32C-067 (21) 2 CONZ ST BP-2016-1487
GIS#: COMMONWEALTH OF MASSACHUSETTS
MaryBlock. 32C-067 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:Porch Repair BUILDING PERMIT
Permit# BP-2016-1487
Project# JS-2016-002548
Est. Cost $7500.00
Fee:$100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JOSEPH KENNEDY 055440
Lot Size(so.ft.): 30666.24 Owner: MAPLEWOOD SHOPS INC
Zonino: CB(100)/ Applicant: JOSEPH KENNEDY
AT: 2 CONZ ST
Applicant Address: Phone: Insurance:
38 HARKNESS AVE (413) 525-1735 () Liability
EAST LONGMEADOWMA01028 ISSUED ON:6/15/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:REPAI R 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 II 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:
FeeTene: Date Paid: Amount:
Building 6/15/2016 0:00:00 $100.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File# BP-2016-1487
APPLICANT/CONTACT PERSON JOSEPH KENNEDY
ADDRESS/PHONE 38 HARKNESS AVE EAST LONGMEADOW (413)525-1735 Q
PROPERTY LOCATION 2 CONZ ST
MAP 32C PARCEL 067 001 ZONE CB(1001/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid C.K.N Gia /07J -
Building Permit Filled out
Fee Paid
Tvpeof Construction: REPAIR PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 055440
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
kV-Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:$
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
Dir ol' -• ya
X747
Sig ..1117eo Buil• g I r"'tial 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.
..-?,l Versionl.7 Commercial Building Permit May 15,2000
Department use only
City of Northampton Status of Permit
QBuilding Department Cub CUUDriveway Permit -
5 212 Main Street Se*erISeplicAvaiabifay
• � % Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of SnudwS Plans
of phone 413-587-1240 Fax 413-587-1272 Plot/Site Plan
Other Specify
AP-LIGATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOUSH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWEWNG
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed &l
ice
by office
2 Conz St Northampton MA Map Lot Unit
zone Overlay District
• Elm St.District C8 District
SECTION 2-PROPERTY OWNERSHIPIAUTHORRED AGENT
2.1 Owner of Record:
Marybeth Bergeron 38 Harkness Ave East Longmeadow Ma 01028
Name(Print) Current Mailing Address:
(413) 525-1735
)fitarett rg.
SignatureTelephone
2.2 Authorized Agent:
Joseph Kennedy 38 Harkness Ave East Longmeadow Ma 01028
Name(Rini) Current Mailing Address:
(413)627-7376
O ,4 K.s�
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building $7,500.00 (a)Building Permit Fee
2. Electrical $000 (b)Estimated Total Cost of
Construction from(6)
3. Plumbing so 00 Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection $0.00 /y
6. Total=(1 +2+3+4+5) Check Number Q,jeMS Otto
This Section For Official Use Only
Building Permit Number Date
Issued
Signatu -. 00,--#1,fr.ii--
Building Commissioner/Inspector of Buildings Date
Versionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wall Signs 0 Demolition❑ Repairs Additions Accessory Building
Exterior Alteration ❑ Existing Ground Sign 0 New Signs❑ Roofing❑ Change of Use❑ Other 0
Brief Description Replace 25 damaged halusters,replace damage and rotted deck boards.Install 4 new 12 inch concrete piers under the right side
Of Proposed Work: porch.Replace damaged top rails about 30 feet.Construct two new rails total of 16 feet.Replace one 8 inch round support
of con.
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-I 0 A-2 0 A-3 0 1A 0
A-4 ❑ A-5 0 lB I ❑
B Business 0 2A ❑
E Educational 0 2B ❑
F Factory ❑ El ❑ E2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I Institutional ❑ I-1 ❑ 1-2 0 I-3 ❑ 3B 0
M Mercantile ❑ 4 0
R Residential ❑ R-1 0 R-2 ❑ R-3 ❑ 5A 0
S Storage 0 S-1 ❑ S-2 ❑ 5B 0
u Utility ❑ Specify:
M Mixed Use ❑ Specify:
•
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor Oh
1°
ist
2" 2 w
3b 3r
40'
411'
Total Area(sf) Total Proposed New Construction(sf)
Total Height(ft)
Total Height ft
7.Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public El Private 0 Zone Outside Flood Zone Municipal 0 On site disposal system❑
Version!.7 Commercial Building Permit May 15,2000
B. NORTHAMPTON ZONING
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)
N of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O YES 0
IF YES: enter Book Page and/or Document X
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location: smaller roof/wall mount 385, 5x5
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES, describe size, type and Location:
E. Will the construction activity disturb(dealing, grading,excavation,or filling)over aae or is it pan of a common plan
that will disturb over I acre? YES O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Versionl3 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
NONE Not Applicable El
Name(Registrant):
NONE Registration Number
Address
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
NONE
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Charista Construction Not Applicable 0
Company Name:
Joseph Kennedy
Responsible In Charge of Construction
38 Harkness Ave Fact Longmeadow
Address
K'""' (413)627-7376
Signature Telephone
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes O No Q
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Marybeth Bergeron as Owner of the subject property
hereby authorize Joseph Kennedy to
act on my behalf, in all matters relative to work authorized by this building permit application.
?tiara 8r, 06/07/2016
Signature of Owner Date
Joseph Kennedy ,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.
Joseph Kennedy
Print Name
KGaa.t 06/07/2016
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Nader: Joseph Kennedy 055440
License Number
18 Forest St Bondsville Ma 01009 07/22/2016
Address Expiration Date
2.441,4 Kig.tz 6 (413)627-7376
Signature Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152,§25C(8))
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 O No 0
A� � ""
CERTIFICATE OF LIABILITY INSURANCE GATE' n ""
6/7/2016
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 lime Lisa Leon AAI
Berkshire Insurance Group, Inc. mPINNE (413)935-1200 FAK No:0131567-5300
138 Longmeadow St. Ea pp ss:llenon@berkshireinsurancegroup.come
INSURERgSI AFFORDING COVERAGE _ PMJC
Longmeadow EA 01106 _ _ BOOMER A:The beating Group
INSURED MSU R B Safety Indemnity Co. ' 33618
azw
_._ Inc._..
Chiata Construction Services, Inc. NRERC TPA InsuranceAgancy� _
38 Harkness Avenue NSORERO:
'SURER E:
• East Longmeadow NA 01028 MUTER F; -._. . . _.. . _..
COVERAGES CERTIFICATE NUMBERCL165443989 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.
NSR
LT0. - A Lweb POLICY EFF POLICY EYP TYPE OF INSURANCE HIED WO POLICY NUMBER IWWMYYN UNITSVOONYYN IMO
X COMMERCAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
DAMAGE TO RENTED -- - 300,000
A _ CLAIMS-MADEI X OCCUR PREMISES(Ea occurrence) f _
AlS1026417 5/6/2016 5/6/2017 I MED EXP(Any wIe pawl) S Excluded
PERSONAL BAOJ INJURY f 1,000,000
GERL AGGREGATE LIMIT APPLIES PER: 'GENERAL AGGREGATE S 2,000,000
XI POLICY I �'o-J JECT LOC PRODUCTS-COMP/OPAGG S 2,000,000
F _
OTHER
Pro[aM1Y OareEh Dedc f
j AUTOMOBILE DIMWIT, •I (Ea CdA21NEn0SINGLE sem S
acciden
B �~l ANY AUTO BODILY INJURY(Pa Person) 15 250,000
ALL OWNED X SCHEDULED 5021567 6/2/2016 6/2/2017 BODILY INJURY(Paaxea) S 500,000
AUTOS H AUlINOWNED PROPERTY DAMAGE S 100,000
X HIRED AUTOS b NN-OAUTOS (Per acadmi0
S
UMBRELLA LIAO _ OCCUR EACH OCCURRENCE 5
EXCESS UAB 1._ CLAIMS-MADE r AGGREGATE S
DED RETENTIONS I 1 S
WORKERS COMPENSATION PER I 10TH.
AND EMPIOYERSMOUT( YIN STATUTE I ER
PROPRIETOR/PARTNER/EXECUTIVEEL EACH ACCIDENT _ S _ 1000,000
j CFFICERMEMBER EXCLUDED? NI A - -
C 1 nmlmeory in NH) S 0002537 ' 6/8/2016 16/8/2017 EL DISEASE-EA EMPLOYEE S 1 000,000
IIWS.0emnbeudlr —J
DESCRIPTIONOFOPERATIONSCew E.L.DISEASE-POLICY LIMIT S 1,000,000
I
I
DESCRIPTOR OF OPERATORS I LOCATORS/VEHICLES (ACORD 101,AOCmuel Ralub Schedule,may be Mauna is mon spite Is reeMeN
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Am ONZED REPRESENTATIVE
Judi Mabee/J[1 �"�x"��
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
INS025n0I40n -
1� The Commonwealth of Massachusetts
�. Department oflndustrialAccidents
Ns.
c E,E _®" Office of Investigations
W4Tt1_ 9 1 Congress Street, Suite 100
• �" ' I Boston, MA 02114-2017
�'>® www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Charista Construction
Address: 38 Harkness Ave
City/State/Zip: East Longmeadow Ma 01028 Phone#:413-525-1735
Are you an employer?Check the appropriate box:
8 4. I am a general contractor and I Type of project(required):
1.0 I am a employer with ❑
employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction
listed on the attached sheet. 7. Q Remodeling
2.❑ I am a sole proprietor or partner-
These and have no employees These subcontractors have g, ❑Demolition
working for me in any capacity. employees and have workers' 9 ❑ Building addition
[No workers' comp. insurance comp. insurance.t
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
officers have exercised their 11.0 Plumbing repairs or additions
3.❑ I am a homeowner doing all work
myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs
insurance required.] f c. 152,§1(4),and we have no
employees. [No workers' 13.0 Other porch repairs
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.
tContractors 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.
Insurance Company Name: Berkshire Insurance Group
Policy#or Self-ins. Lic. #:WC0002537 Expiration Date:6-8-17
Job Site Address: 2 Conz St City/State/Zip: Northampton
Attach a copy of the workers' 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 pains and penalties of perjury that the information provided above is true and correct
Si>;nature:
A Kr.* Date June 7 2016
Phone#: 5254735
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):
I Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
Other
///Contact Person: Phone#:
V1ps.,< s ':s Depatr t 1‘ ,r
3(1 2 a. i.. .P.ag Rag., nt ) c Sar.1.,rr_..
aeon a CS05 :0r
[As . 08-055410
JOSEPH A KENNEDY
IS FOREST ST _
PO BOX 1356 9e
BONDSYILLE MA0/0011,:7
COpll 'I. Ini e' 07/22/2016
City of Northampton 212 Main Sheet,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: C c "2 S ,\4- i o rtn[.u,4e(q
The debris will be transported by: U S A \Ci
The debris will be received by: Fc<S-I kML, (icor C+ . Recycli 7
Building permit number
�t'F
Name of Permit Applicant-TC Ltd /
C 1`1 — lG
Date Signature of Permit Applicant
Louis Hasbrouck
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
I request that you grant a modication to waive the requirement for control
construction for the project at 2 Conz St "Maplewood Shops" Northampton because the
work is of a minor nature,will not affect health, accessibility, life and fire safety, or
structural requirements and is impractical in that the cost of control construction is
considerable when compared to the cost of the proposed work. I have provided a
stamped letter from Erskine Chaffin of Chaffin Associates Architect in support of this
request.Thank you for your consideration.
Respectfully,
Joseph Kennedy
Charista Contruction
38 Harkness Ave
East Longmeadow, Ma 01028
1
chaff in
associates
architects .
planners
121 chestnut st.
spring field,
mass. 01103
413-732-1650
Mr. Louis Hasbrouck, Commissioner
Code Enforcement, Building
212 Main Street
Northampton, MA 01060
RE: Repair Work at 2 Conz Street
Dear Mr. Hasbrouck,
It is my opinion that an Architect for Construction Control is not necessary for the repair work to
replace porch balusters, replace damaged porch boards and raise and support sag in porch
steps.
Very Truly Yours,
Signed:
._--)
,R �,
Erskine E. Chaffin, Reg - Design Professional.
s
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