25A-181 (16) 01
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-ACOPD. CERTIFICATE OF LIABILITY INSURANCE DATE;MMIDOA'Y)
02/28/2000
PRODUCER (413)S86-0111 FAX (413)586-6481 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
gibber & Grinnell Ins. Agcy. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
8 North Kin Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 538 COMPANIES AFFORDING COVERAGE
Northampton, MA 01061 COMPANY Acadia Insurance Company
Attn: Ext: A
INSURED Wright Builders Inc
i COMPANY
48 Bates St, a
Northampton, MA 01060 COMPANY
C
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ASCVE FCR THE POLICY PERICO
INDICATC0,NOT WITHSTANDING ANY REQUIREMENT,TERM OR CONDITION Or ANY CONTRACT OR OTHER DOCUMENT bV17-{RESPECT TO WHICH THIS
CERTIFICATE MAY DE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE'.N IS SLF5 cCT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION, LIMITS
LTR DATE IMMIDONY) DATE(MMJDOlYY)
!GENERAL LIABILITY CEN=—P.AL ACCRECATE $ 2,000,000
X COMMERCIAL OFNERAL LIABILITY PRCOUC—S,COMP/OP AGG S 2,000,000
A
CLAIMS MADE X OCCUR CPA004952810 03/O1/2QQ0 03/01/2001 PE*SON�t&AOV INJURY S 1,000,000
! X OWNER'S S CONTRACTORS PROT EACH CC. RRENCE S 11000,000
I X Blanket Add't Insu FIRE DAMAGE(Any ono nro) s 250,000
i MED ExP;kny one person) S 51000
AUTOMOBILE LIA DUTY
COMBFN SINGLE LIMIT S
� X ;ANY AUTO 11000,000
ALL OWNED AUTOu^
j ;BODILY,t+JURY S
A I
SCHEDULED a lms-I
LEUAU70S MAA130038310 03/01/2000 03/01/2001 (P
HIRED AUTOS
BODILY NJURY S
NON-OWNED AUTOS (Pcr z)=:cnt)
I
PROOSP--Y DAMAGE $
GARAGE LIABILITY AUTO CH:Y-F A ACCIDENT S
ANY AUTO OTnCR-FAN AUTO ONLY;
!
EACH ACCIDENT S
I
AGGREGATE, IS
EXCESS LIABILITY FACT'OCCURRENCE $ 1,000,000
A X UMBRELLA FORM CUA004953010 03/01/2000 03/01/2001 AGORECAT_ s
OTHER TITAN UMBRELLA FORM 1000000 S 1,000,000
WORKERS COMPENSATION AND X TORY LIMITS ER
EMPLOYERS'LIABILITY CL EACH ACCIDENT S 100,000
A TI IC PROPRIFTOPi INCI WPA130038210 03/01/2000 03/01/2001 EL DISE+Sc-POLICY LIMIT $ 500,000
PARTNCRStXECUTIVE
OFFICERS ARE EXCL CL OISE?:.0-EA EMPLOYEE S 100,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHFCLESISPECIAL ITEMS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCtES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 DAYS wRITTr•N NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Richard Webber/KADla'�"��� ``
ACORD 2"(1195) CACORD CORPORATION 198
s
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10-`STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes......❑ No....
SECTION 11-OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
{ as Owner of the subject property
hereby autho z r 1 r S to act on
behalf, s relative work authorized by this building permit application.
Zu
igna w W Date
as Owner/�horized Agen
hereby declare that the statements and information on the foregoing application are true and accurate, to the besF67 y
knowledge and belief.
Signed under the pains and penalties of perjury.
I ) C C)�--))L.
Print Na
l to e� t
ig ature of Owne A Da e
SECTION 12-CONSTRUCTIOW SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: 1 (2 cs O's -
License Number
Address t Expiration Date
X Co
Sig tore Telephone
c.'
SECTION 13 -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....... No...... ❑
Version 1.7 Commercial Building Permit May 15,2000
SECTION' 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES -FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE)'
9.1 Re 'stered Architect:
Not Applicable ❑
Name(Registrant):
=• ....... , Registration Number
Address
' ation Date
Signature Telephone
92 Registered Professional Engineer(s): `
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration D e
Name Ar of Responsibility
Address Registration Number
Signature Telephone Expiration Date
y�
Name Area of Responsibility
Address Registration Number
Signature Telephon Expiration Date
Name Area of Responsibility
Address Regi'st(ation Number
,a
Signature Telephone Expiration Date,,
9.3 General Contractor
1 f-S _--,Y-1 Not Applicable ❑
Company a e:
w i C hae, 1 h CGC
Responsible In Charge of Construction
Ad ress
IZY-'
ignature A Telephone
F Version 1.7 Commercial Building Permit May 15,2000
7. Water Supply(M.G.L. c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public ❑ Private ❑ 1 Zone: Outside Flood Zone ❑ Municipal ❑ On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontase
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking S aces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding/ever been issued for/on the site?
NO DON'T KNOW ✓ YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW ✓ YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T 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: NO V30f\1, Lo bC 6�0r _ r)y-\ 5)G nJ
D. Are th any proposed changes to or additions of signs intended for the property?YES_
No
IF YES, describe size, type and location:
Version 1.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑
❑ ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other
❑ Accessory Building[ ] Repairs
SECTION 5 USE GROUP AND CONSTRUCTION TYPE`
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1.1 ❑ 1-2 ❑ 1.3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B g'
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS,SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USEONL
.
Floor Area per Floor(sf) ?W s
2nd
1st
r
2nd 3 ��
4thx =�
3'd
4tnk
Total Proposed New Construction (sf) g
Total Area(sf) p
n.
................................... ,
Total Height(ft)
Total Height ft -------••••••••-••-
r
Versionl.7 Commercial Building Permit May 15,2000
rc,
1� It orthampton
l Department
dui
2 in Street
Roo 100
i �EP1�F b�IN Oit9lmpt n, MA 01060
NOR
t Fax 413-587-1272
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
r
This sectio to,be completed by office
1.1 Property Address: j� Ay1f
�� ✓i (�
MAP t Unit
r�l &
N y
Zone t�uertay
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: ii t
Name( ri ) Current Mailing Address:
1-ll3 - LQ x-k-7
r9a Telephone
2.2 uthorized Agent: n
W�
Name(P ' t) Current Mailing Address: cam—
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION GOSTS
Item Estimated Cost(Dollars)to be Official Use only
completed by ermit applicant
1. Building c,� (a) Building Permit Fee
2. Electrical �j (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) 'Check Number
This Section For Official Use Only
Building Permit Number: Date Issued: '
Signature:
�; Budding Commissioner/Inspector of Buildirigs' = Date
115 INDUSTRIAL DR BP-2001-0628
GIs#: COMMONWEALTH OF MASSACHUSETTS
lap:Block:25A- 181 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:windows replaced BUILDING PERMIT
Permit# BP-2001-0628
Project# JS-2001-1124
Est.Cost: $11887.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Wright Builders 101536
Lot Sizes .ft. : 108900.00 Owner: WRIGHT JONATHAN A
Zoning: GI Applicant. Wright Builders
AT. 115 INDUSTRIAL DR
Applicant Address: Phone: Insurance:
48 Bates St (413) 586-8287 Workers Compensation
NORTHAMPTONMA01060 ISSUED ON.1 110 1010:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Jnderground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 1/10/010:00:00 9098 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
115 INDUSTRIAL DR BP-2001-0628
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25A-18 i CITY OF NORTHAMPTON
Lo: i
Permit: Building
Categ rv-windows nW-Wed ]BUILDING PERMIT
Permit# BP 2001-062$
Proiect#' JS-2001-1124
Est,Cost:$11887.00'
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groun:` Wright Builders 101536
Lot Szetsa.ft.), owner: WRmHT JONATHAN A
Z Sd dw icant: Wright- i"we -
AT: 115 INDUSTRIAL DR
AppticantAddress; Ph one: Insu
48 Bates St 1413)586-8287 Workers Compensation
NORTHAMPTONMA01060 . ISSUED ON:I 1I0141 P:00:00
TO PERFORM THE FOLLOWINGWORK:INSTALL REPLACEMENT WINDOWS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring` D.P.W. Inspector of Buildings
Underground: Service: Meter.
Footings:
Rough: Rought- House# Foundation:
Final,. Final:
Rough Frame:
Gas Fire Department Fireplace/Chimney:
Rough: Oil• Insulation:
Final: Smoke: Fina# lr. .7-/G•o/� +bn
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION
ANY OF ITS RULES AND REGULATIONS. ,
erti#irate f ec nc s ature:
Fee TMe: Receipt No Date Paid:` Check No: —Amount:
Building 1/10/010:00.00 9048 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo