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32A-178 (4)
82 BRIDGE ST BP-2019-1075 GIs u: COMMONWEALTH OF MASSACHUSETTS Mao:Blo k:32A- 178 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Category'New Multi-Family Housing BUILDING PERMIT Permit 4 BP-2019-1075 Proiectft JS-2019-001744 Est. Cost: 54436882.00 Fee 510291 00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: WESTERN BUILDERS INC 072840 Lot Size(sa R.): 20908.80 Owner. VALLEY COMMUNITY DEV CORP zoning: URC(190v Applicant: WESTERN BUILDERS INC AP 82 BRIDGE ST Applicant Address: Phone: Insurance., P O BOX 587 (413)467-9171 Workers Compensation GRANBYMA01033 ISSUED ON:4/1912019 0.00.00 TO PERFORM THE FOLLOWING WORK:RENOVATIONS AND ADDITION - phased approval' POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspecmrof Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House It Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: f 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: FeeTvne: Date Paid: Amount: Building 4/19/20190:00:00 $10291.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File #BP-2019-1075 o1,05 APPLICANT/CONTACT PERSON WESTERN BUILDERS INC ADDRESS/PHONE P O BOX 587 GRANBY (413)467-9171 PROPERTY LOCATION 82 BRIDGE ST P MAP 32A PARCEL 178 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENC REQUIRED DATE ZONING FORM FILLED OUT Fee Paid �yy//�.� . Buildine Permit Filledout Fee Paid Qom• Tveof Constructon: UNOVATIONS AND ADDIT N �U��thy New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 072840 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: ✓Approved_Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER§ Intermediate Project: Site Plan AND/OR _Special Permit With Site Plan Major Projeee 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 Peratit from CB Architecture Committee 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. Versionl.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit Buildir I Department Curb CuttDrimir ay Permit 21, vilain Street Sever/Septic Availability c Room 100 WaterMell Availability — Northampton, MA 01060 Two Sets of Structural Plans t phone 413-587-1240 Fax 413-587-1272 Plo(lSiterPlans ' Other Specify ° APPLICATION TO CONSTRUCT,RIEPAIe� E OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OF MI LY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address'. I MAtl Z 6 21,)J�jThis Section to be eompbtW by oMce �82 Bridge Street { ap La /7 S Unit. Northampton, MA 01060 nFPT o=umnlNe V`AP CTION3 NonntAmi gym.Ana niT OwrlayDhMct. - Elm 34DISVIct CS Wal SECTION 2.PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: _ Valley Community Development_ Corp. 30 Market Street Northampton,MA 01060 Name(Print) Current Mailing Address (413) 5.86-5855 Signature Telephone 2.2 Authorized Agent: ..Laura Baker 30 Market Street Northampton, MA 01060 Name(Pont) Current Mailing Address: (413) 586-585.5 _ Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed tv Permit applicant 1. Building $2,984,039.00 (a)Building Permit Fee 2. Electrical $602,603.00 (b)Estimated Total Cost of Construction from 6 3. Plumbing $336,000.00 Building Permit Fee OT 4. Mechanical(HVAC) - - - /Dy ,• V V 5. Fire Protection $514,240.00 6. Total=(1 +2+3+4+5) b� Check Number /� yd This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissionedinspector of Buildings / ,Date Bl Versionl.7 Commercial Building Permit May 15,2000 SECTION 4 CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑+ Demolition❑ Repairs❑+ Additions (] Accessory Building Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑+ Roofing El Change of Use❑ Other❑ Brief Description EXISTING STORY OLM SAND 9RD AND NEW FORCE STOrt(ADDITION FUS Of Proposed Work: "wuN7EDSD.ER RW iRUFFATORYWOOD FRuazoe,:FOUR CDNTAwn,c,I UNITS OF ROOM OCCUPANCY TUNA SRO 1) SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Cheek as applicable) CONSTRUCTION TYPE A AssemblyElA-1 11A-2 ElA-3 El 1A A-4 ❑ A-5 ❑ 1B ❑ B Business 1] 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 38 El M Mercantile ❑ 4 ❑ R Residential 1] 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: I - COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: R2, B _ - Proposed Use Group: R-2, B _ Existing Hazard Index 780 CMR 34): _ __ Proposed Hazard Index 780 CMR 34)'. _- SECTION S BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sB 1. _ 1.. _ 2,424 2m 2 n . .4,989 3`° 31c 4,930 4" 4"' 4,808 Total Area(sf) Total Proposed New Construction(so - 17,151 Total Height(ft) - Total Height it _ 38 7.Water Supply(M.G.L.e.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public Private ❑ Zone Outside Flood ZoneO Municipal [] On site disposal system❑ Version1.7 Commercial Building Permit May 15,2000 11. NORTHANMON ZONN Existing Proposed Required by Zoning This column to be filled N by Building Department Lot Size 20,823 20,823 Frontage 99.49 99.49 Setbacks Front 18 10 Side 4 36 R:22 L: 10 R; 10 Rear 102 20 Building Height 37.5 37.5 E quare Footage 9351 % 1716 pace Footageminus bldg&payed 1508 7200 4o Parking Spaces 14_ Fill: volume&Locatian A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 0 , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(Gearing,grading,excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management Perrnil from the DPW is required. 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 Dale Name Area of Responsibility Address Registragon 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 O+ Company Name'. Responsible In Charge of Construction Address Signature Telephone Version1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes Q No O SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS 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 Dale 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 Name - - - Signature of OvmedAgent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder William Darting _ _ CS072840 License Number '.61 Brekenbridge St. P.O. Box 335 Palmer,MA 01069 04/28/2020 Address ,, ��ll Expiration Date Slgnatn!_ r TelephoqJ3ne 335,- V�y0 SECTION 13-WORKERS'COMPENSATION INSURANCE AF DAVIT(M.G.L e.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 Q 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 definedbyMGL c 111, S 150A. Address of the work: $Z�¢iDCp 1.3/T��• 1 1 The debris will be transported by: SOC��AaecX �D$• OF IRCK� The debris will be received by: /t)a y Building permit number: Name of Permit Applicant �lrJ alJDb1.5 Date Signaturi of Permit Applicant The Commonwealth of Massachusetts VW.rlgersl Department of IndustrialAccidents 1 Congress Street,Suite f00 Boston,MA 01114-10]7www.mass.gop/dia Compensation Insurance Affidavit: Builders/Contractors!Electricians/Plumbers, TO BE FILED WITH THE PERMITTING AUTHORITY. Aripticant Information Please Print Lecibly Name(BusinessiOrganimtiowlndividua0: Western Builders Address: 73 Pleasant Street City/State/Zip: Granby, MA 01033 Phone#: 413-467-9171 Are you an employer?Check the appropriate boa: Type of project(required): 1,E]l am a employer wifi employees(fall and/or pin-tams).' 7_ ❑New construction 2❑1 am a sale propdmor or pa ership and have nc employees working palmetto S Q Remodeling any capacity.(No workers'comp mormme requhed] QI mn a homwwnerdoing all work myself[No workers'comp.os. ce requited.)t 9. O Demolition 4.0I am a homeowner and will be turnstractors to conduct all work on , Iwill Io Q Building addition con y property, ensure amt all contractors either have workers'compensatron insuranne or are sole 11.0 Electrical repairs or additions pmpnnum vent no empbyees. 12.OPlumbing repairs or additions 5.01 mn a ge l coneactor and I have hired dm sub-contractors listed on the aMched sheet ]7.ORoof repairs These subcontractor have employees and have workers'comp.insurance I 6.❑We.are a ouPomtion and its officers have eaere,wdtheir right efevereption per MGL a 14.❑Other 152,§I(4),and we have no empin,,, [No wodrers'cavya res.requited] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infonrmtion. t Homeowners who submit this affNavit indicating may are doing all work and then hire outside contractors most submit a new affidavit indicating such. TCon tronas that check this We must attached an additional sheet showing the name ofthe subcontractors and state whether or not those entities have employees. Ifthe subcontractors have employees,they must provide then workers romp.Wiley number I man employer that is providing workers'compensation insurance for my employees. Below is the polity andjob site information. Insurance Company Name: Travelers Idemnity,Co.of CT Policy#or Self-ins.Lia#: UB-6K239300 Expiration Date: 6/1/2019 Job Site Address: 62 Bridge Street City/State/Zip:Northampton-Ma 01060 Attach a copy of the workers'compensation policy 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 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 certify underp ' s e Ides of perjury that the information provided above is true and correct Si nature q J Date: 3 Ph #, 413-467-9171 M�atssa A, r�'dAAf Official use only. Do not write in this ares,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: A� CERTIFICATE OF LIABILITY INSURANCE DA EINNMDN YI 11/09/2018 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 Me certificate holder is an ADDITIONAL INSURED,the policy(ler)must have ADDITIONAL INSURED proolslons or be endorsed. If SUBROGATION LS WAIVED, subject to Me terms and conditioned of the policy, cartain policies may require an endomement A statement on this ceNficate does net confer rights to Me celtiflcate holder in lieu of such endorsemen a. PRODUCER L TACT Nel'e6a S Np20a She Matte Group, DID. 65 (860) 211-0350 x4 FA% ;1860) 331-]340 65 Le Salle RoadFol suite 209 ADDRESSEMAIL �o ewatte gs"th Meet Hartford CP 06107 - G LOVEMmDRU IXSVRE SYFORDINGE MARC. NSURERA:Charter Oak Fire Insurance Co. 15615 INUREO MSURERB;Travelers Pro Can Co Of AEII 25674 Western Buildera, Inc. INSUBERC'. Steri IndesI 6 Liability Co. 38318 73 Pleasant Street INSURERD:Travelers Indec it CO. of CP. 25682 Granby MA 01033 INSURER E:American Guarantee insurance Co. 26237 IHSURERF'. Steadfast Insurance Cc 36]8] COVERAGES CERTIFICATE NUMBER Gert To S15O 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 TYPE OF INSURANCE ADDU9U POLICY NUMBER MMDCY FFA PO YBe LIMITS A X COMMERCIALGENERALUUMM RY ENCHCCCUPRENGE E 1.000,000 CWMAM1N➢E O OCCUR CO-]F919]19 06/01/3013 Do/0112019 TET 1 300,000 X TOO Included AND B%P Any an $ 10,000 X NO Deductible PERSONAL6ADVIWURY 6 11000,000 GENL AGGREGATE LIMIT APPLIES FER GENERALAG REGATE S 2,000,000 -1-YO PER 1-1 LOC PROWCTSmOsWCPAGG 5 2,OO G,000 OTHER: AUMMOBILFOABILRV CO BINED SING LIMIT $ 5.000,000 B % ,WYADIO 910_40141465 06/01/2016 06/01/2019 HOMILY INJURY(Pep—) 5 OWNED SCHEDULED MOOILYINIURI acaEml) S AU CS ONLY AUTOS HIRED WA WNEO PROPERTYDPMAGE S ALTOS ONLY ANTI ONLY I$ C X UNBRE LGLIAa Y OCCUR 1000595012191 04/01/2818 04/01/2019 EACH OCCURRENCE S 10,000,000 tDEEXCESS X .EMION LNe QUA MSa ADE AGGREGATE S 10,000,000 10.000 S WORHERSCOMPENSATWN % R OTH- D AND EMPLOYERS'LIABILITY Da-6X319300 06/01/301906/01/3019 T RNYPROPRISTE"ARTNENEXECUTIVE YIN EL EACHACCIDENT S 1,000,000 (Mvever,In Mn EL O MIA ELOISE45E-EAEMPLOYEE $ 1,0OO,OpO xy deem.mee. DFSCRIPTIENOF OPERATIONS telow ELDSEASE-PoOCYUMIT S 1,000,000 B 2nd Layer Mobrella kat, 9242691 04/01/2013 04/01/2019 Occurrence/ 99 E S,GOO,OpO F Professional / Pollution 3005574436 05/15/3019 05/15/2019 P=5,000 dedouatiblee S 5,000,000 OEWRIPTIOHOFDPEMPg SILOCATIOHSIVEHICLES IACORDIOI,A Wo,WRnnahe6hM ,mry Getl dHMOMSPcabMu.m RE: Sergeant House Project 82 Bridge Street, Northeast— MA. Certificate holder named additional insured when —gaited by Britten contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Valley Cs ity Development Corporation Me. Lara Baker Real Estate Project Manager 30 Market Street AUTHORI2EDREEP,FRR,EESENTATIVE Northempton MA 01060 V ©1985-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks Of ACORD Page 1 of 1