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10D-040 (5)
BP-P 022-1365 99 WATER ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 10D-040-001 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-2022-1365 PERMISSION IS HEREBY GRANT, D TO: Project# RETAINING WALL Contractor: License: Est. Cost: 32000 ALLEN GUIEL CS-054248 Const.Class: Exp.Date: 04/12/2024 Use Group: Owner: J. ERICKSON, SARAH Lot Size (sq.ft.). Zoning: URB Applicant: GUIEL CONSTRUCTION Applicant Address Phone: Insurance: 63 CHESTERFIELD RD 412-268-9200 6S6OUB-9F66069 WILLIAMSBURG, MA 01096 ISSUED ON: 10/28/2022 TO PERFORM THE FOLLOWING WORK: RETAINING WALL 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: . 3)0,01 Fees Paid: $208.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner Z-6(Z File #BP-2022-1365 APPLICANT/CONTACT PERSON:GUI EL CONSTRUCTION 63 CHESTERFIELD RD WILLIAMSBURG, MA 01096 412-268-9200 PROPERTY LOCATION 99 WATER ST MAP:LOT I OD-040-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Pe illei out Fee Paid 208.00 Type of• nst 'in: RETAINING WALL New Cons c ion Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: 'J Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay AGA14, , `41 b 07,2 pa Signa ure of BuildingOfficial V Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Depart lent of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office i f Planning&Development for more information. OCT 2 1 2022 ,0,(Ita-ectI/A5 The Commonwealth'sfrMa s , LJ,§q PFCTIONS I FOR Board of Building RegulatiO? na ld&i'als7oM Massachusetts State Building Code, 780 CR MUNICIPALITY USE Building 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: GP- 3-- 1 ?,�-(/ Date Applied: Building Official(Print Name) Signature SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 99 WATER STREET 10D 040 1.1a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: UAB SINGLE FAM 17000 100 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 yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: SARAH ERICKSON CHESTERFIELD,MA Name(Print) City,State,ZIP 588 MAIN ROAD 3;Z-35 S4ri-Yt Crccle—s vj No.and Street T ephone 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) 0 Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other 2 Specify:RETAINING WALL Brief Description of Proposed Work':INSTALL RETAINING WALL 6'TALL AND APPROXIMATELY 64'LONG SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $32000 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All Fee • ( lip Check No.0 heck Amount: / Cash Amount: 6.Total Project Cost: $32000 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 054248 04/12/2024 ALLEN GUIEL License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 63 CHESTERFIELD ROAD No.and Street Type Description WILLIAMSBURG,MA 01096 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 SF Solid Fuel Burning Appliances 413 268 9200 allen@guiel.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 104444 07/13/2024 ALLEN GUIEL HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 83 CHESTERFIELD ROAD alien©guiel.com No.and Street Email address WILLIAMSBURG,MA 01096 413 268 9299 City/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 0 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 ALLEN GUIEL to act on my behalf,in all matters rela' o work authorized by this building permit application. SARAH ERICKSON leAt/vim Print Owner's Name(Electronic ' ure) 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. ALLEN GUIEL 10/16/22 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 Massachusetts } _* 1, Department of Industrial Accidents _=Oi 1 Congress Street, Suite 100 2-'11; Boston,MA 02114-2017 � www.mass.gov/dia v Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name:Guiel Construction Address:63 Chesterfield Road City/State/Zip:Williamsburg, MA 01096 Phone#:413 268 9200 Are you an employer?Check the appropriate box: Business Type(required): I.❑✓ I am a employer with 2 employees(full and/ 5. ❑Retail or part-time).* 6. ❑Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7, ❑Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers' comp.insurance required] 8. ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. El Entertainment their right of exemption per c. 152,§1(4),and we have 10.13 Manufacturing no employees. [No workers'comp.insurance required]** 11.❑Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees. [No workers'comp.insurance req.] 12.0 Other Building and Remodeling *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#I. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: Hartford Underwriters Insurance Co Insurer's Address: PO Box 4614 City/State/Zip: Buffalo, NY 14240-4614 Policy#or Self-ins.Lic.# 6S60UB-9F66069-2-22 Expiration Date:04/27/23 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce under the ins and pena ties of perjury that the information provide above' true and correct. Signature: Date: lV `�P a a` Phone#:413 289 9200 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia %,... ...----------- , ,-------- c, a-. ......'".4" VI ...'' '''''.*'. N,isa form r"------ it (74/? a •••'' '''''''. 0-X1 \\I ' 99 Water t! ' , Leeds. MA 0 053 i i I ACE OF WALL __ . .. ...... _ 7,. ..z., , \ Do .47 'P. 91 V) k(-Ee C;c-C2t-i