32A-178 (5) 82 BRIDGE ST BP-2019-1075
Glsa: COMMONWEALTH OF MASSACHUSETTS
Mao:Block:32A- 178 CITY OF NORTHAMPTON
Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit. Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
C�orv'New MulC-Family Housing BUILDING PERMIT
Permit BP-2019-1075
Pmicet 4 JS-2019-001744
Esc Cost' $4436882.00
Fee' $10291.00 PERMISSION IS HEREBY GRANTED TO.
Const.Class: Contractor: License:
Use Grouv WESTERN BUILDERS INC 072840
Lot Size(sa.ft.): 20908.80 Owner: VALLEY COMMUNITY DEV CORP
Zoning URC(1001/ Applicant. WESTERN BUILDERS INC
AT: 82 BRIDGE ST
Applicant Address: Phone: Insurance:
P O BOX 587 (413)467-9171 Workers Compensation
GRANBYMA01033 ISSUED ON:411912019 0:00:00
TO PERFORM THE FOLLOWING WORK:RENOVATIONS AND ADDITION - * phased
approval*
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 4 Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Deuartment Fireplace/Chimney:
Rough: -0 L1.1 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 denature: J /YTS 2auc/fv
FeeTvpe: 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 4 BP-2019-1075
Solc
APPLICANT/CONTACT PERSON WESTERN BUILDERS INC �I� �
SPEa��
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
ZONING FORM FILLED OUT ENC REQUIRED DATE
Fee Paid "y/
Buildin Permit Fill dout �yu�-
Fee Paid
TypeofConstruction: RENOVATIONS AND ADDIT N Il'1h
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 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
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.
Verstori Commercial Building Permit May 15,2000
Department use only
City of Northampton Status of Permit
Buildir IDepartment Curb Cut/Driveway Permit -
21. idain Street Sewer/Septic Availability
Room 100 WaterMell Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413587-1240 Fax 413-587-1272 PloySiterplans ' ,(
Other Specify
APPLICATION TO CONSTRUCT, EPAIR,-B _ E OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OF MILY DWELLING
SECTION 1-SITE INFORMATION
T
1.1 Property Address: ThisaecgontoM completed by oRlw
F82 Bridge Street ap ao lot / 7 9' Unit
Northampton, MA 01060 n,'T of FU6 own wsPECT10N8
%0RTH&%',1oN.wn01060'. Ovettay District
'eas SL'Darwot CB pleas:
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED 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 Anent:
.Laura Baker _ 30 Market Street Northampton,MA 01060
Name(Print) Current Mailing Address:_
(413) 586-585.5
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Oficial Use Only
completed by vernint applicant
1. Building $2,984,039.00 (a)Building Permit Fee
2. Electrical $602,603.00 (b)Estimated Total Cost of
Construction from 8
3. Plumbing $336,000.00 Building Permit Fee
4. Mechanical(HVAC) $514,240.00
5. Fire Protection
6. Total=(1 -21314t5) 2l. ba 1 Check Number /e7Cl C141,;io
This See6on For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Coming s oner/Inspector of Buildings Date B
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 1] Demolition El Repairs(] Additions )] Accessory Building
Exterior Alteration ❑ Existing Ground Sign❑ New Signa(] Roofing0 Change of Use❑ Other❑
Brief Description THREEON OF EFICINAL S TION OF exrsmm
NE5TORI GARAGES AND 15NEV AND.EW11 ITrHX[SNR w RTFI'ONL.FINISHED
Of Proposed Work: eNH.NaD Sw EATNw`�STGRvwooD FMMED RVDDINGCONTAINING,)ONITS OF
ORIURWERYI ITSFSREn1
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 ❑ 18 ❑
B Business 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H Hiah Hazard El3A ❑
1 Institutional ❑ i-1 ❑ 1-2 ❑ 1-3 ❑ 3B 101
M Mercantile ❑ 4 ❑
R Residential 0 R-1 ❑ R-2 0 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 EXJSTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group-. R2, B _ Proposetl Use Group: R2,B
Existing Hazard Index 780 CMR 34J'. _ _. Proposed Hazartl Index 780 CMR 34): ._ _-
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY.
Floor Area per Floor(sf)
ist .. _ _ _ 1>� _. 2,424
2oe 2E .. _. _ 4,989
31° _. . 3,d 4,930
4" _ 41, 4,808
Total Area(sf) Total Proposed New Construction(sf)
17,151
Total Height(ft) _. .
Total Height It 38
7.Water Supply(M.G.L.c.60,§56) 7.1 Flood Zone Information: M Sewage Disposal System:
Public +❑ Private ❑ Zone' _ Outside Flood Zoned Municipal ❑+ On site disposal system❑
Version L7 Commercial Building Permit May l5,2000
8. NORTHAWTON Z.ONDVO
Existing Proposed Required by Zoning
This rows m Is,rnol in by
Building Department
Lot Size 20,823 - 20,823
Frontage 99.49 99.49
Setbacks Front 18 10
Side L:36 R:22 L: 10 R: l0
Rear 102 20
Building Height 37.5 37.5
Bldg.Square Footage 9351 % ll
Open Space Footage
(Lot=a minus bldg&paved 15001 7200
atkin
#of Paricing Spaces 14,
Fill:
volume&Imatiov
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT 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 O
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 O , Date Issued:
C. Do any signs exist on the property? YES O NO 0
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 O
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 O NO O
IF YES,then a Northampton Ste"Water Management Permit from the DPW is required.
Versionl.7 Commercial Building Penult 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 Dale
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 Dale
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
I i
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable OO
Company Name'.
Responsible In Charge of Conshuction
Address
Signature Telephone
Versirri 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
I, 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 Data
I, as OwnerlAuthorized
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 OwnetlAgent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervise, Not Applicable ❑
Name of icanse Holder: William Darling _ _ _ CS072846
License Number
i.61 Breken_brid_ge St. P.O. Box 335 Palmer,-MA 0.1069 _ 04/28/2020
Morass Expiration Date
Signature ` Telephone
335- baYO
SECTION 13-WORKERS'COMPENSATION INSURANCE Ali(M.G.L.c.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affitlavit will result
in the denial of the issuance of the building pertn8.
Signed Affidavit Attached Yes Q No
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: $Zt ip(p �3/T�• ` 1
The debris will be transported by: /0CT
The debris will be received by: "� 1f 't1 zCV L14 . 41,/
Building permit number: /
Name of Permit Applicant "13 "D�LOIVLIS
Date Signaturj of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston, MA 02114-2017
www.mass.goP/dia
1VBarkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
ArvaliveratInformation Please Print Legibly
Name (eusiness/OrganizatioMndividua0: Western Builders
Address: 73 Pleasant Street
City/State/Zip: Granby, MA 01033 Phone#: 413-467-9171
Are you an employer^Check the appropriMu bar: Type of project(required):
1.E3Iamaemployerwith employees Hull imakor Incomes)." 7. ❑New construction
2.❑lam aaole proprietormparmership end have no emplovices working forme. $. ❑Remodeling
any capacity.[No workers'comp.commerce nquhN.]
3.OIamaMmeownttdxoingallworkeryself[Nowcr10comp.Insumncerequin l' 9. ❑'7 Demolition
4.E]I em a hoerrcownmid will be hiring conttnemrs to conduct all work on my property. I will l0 O Building addition
encres,that all contractors either have workixecoupereacon insurance or are sole 11.0 Electrical repairs or additions
proprietors withao employees. 12.ZPlumbing repairs or additions
5,M I am a general contractor and l have hired the subcontractors listed on the attached sbect
These mb,conex m s have employees and or
have workers'comp urua
Insel 13.Orapers
6.[]We are a eowemliml and its officers have exercised theirright of exemption per MGL c. 14.[:]Other
152,§I(4),and we have an aeployecs.(No workers'comp-iouumnce required.I
'Any applicant that checks No#1 mast also fill out the section below showing their workers'compensation pdky mterminator
t Homeowners who submit pis affidavit indicating they are doing all work and men hire outride conhactors must submit a new affidavit indicating such.
<C'onoactors pal check this box must attached an additional sheet showing the name of the subconbacmrs and state whether nut those entities have
employees. Ifere mbcontracmrs have employees,ley most provide their worken'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site
information
Insurance Company Name: Travelers Idemnity Co. of CT
Policy#or Self-ins.Lic.#: 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,p25A 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 under p ' e lues of perjury that the information provided above is nue and correct
Si nature: Date: .�
Ph #� 413-467-9171 V I KW%A A5o_m
Official use only. Do not write in this area,to be completed by city or town offuial.
City or Town: PernakfLicense#
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 M
A� CERTIFICATE OF LIABILITY INSURANCE DATE IMwom l
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 Ne certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to Ne terms and conditions of the policy,certain Policies may require an endorsement. A statement on
this certificate does not confer rights to the cariiRcate holder In lieu of such endorsement.).
PRODUCER CONTACT ME Mae S MOrxs
The Watts Group, LLC. PHONE FA%
65 La Salle Road (860) 231-7]50 x4 (S60) 231-7240
Suite 209 EMAIL xaeathewatte z
..at Hartford CT 06101
INSURE I AFFORDINGCOVERAGE NAICa
INSURERA:Chaitei Oak Fire Insurance Ca. 25615
INSURED INSURER RTravelers Prop Cas CO Of America 25674
western Builders, Inc.
Ix3U0.ER L:Steil Inderatity i Liability Co. 38318
73 Pleasant Street INSURERD:Travelers Indemnit Co. of CT. 25682
Steady MA 01033 INSURERE.American 4lecantee Insu[enCe CO. 26237
INSURERF: Steadfaat Insurance cospany 26387
COVERAGES CERTIFICATE NUMBER:cert In 1150 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 TYPEOFINSURAXCE Aun SURR POLICY NUMBER MMNDriYYW EFF MOLICVEXp LIMITS
A X COMMFACWLGENERALLIAMLIWEACH OCCURRENCE S 1,000,000
1.KENU CWMSMPLE O OCCUR CO-0P914T19 06/01/2018 06/01/2
019 —r $ 300,000
E XCO Included MED SAP IA,on $ 10,000
E MO Deductible PERSCUNM& VIUJURY $ 11000.000
C£NL AGGREGATE LIMIT APPUE6 PER GENERALAGGREGSTE $ 2,000,000
POLICY��j LOC PRODUCTS-COMP/OPAGG $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
B % MY ALTO 810-4$143465 D6/Dl/201806/01/2019 ARDILY BLURY(Px PIMA) $
OWNED SCHEDULED BOoav INJURY Fe,.1.11) 6
AUT06 ONLY AUTOS
HIRED NCNOWNED PROPERTY DAMAGE g
AUTOS.. AUTOS ONLY
C % UMBReLuwn Y OLLUR ID00585032191 04/01/2018 04/01/2019 EACH OCCURRENCE S 10,000,000
EXCESS WB LWE6-M.DE MORE. $ 10,000,000
OEO I E I RETEMION 10,000 4
WOAPESS COMPENSATION % PEF F.
D AND EMP LOYERS'LIABILIry YIN Da-6a2393DO O6/O1/]018 06/01/2019 ME OR
OFFLEIRS STOUREXCLUCROICM11 O NIA EL EACH ACCIDENT $ 1.000,OOD
(MagabyMNH) EL DISEASE EA EMPLOYEE S 1,000,000
If dart'".
DESCRIPTION OE OPERATIONS etlw, EL DIS FTSE-POucr uMrt $ l,ODO,DDO
B 2nd Layer OGlbrella ASC 9242691 09/01/201: D9/DS/2019A99regetee/ g $,000,000
P Professional / Pollution ECC 5'74436 05/15/2018 DS/15/2019 Pei Claim/Aggro9 to E $,000,000
Sts,000 deductibI
OVICUMPTION OFOPERAnONSI LOCAnpISIVEHOLES[ROUND 101,Assi-ol Ramvna Sin Mule,maY W Mnmed Nmonep.c.Ie nquIna
Ra: Sergeant House Project 82 Bridge Street, Northampton MA Certificate holder named additional
insured when required by written 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 Co® pity Development Corporation
Me. Laura Baker Esal aetete Project Naneger
3 MRZkst Stieat A/U,4TTHHOOAR[�USEDUREEPRRREESSEEN.TTATTIIV�E
Northampton MA 01060 • (I '
0198SH 015 ACORD CORPORATION. All rights reserved.
ACORD 25)2016103) The ACORD name and logo are registered marks of ACORD
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