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31C-023 Permit No. D08-14 Conditions: Driveway Permit In lieu of plan approved by the City Engineer I agree to the following added conditions: 1. I will contact the Department of Public Works and have an inspector check and approve the graded gravel base prior to paving to insure compliance with slope and location; 2. I further agree that if in the inspections, any of the permit conditions are not met that I will at no expense to the City remove and replace thp driveway as directed by the City Engineer. By: Petitioner Signature Name: Kent Pecoy & Sons/Don Clarke Address: 315 Baldwin Street W. Springfield, MA 01098 Note: The Public Works Department recommends that you provide a plan showing the proposed driveway with grades and location in the future to avoid possible expense which you will incur by not getting approval of actual plans in advance. For Commercial and Industrial applicants, a plan showing the proposed driveway with grades, location and Planning Board permits are required. Cc: Building Inspector Permit No. D09-14 CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: 1/22/14 Check#: FEE: $250.00 THE BOARD OF PUBLIC WORKS Driveway must be staked and house& lot number posted The undersigned respectfully petitions your honorable body for: A new curbcut Permission to install a driveway at: 65 Ford Crossing Fifteen(15) foot maximum width at the street line. Gutter drainage not to be disturbed. All Drainage shall be directed off the driveway surface to adjacent land and not on the existing Roadway. Driveway surface to be paved as soon as possible if the grade of the proposed Driveway exceeds 3%or more. Homeowners will be held responsible for any cost to the City of Northampton in the event of a washout of this driveway. Code of Ordinances §350-8 8 providing standards for private,individual driveways as amended by the City Council on October 15, 2009,must be followed. By: Kent Pecoy & Sons/Don Clarke Telephone: 413-246-3749 ature: ,r Proposed Location Inspection By: G/j <41, it C5 '67- 154 Gravel Base Grade Inspected By: 3 — 6�! Final Approval: /A . THE BOARD OF PUBLIC WORKS voted that petition be granted. jAgff(�_Edward S. Huntley, �.E �� Director of Public Works Cc: Building Inspector (SUBJECT TO ATTACHED CONDITIONS 1 & 2) Jan 28 2014 8: 29 City of Northampton DPW (413) 587-1389 ° p. l MUNICIPAL WATER AVAILABLLI TY APPLICATION Northampton Water De mrtnhent 237 Prospect St Northampton,MA C10150 587-1097 A Department of Pablic Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 65 Ford Crossing, Lot#A23 Inquiry Made By: Kent Pecoy&Sons Don Clarke 2463749 Date of Inquiry: 1/E2f14 Number of Type of Single Family a Type of Private x Units: 1 Unit(s): App. Comma Ownership Condo Mulct-family Rental (Annlicant to fill Out he ahavel Municipal Water Main in Existing service to Front of Location? Yes: Z No: site? Yes:x No Size of Water Main: 8" Material: Ductile Iron Age: 2010 Approximate Static Street Floe.Test Conducted:Yes: No: X Pressure: 90 psi If done attach results Size of Service Connection 1" Suggested Meter Size: Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. • A corresponding water entrance fee shall be paid prio-to-making any connection to the municipal water system. • ementa of such installation ail be made with the Northampton Water Department with a minimum of 5 idng days notific .�'' • A44ark shall coaf to N on Water Deparrnent specifications. r 'f� David W.Sparks, Superintendent of Water Dept. Water Entry$2100.00 Meter$100.00 Radio S 100.00 cc: Ned Huntley,Director cc: Louis Hasbrouck,Building Commissioner / Nom availability is for a new construction it must be band delivered to the Building Inspector ` MUNICIPAL SEWER/AVAILABILITY APPLICATION Northampton Streets Department 125 Locust Street Northampton, MA 01060 587-1570 A Department of Public Works Trench Permit and Sewer Entry Permit shall be required prior to any construction or connection activity associated with this application. Location: 65 Ford Crossing, Lot A23 Inquiry Made By: Kent Pecoy&Sons Don Clarke 246-3749 Date of Inquiry: 1122/14 Reason for Request: Hook into City Sewer System Municipal Sewer Main in Front of Location: Yes No Municipal Storm Drain Available: 5 '/2 deep Yes No Size of Sewer Main: Material: Age: Depth of Sewer Main: Length of Sewer Main: Size of Service Connection: Type of Service Connection: Tie-in to Sanitary Main Tie-in to Sanitary Stub Comments: City Requires 6" cleanout installed at City Property Line Note: If this availibility is for new construction this form must be hand delivered to Building Inspector. A corresponding"sewer entrance fee"shall be paid prior to making any connection to the municipal sewer system.Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notification. All work shall conform to Northampton Streets Department specifications. John Hall Sewer Department cc: Ned Huntley; Director DPW Louis Hasbrouck, Building Commissioner Q h C Ln Ln O Ln O O UM — IA � L QI a W N " 'D Ol W n N Viris � � a, � L C w v N o N O, c C C a N ro 5 E 2 " _a a Wm N 5 0�an N a u T to o M c 3 0 c L m Y O 0 R 'o }. 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AMOUNT BASEMENT @ :20 �`�y� — 3 o Y 1sTFLOOR @.50 /SLR 7/00 . 2ND FLR 0.30' , I, Yi FLOORS, FINISH ATTIC,GARAGE @ 20 DECK/PORCI3ES @ -20 TOTAL.. 3 70 ya ,aco CERTIFICATE OF LIABILITY INSURANCE D2/16/p 013) `..� 12/16/2013 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 Irene Balise NAME: Alexander W Borawski Inc PHONE (413)5H6-5011 FAX (413)586-7973 88 King Street, Suite B UC)Ag'Lss:ibalise@borawskiinourance.com INSURERS AFFORDING COVERAGE NAIC i Northampton MA 01060-3257 INSURER A:Netherlands Insurance 24171 INSURED INSURERB:Peerless Insurance 24198 Kent Pecoy & Sons Construction, Inc INSURERCMass Employers Ins. Co. 215 Baldwin St INSURER D: INSURER E West Springfield MA 01089 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1371701444 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 JUL L UB POLICY NUMBER MMIDDY LTR /YYYY MM DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES E occurrence) $ A CLAIMS-MADE OCCUR CBP8780556 /1/2013 /1/2014 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY 7 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BA8781850 /1/2013 /1/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED Pe'accidentDAMAGE $ Underinsured motorist BI split $ 100,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 51000,000 DED I X I RETENTION 10,Doc CU8783651 /1/2013 /1/2014 $ C WORKERS COMPENSATION I WC STATU- I OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 M FICER/MEMBEREXCLUDED? N/A CC2000239012013 6/30/2013 6/30/2014 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/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 ACCORDANCE WITH THE POLICY PROVISIONS. City of Northampton 212 Main Street Northampton, MA 01060 AUTHORIZED REPRESENTATIVE R Borawski/BOREG1 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25 rgmnnF�m Tha Ar npn nama and Inn^ara ranietararl martrc of Ar npn K r' SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: ') Not Applicable ❑ Name of License Holder: �r f l / t<< C S S I-)S v `) License Number Address Expiration Date Signa re Telephone 9.Registered Home improvement Contractor: Not Applicable ❑ 4(1- /� Company Name Registration Number ;A, Address Expiration Date Telephone��� l/ jC t zf 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....... 21" 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) 0TRoofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding[[3] Other[p] Brief Description,of P,oposed 1 Work: �1 ,tO /��Si�fz Tin �cNS�Q�%�Tit� 3 <20,12 / 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 existina housina, complete the followin : a. Use of building :One Family Two Family Other b. Number of rooms in each family unit: it Number of Bathrooms 3 ��- c. Is there a garage attached? I C-S d. Proposed Square footage of new construction. Z,2 !R Dimensions 7ti x 5 e. Number of stories? f. Method of heating? w A-S j CRCf-1 ALP, Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Y S Masscheck Energy Compliance form attached? h. Type of construction WI LA i. Is construction within 100 ft. of wetlands? Yes ✓ No. Is construction within 100 yr. floodplain Yes k/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 10-7 as Owner of the subject property hereby authorize to act on my behalf, in all ma"relative to work authorized by this building permit application. Signature of Owner Date 3 .- 1, 2 /L l k1 / 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 pair's and penalties of perjury. Print Name Signature of Owner/Agent Date - -l It ?ifs 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 � DON'T KNOW C) YES IF YES, date issued:. IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO W DONT KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained ® , 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 0 NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. f Department use only City of Northampton Status of Permit: `.,Building Department Curb Cut/DriVewayPermit 212 Main Street Sewart$eptie Availability Room 100 W0ter1Well Avaitability ortham ton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Sda 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 — (.Il1� i t" //tLL ► Map Lot Unit Af r Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Anent: ty -L.72 }LS t�% 1 r)u't� Slle�1'7. Name( ' t)' Current Mailing Address: ell ?9 Sig ture Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by rmit applicant 1. Building (a)Building Permit Fee 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) 1 Check Number a his Section For Official Use Only Date Building Permit Number: Issued. Signature: Building Commissioner/inspector of Buildings Date File#BP-2014-0934 APPLICANT/CONTACT PERSON KENT PECOY&SONS CONSTRUCTION INC ADDRESS/PHONE 215 BALDWIN ST WEST SPRINGFIELD (413)781-7008 PROPERTY LOCATION 65 FORD CROSSING-A23 MAP 3lc PARCEL 023 ZONE PV THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Zc) Fee Paid Typeof Construction: CONSTRUCT 2 STORY ATT/GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 052589 3 sets of Plans/Plot Plan ' THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 _ elay Sign re of B d' g facia 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. 65 FORD CROSSING-A23 BP-2014-0934 GIs#: COMMONWEALTH OF MASSACHUSETTS MM:Block: 3 1 c-023 CITY OF NORTHAMPTON Lot:- PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New single Family House BUILDING PERMIT Permit# BP-2014-0934 Project# JS-2014-001615 Est. Cost: $260000.00 Fee: $1370.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KENT PECOY & SONS CONSTRUCTION INC 052589 Lot Size(sq. ft.): 4500.00 Owner: KENT PECOY&SONS CONSTRUCTION INC Zoning: PV Applicant: KENT PECOY & SONS CONSTRUCTION INC AT. 65 FORD CROSSING - A23 Applicant Address: Phone: Insurance: 215 BALDWIN ST (413) 781-7008 WC WEST SPRINGFIELDMA01089 ISSUED ON:311412014 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 2 STORY ATT/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: 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 3/14/2014 0:00:00 $1370.00 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Louis Hasbrouck—Building Commissioner