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30C-053 (5) 119 CLEMENT ST BP-2021-0984 GIS#: _ COMMONWEALTH OF MASSACHUSETTS Map:Block:30C-053 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2021-0984 Project# JS-2021-001685 Est.Cost: $23600.00 Fee:$153.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: J C PRATT BUILDERS 061401 Lot Size(sq.ft.): 13764.96 Owner: BOND STEPHEN M&DEBORAH L Zoning: SR(100)/ Applicant: J C PRATT BUILDERS AT: 119 CLEMENT ST Applicant Address: Phone: Insurance: 43 MONTGOMERY RD (413) 568-4246 O WC SOUTHAMPTONMA01073 ISSUED ON:3/8/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:14X17 3 SEASON PORCH 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 Signatur;! r • 1 FeeTvpe: Date Paid: Amount: Building 3/8/2021 0:00:00 $153.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner The Commonwealth of Mas ch 0 FOR Board of Building Regulations and St MUNICIPALITY 41 Massachusetts State Building Cae,�780 Cl �Q�/ USE Building Permit Application To Construct,Repair;i4,• e Or Dem lish a" Revised Mar 2011 One-or Two-Family Dwelling..:?, ^,,�,�, Thi Section For Official Use Only °')o°Ns ' Building Permit Number: 6P"/3 / Foci Date Applied: ---..,, Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION , 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers //1 C1 ,,=)"1- `3oC.-o 3 00f _1.la Is this an accepted street?yes ✓ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: i c /376 fic? 20q Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 2La' L / 32 e ` R - 4.-ii ' iv ` , 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public fir- Private❑ Zone: — Outside Flood Zone? Municipal IZYOn site disposal system 0 Check if yes SECTION 2: PROPERTY OWNERSHIP' ' 2.1 Owner'of Record: s'fi-P i 6 ✓t yr\ • 2 c'0JvD DOS c)l d L Name(Print) City, State,ZIP )1 1 Geirwyl I Sl c) 3-$ T 7 6 1Vt✓h l'5-6/g cPrie ?la No.and Strut Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 i Alteration(s) 0 i Addition C— Demolition 0 Accessory Bldg. 0 Number of Units i Other 0 Specify: Brief Description of Proposed Work2: Ceiki=y,e,„wi: .vi,.) fr)F 4 i,-/y,.71 ::-; .. e_),,i ?r,tc • (.4.4 !rr- 0 r hisef, i/r Y,,,ei2 i w, c, Jr,xt.'rn SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ j i 2)4,c_ . . Building Permit Fee:$_ Indicate how fee is determined: 2.Electrical $ / 00•, 0 Standard City/Town Application Fee 11)❑Total Project Costa(Item 6)x multiplier_ x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fees:$ (�?� Check No. Check oun : '0 A' • Amount: 6.Total Project Cost: $ ?3, (' C "e:-"c"0 paid in Full 0 I ance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) / / 06-1 v o Z%j) ���' %'i �. /r:A-1—`,t'" License Number Expi 'on e Name of CSL Holder n List CSL Type(see below) A. No.and Street / Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) �t(¢ /t fl' �iL) / '{t•' C/0/ R Restricted 1&2 Family Dwelling CityTTown,State,ZIP Ir M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances t�, L- 7 - L/3 S,j I Insulation Telephone Email address D Demolition 5.2 Registered Home Improve gent Contractor(HIC) jExpiration - ' HIC Registration Number Exp'irat n Date HIC Company Name or HIC Registrant Name No.and Street f / U / Email address City/Town,State,ZIP Telephone SECTION 6: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 building permi. Signed Affidavit Attached? Yes 0 No 6":1" SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMI sst I,as Owner of the subject property,hereby authorize 'J T C to act on my behalf,in all matters relative to work authorized by this building permit application. 9:4 vx. , o is )__)-2---) 12.074 Print Owner's Name(Electronic Signature) Dat SECTION 7b:OWNER'OR 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 true and accurate to the best of my knowledge and understanding. j .1 PPS a /'�"r Print Owner's or Authorized'Agent's Name(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. I42A.Other important information on the HIC Program can be found at www.mass.2ov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) 9 3 S =y ' (including garage,finished basement/atti decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms 3 Number of bathrooms J 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 Project Cost" The Commonwealth of Massachusetts =_�,— Department of Industrial Accidents i _. 41'.r, 1 Congress Street,Suite 100 a.. ear _.. Boston,MA 02114-2017 www.mass.gov/dia 1%otters'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Piumhers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annlicant Information � Please Print Leitibls Name(Huskies+o ganization A- T/1• Lut',1 / A. Address: Lis Atzixtroz- eirtz,=-Ay City/State/Zip: 3 iv 4/4. (9!o73 Phone#: Lie- 5 7? L/3 y ---- -- _ Are yea tot esnpim er!Check the appropriate Aux: I Type of project tr --`red): I.Q lam a crnpkiyer with .... caayficoyees(full and•or part-timed.• 20 am a sole proprietor or partnership and have nuemployees wurkr any capacity.[Nu workers'comp.irwunince required.) 30 lam a homeowner sluing all wort myself.[No workers'camp.imo a. I am a homeowner and will be hirisrg ourrtracturs to conduct all w urk u that all cwuractun either have workers'compensation insister d ' ensre c"" F� ? addition, prtprretors with no employees. /� U addition 50 I am a gm-nil contractor and 1 has c lured the sub-t arntractors listed or 11) ,f These sob-euntracturs base employees and have workers'comp.insur. R/, It'rC"o b.D We are a corp oration and its officers have ex rcised their night of cxerroy Yr V t 1 t2..§Iti1.and w ur e base nu rluyen.[No workers'sump.insurance r j 11 •Any applicant that checks boa til meet also fill out the simian below showing t t Homeowners eowners tabu submit this affidavit indicating they arc doing all work and a cl:. :Contractors that check this box must attached an additional sheet showing the nu employees- lithe sub-contractors Have employers.they must provide their work‘ l am an employer that is providing workers'compensation insur ►e information. Insurance Company Name: -- — Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attack 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 anci•'or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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 the pains and penalties of perjury that the information provided above is true and correct Signature: >e2 F'"Li Date: //J-7/2---,/ Phone#: Official use only. Do not write in this area.to be completed by city or town ofcial City or Town: Permit/License# laming Avtkorih (circle one): 1. Board of Health 2. Building Department 3.('it}/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other ( ontait Person: Phone 4: 3c c - c2$3-00 .. t ,.n { - Zonin 1"_ — M , .., Zoning: Zoning:FFR Ir .�• f.. ' _ \ P,, { ,.,- \ I M.w L .". V U ..q , _11,J�_i; , —i Irti�" 1 4 Zoning:WSP - 1 1 i I y - t ; - .... �� rr a �.�..,,� i -1" / / Zoning: �, Imo_ -Zontna-SR _ — ning:SC %Northampton Zoning Map .'. � � � �T - `_ _ Map Sheet --------_---- -.._----------_------------'--"-- i\-I••I-1•IITT- City of Northampton aSMl1 T -. Massachusetts I '•I DEPARTMENT OF BUILDING INSPECTIONS r' 212 Main Street • Municipal Building �.'7 Northampton, MA 01060 r '. •, ��,c CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: r Location of Facility: 4 i L-i� y ,�c`y(„f, /t1 -,;, ;1//I The debris will be transported by: Name of Hauler: Ni ( , 1-A Signature of Applicant: Date: d- rZ di • 0 CUSTOMER + LIST COPY Date Entered: 2/sn021 Date Printed: 2/15/2021 QUOTATION #1445650 Printed By: Kevin Lewis S I MON TON SOLD TO: SHIP TO: Phone: Phone: Fax: P-0 f i q i S tt = N @ tt? CFt `tJSTR.Lt c-r/o/tj PO NUMBER QUOTE NAME PROJECT NAME JC Pratt Builders Unassigned Project Lineltem# Qty. Description List Price Unit Price Ext. Price 100-1 7 ProFinish Contractor Double Hung 44"X 62" $613.90 $488.14 $3,416.98 RO: Operation=Operating,Frame=Deluxe J-Channel, 44.5 x 62.5 Frame Modification=J-Channel Removed,Ext. Color=White,Int.Color=White,Glass Package= -_—- --— _-- Room ID: Energy Star Northern, ProSolar Sun Low E,Argon, — ,-, Custom Supercept,3/4"IGU, Glass Thickness= I/8 in- 1/8 -,'— out DS,Upper=Annealed.Lower=Annealed, �j Locks=2, White,Cam,Air Latches=2,Screen a a 1 lot 11 Coverage=Full,Fiberglass,Extruded, Screen Mullion=Yes,Grille Pattern=Colonial,Grille App Orr 5/8" Flat, White,3W2H,U-Factor=0.3,SHGC= 1 0.44,VT=0.53,STC=0,Meets Enemy Star Zones K a =Northern,DP=35,AAMA,TDI=WIN-833, — RC--S Florida Approval Code=5167 No )C-V zri vst bS . Initials: 7 Total Qty Units SUB-TOTAL: S3,416.98 TOTAL TAX: S213.56 Comment: TOTAL LABOR: $0.00 TOTAL: S3,630.54 DEPOSIT PAID: (S0.00) AMOUNT DUE: $3630.54 Submitted by: Accepted by: Date Page 1 Of 1 Quote#: 1445650 CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: /'3.7 4., REAR LOT DIMENSION: REAR YARD (e SIDE YARD /3 SIDE YARD Y � u i FRONT SETBACK - l D^ FRONTAGE , • , _ . 1 il . i 0 th II . 4 0 0 4 Z th 1 cz) Pt 1 t it4 i 'an t 0 NJ 0 \ Vat '6% 13 t . . • % . •,.. . . . . . g `'''7")ki,--4414.)c-- --c-k.._ . . 5. k>f--2, IP, % 4•At e"dt 01 Jo t-f-1,-- , ii \1 /2—ci 0.•C . .‘ , ....,,. , . . ..... ..., /7>V?A-AA V 0 - '; - -: • fla i ii ) z,,.._ ; . • VA 1 =-:,.,-,: . . I I% ''s .... 1)002,b 1 E_ h-- 4 . , • '4,-•;. 71k ......„.... . 1 1 a. • - i. . , r • h4s ....r. 1. /- 061-/-/ /6(1 ea) 6,v",15,'X -10'I Yb,w5 a I • THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED. BUILDING LOCATION ACCURACY IS NOT GUARANTEED • • __ �v c3m t_ \\ 3 Gd t 1" 11)4 vI U1 F cet- _VD #3oc-030-00( >> }I3C-O5i- 1 1 t09.��.' { , D TO: FLORENCE SAVINGS BANK & LAWYERS TITLE INSURANCE CORPORATION TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY # 250167 —NOTE— SURVEYOR • - THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY /mot oF ,�S —MORTGAGE LOAN INSPECTION PLAT- 4Oy NORTHAMPTON, MASSACHUSETTS 22 RANDALL TA\� PREPARED FOR STEPHEN M. & DEBORAH L. BOND #35032 J SCALE: 1 "=40 ' JULY 30 , 2003 \\'� surr - 1 HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET — HADLEY — MASSACHUSETTS -.)/ e-Ve I vE b ovAxt 3 so"� pa il as1 CLe.4€dV x r7 • L e e-, Ai* : n1(9'— PRATI JC. BUILDERS CONST.LIC. #061401 • REG.# 115419 : ..AoAr 1elF= to a �, gi7 -z- .4 -'4c--k I • 2 a4 li I — 4Pz-'� t,0 XGa `� b/� I �v 'poo A- I 4 43 Montgomery Road • Southampton,MA 01073 • Phone:(413)585-1627 J.C. PRATT BUILDERS 4 � .__ -_1 7�, ., -; 1/3 _ /3 CONST.LIC. #061401 • REG. # 115419 a X s R, Vef, 43 /Z- C<L L. 5 , Hi-1 4- 1 { i> it 43 Montgomery Road • Southampton,MA 01073 • Phone: (413)585-1627 .-,c.v�,rr'T a.ii- r.� ••••••v v� 6 — ( 1c 'S49 n; I ;tZG it1' L .-i tie-/i3" pi -.4 17 1-1-0.4 MA. iap-e__ LC. PRAT!' skotc... BUILDERS 4-3 57?-4137 ?i firi 6 �" CONST.LIC. #061401 • REG.# 115419 e " /2 c y as yy "tie. i ' 43 Montgomery Road • Southampton,MA 01073 • Phone: (413)585-1627 ion n, - U .4 6 vn.oC - sr a. 0 /1'4 GL. w34 -r 4 .0442— J.C. PRATT BUILDERS CONST.LIC. #061401 • REG. # 115419 rJ f' , ` S ( /�i y7ri0 yYi°.0 a b oo 2-- f rl? s ;4/ -4 14, s LP ' SL.._f ,1 140CSC-. 43 Montgomery Road • Southampton,MA 01073 • Phone: (413)585-1627 /i q 6 /rt Q .il 4 J+ b r`�Y -�C i L�6 Li • Fi-e4E-A , - J.C. PRATT 3 • BUILDERS CONST.LIC.#061401 • REG.# 115419 ;Z� 7 5 c l6 ilv %K 1- 02 )C itt, 91- S- y i Ia it C b k x 5 i/04 4 5tzli • 43 Montgomery Road • Southampton,MA 01073 • Phone: (413)585-1627 yoto. -Nrif • • 7ACORO® in ripDATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE \\. 0 211 912 0 21 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 the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 Barbara Van Mourik Finck&Perras Insurance Agency Inc. PHONE (413)527-5520 FAX (413)527-5970 (A/C,No,Ext): (A/C,No): ) 6 Campus Lane A°oRIEss: bvanmourik@finckandperras.com INSURER(S)AFFORDING COVERAGE NAIC# Easthampton MA 01027 INSURER A: Main Street America Assr Co 29939 INSURED INSURER B: J C PRATT BUILDERS INSURER C: 43 MONTGOMERY RD INSURER D: INSURER E: SOUTHAMPTON MA 01073-9597 INSURER F COVERAGES CERTIFICATE NUMBER: CL2121905404 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 ADULSUtfir POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INS° WVD POLICY NUMBER X COMMERCIAL GENERAL LIABILITY (MM/DD/YYYY) (MNUDD/Y'rYY) LIMITS EACH OCCURRENCE $ 500,000 DAMAGE TO REN rED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 500,000 MED EXP(Any one person) g 10,000 A MPP3061P 08/06/2020 08/06/2021 PERSONAL BADVIWURY g 500,000 GEN'LAGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY JEa LOC PRODUCTS-COMP/OP AGO $ 1,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE UMIT S (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATE S DED RETENTION$ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more apace is required) i rr ti' d CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Northamtpon ACCORDANCE WITH THE POLICY PROVISIONS. Building Inspector 212 Main Street#100 AUTHORIZED REPRESENTATIVE Northampton MA 01060 �x�9 � . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD