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31A-003 (5)
1 Xf Imf File#BP-2018-1245 APPLICANT/CONTACT PERSON MICHAEL DAVENPORT ADDRESS/PHONE 74 FAIRFIELD AVE WESTHAMPTON (413)454-3476 PROPERTY LOCATION 319 ELM ST MAP 31A PARCEL 003 001 ZONE URB(100)/URA(0)/ THIS SECTION FOR OFFICIAL USE ONLY. PERMIT APPLICATION CHECKLIST + D REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinp,Permit Filled out Fee Paid T eof Construction: REPLACE RAILING AND DE EXISTING DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 053077 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PIjESENTED: Approved VAdditional 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 v/Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 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. 'MOldM1�N V rsionl.7 Commercial Building Permit May 15,2000 Department use only City o No ampton Status of Permit: �1� £ Win De artment Curb Cut/Driveway Permit - 212 aln treet Sewer/Septic Availability om 00 Water/Well Availability G 0 k4ton, A 01060 Two Sets of Structural Plans ax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 31q m Map 31 A Lot 00,:5 G�L� � Unit /" !��I ' �n�i'"" s• Zone Overlay District e9jo do Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) / Current Mailing Address: Signature Telephone 2.2 Authorized Agent: tCIII k. Ve.hpdn'1- _ 7q Far-Pit�C AVe,kAl �F-po,;, 1 : ®l OL'Z Name(Print) Current lin Address: (L / Signature Telephone SECTION 3- ESTIMATED CONSTR TION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building S, c (a) Building Permit Fee � � � G 2. Electrical 1-Qt*1 YM S (b) Estimated Total Cost of Construction from 6 4 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Versionl.7 Commercial Building Permit M 15 � �=iO4 ijic�H'#"Qj Q0 ,�`wt,'1N�a�CltpYq SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 l CUBIC FEET OF ENCLOSED SPACE ' s Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additibns ❑ Accessory Building❑' Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. Of Proposed Work: ke-fol'ace, ,fiAfekiva SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(so 15 1St 2nd 2nd 3rd 3rd 4m 4th Total Area(so Total Proposed New Construction (so Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: F7.733Sewage Disposal System: Public ❑ Private E] Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑ r Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZOMNG Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: J R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Spe 'al Permit/Variance/Finding ever been issued for/on the site? NOfxA Vy DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO (S� DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO Q IF YES, describe size, type and location: ; E. Will the construction activity disturb(clearing, grading, excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO , 4 " IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 1 Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Not Applicable ❑ Company Name: Responsible In Charge of Construction Address Signature Telephone i Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes ® No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, N AJ A V pla —1 as Owner of the subject property hereby authorize 2J - to act on my behalf, in all matters relative to work authorized by this building permit application. s� d -2 Signature of Owner Date I, , 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. Print Nam Signature of Owner/Age Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: '-MI 1 C'1(R( 1/n A(/t✓1 p2 r T 3 CS –6S- / �— License Nu7,r Fa�ri ill l� � �rt/�SY;,cr�ito'1 /'1 R 010 �S _ g , 0' Address Expiration Crate �+i 3 ►+s -�'f 7 Signature Telephone SECTION 13-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 e No 0 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, 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 defined by MGL c 111 , S 150A. Address of the work: The debris will be transported by: The debris will be received by: Building permit number: Name of Permit Applicant Date Signature of Permit Applicant f The Commonwealth of Massachusetts W Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lejibly Business/Organization Name: k? f loclo�I&I 94W d U1,h r� Address: 74 Pal l rf e Id V e City/State/Zip:\,asstc C U A- o L ., Phone#: LP A l'S Are you an employer?Check the appropriate box: Business Type(required): 1.1�1 I am a employer with 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] g• r-1 Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.❑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 "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#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: r, o r 1/ Q Idk of ,�)0, Insurer's Address: OfA f h, City/State/Zip: r.' ( `r /� 01030 U Policy#or Self-ins.Lic.# & W c ?a 11 3I ff- 7 Expiration Date: W14 S O Attach a copy of the workers' compensation policy declaration page(showing the policy number aA 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 certify,under a pains and penalties of perjury that the information provided ab ve is true and correct Si ature: I \ Date: J Phone#: 4 ff S�_3 4j` 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 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint ente ris , d including the legal representatives of a deceased employer,or the receiver or trustee of an individual,p ership,association or other legal entity,employing employees. However,the owner of a dwelling house having not m than three apartments and who resides therein,or the occupant of the dwelling house of another who employs pe ons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 www.mass.gov/dia Form Revised 02-23-15 �'�® DATE(MM/DD/YYYY) A C" CERTIFICATE OF LIABILITY INSURANCE 05/22/2018 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 NAME: Melanie Nacewicz CANARY BLOMSTROM INSURANCE AGENCY PHONE 413 789-3995 ac No: E-MAIL ADDRESS: mnacewicz@r-anaryblomstrom.com 868 SPRINGFIELD ST INSURERS AFFORDING COVERAGE NAIC# FEEDING HILLS MA 01030 INSURER A: AIM MUTUAL INS CO 33758 INSURED INSURER B DAVENPORT FLOORING AND REMODELING INC INSURER C: INSURER D: 97 FAIRFIELD AVENUE INSURER E: WESTFIELD MA 01085 INSURER F: COVERAGES CERTIFICATE NUMBER: 272147 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 LIMITS T TYPE OF INSURANCE POLICY NUMBER MM/DD YYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE F7 OCCUR REMIDAMAESES S(ERENTE PREMID a occurrence) $ MED EXP(Any one person) $ N/A PERSONAL 8 ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 17 PRO-JECT 17LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Par accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ R,7: ESS LIAB CLAIMsy DE N/A AGGREGATE $ RETENTION$ $ WORKERS COMPENSATION PERX STATUTE ETH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT s 500,000 A OFFICER/M EMBER EXCLUDED? I WA WA WA AWC4007031638201/A 09/25/2017 09/25/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under ! DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Kristopher Dawson ACCORDANCE WITH THE POLICY PROVISIONS. 31 Davenport Street AUTHORIZED REPRESENTATIVE Chicopee MA 01013 Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ., ,.. �;:. � 7;fir � _�ft ::'� ;.it -•�..f ��..{.' r •. ,. t ,. �;:Y � . ..,_ .. <�. .: ,.: . . .. ._,, ..... 'r ,. .. .... ,.. t:�. .. .... ,. .... V <" [: .. .. '.; '. �.- ,. :: .. .. � '.. .. . ... . . ..ii.. .. .. .. ... ... ..... .� _. ' s.�t a .. .. .. �.. � .. �. .y•, .. .. - his ,r'..' � �, i... ... , :. .. .. �:.: ': .. �.. P• ... ,. � ,. ;,.. , �:,,: s a � .. _ 4 ,. ,, ,. �. .• .: {{ '�f DAVEN-1 OP ID: MN ACORO CERTIFICATE OF LIABILITY INSURANCE 705/22/2018 (MM/DDlYYYI� 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 CNgMEACT Melanie Nacewicz Canary Blomstrom Ins.Agency PHONE .413-789-3995 FAX No:413-786-7004 868 Springfield St. N EM Feeding Hills, MA 01030-2151 -ADDRESS:rnnacewicz@canarybiomstrom.com INSURERS AFFORDING COVERAGE NAIC! INSURERA:General Casualty Ins Company 24414 INSURED Davenport Flooring INSURER B: and Remodeling,Inc. 97 Fairfield Ave INSURERC: Westfield,MA 01085 INSURER D: INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: 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 TYPEOFINSURANCE ADDL UB POLICYEFF POLICY EXP LIMBS LTR POLICYNUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE i OCCUR CCX 0396903 06/02/2017 06/02/2018 PREMISES EaE NTED -- oc urrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY F7E T F7 LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ 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 $ UMBRELLALIABOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I JER ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ tf yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may beattachedifmlorespaceisrequired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Kristopher Dawson ACCORDANCE WITH THE POLICY PROVISIONS. 31 Davenport Street Chicopee,MA01013 AUTHORIZED,REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD r y •� 3 r a y .f r w .. .. .. d ry aP( w A .•. .� ".. _ ..,. . .,». ... •. i r ,4 • �-N� I.r. ,x+! X1944 .. ti} 3. fjCx ....- .. -•_ .��-.. � x � rs } A + �ir'1 wC:, s S ( fti x "n > .. ::1: .w ad. .. I?,G ,?— is -C r. )Y:•t..1YR ,. 1 ��; .t- { t �h� i� �f , � �� �, a I Q�t I 11 I �. I ---.- �i � � , ---.-� g� � � ��� � '�� � . �� � �'N � � � � � , � I i L P'Y.ANNTNG ANT)✓�L TSI A1NA�iII..i'.lY G`i'.i'Y OF NaR 1 iAMP'I�ON �-q ,vluavuirali•axsn,aa-evaatinn•si..aaivyl•+anr 1 pu n a'3tt2•h)ru,ai.-•rvaauu.uuity}svx• 4uv.a-a-+atrnl tspwlvva-.pw uvx-hlaap•ana-a- �..; £iprnh I..pVnilcy,G+•upv rvptlnn.l>rc..a utinu.�l..puA L%xc x•Innncr-pipwalfcy(.y,n etiap.rnlatavump.Mm•qvy-;iN;--run,y Vis' k. August 25, 2oi6 Denny Nolan 319 Elm Street Northampton MA o1o6o RE: Elm Street Historic District Certificate of Nonapplicability 319 Elm Street removal of section of porch Dear Mr.Nolan: Thank you for submitting an application for a Certificate of Nonapplicability for removal of a portion of porch within the Elm Street Local Historic District,as shown in the plans submitted with your application. In accordance with§195-5 B(3)and(9),the work proposed falls under `Cornices,columns,pediments and trim: repair and replacement with the same design or appearance but different materials.'And`railings: replacement with the same design but different materials'. and is exempt from Historic District Review. Reconfiguration of the stairs is exempt as they are not visible from the street. This Certificate is issued by staff to the Northampton Historical Commission,acting on behalf of the Director of Planning and Sustainability. No further Local Historic District Review is required for this project. Thank you, �tl f(� I Sarah 1. LaValley City Hall-210 Main Stet-N—thantpt—,NSA".- o�wHw.noMhamptonnaa.,SxavJOPD � `\�� 0.j 319 ELM ST BP-2017-0199 GIS:*;',- COMMONWEALTH OF MASSACHUSETTS Map-Block: 31A-003 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: renovation BUILDING PERMIT Permit 4 BP-2017-0199 Project# JS-2017-000332 Est. Cost:$1500.00 Fee:565.00 PERMISSION IS HEREBY GRANTED TO: Const Class: Contractor., License: Use Group: Homeowner as Contractor Lot Size(sq.ft.): 14723.28 Owner: NOLAN DENNIS R&ARLENE T Zoning. URB(100)/IJRA(0) Applicant: NOLAN DENNIS R & ARLENE T AT: 319 ELM ST Applicant Address: Phone: Insurance: 319 ELM ST (413) 626-2357 0 NORTHAM PTONMA01 060 ISSUED ON:8/29/2016 0:00:00 TO PERFORM THE FOLLOWING WORK. REDUCE & REPAIR DECK 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: F'eeTvpe: Date Paid: Amount: Building 8./25/2016 0:00:00 $65.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck-Building Commissioner L File#BP-2017-0199 APPLICANT/CONTACT PERSON NOLAN DENNIS R&ARLENE T C vG � o � C ADDRESS/PHONE 319 ELM ST NORTHAMPTON01060(413)626-2357() PROPERTY LOCATION 319 ELM ST MAP 31 A PARCEL 003 001 ZONE URBO 00)/URA(0)! THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REDUCE&REPAIR DECK New Construction Non Structural interior renovations Addition to Existin 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 INFOfi�NATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/Oh 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 a qP�-I, Permit from Conservation Commission Permit from CB Architecture Committee OV-Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay (7/C 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. : :De artmentlrse crit. .. .._7;•:• �l��eCt:rle.�;-:exiu:.;.•I� ECEIVED City or NorthamptonsrwtrtsaF'Pe mBuidnR::_::._ �..;::.:7: ,Y g Department - _:c'r�Liv!M1Yi�S:..,. .,_L..:R= _ _ _� ..r.::-.:,'`.:.'c•''•:.':"T.i.$li!*_- 'moi 1 5 7016 21.2 Main Street ::.. .. . ;?'. a vim,._}:I:�:'+• ME H5V' i'lc •'��� Room 100 A-t,._ Y �y�:erUliel�Avntlabilltt7 ����_ [�..-D- .. 1 11 (" -'- I'.:� -(:.:r.. ....�.::__. �ti:a,,:.fir:ii:.._........ n r:•�kl�• '. OC�F.OFBIUD1NG.: .- --:.Ns orthamp[Grl MA 01000 �TUIOSeiS;Q:f-S,t[[7 UKA1:'1.13!]5`c��'�'�.' .7 . .....__._ _ - 3-587-1240 Fax 413-587-1272 li�Plansg.,." : ` . -608 ;r. . .: .:.......... :.} [::: 2iR:4 --m�?`{tib :•,S - : : APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TlUO FAMILY DWELLING SEC710H 7 -SITE INFORMATION Tii�'s_�ectjon'_to,:be.compiEted;b:�.orifice= 1.1 Pro;}ertvAddress: --� � - "°Ma :.:fn: - _:='�:�;�-.L+o•t.,-,'��: _ .4 ;;;::r''':.r•Over 1a�[3isir1cf,.: CBrpistrfri . SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: ac•U N Name(Print) Current Mating Address: Signature U Te,ephone �� �� L �� .5 2.2 Authorized Agent: 6-7ti N i AJ J/P d 31 p ��'�_ Name(Print) Current 10ailing Address: Signature v Teiephnne SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official U-•e Only completed by permit applicant 1. Building #�SdQ� l (a)Building Permit Fee 2. ElectricalII (b)Estimated Total Cost of 4f9- Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) � 5. Fire Protection ,6 ! B. Total=0 +2+3+4+5) $L/ $Od Check Number This Section For Official Use Only BuildingPermit Number. Date Issued: Signature: Building Comm6sionedlnspector of Bjildings Gate - `� _ __ _`-_____ __________�________� � ___�� � � \ f-\ `� -� \ -~ \ " ----�`��� -^) ` ' _ _ / __-'___ _---_-_'__ -�-'_� - -_' -� _'-'_--_ -_ ` -' File#BP-2018-1245 APPLICANT/CONTACT PERSON MICHAEL DAVENPORT LIV1 21 V,_.. ADDRESS/PHONE 74 FAIRFIELD AVE WESTHAMPTON (413)454-3476 PROPERTY LOCATION 319 ELM ST MAP 31A PARCEL 003 001 ZONE URB(100)/URA(0)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST • D REQUIRED DATE �L d, 44t s I AAV0 • le ,-LING AND DE KINEXISTING DECK ES 14b L3� q Art�V 00/" � 3077 Y__ v / � EEN TAKEN ON THIS APPLICATION BASED ON / r required(see below) FIX REQUIRED UNDER:§ ite Plan AND/OR Special Permit With Site Plan Site Plan AND/OR Special Permit With Site Plan 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 v Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay / f s—/;?Y l 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. /g i leu l� � 5 a 1` {P i t � ,+wN' 141 , IlawW � � _•P r PREMIER RAILING Black a CLASSIC Premier Railin Premier Railing offers the beauty and feel of real-wood coupled with the added strength and safety of performance materials. This classic profile features a flat top rail with delicately beveled TOP RAIL SIZE:3.5"X 2.7" edges for a high-end took that lasts. ,� i� �, ����, �'' -� �,,� � -A �� � �� t� ,�''� � � r �r, • 3: r �^�• .} 1 .� Select Your Rail Style Select the rail style that best complements your home. From the clean lines and striking silhouette of a contemporary profile to an elaborately detailed and robust traditional profile, each of these rail lines makes a statement. Backed with a 25-year limited warranty, all of our railing profiles undergo rigorous testing, ensuring they are as safe as they are stunning. c lassic Styles PREMIER RAILING' RADIANCERAIL* RADIANCERAIL EXPRESS* R 6L ,� f S TRADEMARK RAILTM* RESERVE RAILTM* Lv ps k s *Available regionally *Available regionally Contemporary Styles IMPRESSION RAIL TM IMPRESSION RAIL TM EVOLUTIONS RAIL° EVOLUTIONS RAIL* EXPRESS CONTEMPORARY BUILDER 35 Unlike some wood railings,all AZEK*Rail profile designs are tested by a third-party,independent agency to ensure safety code compliance standards are met or exceeded.AZEK railings undergo rigorous testing and are engineered for safety and strength. r �y�. } j�, ` r�i 7..� r F �. �� �•�- �^• � � ., � ��` R ,��, �� '�t.a,,� �► � �*�.. �� , g � 4 ;:; � . '-- i �,.. .` t t +"r I"i.ANN7NG A7�Tf>LSLTSI'ATNAI�Y[.i'1'Y-C."['IY dr NoRTr7AMP''Li(�N +::� � � � +7 y y na,y 'r.• F ..rn.. V L1xua.xFir,n<i� i uaa .x -i I.1 4 u,a.1 3. I• �..: ^-I `I Snrnla t.u'i.rllt-J.f xa.rxut...n.I rr.u.rx uiiaan F l..und L:xt.I)nnr.er «lx.vnlit\'G�'xanri i.x rr.,t xnaau.l.r .L 9-Ci1t _,1Z�Y'sa. #16 August 25, 2016 Denny Nolan 319 Elm Street Northampton MA o1o6o RE: Elm Street Historic District Certificate of Nonapplicability 319 Elm Street removal of section of porch Dear Mr.Nolan: Thank you for submitting an application for a Certificate of Nonapplicability for removal of a portion of porch within the Elm Street Local Historic District, as shown in the plans submitted with your application. In accordance with§195-5 B(3) and (9),the work proposed falls under 'Cornices, columns,pediments and trim: repair and replacement with the same design or appearance but different materials.'And `railings: replacement with the same design but different materials'. and is exempt from Historic District Review. Reconfiguration of the stairs is exempt as they are not visible from the street. This Certificate is issued by staff to the Northampton Historical Commission, acting on behalf of the Director of Planning and Sustainability. No further Local Historic District Review is required for this project. Thank you, Sarah I. LaValley City I;ati 2>.o A1.ain.strict-North—ptoa>_,NIA ou>G"---O--pt g—/OPD meq• hj ..:yam- ,•� H R �� !�>. .� •� a ' L File#BP-2017-0199 ' APPLICANT/CONTACT PERSON NOLAN DENNIS R&ARLENE T ADDRESSIPHONE 319 ELM ST NORTHAMPTON01060(433)626-2357() o r PROPERTY LOCATION 319 ELM ST MAP 31 A PARCEL 003 001 ZONE URBO 00l/URA(,0)! THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE 1 ZONING FORM FILLED OUT Fee Paid Ilk Building Permit Filled out ' Fee Paid Tvaeof Construction: REDUCE&REPAIR DECK New Construction t Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan TETE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON I.NFQ�IMATION PRESENTED: /Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/Ok 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 -r� CR 1 Permit from Conservation Commission Permit from CB Architecture Committee 8 Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 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. 319 EUM ST BP-2017-0199 els ir COMMONWEALTH OF MASSACHUSETTS Man-Block 3 IA-003 CITY OF NORTHAMPTON Lot_W: Permit- Buildinq 01 y:renovation BUILDING PERMIT ermet Bfi- 17-0199 #" 7-000332 $I SOWN =F e:S6 PERMISSION IS HEREBY GRANTED TO: ans.t.Class 7 Contractor: License: Use to Homeowner as Contractor Lot Size(sq.6.): 14723.28 Owner: NOLAN DENNIS R&ARLENE T Zoning:URB(100)/URA(Q) Applicant: NOLAN DENNIS R &ARLENE T AT. 319 ELM ST Applicant Address: Phone: Insurance: 319 ELM ST (413) 626-2357 Q NORTHAMPTONMA01060 ISSUED OiV.8/29/2016 0:00:00 TO PERFORM THE FOLLOWING WORK: REDUCE & REPAIR DECK 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: Rouah: 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 5ienature: FeeTvpe: Date Paid: Amount: Building 8.12512016 0:00-00 $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck-Building Commissioner -r - F=• Re�rtrrerise�crii 4=`�:�£���-�:___ 'U=ate. ��x� ���= � � �,,•-.:._ BECEIVED City of 1`torihFmptor, ss FP r r.�: = Building De artmart 10152016 :.,..,.'.— a --+,s'*'eft i•:�.. '-: -+_}:., 21.2-Main 5&-a �er st se Room 10'0 r r ler :,_=_•. = llt:4vaiiabillty ♦ A ry:`.'sem st.:y�aBE...�-.7- yeas orthampron, ��n 01 Cfi0roi-a- e��n #rrriurL`t�ars Fax4l,' 587-1272 .PI'or7Site�P�fans'•._ :0t�(�' `Sp�'ci�����a���::"_'�• r~..,Y�._ �.-,mai TO CONSTRUCT,ALTEi?,REPAIR,RENOVATE OR DEIW0LlSN A ONE OP-.TWO FAMILY DWELLING I SEC— '•-i 'WOPWATION ���-�"`.�x,+,"-=Tiii-s=sectjon'to';bescdmpietedb,��or�ce= . - ? •c-- ,=amass: _r._.__ .s�-' .-�= -�'' •-_-- •__:•. - _ - _ _ _ , -•Vnt _ b f� Zone_.- sit• _v 0�er1a_ .C3isi�ict`-c`;•_<_.- rn I- T 6r?'t / � cr;L .- t'161"-a:+,.E' j.:i-iJ•La��-_�___ _ �_ _L.1!s ma�yy.... 96 �:•_ s..- .C�,'DfS1:CICt=''—r � ' SEC"_ -=?;PErZTY OWNEf�SY.lP7AtlTHORI7_E'D AGENT Current Mailing Address: a � L Z,3 Y f ry Current Mading Address: 4-13 - -z 3Y,7 3-ESTIMATED CONSTRUCTION COSTS Estimated Cost(Dollars)to be Oficial Use Only completed by permit applicant S-OQ. (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Corstructfon from 6 3. Plumbing -169- Building Permit Fee 4. Mechanical(HVAC) b. Fire Protection S. Total=(1 +2+3+4+5) `� 5110. ov Check Number This Section For Official Use Only Building Permit Number. Date Issue-d: Signature: Building Commtssfcner/Inspector of Bindings Gate 94 9 a�'el Ilk Vii; arAllY�lilrrr _ _ LE I� r r I I - WL w. r � LL-LL LLlLLLLLLLLLLLL' ^X,f .� • _ 46. :11Jill e � - 1 i - � kT I I v ,rJ ". im 441 r !� S I I i jl II I i ` f � '�I i �� • Ii I mai--•r- t _ _ I