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32A-111 (4) BP-2024-1324 66 MARKET ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-111-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-1324 PERMISSION IS HEREBY GRANTED TO: Project# SIDING 2024 Contractor: License: Est. Cost: 14780 FJM HOME CONSTRUCTION LLC 084909 Const.Class: Exp.Date:07/02/2026 Use Group: Owner: NORTHAMPTON HOUSING AUTHORITY Lot Size(sq.ft.) Zoning: URC Applicant: FJM HOME CONSTRUCTION LLC Applicant Address Phone: jinurance: 4 TRACY ST APT #4 (413)273-9727 SPRINGFIELD, MA 01 104 ISSUED ON: 10/09/2024 TO PERFORM THE FOLLOWING WORK: SIDING 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: Final: 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: $60.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner / is. ,c, . The Commonwealth of Massachustts ��.' Board of Building Regulations and S ndar f^T .9 P�DR D Massachusetts State Building Code, 0 C�`)GI ��QMUN US TY Building Permit Application To Construct, Repair, Renov °' 'by ' h a R sed r 2011 One-or Two-Family Dwelling '"•'OA, 4N spa This SectionFor Official Use Only t��kPNs Building ermitNumber: 8110-As"/✓ Date Applied: El "-S /Z q Z€)ZL,1 Building Official(Print Name) Signature Date SECTION 1:SITE INFORRMATION 1.1 Prooe Address: `` 1( 1.2 Assessors Map& Parcel Numbers — Q✓ ✓tVlc l I.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?, one'? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 42 1 Ow rr of Record: 0V-tiVivnp , 404N -il ' NO A hcvvl p t•dl C i 0 Norte. Name(Print) City,State,ZIP 4G Did SnAt 34,e 4 . 4 -S2.+4Q V 1 y no USln8-0✓5 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied ❑ Repairs(s) IV Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other el Specify: 51( Brief Description of Proposed Work2: /vlC J .. eX l5}tM Wt SICIt✓11 � . expasc UA/ / -vie., of--Ike! 5.►dtm r,TD >el ATcA u'- I e� VA t1 t ctorAC. ✓ fil(4 1cY1,-)' SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $1 793 ! I. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee 2. Electrical . $ — 0 Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ ^ 0— 2. Other Fees: $ 4. Mechanical (HVAC) $ —0— List:5. Mechanical (Fire $ ` 0.--- Total All Fees:03' Suppression) • NN Check Not.`'k Check Amo t: Cash Amount: 6.Total Project Cost: $t 4 f��p Ov • - 0 Paid in Full 0 Outstanding Balance Due: h1 Ct i I _ f.,tit N-o'vt E Curl 1'C tv c-r I o i-.I C Gm A I t_. Co►^g . City of Northampton ,�,� Massachusetts c. r ,4 DEPARTMENT OF BUILDING INSPECTIONS `• 212 Main Street • Municipal Building `�'i ,--c'•� Northampton, MA 01060 1S` �1"` PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW 1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES, FENCES, GROUND MOUNTED SOLAR, ETC. I. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specifications of proposed work. (Digital and hard copy) 3. Site plan with location of proposed structure(s) and set backs. 4. Construction Debris Affidavit filled out and signed by applicant. 5. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance. 7. Energy Conservation Compliance Certificate (new/ replacement windows). 8. Home Owner's License Exemption Form filled out and signed by Homeowner (if applicable). 9. Note any Conservation and/or special permit requirements (if applicable). 10. Driveway Permit (if applicable). 11. Proof of Water and Sewer entry fees paid (if applicable). 12. Trench Permit - public land by DPW / private land by Building Dept. 13. Stretch Energy Code - all new construction will require a HERS Rater Affidavit to be submitted with permit application before issuance of permit. 14. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton. SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) A-©$u CI O4i crii l 51 (x\ Gi�{�,S_ License Number Expirati n Date Name of CSL Holder List CSL Type(see below) V _ j L1 13 c No.and Street Type Description tAIC7 ei "M C(f 0100 0 U Unrestricted(Buildings up to 35,000 Cu.ft.) Ott R Restricted 1&2 Family Dwelling City/To ,State,ZIP M Masonry RC Roofing Covering WS Window and Siding 1 1 � SF Solid Fuel Burning Appliances "l 1 3— OG I Z v l St ft'�GU/►p�r�I L $r'Jl�t✓ I Insulation Telephone Email addr .'t t Co"vs D Demolition 5.2 Registered Home Improvement Contractor(HIC) +,t ( o4 21-1�U'z ol r . HIC Registration Number E ''on Date HIC Company Name or H Regi t Name Ll?- 5" S►rvtccY► @ rvtr Pr.Se i p,►.c tic_ ecyY1 ant et Emaildress d n (� wt_� o ou o • City/TovV,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 Issu a of the building permit. Signed Affidavit Attached? Yes No .0 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 to act on my behalf,in all matters relative to work authorized by this building permit application. 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. aecIIto w*O( 1 )oa,202-4 . 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,fmished 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 SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE The Common tvealth of Massachusetts Department of Industrial Accidents = 1 Congress Street,Suite 100 Boston, Ma 0?l14-2017 �-> www mass.gov/din vs(pikers'Compensation Insurance Affidavit:Builders/Contractorc/E:lectriciansfPlumbers. it)LW FILED Vs I ID 1HE:PE:R%IIFILM;Al.fl1ORf1l. Applicant Information , j�. /�,,- A Please Print Leeibls Name tBusinac Chganization'lndividual►:f\� %�Oh.t �JPA T criOM Address: b 5 r K i d d hiL,44 01100 City/State/Zip:_ pv'rr to fl el. a t'nc(,i 2(10LtPhone : 13-V 13 9 2-4. Are you an employer?Cheek the appropriate Mat: Type of project(required): t am a employer with "__emgrduyees(full aeuL'cn part-time).* 7. New construction 2 am a sole proprietor or partnership and have no employees winking fit me it g. 0 Remodeling any capacity.[No workers comp.insumnee aequirad.l 9. 0 Demolition 1 jJ I am a hurrxvumr doting all work myself.(No aortas'comp.insurance rnqumod.)' 4.0 I am a bunw swess and will be B nrine co tractors to cunduci all work on my property. 1 will 10 Q Building addition ensue that all e22A'2231225.either hate workers'esxnperriation insurance or are sole 11.0 Electrical repairs or additions propnetors with no employees. 12.0 Plumbing repairs or additions 5�am a general contractor and I Luse hard the sub-contractors Bated on the anadred sheet !30 Roof repairs These workers'base cnrpluyecs and have worke 'camp.rmurante.• - 6.o We axe a corporation and it.officers luxe exenised their right of exemption per h4Cil.r 14 4A I .$Itd}.and we base no employees.(No worker.'comp.insurance required.( 'Any applicant that clsrx:ks box sal meat also till out the section below stowing their workers'compensation policy rnfixmaticxr. Hurneowners who submit this affi das it indicating they are doing all work and them hire outside contrsetore must submit a new affidavit indicating such. 1Contracton that check this box must attached an additional sheet showing the name of the►ub•contraeturs unl state whether co'nut those entities have employees. If the stab-contractors have employees.diet'must provide their workers'comp.poh..y number. I ant an employer that is providing workers'compensation insurance for my emplarees. Below is the policy and Job site information. y� Insurance Company Name: i Vl (1. 5'TYe_e-4- tine,/ ►c G 4s5 ✓c(-ie Policy#or Self-ins.Lie.#: Y A P?Zq 1 Ut Expiration Date: O I l05 I ZDZ 5 Job Site Address: &—nM.u/t City/State/Zip: 14641,10 d n t sAC,1 C%l p6C Attach a copy of the workers'compensation policy 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 S1,500.00 and'ur one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Ins estigations of the DIA for insurance coverage verification. I do hereby certify u r re'. : n I allies of perjury that the informnation provided a ore is rueand correct St .J nature: Date: � O e O 2.02L1 Phone t: 13 - Official use only. Do not write in this area,to be completed by city or town official (•its or Town: Permit/License h Issuing Authority(circle one): I.Board of Health 2.Building Department 3.('itsI Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton !/•" Massachusetts 4 '�, t7 -. DEPARTMENT OF BUILDING INSPECTIONS ti� "�`' 212 Main Street • Municipal Building rJj �1. \ .411 '" i Northampton, MA 01060 ssY `1� 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: cSADT-1 ( 1 eict The debris will be transported by: Name of Hauler: U J Pk I---1 Q v l e_v-• Signature of Applicant: Date: i 0/Og1201J, �. FJMHOME-01 AWYNNE A�ORO CERTIFICATE OF LIABILITY INSURANCE DATE ) 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 Mr" AXIA Insurance Services PHONE 413 788-9000 I FAX 418 888-0190 84 Myron Street (om'NO' `{ 'NOk� Suite A Mil33,IntoGlaslagroup.net West Springfield,MA 01089 PISU RIS)AFFORDING COVERAGE NAIC I INSURER A:MSA Main Street America Assurance Company 29939 INSURED INSURER B:A.I.M.Mutual Insurance Co. FJM Home Construction LLC INSURERC: _ 4 Tracy Street,Apt#4 INSURER D: Springfield,MA 01104 - 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. NSR _..-.ADM.SUBR ------ POLICY EFF POLICY EXP LTR TYPE OF INSURANCE MILD YAM POLICY NUMBER IDp/Yyyyl LIMITS A X COMMERCIAL GENERAL upsuTY r� EACH OCCURRENCE $- 1,000'000 CLAIMS-MADE n OCCUR X MPP2914F 1/5/2024 1/5/2025 (EaEo er ) $ 500,000 MEDEXPTAny one person) .I_-- 10,000 PERSONAL&ADV INJURY ,3 1,000,000 GE�AGGREGATE LIMIT APPLIES J GENERALPER: AGGREGATE S 2,000.000 On JPERCo-f IL LOC PRODUCTS-COMP/OP AGO 8 2,000,000 OTHER EPU $ 10,000 A AUTOMOBILE LIABILITY 1(ECeeCOMMED SINGLE LIMIT = 1,000,000 ANY AUTO X M1P2914F 1/5/2024 1/5/2025 eooalay IsijuRY(Per person) _ AUTOS ONLY X OS pW�,�Dp GOODLY INJURY(Per accident), X AUTOS ONLY X WNW OILY M ariAGE I_ $ 'A X UMBRELLA UAB X OCCUR EACH OCCURRENCE i 1,000,000 EXCESS LIAR ct.ABIs.MADE X CUP2914F 1/5/2024 1/5/2025 AGGREGATE 3 DEO X RETENTIONS 10,000 • Commercial Umbr $ 1,000,000 B WORKERS COMPENSATION X S RRTtITE O 1 AND EMPLOYERS'LIASLITYER ANY�EXa CUill NIA BINDER 9110/2024 9/10/2025 EL.EACH ACCIDENT $ 1,000,000 EL I»Aa-EA EMPLOYEE, $ 1,000,000 M yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LW $ 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES``ACORD 101,Additional Remarks SclwMie.may be attached II more space Is required) Housing Management Resources,Inc.,Valley Milbank LLC are named as Additional Insureds with respects to General Liability,Auto Liability and Excess/Umbrella Liability. CERTIFICATE HOLDER CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ValleyMillbank LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 16C North Maple Street Florence,MA 01062 — - AU7HORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. F.J.M. HOME CONSTRUCTION PROPOSAL General Contractor 4 Tracy Street Cecilia Pastor Reyes Springfield, MA Ol 104 Tax ID:462677964 Tel: 413-273-9727 Proposal Date:09/30/2024 Fax: 413-732-0504 Billing Address: _ - Name Northampton Housing Authority Address. 66 Market Street crtr/stad1p Northampton Ma, 01060 Qty Product Description Amount Each Amount F.J.M. Home Construction LLC proposes to furnish Labor and Material for the installation of the VINYL SIDING Scope of Work is as Follows: 1 Work : Installation Of Vinyl Siding $13,980.00 -Installation Insulation -Installation Vinyl Siding -Installation J- Channel - Installation Starter Strip $13,980.00 -Installation Aluminum -Installation Soffit This includes Strip and remove damaged siding, preparing each of the walls, and installing Insulation, Starter, J-Channel and Vinyl Siding throughout the House INSTALLATION ALUMINUM The window frames are prepared on the outside side to which a new Aluminum Installation will be made around each of them. Installation New Soffit The new J-Channel installation, Soffit, will be carried out in the two-lateral side in the house. THIS PRICE INCLUDES DUMPSTER AND ALL MATERIAL Permit Cost $800.00 $800.00 Subtotal: $14,780.00 Tax: -0- Grand Total: $14,780.00 Thank you for your business! F.J.M. Home Construction LLC Commonwealth of Massachusetts Construction Supervisor 8 Division of Occupational Licensure Unrestricted-Buildings of any use group which contain less than ' Board of Building Reg�ations and Standards 35,000 cubic feet(991 cubic meters)of enclosed space. Cons lon dti rvisor CS-084909 * spires:07/02/2026 SIMEON MAVR 427 BEECH ST 0 HOLYOKE M +0 O b`0l.1N.1 000 , Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner _...cLe uns.._ Contact OPSI:(617)727-3200 or visit www.mass.gov/dpllopel