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18D-009 (2) BP-2024-0849 908 BRIDGE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18D-009-001 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-2024-0849 PERMISSION IS HEREBY GRANTED TO: Project# BATH RENO 2024 Contractor: License: Est.Cost: 25100 WILLIAM DZIURA CFS045994 Const.Class: Exp.Date: 02/17/2025 Use Group: Owner: MAXIM MIREYEV Lot Size(sq.ft.) Zoning: SR Applicant: WILLIAM DZIURA Applicant Address Phone: Insurance: 9 CONWAY ST (413)427-7646 SOUTH DEERFIELD, MA 01373 ISSUED ON: 07/05/2024 TO PERFORM THE FOLLOWING WORK: 2ND FLOOR 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: ///: Fees Paid: $188.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner NtCEIV---- Jul. - 2 2024 The Commonwealth of Massach .etts I EPr OF t3U,L170/� 1711.10NS F•R NORTHAMPTON.MA01%, Board of Building Regulations and Staniar. C Massachusetts State Building Code, 780 CMR 1 USE LITY Building Permit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling p a r!_TheSe�gtigp For Official Use Only Building Permit Number: T ! GlJ Date Applied: Ka,101i�s //& 7-3-202/ Building Official(Prim Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers ClO$ 6n;ky. Rom► fy; (l; .:oDa 0e�l1 No-oo4-ool 1.1 a Is this an accepted street?yes V eetiW no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: .5(S R{s,.enJrio..\ 16+Sal Zoning District Proposed Use Lot Atka(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: PuhlicX Private 0 Zone: _ Outside Flood Zone? Municipal On site disposal system 0 Check if yes0I, SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: � - Not p 4�r fA 0 I 73 Name(aa PrrntI -1. 5 ' ` City,State,ZIP CIOS Geia.of Ric. 201 707-.51311 _ No.and Street J Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 1i Owner-Occupied IX Repairs(s) 0 Alteration(s) tat Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work': ' , floc Q Amor% I' rivele`_ -- Rertove. i- Rt Place, e6_94-� -Vub/4ower, gnK 1 -1c,;I4 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials 1. Building $ 11 /00, 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ �, 00.' 0 Standard City/Town Application Fee f 10 , 0 Total Project Cost (Item 6)x multiplier x 3. Plumbing $ 6 t)ix."°. 2. Other Fees: $ / 4. Mechanical (HVAC) S List: 5. Mechanical (Fire S Suppression) Tot a*e $ -- ` I0 in (2Z/ Ch Check Amount: a) 6.Total Project Cost: $ a 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Cr.S--oys9yy "r' n x Kuzd License Number Expirat n D e Name /ofjCSL HolderLJ /� I6 ( / /u / hel(AS /l DQ / List CSI,Type(see below) v No.and Street ,�y, pl/ Type Description Co()G0aA Pi A On�/ Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,Stat , _.IP' M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances y/3 a2?-333a I Insulation Telephone l;rnail address D Demolition 5.2 Registered Home Improvement Contractor(HIC) pZ Ida-1 S !W r/Il a to L L C HIC Registration Number Expiration Date HIC.ompany Name or HIC Registrant Name I� IDah 54 ee+ cv,�l 0 nrof=kriml iotleMa.CO" No.an d Street, cadk M n 01373 y13,y27�-76 y 6 Email address 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 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,hereb authorize f fth')K Kvud_e to act on my behalf,in all matters relat v o ork authorized by this building permit application. S, none Ut.er Print Owner's Name(Electronic Sign 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. 1—Ri..n14 „Zcaeb �cgy 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 Department of Industrial Accidents 4 .ri l , 1 Congress Street,Suite 100 F.V: fr=, , Boston, MA 02114-201.' w ww t mass.govidia - Workers'Compensation Insurance Affidavit:Builders/ContractorslElectricians/Plumbers. TO BE:FILED WITH THE PERMITTING AUTHORII 1' %nnlicant Information Please Print I_et;ihly Name(ausincs or aniratuon^lndtviaual): W i' \ 1)7,1 J L L C, Address: q CrAitateA61 C e.. City/State/Zip: 6, Qee€ ;(1,rMk 01373 Phone#: 4.1)3-- /427- 76 1/6 Are y as as aetaph7er?Cheek doe appropriate bat; Type of project(required): t.0 I ant a trim l yer with employeea(full andurptrt-tinter• 7_ 0 New construction 2.0 I am a sole proprietor or partnership and have no employers working for use m 8. Of Remodeling any capacity_[No workers'comp.ituutrunce regturc'd-j ( * 3 I ant a homeowner doing all work.myself [No workers'comp-imurune-e required 1' 9. Demolition � 40 I am a homeowner and will be hiring asntrnctors to conduct all work on my property I wall 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions pruprietoes with no employees_ 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub attuactors listed on the awaited sheet_ 13 D Roof repairs These utb-eantractun have a employees and have workers'com insurance.: p.insunce. t+.Q We are a curponmon and its officers have exenised their right of exemption per MGL c. 14.0 Other 152.,)l(4).,and we have no atimpbyecs.[No workers'comp-insurance reguited-J 'Any applicant that checks box t)must also till out the section below showing then workers'compensation policy information_ t hioenaowzwn who submit this affidavit indscaturg they ate doing all work and then hire outside contractors must submit a new affidavit indicating such. (._'untracto s that check this box must attachasl an additional sheet showing the name of the subcontractors and state whether or out those entities have ennplovees, If the subcontractors Invc employees.they must provide thew workers'tamp.policy number. I am an employer that is providing workers'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/StaterLip: 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 tine 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 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 certify under the pal and penalties of perjury that the information provided above is true1 and correct. Signature: ,� L-/;'/i7 Date: l/�/f�((JQZ'/ Phone#: Lii3—y:2 74/6 Official use only. Do not write in this area,to be completed by city or town official City or Ton n: Perntiti).icense# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.('its''1"own Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton K. Massachusetts kti010 �- '''<< , w It r t. ,, , DEPARTMENT OF BUILDING INSPECTIONS S% t 212 Main Street • Municipal Building J`L` 5* of..' JOCK Northampton, MA 01060 -• --N% 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: 2eteccejCi- /1 A The debris will be transported by: Name of Hauler: / 6 Dispal . ,- Signature of Applicant: Date: 02 024f r-43, r-T D}• .....• A WAT@ IWFi•EXPOSED r r EXPOSE VENT PIPEE NtWAISTNN D LOCATION A 512 DUI►,O 01//O / AND!III -^--- I �� FIXTURES AND FINISHES OF/2'•7}• () •. L ..JTYPE 1 M IPPACINER PRO COLR/0 RVMMR3Rot IHNNWNNWSILT 1I QHORAWION IM(1)� LOCATE 4 1R01 R• SMc KO AtEMORIS STOW xL-w L HIR r SINK FAUCET TIO TED e-7}' e.2;v! © TORET ROME STATELY(wimp —� Al M S10FMTL R! M MSTEEV AQ UC IO,IFOOT OlI l FAUCET SIOIOAINR WALLAtOUFR TR@HOIE PAUCET.CROSS Oil () MMEDIC,* v61 CIE CARNET KOKO 0ERA 22 x 36 FEAMED WAR DOOR !,/ U WALL STORAGE POrnoT RAM NANZAMTA CAMWALLCAIWET �} _ WALL HOOKSPOTIONM POTION RA xWQ�WRA IOW OF HOOKS FLOORINGno TED — Mt• 9'.7}•Or 11 M _u SE5OARD TEO I XIS FTC BASEBOARD-WHITE WAINCSOT TEO INC PANEWO-e•TO-WHITE OEXISTING BATHROOM OPTION 3B RAIL TEO Ix]PvC-WHITE SCALE:3/$"•1' a SCALE: 3/B'•1' WALLPAPER TED 1ED DROWN TED IX3 WC.WHITE 0. ,4 WMOW TRW TED MACE wrm 103 PVC-vW RTE 1P D6FB6ER AN RAO STTIE wm,SHOP-NAM MACK CURTAIN ROD OPTIONAL I NEW WIIOOW TRIM I I EXPOSED VINT PIPE CROWN IF' -il TIIIIIIIIIMINNINEENNOINIME ORAGE.WNLPAFR IVAPTf WALL TINT TAP OOOPSWNG(DOTTED) 1 IOR NR3T►YDRIfi1 \ ' ' ' !■■ AIL 06 wf y.7}. Wallo■ NA DES WEVDOW IWA AT DOOR TNMT _miii �';11 _ scREE it f l AT .lwAWXOi_I'.WENT MIGHT I ... W/nxTVR6 , 1 •Am. ,`}. I I MSESOAxD D!S .rori. D G$. AT DOOR TIN CDPROPOSED ELEVATION PROPOSED ELEVATION PROPOSED ELEVATION PROPOSED 0, `3 JI BATHROOM SCALE:3/8'•1' SCALE: 3/8"•1' SCALE: 3/8"=1' OPTION..3 FOR REVIEW 6/18/?4 A-003 THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston; Massachusetts 04118 Home Im•ro ement Contractor &egistration M z 111111r >t ^' gm�— _ I,! (type: LLC ;e ation: 210298 WILLIAM DZIURA LLC • = E ration 11/12/2025 D/B/A CRAFTSMAN RESIDENTIAL SERVICE Weft 9 CONWAY STREET �� 1;= _ �/ ©t SOUTH DEERFIELD, MA 01373 . WO ; # c, —111111:, '41.1M Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation I Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:L C Office of Consumer Affairs and Business Regulation Registaatlorj Expiration 1000 Washington Street -Suite 710 210298 11/12/2025 Boston,MA 02118 MLLIAM DZIURA LLC )/B/A CRAFTSMAN RESIDENTIAL sERVIC S „zi NILLIAM T. DZIURA ' p/f ` ti i CONWAY STREET may" SOUTH DEERFIELD MA 0147 1:. % Undersecretary Not valid wi out signature