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24D-229 (2) A�°R°® CERTIFICATE OF LIABILITY INSURANCE 2" 2; /201"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(les)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 CT i I Webber & Grinnell Ins. Agency, Inc. PHONE 413.586.0111 FAX No:413.586,6481 1AJC 8 North King Street AnnRpqq- INSUR S AFFORDING COVERAGE NAIC k ! Northampton MA 01060 INaURPRAExoelsior/Peerless 11045 INSURED Wright Builders Inc INSURERS'Miscellaneous 48 Bates Street INSURER C:Netherlands Peerless 2A1 71 Northampton, MA 01060 INSURER DAdmiral Ins Co REU SURER E: INSURE F: COVERAGES CERTIFICATE NUMBER:Exp 2014 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 ADDL3UBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DO LIMITS GENERAL LIABILITY BP8616138 3/01/2014 3/01/2015 EACH OCCURRENCE $ _ 1,000,000 X COMMSIRCIAL GENERAL LIABILITY DAWGF:TO RENTED 1 $ 100 OOO A CLAIMS-MADE OCCUR MEDEXP one son $ 5,000 X Blanket Add't Xnau PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMPIOP AGO $ 2,000,000 POLICY X P 10' LOC $ JECT AUTOMOBILE LIABILITY BA8615140 3/01/2014 03/01/2015 1 ';0 INGLE LIMIT 000 000 ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED $ B AUTOS X AUTOS BODILYIWURY(Peraccident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $AUTOS (Per scaldentl X UM13RELLALIHB X OCCUR V8618241 3/01/2014 3/01/2015 EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLNMS-MADE AGGREGATE $ 5,000,000 BED X I RETENTION$ 3-0,000 $ L'' WORKERS COMPENSATION KC8612741 3/0112014 3/01/2015 X WCSTATU OTH- AND EMPLOYERS'UABIUTY ANY PROPRIETOWPARTNMEXECUTIVE a NIA E.L EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ 500,000 D OM'1P T e OF pPERATI0N3 t.I.,. E.L DISEASE POLICY LIMB $ 11000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(AMach ACORD 101,Addl80nal Remarks Schedule,II 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. AUTHORIZED REPRESENTATIVE Jenne Rodrigue, ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(2moos).Dt The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Cc fi#rartor Registration Registration: 101536 Type: Private Corporation Expiration: 6/26/2016 Tr# 254208 WRIGHT BUILDERS, INC. Jonathan Wright 48 BATES STREET `•..�, `��.::_H _ _._�.., .w, Northampton, MA 01060 Update Address and return card.Mark reason for change. Address [] Renewal F1 Employment Lost Card SCA 1 Co 2OM-05111 �jie�pomvinrnecoea,�i o�G�ac�ucae�la Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: ;101536 Type: Office of Consumer Affairs and Business Regulation xpiration:.:- 3} Private Corporation 10 Park Plaza-Suite 5170 Boston MA 02116 WRIGHT BUILDERS2) .. -=- s: Jonathan Wright ]"� 48 BATES STREET Northampton,MA 01060 `i ` c Undersecretary a' bout signature sli.OZ/90/c0 lauctisslWWOZ) uoixi id Y� 0 IS 1111710S LLZ 13zzflg S U300H O9zVWS3 as"31-1 spiepuelS pue suoqejn6a8 6uiplina jo piecig AjajeS :)ilqnd jo juawpecla(3 - sjjasnLjOeSSeVq Unrestricted- Buildings of any use group which contain less than 35,000 cubic feet (991m)of enclosed space, Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Ucensing information visit: www.Mas.s.Gov/DPS I SECTION 8-CONSTRUCTION SERVICES 7 8.1 Licensed Construction Supervisor: Not Applicable ❑ XA Name of License Holder: R o4� r BtiL Lc�l 63 oB Yd"G License Number g 6461 St. A/4.-J$4!v1pn . M4 0160 31411.t' Address Expiration Date ,- / 2G✓� X113 - Sgt Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Vr4hf- I'AIf's 1613,34 Company Name Registration Number Hg 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....... 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 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding[01 Other[E j Brief Desc iption of Proposed t� Work: MWVJ1– MilStk"' 74A W1,84' Am i,% w' tAen AtC Alteration of existing bedroom--A/—Yes No Adding new bedroom Yes x No Attached Narrati Renovating unfinished basement Yes XNo Plans Attache -Sheet 6a.If New house and or addition to existing housing, complete the following: 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? Fire s 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 ands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement ellar floor below finished grade k. Will build' conform to the Building and Zoning regulations? Yes No. I. tic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, )04A4t /G4!!!4wSee as Owner of the subject property pp hereby authorize W�t��r 4M�14f ff, 1116 to a o my behalf, in all matters relative to work authorized by this building p it application. Si a re of Owner D t f1 j►� u���b� Z�►G• as Owner uthorize e hereby declare that the statements and infor ation on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Uvr Print Na Signature of Owner/Agent Date All pAA V0 he Jd ;- EX i4 f�� -�vo}-pr14 of k4d I d�� 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 Building Department Lot Size Frontage Setbacks Front Side L: R: L Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Sp s Fil olume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DON'T KNOW YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO A DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained © , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q 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 Q NO 9 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. n _ Department use only City of Northampton Status of Permit: NOV — 7 Building Department Curb Cut(Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Electric F7, _ Northampton,i MA 01060 Two Sets of Structural Plans r phone-41�-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 1.1 Property Address: This section to be completed by office aa4 ��fjJl�i.f !�} Map Lot Unit 0` //��'"' Zone Overlay District DI 66 Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: drkme. Atgwsee It 044144 6�. GeXi M�# MA oayao Name(Print)-,, Current Mailing Addre t.J; Telephone Signature 2.2 Aulhorized Agent: W roil is Inc, Af-eS Sf. Nom/' �oh�, fd 0/&V Name(Prit) 77 Current Mailing Address: r �j �a�.�!C� y/3- 5.86 Fdg7 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS JJ K * $4/00 't Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building r 3a 6 (a)Building Permit Fee 2. Electrical �`� `3 (b)Estimated Total Cost of Construction from 6 3. Plumbing 4, )33 Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection 6. Total=0 +2+3+4+5) 110 4Y7 Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2015-0538 APPLICANT/CONTACT PERSON WRIGHT BUILDERS ADDRESS/PHONE 48 Bates St NORTHAMPTON (413)586-8287(116) PROPERTY LOCATION 226 PROSPECT ST MAP 24D PARCEL 229 001 ZONE URB000)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ►ldt q i4� Fee Paid Tvpeof Construction: RENOVATE MSTR BATH,KITCHEN&INSULATE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 84280 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INPs R�TION 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 D oli ' n lay /y 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. 226 PROSPECT ST BP-2015-0538 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24D-229 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-2015-0538 Project# JS-2015-000603 Est.Cost: $110687.00 Fee: $666.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WRIGHT BUILDERS 84280 Lot Size(sq.ft.): 39204.00 Owner: MARQUSEE JOANNE Zoning: URB(100) Applicant: WRIGHT BUILDERS AT: 226 PROSPECT ST Applicant Address: Phone: Insurance: 48 Bates St (413) 586-8287 (116) Workers Compensation NORTHAMPTON MAO 1060 ISSUED ON:11/10/2014 0:00:00 TO PERFORM THE FOLLOWING WORK:RENOVATE MSTR BATH, KITCHEN & INSULATE 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 Sisnature: FeeType: Date Paid: Amount: Building 11/10/2014 0:00:00 $666.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner