im4l job site infitrotation. litsunince Company Name: c_6 cc-A co csi.p n.s us-ctnct Policy or Self-ins.Lie 41 .3 00'3 Ct gCf) Expiration Date: 7fao<9.5 Job Site Address.. 21L6f.nficitiltzi &--xrd ut,)J 1 Ciy/State/Zip: F1ccence inn (0:a Attach a copy of the workers'compensation policy dechtratton page(showing the policy number end leap n date). Failure to secure coverage as required under MGL c. 152.§25A is a cruninal violation punishable by a tine up to$ ,500.00 andior 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 stternent may be forwarded to the Office of Investigations of the[MA for insurance ctwerage verification. I do lierekv certify e the Ms an tittles of perjury that the infiirmaition provided above L trite and correct. Signature: -1////'"— D. •-a_q —2 2— Phone Officio/use only. Do net write In this area,to be completed by city or town official tits or Town: Permit/License - Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Ckrk 4.Electrical Inspector S.Plumbing Inspector tither Contact Person Phone#: City of Northampton f Massachusetts g p DEPARTMENT OF BUILDING INSPECTIONS ?, 212 Main Street to Municipal Building Jos 'ter Northampton, MA 01060 P. % 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: Valiel l ee,t3C\,n ECis}-hGm pion ►c()A The debris will be transported by: Name of Hauler: ;awl 1�cS S Signature of Applicant: Date: %_a c7 - 22-