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24C-126 112 FRANKLIN ST BP-2020-0751 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24C- 126 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2020-0751 Proiect# JS-2020-001294 Est.Cost: $2000.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: KEITH DEVIN - TOTAL REMODELING & REPAIR 110285 Lot Size(sq.ft.): 6272.64 Owner: DAVIS R EUGENE&OLIVIA S ILANO-DAVIS Zoning: URB(100)/ Applicant. KEITH DEVIN - TOTAL REMODELING & REPAIR AT: 112 FRANKLIN ST Applicant Address: Phone: Insurance: 148 DOTY CIRCLE (413) 739-4333 WC WEST SPRINGFIELDMA01089 ISSUED ON.12/23/2019 0:00.00 TO PERFORM THE FOLLOWING WORK.-REMOVE AND REPLACE 3 WINDOWS 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 12/23/2019 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner v Tj m z� -j MO 0 X aw' a c The Commonwealth of Massachusetts >� zs Board of Building Regulations and Standards FOR z z Massachusetts State Building CodeO ,780 CMR MUNICIPALITY a USE o M m Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 o One-or Two Family Dwelling u+ •:. .:.....rc : y x„ Se ..en•D�>;1a1"C��e Onl` - ire .�.�.� ---- P7abe.Appli Signature ti J bate, .-16 SiZ'RTNFORMATIC)N — - - 1.1 Property Address: 1.2 Assessors Mp&Parcel Number L la is this an accepted street?yes_ _ no Map Number Parcel Nwnber 13 Zoning Information: 1.4 Property Dimensions: Zoning Diitr ct Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Bmlding Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zane: — Outside Flood Zone? Check if yes❑ Municipal❑ On site disposal system ❑ �rdb1b �� U �0 - Name(Print r h ► r _�� City,state Z P No.and Street Telephone Email Address 7 - $EO1�r :~ 6QIPTI© T;A$BItOP�SED'WOetI ) New Construction❑ Existing Building OwMer-Occapied ❑ Repairs(s) ❑ Alteration{s) ❑ Addition ❑ Demolition ❑ Accessory Bld ❑ Number of Units Other ❑ Specify Brief Description of posed Work- . ?VvrAioisiizvc-itivis . Item Estimated Costs: or and Materials ffda1 use....la 1.Building $ d� '1`$ni1 13erriiit Fee:: :; to ho-W fee'ts dg miffed: b Stanclatd Eitqown hP 2.Electrical $ PP 15— E 'total PiactlecC(1os13(Iteri#y6}xiter j x' 3.Plumbing $ 4.Mechanical (HVAC) $ 5.Mechanical (Fire Suppression) `x 6.Total Project Cost $ a C]ieel�Nn, Che¢ Aupxa -., Aimouut p.P�uc1 in Fu11 .p.¢)iitsta�adiitg Balauee SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor license(CSL) r' ` `� , 'n I,n wJv-., License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street - — Type Description K UU _ Unrestricted Buildin rs a to 35,000 cu.ft. Restricted I&2 Family�Dwellin ) City/Town,State,Z11' M Masonry RC Roofing Covering --- WS Window and Siding SF Solid Fuel Burning Appliances 1 Insulation Teleohone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) T4rNm�e ! I HIC Registration Number *xpiration Date `�C om any e or C.Registrant Name r `S?�andStre -- --- Email address CityiTown,State,ZIP Telephone _ SECTION 6: WORKERS' COMPENSAl ION 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 .......... ❑ No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize ` �) 'o `.d Ct G to act on my behalf, in all matters relative to work authorized by this building permit applicatio . Print Owner's Name(Electronic Signature) Date SECTION Tia: OWNER' AOR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is tru an accurate to ttl e t of my knowledge and understanding. v � Print Owner's or Authorized Agent'same(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work, or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC) Program), will not have access to the arbitration program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program can be found at www.rnass.i.Tov/oca Information on the Construction Supervisor License can be found at �\ww.111, 'ov/d s 2. When substantial work is planned,provide the information below: Total floor area (sq. ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms_ Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage" may be substituted for"Total Proj4ect Cost" TOTAL MODELING & REPAIR, LLD All home improvement contractors and subcontractors M #175790 e CT#637217 engaged in home improvement contracting, unless specifi- 144 Doty Gircle cally exempt from registration by Provisions of Chapter 142A est Springfield, MA 01089 of the general laws, must be registered with the Phone: 4 -437-8228 • Fax: 413-437-8241 Commonwealth of Massachusetts. Inquiries about registra- • t alremodelingandrepair.com ® tion and status should be made to the Director,. Home } Improvement Contract Registration, One Ashburton Place, Submitted ' �� ! �'? Room 1301, Boston, MA 02108 (617)727-8598 j :d' , JOB NAME Lj JOB LOCATION PHON ;f f; rf. ATE ff 7: 1' ,a r :'i ,l f ti rrf� !! ,' •' ESTIMATOR We hereby submit spa ications and ejstimates for work to be pefformed and materials to be used /• .. 1.+f f'j /e 1 ,: j)t }j') +t,r°i yC' �'' dpr'i �.1 .:'9+? +J s..%i� j/! ' ' „{- , �t. l + -j �I•l .n��`"f l• �j~1/�l !f/ ' f; ' , stf i , .....1r /�} ./ •r.!r ,,j' r!^5:1 % �! J. t. t. tf ! .% ''rl of.� ••_ , Do not do: Construction related permits: WORK CHEDI%LEF Cortiraggr vfill nqt begi he work or order the materials before the third day following the signing of this Agreement,unless specified'Jre)ei�l ontractor will begin the work on or about �,/_ ;�a ) (d.. ).Barring delay caused by circumstances beyond Contractor's control,the work will be completed by ,r% - (date).The Owner hereby acknowledges and agFeesgtliat the sch uling dates are approximate and that such delays that are not avoidable by the Contractor Including,b I notlj(nited to strikes,Acts of God,shortages of materi- als,acdiden)s,and all r delays beyond its control,shall not be considered as violations of this Agreement. WARRANTY / The Contractor warrant hat the work furnished hereunder shall be free from defects in materials and workmanship for a period of .r+�E!lt`° dllowing completion and shall comply with the requirements of is Agreement.In the event any defect in workmanship or materials,or damage caused by the Contractor,its subcontractors,employees or agents, discovered after completion of any i including cleanup,the Contractor shall,at its own expense,forthwith remedy,repair,correct,replace,or cause to be remedied,repaired or replaced,such dam- a e or such defect in m rials and workmanship.The foregoing warranti s shall survive any Inspection performed in connection with theagreed-upon work. We Propose her, y to furnish maer( I and labor complete in accordance with above specrflctions,for the sum of: ,+ j „ t; .4;/. ($ I I Payment to be made f follows: %($ 1'; .',' A )upon signing contract; TOTAL REMODELING & REPAIR. LLC 1, a r '' Name of Contractor/Designated Registrant %($ � ',' " )upon completion of / •%{P 4.a 144 DOTY CIRCLE F i Street Address iia($ `'%' -' )upon completion of i L dd> WEST SPRINGFIELD MA 01089 4Phone -4330 City/State Phone %($ )shall be made forthwith upon 175790 _ r 637217 completion of work under this contract. MA No. ` CT No. Name of Salesman !1 •rt�,' Y +"" !J CREDIT TYPE: MC AME VISA DIS EXP:_ Authorized Signature Notice: No agreeme or home improvement contracting work shall require a down payment(advance de sit)of more than one-third of the total contract price or the total amount of all de sits or payments which the contractor must make,in advance, to order and/or othe a obtain delivery of special order materials and equipment, whichever amo nt is ater. Acceptance of oposai: I have read both sides of this document and accept the prices, specifications and conditions stated. I under- stand that upon Hing,this proposal becomes a binding contract.You are authorized to do the work as specified..Payment will be made as outlined abov You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this tran action.See the separate notice of cancellation form for an explanation of this right. Piease refer to the Notice of Cancellation t t accompanies this contract; contents of which are referred to above and incorporated herein by reference. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature Date Signature Date The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 a wwiv.11t as,&gov1dki ' r v Workers'Compensation Insurance Affidavit: General Businesses. TO BE FILED wi,rwrliE P1;RM1'1"11NG AUTHORiTY. Avvlicant I nformation Please Print Le ibl i & twouBusiness/O anization Name CdP_,Item Address: r Q 21\ City/State/ p: { t l l �f� 'hone Are you an em foyer?Check-the appropriate box: Business Type (required): 1. I am a el iployer with employees (full and/ S. 0 Retail or part-t e),* 6. ❑Restaurant/Bar/Eating Establishment 2.[ I am a s e proprietor or partnership and have no 7. ❑Office and/or Sales (incl.real estate, auto,etc.) employe s working for Inc in any capacity. g C_i Non-profit [No wor ers' comp, insurance required] 3.77 We are corporation and its officers have exercised i 9. t j Entertainment . their rig of exemption per c. 152, §1(4),and we have I i 10.� Manufacturing no empl ees. [No workers' comp. insurance required]** 11.❑ Health Care 4.❑ We are non-profit organization,staffed by volunteers, with no nployecs. [No workers' comp. insurance req.] 12.01 Other *Any applicant that ecks hox#1 nuist also fill out the section below showing their worke s'compensation policy information. **if the corporate of cern have exempted themselves,but the corporation has other omployces,a workers'compensation policy is required and such an organization should eck box#1. I am an employ that is providing worAers'colll(t�1,pL'l�l5atlU1�7ylit,4t2`a1tCE'J�<SrJ"`.lily erllployces. Below is the policy information. Insurance Comp iy Name: :, i_. i IVA �l i E l� Insurer's Addres :0 a��i Irt�� tR �, .��k�20(�X QQq t. City/State/Zip: �- r 1 `Yl ��Dgq Policy#or Self s. Lic. # IJ.J Expiration Date: Attach a copy o the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure overage as requirea under Section 25A of Iv1GL c. 152 can lead to the imposition of criminal penalties of a .`'` fine up to 51,50 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 day against the violator. Be advised that a copy of this statement may be foiwvarded to the Office of Investigations o he DIA for insurance coverage verification. �Si ',erel3y L'eq, ZfitllBl't/2e 1f[L(Itti!!72[l/)L'12lllt/L'S U%[JL'3JlfP1 /�2Clt t12L'1/1�!)?I;tation Provided above is true and correct. nature: % / f Date: Phone#: Qfficia/Ilse o /y. Do flat mote in thi'area, :O he l:0111J)1,.'`0! by City ar io-wn offLial. City or Tows Permit/License;i Issuing Authi city(cirrie one): L 13oard ot'P >alth 2. Building lie-ar{me;.t 3. City/Token Clerk 4, L-^?nsing Boao'd 5.Selectmen's Office 6.Ot!ier Contact Pers n: Phone ww�c.mass.eov/din Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type: LLC TOTAL REMODELING&REPAIR,LLC. - _ Registration: 175790 144 DOTY CIRCLE " - Expiration: 01/10/2020 _�. - - WEST SPRINGFIELD,MA 01089 Update Address and Return Card. SCA 1 0 20M-05117 n�/u�parnirreo�suuealll 0�6%��aaaac�icraP,CLa Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid'.or individual use only TYPE:LLC before the expiration date. N found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 175790 01/10/2020 10 Park Plaza-Suite 5170 OTAL REMODELING-&REPAIR,LLC. Bost A 116 ROBERT TARIFF 144 DOTY CIRCLE u WEST SPRINGFIELD,MA 01089 of 4illid WlthGot Signature Undersecretary TOTAL-1 In CERTIFICATE OF LIABILITY INSURANCE D 05/02/201TE YY) 05/02/2019 THIS CERTIFIIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIRTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTAOR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificatenot confer rl hts to the certificate holder In lieu of such endorsement(s). PRODUCER 413-73 -5359 cT J Raymond Lussler Ins Agcy Inc J Raymond Lusss Agcy Inc P NE 413-737-5359 FAX 413-732-2027 181 Park Avenueo 8 IN,No Ext): (A/C,No): PO Box 499 Mss:In O USSIer nSUrance.COmWest Springfield01090-0499 J Raymond Lusss Agcy Inc IN9 RER 3 AFFORDING COVERAGE NAIC N INSURER A:Atlantic Casualty CO INSURED INSURERS:A.I.M. Mutual Ins.Co. Total (od�ling S epair LLC West Springfield,M 01089 INSURER C: INSURER D INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIF THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW rHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY lE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND NDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE 0 INSURANCE ADDL SUB POLIICCYYEFF POLICY EXP LIMBS LTR 1 D D POLICY NUMBER A X COMMERCIAL NERAL LIABILITY 1,000,000 EACH OCCURRENCE $ CLAIMS-M E �OCCUR L261002985 03/01/2019 03/0112020 DAMAGE TO RENTED $ 100,000 MED EXP An n person) 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE MIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 11 CT LOC PRODUCTS•COMP/OP AGG $ 2,000,000 OTHER: C $ AUTOMOBILE LIABIL Ea eBddeDtSINGLE LIMIT $ ANY AUTO BODILY INJURY(Parperson) $ OWNED SCHEDULED AUTOS ONLY AUTOSBODILY E BODILY INJURY Per accident $ AUTO ONLY AUTOS ONL� Per a ERJ.Y AMAGE $ $ UMBRELLA LIA OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS•MADE AGGREGATE S DED R NTION$ $ B WORKERS COMPENS ION PERTUTr OTH- AND EMPLOYERS'LI ILITY TA 2AWC-400-7036250-2019A 03/01/2019 03/0112020 FIR 100,000 ANY PROPRIETOR/PA NER)EXECUTIVE YIN E.L.EACH ACCIDENT $ OFFICER/MEMBER EX UDEO? N/A 100,000 (Mandatory in tJH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OP ATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATI S f LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLE R CANCELLATION CUSTOME SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHO RIZED/REPRRESENTATIV E ACORD 25(2016/03) /©1988-(2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DEBRIS DISPOSAL AFFIDAVIT In iccordance with the provisions of M.G.L. c. 40, s. 54, Building Permit # was issued with the condition that all debris resulting fr this work shall be disposed of in a properly licensed solid waste dis gosal fa ility as defined by M.G.L c. 111 s. 150A. T debris will be disposed of in: S�Pr I n Name of Vaste Facility I I�Y1 d(e n V-d nGQ-H" O-T cam Address of Waste Facility 111.5 Debris: As a condition of issuing a permit for the demolition, renovation, rehabilitation or other alteration of a building or structure, M.G.L.c.40 s.54 requires that the debris resulting therefrom shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L.c. 111 s. 150 A.Signature of the permit applicant, date and number of the building permit to be issued shall be indicated on a form provided by the Building Department and attached to the office copy of the building permit retained by the Building Department.If the debris will not be disposed of as indicated, the holder of the permit shall notify the building official, in writing,as to the location where the debris will be disposed. 780 CMR—6th Edition Signature of Permit Applicant �e ttpljG Date MasS."AlLISPtM Department aP Nuhiic oafuty . Board ofi Buiiding Reg ulatiods.arid Standards License: CS-110285 .construction Supervisl3r KEITH W DEVIN 3134 MOUNTAIN ROAD WEST SUFFIELD CT 06093 0110912020