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38B-084 (4) 136 SOUTH ST BP-2019-0826 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.Block: 38B-084 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BASEMENT RENOVATION BUILDING PERMIT Permit# BP-2019-0826 Proiect# JS-2019-001361 Est. Cost: $30416.00 Fee: $201.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WRIGHT BUILDERS 106505 Lot Size(sq.ft.): Owner: GRIGGS RUTH Zoning: URB(100)/ Applicant. WRIGHT BUILDERS AT. 136 SOUTH ST Applicant Address: Phone: Insurance: 48 Bates St (413)586-8287(116) Workers Compensation NORTHAMPTONMA01060 ISSUED ON:1/22/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.BASEMENT BATH RENO AND EGRESS WINDOW**SEE PLAN NOTES RE SMOKE DETECTORS 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 1/22/2019 0:00:00 $201.50 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck r-Building Commissioner File#BP-2019-0826 APPLICANT/CONTACT PERSON WRIGHT BUILDERS ' ADDRESS/PHONE 48 Bates St NORTHAMPTON (413)586-8287(116) t%, Sd a-W Sir SO(Mi ST PROPERTY LOCATION =S=f NOT6 : MOVE POjAl J TO 1U MAP 001 ZONE URB000) deg � ag �' 038o8K THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLI N CHECKLIST ENC SED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid .. S/'►aol�l 1�EfK70(�S Typeof Construction: BASEMENT BATH O AND EGRESS WINDOW 56E ft&4 New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 106505 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO,RMATION PRESENTED: 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 � Ig 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. Department use only City of Northampton status offiermit.y Building Department CurbCut(Driveway Permit: 212 Main Street Sewar/Septic Availability} ROOM 100 Water/Well Availabtl'ity Northampton, MA 01060 Two Sets of StrUctdral Plans phone 413-587-1240 Fax 413-587-1272 Plof/Stte Plans , ec'ify APPLICATION TO CONSTRUCT, ALTE , RE OLI H A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION JAN 18 2019 1.1 Property Address: Thi section to be completed by office DEPT OF 51,311,DING INaSPEC TIONS 1p0p ��D�� 1L''VLtc'i"CI NORTHAMAMPTO�iP0106060 Ot —Unit Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: f2 15� Name(Print Current Mailing Address: I� r l Telephone i ture 2.2 Authorized Agent: LVP Name�P,�in9 1 Current Mailing Address: 1 lel �Mjc Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS -6•'Sb Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building // n (a)Building Permit Fee ` bit 2. Electrical ! �. (b)Estimated Total Cost of b16 0 Construction from 6 3. Plumbing 11 Building Permit Fee Vdot' 6V 4. Mechanical(HVAC) a _6 5. Fire Protection 6. Total=0 +2+3+4+5) 0 �- Check Number This Section For Official Use Only Building Permit Number: DateIssued: Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Complet . Permit Can Be Denied Due To Incomplete Information Existing Proposed Requiredby Zoning This column to be fil m by Building Depart nt Lot Size Frontage - I-- Setbacks Front Side L: � R:��.,.__,� L. Rear _ Building Height i Bldg. Square Footage % 9 Open Space Footage _ % (Lot area minus bldg&paved ;� s parking) #of Parking S ces - olume&Location) ---J L---- A. - A. Has a Special Permit/Variance/Findin ever been issued for/on the site? NO Q DON'T KNOW YES. Q IF YES, date issued:[--,� IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW Q YES Q IF YES: enter Book Page mM and/or Document # B. Does the site contain a brook, body of water or wetlands? NO tK DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained © , Date Issued. i m C. Do any signs exist on the property? YES O NO ):9� � prt IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO IF YES, describe size, type and location: i E. Will the construction activity disturb(clearing,gradin ex vation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors 0 0 Accessory Bldg. ❑ . Demolition ❑ New Signs [0] Decks [Q Siding [0] Other[dJ Brief Description of Proposedr LAM�Lp hN0 V/► b� (Nl t4TVJWork: f"Gv � )� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished base ent Yes No Plans Attached Roll -Sheet L 6a. If New house and Or aMtion 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. Dimen ' s e. Number of stories? f. Method of heating? eplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. o lands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basemen cellar floor below finished grade k. Will buil ' conform to the Building and Zoning regulations? Yes No. I. ptic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, X , ,( IL� as Owner of the subject property hereby authorize LO P4 6,t,W-c— –r-J%), to act on my beh f, in all matters relative to work authorized by this building permit application. Signature ONer Date �� 6')' (M t/b 12 r f as Owner/Authorized rn Ay „hereby declare that the statements and information on the foregoing application are true and accurate,to the best o my knowledge and belief. Signed under the pains and penalties of perjury. Print Na Signature of 01h Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: '' ���Q1AV ,( q�� Not Applicablee ❑ Name of License Holder: Vy a,; (�{;ti`�� 0 (��V J� ' � 6 License Number A s Expiration Date r Awl S10 1 13- oe SignYuM Telephone • 9.Realstere!&Homq Improvement Contractor: Not Applicable ❑ Company Name Regist ation Numbe r � 6 `fiU �v Addr Expiration Date Telephone 'fib' 4-d-0 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 buil 'ng permit. Signed Affidavit Attached Yes....... No...... ❑ The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 1 p "e �'r. City/State/Zip:N 0 jpjy 4 M14' 11 foo Phone#: 47 Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.M I am a sole proprietor or partnership and have no employees working for me in $ Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3.F�I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 Q Building addition 4.n I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.r-1 Electrical repairs or additions 5.1roprietors with no employees. 12.E]Plumbing repairs or additions am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. ROOF repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.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: �'. ly 4•—1 Yy'V VL- Policy#or Self-ins.Lic.#: M CG. O�'"b 6 V7'b (pIN Expiration Date: 3 1 Job Site Address: C City/State/Zip: N 0l'` Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).Q'p 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 of a STOP WORK ORDER and a fine of up to$250.00 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 cert' under the pains and na ties a 'ury that the information provided abo a is t ue and correct. Signature: /� Date: Phone# /b 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.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton Massachusetts •:G we i� DEPARTMENT OF BUILDING INSPECTIONS iy 212 Main Street •Municipal Building �J6.• ;'ate Northampton, MA 01060 Debris 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. The debris from construction work being performed at: I '% Csv ' s-r; N o (z1-1-t &YM (Please print house number and street name) Is to be disposed of at: V ct N G- (Please print name and I cation of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) I na re of ermit Aj5plicant 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. DATE(MMIDD/YYYI) A�" CERTIFICATE OF LIABILITY INSURANCE 03/22/2018 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND 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(les)must have ADDITIONAL INSURED provisions or 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 Jenna Rodrigue,CISR Elite NAME: Webber&Grinnell PHONE (413)586-0111 FAX (413)586-6481 C No Ext: AIC No: 8 North King Street E-MAIL jrod6gue@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA: Arbella Insurance Group 17000 INSURED INSURER B: A.I.M.Mutual Wright Builders,Inc. INSURER c: Attn:Jonathan Wright INSURER D: 48 Bates Street INSURER E: Northampton MA 01060 INSURER F: COVERAGES CERTIFICATE NUMBER: Master-2019 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDL31JBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSO WVO POLICY NUMBER MMIDD MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A 8500068268 03/01/2018 03/01/2019 PERSONAL aADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY 0 jEa F LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED 1020070845 03/01/2018 03/01/2019 BODILY INJURY(Per accident) $ AUTOS ONLYX AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per acddent PIP-Basic $ 8,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE 4600068266 03/01/2018 03/01/2019 AGGREGATE $ 5,000,000 DED I X RETENTION$ 10,000 $ WORKERS COMPENSATIONX STATUTE ETH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBEREXCLUDED? NIA MCC20020005342018A 03/01/2018 03/01/2019 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Informational Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts { Division of Professional Licensure + Board of Building Regulations and Standards Con strlrctivn"Supervisor CS-106505 E Aires: 11/01/2019 ANN MONICA-LEDWEk , 231 WEST HA EY R CHARLEMONT MA_ 01336 Commissioner w Unrestricted Construction supervisor Less than 3 auildhVs of any use group which contain ubic feet(991 cubic meters)of encased space. Falure to possess a cwt edition of the State Building Code is cause for r Massachusetts For I evoca#ian this r+cense. Cali(617)'1 a about thi t license visit nn"w.mass.gov/dpl , Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Musetts 02118 Home Improv ctor Registration ii TY mI l`I PECorpwakm WRIGHT BUILDERS,INC. z Rein: 101536 48 BATES STREET �� y� 06258020 NORTHAMPTON,MA 01060 ] w t F e Lq� Sy�y Update Address and Return Card., SCA 1 d 20M-05117 v 'V z Fir�ea�`J�a�/iaJJa�u�efJ� Office of Consumer Affairs&Business Regulation HOME IMPRO ENT CONTRACTOR Registration valid for individual use only before the wcpkvdondbts. If found nrturn to: EmWradon Office of ConsunwAflasm and Business Regulation ,..,,06252020 1000 Wad Ington -Suite 710 WRIGHT 8UI �-' Boston,MA 0 $: JONATHAN f 48 BATES STRE '-ter NORTHAMPTON,MA Y11060 Undersecretary WcA valid without signature i o .1 LU g Z mz2 cv N HER 000 z 3 �o o Wa L1J w Uy'W EQ EQ �a LL 2 Bilco Scapewall egress system duct heat down wall at new egress window to toe kick in vanity demo walls as needed to Owner: exhaust fan/light install egress windows 3 112" Ruth Griggs t—\ ­—) ne tub/shower --- 136 South Street ne vanity _ Northampton, MA new toilet ci reframe!sheetrock Project Name: saw cut floor and add . fci top 2'-0' and trim at new window underslab plumbing to new Bath Renovation sewage ejector pump. f/I _ _ Egress Window (to be verified) CO 28"bifordIV 28"biford 60"vanity � II o Drawing Name: towel bar exhaust fan/light @ 48"a.f.f. u' existing washer/ w Floor Plan dryer to remain — fn N , Bath / Laundry " new closet CV 7� C) -add duct to feed at floor level LO Qi -add electric baseboard? existing Date: � r____–– ____ elec. panel Revisions: 2 towel bars Review 11/07/18 Review 11/13/18 Review 11/30/18 existing cabinets , P Review 12/04/18 to remain Review 12/11/18 Bedroom relocated cabinets and counter --- ♦----- add duct to bedroom Scale: Sb jco or as noted. LOwer Level Floor flan _ _ Approvals: -- 1 /4 11-011 I I &p. n A --- _ No. Al