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25C-241 (2) �1te T�omvrreoozzwea�l/ o�../�aaaac/%uaet7a j Board of Building Regulations and Standards i Construction Supervisor License License: CS 17699 Expiration. 1/18/2010 Tr# 15853 Restriction: 00' DONALD W LOMASCOLO 660 PROSPECT ST E LONGMEADOW,MA 01028 Commissioner Board of Building Regulations and Standards sup HOME IMPROVEMENT CONTRACTOR Registration: 100216 Expiration: 6/12/2008 Type: Private Corporation PROSPECT BUILDERS, INC. Donald LoMascolo PO BOX 302/660 Prospect St E.Longmeadow,MA 01028 ------- Deputy Administrator NEW HOME CONSTRUCTION CONTRACTOR PROSPECT BUILDERS INC 660YAOSPECT ST E LONGMEADOW,MA 01028 PROSPECT BUILDERS INC LIC./REG FE TIVE EXPIRES NH C 044 10/01/2007 09/300/2009 SIGNE STATE OF CONNECTICUT /)E/It R111ENT OF CONS11tER PROTECTION HOME IMPROVEMENT CONTRACTOR PROSPECT BUILDERS INC 660 PROSPECT.ST E LONGMEADOW,MA 01028 LIC./REGN ..--.� EXPIRES HIC:fl551442 12 . 2007 11/30/2008 , SIGNE �If 1/23/2008 15:58 Insurance Center of New Englan Marie Proulx-►DENISE 2/5 ACORD DATE(MM/DD/YYYY) TM CERTIFICATE OF LIABILITY INSURANCE 01123)2008 PRODUCER Phone (413)787-2410 Fax 473-737-9539 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION INSURANCE CENTER OF NEW ENGLAND ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O BOX 1175 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR WEST SPRINGFIELD MA 01090-1175 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: ESSEX PROSPECT BUILDERS INC INSURER e: Commerce Insurance Company 34754 660 PROSPECT ST INSURER C: ADMIRAL INS CO EAST LONGMEADOW MA 01028 INSURER D: AIG INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICYPERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOWHICH 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IN SR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMBS LTR INSRD DATE MMMDNY DAIS MMrDDNY GENERAL LIABILITY 3CY0179 10/31/07 10131/08 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DR0 EM SET O RENTEDence) $ 50,000 CLAIMS MADE � OCCUR MED.EXP(Arty one person) $ EXCLUDED A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG. $ 2,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY 07MMOBWPZC 10/31/07 10/31/08 COMBINED SINGLE LIMIT ANYAUTO (Eeaccident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS BODILY INJURY $ X 1\10t,-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO $ OTHER THAN EA ACC AUTO ONLY'. AGG $ EXCESS I UMBRELLA LIABILITY EX000006550-03 10/31/07 10/31108 EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 C $ DEDUCTIBLE $ RETENTION $ 0 $ WORKERS COMPENSATION AND we STATLL OTHER EMPLOYERS'LLABILnY WC6715779 10!31107 10!31108 TORY LIMITS D ANY PROPRIETORIPARTNEIVEXECUTIVE E.L.EACH ACCIDENT $ 5500,000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 N yes,describe under SPECIAL PROVISIONS below E .DISEASE-POLICY LIMIT $ 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS TO SHOW EVIDENCE OF COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO FOR INSURANCE VERIFICATION PURPOSES ONLY OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,F'S AGENTS OR REPRESENTATIVES AUTHORLEED REPRESENTATIVE _ Attention: Z'Miarn 0. u, ACORD 25(2001108) Certificate# 32269 ©ACORD CORPORATION 1988 1 OQ�tf pT0 0 a6 �asaachnsctta Yp - V DEPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFTDAVIT I, Z90,I 11::712 113 do c (licenseeJpermitLee) with a principal place of business/residence at: .L-3;4X "30 —(phoneft) .5e5---317r� (street/ci ty/s-tatr/a p) do hereby certify, under the pains and penalties of perjury, that. (e� I am an employer providing the following workers compensation coverage for my employees working on this job: (Insu=c-- Company) (Policy Number) (Expiration Date) O I a-m, a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Lnsurance Company/Policy Numbcr) (Expiration Date) (Name of Contractor) (Insurance Company/PoLcy Numly--r) (Expiration Date) (Name of COD-tractor) (Insw-ance CompiuyiPolicy Number) (Expiration Date) (Name of Contractor) (Lasumace Compa-ay/Polim.,Number) (Expiration Date) (&Mach acklittioo1j lhcct Lf ntcCV irj to include infornIlEod Pertaining to a IX'X&a._Ior3) O I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be awart that whilo homcovenem who cmplay persa=to do r coast-,d oo or repair work ou a dwelling of not nxce than thrco ur s in which the hour_o%v resides or on the pvur dl appurtenant thereto arc not gcnrrnity oomidcrtd to be rmploy�s under the wm+-cx's oampc=atioa Act(GL152,ss 1(5)�application by a homcowncr for a Le=e or permit may cvideaoc tho legal status of an employer under the Workeee Compomation AcL I undertund thlt a copy of this ctatcmcat may bo forwarded to tho Departmcor of lodzrl ,l Arad.&OfB of lns-for the covcmx vcrificatioo and that failure to secure coverage uadcr socUoa 25A of MOL 152 can Iced to the imposition of criminal pcaaWcs comistmg of a•Elam of up to S1,500.00 atuyoe im� of up to one year and civil penalties in the form of a stop Work Order and a find 0�000AQ a day tpinst try For depsrt:ne�-J use oaly ( peTmtt N=bef ✓ ✓` <'{- -�`-'�_�"� �La t _ Mals 1 Lot# r Signature of Liccnsec/Permittee UaLe SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: �J .Z v/ G -�L s /71r-fit' License Number 2 00 Address Expiration Date gnature Telephone rRealstered F(olne lmororrein+ ii�tlrbi ` , ,,,, , Not Applicable ❑ Company Name Registration Number dress Expiration Date 4 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....... CY' No...... ❑ 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 D Accessory Bldg. ❑ Demolition ❑ New Signs [[J] Decks [M Siding[0] Other[❑] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes 4 ' No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet � se anc +or�x dltloh to B r st n#tl' Iril�: io"4 folio hi sl: 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 v I, C t---13 e r. as Owner of the subject property hereby authorize Pn ti''a_ -t c 4?1 u to act on +y beh�ff in III maters relative to work authorized by this building permit application. �1 Signature of Owner Date I, ,1,96 L A d/, Se 61L 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. Signneg-under the pains and penalties of perjury. ,rint Name Signature of Owner/Ag nt 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:l R:L_-, L:=j R:= Rear Building Height Bldg.Square Footage 011'0 Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) IF A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO () DON7 KNOW 0 YES 0 IF YES, date issued:L-----i IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON7 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 0 DON7 KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: 0 0 1 C. Do any signs exist on the property? YES 0 NO (D, ............. 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 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation, or filling)over I acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO ( 7*11 %—L:2 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. ` t tit bf,Northampton B � ' uildiDepartment 1 , 21ZM,ain Street 4' Room 100 4 Northarppton� MA 01060 phone 413 5812401 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: j$ ,alel0 This section tCtbe compIeted b�►offlce " fi SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: lip'/G G 41�i�c 2 2- 73 Name(Print) / Current Mailing Address: C �"�`� Telephone f Signature 2.2 Authorized A ent: Name(Print) '�" Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee d 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) — 5. Fire Protection 6. Total=0 +2+3+4+5) 3 (3 C1 a Check Number 0 `� This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2008-0798 APPLICANT/CONTACT PERSON PROSPECT BUILDERS INC ADDRESS/PHONE P O BOX 302 EAST LONGMEADOW (800)486-4976 PROPERTY LOCATION 235 BRIDGE ST MAP 25C PARCEL 241 001 ZONE URB 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: REPAIR FIRE DAMAGE ROOF INTERIOR STUD WALLS New Construction Non Structural interior renovations Addition to Existing Accessor Structure Building Plans Included: Owner/Statement or License 017699 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 Demolition Delay Signature of Building Official 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. BP-2008-0798 GIs #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: FIRE RESTORATION BUILDING PERMIT Permit# BP-2008-0798 Project 1;' JS-2008-001133 Est. Cost: $39000.00 Fee: $195.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PROSPECT BUILDERS INC 017699 Lot Size(sg. ft.): 7056.72 Owner: WEBER WILLIAM R URB Applicant: PROSPECT BUILDERS INC AT. 235 BRIDGE ST Applicant Address: Phone: Insurance: P O BOX 302 (800) 486-4976 Workers Compensation EAST LONGMEADOWMA01028 ISSUED ON:312512008 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPAIR FIRE DAMAGE, ROOF, INTERIOR STUD WALLS 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: iZough: 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: 1 tl;ld111,, 3/25/2008 0:00:00 $195.0035440 212 Main Street, Phone(413)587-1240, Fax: (413) 587-1272 Building Commissioner-Anthony Patillo BP-2008-0798 235 BRIDGE ST GIs#: COMMONWEALTH OF MASSACHUSETTS Map-.Block: 25C-241 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: FIRE RESTORATION BUILDING PERMIT Permit# BP-2008-0798 Project# JS-2008-001133 Est. Cost: $39000.00 Fee:Cost: $0 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use.Group: PROSPECT BUILDERS INC 017699 Lot Size(sq ft.): 7056.72 Owner: WEBER WILLIAM R Zoning:URB Applicant:_PROSPECT BUILDERS INC AT: 235 BRIDGE ST Applicant Address: Phone: Insurance: P O BOX 302 (800) 486-4976 Workers Compensation EAST LONGMEADOWMA01028 ISSUED ON:312512008 0:00:00 TO PERFORM THE FOLLOWING WORK:REPAIR FIRE DAMAGE, ROOF, INTERIOR STUD WALLS 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: 413/3 Rough Frame:d K Y__70 a Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: 0 Final: d `'C 4j Final: Smoke: v,Zg Jod THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu anc Si nature: Feel e: Date aid: Amount: Building 3/25/2008 0:00:00 $195.0035440 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo