25C-242 (10) BP-2024-0848
239 BRIDGE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
25C-242-001 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-2024-0848 PERMISSION IS HEREBY GRANTED TO:
Project# PORCH REPAIR 2024 Contractor: License:
Est. Cost: 36500 JONATHAN SOUTRA CS-112307
Const.Class: Exp.Date: 10/25/2025
Use Group: Owner: DEBORAH KEISCH
Lot Size (sq.ft.)
jONATHAN SOUTRA dba SOUTRA HOME
Zoning: SC/URB Applicant: IMPROVEMENT
Applicant Address Ehne: Insurance:
5 MUNSELL ST 413-977-3212 BOP 0100741636
BELCHERTOWN, MA 01007
ISSUED ON: 07/23/2024
TO PERFORM THE FOLLOWING WORK:
REBUILD 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:
(:as: 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: if://2.
Fees Paid: $274.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
/ iic7 ---
C---
14 The Commonwealth of Mass chus tts 2 /
Board of Building Regulations rid Sfd '02Q FOR
(6)
Massachusetts State Building Code 780; Rty�
M 1CIPALITY
' �•n;kr,/tis, USE
Building Permit Application To Construct, Repair, Renovate-OOr R ised Mar 2011
One-or Two-Family Dwelling r ° s
!
r2 This tion For Official Usc Only
Building Permit Number: 7/�ih`�1 ,ram Date Applied:
4-o;,..., 14, .//�2 7-Z5-zoz4e
Building Official(Print Name) Signature Date
SECTION l:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
1.1a Is this an accepted street?yes I/ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(It)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Wate Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Ig Private 0 Zone: Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP' ,mot�} a
2.1 OI�)vne�07.tfiez.-d:
I/_�,�,/ i ,I� _ �n 1 r�1' aliiv
Name(Print) City,State,ZIP.3'1 b 'i -0 i plc boa k ,
1
No.and Street a Telephone Email Address V
SECTION 3: DESCRIPTION OF PROPOSED WORK2(chec 11 that apply)
New Construction 0 Existing Building L'1/ Owner-Occupied ad Repairs(s) ad Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work?: F)C bk.), 1 d j AS cc o(14' pb((...in
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ .3 -5 D Dt) 1. Building Permit Fee: $ Indicate how fee is determined:
0 Standard City/Town Application Fee
2. Electrical $ 115 b O 0 Total Project Cost'(item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire S
Suppression) Total All Fees: (.�
Check No.\l. ') Check Amount: 01 /Cash Amount:
6.Total Project Cost: $ 3(„1• sbh ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS -I(?-3c)7
—lock OSLti SO License Number Expiration Date
Name of CSL Holder
M✓r S( +) J C f, List CSL Type(see below) (f
No.and Street Type Description
n_ ((V c- .F 6)/6)01 Unrestricted(Buildings up to 35,000 Cu. ft.)
City/Town,State,ZIP / R Restricted 1&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
//3--1.77 0f'L '' i Pro•( Ok 4,)(17mq$I I Insulation
Telephone Email address D Demolition
5.2 Registered Home`Improvement Contractor(HIC) (91 10 3 i l�'t
on c;kf t- 1-1 S U U
HIC Registration Number Expiration Date
HIC Company Name or HIC Registiaut Name
•
,vl U rt 5r,H 1 S SD at-co. +vle;,nrnuLn�n1'��
No.and Street Email address
l ,h u- tin M A. 01067 y 7-3
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 Iss c 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 0k.to act on my behalf, in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Dat
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.
4-1 — 7/),7' °
Print er'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:f,lassachusetts
'_ — Department of Industrial.4c cidents
• =dD_ Ft. 1 Congress Street,Suite 100
::.= ; Boston,MA 02114-2017
'; �.e. 1' www mass.gor/dia
1%utkers'Compensation Insurance Affidavit:Buildens/ContrsctotsiEkctrlcians/Ptumbcrs.
It)RE Eil.E:1)WITH THE PERMITTINGAI:THOItITY.
Applicant Information Please Print Leeibh
Name(13usinccs Organization lnih.;dual l:
Address:
City iState'Zip: Phone#:
Ire you as t-mpktyer?('leek die apprapriaiebiz:
Ty pe of project(required):
i-a t a employer with :mployeas tfldl and'or part-trawl-' 7. a construction
Ina ark proprietor or parinetstup and have nu employee.Needing for::ir in ding
any lapac it)-[No worker?comp.insurance n>lumd.I
10 I ant a homeowner doing all wort.myself.(No workers"comp triurante n'yuar!j
9. 0 Demolition
I0 a Building addition
40 I am a homeowner and will be taring contractor.to o antuct all work on my property- I will
ensure that all contractors either have workers'ournponation nnsuranca or arc tok 110 Electrical repairs or additions
propnctUts with no employees
12.0 Plumbing repairs or additions
5C)I am a general contractor and 1 Iasi hard the sub-co ntracton tinted tin the attached Meet_
There sub-eontsacton hose onpluyoe.and hasc workers"eoanp.insurance.: 130 Roof repairs
6.0 War rp arc a coorattun and its officer C.hat exuded data nght of eve:ripirun w*Ak al_c- 14. Other
152,I1(i h.and we hate no employees.[No worker,'comp.assurance reyuirod.l
•Any applicant that crocks box al mum abo till out the wetwa below stow mg then w otlm'eompi.mation policy information_
Iknneuwrnn who submit this attrdatrt medicating they are doing all work and than hoe outside contractors midi submit a new atfrdat it indicating such_
:Contractors that check this but must attached an additional shut show mg the name of the sub-contractors and state w hinter or not those emetics have
ourplusees It tho sub-contractor tat e employees_they must provide their workers"comp polscy 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: Pre/(erial M oi-oli --
Policy#or Self-ins, Lie.#: go f 0100 71(1 6 34 Expiration Date: Vaai1a6'
f.1
Job Site Address:ig 3 / 1/r1dl�• S+, Cit StateJZip: NOClikk n i t''�Y 01 Ij
Attach a copy of the workers' mpensation policy declaration page(showing the policy number sad expiration dote).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
and'or one-year imprisonment,as well as civil penalties in the form ofa 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 yentication
I do hereby certify under the pains and penalties of perjury that the information provided above is(true and correct.
Signature: 4, A Date: 7r./�_/
Phone 4: Li 13 7 -3 d--1 at
' Official use only. Do not write in this area,to be completed by city or town official
( its or-town: Permit/License ft
Issuing Authority (circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
City of Northampton
o� HAMYip.
Massachusetts At �:_ 'c�•
d r G
cal
-r t,•t DEPARTMENT OF BUILDING INSPECTIONS �S• hf
212 Main Street • Municipal Building ' .. a�
Northampton, MA 01060 .P.r•• •' `^�O
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: Vc \\ I KCC1 e �1
The debris will be transported by:
Name of Hauler:
Signature of Applicant: 97,A A ,� Z Date: 7/ l
POLICY ISSUED ON THE CO-OPERATIVE PLAN
NON ASSESSABLE POLICY
Policy was prepared for:
JONATHAN SOUTRA
COMMERCIAL
POLICY
Preferred
Mutual
Live Assured"'
Preferred Mutual Insurance Company
One Preferred Way • New Berlin, NY 13411
1 .800.333.7642 • preferredmutual.com
Policy BOP 0100741636 effective 01/23/2024 to 01/23/2025
Preferred Mutual representative:
AQUADRO & ASSOC INS AGENCY INC /RAIS
413 586 7373
020129900
COMMJCKT(10-14) Insured Copy
n THE: COMMONWEALTH CF MAS,3ACHU3ETTS
Thc-t` `/1. . Office of Consumer Affair`s and Business Regulation\� 1000 Washington Street- S Jite 71 G
Boston, Massachusetts (2118
Home Irrpro ent rItractor Registration
,'17) i
'*" •y! • Type: IndiviJual
JONATHAN SOUTRA fv .....i. f tegtstratio 1: 191803
5 MUNSELL ST. t fit `"' Expiration 01/102025
BELCHERTOWN,MA 01007 \-NA, ,.... .__
A • - . .-"7
k'„.,,,,.., ....,..._.:,,,,,, ,.:„..
, . .1 Uplate Addre>s and Ret Jrn Card.
I
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation 2eglstration valid for ndividual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return t):
TYPE:individual '7ffice of C3nsumer Affairs and ftusiness Regulation
NMI/UAW EXItitilii20 1000 Wash ngton Street -Suite•'10
191803 _ 01/14/2025 3oston,MII 02118
JONATHAN SOU rRA s+: ,,,
wit
JONATHAN S.SOUTRA
5 MUNSELL ST. �,!/,��1:' 2> A, kz?/‘
BELCHERTOWN,MA 01007 Undersecretary Vot valid without signatur3
/
•
Commonwealth of Massachusetts
; , Division of Occupational Licensure
.. . " Board of Building Regulations and Standards
Conrittle4n16144,rvisor
a. I '
CS-112307 ei_�
3 ires: 10/25/2025
JONATHAN S • ` .. ", f 74
5 MUNSELL T. a ; ,,-,
BELCHERT N MA 01007 J ___________0
r� Q
Commissioner ��� s,,_
Construction Supervisor
Unrestricted - Buildings of any use group which contain
less than 35,000 cubic feet (991 cubic meters) of enclosed
space.
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
For information about this license
Call (617) 727-3200 or visit www.mass.gov/dpl
MI
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