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38A-129 AC°R" CERTIFICATE OF LIABILITY INSURANCE �2;i6i20"3'' 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)586-SO11 FOX No,: (413)586-7973 IAI 88 King Street, Suite B ADOReSS:ibalise@borawskiinsurance.com INSURERS AFFORDING COVERAGE NAIC# Northampton MA 01060-3257 INSURER ANe the rlands Insurance 24171 INSURED INSURERB:Peerless Insurance 24198 Kent Pecoy & Sons Construction, Inc INSURERC-Mass 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 INSR WVD POLICY NUMBER MM Ll LTR IDDIIYYYY MM/DDIIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea current. $ A CLAIMS-MADE FZ OCCUR CBP8780556 /1/2013 /1/2014 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 PR GEN'L AGGREGATE LIMIT APPLIES PER: ODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident 11000,000 ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED X SCHEDULED A8781850 /1/2013 /1/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident Underinsured motorist BI split $ 100,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION 10,00 U8783651 /1/2013 /1/2014 $ C WORKERS COMPENSATION NC STATU• I OTH- AND EMPLOYERS'LIABILITY FIR ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? NIA CC2000239012013 6/30/2013 6/30/2014 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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/BOREGI �irC ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INR025 romnns)m Tho A('npiri name and Innn are raniefororil mnrirc of Ar:r1Rr1 Home Energy Rating Certificate Regi ID Rating Nuu mber mber HERS-321 Certified Energy Rater Matt Turcotte 104 Moser St Rating Date 6/17/14 Northampton, MA 01060 Rating Ordered For n Estimated Annual Energy Cost Use MMBtu Cost Percent 5 Stars Plus Total 65.6 $1652 100% Projected Rating HERS Index: 53 Projected Rating: Based on Plans - Field Confirmation Required. General Information Criteria Mechanical Systems Features This home meets or exceeds the minimum criteria for the following: Building Shell Features Lights and Appliance Features The Home Energy Rating Standard Disclosure for this home is available from the rating provider. REM/Rate- Residential Energy Analysis and Rating Software v14.4.1 This information does not constitute any warranty of energy cost or savings. O 1985-2014 Architectural Energy Corporation, Boulder, Colorado. Page 2 of 2 Home Energy Rating Certificate 104 Moser St Northampton, MA 01060 Estimated Annual Energy Cost Use MMBtu Cost Percent 5 Stars Plus Heating 30.0 $436 26% Projected Rating HERS Index: 53 Cooling 1.8 $93 6% Hot Water 13.2 $186 11% Projected Rating: Based on Plans - Field Confirmation Required. Lights/Appliances 20.6 $937 57% General Information Photovoltaics -0.0 $-o -0% Conditioned Area 1600 sq. ft. House Type Single-family detached Service Charges $0 0% Conditioned Volume 18933 cubic ft. Foundation Conditioned basement Bedrooms 3 Mechanical Systems Features Heating: Fuel-fired air distribution, Natural gas, 97.0 AFUE. Cooling: Air conditioner, Electric, 16.0 SEER. Water Heating: Instant water heater, Natural gas, 0.95 EF, 0.0 Gal. Duct Leakage to Outside 16.00 CFM25. Ventilation System Balanced: ERV, 46 cfm, 24.0 watts. Programmable Thermostat Heat=Yes; Cool=Yes Building Shell Features Ceiling Flat R-59.2 Slab R-0.0 Edge, R-0.0 Under Sealed Attic NA Exposed Floor NA Vaulted Ceiling NA Window Type U-Value: 0.300, SHGC: 0.250 TITLE Above Grade Walls R-26.0 Infiltration Rate Htg: 3.00 Clg: 3.00 ACH50 Company Foundation Walls R-12.0 Method Blower door test Address State, Zip, Lights and Appliance Features City, # Percent Interior Lighting 80.00 Range/Oven Fuel Natural gas Fax# Percent Garage Lighting 80.00 Clothes Dryer Fuel Electric Refrigerator(kWh/yr) 575.00 Clothes Dryer EF 3.01 Dishwasher Energy Factor 0.70 Ceiling Fan (cfm/Watt) 0.00 The Home Energy Rating Standard Disclosure for this home is available from the rating provider. REM/Rate- Residential Energy Analysis and Rating Software v14.4.1 This information does not constitute any warranty of energy cost or savings. ©1985-2014 Architectural Energy Corporation, Boulder, Colorado. 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: 104 Moser Street, Lot 10 Village Hill Inquiry Made By: Don Clarke Kent Pecoy&Sons 413-781-7008 Date of Inquiry: 6/16/14 Reason for Request: Hook into City Utilities Municipal Sewer Main in Front of Location: Yes No Municipal Storm Drain Available: 5%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: •_jZ\11 j 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. . �J,. , /,,/ John Flail Sewer Department cc: Ned Huntley, Director DPW Louis Hasbrouck, Building Commissioner MUNICIPAL WATER AVAILABILITY APPLICATI Northampton Water Department 41" ,� 237 Prospect St. Northampton, MA 01060 587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 104 Moser Street, Village Hill Lot 10 Inquiry Made By: Don Clarke Kent Pecoy& Sons 413-781-7008 Date of Inquiry: 6/16/14 Number of Type of Single Family X Type of Private X Units: 1 Unit(s): Apart. Comm Ownership: Condo Multi-family Rental (Annlicant to fill n th . have) Municipal Water Main in Existing service to Front of Location? Yes: X No: site? Yes: No: X Size of Water Main: 8" Material: Ductile Iron Age: 2010 Approximate Static Street Flow Test Conducted: Yes: No: X Pressure: 90psi If done attach results Size of Service Connection 1" Suggested Meter Size: 5/8" Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. Meter must be installed as close as possible to building service entrance. • A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. • Arrangements of such installation shall be made with the Northampton Water Department with a minimum of 5 working days notification. • All work 1 confo orthampton Water Department specifications. Gregory u man, Superintendent of Water Dept. Water Entry$200 Meter$ 100 Radio$ 100 cc: Ned Huntley,Director Note: If this availability is for a new construction,it must be hand delivered to the Buildine / Inspector. %%sinb] Application`Akiatet Awjilabifity.doc DUAS7MENT OF BUILDDtG�SPECITONS Q=° INSPECTOR 212 Main Street 6 -Municipal Building ; `' Nord=ptna,MA 01060 LOCATION SOT /� .�� , 7 M`�-' F� � - -- - - - --- - SOUAR:E FOOTAGE AMOUNT BASEM2 NT @ 1STFLOOR g.50 bQ 2NDFLR @ 30' %FLOORS, FWISH ATTIC,GARAGE @ 20 DECK/PORCBES @ -20 0 T OTAL-. D . 3 .a SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holde C<, 'S S ✓ j License Number q- !S Address Expiration Date Signaikke Telephone 9.Reaistered Home Improvement Contractor: Not Applicable ❑ t'f,-c S Inc C Company Name Registration Number %l5 ;lrf1% jlC' �' 7- 31- /y Address Expiration Date Telephone 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....... a," 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) ❑ Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [[3] Decks [M Siding[p] Other[p] Brief Description of Proposed Work: N6d A S9of5d SirU6Lf_ WIL 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 existim-housina, complete the followin : a. Use of building :One Family Two Family Other b. Number of rooms in each family unit: 7 Number of Bathrooms c. Is there a garage attached? Cs d. Proposed Square footage of new construction. �• 6 Dimensions J� e. Number of stories? 02 f. Method of heating? y Deec,� Alie- //r�95 Fireplaces or Woodstoves N .4- Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? ILS h. Type of construction lJO 6 i. Is construction within 100 ft. of wetlands? Yes /X No. Is construction within 100 yr. floodplain Yes_/No No j. Depth of basement or cellar floor below finished grade `7 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 OWNER//S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT a, as Owner of the subject property hereby authorize to act on my behalf, in all matt relative to work authorized by this building permit application. Signature of Ovger Date 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. Signet) under the pains and penalties of perjury. Print Name N' V , - 7� g -�� 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 Frontage E 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 W DON'T KNOW C) YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW f—,% 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 0 NO 0 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 it Dart of a common plan that will disturb over 1 acre? YES 0 NO ((� (� �� -� a IF YES,then a Northampton Storm Water Management Permit from the DPW is req ' • 0 2014 ,J ructions Department use only City of Northampton Status of Permit: A V 2�r Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability 00 Room 100 Water/Well Availability. Northampton, MA 01060 Two Sets of Structural Plans phone 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 This section to be completed by office 1.1 Property Address: Lf jl,�P�f �/L1_ l Map Lot Unit �p Zone Overlay District l�,'�/�7�i,tl f,�j�j'•j`i�fur �I.4 .. L'�/L'�C'J Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: A7<< �S <c�/4'S 1K'� 'c' feGk_4 � '`�ZAu`fR:' Tf.f; Name(Print) Current Mailing Address: r� Telephone Signature 2.2 Authorized Agent: Name( pnt} Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by rmit applicant 1. Building (a) Building Permit Fee /O �Oo6 2. Electrical (b)Estimated Total Cost of a Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) Q 5.Fire Protection 6. Total=(1 +2+3+4+5) T Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissionerlinspector of Buildings Date oK File#BP-2015-0064 APPLICANT/CONTACT PERSON KENT PECOY&SONS CONSTRUCTION INC ��� ADDRESS/PHONE 215 BALDWIN ST WEST SPRINGFIELD (413)781-7008 PROPERTY LOCATION 104 MOSER ST MAP 38A PARCEL 129 ZONE PV THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: Single Family 3 bed 2 bath 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 INFQ,AMATION 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 ?V _ Si e of Building fficial 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. 104 MOSER ST BP-2015-0064 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38A- 129 CITY OF NORTHAMPTON Lot: - PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category BUILDING PERMIT Permit# BP-2015-0064 Project# JS-2015-000125 Est. Cost: Fee: $873.20 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KENT PECOY & SONS CONSTRUCTION INC 052589 Lot Size(sg.1): 6123.00 Owner: KENT PECOY&SONS CONSTRUCTION INC zoniniz:Py Applicant: KENT PECOY & SONS CONSTRUCTION INC AT. 104 MOSER ST Applicant Address: Phone: Insurance: 215 BALDWIN ST (413) 781-7008 WEST SPRINGFIELDMA01089 ISSUED ON.81112014 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 2 STORY SFH W/ATT GARAGE/PORCH 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 8/1/2014 0:00:00 $873.20 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner