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32A-171 BP-2023-0798 10/20 HAWLEY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-171-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0798 PERMISSION IS HEREBY GRANTED TO: 2023 20 HAWLEY APTS -PHASE Project# 1 Contractor: License: Est. Cost: 1052206 WESTERN BUILDERS INC CS-051113 Const.Class: Exp.Date: 09/10/2024 Use Group: Owner: LLC O'CONNELL HAWLEY Lot Size (sq.ft.) Zoning: CB Applicant: WESTERN BUILDERS INC Applicant Address Phone: Insurance: 73 PLEASANT ST (413)265-8793 UB-6K239300 GRANBY, MA 01033 ISSUED ON: 06/26/2023 TO PERFORM THE FOLLOWING WORK: SELECTIVE INTERIOR DEMO, REPLACE ROOF, RESTORE/REBUILD MASONRY, REPLACE WINDOWS, INSTALL ACCESS RAMP 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: ( Fees Paid: $7,364.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner T'oT mIAL ffi �—� The Commonwealth of Massachusetts ( ; ' Office of Public Safety and Inspections f - M Massachusetts State Building Code(780 CMR) o Building Permit Application for any Building other than a One-or Two-Family Dwelling • ro ,gyp (This Section For Official Use Only) Buildig Perm-tiiun�5er: �'07(ig Date Applied: Building Official: 1 SECTION 1:LOCATION 20 Idaitrl�ey SUT1 ) Northampton 01068 Church No.and Street- City/Town Zip Code Name of Building(if applicable) 32A 171-001 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• Repair U Alteration 0 Addition 0 Demolition• (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes U No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No Brief Description of Proposed Work: Selective demolish and Abate of Interior,Scaffold building,remove and replace roof,restore and rebuild masonry where appropriate(as shown in drawings)remove and replace existing windows,perform excavation for in-ground drainage,construct accessible ramp and install sidewalk leading to it from Park St,install accessible parking space. SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Assembly Proposed Use Group(s): RESIDENTIAL SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 3 7,020 NO Total Area(sq.ft.)and Total Height(ft.) -Exterior Renovation Only- 7,020 95' CHANGE SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ 1-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3. R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ HA 0 IIB 0 IIIAU IIIB ❑ IV 0 VA 0 VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: U Public MI Check if outside Flood Zone A trench will not be Licensed Disposal Site Indicate municipal required❑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 U Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No. Yes U 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 O'Connell Hawley LLC 800 Kelly Way Holyoke,MA 01040 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Development Manager 413- 540 -1345 413- 207 -7805 sstine@oconnelis.com Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Richard Dobrowski 73 Pleasant St. Granby MA 01033 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 O. 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) Mark E.Thaler 518- 375 - 3164 mthaler@trw-arch.com 32948 Name(Registrant) Telephone No. e-mail address Registration Number 25 Monroe Street Albany NY 12210 Architecture 08/31/23 Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Western Builders,Inc. Company Name Ed Ackley CS-051113 U 10 Sept.2024 Name of Person Responsible for Construction License No. and Type if Applicable 73 Pleasant St Granby MA 01033 Street Address City/Town State Zip 413 _ 265_ 8793 413 _ 537 _ 1677 eackley@westernbuilders.com 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 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1,052,206.00 1.Building $ 1,052,206.00 Building Permit Fee=Total Construction Cost x 7.00 (Insert here 2.Electrical $ appropriate municipal factor)_$7,364.00 . 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ $7,364.00 Enclose check payable to 6.Total Cost $ 1,052,206.00 (contact municipality)and write check number hereek,#/27343 S. 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. Richard A. Dobrowski Project Manager 413 265 8793 06/14/23 Please print and si name Title Telephone No. Date 73 Pleasant St.i Granby MA 01033 rdobrowski@westernbuilders.com Street Address City/Town State Zip Email Address 3 Municipal Inspector to fill out this section upon application approval: (4 ` I 11i Name Date CITY OF NORTHAMPTON SETBACK PLAN MAP: 32A LOT:171-001 LOT SIZE: 1.85 REAR LOT DIMENSION: —99'-7" REAR YARD 20' It it x z ?\ e il is II I \ 19 6%\\V �������������������a��������ua�����a�����a����������e�a�����o \r , ram. \ . iiii L__ _ \ -J .,,..,m : alk, .____________1_.__ SIDE YARD 20 4I I 111i ; i SIDE YARD 5 \ ill \ ill 8 1 1 li Ili , ,, . „ - ,\ , ,\ li, , P \ /ill \ 1 I\ : di 1 ii , N 1: i : /-- dt\k/ """ I 1 i , 91 a i s w ' a gil mom 1 11 IT 0:":- FRONT SETBACK 5' FRONTAGE 100.65' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations = 1= Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Western Builders, Inc. Address:73 Pleasant Street City/State/Zip:Granby, MA 01033 Phone #:413.265.8793 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 25 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction listed on the attached sheet. 7. ❑■ Remodeling 2.El I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. [' Demolition workingfor me in anycapacity. employees and have workers' P ty $ 9. [' Building addition [No workers' comp. insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12..Roof repairs insurance required.] t c. 152, §1(4),and we have no Site Draina a/Flatwork employees. [No workers' 13.❑■ Other 9 comp.insurance required.] *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy 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: Travelers Indemnity Company of CT Policy#or Self-ins. Lic. #: UB-6K239300 Expiration Date:6/1/2024 Job Site Address: 20 Hawley Street City/State/Zip:Northampton 01068 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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. Richard A. Dobrowski .�,a„�. &m., '�.�.n Signature: �a.,...ng.a Date: 06/16/2023 Phone#: 413.265.8793 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department 30City/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0Other Contact Person: Phone#: ��'..R,io WESTBUI-01 MMORSE A�ORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYVY) 6/12/2023 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 Melissa Morse NAME: Watts Group LLC PHONE FAX 29 S Main Street,3rd Floor (NC,No,Ext): (860)231-7250 (A/C,No): West Hartford,CT 06107 ADDRE-MAIL mmorse ewas r ESS: th tt � 9 P•com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Charter Oak Fire Insurance Company 25615 INSURED INSURER B:Travelers Property Casualty Insurance Company 36161 Western Builders, Inc. INSURER C:Starr Indemnity&Liability Company 38318 73 Pleasant Street INSURER D:Travelers Indemnity Company of CT 25682 Granby,MA 01033 INSURER E:Berkley Regional Insurance Company 29580 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR CO-7F914719 6/1/2023 6/1/2024 PREDAMMISE AGE TO S(Ea RENTED ) $ 300,000 X XCU INCLUDED occurrence 10,000 MED EXP(Any one person) $ X NO DEDUCTIBLE PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 4,000,000 POLICY X PE LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ CMBINED B AUTOMOBILE LIABILITY Ea accident)SINGLE LIMIT $ 1,000,000 X ANY AUTO 810-0N700762 6/1/2023 6/1/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS-MADE 1000585032231 4/1/2023 4/1/2024 AGGREGATE $ 10,000,000 DED RETENTION$ $ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N UB-6K239300 6/1/2023 6/1/2024 STATUTE ER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 1,000,000 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E Umbrella BCS 8800013-11 4/1/2023 4/1/2024 2nd layer 15,000,000 B Installation 660-1S737386 4/1/2023 4/1/2024 $5,000 DEDUCTIBLE 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) The project name: Hawley Church Address: 20 Hawley Street,Northampton,MA 01068 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD City of Northampton a SS S Massachusetts 72 _ '<< DEPARTMENT OF BUILDING INSPECTIONS 7% 212 Main Street • Municipal Building yJti C�� -4? Northampton, MA 01060 rSNw 3r7‘^`` 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: Casella Waste Systems, 686 Main St., Holyoke, MA The debris will be transported by: Name of Hauler: Associated Building Wreckers Digitally signed by Richard A.Dobrowskl ON C=US,E=rdobrowski@westernbuildors Com, Richard A. Dobrowskl °Western Builders,Inc",OU=Project Manager CN=Richard A.Dobrowskl Signature of Applicant: Date:2°23 °g°°"_°°°°' Date: 06/16/2023 Initial Construction Control Document 'lit t1�`, ! To be submitted As:ith the building permit application by a Registered Design Professional for work per the ninth edition of the ' Massachusetts State Building Code, ''780 C11R, Section 107 Project Title: Date: HAWLEY APARTMENTS 06/14/2023 Property Address: 20 HAWLEY STREET Project: Check (xy one or both as applicable: New construction Existing Construction X Project description: Mark IThalert' IA Registration Number: 32948 Expiration date:08/31/23,am a registered design professional. and I have prepared or directly supervised the preparation of all design plans.computations and specifications concerning,: Architectural X Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information., and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1_ Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents_ 2_ Perform the duties for registered design professionals in 780 C ;IR Chapter 17, as applicable_ 3 Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code_ Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107_ When required by the building official,I shall submit field/progress reports(see item 3_)together with pertinent comments,.in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a 'Final Construction Control Document'. *41A44 Enter in the space to the right a "wet`" or c3.‘EgED AR0,11 electronic signature and seal: :Q 44,0,E. 7 7,1, '9ec'r: e3V W\ i3A2? 8 1) afi:Phone number: 518-375-3161 Email: mthaler@trw-arch.con'� Y WY otk, Building Official Use Only4474F NO Building Official Name: Permit Noa Date: Note 1.Indicate with an'x project design plans,computations and specifications that you prepared or directly supervised. If'other'is chosen,provide a description. Version O1 01 201S Appendix 1 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where a•plicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing(include local connections) 9 Gas(Natural,Propane,Medical or other) 10 Surveyed Site Plan(Utilities,Wetland,etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 _ Existing Building Survey/Investigation 16 _ Energy Conservation Report 17 Architectural Access Review(521 CMR) 18 Workers Compensation Insurance 19 _ Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Registered Professional Contact Information Mark E.Thaler 518- 375 - 3164 mthaler@trw-arch.com 32948 Name(Registrant) Telephone No. e-mail address Registration Number 25 Monroe Street Albany NY 12210 Architecture 08/31/23 Street Address City/Town State Zip Discipline Expiration Date - - Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date - - Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Please follow this link for construction control forms to be used by Registered Design Professionals.