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C1. CO « a Cl •3 U :--- •+-� CC7 �- C7 � O O p 117 41= o _ V .0 i v � � Q, rn a a — c n Cl) cn 0 ... �O � 4- 3 =' CL n '-' W oo Q 'E Y c v cv v a v Q d Q >o Q oo Lt Cnv E v c Q CL W Z `uo so uolssiwwo W uoi o i ! o a M3 A83n0 � .� �.l.q � � b'W 4- �ao�� VYV `30N3aM3 z N yW `4oimglnoS OV08 30N]8MJ 9D Q o �. su6rsaQ uoslaN Baia SaONN00 A W3a3r ca �o kY. rf h' 3 V 4F d` [k IR V ! S./ L W Z O Q ; CL Qom. CG Q� Z V m ►_-- Q cr- Z m O D V ZWZ mU z t 3 �2 ¢ C� (� "� $ 3 It � O J6 LL- cr- z W ¢ ¢ ~ E W ¢ p Cl J F-- Z W Z � m M W CD o UJ z �- Cl no Z � `-� WO o -� m uj m Y Cl t¢i_ _ Q p � ¢Z CID Q Uj �.Z".. Q- Cn ¢ (Y N � � OWE >- z_ O ¢ � O �TQX OmO m stn O t= W � z U) W � O mho ``' = o Q Ce © ►- < o o � Q m � wq w Q z m uj w � moo F- S U — Z N x � n p ¢ > ti p W (n 0 � � wWo �' °zw `�'OE City of Northampton Mail-Fwd: Permit for 435 Florence Street Flore... https://mail.google.com/mail/u/0/?ui=2&i1--39211afc3d&view=pt&se... /// Charles Miller<cmiller @northamptonma.gov> Fwd: Permit for 435 Florence Street Florence Ma 1 message Kyle Scott<kscott @northamptonma.gov> Mon,Apr 28,2014 at 2:57 PM To:Charles Miller<cmiller @northamptonma.gov>, Louis Hasbrouck<Iasbrouck @northamptonma.gov> ----------Forwarded message---------- From:Frank J.Limone<Frank @prsconstruction.com> Date:Mon,Apr 28,2014 at 1:45 PM Subject:Permit for 435 Florence Street Florence Ma To: kscott @northamptonma.gov spoke with you about the above permit for 435 Florence Ma being pulled by Premiere Renovation Specialists.At this above property we will no longer be doing the ramp as per the home owners request. Any questions or concerns please feel free to contact me. Thank You, Frank J.Urnone Direct (877)558-1565 Fax (617)849-5812 (City of Northampton E-mail is a public record except when it falls under one of the specific statutory exemptions.) 1 of 1 4/28/2014 4:27 PM List of Subcontractors Tonya Hall DBA Adjutricem is a Sole Proprietor Wynne Electric is a Sole Proprietor Tracey L. Tristany is a Sole Proprietor OP ID:LR CERTIFICATE OF LIABILITY INSURANCE 03131 pATD/YYYY) n3r31i1a 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 pollcy(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 Phone:781-593-9393 NAME. Frank Limone Soderberg Insurance Services Fax:781-599-7338oNE N0 200 200 Broadway — Lynnfieldi MIDI Ion Douglas`a.Soderberg cusT P1EMI-3 INSURE 11 AFFORDING COVERAGE NAIL N INSURED Premiere Renovation INSURER A;Merchants Insurance Co Specialist,LLC INSURER B:Acadia Insurance Frank Umone INSURERC. 17 Roughen St.,Suite C Revere,MA 02151 INSURER D. INSURER E INSURER F, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: IHIS IS TO CERTIFY THAT nic POLICIES 01:INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POI ICY 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 SUBJFCT TO ALI T14E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY P/UD CLAIMS IN SR TYPE OF INSURANCE POLICY NUMBER INEW F M OJY L"Ts GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 A X COMMERCIAL GENERAL LIABILITY BOP1065195 04113113 04113114 PREMISES E s X CLAMS-MADE F]OCCUR MED EXP(Any ono person) $ 5,0 PERSONAL&ADV INJURY S 1,000,00 GENERAL AGGREGATE S 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER ;PRODUCTS-COMPIOP AGG 1 S 2,000,00 POLICY Po- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea awdent) ANY AUTO BODILY INJURY(Par person) S ALL OWNED AUTOS BODILY INJURY(Per aoradeM) S SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Par ern) Ig NON-OWNED AUTOS — 1 S �dUMBRELLAtJAB OCCUR EACH OCCURRENCE S EXCESS I CLAIMS MADE AGGREGATE $ DEDUCTIBLE I S RETENTION S S WORKERS comwam MON X VJC S ATU- OTH- AND EEiPIAYERS'LIABILITY B ION AROPMETORIPARTNERIEXECUTIVE YIN N/A C20200051 5700 11112/13 11112114 E L EACH ACCIOENT $ 100,0 NY P OFFICERNEMSEREXCLUDEO"+. : D 100,00 Iy M M14 E L DISEASE-EA EMPLOYEE S DESCRIPT OF OPERATIONS 1 E L DISEASE-POLICY LIMIT S 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Aftch ACORD 101,Additional Rws*s Schedule,h a mm space Is VOW" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ***information Only***** ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOMW REPRESENTATIVE Dou od ,berg ®1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of IndushialAccidents r Office of Investigations w I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0b1 y Name (Business/Organization/Individual): I N r env ✓c.� ^r1. �1-t Address: tV City/State/Zip: ur c M C� O L 1 5� Phone #: t - �o 17 `1- Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. n I am a general contractor and I employees(full and/or part-time).* TT have hired the sub-contractors 6. E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. X❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working or me in an capacity. employees and have workers' g Y P h'• # 9. F1 Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box 41 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 fur my employees. Below is the policy and job site information. Insurance Company Name: A A'® C, S 'r- °` V" C_ E Policy#or Self-ins. Lic. #: W C 2-° �— `� 'S 1 !; 1 0 L' Expiration Date: Job Site Address: y3f tl,r°e nc ebc cl Flo((,I c'"I C 01.9 4 L 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. I do hereby cert! the p 't nd p n . of perjury that the information provided above is true and correct s ��<r Signature: - - .� Date: Phone#: 1 1­7 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 7 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: tl Lt M ( 5 - 013 0 License Number L I�A Ci SA t veA f 6�- o I S 0G-01 2,01S Ad _ Expiration Date Signature Telephone 9,14egistfred Horne Contractor. _ Not Applicable 0 P{C w-,i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) CE Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks (M Siding[❑] Other[E:Q Brief Description of Proposed tt Work: f3 CO�, r ., ... .— a-6:�...v ;aL- � ex� , and 1S O r 4 rcl� c` c•d Gct #a c c �a•,n1 Alteration of existing 4droom Yes No Adding new bedroom Yes X—No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.If New house and or addition to existing housing,camolete the followino: 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 1, as Owner of the subject property hereby authorize t '((A AA to act on my behalf, 11 matters relative to work authorized by this building permit application. Signature of Owner Date 1, F s-C,n k L' ,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. Prin Signature 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 5 3 t1-4 3 s,y F t 5 3 `{ 3 s �� Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage 11 3S % Open Space Footage % (Lot area minus bldg&paved J 11� ; SI 1GI ark #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW � YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained ® , Date Issued: C. Do any signs exist on the property? YES ® NO Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO IS 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 City of Northampton Status of Permit: 1 Building Department Curb Cut/Driveway Permit i6.J 212 Main Street Sewer/Septic Availability 2 2 214 Room 100 Water/Well Availability N hampton, MA 01060 Two Sets of Structural Plans o� plumbin9&MA�1 87-1240 Fax 413-587-1272 Plot/Site Plans 0! ortharn ton. 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 4% F("r-e^ce Map Lot Unit Fl-,rt..ir, Mct Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Name(Print) k Current Mailing Address: (�A A A d Ck Telephone Signature 2.2 Authorized Ascent: U CIO, J r Na t) Current Mailing Address: Signature Telephone SECTION 3-ESTLATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building S 7 7i- (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing S Building Permit Fee r 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) i} ' v Check Number This Section For Official Use Only Building ermit Number: Date g Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-1094 APPLICANT/CONTACT PERSON FRANK LIMONE ADDRESS/PHONE 17C ROUGHAN ST REVERE (617)401-6172 PROPERTY LOCATION 435 FLORENCE RD MAP 30C PARCEL 008 001 ZONE SR(100)/WSP(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 Wv- Typeof Construction: REMODEL BATHROOM ADD RAILS&GRAB BARS IN BEDROOM New Construction Non Structural interior renovations Addition to Existina Accessory Structure Building Plans Included: Owner/Statement or License 080162 3 sets of Plans/Plot Plan THE FOL WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION 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 emol' ' ay ignature o uilding Of icial 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. 435 FLORENCE RD BP-2014-1094 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 30C-008 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-2014-1094 Project# JS-2014-001869 Est.Cost: $64000.00 Fee: $330.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: FRANK LIMONE 080162 Lot Size(sq_ft.): 53143.20 Owner: KIELY MAUREEN Zoning: SRO 00)/WSP(100) Applicant. FRANK LIMONE AT. 435 FLORENCE RD Applicant Address: Phone: Insurance: 17C ROUGHAN ST (617) 401-6172 WC REVEREMA02151 ISSUED ON:413012014 0:00:00 TO PERFORM THE FOLLOWING WORK.REMODEL BATHROOM, HANDICAP RAMP & ADD RAILS & GRAB BARS IN BEDROOM 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 4/30/2014 0:00:00 $330.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner