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35-155 Northampton, MA Property Detail Page 2 of 2 Additional Features: Brick Trim: 0 X 24 Stone Trim: 0 X 0 Remodeling Data: Year Remodeled: 2009 Kitchen Remodeled (Y/N): Bath Remodeled (Y/N): Land Data Outbuilding Info Square Foot Type Utilities Type F Qt Value no Prime 21,070 88,870 information Type Qty Year Size 1 Size2 Grd Cond Site RS 3' 1 1970 1 136 C A Acreage Type R - 1 1 2009 1 660 C A Street/Road Type Acres Value no no information information Sales Info Permit Info Date Type Price Validity Date Permit # Price Purpose no information 05/08/2009 898 15,900 22 X 30 GARAGE i http://www.northamptonassessor.us/noho/propertydetail.php?map_no=35 -155-001&pageca... 9/9/2013 A'WRO CERTIFICATE OF LIABILITY INSURANCE 9/9/20 13 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 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 Jenna Rodrigue, CISR NAME: Webber & Grinnell PHOt Q Es : (413)586-0111 I(q/C,No): (913)586-6481 8 North King Street $$.jrodrigue @webberandgrinnell.com INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERAMain Street America/MSA 29939 INSURED INSURER B: Theodore Towne, Jr. INSURER C: PO Box 150 3 INSURER D: INSURER E: Easthampton MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER:Exp 2014 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSR *ND, POLICY NUMBER (MMIDOIYY) (MMIDO$WYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500 000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR MPI51046 6/29/2013 6/29/2014 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG_ $ 2,000,000 l POLICY n PICT n LOC $ AUTOMOBILE COMBINED SINGLE LIMIT UTOMOBILE LIABILITY {Ea accident) $ — _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ DED I I RETENTION$ $ WORKERS COMPENSATION I TORY LIMITS U- I 10TH- AND R N EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE N!A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E .DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E .DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. Main Street Northampton, MA 01060 AUTHORIZED REPRESENTATIVE B Grynkiewicz/BARBG ■ ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: ( /-{ e::047:>f)at sue. . Q'v IILI E N:-12 • L 5 72 Z License Number P® Svc ( 5a 3 ; t577(*kP• a).‘, . Mi• o'd27 8 - 1.o - /,,S Address Expiration Date --7/4"--4 .--) - 163 all- 2112 Signatu Tele one 9.Registered Home Improvement Contractor: Not Applicable ❑ I(01.1 (... e.112'...1.1. a',..) ..SIC /3Z 737 Company Name esie... 2.7 Registration Number P .-.L rx.x (5d"N , 4►k51).k-11A. Pie--,Li, N,tt f-f •2 - LS" Address Expiration Date Telephone 103 7-2-7/ 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 it 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 /'V A SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing ❑ Or Doors e Accessory Bldg. ❑ ' Demolition El New Signs [O] Decks [q Siding[D] Other[0] Brief Description of Proposed � p �, /1 •,_aaC�Work: Replacement window 11 G„e oitrC W ttntef Alteration of existin bedroom Yes xxx N Adding xxx existing No dd ng new bedroom Yes No Attached Narrative Renovating unfinished basement Yes xxx No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: 7 b. Use of building: One Family Two Family Other 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 I, ,1 T7%5 , as Owner of the subject property -737, e hereby authorize / 1`t t i 24 i 1 J 2. to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date s I, /f7i.-21 Gpc a-&-c,.<- C ji2-, , 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. s� °714 t.S:e.a>oil-LC 1 o'er A> 14- Print Name /_ /_ 5L P 4.5"; 2,03 Sign. :re of Owner/Agent Date 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 0 DONT KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW © YES 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 ® NO 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. 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 ® NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only �'r � \,� City of Northampton Status of Permit_ �� Building Department Curb Cut/Driveway Permit D9 2013 212 Main Street Sewer/Septic Availability SEp Room 100 Water/Well Availability Gas tn5Pect'on orthampton, MA 01060 Two Sets of Structural Plans p',in`pt°9 n t"A:•':c - 413-587-1240 Fax 413-587-1272 Plot/Site Plans e\eclriCN°ttt,amPlcn, 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 .1'1 5`-- rr_ ` a . Yf Mfr f✓ " Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Lee Bates 802 Ryan Rd,Florence MA 01062 Name(Print) Current Mailing Address: (413)584-6465 j `. 1 Telephone Signature 2.2 Authorized Agent: P.O. Box 1503,Easthampton,MA 01027 P.O.Box 1503, Easthampton,MA 01027 Name(Print) � Current Mailing Address: /� t o w J JR P.O.Box 1503,Easthampton,MA 01027 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 4,500 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee f3.5 4. Mechanical(HVAC) r• 5. Fire Protection 6. Total=(1 +2+3+4+5) 4,500 Check Number ,5cs y`z5 This Section For Official Use Only Date Building Permit Number: _ Issued: d % — Signature: i C �� Building Commissioner/Inspector of Buildings Date 802 RYAN RD BP-2014-0290 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 35 - 155 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2014-0290 Project# JS-2014-000487 Est. Cost: $4500.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THEODORE TOWNE JR 722 Lot Size(sq. ft.): 21083.04 Owner: BATES LEELAND T&MARGARET T&M QUATTLEBAUM&T BATES Zoning: Applicant: THEODORE TOWNE JR AT: 802 RYAN RD Applicant Address: Phone: Insurance: P 0 BOX 503 (413) 297-2916 () WC EASTHAMPTONMAO1027 ISSUED ON:9/10/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT WINDOW 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 9/10/2013 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Louis Hasbrouck—Building Commissioner