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17C-253 l_'._ t. 18 '10 8:15 JUB3 CO; GFLD, Mi:i FROM P. 3 P OPOSAL The Jubb Co., Inc. d.b.a. MA LARRY JUBB'S MA Cons.tSup n . 055333 Page 2or2 IMPROVE- A- HOME' 7 Devens Street P.O. Box 51 P.Q. Box 429 Hatfield, MA 01038 Greenfield, MA 01302.0429 Northampton, MA (413) 772-6217 (413) 684-3716 PHONE DATE TO: apical & Support Options 773 -1314 X 1006 0/18/2010 111 Fedra l Street JOB NAME / LO ATION 29 North Main Street Greenfield, Ma. 01301 Florence,iMa. 01062 JOB NUMBER JO8 PHONE_ We hereby submit specifications and estimates for. • SERVICE FEE: $375.00 (includes permit and disposal of all job related refuse) service fee amount not included in total below and will be added to final invoice. We Propose hereby to furnish material and tabor — complete In accordance with the above specifications, for the sum of Thirteen Thousand Three Hundred Eighty Four and 00/100 Dollars 13 ). _ dollars ($ P ayment to be made as follows: 1/3 DEPOSIT UPON ACCEPTANCE. invoices are due upon receipt. An interest charge of 2% per month (24% per annum) on past due balances, plus all costs, including reasonable attorneys fees, incurred in collecting any sums owed. All material Is guaranteed to be as specified, All work to be completed in a professional manner acceding to standard practices. Any alteration or deviation from above specifics- Authorized r5 (.7/' 7 r r� n +ti_.... ttonu Involving exl a Oasts will be executed only upon written orders, and will become an Signature t - p ' ,/ t� S�ri2 1 extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control, Owner to atny fire, tornado, and other necessary Insurance, Note: This propos I ma e Our workers are fully covered by worker's Compensation Insurance, withdrawn by us if not accepted hin 30 days. Acceptance of Proposal — The above pricea, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work Si9nfllur'd _ - -_ -.- as specified. Payment will be made as outlined above. Signature Date of Acceptance: .. *� Oct, 1h ' 11_8 • I . JUBB CO; GFLD,MA FROM - P. 2 p Ro p os AL e Jubb C • Inc. d.b.a. MA Registration ti0000i pis 1 of 2 LARRY J BB MA Cons. Sup. tac. 055333 IMPROVE - - HOME 7 Devens Street P.O. Box 51 • P.O. Box 429 Hatfield, MA 01038 Greenfield, MA 01302 -0• 9 • (413) 7724217 Northampton, MA (413) 584.3716 PHONE Clyn . & Su • • Options 773 -1314 X 1006 10/18/2010 TO. y 8/2010 111 Fedral Street D h l J OB NAME / LOCATION Greenfield, Ma. 01301 J 03 29 North Main Street n Florence, IMa. 01062 ' n \ID I „ 1 `3 JOB NUMBER JOB PHONE We hereby submit specifications and:estima>;te$ • for fi 2fcy(/'� f /(Jp��� 5G'b' COVERAGE OF UPPER FRONT MAIN HOUSE FASCIAS AND CROWN MOLDING AS FOLLOWS: 1). To remove and dispose of the existing wood gutter system. Gutter system will not be, replaced at the request of the owner. 2). To re- secure as necessary any loose *fascia. *Any rotted fascia requiring replacement will be billed as extra. Jubb will notify owner prior to any replacement work advising of cost. 3). To install a horizontal furring or similar to add structural integrity to cladding, • 4). To clad fascia with an .019 guage, custom fabricated baked enamel aluminum trim coil. NOTE Due to width of fascia the horizontal furring as outlined in line 3 will help to reduce any oil canning of cladding, There may be some oil canning evident. 5). To clad upper crown molding at top roof edges with custom fabricated baked enamel aluminum coil .019 guage. 6). Price does not include window clad. soffits. upper front *widows watch. or any other areas not specifically outlined here -in. *OPTION: upper front widows watch. cladding of crown moldings as outlined above. $4 due to height and stagging requirements. YES add $4,500.00 to below price. NOTE: An aerial articulating boom lift will be required to reach certain areas of this house to assist In the work outlined above. Said cost for the aerial lift is not included in below price. It is anticipated that the cost of the lift may be up to $5,000.00 or more if the widows watch is accepted. NOTE: Due to hidden fascia damage /rott that is not known until work begins it is suggested that up to an additional $3,000.00 to $5,000.00 be budgeted. WARRANTY: 20 years on aluminum cladding against substantial fade. Labor 1 year. We Propose hereby to fumish material and labor — complete in accordance with the above apeclfications, for the sum of: Cont'd dollars ($ Cont'd ) Payment to be made as follows: 1/3 DEPOSIT UPON ACCEPTANCE. Invoices are due upon receipt. An interest charge of 2% per month (24% per annum) on past due balances, plus all costs, including reasonable attorney's fees, incurred In collecting any sums owed. All material Is guaranteed to be as specified. All work to be completed In a profeeslonal ! • r manner according to standard practices, My alteration or deviation from above apedflca- Authorized ` Do involving extra costa will be executed only upon written orders, and will become an Signature � . ''•'t�) _ extra charge over and above the estimate. All agreementa contingent upon strikes, acddents or delays beyond our control. Owner to carry fire, tornado, and other rwcessaty Insurance. N e: is pr 'pose! may e Our workers am fury covered by worker's Compensation Insurance, withdrawn b us If of a epted within 30 days. Acceptance of Proposal — The above prices, specifications and r conditions are satisfactory and are hereby accepted. You are authorized to do the work Signature !L / < as specified. Payment will be made as outlined above. / p / Signature Date of Acceptance: / raison rnn FOLD AT (y to m Dareueam m 011 WREN. NEBS/A Deluxe Company 1 -800- 225.5380 or www.neba.com mom . . • • • Alassachuselis - Department of Public Safcl Board of Building Ite:oulations ant! Standards construction Sul,rrvi ;or L icense License: CS 55333 Restricted to: 00 a g c ' ° LAWRENCE A JUBB JR . 1 1 '„j, t. PO BOX 429 `` GREENFIELD, MA 01302 - — Expiration: 5/21/2012 ( omnii.vion�,. Tr#: 24599 . . • _ e ,,, y7 , 6 ,,,,,, Attoe . ,,„.„__iz to:J gi/ Office of Co Affairs and usiness Regulation ( 1 0 Park Plaza -Suite 5170 .,. Boston, Massachusetts 02116 Home Improvement Cqr tractor Registration , -- - `= -.-„,,--.1„ 100001 ` - Type: Private Corporation __-: - 1 - - - - -- : Expiration: 6/8/2012 Tr# 297762 The Jubb Company, Inc .: Larry Jubb - - _ -._' : r - P. O. Box 429 =,_= '- =- Greenfield, MA 01302 - E= ? C _ ~ Update Address and return card. Mark reason for change. �__ ❑ Address D Renewal El Employment 0 Lost Card DPS -CA1 0 50M- 04/04- 0101216 4 • • • . . . . • • . • . AFFIDAVIT • • • . As a result of the provisions of MGL c 40, S54, I acknowledge that as a condition of Building Permit .. . Number • all debris resulting from the construction activity governed by this • Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL '. c11].,S 150A_ . . . • . • . • I certify that I will notify the Building Official by . . (Two months maximum) of the location of the solid waste disposal facility where_the debris resulting from • , . • the said construction activity shall be disposed of and I shall submit the.appwpriate forr.fot attachment • • • to the Building Permit. " . ' . ' • • • . • Date %' Signal of Permit Applicant ' (Print or type the following information) • . • • • • , '.L_ •> ) (6 Name of Permit Applicant . . ; • . Firm Name. if any • , . ( ) /1:ki (c-c ' ' • - . • . . • . • • Address • 'e•:'`debris "`iai•1I' b'e': disposd`'' af'::,:••'•'• •:• : ••"'"'•"* •: h , .... .. . • J L d ) ( C 7 Jk 4. 1 ;' / • • • (Location of Facility) • ' `(C/ . -J 1 t . • • • • The Commonwealth of Massachusetts Department of Industrial Accidents ir w , �1Mi.� l Office of Int'estigations � 600 Washington Street Boston, MA 02111 titntnt: mass.got' /din Workers' Compensation Insurance Affidavit: Builders /Contractors /Electricians /Plumbers Applicant In formation Please Print Legibly Name ( Business /Organization/Individual): k I� Cc j V i i 1 t ► 1 C Address: - . 0. U L 9 City /State /Zip: )C_ H Phone #: a / • 7 Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ 1 am a employer with 4. ❑ I am a general contractor and 1 6. ❑ Ncw construction employees (full and/or part - time).* have hired the sub - contractors 2. ❑ I am sole proprietor or partner- listed on the attached shed. x ❑Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3. ❑ I ani a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12.0 Roof repairs insurance required.] t employees. No workers' comp. insurance required.1 13.0 Other *Any applicant that checks box N 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 shcct showing the name of the sub - contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. - —� Insurance Company Name: . C. ) . - TIIE S (C? t'1( Q Policy # or Self -ins. Lic. (e (o L i - q ( "1 Expiration Date: .5 /3 / ) / 1 Job Site Address: City /State /Zip: 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. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: u-. Datc: � Phone #: ] 7 ( a f 7 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: • . SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(8)) 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 ❑ 11. - Dome Owner Exemption The current exemption for "homeowners" was extended to include Owner - occ upied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5,1. Definition of Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks (0 Siding [0] ; Other [CI] Brief Description of Proposed < �, fi lf� / ) Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction 1. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, , 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. Signature of Owner Date 1, , as Owner /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signature of Owner /Agent Date . . . . Section 4. ZONING AU Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L:. R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved pig) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit/Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES 0 IF YES: enter Book Page! and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 .................... .. IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES ® NO IF YES, describe size, type and location: E. WII the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. tE14 son V 4O Dap rrat se only '� City of Northampton Status of Pern ime Building Department Curb CutlDriveway p ermit ' ,` t0 . \ 212 Main Street Sewer /Septic Ava,lability Room 100 1NaterIWe Availability Northampton, MA 01060 060 Two Se tact Structural Plans cO ,' phone 413- 587 -92 Fa x 413- 587 -1272 Plot/Site P tans Other Specify A -- PPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: / This section to be completed by office Cj � � l l � - 1 ( ,it, , � ,i Map Lot Unit 11 Zone Overlay District Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 1 Owner of Record: 2. 7 L f' )1(G, " 2 r'I` O�� `LS (1 / /{�CJJ.f,.k )��t " Name (Print) Current Mailing Address: / L Telephone Signature 2.2 Authorized Ascent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Con fro (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + q + 5) I � � ( t i Ch Number �> Q�� W'���I This Section For Official U Only Date Building Permit Number: issued: Signature: Building Comm Buildings Date e • 29 NORTH MAIN ST • BP- 2011 -0689 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C - 253 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Non structural interior renovations BUILDING PERMIT Permit # BP- 2011 -0689 Project # JS-2011-001128 Est. Cost: $13384.00 Fee: $128.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THE JUBB CO INC 055333 Lot Size(sq. ft.): 18948.60 Owner: CLINICAL & SUPPORT OPTIONS INC Zoning: GB(100)/ Applicant: THE JUBB CO INC AT: 29 NORTH MAIN ST Applicant Address: Phone: Insurance: P O Box 429 (413) 772 -6217 Workers Compensation GREENFI ELDMA01302 ISSUED ON:2/22/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: REPAIR & WRAP FASCIA 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department 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. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 2/22/2011 0:00:00 $128.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner __ 29 NORTH MAIN ST BP- 2010 -1059 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C - 253 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit # BP- 2010 -1059 Project # JS- 2010 - 001560 Est. Cost: $3000.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PHILLIP WALDRON 88999 Lot Size( sq. ft.): 1 8948 .60 Owner: C S 0 INC Zoning: GB(100)/ Applicant: PHILLIP WALDRON AT: 29 NORTH MAIN ST Applicant Address: _ Phone: Insurance: 46 HIGH ST (413) 422 -2252 ERVINGMA01344 ISSUED ON :5/25/2010 0 :00 :00 TO PERFORM THE FOLLOWING WORK: INSTALL NEW EXTERIOR DOOR & ROOF OVER DOOR 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: DK ' ® -1® G r,Gnvt- THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. ,, . � � .-1 44th; A414.44.4 Certificate of Occupan « mature: FeeType: Date Paid: Amount: Building 5/25/2010 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo �� � i \\() r t Louis Hasbrouck From: Ryan Hellwig [rshpe @crocker.com] Sent: Wednesday, September 29, 2010 9:33 AM To: Louis Hasbrouck Cc: George Dole; JJackson @csoinc.org; genek @pvrebuilderscdc.org Subject: CSO- Florence Ramp & Fire Escape Good Morning Louis, I am writing to inform you that the proposed change to the framing, which removes the HC ramp post load from the footing that is to support the relocated fire escape post, is acceptable to me. This revised footing base for the fire escape post should be 18" minimum if round, and 16" if square. Please let me know if you have any questions. Sincerely - Ryan Ryan S. Hellwig, PE Structural Engineer 28 Aldrich Street Northampton, MA 01060 Voice: 413 584 HLWG (4594) rshpe@crocker.com 1 9/22/2010 8:31:31 AM 8740 ® 02 /02 (biM/DDIYYY) CERTIFICATE OF LIABILITY INSURANCE D ATE 09/22/2010 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 nR AT.TER THE rfVRHA:E- BFFARDED RY_TRE_pOI. TOTAL_ it :T.D.W._TFTJC_1'.RILTJ.FT_CATR_ OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TEE ISSUING INSURER(S), AUTNORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE POLDER. IMDOATAMTs I£ that coostiFioata hold.= lc an ADDITIONAL INCTNN.'D, tha peliay(laa) m.e4 be ondeseod. IE CURROCATION IC WAIVED, evbjook 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 Regina Jasak NINIE eNaNE 1 Fax P 0 Box 483 (a/c ND. VAN): (A/c. No): E-MAIL Ludlow, IA 01056 ADDRESS° PRODUCER CUSTWUR IOU INSURED (1) PFPORDINO COVERARE NAEC N INSURED INSURER a: A. I .M. Mutual Insurance Co Pioneer Valley Rebuilders Community INSURER B: Development Corporation INSURER C: 1325 Springfield Street =N�REEe Feeding Hills, MA 01030 INSURER E INSURER Y: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES or INSURANCE LISTED BELOW NAME BEEN ISSUED TO TEE INSURED WANED ABOVE Fox TEM POLICY PERIOD INDICATED_ NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY HE ISSUED OR MAY PERTAIN, TEE INSURANCE AFFORDED BY TBE POLICIES DESCRIBED VERMIN IS SUBJECT BO ALL THE TEEMS, ENCLUSIONE AND CONDITIONS OF SUCH POLICIES_ LffiTS SHOWN MAY RAVE BEEN REDUCED BY PAID CLAIMS. Lt� TYPE Or mummer POLICY mimes POLICT PO A BP LIMITS GENERAL LIABILITY EACH OC CNRAECB ❑ Cd.PRERCIAL GENERAL LIABILITY DAMAGE TO RENTED RRNEIN ear=e ES Ve a.ee nee 6 ID CLAIMS MADE OCCUR NED ESP (Rep One person) ❑ PERSRIDB. & PDY usu. 6 GEN'L AGGREGATE LIMIT APPLIES ER: GENE KGRE GATE 1:1 Pat, ICI ❑PROSE CT ❑IOC PRODUCTS - CWT /OP AGG 6 AUTOMOBILE LIABILITY coo DNEe sINOLE LIMY ❑ (ea aooideet) 6 DY S d nTO BODILY INJURY (per person) $ ouxnO nut. ❑ SCHE MIL ED AUTOS BODILY INJURY (per accident) 6 PROPERTY DNTARE HIRED AUTOS per aocident) 6 El NON -OWNED AUTOS 6 ❑OdBRP.LLA I. IAO ❑ occO! TICK OCCURRENCE $ El EXCESS LTAB ❑ CIA IDS MADE AGGREGATE 6 ❑DEDUCTIBIN 6 El RETENTION 9 6 ' WORKERS COMPENSATION pc oar L AaD- OTH AND EMPLOYEES LIABII.ITY r DiBY S ER THE PROPRIETOR/PARTNERS/ E.L. EACH ACCIDENT 8 100, 000 EXECUTIVE GYYICERS ARE A incl ❑ excl 7024303012010 07/02/2010 07J02 /2011 E.L. DISERNE Ea EMPLOYEE 6 500,000 E.L. DISEASE - EA EDRLOYEZ c 100,000 CLIENTS / DESCRIPTION OF OPERATIONS OR LOCATIONS: CERTIFICATE HOLDER CANCELLATION CITY OF NORTHAMPTON BUILDING DEPARTMEN sEOULn ANY OF THE RHONE DESCRIBED POLICIES BE cAmcFEERE BEFORE --' -'- EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE 212 MAIN STREET POLICY PROVISIONS. NORTHAMPTON MA 01060 ANTHDRI ZED REPRE 9319 , 11.............• . .. , .... , . : . .. ... .„Ver51041:7 Comernitl Building Permit May 15,2000 . . *0 : .... .....„" r*MW%10.:V!,410.1,04,70:',!.,4::•;;P:::..;.:),...i.:;'.::"'• , t - - • - - ent Structural .,,,,,1 structural! Pee( Review — - mired vee 0 No 0 : ....---....... ...... _ , , . .,i) , . ., .:1:.! ".. = '', '; ; '37 0 - ,.. r,, .,40:15E,Em Ti;,..: :TKIR,=.::;;-:.,.: • 001WASMEttri*C N , A 1, 1,, - J. .• .. .. ..7_,_, , ______I _ _ &L± Alfr ____ 6 _ ' 0 Owner of the subject propoty . i h ereby , authorize „s _ i A . .„..e / .,4.-.. ,.....0 ,......4 ± . 2 , 4 .,..._ . _,, - - -.----...------, .....it0 —a 1 matters relative to - euthortted by this building penhit application. _ 4 .441..._ ___ _ _ - - .. 9116/2010 .. .o.. .■•■•■•■ur v+,••■••••■■•11.4111,..1. illitV;Alia ,Apo, Clete , - — - — — -- — - - — • -, Geneicedyvin=4=======i0==mcm . . .. v . 1. --- 1, , BS OwnertAuthorized Agent tort* declare that the detentes* and information on the forego PPlination are true and accurate, to the beef of my knowledge arid beVer, Gene Kentiedy, PVR , amkt,==gi----.---._____ print , ,,_.:4„,._ ma _,..... ___.,—............._,... Date A ' —. - ,_,. 11.4., Not Applicable D Stove Thorn 1S=0., AMOVAUSIMUSIft ' - - L. Arici nos signature — : - 413,221.6698 Telephone - Esqtration Otto , =001104:43:44 COPPOSAt10/407filP*011441114.;#41.04104,0*:::::-.: .: L''':' Iterff . 0 / ., ,,,;•. •"7. .. '. . • m".' :'' .'& Woke% ConipensEdion Insurance (EOM inlet be oomPleted end s unteltuad with this application, r Mute to provide this sitibevit will rem* in Me clenial Of the isevante of tha biAlcil _.! Dank Signed AffidetAt Molt ed y eP 0 No * .., • . • . , • . . . . , , Voralool .7 Commercial Building Permit May 15, 2000 • , , .. ...„ ,. • ..... . .. . ... . . i idONS7RILP.1002, ffa'G'P'; . THM L'I:: ••::.::".. -----------....---- ftr i to M 1 --t• Fust — fita ; ti - art . L IMP*M11••■••••■■•■•■■•... '......• . Addrotis - 1 " ----- Ti &photon date sigrurt Telephone 0•2 PioEilatered Professional Bi2gL_nonAkt_____________ 2 17 - , , 1kkass Ants of ResponatetY _ r • __________ Morass Rentatmthon NumOor 1 ---------- ute ______________SitofrOOon Date [=------. 7 1 , . . . ......■rurn NOM Rap ty .. . . • Acidosis .._.... .11;tojakellumkal:._ •••••../~./■/...../•••■•Vown■ "...''' ..E.,_.....,........................,......................e/Ph DO6EAPirdti On - 1/ 1 - I MOO 70a of fisilaponslAN F -7 . ------ Z. Mims Roglatillio-Thl1Wba7------- r ......---....-- 7 S0 — —„-- • Nam ..,.. ---L.,—... e Ares of Reaponsdblity L ‘.. Fi Numper A Telec l hal,....± ...,.. %L ..............................................,.. - 1117;ik Date * ........11... , 2.3 Genera) COOftflOtOr 1.PiptIVX VilikilebIlilden ! Nat AnPlIcable 0 stirriparvatrsik -----; ftenoponeible In Otsettle /93 Mill Street #84, Spring6eld MA. 01108 — -----= .. ,. _ 1 or' ' , , „ ...._ _.....,.„ RFAWorl nhasounl. Tateplione , • . Varnionl_ ?,Cotamercial &hiding PermitMay 15, 2000 .. . ',, r rra 'N'zO i'+ . • - Existing Proposed rquudy zoning Tht9 �r>� LJIcdbb Lot Size iJ .«...�._� t Frogaa_ _..- .—. 1 L Setbacks Frog Aide l L :C,.= 1: 17 E PAU Building }lei* Bldg. Squa o Footage „ i % r _ _ ( o ve oral p.ae t,* pavoi /a 1 ! .= ..' - , ...._ offF g S aces �� A. Hasa Special Permit /Variance /Finding ever been issued for /on the site? NO CI DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'l KNOW 0 YES 0 W YES: enter book [� Page{ and/or Document # B. Does the site contain a brook, body of water or wetlands? NO l DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YE5, describe sl2e, type and location: stand busin ide nrificafaora, fon 1 awz G t D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 IF YES, describe size, type and location:__ E. VViiII the cons Lion activity disturb (cleanrg, grading, excavation, or filing) aver 1 acre tit is it part of a common plan that will di irb over 1 acre? YES 0 NO 0 IF YES, then a Northampton Storm Water Management Permit front the DPW is required. • . . - . . VersionI.7, Carlsson-tat Building Permit May 15, 200e . 1.1131C.FEFOFANI*M913:SPAC19.,:. ... • -•• : : : • •..:., .:: • li .1 ...:;;;J:.! .'. , l': • !'. .............../...1,...■■■•+■.--, .11111.11Maml•■ , !raider Alterations 0 Mdsiing Wall Signs El Demolition° Repairs 0 Additions 0 Accessory 13411k1109123 Exterior Mammalian 0 basting Ground Sign 0 New Sighs 0 Roofing In charm.. of Use 0 . Other_ 0 _ ..... .._ ..... Brief Description 1 N - heektair ramp — c e...t p la $ s ci 4 4-cist. 4 - of Propoted Work ..-...,, s , — USE GROUP (Check as spplIceIge) CONSTRUCTION TYPE . A Assembly I:3 A 0 A 0 A 0 1A 0 A.4 n A-5 0 1B B : Incas CI 2A ID E Educational 0 29 0 r Factory 171 F-1 0 F-2 1::1 2C 0 . H I h Ha=ar_ 3A 0 1 1 , si 0 1-1 E3 12 0 1-3 © as C.3 Nt Marcantlie 0 4 El Reside 0 R-1 W' 13-2 CI R 0 nilli s Storage 0 S-1 0 S-2 0 El U Utility 0 SPer* L.-- ' ---- — . 1.1 Mixed Use El Sp __—...-------- actly: --..--_—.--,.-----,—_,.......„...._, .......,—. ........—..........--..—..wrommsa S Speci,a, Use 0 %xi:HY: , „ ,,:..., ,,t , ,, t ;71 , -.tir...p .3 lir ...ti -ZAi - ' 71i.n... .7..m. , na.: .! rm. ' redthilifrr9 5117: ''' ........P".1.9'.WrArtg . .: 2 .,;','„.. ' .r.: L _ ehafirifj Usa Group: .— _ Propose Use Group. - Existing Hazard index ;.0 CVO 34 :1 • . . .. 1 Proposed Hazard Index 780 CMR34,: =,) ":W D enmo -- UILDING AREA m ,..---. :: ..: .. .M6Y PROPOSED NEW coNSTRuc-rio OFFICE NL N !;....' ::4 i ,, :, ' , : ,, . • : • ! ' . : . ,, , Piece Are41 par Floor (sf) 1 200 n . ., 3 rd 3" - .—....1 .. ..: : .. . ' . . e i r -- ...--____.-- 1 .- .._ ..—__________l Total Area (sf) l ' Total Proposed NConstruegpr it_ : .. ,11%41...a.■ • Total Height (ft) Total Height ft C=11 ...] 1 l'., , . •' . . - „: „ . . . 4 7. Water Supply thi.G.I... e. AO, 5 54) 1.1 Flpod Zone Information: 7.3 sewage Disposal Systetn: 5 . ) , Public 0 Pervate w Zone 1,____,:j Outside Flood Zone. Munitipal 0 On site disposal system a _ .,. , . Versiaa1.7. Commercial B . , Pecrit Ms, 15 2000 F:Igrt T''' ,j'','": ( � �ur.r,,. v • r r t, ^r' ) + 1` . ,. 0 I I.r i ,�"d f f,, a 4,' 1 — - CityCity of Northampton ` h� �' � 1 r v � rt � r .a I r � , �r ' n siI (r ,.y{ � ' F -,",:4 + ,/,'„:',' i t J t, J J r i yt 1 >i ly �i I NA 8uiidjr Department „^ ,, , , v3 r r " � y'J , - � 3;, :, J'r $ ,I.'H` r` Jrr r j,9 �� 2 - 212 Min Street s� ,, , ! ' ' C� , �"� 4I < Y, t"�, ru o; ;'� l' ;r "'jr , ,' J ' I v .''',;.111 7 7 1, :.' ..,, , , '" , ..' ,, t 1 � I S ] r J i� L..v4.r' s�, ' n...+x.t1.,,,.r.ut �i{, -+>EI, l ( r' , n ; / d N : r r , J , k v'k , 7 a Room 100 r w J , ) +'� t t s ,t�„I , , � n', Northa il . MA 01060 r 7l''''.111.% + " ; ,, , , - 1f i y(1 7 I.T � µ 51 '. 't i I � « ! wtt ' , y u f r ' i L 44/1 , I ., J � r rIr t 9, d l a J '���, Sf. � f r r JI f' , r: y{r !k 1t phone 413-667-4240 Fax 413- 587 -1272 ' 4g t 4 1 fix : a •r, ,1 u, r ' �'' , ' i ( , 41 �t1 r F . 4 f , w s' 1 a (r (,Y �, 7 1 „1 (, I yl J (. Ir 3,x �a jw ;�,, r b3 1y i i , a 'i r:. � _ I , h ch yull � 3 4ti � J r•, e;t , � J� 1 1 v. r� �' , a t 1 I �.. 7.',.�.M U. ,,. �. r:�..aL.,l APPUCATNON TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DMIOLIGH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY MIFF-LUNG SEd111 ti'l- IT 1NFQ A,TIQN ' .z h, '' r L4 . This section b be. a (,/ _ ... . ` 29 North Main Street, Florence — 1 , „ : :A a'p , . , , Lot :l hlt Via , Ovnr y py tr1e r 1ii� ,.r;. , "•V.i '. ".,, ,. "::: I fi"," , .f3' ii7r” r :111,. , ... 2.1 Gw nar of v Clinical Support Opttetts (CSO) 111 Federal Street, Greenfield MA 01301 Name (Pint di , T . Cufrent MOilin Ade roigs" _ w _,. ,.,. �/ // 13.4752.56 — — �.-- { $I Wren / �_... _ TetmAhn�lkl 2.2 9....iO Lie _ . _ 93 0 1 1 0 8 Name (Print) Current Ma ' - - . 413.6363960 sign ,e" . , / W e y 7, 1> _.. aka b� �,. � , ,4 : �.. ., ; - (Dollars)lclye °I" : w :Official' Building r.--- ,� 1 y t ,, : ,r _ '�„�, ;,, • 2. Eleotriice! — (b? n t 1 eat ;aS ' -" .-.' : wiiiiiiiiiims Vim, s , I,' „,_:,,:); 3, Plumbing 4. Mechanical (M/AC) r �,,.Y,.,_.,.,,,._..r,.� -.. ; I , , _ f ��""""°�.. -' ::�;:r;:+= �:•�:;:4 5, 1~'ire Protection 1; -- 6. IMO= 1+2+3+4+6 I 600 ;Cii ;, ...., S, 11 WI 4 ,. Bu11Ct1t1Q;Perm(t NIll1 ber' p ' ' 1s9! 11e1 _ .ar - .', 1 _ . . f ,t . $ I Y.I. : :,--,%.;•,, . „ if : I, _ e .,.. ,. " r` i'It'i _ . . • File # BP- 2011 -0255 NM) ' 'jF6) APPLICANT /CONTACT PERSON PIONEER VALLEY REBUILDERS COMMUNITY DEV . eat t ADDRESS/PHONE 93 MILL ST #b4 SPRINGFIELD (413) 636 -3960 - f L` PROPERTY LOCATION 29 NORTH MAIN ST TO PRA eDi MAP 17C PARCEL 253 001 ZONE GB(100)/ 8 Lt t LT P1f PLA N S THIS SECTION FOR OFFICIAL USE ONLY: (fl p E� d PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE 1_ 1" � A N ��P TO /Lr ZONING FORM FILLED OUT Fee Paid 1 (2-f7 ( E3 t 4J Building Permit Filled out ,,��` Fee Paid 0175/ */oa- NOT O t•1 P to 6 L L G Typeof Construction: CONSTRUCT HANDICAP RAMP New Construction P 11-0J'6 R-T isj w rn Non Structural interior renovations Addition to Existing p c66b Accessory Structure �-� Building Plans Included: o (1J P (� S �� Owner/ Statement or License 80004 RA SK sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN� TION PRESENTED: pp roved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit 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 Availability 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 Signature o iuilding 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. Y 7 • 29 NORTH MAIN ST BP-2011-0255 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C - 253 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP-2011-0255 Project # JS- 2011- 000428 Est. Cost: $17000.00 Fee: $102.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PIONEER VALLEY REBUILDERS COMMUNITY DEV 80004 Lot Size(sq. ft.): 18948.60 Owner: CLINICAL & SUPPORT OPTIONS INC Zoning: GB(100)/ Applicant: PIONEER VALLEY REBUILDERS COMMUNITY DEV AT: 29 NORTH MAIN ST Applicant Address: Phone: Insurance: 93 MILL ST #b4 (413) 636 -3960 WC SPRINGFIELDMA01108 ISSUED ON:9/28/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: CONSTRUCT HANDICAP RAMP - NEED PLOT PLAN TO BE SURE NOT ON PUBLIC PROPERTY,BUILT PER PLANS,PROCEED AT OWN RISK 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department 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. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 9/28/2010 0:00:00 $102.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner Animmemonnommount