Loading...
06-029 01111k Icf ' - CS-074666 RICHARD L ARTS 132 PROSPECT STREET EAST LONGMEADOW MA 01028 02/05/2014 fill** p• 44111101,1101r.."" L d 0 I 01 V 0 TA u .. L G i G -J ' ! O .a 1 CC 0 U L E +5 I L O ��F-� O) N 0 . . a W o ▪ �` \t l) •C t 1 = "ii = G O: S") iii O. 0 y � V O. y '� O O ▪ G y a1 : r > • '"q � I- tad C a ! L• C p r—+ bA N a , y c c .� N N/ O: w I 1." • L w I G ti = 4 r--i N . a 4° - G an i1 U ; H � OG< d CA -I-) L E . . � U O E a= es o L. �x Z os v� a Col Q' a cc,, 4J o a, h `■ _w 4. w o O r—+ O P.. O Ir4 E -.:....,-- a �U c o a I ' i t .%(-18 • ca O 0 �;; �' 6. cr C) E U ()\,:',.. W(n } �" z Z y U M WQDw ►- a) o ZQ - L. w (O V. CL W W ` Z =o0 1` C a > co C CI o _ V. ¢ J� ° N Q. W m 1- Z 7 c r: o 2 W z ¢ ��I MC IhIIp'1Y1 O_ /! ��9�IIIII4RRII1 N % .91111.11%,; W a 2 v ? 1(0!!!!in11.: , 11IIIIII ;x,118 , 5 a M Z ch �� '�I Offi of Consumer Affairs and usiness Regulation 1, g e .40,Ew 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169979 Type: DBA Expiration: 8/25/2013 Tr# 216225 LANTERN ENERGY PETER CALLAN 33 WISCONSIN AVE. -- __ NORWICH, CT 06360 Update Address and return card. Mark reason for change. oPS•cai 0 50M- 04104•G101218 0 Address l.-) Renewal H Employment 0 Lost Card Office me r Af Business y e Regulation License or registration valid for individul use only 1. -" _V - -- HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: ► i Registration: 169979 Type: Office of Consumer Affairs and Business Regulation e H----- Expiration: 8/25/2013 DBA 10 Park Plaza -Suite 5170 Boston, MA 02116 LA RN ENERGY,_ , PETER CALLAN 1200 MILLBURY ST 9D. ; .— WORCESTER, MA 01607 Undersecretary N alid without signature • x/114,, ACORD TM CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDA'YYY) 12/27/2012 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. .MPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 NAME: Shoff Darby Companies, Inc. j a " " c " N ,Ext): 203.288.7305 I �v , N e ) : 203.354.6480 250 State Street A -1 EMAIL ADDRESS: - North Haven, CT 06473 PRODUCER 00046616 CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAIC N INSURED INSURER A: Union Insurance Company Lantern Energy, LLC INSURERS: Acadia Insurance Company 31325 33 Wisconsin Avenue INSURERC: Evanston Insurance Company Norwich, CT 06360 INSURER D : _ INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 12 -13 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. I LTR TYPE OF INSURANCE ADM WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMlDDiYYYY) (MN1DDlYYYY) GENERAL LIABILITY CPA5077122 12/31/2012 12/31/2013 EACH OCCURRENCE S 1 __ , 000, 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 10 000 PREMISESlEaoccurrencel � J CLAIMS -MADE I X I OCCUR MED EXP (Any one person) $ 5 ,000 A X PERSONAL 8 ADV INJURY $ 1,000 000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 7 POLICY n rj X LOC _ $ AUTOMOBILE LIABILITY CAA 807712412/31/2012 12/31/2013 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 J ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ B SCHEDULED AUTOS PROPERTY DAMAGE S X HIRED AUTOS (Per accident) X NON -OWNED AUTOS $ $ X UMBRELLA LIAB X OCCUR I CUA507712512/31/2012 12/31/2013 EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 4,000,000 B DEDUCTIBLE — $ X RETENTION $ 0 $ WORKERS COMPENSATION ! WCA507872812/31/2012 12131/2013 X I TOR WC YLIMIT STATU- S ER I IOTH- ANY PROPRIETOR/PARTNER/EXECUTIVE I Y! NI N ! A E.L. EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER I n (Mandatory In NH) EXCLUDED? E.L. (Man NH) _ .L. DISEASE - EA EMPLOYEE $ n S. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000 ,000 Professional Liability 1 12CPL01180 12/31/2013 Each Claim $1,000,000 C Contractor Pollution Each Condition S1,000,000 DESC OF OPERATIONS! LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Western Mass Electric Company, and Bay State Gas, Berkshire Gas, Cape Light Compact, National Grid, New England Gas, NSTAR Electric & Gas and Unitil as program sponsors are included as additional insureds per written contract or agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE h„A.t1\'ls4z I _Megan McCloskey /MEGANM © 1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ,1 , 1 ne t- urnrriunyveUii i Vf in U3JUI. 41.1 Department of Industrial Accidents ;_ = ... Office of Investigations '� � E = `' �" ! =' 600 Washington Street Via Boston, MA 02111 ��= r s„... www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Lel<ibly Name ( Business /Organization/Individual): LA t+e.lr (n £, K e 5y L L C. Address: 3 3 ltlls co Ks ; rt v. .ie . City /State /Zip: /Vo r w i c k CT 04;3 (o a Phone #: $ 77 - 97 8- 3 00 (v Are you an employer? Check the appropriate box: general contractor and I Type of project (required): 1. © I am a employer with a b 4 . ❑ I am a g 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. ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance 9. ❑ Building addition [No workers' comp. insurance p' 10.E] Electrical repairs or additions required.] 5. ❑ We are a corporation and its 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 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.® Other i employees. [No workers' rl Sul vfiiok 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: AGgo(io T11S vice. Co VW, p uw Policy # or Self -ins. Lic. #: (A)GA .co 7g 7 2. R Expiration Date: i2131 / 241 3 Job Site Address: 2.52. 14 0„ v, v i 11e. `Rrl . City/State /Zip: Leed s , M6 0 ( 05.3 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 Signature: E6JLJ alJ5 Date: y,41/3..0, Z. Phone #: ' &z — 3 ©(a -,2 76 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 #: es 4001(i 0- A PAZTICIPAThia mass save COMM= Swifts Owoegh etteNY.Oh' ncY PERMIT AUTHORIZATION FORM 1 C , owner of the property located at: (Owner's Name, printed) (Property Street Address) (City/Town) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and /or weatherization work on my property. Owner' . ignature /0 — / 7 - l �2 Date FOR CET OFFICE USE ONLY Center for EcoTechnology has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Let.v►tew,rt E .€,w5)/ LLG Participating Contractor Date P Rev. 5/24/2012 Property Address: 232. NaydeN Rd Leeds MA 0tos3 _ Contractor Name: LaK4-ewv` EV II-sy LLC Address: X�33 W. se n K s ti rare /t City, State: r 1 4 ) LT 6t2 3 to 0 Phone: 577 - 375 - 3 00 to Property Owner Name: fa.w. e_5 Fn +e.v► Address: 252. FEet i lie vcl City, State: Leec.t s MA 1, ∎ c k.a wl A b4- < (contractor) attest and affirm that the building I intend to insulate does not have any open air (knob and tube) wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. Contractor signature i o eG� , .,l�1teJC ��W3 Date 1 1,4/20 I L SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor, / Not Applicable ❑ Name of License Holder : ; c ko v e A k t s d 7 4) We License Number -3 7, t'.PnS ,of.4 S +. at +1 nut. - rinu) M/4 Go h2.81 .Z js /Irf Address /� r J Expiration (j ate 1 g &O - 3 o& ' 72. 9S Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Lau +evpt kxeo LL,C Re 95 79 Company Name Registration Number 33 W;scoksiK ove. e t'cit Cr O(0 3Lo0 / 3 Address Expiration Date Telephone 377- 873 - 3006 — SECTION 10- 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 X' No ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner occupied 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) n Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [CI Siding (D] Other (]:4] Brief Description of Proposed Work: T, .ts t. to +e a+l i c - C100 v' /0 „ 1310W14 Cellulose. psdorr to. air s ea.(; Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll - Sheet si 11 New house and or addition to existing housing, complete the followirut 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 i. 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 See tow&e. oWKeVV ace-f-Lovt 2ca i-.ON. leffetn , 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 I, ” r.koupei . A bt 5 , 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. r G Vl et A lo-(- 5 Print Name tow- !/ 1 cF/ 20 ! Signature of Owner/Agent Dat Section 4. ZONING All 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 parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO QJ DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO t DONT KNOW 0 YES C� IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW 0 YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O ,Date Issued: C. Do any signs exist on the property? YES 0 NO el IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO 0 IF YES, describe size, type and location: E. Will 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 O NO (5 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Department use only Va ` City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 4 20 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability °I of THAMF TO� tJ p Alo hampton, MA 01060 Two Sets of Structural Plans Noy one 413- 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPLICATION 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 2 52 No�yc(eM ✓� Mee Map Lot Unit L ee of $ , ,I4 0106.3 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: 0 - avhes Fos +ew 25.Z I- Io. rd. M4 01o5 Name (Print) Current Mailing Address: /E13 - 961 - 9056 5PC LteAKe.AWL4 J. oi (.t +14not zea+iet4 I C Telephone Signature 2.2 Authorized Agent: R;cko,o0/ A6 +S 13 Poe*spect st , E... [.o N wteaodow / QfoZB' Name plibtq) ©rrtesel I llim Malm,ass: ,_,i uX cun 860 - 30(0 - 7R ?.- Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 7 ) 2(o3 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total= (1 +2 +3 +4 +5) *2. t 1(03 Check Number ,9 - This Section For Official Use Only s Building Permit Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2013 -0701 APPLICANT /CONTACT PERSON RICHARD ABTS ADDRESS/PHONE 132 PROSPECT ST EAST LONGMEADOW (860) 306 -7275 PROPERTY LOCATION 252 HAYDENVILLE RD MAP 06 PARCEL 029 001 ZONE URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Construction: INSTALL ATTIC INSULATION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 74666 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION PRESENTED: Approved 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 l 12. Signature of Building 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. 252 HAYDENVILLE RD BP- 2013 -0701 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 06 - 029 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit # BP- 2013 -0701 Project # JS- 2013- 001158 Est. Cost: $2263.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: RICHARD ABTS 74666 Lot Size(sq. ft.): 18948.60 Owner: FOSTER JAMES Zoning: URA(100)/ Applicant: RICHARD ABTS AT: 252 HAYDENVILLE RD Applicant Address: Phone: Insurance: 132 PROSPECT ST (860) 306 -7275 WC EAST LONGMEADOWMA01028 ISSUED ON:1/23/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL ATTIC INSULATION 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 1/23/2013 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner