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13-073 unit #3 BP-2023-0851 37 COLES MEADOW RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 13-073-001 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-2023-0851 PERMISSION IS HEREBY GRANTED TO: Project# DECK 2023 Contractor: License: Est. Cost: 6200 079160 Const.Class: Exp.Date: 04/28/2025 Use Group: Owner: NEW ENGLAND DEACONESS ASSOC Lot Size (sq.ft.) Zoning: RI/SR Applicant: STEPHEN ROSS Applicant Address Phone: Insurance: 36 SERVICE CENTER RD (413)584-1224 NORTHAMPTON, MA 01060 ISSUED ON: 06/30/2023 TO PERFORM THE FOLLOWING WORK: 6X12 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: itywiL Fees Paid: $100.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner / 2-0 R C_IJ vPn rYx-A- r-C-/I ,C<N, The Commonwealth of Massachusetts \� 4/et . OR W Board of Building Regulations and Standards 9r m�,� FOR Massachusetts State Building Code, 780 CMR �� o�ti�,. M UIP ITY Building Permit Application To Construct, Repair, Renovate Or Demolish A. '•', ise, Mar 2'11 One- or Two-Family Dwelling '6'00'otis This Section For Official Use Only Building Permit Number: 13 n 2-b - Date Applied: S -561( 00/(92 Building Official(Print Name) Si aturea SECTION 1: SITE INFORMATION 1.1 Prop tN Address: 1 1.2 Assessors Map& Parcel Numbers 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 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 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of ecord: i c �z Pot c•o--4SJ A(-1 AC.Ahiplot /oplR if/Ob& Name(Print) City,State,ZIP 37 C047/0,4,,./.4.4./ 14nil 4/3 q/3-3-7d-28$7 )wyk•$49si?,Q_ eaLGt( .cipevio, • °r9 No.and Street Telephone / Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction 0 Existing Building lI Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': a"'^�'� -{ k j : r S'tv. �-' ¢ )( ( Z shr��.. e P SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 6 Zoo, ,,J 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ - f - ❑ Standard City/Town Application Fee ❑Total Project Costa (Item 6)x multiplier x 3. Plumbing $ - 6 " 2. Other Fees: $ 4. Mechanical (HVAC) $ .- 0 - List: 5. Mechanical (Fire Suppression) $ V Total All Feeps: �q ry Check No.lit heck Arno : �/ Cash Amount: 6. Total Project Cost: $ Z�, 0 Paid in Full 0 Outstan mg Balance Due: SEc c. s ell() I sFigVICES , 5.1 Constructionct Supervisoror License(CSL) (�3 7 9/G D T ' 2B -�« ( akL .`./ 0• r?O5$ License Number Expiration Date Name of CSL Holder 3 4 `4erv,Ce.eeniek• Ifoad List CSL Type(see below) U No.and Street Type Description AIr7 k M met.. 6/b 4 6 U unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP ` R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering I WS Window and Siding SF Solid Fuel Burning Appliances y��56INavey S pdro55 ZVighOD•COM I Insulation Telephone Email address 1 D Demolition 5.2 Registered Home Improvement Contractor(HIC) /5. 0 V f I 5, ..t V- e/hen`,' 0 5.$ q HIC Registration Number Expiration Date? HIC .....y Name or C Regi ame No.and Street A/WeY ret#n i 1I'M 6l6646 g/3•51T9-iaay Emelt address City/Town,State,LIP Telephone SECTION&WORKERS'CO11 'E CE AFTHAV1T 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 0 No .❑ _ SECTiOlti 71c e q- , OWNtleS AGESTOlt : 1044*10Pttrstrr I,as Owner of the subject property,hereby authorize 5i 4-'(- p it./S to act on my behalf,in all matters relative to work authorized y this building permit application. �Li!/6.1.:1(it,Ci ClGt Co k-a,f 6/--7/7 Print Owner Name(Electronic Signature)I Date SEItAllON C ; . ..__ _ AU �,A 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. 514 4 D. le.s3 0 7/2-5 Print Oier's or Authorized Agent's Name(Electronic Signature) Date 1gQTSc I. 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 I program or guaranty fund under M.G.L.c. 142k Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dos 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 halflbaths 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" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD (.10 SIDE YARD i" SIDE YARD O -eo FRONT SETBACK /61° FRONTAGE ..........mow The Commonwealth of Massachusetts ki,,z, Z t=q,r Department of Industrial Accidents I congress Street,Suite 100 Boston, MA 02114-2017 wwry mass.gnt'/dia %S takers'Compensation Insurance Affidavit:BuildersjContractorr/ElectriciansiPlumberr. TO HE HEED 11'till 1 I1I:PERMtl'it\(:At TDOR1Tl'. Applicant information h Please Print Lecih Name(Business Organization Individual!: .5: -1Vc/,-^-lot P 4%f Addrress:. 34 5'..e_rv.c..- C.,,.,!-t,---- Izti City/State!Zip:Moir 4.-7pAt ,,t o.i6v Phone#: Yam— ��/Zz c( Are you an entpksytil(peek the appropriate hot: Type of project(required): I.o I a al employer with employees(lull and or part•timet.• 7. O New construction 2 aria a sole proprietor or partnership and have no employees working fur me in any capacity.lieu wotkr.r)'comp.imurnnte resorted..( (O""��Remodeling3"D 1 am a homeownerdoing all work myself.ftio workay`s'comp_insurance ntuu trd_)` 9. ts.1 Demolition i.�I am a larnnrw aner and w m(t ill be hn contractors to conduct all work on my property_ I will Ifl Building addition �-+crosutr that all contractors tither hoe workers'contpensauwt insurance tie are wale I ICJ Electrical repairs or additions proprietors with no employees. 12.0 1Thruding repairs or additions SC1 i inn a general contractor and I have herd the sub-cumnictors listed on the attached sheet. 130 Roof repaint These sub-contractors hove employees and base workers"comp.insurance_: 6.0 We are u corporation and its officer)have exercised then nght of exemption per Attic.c 14. I51 Ii41.and we liase no employees.(No worker'comp.insurarxe tcyuia-d.j 'Any applicant that clucks boa a I must also till uut the section below show my then winker).compensation policy tniolltutuan i Homeowners who stl'mt this att'ut acit marching the are doing All work and then hue outside contractors mica snbtmt a new affaIav it sta ic.riiag srr'•la :Conuacton that check this box taus attached an additional sheet showing the roan of the sub-contracture and state whether or not those entities base emplmees if the sub-contractors have employees,they stoic provid..their workers'crimp.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 Nance: Policy#or Self ins. Lie. #: — Expiration Bate: Job Site Address: City/StateZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MM(iL c. 152. §25A is a criminal violation punishable by a tine up to SI,S0(1.00 andior one-year imprisonment,as well as chit penalties in the form ofa STOP WORK ORDER and a fine of up to S250.01)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 certl y under the pains and penalties of perjury that the information provided a re is true d correct Signature - �"'" Date: Z—? 2-3 Phone tr: (i) <6_P _ / z zy Oncial use only. Do not write in this area,to be completed by city or town official I (Wits or Town: Permit/License# _ issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5, Plumbing Inspector 6.Other Contact Person: Phone#: , ____,'�...1 CONSTRAS01 CPOROWSKI '4 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°D/YYYY) s/2o/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 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 I NAME: '.CONTACT AXiA Insurance Services I PHONE FAX 84 Myron Street (A/C,No,Ext):(413)788-9000 (ANC,No)_(413)886-0190 Suite A E-MAa info^axia rou net_ v INSURER(S)AFFORDING COVERAGE I ADDRESS: I West Springfield,MA 01089 P INSURERA:Arbelia Mutual Insurance Com _any 17000" - __ ---- r INSURED INSURER B:A.I.M.Mutual Insurance Co. Stephen Ross INSURER C: 36 Service Center Road INSURER 0: Northampton,MA 01060 INSURER E: 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 —...--- ------- ------ ---.-__..----... T X COMMERCIAL GENERAL INSURANCEABILITY ADDL'SUBRI POLICY NUMBER POLICY EFF POLICY EXPT LTR - - - INSD�WVD '�(NM/DD/YYYY)!(MM/DD/YYYY) UMITS ALI EACH OCCURRENCE $ 1,000,000 _� CLAIMS-MADE X OCCUR 8500071119 7/1/2022 7/1/2023 PREMISESEaEoccu occurrence) $ 100,o0O MED EXP{ _Anyone person)._ 5,000 —__1 _ __-_ ____ _ - _ _.. .-_ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY xi piLOC ' PRODUCTS-COMP/OP AGG I 2,000,000 OTHER: IEPLI $ 25,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 .Ea_Oocident) $ ANY AUTO 1020098280 7/1/2022 7/1/2023 BODILY INJURYJPer personl ;$ OWNED X SCHEDULED I AUTOS ONLY ' BODILY INJURY(Per accident) $ AUTOS X , HIRED XI NON-OWNED - PROPERTY DAMAGE _ Y .. AUTOS ONLY AUTOS ONLY jeer accident) A X UMBRELLA LIAB X OCCUR 2,000,000 EACH OCCURRENCE I$ EXCESS LIAB 1 CLAIMS-MADE10,000'. AGGREGATE $ 4620098565 03 7/1/2022 7/1/2023 11 DED X RETENTION$ i$ 2,000,000 B 1 WORKERS PROPRIETOR/PARTNER/EXECUTIVE -- AND EMPLOYERS'LIABILITY Y/N ; I _ 1 TATUTE HRH IWMZ-800-8006546-2021A 7/1/2022 7/1/2023 500,000 OFFlCER/ME.Ing EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) ,E.L.DISEASE-EA EMPLOYEE$ 500,000 If yes,describe under i - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ SOO,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 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 Commonwealth of Massachusetts A Division of Occupational Licensure Board of Building Regulations and Standards ConstionrSvisor CS-079160 _ EXpires:04/28/2025 STEPHEN D OSS 36 SERVICE ETR RD NORTHAMPTi�N MA 01060 • • ib• ::"fix ,,D .. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Aff.' ~a . Business Regulation 1000 Washing2.: = - Suite 710 Boston& 118 Home Im.ro'•,p.4 ,-.istration `~t ! Type: Individual = 1 ---� r e•.. ation: 150847 STEPHEN D. ROSS _ = E - .tion: 05/03/2024 36 SERVICE CENTER RD. '- NORTHAMPTON, MA 01060 wi►,Ire krt "iltl 0 ...L= ik ''ii. i dr fte- Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVE . NT'CONTRACTOR expiration date. If found return to: F, •0Talduai . Office of Consumer Affairs and Business Regulation Resist___ _:--. =z+=.iption 1000 Washington Street -Suite 710 >4 `s $24 Boston, MA 02118 ,TEPHEN D. ROSS • i N , 1 n� A < ;TEPHEN D. ROSS a of t6 SERVICE CENTER ' -7 ,,,,, 4Y,'%. _ %rf 0A. JORTHAMPTON,MA 0 • 1`' 4meV'`` Undersecretary Not valid without signature City of Northampton 0.YHAMyT Massachusetts !1. } DEPARTMENT OF BUILDING INSPECTIONS IiJ212 Main Street • Municipal Buildingr:t \ �: r:•+' Northampton, MA 01060 rSy -.• �tiOC 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: �/a� l2_e G,4'1'7 Y j �I — The debris will be transported by: Name of Hauler: Co4e7 Arq-cA Signature of Applicant: 7 Z From: ��7 leCS Yam ' 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 modificationic^ to waive the requirement for construction control of the project at C_- 0 f-QS 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, 4 Construct DEMOLITION GENERAL NOTES Associates MU*. ..Ma m'a. o ''..-,a. A_ REMOVE FROM SITE AND LEGALLY DISPOSE OF gym' ALL DEBRIS.RUBBISH AND OTHER MATERIALS RESULTING FROM DEMOLITION AND CONSTRUCTION OPERATIONS. I\ M�� E.,s.A�s.E>wE�o 17-0' /3\ A000 TO BE REMOVED --- -- - _ EXISTING TO REMAIN O1ST FLOOR DEMO PLAN 2 PROPOSED FIRST FLOOR PLAN aa)i ,/4"=,•-0" O 1/4"=1•-0" a DEMOLITION GENERAL NOTES ir 1 (DEMO KEYNOTE I� a I a _ ■ ,� 11111111 .. DE DATE-iii—i�r—i i—nt=iil-i�i=i� NI _ . DOTP. 111 1 I l-1 I I—I I I-1 — i-1 I I— IIII —111 11I-1I=l11=111=111=11!: r A01. NG CONDITIONS South Elevation ()Framing Plan ��, A O 1/4"=1'4' 1/4"=1•-0" No,s Aa.,number °""'NX" Eric Parham • EXISTING/DECK PLAN ''ET'''. A000 sum ,ir•ro < ORIGINAL DRAWING SIZE IS 24'X IB'DO NOT SCALE DRAWINGS FOR MEASUREMENTS