Loading...
38C-010 (5) ^�h�- • �,� PLANNING AND SMAINABaR Y•C TI'Y OF NORTHAMFPON planning•conservation•zoning•northampton GIs•historic•community preservation•central business architecture d _ Sarah Lavalley,Conservation,Preservation,&Land Use Planner•slavalley@northamplonma.gov•413-587-1263 [pK�TP JJSi May 8,2015 Bruce Volz 43 Winterberry Lane Florence MA olo62 RE: Order of Conditions, Grove Street Housing Dear Bruce: Enclosed please find the original signed Order of Conditions for the above referenced project. This Order has been recorded in the Hampshire County Registry of Deeds. The ten business day legal appeal period from the date of issuance will expire on May 22,and the project may begin at any time after that date once pre-construction conditions are met. Please read the document carefully,as it contains conditions that must be adhered to before,during,and after work on the project. Please feel free to contact me with any questions or concerns. Thank you, Sarah . LaValley City Hall • 210 Main Street,Room 11 • Northampton,MA 01060 •www.NorthamptonMa.gov • Fax 413-587-1264 original printed on recycled paper CITE' OF NORTHAMPTON, MASSACHUSETTS DEPARTMENT OF PUBLIC WORDS ' 125 LOCUST STREET NORTHAMPTON. MA 01060 t mu<+Tm junrt 413-587-1570 FAX 413-587-1576 Edward S Huntley, P.E. Director April 23, 2015 Louis Hasbrouck, Building Inspector Municipal Office Annex 212 Main Street Northampton, Ma 01060 Dear Mr. Hasbrouck: The water service at#108 Grove Street has been disconnected from the city water supply and the water meter has been removed from the premises as of April 23, 2015. Please contact me if you have any questions. Sincerely y uttelman -Superintendent of Water Cc: Ned Huntley, Director of Public Works Jim Laurila, City Engineer Bruce Volz From: Ryan, Nathan [Nathan_Ryan @cable.comcast.com] Sent: Thursday, May 14, 2015 1:23 PM To: bvolz @vca-inc.com Cc: Ryan, Nathan Subject: Cable Services to 108 Grove St, Northampton MA Bruce, This email to inform you that all cable services have been removed from the property at 108 Grove St, Northampton Ma. Nate Ryam Technical Operations Supervisor 1110 East Mountain Rd,Westfield MA 01oa5 413/562-9923 ext.73286 nathan cyan @cable.comcast.com 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling housd or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current ohcy-information-(if-neces-aTy)-and-under"Job-Site-Address' the-applicant-should_write"alllo_cations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia The Commonwealth of Massachusetts Department of Industrial Accidents a I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia «'orkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNRTTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): Lc vii l T Cv2 "a Cr(u 5 Address: 02 3 ai JV CiS 1, _eW; a City/State/Zip: Q V S�l l g a, P MI,I Phone#: i ', (P`/5 3 C Are you an employer?Cheek the appropriate box: Type of project(required): 1.5il am a employer with _employees(full and/or part-time).* 7. EJ New construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in $• ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. gDemolition 3.]I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.F1 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.❑We are a corporation and its officers have exercised.their right of exemption per MGL c. 14. Other 152,§1(4),and we have no employees.[No workers'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 for my employees. Below is the policy and job site information. i Insurance Company Name: 04'2(0 4(?q) 1 AI S 146i"V 7 Policy#or Self-ins.Lic.#: Expiration Date: 5 4 ? Job Site Address: 10 S� C, ,z(:v 4, City/State/Zip: `lrca2 i r/A.41(�> __—_— Attachacop_y_oithe-w-orkers_compensation_policy–declaration_page_(showing_the_p_olicy number-and_expiratiou_da.te).—__ __,_ Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sienature: �� t Date: r C ' Phone# 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#: DATE(MM)DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/15/2015 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). CONT CT PRODUCER NAME: Nadine West Orchard—Dowd Insurance Agency LLC PHONE FAX 19 Bobala Road A/c No Ext:413-437-1050 (AC,No):413-437-1450 E-MAIL Holyoke MA 01040 ADDRESS: nwesOdowd.com PRODUCER CUSTOMERID#:DAVELOV-03 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Harleysville Worcester 26182 Dave Loven Excavating & Construction INSURERB:SafetV Indemnit • ComIDany 33618 230 Reservoir Road Westhampton MA 01027 INSURERC:Workers Compensation Pool INsuRERD:Quaker Special Risk INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1475065983 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 RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE 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 ADDL SUBR POLICV EFF POLICV EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A GENERAL LIABILITY SPP00000073935J 5/27/2014 5/27/2015 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE 'xK OCCUR MED EXP(Any one person) $5,000 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 PECOT- LOC $ B AUTOMOBILE LIABILITY 6217235 3/8/2015 3/©/2016 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Pei aociderlt) $ X SCHEDULEDAUTOS PROPERTY DAMAGE $ X HIREDAUTOS (Per accident) X NON-OWNED AUTOS $ $ A X UMBRELLA LIAB OCCUR CN300000039742K 5/27/2014 5/27/2015 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DEDUCTIBLE $ X RETENTION $0 $ WORKERS COMPENSATION WCVC0889304 5/27/2014 5/27/2015 WCSTATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE� EL EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $500,000 D D Liability TBD 5/5/2015 5/5/2016 1,000,000. Each Occurrence 2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Northampton Building Department 210 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 � ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: fC):� 6,,-�vE i /��n���f"�/tk'To (`-,/ '/U-4 The debris will be transported by: ( t. The debris will be received by: r o�z vt io ( ,, Building permit number: Name of Permit Applicant Date Signature of Permit Applicant SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ! r/ Name of License Holder: AOU6A �� �✓� �� License Number Address Expiration Date Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ! Company Name Registration Number 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,,rd d Local Zoning WLawsan tat e of Massachusetts General Laws Annotated. Homeowner Signature �—� SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows AlterWon(s) ❑ Roofing ❑ Or Doors rul Accessory Bldg. ❑ Demolition New Signs [0] Decks [M Siding[0] Other[d] Brief Desc iption of Proposed / Work: 6L , fi;0 k" —4 0 ' W'' "d Alteration of existing bedroom Yes No Adding ne bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -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? 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 I as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner 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. Signed under the pains and penalties of perjury. Phn am j S/�• ~_' ignature 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 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 © 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, a and location: � tYp ��� `v�s�� � r✓�� 71"a � .f 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 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. i Department use only City of Northampton Status of Permit 5 �Q{5 !I Building Department Curb Cut/Driveway Permit MAY " 212 Main Street Sewer/Septic Availability ROOM 100 WaterlWell Availability Electric,Plumbing&Gas Insp Northampton, MA 01060 Two Sets of Structural Plans Northampton,MA 0106 p p 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 Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Na (Print) Current Mailing Addye a -ss: Telephone Signature 2.2 Authorized Agent: Name Current Mailing Address: -i4t 3 -- (0 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building f (a)Building Permit Fee .rzrti 1 2. Electrical (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 Q This Section For Official Use Only Building ermit Number: Date g Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2015-1116 APPLICANT/CONTACT PERSON SHOP DEVELOPMENT LLC ADDRESS/PHONE 108 GROVE ST NORTHAMPTON01060 PROPERTY LOCATION 108 GROVE ST MAP 38C PARCEL 010 001 ZONE URB(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 Tyneof Construction: DEMOLISH HOUSE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN�FRJIMATION PRESENTED: I/ 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 E/2,( rS 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. 108 GROVE ST BP-2015-1116 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38C-010 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: demolition BUILDING PERMIT Permit# BP-2015-1116 Project# JS-2015-002112 Est. Cost: $15000.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 24916.32 Owner: SHOP DEVELOPMENT LLC Zoning. URB(100)/ Applicant: SHOP DEVELOPMENT LLC AT. 108 GROVE ST Applicant Address: Phone: Insurance: 43 WINTERBERRY LN (413) 695-3314-0 FLORENCEMA01062 ISSUED ON.512612015 0:00:00 TO PERFORM THE FOLLOWING WORK.-DEMOLISH HOUSE 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 5/26/2015 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner