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32A-178 (6)
82 BRIDGE ST BP-2019-1075 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block;32A- 179 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Category:New Multi-Family Housing BUILDING PERMIT Permit# BP-2019-1075 Project# JS-2019-001744 Est.Cost:$4436882.00 Fec:$10291.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor.- License: Use Group: WESTERN BUILDERS INC 072840 Lot Size(su. Rl: 20908.80 Owner: VALLEY COMMUNITY DEV CORP Zoning:URC(100y Applicant. WESTERN BUILDERS INC AT. 82 BRIDGE ST Applicant Address: Phone. Insurance. P O BOX 587 (413)467-9171 Workers Compensation GRANBYMA01033 ISSUED ON:4/79/2019 0:00:00 TO PERFORM THE FOLLOWING WORK RENOVATIONS AND ADDITION - ` phased approvals 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: 001: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. r/ 12op utif/v Certificate of Occupancy signature: FeeTYpe: Date Paid: Amount: Building 4/1920190:00:00 $10291.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019.1075 �' t APPLICANT/CONTACT PERSON WESTERN BUILDERS INC ADDRESS/PHONE P O BOX 587 GRANBY (413)467-9171 (] PROPERTY LOCATION 82 BRIDGE ST P 1 MAP,3,2A PARCEL 178 001 ZONE URC(100V THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST EN REQUIRED DATE ZONING RM OUT Fee Paid Building Permit Filled out F id e f Construction, RENOVATIONS AND ADD 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 inning 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 Stags of Permit Buildil 1 Department Curb Cut/Driveway Perms 21, Main Street Sewer/Septic Availability Room 100 WaterANell Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Oyler Specify APPLICATION TO CONSTRUCT,REEi EOR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OF MILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address: This section to be completed by office X82 Bridge Street x, ep aAA Lot ( 7 � unit Northampton,MA 01060 DEPT OF nUILDING INSPEC NORTHAMPTON.MA01 Overlay District Ii]m Slbisbtct CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Valley Community Development Corp. 30 Market Street Northampton,MA 01060 Name(Pong Current Mailing Address: 1586-5855 _ Signature Telephone 2.2 Authorized Agent: Laura Baker _ 30 Market Street Northampton, MA 01060 I Name(Pring) Current Mailing Address: (413) 586-5855 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by parmt applicant t. Building $2,984,039.00 (a)Building Permd Fee 2. Electrical $602,603.00 (b)Estimated Total Cost of Construction from B 3. Plumbing $336,000.00 Building Permit Fes all 4. Mechanical(HVAC) $514,240.00 5. Fire Protection _ _ _ _ __ "-'- ' -- - - — 6. Total=(1 +2+3+4+5) dD I Check Number This Section For Official Use Only Building Peri[Number Date Issued Signature: Building Commissbrwr/Inspector of Buildings Date Z;nal ' `u4lle14Cv4tY4 �uIll o�yg� . CD Versionl.7 Commercial Building Permit May 15,2000 SECTION4,CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs 0 Demolition El RepainO Addition; (] Accessory Building Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑+ Roofing El Change of Use❑ Other ❑ Brief Description emriwc oemoumN OFEXIi.INLTWO smee ADDITION WNFOLITION OF FAnrnr. nEFsroxy AnmwN.FM Of Proposed Work: EFn:ni NIU EAeTMREi.sTT Ywao Fueneunww; NTAmrvc,i,M,..oF Fo LExaou .,ivnx -uArroxo`a. SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ to ❑ A-4 ❑ A-5 ❑ 10 ❑ B Business El 2A ❑ E Educational ❑ 28 I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hiah Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ I-2 ❑ 1-3 ❑ 3B El M Mercantile ❑ 4 ❑ R Residential ❑+ R-1 ❑ R-2 ❑� R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 58 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 R2,13 Existing Hazard Index 780 CMR 34): ...._ __ Proposed Hazard Index 780 CMR 34): .. SECTION 8 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(so _. __._______ _—. in t__ 2,424 1. 2n° — — --- — 2n0 - 4,989 3" 3 4,930 0 . . _.. . qe .4,-808 Total Area(so - Total Proposed New Construction(so 17,151 Total Height(ft) - - -- - Total Height It 38 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑+ Private ❑ Zone Outside Flood ZoneEj Municipal o On site disposal system[] Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTONZONBVG Ii isling Proposed Required by Zoning This column m be filled N by Building Depamnmr Lot Sin 20,823 20,823 Frontage 99.49 99.49 Setbacks From 18 10 Side L:36 R:22 _ L: 10 R: 10 Rear 102 20 Building Height 37.5 37.5 E quare Footage 9351 % 1716pace Footage % maim bldg&pavod 1508 7200 #of Parking Spaces 14_ Fill: vohuve a Locatiov 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: I 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 O IF YES, describe siu, 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(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 Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,20D0 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 178 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 Englnaerts): Name Area of Responsibility Address Registration Number Signature Telephone Eviration Dale 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 Data 9.3 General Contractor Not Applicable Comparry,Name: L... Responsible In Charge of Construction Address Signature Telephone 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 O No O SECTION II -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 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 Name _ Signature of OvmerlAgent Dale SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: William Darling _ CS072840 License Number 61 Brekenbridge St. P.O. Bo_x 335 Palmer,MA 01069 04/28/2020 Address Expiration Dale Signature,.. Telephone 33S- ba`l0 SECTION 13-WORKERS'COMPENSATION INSURANCE AF DAVIT(M.G.L.e.152,S 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provitle this affitlava will result in the denial of the issuance of the building permit Signed Affidavit Attached Yes (D No O 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: aZe 1 DC e 51 • 1 ' The debris will be transported by: �S�2wC. NF%ULC40 The debris will be received by: //(/�s [ei//'/tea Building permit number: ( +� Name of Permit Applicant W.E` 0 16�UD6t..5 Date Signatur of Permit Applicant The Commonwealth of Massachusetts Department of IndustrialAccidents I Congress Street,Suite 100 Boston,MA 01114-1017 wwwmass.govldia WWorkers'Compensation Insurance Affidavit:BuiMers/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Tare(BusinessOrganiaation/ ndividush: Western Builders Address: 73 Pleasant Street City/State/Zip: Granby,MA 01033 Phone#: 413-467-9171 Areym an eraployer?Clerk the apprepdne hoe: Type project(required): L�lunaemployer with employees lfullmWar lsan-time)." 1 7. ❑New construction 2.❑l mawleprop6cwrmputrwrshipmdovenoemployeeswoddng Norman 8. QRemodeling aoy capacity.(No workers wrap.insurance require.] 3❑Iaura Mmeowmr doiall w ng ork myself[No woMs'wmp.imurarce neuhed.l' 9. ❑O Demolition 4.❑Itea homeowner and wM ill hirinws we g contracrcomtall work m my prom py. l will 10❑d Building addition ensure that all cmwctors either have wmkns'wmcemmion insurance or are sok 11.©Electrical repairs or additions proprietors wiN To employees. 12.©Plumbing repairs or additions 5.0 1 per a general mntratthose e I hav<hhe the rub<ol,co'ora listed on Ne anach<d shat. 13,ORoof repairs These subcontractors have empbyec and have wokers'wrap.msurarce. 6.❑W'e area onearanon and in osicers have eaereved Neh right ofeacmplion per MGL c. 14.❑Other 152,§1141,ae we have on cmployeas.(Nowahers'wrap.wumncens,dred.] .Any applicant not checks boa al most also fill out the section below showing their workers'compmsvion policy int tion. 'llmneownem who submit Nis affidavit indicating they are&.1.11 work and then hire outride eonhactors most submit a new amdavh indicating such. tContracsors that check Nis baa must atta lad m additional sheet showing the name of Ne subcontractors and sate whether or not those entities have empluyees. Irthe subwno-actors have employtts,they must provide Nair workers'camp.pdicy number. I am an employer that is providing workers'monpensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Trevelers Idemnily Co. of CT Policy#or Self-ins.Lia#: UB-6K239300 Expiration Data 6/12019 Job Site Address: 82 Bridge Street City/Statc/Zip:Northampkal 01060 Attach a copy of the workers'compensation policy declaration page(showing the policy number mod 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 underpins a des ofperjury that the information provided above is nue and correct. Si nature: Date: 3 ) Phone 4: 413-467-9171 Mw%A AV- oyL 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.Budding Department 3.Citylfown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: AC& CERTIFICATE OF LIABILITY INSURANCE °"11/09/3015 vv/Oa/xove 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. TRIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUMORu x:D REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N Me GnM holder Is an ADDITIONAL INSURED,Me pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the tarrrM and Conditions of the policy,certain policies may require an endorsement. A statement on this urfMcate does not center rights to the unmcate holder In lieu of auch endomemen s. PRODUCER c°xT w11u. S Haas. The Matt. Group, LLC. 65 Le Bale Road PrwRE 0601 111-7110 z6 FAIT (860) 231-7140 Suite 109 BMAa reNthwates gop. w Mut Hartford CI 06107 S CW9R@Make _ INSURER.:Charter Oak lire Incur C. Co. 25615 INSURID INSURER :Travelers PI. Cu Co of AMe[10a 15674 Nestern Builders, Inc. Iuueea C:80¢r ludernity . Liability Ce. le)le 73 Pleasant Strut INSURERO:Trawlers In ity Co. of Cf. 25612 G[aoEy MA 01033 INSURERE:Wrlese Wa[antee Ineu[anee CO. 16137 WSURERF: BbN1Ut INY[aOC. COMPREFY 2r. COVERAGES CERTIFICATE NUMBER:Cert ID 1150 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FDR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF MY 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 MY HAVE BEEN REDUCED BY PMD CLNMS. NIR TYPE OF INSURANCE POIICY NUMBER POLM:YEfP PG1CY Em LBMIB I CawmClu GErEnuwauTF F HOcaRRD10E f 11000,000 CWMSMI,CE OOCCLR ro-TP914T19 06/01/2011 06/01/2019 f 300,000 X SCD Included MEDUP 6 10 000 X No Deductible PERWNAL.IDJ InILRr f 2,000,000 OB3M1M TEgW�RMROPFIe GEFBUL.GGPEGME 2,000,000 FGMDY o,ECr ❑LOC PRODUCTS-CAHOP 5 2,000,000 f AYIOYOeLILWYIY NFD f 1,000,000 B x AAYAUTO e10-4u161665 06/01/2018 06/01/2019 BODILY INRIHY(Pw P.Om) f ANOVAO Y AUTO, D BODILYINIURY(PMKaGnO $ HIRED IKRO'M® PISO CTYOVAHg f AUTOS ADIOS ONLY f C I UMBRELL 1 OCWa 1000595032181 04/01/201804/01/x019 FAbrpCCIHREiYE f 10,000,000 ...WB CVRRLWIE IDfAEGSTE f 20,000,000 DEO I N I RETEM 10,000 D WORRERSCOMPENSATIDN 1 AND EMPLOYERS LIABILITY YIN °8-66]]9300 06/01/x011 D6/01/x019 ANYPROPRETORPAATNER£XECUIIYE ELF HILCDEM ! 11000,000 CFF ICE QIMSERE.LUDED, O MIA IMnaMay In an EL pBH6E-FAFWO $ 11000,000 wn CYF,'-GMM DCRIPTCNOPOPERATMX69NM EL DNFA4E-PoIA,Y WII f 11000,000 B Ind Layer CmDrelle ARC 916x691 04/01/x011 04/01/x01!Deeu ../ 6 5,000.000 Aggrega. 9 Professional / Pollution IOC SST6636 05/15/1018 05/l5/1019 .ARS 0°0 d1Guvtlhlte B 5,000,000 OEBpVNOMDF MEMTMRS project 82F Brid IACDRDeet, North- too tifica Mmnlde Mle01M0I es: e.rq.ast Bouui project it eriage contract. NOrehaTgem M. Certificate Bolder ndd aaditiemal in.Mree NN required by rriteas emeuee. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Valley Ca ity Dev.lepeant CoMoratlen ACCORDANCE WITH THE POLICY PROVISIONS. Mar. Lura Baker Real estate Project Manage[ 30 w[ket Street AUTHDRGEDREEPIRREEME.NTTATYE Northae,ton M 01060 `() ®1988-3015 ACORD CORPORATION. All rights reserved. ACORD 25(207&03) The ACORD name and logo are registered marks of ACORD Page 1 pf 1