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18C-178 (5) BP-2024-0539 705 BRIDGE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18C-178-001 CITY OF NORTHAMPTON Permit: Demo PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-0539 PERMISSION IS HEREBY GRANTED TO: DEMO MUDROOM AND Project# GARAGE Contractor: License: Est.Cost: 5500 BACKYARD ADU'S LLC 116643 Const.Class: Exp.Date: 07/13/2025 BERKOWITZ-GOSSELIN GOOSE &LEAH Use Group: Owner: BERKOWITZ-GOSSELIN Lot Size (sq.ft.) Zoning: URB Applicant: BACKYARD ADU'S LLC Applicant Address Phone: Insurance: 247 COMBS RD 207-252-9893 04WECAN6MGS BRUNSWICK, ME 04011 ISSUED ON: 05/02/2024 TO PERFORM THE FOLLOWING WORK: DEMO MUDROOM AND GARAGE 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: /Z. Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner tl [MAY ;' I I I The Commonwealth of Massachusetts T OF SOIL DING�N,P�-�'~�OR Board of Building Regulations and Standards "'^'�T�+a,,1P,,-, M4IPALIT Y Massachusetts State Building Code, 780 CMR --. USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number. ` A .2-5 5.59 Date Applied: Lo(A,bS Ha bratLt: j,.. li...AA -Q s 2 2Y Building Official(Print Name) Signature SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 705 Bridge Road 18C 178-001 1.1 a Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: URB single family residential 19226 84.55' Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided 1 10' 132.33' 15' 15.66' 20' 126.5' 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 6 ' Private 0 Zone: Outside Flood Zone? Municipal l ' On site disposal system 0 Check if yes121 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Goose and Leah Berkowitz-Gosselin Northampton,MA,01060 Name(Print) City,State,ZIP 705 Bridge Road 510-325-1050 leah@tahlstar.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 I Existing Building❑ I Owner-Occupied 0 1 Repairs(s) 0 1 Alteration(s) 0 I Addition 0 Demolition Si I Accessory Bldg. 0 1 Number of Units Other 0 Specify: Brief Description of Proposed Work':Remove the existing garage and mudroom on site and prep for new construction. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $5,500 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All F 11 s: $ 5 Check No.. )I Check Amount: Cash Amount: 6.Total Project Cost: $5,500 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C5-116643 07/13/2025 AUSTIN GREGORY License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 47 GEORGE STREET No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering 1 PORTLAND,ME,04103 WS Window and Siding SF Solid Fuel Burning Appliances 207-252-9893 AUSTIN.GREGORY@BACKYARDADUS.COM I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 203349 10M612025 CHRIS LEE-BACKYARD ADUS HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 247 COOMBS ROAD CHRIS.LEE@BACKYARDADUS.COM No.and Street Email address BRUNSWICK,ME,04011 781-999-0773 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 permit. Signed Affidavit Attached? Yes No .❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMiT I,as Owner of the subject property,hereby authorize CHRIS LEE-BACKYARD ADUS to act on my behalf,in all matters relative to work authorized by this building permit application. Goose and Leah Berkowitz-Gosselin 4/26/2024 Print Owner's Name(Electronic Signature) Date 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. Chris Lee 4/26/2024 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. 142A.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/dps 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 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" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD See Attached Site Plan SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton Massachusetts } sj�,t DEPARTMENT OF BUILDING INSPECTIONS o J 212 Main Street • Municipal Building Northampton, MA 01060 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 Rd, Northampton, MA 01060 The debris will be transported by: Name of Hauler: Backyard ADUs Chris Lee 4/26/2024 Signature of Applicant: Date: The Commonwealth of Massachusetts Department of Industrial Accidents a fr) `'� —D1 Office of Investigations l; _=�= 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): Chris Lee - Backyard ADUs Address:247 Coombs Road City/State/Zip: Brunswick, ME, 04011 Phone#:781-999-0773 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 21 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ©New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workingfor me in anycapacity. employees and have workers' P h' 9. ❑Building addition [No workers' comp. insurance comp.insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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 employees. [No workers' 13.0 Other comp. insurance required.] *Any 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. tContractors 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: Maine Employers Mutual Ins Co Policy#or Self-ins. Lic. #: 1 81 01 28403 Expiration Date: 10/07/2024 Job Site Address: 705 Bridge Road City/State/Zip:Northampton,MA,01060 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 certi un er the pains and penalties of perjury that the information provided above is true and correct Signature: 7 Date: 4/26/2024 Phone#: 78 -999-0773 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 2❑Building Department laity/Town Clerk 4.0 Electrical Inspector 5Elumbing AcoREP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) kia..../ 04/12/2024 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 Kristen Jenkins NAME: Paquin&Carroll,LLC PHONE (207)283-1486 FAX (207)283-4258 (A/C,No,Est): (A/C,No): 260 Main St. E-MAIL kjenkins@insurancepo.com ADDRESS: P.O.Box 356 INSURER(S)AFFORDING COVERAGE NAIC# Biddeford ME 04005 INSURER A: Berkley Excess Underwriters INSURED INSURER B: Concord General Mutual Ins.Co 20672 Chris Lee,DBA:Backyard ADUS,LLC INSURER C: Maine Employers Mutual Ins Co 11149 247 Coombs Rd INSURER D: INSURER E: Brunswick ME 04011 INSURER F: COVERAGES CERTIFICATE NUMBER: 24-25 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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD, POLICY NUMBER (MM/DDIYYYY) (MM/DDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 l CLAIMS-MADE LXI OCCUR DAMAGE ES(a RENTED $ 1 MED EXP(Any one person) $ 5,000 A Y Y CGL 0162726-22 03/24/2024 03/24/2025 PERSONAL&ADV INJURY $ Excluded GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000,000 POLICY ECTT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED 20050012 02/14/2024 02/14/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS 1- HIRED NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _ AUTOS ONLY (Per accident) Medical payments $ 5,000 UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 500,000 C ANY CER/MEMBPROPRIETOR/PARTNER/EXECUTIVE N N/A 1810128403 10/07/2023 10/07/2024 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS WOK E.L.DISE•RE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached N more space is required) In regards to General Liability,certificate holder and any other person is an Additional Insured when required by written contract,written agreement or permit. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Professional Building Systems ACCORDANCE WITH THE POLICY PROVISIONS. 72 Market St AUTHORIZED REPRESENTATIVE 1' Middleburg PA 17842 v—Jy,,� I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts } Division of Occupational Licensure • Board of Building Re ulations and Standards Cans 1 i©nl rv. CS-116643 ;; spires: 07/13/2025 i AUSTIN R GGORY , 47 GEORGE STREET _et ; t I . it ,-.4... PORTLAND lt* 04103 ' 1 I •.r f CommissionerdaIA% '. blEmcitA., 13R1DGE ROAD - PU BLIC s 73°28'1o"°I-1E IIIIIIIIIIIIIIIIIIril 84.55' G SETBACK o; 10 ZONIN LINE B 1 -- 15.00' I N/F DEBORAH&JASON TATORO ASPHALT 01 I DEED BK 11695 PG 195 I DRIVE PLAN BK 32 PG 28 1 65 SQ.FT. MUDROOM REM. WALK &REBUILD GARAGE \ ORC TO BE \\\ REMOVED _ ---- - 1 2 STORY WD.FRAME 770 SQ,FT.± 1 1.46' ! #705 1 1 1 \\\\\\\\Y N/F ' 1 PROP ADU 1 CYRUS&KATHERINE NEWMAN 820 SQ.FT. STONE N/F 18.75' PATIO LAWERENCE AUDETTE(A) DEED BK 4897 PG 291 I HEIGHT DEED BK 13282 PG 183 PLAN BK 138 PG 9(LOT 2) Y 1 1 PLAN BK 32 PG 28 PROPOSED cn JOHN&BETSY BARROW UTILITIES- 1 N DEED BK 13021 PG 179 1 = DECK PAVERS TO BE REM.1 o PLAN BK 32 PG 28 (.3 1 1.37' 0 W � N I N Of c I N N N N Z 1 2 I Co)illtD A J1 1 °' U mi 1 H W (Z.- Zi I O N TO THE BEST OF MY PROFESSIONAL I 1 KNOWLEDGE, I INFORMATION,AND BELIEF, I HEREBY REPORT THAT 1 THE STRUCTURES SHOWN HEREON ARE 1 N/F LOCATED AS NELLY CARMONA SHOWN. „ I DEED BK 14130 PG 229 P��N OF M9ss�'% 0 I PLAN BK 32 PG 28 ey ',_ DANIEL 1 1 SLL� : 1 I 1),? • 54625 =/1.44 .� E4y 1 1 ' SURV '' I1I " I 15.00' ZONING SETBACK LINE D P ,I,Sgel o PROFESSIONAL LAND SURVEYOR o N Nfi= N 59°03'41"W ROMAN CATHOLIC BISHOP OF 84.84' - SPRINGFIELD DEED BK 461 PG 265 PROPOSED ADDITION (SECOND UNIT) # 705 BRIDGE ROAD NORTHAMPTON, MA LOCUS INFORMATION LOCATED IN ZONING TABLE OWNERS:GOOSE&LEAH NORTHAMPTON, MASSACHUSETTS ZONING DISTRICT: URB BERKOWITZ-GOSSELIN TAX MAP: 18C-178-001 PREPARED FOR MINIMUM LOT SIZE: 3,750 S.F. DEED BOOK: 14379 PAGE 37 LEAH BERKOWITZ- GOSSELIN MINIMUM FRONTAGE: 50.00' PLAN BOOK: 138 PAGE 9(LOT 3) FRONT SETBACK: 10.00' ZONED:URB(NO OVERLAY DISTRICT) DANIEL SALLS LANDS SURVEYING REAR SETBACK: 20.00' FLOOD ZONE C 267 AMHERST ROAD SUITE 18 SUNDERLAND, MA (413) 824-8165 SIDE SETBACK: 15.00' LOT AREA= 19,226.08 SQ. FT.±(0.44 AC.±) DRAWN BY:DPS I DATE:02-27-2024 LOT COVERAGE=20%± MINIMUM LOT DEPTH: 75.00' OPEN SPACE=80%± 0 20 40 60 Ell NI MINIM 111111111M=111 OPEN SPACE REQ.: 40% TOWN WATER AND SEWER AVAILABLE I= NM NM MAXIMUM HEIGHT: 35' HORIZONTAL SCALE 1"=20'