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31A-333
20 MAYNARD RD BP-2021-1271 GIS#: _ COMMONWEALTH OF MASSACHUSETTS Map:Block:31A-333 CITY OF NORTHAMPTON Lot:- PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New Single Family House BUILDING PERMIT Permit# BP-2021-1271 Project# JS-2021-002107 Est.Cost:$602000.00 Fee:$1498.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: TIM STOKES 083602 Lot Size(sq. ft.): Owner: SEXTON MARTIN Zoning: Applicant: TIM STOKES AT: 20 MAYNARD RD Applicant Address: Phone: Insurance: 20 TURKEY HILL RD (413) 695-2264 () WESTHAMPTONMA01027 ISSUED ON:5/11/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:NEW SINGLE FAMILY HOUSE 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:, 2 TO • , • , FeeTvpe: Date Paid: Amount: Building 5/11/2021 0:00:00 $1498.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Z -C3K File#BP-2021-1271 APPLICANT/CONTACT PERSON TIM STOKES ADDRESS/PHONE 20 TURKEY HILL RD WESTHAMPTON (413)695-2264 Q PROPERTY LOCATION 20 MAYNARD RD MAP 31A PARCEL 333 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSE QUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 11� Fee Paid \1 Typeof Construction: NEW SINGLE FAMILY HOUSE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 083602 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: X 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 t / "ii `I/ leOP I ture of Building Official Irb 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. ,� i IW L U�� k L P & C\ 4,o /L The Commonwealth of Mass setts 9 0 . Vi. Board of Building Regulations ap rds 0 FOR Massachusetts State Building Code;: "CIPALITY • 'r USE 2" �� - Building Permit Application To Construct,Repair,R t Demol- a .'evised Mar 2011 One-or Two-Family Dwelling Ayqc,"%'CT This Section For Official Use Only �4,9 Building Permit Number: ep.-2./•/� 7/ Date Applied: \�/ / Q ' -/)I a, Building Official(Print Name) Signature [aQte SECTION 1:SITE INFORMATION 1.1 0 operty Address: 1.2 sess s Map&Parcel Number3 3 1.1 a Is this an accepted street?yes ')< no Map Number ber Parcel Number 1.3 Zoning Informa ' / 1.4 Property Dimensions: U12- 3 \ I 6zcx) 6l. 7 ? 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 lot (o' str, '-� C L Z© 7.0 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: PublicL() Private 0 Zone: _ Outside Flood Zone? Municip04 On site disposal system 0 Check if y SECTION 2: PROPERTY OWNERSHIP' KikOwneNrI of Re ord: 11 vaki4...ieurzSexpri 0.1_64.144stivkitkcq v\A.4 ej 10 66 Name(Print) j� ,� -+� City,State,ZIP C� -+r / d -7 P146,/ 4-r ZV \9 l-t/ �f1�U, 1 zD•3-z4° - J32 / L(6-d 1� F 1® ( No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction$ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Bne Description of Proposed Work': "stli5V S 1511..0,‘ "Ftilvt7 '15' Vve--- r. •ik' '61-1019 (P140i SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 5 2 5 D 0 a I. Building Permit Fee: $ Indicate how fee is determined: 1 0 Standard City/Town Application Fee 2.Electrical $ 371 DO D ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ M1 0o O 2. Other Fees: $ 4.Mechanical (HVAC) $ Z-1 i PO O List: 5.Mechanical (Fire $ Suppression) )Total All Fees,;. Q� ils Check No Check Amount: \, ' Cash Amount: 6.Total Project Cost: $ QZ'U 0 ❑Paid in Full 0 Outstanding Balance Due: The Commonwealth of:Massachusetts Department of Industrial Accidents • u -i __ 1 Congress Street,Suite 100 ``, Boston. MA 02114-2017 www:mass.gov/dia 1lpikers'Compensation Insurance Affidavit:Builders/ContractorsfEkctriciansfPlumbers. TO BE FILED WITH THE PERMUTING Al'1'HORICl. Applicant Information Please Print Legibly Name I Business'Organization:individual►: )i‘Aifil o � Address: 26 l U K-�' +t1(�l� City,State/Zip:W61 OZ7_ Phone#: �3 to /S 7 161' Are yur an mini/nee'Check the appropriate hot: Type.1 project(required): LEI I am a emplol er math employees(full endue part-time i' 7. New construction 201 am if sole proprietor or partnership and have no employees working for nu:in N. ❑Remodeling any capacity [No mortice':ornp.insurance mooed.) 9_ ❑Demolition t.o I am a humoowncr doing all work myself.[Ado woekeas'comp.itburana.e mowed.)' l 0 Q Building addition 4.0 I am a homer ace and w ill he hiring anatractors to conduit all work on my property. I will censure that all Lontracturs either have waken eoanpennatum msuranix or are Nude 1 I.o Electrical repatn or additions prupnetor,w ith nu cinpluyces i I__O Plumbing repairs or additions !..0lam a general cunUactur and I base hated the sob-contractors listed on the attached Meet These so or sub-contractors base employees and has a wkers'comp.insurance.; 13❑Roof repairs 6.Q We an a corporation and exemplum offieen hase exercised their nght exemplum per At(,L c 14.0 Othet I:‘2. 1141.and we ha%e no cmpluyees.[No murkcn'emrnp insurance required.[ 'Any applicant that chocks box at must also till out the section below showing their worker.'compensation policy information. •i nneuwnrn who submit this atlida%it indicating they are doing all work and then hare outside contractors must submit a new aili.las it indicating such. :Contractors that check this box must alt.-led an additional sheet show rn:the name of the sub-:cmtraetucs and state w tether or not those ntitie,lws: employees If the sub-contractors base cuiplo+eeh.they must prams ide their workers'comp.polies number I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: _ Job Site Address: Cityr'State:Zip: Attach a copy of the workers'compensation polky 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 tine up to S I.500.00 and or one-year impnsonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 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. do hereby certifyaleder the x n and tirraf perjury that the information provided bone true and correct Signature: Date if 707/ Phone>:: 4 3 695 `Zb Official use onir. Do not write in this area,to be completed by city or town official City or-Toss n: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Tows Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: • City of Northampton ,%jOp.t HAMPro 5 S Massachusetts ��5. /cc; DEPARTMENT OF BUILDING INSPECTIONS Z ® M 212 Main Street • Municipal Building vti OD Northampton, MA 01060 sfh. 7�^� 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: Location of Facility: The debris will be transported by: Name of Hauler: -44b-161-iS \I GIL IGt/1 Signature of Applicant: Date: 'l -u17 1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDmrY) 04/21/2021 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 Elizabeth Carballo,CISR,CPIA NAME: Finck&Perras Insurance Agency Inc. PHONE .Edt: (413)527-5520 ( No):FAX (413)527-5970 6 Campus Lane E-MAIL bcarballo@finckandperras.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC A Easthampton MA 01027 INSURER A: Russell Bond INSURED INSURER B Timothy Stokes,DBA:ACME Design INSURER C: 20 Turkey Hill Rd INSURER D: INSURER E Westhampton MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2142105518 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. LTRINSR IA SD 5WVD POLICY NUMBER POLICYUBR EFF POLICY YT LIMITS TYPE OF INSURANCE ( OYEFF (POLICY EXP YY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENI CLAIMS-MADE I' OCCUR PREMISESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A VBA784122 11/26/2020 11/26/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY n jE 7 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - OWNED SCHEDULED BODILY INJURY(Per accident) $ - AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ - EXCESS LIAB CLAIMS-MADE AGGREGATE •$ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Coverage 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. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 117 Commonwealth of Massachusetts Division of Pr Board of BuildingRPessronal Licensure gulations and Standards Cons� tiQ�t`�tt, �yisor CS-083602 � � Expires: 02/06/2023 TIMOTHY C STOKES 20 TURKEY HILL RD WES THA MPTONy MA 01027 Ar Commissioner " Fly // /J-,14.9/ !/i r-//:, Office of Consumer Affairs & Business Regulation HOME IMPROVEMENT CONTRACTOR • TYPE: Individual Registration Expiration 175925 06/19/2021 TIMOTHY STOKES TIMOTHY C. STOKES 20 TURKEY HILL RD (i�r..,f G� l WESTHAMPTON, MA 01027 Undersecretary Mo,^ CITY OF NORTHAMPTON,MASSACHUSETTS "s?. DEPARTMENT OF PUBLIC WORKS Trench Permit Number: �), 125 Locust Street C *' Northampton.MA 01060 Date Approved: _ tfa 413-587-1570 Expiration Date: -;' Fax 413-587-1576 (for City Use Only) EXCAVATION/TRENCH PERMIT Pursuant to G.L.c.82A and 520 CMR 14.00 et seq.(as amended) This permit must be priorfully completed to consideration.Submit01060.permit t fee to Northampton Department of PublWork � l5Locust Street,Northampton,MA This permit is issued under the provisions of M.G.L.c.82A,520 CMR 14.00 and applicable sections of the Revised Ordinances of the City of Northampton,including,but not limited to,Section 285-21. Fee:$250 Check#: Date Issued: Name of Applicant Primary Phone# 1 IMA —��s .0 ^ 6ct - z-z64 Street Addres Emergency Phone# 7C TklW 11ti .o it —6416— 6zg6 City/Town State Zip Email V - likA4 Q 10 ! f:co kr 1 i LiO tilt . Cf L i.M1 Name of Ex valor Primary Phone# 1-0 Vert ''X day 4 --s cci '730I. Street Address Emergency Phone# Z36 s> 01,1Z- �t3 6°► 5 7305 City/Town State Zip Email (l�}t5�- I YYI dial Lov'31p C It i 1L,Co+M Name of Prope Owner(s) Primary P one# nolgrok 4 Ga0 ,&�-} �X a" t ZO3- Z ( - 1 t'7 Street Address Emergency Phone# z o t1 k y-,a->ZI) �d Ar a 20. -- Z4q — °I "2-`7 City/Town ! State Zip Email 1\6 t4A- ()C60 C€oRcv4Iiii i® Pi AG,cavh Insurance Certificate# Policy Expiration Date Name&Contact Information of Insurer Dig Safe#&Start Date from Dig Safe o Ticket: 4)z u ( �OZ (- 'Go'bt7 Project Description/Location of Work.Provide the following: %Description of purpose and exact location of proposed work including description of what is to be laid or repaired in the proposed trench(e.g. water pipe,sewer pipe,drain pipe,gas line, power line,communication lines,etc.) ❑Sketch or drawing showing all proposed work. ❑Anticipated Start of Work Date. Description: a S 1"1—F cfc. $"'t 4-( -1 GO ., Co- .ucmo o r kbw1 SciAkt,t - F-A-AA\L / t26 j10 tc.‘ km to hv.Jl�1�r-1�S1,0 '�E 9O o i\E J ?ov7\042P kC ) }Mtiniti�f # '\ ) U"C+L o CRI034S / .1 . . , ., Check if applicable: • Emergency Work on Private Property Work in Public Right of Way Work within State Layout(attach State Permit) ❑ Work within 50'of a Public Shade Tree(see attached Public Shade Tree Regulations) ❑ Tree removal required(see attached Public Shade Tree Regulations) ❑ Tree protection,trimming,or root pruning required(see attached Public Shade Tree Regulations) ❑ Work within 100'of a wetland or 200 Ft.of a stream or river (attach Permit) ❑ Work within floodplain (attach permit) °Public Water/Sewer/Drain Entry Permit(attach permit,if available) kig Driveway Permit(attach permit,if available) ❑ Pole and Wire Petition(attach approval) Po 2/4 By signing this form,the applicant,owner and excavator all acknowledge and certify that they are familiar with, or, before commencement of the work, will become familiar with, all laws and regulations applicable to work proposed,including OSHA regulations,M.G.L.c.82a,520 CMR 14.00 et seq.,and any applicable municipal ordinances,by-laws and regulations,and they covenant and agree that all work done under the permit issued for such work will comply therewith in all respects and with the conditions set forth below. The undersigned owner authorizes the applicant to apply for the permit and authorizes persons duly appointed by the municipality to enter upon the property to monitor and inspect the work for conformity with the conditions attached hereto and the laws and regulations governing such work for the duration of the construction. The undersigned applicant,owner and excavator agree jointly and severally to reimburse the municipality for any costs and expenses incurred by the municipality in connection with this permit and the work conducted thereunder, including but not limited to enforcing the requirements of state law and conditions of this permit,inspections made to assure compliance therewith,and measures taken by the municipality to protect the public where the applicant, owner or excavator has failed to comply therewith, including police details and other remedial measures deemed necessary by the municipality. The undersigned applicant,owner and excavator agree jointly and severally to defend, indemnify, and hold harmless the municipality and all of its agents and employees from any and all liability, causes or action,costs and expenses resulting from or arising out of any injury,death,loss or damage to any person or property during the work conducted under this permit. By signing this form,the applicant,owner and excavator acknowledge that they have read and understand all the information set forth in and referenced within this application package and that they agree to comply in all respects with the requirements therein. 7.----17- _..----17"—±---- 1/1 /Z0 / pplican Dat 4 1 / Z.1 Exca tor igna (if different) Date O Zi Owner Signature(i ifferent) Date I o he completed‘s hen approved permit is nicked un. By signing bet , applicant acknowledges and agrees to all the conditions of approval stated below and valid this permit. 7-6 74 4 -pplicant Date For City Use—Do not write in this s tion Department Approvals/Comment Water: Sewer/Storm Drain: FPC: Streets: • Traffic Signals: ❑ Subject to 5-yr.pavement moratorium Road last paved: ❑ Special Conditions: Fee ❑ S250 Permit Application received(Check payable to the City of Northampton) ❑ Waived. Reason: ❑Tree mitigation: Permit Approval Director of Public Works Date Pg.4/4 MUNICIPAL SEWER AVAILABILITY APPLICATION Northampton Streets Department Director 125 Locust Street Northampton,MA 01060 413-587-1570 A Department of Public Works Trench Permit and Sewer Entry Permit shall be required prior to any construction or connection activity associated with this application. Location: 20 MAYNARD ROAD Date of Inquiry: 04/22/21 Inquirer with contact info: STOKES and COMPANY TIM 695-6266 Reason for Request: NEW CONSTRUCTION SINGLE FAMILY HOME Municipal Sewer Main in Front of Location: Yes X No Size of Sewer Main: 8" Material: VC Age: 1931 Depth of Sewer Main: 4'6" Length of Sewer Main: 227' Size of Service Connection: 6" Type of Service Connection: New to Main. Domestic Tie In: X ($1,250) Subdivision Tie In: ($2,500) Tie-in to Existing Sanitary Service: ($1,250) Comments:New Service to Main. City Requires 6"cleanout installed at City Property Line A corresponding"sewer entrance fee"shall be paid prior to making any connection to the municipal sewer system.Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notificaiton. All work shall conform to Northampton Streets Department specifications. Brendan Shea Date: 4/28/21 Sewer Dept.Foreman *Sewer Entry$ 1250.00 *Fees will be charged based on current fee structure at the time of entry application If this availability is for new construction,it must be submitted electronically or mailed to the Building Inspector. MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department Director 237 Prospect St. Northampton,MA 01060 413-587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 20 MAYNARD ROAD Inquiry Made By: STOKES and COMPANY TIM 695-6266 (Name) (Telephone Number) Date of Inquiry: 4/22/21 Fire Line Irrigation Domestic X Number of Units: 1 Type of Units: Type of Ownership: Single Family X Private X Apartments Condo Multi-Family Rental Commercial (Applicant to fill out the above) Municipal Water Main in Front of Location: Yes X No Existing service to site? Yes No X Size of Water Main: 6" Material: Cast Iron Age: 1922 Approximate Static Street Pressure: 100 psi Flow Test Conducted: Yes No x (If flow test conducted attach results) Size of Service Connection: 1" Suggested Meter Size: 5/8" Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320' - A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. -Arrangement of such installation shall be made with the Northampton Water Department within a minimum of 5 working days notification. -All work shall conform to Northampton Water Department specifications. David Sparks 4/23/21 (Water Superintendent) (Date) *Water Entry x ($1,250)Domestic *Meter $ 450 *Radio Read $150 ($2,500)Subdivision (fee to be determined) (Includes fire line if required) cc: City of Northampton Building Dept./Commissioner NOTE:If this availability is for new construction,it must be submitted electronically or mailed to the mailed to the Building Inspector *Fees will be charged based on current fee structure at the time of entry application