Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
35-281
--..;,--, -----"' COM?kton'i ; •= 0,`-'' - M-:,":."'S , ' .. =- 0 -' - - -'-.^-;-----=-,-,-;. .. OfifCe Cf InveszigazZon:.. 600 Washing, 55e?. 7;.7.0,--' 7 V:[ A f ■.' ...:' ? ? •:. ..'"'3'11DA..?"3.2'Ci''' ''''' ra .'131:7',7■Vft.: BUi:::"'Cif■TS/CGsZtra'CrSiEleCS:riCialiSTP. 5.11Mr./Z.r...S. oia... 1721-ormatzz: -->„ , - Pea se Pri 1 1 ( • -----. - 7 , ' 7,4- '" -77/77. ' ' r ', ' i ---7- fih 11 ..-k_ 1 i ',. .3...Z■1, • t { • .."'" ''..i ' -,.,..., i ' " ' : .....- 1 4r • -.'. I '''-'.-,, , ,,,, ..■C■.:17■ . ..... 1....1 .,,.• V i j 7i I,•+: V .. ,...■.,,...... .. , I , --,-',' :=.....:-.-.,:- 2:--_:. iv. ;:. AON,3...i'f \'`°- ; / ,;-- .,*,_;.:' • rf.131.:.e.. 7-,-. i L____, am:_.loyer: Cheolt. fae apprr..‘priara bor.: Type of pro;:ect. :-- ---' I .- e... a , - . 7er , :r - a: con:77.31 3r i. .1 ,-:.-... -- e,- tv - , ' 7.: : - `,'•:: '..1::::::: T.r..' e F,'..... . _ _ - ls cfa lot a:faacr_to sate:. . ---7 Rerr_cclel:ag _L . t...-r. a so_e prr...,-pr.e or rn-- - 17o.--ese s tavt, • S - Theafrolitoti e,..,..0 p er_aloyfr.es aalcl a. e war:re:7s ... ___ _ wo:lola2 fa: role :17i a:: Capa.Cify. 5 ' '.:--:::Ioac N wo., fa adP.:itio= co. - ...--Isu.rasar. - ,e_; o :kela: ' coral::: las'arrarace We .. - ,` ..." , ' -o : 4 , 2 . 1 Ci. Elecr rer/a7..rs ::: aceons reo a= a. o:ntovrat: 3C-. LI:. -•=work off,!ce'.:s 'Lave eXel ±e= 11.7 Plum1.g res o: ad:Li:iv myself. 7 _1"Co workers' c..•:,=:....p. ' - , . . •-(001" r -. _ _ - . ....- -: ::-.51:::.ance 3a+ sl a?t:It..7...-..,...,--t:..:::t.cas Z .$:..C "... Wirir.K-77:: :..;:::sz. .7.C.;:Cy :7".^27.10r. , .." ,, , , , , ..C75.';::::::. , i.:7, 7 .r.'ii.?:: , IS. af.:,0..z. e. z_.-.1. c.:oing :-.1 W3:.< :Z.7....: - ....',.. - 1 - : ',,.;•:: :-S C C.Cinfra-L'a.77;, v. =1 CO3:;0 is 03X 7710 r. a:12C7,C...:3 20 £it'.07.,:::: Srleer 232 0J r,17,':: -3: !..r.:e. f.;'..:b 200:. s=t, ,A,hc 3: 71.St tnOSC CfltIliCS nv. t.77,),CyCC.S. :- 0.33023003022 r.', ac VIT.7. Lc ye..t.....<, '....",c3 '230230 303 , , , ,,-032 ......r. :032:::y rternte.' _ ------ :ii;aa.. Es . .57.75 , :ding workic, co.e..ns0oa00. 292132 j03 :,3.? ar....np:o ...:e:: :S, :Az paid and job siZe . .,, :-. '4 0: Se.f-111.S. I.:3 T-":: " . ( r ,, -; ;., i j_•.> ----:, + l-.., -',..; 1. - t...- .., z 7-7.31:7 a ,..:0 7- .L.),....z..- : i / , -) i -, i 1 i -- 4 i V•I' 004..1_4_'ZNC v'S25:t/Zpc_143.( AO-AA a copy of flla warkars' compar.asadva = de=art..;;_ao. 92:%; IS.:(1,;. vae vocy r.tzraber arid el dz. .. 13003.: cove:age as :t021.:106.Laraar Se'C'::13:1 2. c.: ai... a. .51 oar. ..:fta...a :o - ....1`,..e '..... cf a pet:aes of a Sl..5 O'r_, andlo: oat-ye20 -7 ...-r_Tirist=003, az w-r,..: as a. •,'-':_. atoal::_es :7- =a 732_7: 033 a ST. a? '7: ORDER. aze a ft.lie :.fl 7.3 .S23•C a Gay agear_sr fat •lolot 1-:,. a(i-viserl La: a casy of ra_.s saafernear ., ^_ay az for 'Z0. '. Office of lavestigataons of the DL for Liaslralice cove VeriEcar,k;:_. - r.E.i-eby ::11 1.2.iteer the o dins ‘Ind per.tai.rle.3 of pe?"::: :i2d:.: th ... in mdtion provided. c.. fs :ra-.5end correc;. ' ---- , I'Llont #: ; :::L32 5:-2:2. De 7:: o: - ,'rite th. this 2.-ed :o be fompleozd �y City" ;5?' 2'...:: -- i - C:i.S.:. '.: • -S.13'..41:.,■":,4 AUZI71Crfi:Zi 1:CTC:a az.z..- ' ... - -2,poral of Healtri 2. 3a:Zia.ize DePartfaear 3. Cfailrov,.o. L s'... Elttotrizz.: Peczo: 5. Piumbirag Inspector -c. Dtr:atr aziracz Persr;o: . , Office of Consumer Affairs & Bums R'.uiation HOME IMPROVEMENT CONTRACTOR Registration: 162770 Type: Expiration: 4/6/2013 _LC COZY HOME PERFORMANCE. LLC MARK LANTZ 7 4 LYMAN RD. NORTHAMPTON MA nderseci clan. N... - .P .. struction Supervise, Soecialcy S_ 102169 MARK LANTZ fi7:4 74 LYMAN ROAD NORTHAMPTON, MA 010Fr 12/10(2012 T -- - - - 102169 _ - - • •A'A A • • • • • ,•■•• • Ara, , r imI • Accwc, CERTIFICATE OF LIABILITY INSURANCE ii23i2o ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jody Dodge Berkshire Insurance Group, Inc. PHONE Fxt) (413) 773 -9913 (A/C. NO): (413) 774 -3872 117 Main St. ADDRESS: dodge rou ADDRESS: 7 g g p . com INSURER(S) AFFORDING COVERAGE NAIC 8 Greenfield MA 01301 INSURERA:NGM Insurance Company 14788 INSURED INSURER El :Continental Indemnity Company 28258 Cozy Home Performance LLC and Mark M. Lantz INSURERC: 74 Lyman Rd. INSURER D INSURER E Northampton MA 01060 _ INSURER F: COVERAGES CERTIFICATE NUMBER:11 GL/ WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVn POLICY NUMBER (MMIDDIYYYY) (MM /DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 A CLAIMS -MADE X OCCUR MPJ6905M 4/17/2011 4/17/2012 MED EXP (Any one person) $ 10,000 _ PERSONAL & ADV INJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP /OP AGG $ 2,000,000 X POLICY PRO- LOC $ - JFC7 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ - ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS -MADE AGGREGATE J $ DED RETENTION $ $ B WORKERS COMPENSATION. ( WC STATU- `0TH - AND EMPLOYERS' LIABILITY Y / N TORY I IMITA 10TH- FR ANYICEOPRMTOOR /PARTNER /XECUTIVE .Y N/A E.L. EACH ACCIDENT $ 500,000 (Mandatory in NH) 46- 945373 -01 -01 11/2/2011 11/2/2012 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE • POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION (413) 259 - 2402 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cozy Home Performance ACCORDANCE WITH THE POLICY PROVISIONS. C/O Libby 74 Lyman Road AUTHORIZED REPRESENTATIVE Northampton, MA 01060 Jody Dodge /JODY ACORD 25 (2010/05) ©1988 - 2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD SECTION 5: CONSTRUCTION SERVICES 5 Licensed Construction Supervisor (CSL) 1 . 4.4(v... Ley\A License Number Expiration Date Name of CL Holder, r, List CSL Type (see below) ,- c ? ( t() A dr s � Type Description . „ k :Lit . L Unrestricted (up to 35,000 Cu, Ft.) Signature L R Restricted I &2 Farnily Dwelling G_I (' J � -u • • % M Masonry Only RC Residential Rooting Covering Telephone • WS ' Residential Window and Siding SF : Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5 egistered Home Improvertaent contractor (HI HIC ompan Name or HIC Registrant Nam �/ ✓( Registration N umber • L� /ly11.. t / Nam / ✓I t�4 .__ n �2'li✓� �� • Addywss/� w _�' l' +�✓, .,,- yf.3 , G ,, 7I (1 Expir�t'ion ate 7 Signature Tele5 one 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 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, , as Owner of the subject property hereby authorize to act on my behalf, In all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION 1 , as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and behalf. Print Name • Signature of Owner or Authorized Agent Date (Signed under the pains and penalties of perjury) 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 and Construction Supervisor Licensing (CSL) can be found in 780 CMR Regulations 110.R6 and 110.85,- respectively. 2. When substantial work is planned, provide the information below: Total floors area (Sq. Ft.) (including garage, finished basement/attics, decks or porch) Gross living area (Sc. Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halbaths Type of heating system Number of decks/ porches Type of cooling system Enclosed Open j 3. "Total Project Square Footage" may be substituted for "Total Project Cost" SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature 9. Re.istered Ho - , ovem, . tractor: Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10- 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 ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner- occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signatu • k SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House El Addition ❑ Replacement Windows Alteration(s) El Roofing El Or Doors l3 Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [Q Siding [0] Other [o] Brief Description of Propos d, , y L 1 Work: 'P\ h ' --e \ V\ 1k1 C ct01 4f1 C-t1Iv4 -t n5 v)4110v./, \fen( 6411 Av∎ Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, ? e* U . G,'Y', , as Owner of the subject property (� hereby authorize Ov NI Y'(�{ Q�'`c'YYei'n to ac &Ow y behalf, . Il atilers relative to work authorized by this building permit application. • nat Date I, ` C\ci) .--- \ ov \ "2, , as Owner /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. M `L )--G.- l� Print Na j I / ' /4 Signatu - of Owner /Age Date IVED Department use only ity f Northampton Status` of Permit: I 2 2 012 u iI • i ng Department Curb Cut/Driveway Permit 2 2 Main Street Sewer /Septic Availability am OF euunlrle Room 100 Water/Well Availability mONditA oso orth mpton, MA 01060 Two Sets of Structural Plans phone 413 -587 -1240 Fax 413- 587 -1272 Plot/Site Plans - Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 14—.)da A `F r∎ A, Map Lot Unit \ c McNx. `PI U) o (1 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: jy ►1 11 Weld ctic, y,a1 r . fat enc_e.. Name (Pri ) Current Mailing Address: eta a°Aa -- (s )is Telephone ignature 2.2 Authorized Agent/ Name �r t) Current M cling Address: 6 ' A �) - � .3- 7 11 Signature Telephone SECTION 3 - ESTIMATED NSTRUCTION COSTS • Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 4)3,1 Q Check Number �_5 - 9 c 2 This Section For Official Use Only Building Permit Number: I sssuu ed: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0735 APPLICANT /CONTACT PERSON MARK LANTZ ADDRESS /PHONE 74 LYMAN RD NORTHAMPTON (413) 320 -7611 PROPERTY LOCATION 114 WOODLAND DR MAP 35 PARCEL 281 001 ZONE SR(100) / /WSP II THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � 69c) Fee Paid 45 Typeof Construction: AIR SEAL ATTIC, INSULATION & VENT BATH FAN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 102169 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOMATION PRESENTED: i../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 .1 `. 2. 3Jra Signature of Building Official 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, Department 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 of Planning & Development for more information. 114 WOODLAND DR BP- 2012 -0735 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 35 - 281 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit # BP- 2012 -0735 Project # JS- 2012- 001289 Est. Cost: $3100.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MARK LANTZ 102169 Lot Size(sq. ft.): 30317.76 Owner: DUGGAN PETER Zoning: SR(100) / /WSP II Applicant: MARK LANTZ AT: 114 WOODLAND DR Applicant Address: Phone: Insurance: 74 LYMAN RD (413) 320 -7611 WC NORTHAMPTONMAO1060 ISSUED ON:2/23/2012 0:00:00 TO PERFORM THE FOLLOWING WORK:AIR SEAL ATTIC, INSULATION & VENT BATH FAN 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. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 2/23/2012 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner