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35-289 (12)
9SYLVAN LN BP-2018-1347 GIS#: COMMONWEALTH OF MASSACHUSETTS MV.Block: 35-289 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category'KITCHEN RENO BUILDING PERMIT Permit# BP-2018-1347 Proiect# JS-2018-002391 Est. Cost: $29000.00 Fee: $188.00 PERMISSION IS HEREBY GRANTED TO: Const Class: Contractor. License: Use Group: CHRISTOPHER O'CONNELL108508 Lot Siae(su.8.): 32713.56 Owner: FRIEDMAN PERRY zoning: Applicant. CHRISTOPHER O'CONNELL AT: 9 SYLVAN LN Applicant Address: Phone: Insurance: 63 WORTHINGTON RD (413) 539-1521 WC HUNTINGTONMA01050 ISSUED ON:6118/2018 0:00:00 TO PERFORM THE FOLLOWING WORK:KITCH EN REMODEL, MOVE INTERIOR DOOR IN NON BEARING 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: 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 6/18/20180:00:00 $188.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2018-1347 APPLICANT/CONTACT PERSON CHRIST OPHER O'CONELL ADDRESS/PHONE 63 WORTHINGTON F.) HUNTING JN (413)539-1521 PROPERTY LOCATION 9 SYLVAN LN MAP 35 PARCEL 289 001 ZONE THIS SEC,ICOR OFF, IAL USE ONLY: PERMIT APPLICATIOi CHECKLIST 'LOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: KITCHEN REMODEF-M-OV&INTFRIOR DOOR IN NON BEARING WALL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included, Owner/Statement or License 108508 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN RMATION PRESENTED: /Approved Additional permits required(sce below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance- Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 4ofoat flicial Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. RECEIVED JUN 15 201p-CDepartment use only - ity fN Northampton Status at Pemat f ' Buil Ing epartment Cum Cob0mwomy Pamdt ,V ECT®II$ n Street Sewer/Septic Avetiabtiily I 01080100 WatSaedWeti AvarabYdy orthampton, MA 01060 Two Sets of Structural Plana 3-587-1240 Fax 413-587-1272 Pbusis,Plein other specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING BEC710H t-SITE INFORMATION 7.7 Property Address: section secn to be compleW by office Map�6 Lot�Untt 9 Sylvan Lane Zone OvWW DWMCt am SL Dlsldm CS demes SECTION 2-PROPERTY OWNERSISP/AUTHORMED AGENT 21 Owner of Record: Jennifer& Perry Friedman 9 Sylvan Lane, Northampton, MA 01060 Name(Prim) Conant Msang Addrese: 413-374-1719 x Telephone signmwa 22 Aumodzed AataH: Christopher O'CoTmell 63 Worthington Rd,Huntington,MA 01050 Name(Pnm) Cunam McAing Addmes: ('�fa�:.ts7o,L,,.OrC'niuce22 413-539-1521 signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be official Use Only completed by it applicant 1. Building 20,000 (a)Building Permit Fee 2. Electrical 8,000 (b)Estimated Total Cost of Consuuctlon from 6 3. Plumbing 1,D00 Building Permh Fes n 4. Mechanics!(HVAC) 5.Fire Protection 6. Total=(1 +2+3+4+5) 29,000 Check Number This Section For Official Use Only Building Permit Number. Dine Issued: Sign BuiHln9 Com lalmAnapec[[or of ewdz Dab OCS413 @ Gmail.com. EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Sectiort 4. ZONING All Information hkvt Be Completed.Permk Can Be Den ed Due To Incomplete Information Existing Proposed Required by Zoning Thu eoNmn W befip Wby Building Depamlent Lot Sin N/C Fr WC Setbacks Front N/C Side L R_ L:N/C R:N/C Rear N/C Building Height NIC Bldg.Square Footage % WC Open Space Footage % ([d.minus bWg&pavcd N/C #ofParking Spaces N/C F n: NIC rolume&luudov A. Has a Special Permit/Variance/Finding ever been Issued for/on the site? NO = DONT KNOW FIR YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO = DONT KNOW F-0-1 YES= IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NOO DONT KNOW= YES= IF YES, has a permit been or deed to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YE= NO IF YES, describe size, type and location: E. Will the construction activity disturbring,gra fi ation,or filling)aver 1 acre or is it pad of a common plan that will disturb over i am? YE NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION S DESCRIPTION OF PROPOSED WORK(check all applicable) New Houas ❑ Addition ❑ R ldocamsntD. ❑Windows AltantbMs) © Flooding Q Accessory Bldg. ❑ Demolition ❑ New Signe 101 Docks [O Sidingl[31 Othw[gyp Brief Descnpuon of Proposed Kitchen remodel,move interior door in non bearing wall,typ framing Alteration of existing bedroom_Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement _Yes X No Pians Attached Roll -Sheet Sa M New house and or 1WtlNion to eKiennu howina.complete the followina: a. Use of building:One Famtiy Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is then a garage attached? d. Proposed Square footage of new construction. Dimensions a. Number of stones? f. Method of heading? Fireplaces or Woodomms Number of each g. Energy Conservation Compliance. Mosscheck Energy Compliance form attached? h. Type of construction 1. Is wnstruction within 100 di.of wetlands?—Yes —No. Is construction within 100 yr. floodplain_Yes_No J. Depth of basement of cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes_No. 1. Septic Tank_ CitySewer_ Private"I_ City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS ADEM OR CONTRACTOR APPLIES FOR BIALDING PERMIT Perry Friedman .as owner of the subject prop" hereby authorize Christopher O'Connell to act on bahaK,in all matters relative to work authorized by this building permit application. x � ,, June 14,2015 Sigrwture of Cor Date Christopher O'Connell as OwnedAuOwnzed 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. Christopher O'Connell Print Name (_'iLvaYa u OtCatn & 06/1H/w1e Signature of OwnadPgent Data SECTION B-CONsmuc ION SERVICES 8.1 Licenced Construction Supervisor: Not Applicable ❑ N.m.wLl�.a»Irole.r: C rj,W�ha_O'COnnrll Licenee Number CS-108508 Address Expiration Date 63 Worthington Rd, Huntington,MA 01050 06/24/2020 Signature relepi one 66.q 413-539-1521 Not Applicable ❑ O'Connell Construction,LLC Company Name Registration Number 89 Dana Hl,Belchertown,MA 01007 184844 Address Expiration Date Telephone 413-539-1521 05/22/2020 SECTION 16 WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MAL c.152,125C(8)) 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...... ❑ City of Northampton Massachusetts aspssllRsf' op BUZWZsa Issp z()rat ]1] Main etr wt •lmnieip6l 6uiliinp � ■O MpcOn, M6 01060 'stiry ypP� Debris Disposal Affidavit In accordance of the provisions of MGL c 40, 554, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as damned by MGL c 111, S 150A. The debris from construction work being performed at: 9 Sylvan Lane (Please print house number and street name) Is to be disposed of at: Valley Recycling,234 Easthampton Rd,Northampton,MA 01060 (Please print name and location of reality) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) k�rnuu�O.�aa D'r. /v ob/i 112ole Signature of Permit Applicant or Owner Date If,for any reason,the debris will not be disposed of as Indicated,the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department of/ndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 wwwmass.gov/dia WNVorkers'Compensation Insurance AQldaviL-BuBderstCmtractoMP.kclrlcianWPh mbera. TO BE FH.ED WIT11 THE PERWITING AUTHORITY. antInformation please Print Legibly Nalne Business/Organizanodlndivid:up: O'Connell Conatmction,LLC Address: 89 Dana M,Belchertown,MA 01007 City/State/Zip: Phone#1413-539-1521 are ran m empl"m chats twMwoprba bon Type ofprotect(required): t Iw aemplora with 3 employ«a(foll mNa prt-tim7` 7. [)New,construction 2.�lwaeole papdemraputnaship and l�vemnvploYem working fanaw 8. Remodeling MY m xxity.[No workH9 ramp.inN¢Nce requiroLl 3.(jl m a homocwnn doing all work myself.[No covin.inauamc re uhed.1 9. [)Demolition s.[)lam ahomwwner and will be hirivg cantrecsmamcanm:ctallwmtwmy Pmpmy. l.vi11 10[) iingaddiion wore datdl coanenam dfhn havesvorkem'conya,wriov innvaoceaaR sols Il.[)Electrical repairs;or additions pr.,n. ,wins no employees. 12.[)Plumbing repairs or additions S.Q l amaganeal mobmta and l have hhW the wb-nmmrlors listed on to anachal shxL 13.E]Roof repairs thosO b-monenor¢have ow,anyea act have wohm'conw.in¢umare.r 6.[)We ere a corpmuw and i,owmaehew snocood Neh right ofexemplon per MGL C. 14.[)Other 152.41(4),and we have no employxs.Mo worts¢'mop.no u na,v ru,uirN] `MYNWicun out chock¢bon#1 must also fill as the aecnon below dhow,their workai cO xaaafiw policy iuf tion. I H.. school flue affidavit indicariog they ere doin8 all wok and thin hire onside conn own submit s taw affidavit indicating such. tCoomchos that chock chis box must eWched m edditiond shat showing the verve ofUx mbcanvecmn a:d store whethv or nd those ano"On have eooployees. Iftbe¢ubcmtncu,haw emproyea,they::ores provide tlair waken'comp.polity nombar. Iama,employer Mot is providing worktm'compensaddon dmuronreformy,employees. Below is thepolicy and Job site dnformadon. Insurance company Name: Travelers Property Cas Co Of Am Policy#or self-ins.Lie.#: 7PJUBOG19537217 Expiration Date: 07/28/2018 Job site Addresc 9 Sylvan Lane,Northampton MA cityistate/zip: 01060 Attach a copy or the workers'crompensadon polity 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 fee up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this argument may be forwarded W the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi$anderthe pains andpenandes of perjury due dw information providedabove is true and correct. c . 66-4-fae. O'tnaaau.Qe Date. cb/1H/zcle Ph..#,413-539-1521 O,Q7dd ase only. Do not write in this area,fin be completed by city ortown official. City or Town: Permit/License# heading Authority(circle oue): L Board of Health 2.Building Department 3.City/ro"Clerk 4.Electrical Inspector 5.Dumbing Inspector 6.Other Contact Person: Phone#: ,. —sa3 — 9 a{. %RR °.f A. @ xsceaaem pert- 3zr ,en I I �IGyP All di iwu end mwt Deaigtwtl:3/132018 jtv tam auwj.. wfitijn appli relc Aa ar cam pwdlj Ptinttd:5/162018 job Bite v,d adJuem,eW m fitjab 2020 appli pl fx bu barn paid orjob candiNoro. 1 oNrr Placed JenvifrrFricdtun5howplaceST39We11aBetingArceI All I)nwin88: 1 NO Scale. E Rd CERTIFICATE OF LIABILITY INSURANCEwNWMAGN"O o2N8@016 THIS CERTIFICATE IS HUED All A MATTER OF INFORMAnON ONLY AND CONFERS NO RIGHTS(MON THE CERTIFICATE HOLDER,TIRE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLAMS BELOW. TRAM CERTIFICATE OF INSURANCE DOES NOT CONSUME A CONTRACT BETWEEN THE ISSUING INWRER(3),MTMMED REPRESENTATNE OR PRODBCER.AND THE CERTIFICATE HOLDER. IMPORT : E BY,annals holds,Is a-- INSURED, F ,an, meat ba andmad. M SUBROGATION M WANED,sub)ed b UW terms end eondXlas olMs policy,esrloln palleW wry rewire an rtlaraanxw. A ebbxxd Rn MIG a1NMwa daa nw carver ddhb to Dw cedMlak holder In IIw d Much antlwaxan a. P.m wdWd Bermes BANAS 8 FICKERT INSURANCE AGENCY DI 4t3 522-zlaD bmeshHuwmWmm 63 MAIN ST x ArFasDYW CNwAae xxce EASTHMPTON MA 0102F WWMA. WAVELERSPROPERTYCASCOOFAM 25874 weVl® xwwsa. OCONNEU.CONSTRUCTION LLC <: xeuRAD: B9 OANAHILL ROAD x G: BELCHERTOWN MA DIM COVERAGES CERTIFICATE IRIMBER: 230808 REVISION NUMBER: THIS M TO CERTIFY THAT WE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERM INOLGTM.. NOTWIRISTAHMNG W RFOUMMEM,TERM OR COaMMON OF ANY CONTRI Ct OR OTHER DOCUMENT WITH RESPECT TO WMCH THIN CERT nME MAY BE ISSUED ON MY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS BUBJECT TO ALL WE TERING, EXCLUSIONSANO CONDITIONS OF SUCH POLICES.LOUTS SHOWN MAY IMVE BEEN REDUCED WPM CLIMB, l YwwaO1`M My'vLGxa wmNM"oNW*ALu v pAwaCGnMGNCE t Mm LTm a WA rEALGULawJlHlum a aGNLAaM<aTELINrt ARVwRR: oDReuAaaNGaATE s POIILY❑Kr ❑Lac xLWU'n.CDYG.VPAD6 a s Auawxulrwry a MY NO mDLY wLxIMWeaI f m wTl�rylyn Pyp eooEv aulmlFaruWnC f m s NPEn.WraB Rums i nYw6LLAIxeaLyx I:ACnaCCNMEXCE a uauuw c:yLxAMCE WA ADoxEwre s so s naxu io"Na 'W" AwDDLortM•Lumrr .WYPPMMl1nn9NDE1LE1SCnrNE j/ LEILILACCOE11r 1DDo.OW A Gx,LIIDFDr IrIG an, BY, TPJUB0O11M3T21T O7lPW2017 072W2018 ELLWEA9E-ME a I.0OOA00 • YMa xw D EWv 1.wBFME.eNGY LNM f 1 WDOOO WA ewWrxNOFPxWTXxGI WaMweIV WKLw PCdIC1H,AAfaA�1AYW,b Mrwx.�pMwYeMGYn�n MnYreµM Wodnna'Calrpenwtlon beneNs wW Mpdtl b Mawechuwdsemployws ody.PNauew b EMNwrwnl V/C 200306 B.m eWniwlbn k glvsn W pry Wima Wr SeneMa loampbyw k ebbs oMrMan MaWGMeolb it M WaWad hbee,x has hlwd Mow empbyew aubMe of MeewdadellG. Tara uWAcds of WeMarmwflm'Ae the Wkcy In Wrcearm NWdoledwloc.n Wnm vvw kwsdludas Dxeap Pw dCove Nwabove ne effmNo Ma 311d,w MkC.,raws olMwrerce). TM Mdad0df aowwps term Osmoneastldsky by>ocaw(rx tlW PmoTdCovere0e-Cwabpa VaMcelbn Beardl Hod d nwN.mwa.BwllwWwhxa-mmwwWon9mee00s1brxl. CERTIFICATE MOLDER CANCELLATNIN S OA.DANY OF THE ABOVE DESCNePD POLICES BE CANCELLEDM2PoRE WE EXPMADDN DATE THEREOF, NDOCE WILL BE DELNERED M City Of Northampton AccoROAxcE NTNTHE roUCYP1IWMWN0. 125 LOOrd Sb A`url�wJg1 Dnlsxew,ASNe LIA DIM Nodhemplon OMEN M.C .CPCU.Vla PraNdsnt-RedMd MMM-WCRMIM O 10883014 ACORD CORPORATION. ARdDhb rasrwd. ACORD 25(2014101) The ACORD narne and ktpo an,wBlslenad marks W ACORD