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22B-109 (15) BP-2022-0419 199 PINE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 22B-109-001 CITY OF NORTHAMPTON Permit: Addition PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0419 PERMISSIONIS HEREBY GRANTED TO: Project# DECK Contractor: License: Est. Cost: 20000 RIDEOUT BUILDERS 11635 Const.Class: Exp.Date:05/18/2022 Use Group: Owner: LLC MATT& NICK Lot Size (sq.ft.) Zoning: OI/URA/WP Applicant: LLC MATT& NICKRIDEOUT BUILDERS Applicant Address Phone: Insurance: 155 INDUSTRIAL DR NORTHAMPTON, MA 01060 17 POWDER MILL RD (413)885-2876 NAIC44326 SOUTHWICK, MA 01077 ISSUED ON:04/22/2022 TO PERFORM THE FOLLOWING WORK: 16X24 DECK 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: ( , ' yg . ''1 • Fees Paid: $140.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Flu ildina Commissioner 2- oar/ File # BP-2022-0419 /) APPLICANT/CONTACT PERSON:MATT & NICK LLC 155 INDUSTRIAL DR NORTHAMPTON, MA 01060 RIDEOUT BUILDERS 17 POWDER MILL RD SOUTHWICK, MA 01077(413)885-2876 PROPERTY LOCATION 199 PINE ST MAP:LOT 22B-109-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $140.00 Type of Construction: 16X24 DECK New Construction 1V^V Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO MATION PRESENTED: Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Pennit With Site Plan Major Project: Site Plan AND/OR _Special Perm it 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 Ava ilability 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 14-21-Z40ZZ 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. REC - ` APR 2 0 20.2 The Commonwealth of Massachusetts Office of Public Safety and Inspections s ^T.OF Ft ! ' Massachusetts State Building Code(780 CMR) "rn-''Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number:A - '4ri Date Applied: Building Official: SECTION 1:LOCATION — l�g yt't�1E sT ilo ,a#p7`o., ©r U 6 C9 No.and Street City/Town Zip Code Name of Building(if applicable) L2�-loq Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition❑ Demolition 0 (Please fill out and submit Appendix 2) Change of Use ❑ Change of Occupancy 0 Other .CI'Specify: DEC b Are building plans and/or construction documents being supplied as part of this permit application? Yes No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No Vi" Brief Description of Proposed Work: !6' ze a?' Peck- IUcrtL, c <.a a of t - j.,c; T CI A Doc R �' I< 6 < �, t r� e i4 IA- 4- SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR _ CHANGE IN USF.OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed • No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq_ft.)and Total Height(ft.) • SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2❑ Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 ❑ F2 0 H: High Hazard H-1 0 H-2 0 H-3 ❑ H-4 0 H-5 0 I: Institutional 1-1 0 I-2❑ I-3 0 1-4 0 M: Mercantile 0 R: Residential R-ID R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility❑ Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA 0 LIB ❑ ILIA 0 IIIB 0 IV 0 VA 0 VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Trench Permit: Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Disposal Site 0 Public 0 Check if outside Flood Zone 0 Indicate municipal 0 A trench will not be Po required 0 or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner • Matthew Dufresne 1456 Santa Marta Ct Solana Beach, CA 92075 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Owner/Manager 413-265-3482 matt@pvep.com Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Larry Rideout 17 Powder Mill Rd, Southwick, MA 01077 Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control (the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor --- 2 Company Name n LA.p Fl d•eaYTt"' C S -- Ott 6 3.6-- IJTJ(pr 1 rj/[ 2 Z Name of Pefson Responsible for Construction License No. and Type if Applicable / 7 Pru/d er Mt ij l o)• So Otle� is L,1 hi/4-• 0/07 2 Street Address City/Town State Zip 4/, .287G `/r3 - - ae71 [eery.. rrdeout co,..,ccs.-t t nit. Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. is a signed Affidavit submitted with this application? Yes❑ No ❑ ' SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item' Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6) _$ a- 1 oo a. 1.Building $ 00,COG Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ I �O (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ aCJ/Oc>O -- (contact municipality)and write check number here,. i(L a SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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. Lgr'r ROI€oc.it- Own(e-r e., //3- e d7e76 Y/, ,.. Pleasurint and sign name , Title Telephone No. Date I -/ Pw er Y111r It R1 .OLJC1AuvIc m/+ 0162 7 ._ /gyrr I' tu `' korcac�:nel-- Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: /f` Li"Z I' 2-2— Name Date City of Northampton it�1 Massachusetts a '(;�; t ,} DEPARTMENT OF BUILDING INSPECTIONS ya tt � 212 Main Street • Municipal Building 1a pp�a' » � +'�� Northampton, MA 01060 �'tZy �,-"N'��� 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: Valley Recycling, 234 Easthampton Road The debris will be transported by: Name of Hauler: Amherst Trucking Signature of Applicant: �� Date: 4/12/22 CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: • 6 2 0:kr e REAR LOT DIMENSION: REAR YARD a' SIDE YARD / / I SIDE YARD SOO 1 FRONT SETBACK I S FRONTAGE .. k., 1 The Commonwealth of Massachusetts so; ,.._ r Department of Industrial A eeidents lik - =1 t= I Congress Street.Suite 100 Tik:ittlitil Boston, MA 0211l-2017 — Mogi?!aSS.goildiil Workers'('ompensation Insurance Affid it%it:BuildersiContractorstElectriciansiPlumbers. TO BE FILED W i i li i IIE PERMITTING AITH()RITV. Applicant I nforniation Please Print Lettibls Name(Businiess'OrpantzattonAndividual): Address: 1 —2 pc„„der ._...41v. *et) f City'StatelZip: 114/1 6_#.?„ ?Phone#: Z-Iii 3-Fl,ti:L4... e76.. Are....ou an porptrkv re?Cheek the appropriate host Type of project(required): 1.01.-ani a u.liployer with ,, L . employees(full andfor parbtirtiel* 7. D New construction In I am a sole ptopnetot or partnership and have no employees working for me in K. ci Remodeling any capacity.[No workers'comp.insurance requited" 9. 0 Demolition 30 I ant a!pinworm=doing.all work myself.[No workers'corm.insurance regnant]' 100 Building addition 4.0 i am a hortioiwnin and Pall be hiring contractors to ecodoct at work on erry property. I will ensure that all r.mitractors either have workers*lAirripen,utiott insurance or are sole i 1.0 Electrical repairs or additions proprietors with no cmplilyreS, 12.0 Plumbing repairs or additions 50 I ant a general eontrattor and 1 hose hired the sub:einitraetors listed on the attached sheet ..eth(l4.15a0ther 13.L3 Roof repairs These sub-contractors have et riployees and!save workers'comp.insurance.: D 6.0 w aft a emporation and its°Meets have exercised their right of exemption per SAGE.e. 151.)1(4).and w c itave no empluFees.[No workers comp.insurance required.] 'Any applicant that eltrls box#1 nail olio till out the*tenon below show ing their workers'compensation puke,.infocination. t Honicownen who submit tint affidus a Ord:cantle they are doing all work and then hint outside contractors indst submit a new ash it inilicaling such. :Contractors that check this box mut attar:lied an adihtional sheet show in g the name of the se b-contrac itIrl and'tate whether or nut those entities hasre emplo•vces If the sol,citteractins 1141C iltIrkPfreeS.the'y intal pro A id,:thcir vaytkcch-,xvitif.p.110,y nUmber. I am an employer thug is providing worAers'conspertsation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 33 0("?/4 A.)511,i Ii4j.cele/f Ailcir:- ileirt S. T /14,refietialkOt7-i Policy#Ot Self-ins. Lie.4: /VA-, - 4/4/3?C Expiration Date: 0S/11 42 41.2.3 Job Site Address: /9 q PirvE ...3 T City/State/Zip:iliyeehy,,itetedy Mn (3/46:C5 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required antler MGL c, 152,425A is a criminal violation punishable by a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine dap 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. .. . Ida hereby certify under the pains and penalties of perjury that the information provided above is true and correct, Signature: * 44/2,1"..101-->< c,..A , Date: ‘,//£2/.: *7---- Phone 4: 4,/ — ‘-c-— c_Pe, 76. . . . Official use onk Do not write in this arm to lie completed by city or town Vidal City or Town: _ Periiiiii.icense# Issuing Authority(circle one): I. Board of Health 2.Building Department 3.V iityfrou a Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other ('nit tact Person: Phone#: ACO® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/14/2022 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 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 NAME: Stacie Breck ALEXANDER W BORAWSKI INC Iaco,No.Extt (413)586-5011 (A/C,No): ADDRESS: sbreck@borawskiinsurance.com 88 KING STREET SUITE A INSURER(S)AFFORDING COVERAGE - NAIC# NORTHAMPTON MA 01060 INSURERA: ATLANTIC CHARTER INS CO 44326 INSURED INSURER B: _ LARRY RIDEOUT INSURERC: RIDEOUT BUILDERS INSURERD: 17 POWDER MILL RD INSURER E: SOUTHWICK MA 01077 INSURERF: COVERAGES CERTIFICATE NUMBER: 753037 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 LTR ADDL INSD SUBRi WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE RENTED $ CLAIMS-MADE L__]OCCUR PREMISESO(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per acddent) $ — HIRED AUTOS _ AUUTOSWNED PROPERTY acci ent) DAMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE -ER OTH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A WCV01399004 03/14/2022 03/14/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Pioneer Valley Books ACCORDANCE WITH THE POLICY PROVISIONS. 155A Industrial Drive AUTHORIZED REPRESENTATIVE Northampton MA 01060 Daniel M.lM C CroWtey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD From: --{_ PEA 3utcD6-es / 7 Y 1.Uee1, -11t G � 1.7" c )( 77 To: Jonathan Flagg Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, I request that you grant a modification to waive the requirement for construction control of the project at qe9 rifL+awt pid,-t M1q because the work is of a minor nature,will not affect structural elements, health,accessibility, life or fire safety,and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, /. -.../ i t 000/.4e_i/lir.'elli _ BOON Est! A41:eowl 1� ex* litZI all° �� ` , \- o'dio.oled..". . 4. ) ,. t:?*. -- v. 4..eer i I StaitIV MOM # a r» WI ,015 ..04 • / CId ..or ` ►y Tr� fir.r VOX Pit. AIM 100 4333 r r...s + •' OK r A. ACIIIMnID 1 NOOK f r DOOM iMJ 0,410 1.4 r • y,,nri4 '? MRA�f MOOM is soI 1 7 . �r . �► 4,1 t - •r / •r 1 .a �*r 1 ,.y in r; w s r-s tow ow 1 ,`...„ / �r P. . No r . e/' is L0T 1 0 ' . , • AREA= r ' 4 4$ 4. 67± ACRES c) . .." /441;41 oft 7,,,.L.4,/ TecF% r- 1 sieve 4bet 1 V...-rtio iiill =.46.,, f PONY KUL MAIM r a Al.mil b y 1� ,t/� ... toilf ill ',I ri 'Ale 4/010 aro 4 4- ;,j ► ...two tee« I I I 16"X24' DECK J ADD NEW DOOR 199 PINE STREET I LOADING DOCK i w— s i Q ; i \)/ N 4 . 2"X4" TOP RAIL CABLE RAIL SYSTEM GATE 4"X4" POSTS 2X8"-16"0.C. • _—TRIPLE 2"X10" PT BEAM O GX6 PT POSTS GRADEle' /� BUILDING FOUNDATION ;. PRECAST PIERS k, 4. ' JOIST ANGERS 1 /'\' \/ AT ALL • OIST TO \� \Q/�/ LEDGER '\\/\/ ELEVATION 1 `\\\\/ \ % \• `/ /\/�A/\/ .. i 23 .. \. 40. .\/ Akt'v 7-1 • • .- / 0 " \ /\./\\/\/ t/\/,\\�, \/ LEDGERS BOL D TO WALL ;.B.. rt \•/ WITH 5"ANCHO'S EVERY 16" I - -1 _a `\\ .\ *1. • STAGGERED TO' •ND BOTTOM .. a` ELEVATION 2 SOLID BLOCKING \.',. PLAN RIDEOUT BUILDERS PIONEER VALLEY BOOKS 16"X 24' DECK 17 POWDER MILL RD. 199 PINE ST SOUTHWICK MA, 01077 larry.rideout@comcast.net CS-011635 TEL. 413-885-2876