Loading...
10D-012 141 WATER ST BP-2016-1300 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: IOD-012 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-2016-1300 Project# JS-2016-002242 Est. Cost: $38000.00 Fee: $247.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BAYSTATE RESTORATION GROUP 056785 Lot Size(sq. 1): 6621.12 Owner: ALBRIGHT MARK&MARY MORIARTY C/O RUTH A MOE Zoning: URB(100)/ Applicant: BAYSTATE RESTORATION GROUP AT: 141 WATER ST Applicant Address: Phone: Insurance: 69 GAGNE ST (413) 532-3473 WC C H I CO P E EMA01013 ISSUED ON.•5/10/2016 0:00:00 TO PERFORM THE FOLLOWING WORK.FIRE DAMAGE REPAIRS INCL DRYWALL,PLUMBING,HVAC & ELECTRICAL 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 5/10/2016 0:00:00 $247.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2016-1300 APPLICANT/CONTACT PERSON BAYSTATE RESTORATION GROUP ADDRESS/PHONE 69 GAGNE ST CHICOPEE01013 (413)532-3473 PROPERTY LOCATION 141 WATER ST MAP IOD PARCEL 012 001 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 Typeof Construction:_FIRE DAMAGE REPAIRS INCL DRYWALL.PLUMBING.HVAC&ELECTRICAL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 056785 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOR ON PRESENTED: proved 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 Dem ' ' n el y A Signatu wilding O i 'al 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. E � V Department use only ity of Northampton Status of Permit: uilding Department Curb Cut/Driveway Permit�" : 212 Main Street Sewer/Septic AvailabilityRoom 100 WaterMeff Availability LDING INSPECTIONS No hampton, MA 01060 Two Sets of Structural Plans MPTON otoso _ - 7-1240 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 I I 1 I I , 1*11 1.e�- T_ C _l Map Lot Unit "� ��Jl,� _ Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: j6t AAh -do cn .A- Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: ��r ,;'r.C.)c„ 0 r 73 Name(Print) Current Mailing Address: Signat Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building j _ ;_ , /\ (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of (J Construction from 6 3. Plumbing '�) . Building Permit Fee 4. Mechanical(HVAC) 5 l�:(D I C) .� lJ 5. Fire Protection 'tip. a d p 2_9 -7 2 L 6. Total= 0 +2+3+4 +5) Check Number This Section For Official Use Only Building Permit Number. Date Issued: 1 Signature: Building Commissionerlinspectorof Buildings 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 Sp cial Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES Q IF YES, date issued. IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW Q YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW @/YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 Date Is ed: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, ex ation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all a Iplicable) New House F7 Addition ❑ Replacement Windows Alteration(s) Roofing El Or Doors 171 Accessory Bldg. ❑ Demolition ❑ New Signs [E3] Decks (Q Siding[O] Other[0] Brief Description of Propos d Work: 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 existing housings 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 4 I, IU L as Owner of the subject property 1 � hereby authorize to act on my behalf, in all mo ers relative to work authorized by this building permit alipplication. Signature of Owner Date I, �l,'i v 1a Ue 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 underthe pa and penalties of perjury. )(Ath Print Name Signature of Owner/Agent — Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ! Name of License Holder: achh YlV(C ( L m5 a bi -All o� License Number _q— 9— 1 �] Address Expiration Date Signatu ~/- G '"Telephone a.Registered Home Improvement Contractor: Not Applicable— klak KIWM ! 0- Coma ame Regis ration Num er ress JExpiration Date Telephon6, SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affid must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the b �ding 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 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: 14 � L0,4a �)�7 The debris will be transported by: ) ]e, Lectf 1 C-,,6 The debris will be received by: Building permit number: Name of Permit Applicant Ql G h 0 U 1 aU Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 j� Boston,MA 02114-2017 www.mass.gov1dia Workers' Compensation I nsuranceAffidavit: Builder s/Contractor s/Electricians/Pl umbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): Address:IQ City/State/Zip: > I Phone#: � Are y6u an employer? Checl t appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. Buildingaddition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.El I am a homeowner doing all work officers have exercised their 11.7 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.7 Other comp. insurance required.] Any appli cant that checks box#1 must also fi I I out the Seth on 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-contractorshaveenployees,they must providetheir workers'comp.policy number. I am an employer that is providing workers' compensation insurancefor my employees. Below isthe policy and job site information. Insurance Company Name: -_ U Policy#or Self-ins. Lic. #: Expiration Date: -- —7 Job Site Address: 14` IJ.`aC e( e&) t t ift �I L_ - City/State/Zip: Attach a copy of theworkers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the—paws and penalties of perjury that the information provided above is true and correct. Signature: .� `y 'i? Date: Phone#: 4 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): _ 1.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• 1'usma.y. 3, 1016 12: 54PM, Baystale Restoration Group k 0851 1 s to E,,. I Restoration Group 69 Gagne ST Chicopee, K 01013 (413) 532-3473 FCt3tFr�.T-X852658 EltctilSbg76 . CONTRACT&PA�K� Agreement made this Tuesday, May 03,2016, by and between Baystatc Restoration Group 69 G e ST Chicopee,MA 01013 and Ruth Moe 141 dater St, Leeds Ma 01053 (lscrcina(ter referred to as"You") Article a: Nature of WLX rA and Cofi-Fmct. rice~. 8$ystate R%wrmion Group agrees to commence work:on Your property and 000rdinste matrons with you and Your hidurance company In-order to efleet repairs quicki3l and professionally, Sayatate Restomtibn Group shall supply '[temized specifications to You and Your insurance eompaay showing the vIork specified and its cost, and accept payment In the amount agreed to by Raystate.Rosioration. Group; 11 proposed work is subject to approval by appropriate building officials and You, The total amount a d to be paid for the work specified and the time schedtile of payments is set forth in the attacberi pay, ent schedule. ]lie specifications, payaorit schedule, an), addenda and any change orders shall borne a art of and incorporated into this Contract. Axtig:1e 2; PermJ5ji rB to Start Worm You agree to allow FBaystata Restoration Qroup to eommetice work on the above described property to pair Beysrate Restoration Group be amount agreed to by Bsystate Restoration Group and Y ur insurance company for work ptufarmad by Baystate Restoration Group, and to direct Your ins= oe company to include the nerve of Baystate Restoration 4roup on any settlement drafts or chocks, 4rtielg3: A.4d3fional Changes to')Fork. You thkv, from time to tarn, in writing,melte changes in or additions to the' -ork to be per€'Qrmed y Raystate Resoration Group and Bayciate Restoration Group shall mekc .ucb changes or additions at Your sole cost and expcnse, at such'prices as You and Beyatate Restora#ion Group may agree to in writing, ("Change Orders"). Baystatc Restoration Group wilt obtatn Your vritrenn permission be'f re. doing any work riot covorcd by Your iusuranoe carrier, x i .—I --may, Z V 10 12 r m b a y s I a t e KostoratIop Group klo. ArlAcle 4-, Insur-ROCO BOYS'tatt Restoration Group may not be liable,to be.0.1111 work or continue tht work du- j ther o W, cOndi IOM,strikes,accidents, uawvattlabllity of material, or delay. r.-beyond l3aystate UP Is contrcL You must 'carry fire, general liability, tornado, and other necessary Insurance, 76, 13e, Restoration Group and its subcontractors shall provide all hisliranct rcquirtd to.fully protacc e�jr 01dPlOYeM and subMntractOrrs- If PaYmeats arc not made by You within three{3}days after tile as fipplloablo on the payment schedule, Baystate Restoration Oroup rnV e)ect to terminate perform ncV, and cancel this contract. If Baystzte,restoration Group elects to terminate perkrmain6e and cancel this contract,Baystate Restoration GrQLO'sball do so by notifying You in wNt ng, Perhortnanne by Baystate Restoration Group is conditioned upon payment by You. If Baystate Restoration Group is delay at any time In the progress of the work by an act ornegiect of Yours or by any employee or agent of You, or by any SoPam c*OMWOT=ploy'ed by You or'by changes ordered in the work„ or by labor dist i ires, conditions not reasmabiy anticipated, unavoidable casualties, or any causes beyond BaytateResroration Group's control,orby delay authorized by You, then the conttact,time shall be extends I by change order for sudb reELso-nable itcrns as You and laayqtatc,RcSTQratlon Group may determine.. Baystate. Restoration Group shall cause the work w b-- done in a. good tod worlanarlike rue inor according to the standard practices of the trade.Baystate Restoration Group Will provide a one(l),year warranty as required by Massachusetts State Lam, Article i-- Default, In the cYcat of default its paymcDz or i(I MY other Manner by You, Yoe agree to pay, all co of collection including reasonable attorney's fees, in addition to other damages iwurred by Bay ate Restoratian Group, You further agree To pay the maximum interest permissible by rho laws of the State of-Massacbusetts on any sum in default. Should 13ILY2�ate Rest=atiori Group diascovtz covc-al.-d conditions or urAtmown condidoin's ki an exiAtig structure diMr8nt from normal conditions customarily found or unknown conditions below the groi nd, fbcEn the contract arnount may be increased by a chant/ order upon the request of Baystate kqstorai ion Group or You within five(5)days aftor the,condition is fust observed. Daystale Restoration ioroup,Md YOU and/or Your insurance representative shall agree on the work to be performed and its cost pria-to the work being completed. Both parties agree that any work, to be pedormed shatt be StavA. in WC1 ILE and signed by both parties,which shall become apart of1his Canliact. Article 9, Din digg Dh11,gZtii*V.& The obligations of this Agremaent are binding Upon Baystate Restoration Group and its,successors and assigns and upon You and Your heirs,successors,executors, administrator,2z� assigns. Work to cornmense an or before 05/04/16 and be Substant:1all), completed in accordance with tb- to q of this contract an or beffire 05113/16,which racy be extended for delays beyond tthe,coutro'l of 1�,Xqt ltt tFt ReStOration Group. Any cbsnge orders signed afitir this Agmernent daitrnay affect coinpietion dales It is the responsiblixiLy'of Baystate Restbrafion Grout, to ObLUIR all accessary and applicable'mmits before beginning the Work. In the event You secure Your Own parmit-You will be excLudad'frorn he Residential Contractor's GUarantv Fund. J, 4V V i%.7brm baystaie Kestorat on Group No. 0 85 1 °, 3 fi?l ca.mmctors an'd subcontractors must be r;:&wcd by#ha gta.�,. Any inquiries relating to registr tion should be direete-d to the fb lowing: D ict V C4tsumcr Affairs and Busincss Regu6ttion Ten Pari:Pla.zae, Supe 5170 Boatoll,MA 021 16 Phone: (617)473-57€10 YOU ARE ENTITLED TO A COPi' OF TIRS CONTRACT AT T p- TIME YOU SIIT, X O WORK SHALL BEGIN PRIOR TO THE SIGNING OF TMS CONTit_4CT. Yov, rBE Bum,Mky ckracFL Tins r�SAcrro�r AT ANY IWE LIVOR TO �EMIGHT' OC "HE T-R (3 mZD "° BUS F;' ss.DA- �4 X rrEIL mr,mkn OP TWE TMANgACTIOX. SEE-VAL ATT`,-CHED �a CE OP cA.NcELr,AITON-V0WOF'f rs DO NOT SIGN TMS CONTRACT£la'THERE.ARS ANY BLANK SPA CES. 1126 ystatr'kwcaratian Group Date riot Owner(s): By: Date Duly Authorized By: .Date Duly Authot3zad 3 I AVIV ILDrIMI f5aWate Kestor3,tIon Coup No, 0851 P. �} �:-bitt•atioa Raystate Restoration Gvovp znd You her667y MutualtY 49rae iu 241"ance that it the eveni that Ba}'state Restoration Group tas a dispute concerning fihig calIcsoet,Bnystate Restoration GIOUP many submit such dispute to a private arbitratioa service which has beep apprvred by the Offlace of Cosnaumer AffsAirs and Businas Pa--guietlor, and the eonrumer sinall be rccquiredio suborn It to such&rbitrnOott as provi6ed In MGL C.14ZA. 8ayistato RestDration Group: C� Owner; Xx (?1Ynez; IJ07IC�: The signatures 0-the Parttew above apply wily to the tagrearnenr of the pm-ries to alts !ate disputa resolution Initiated by Saystate ResroratlQn Group, ne owner may initiate altcrnrttive dis tree Pomlution eieyl where this secfion is not Signed sapal'alely by t'hepardes. 4 mayoAay, 1 2416 12.51PM 6aystafe P,estoraf ion Group NOTICE OF CANCELLATION You.array cancel this transaction, without arty penaItY or obligation,, �Ath n dirce (3) bust ess days from the above &tt, provided You submit written notice tca Aaystate Restoratiota Group within the time sett forth herein. If You car=l, any property traded in, any pa ants made by You under' the conixact or sale, any negotiable irn.strurn&nt axecuted by You will be retdmO4 within Un (10) business clays followIng rc ciPt by Baystste Restoration Group or Your canes-U860n nrstioe, Bead my security int©reg$arising out o the ts>rnsactiop Will be cancelled. If You cancel, You must make available to Baystate Restoration Group, at Your residence, any 9 delivered to You ttrzdcr trate contact at sate,or Xoasmay, If Pots wish, comply wi-th t>,Q t»strrtcti I of 'k3Rysmic Restoration Oroup regarding the romm shipment of the goods at Bit etc Restoration up's expense and risk. If Yc'iu do make the goods avasltablc to Baystate Restoration Group and.$aystatc RQAoration a up does riot pick thfrm up within twee(20)days of the date of cancellation, You.may retain or dispo e of the goods without further obligation. if you fats to make the goods available to Saystate Reston tion Group ar if You agree to return the goads to 8aystats ResCoration Group and U1 to do so, chew YQu remain liable fez•perfarmaeace of all obligations under the contract. To caned rhis transaction, inail or dcdivcr a signcd and dated copy of this cancellation notice w any other writtBn notice to Braystaic P aatoratian Group et the following ac#dress. Bad=state Restoratton Group 69 Gape.ST Chicopee,MA 01413 No later t'hm midnight of the Chlyd business day follpwingthc signin of the Contract I(We)hereby canocj this transaction. Buvcr's Signature Date I (We� hereby acknowledge recelpt c�,f'a fully coMpleted Contract & 'cz m nt S`ch X nd Notice o,f Cancellation. Btayer's Cure DAt 6 ,vmyvom(,y. a y s I a I e K storaCioo Group No, 8851 P. 5 rayment S ch dule VS Restoration Gm,' 11053 e Restoration: Structural Repairs Total Cost of Services: 38 462 06 Pa e� 1: Deposit $ 17 427.31 Pavxsm,t 2: ]due upon rottgb.finishes $ 16,927.32 Pm m.ent 3. Due upon job completion(dmrcciatio ) $4107-43 *Total; $3S Qb2 46 This Dgyment scheduled es not include c sts fAr state and local code u r des and pmer's extras.- These costs will be ,invoiced-s srat6ly, *Tow subject to change per s c;d cost witb owmer. Contramors Signanire S f) j Dare Acoopranca of proposal: The above price,specifications.and conditions ara-safisfactory and are hereby acccp�d. You, are auiharizcd to do the work as specified. Payment will be wade as outlined aboYe. All change grdezm,oxta ,and credits will be agreed upon prior to final payrrt ownnn Signature: _ X bane Owners 5