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32C-067 (23) 2 CONZ ST BP-2017-0854 GIS It COMMONWEALTH OF MASSACHUSETTS Man:Block:32C-057 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) CatettormS BUILDING PERMIT Permit# BP-2017-0854 Proiectd JS-2017-001437 Est.Cost: $50000.00 Fee:$350.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor License: use Grouo _ JOSEPH KENNEDY 055440 Lot Size(sq. H.): 30666.24 Owner: BERGERON MARYBETH Zoning:CB(100)/ Applicant JOSEPH KENNEDY AT: 2 CONZ ST Applicant Address: Phone: Insurance: 38 HARKNESS AVE (413) 525-1735 O Workers Compensation EAST LONGMEADOWMA01028 ISSUED ON:1/13/20170:00:00 TO PERFORM THE FOLLOWING WORK:VINYL SIDING ON FRONT OF LONG MAIN BUILDING 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 q 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: FeeTvne: Date Paid: Amount: Building 1/13/2017 0:00:00 $350.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Qp /7- ZSCtt . Versioni.7 Commercial Building Permit May IS,2000 . '. . .. Deparbnent use only r - Cjy of Northampton status of Permit: B ilding Department Curb CutfDrtveway Permit - t ei 1 2 2017 212 Main Street Sewer/septicAvailabity Room 100 Water/Web Ava#abifrty E-7.7—'-7------- -- o hampton, MA 01060 Two Sets or Stn,ntural Plans — r- . phony A13- 87-1240 Fax 413-587-1272 PbVSIte Plans Other Specify APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.11Property Address:`` This section to be completed by office d C.D lA2- 5' V-.Y A Map Lot Unit W 0 C1tk t" i-0in i.'4{ G Zone Overlay District Elm St DisWct CB District SECTION 2-PROPERTY OWNERSHIPIAUTHORRED AGENT 2.1 Owner of Record: (nuryLe4L 3.¢,ro& 3? ltarkterr A&A4 CAC 1. h i otoaA Name(P a \ Current Mailing Address: tt1 ?- 5'ar - 12Tx- Signature ( s' =g .. .... 2.2 Authorized Aslant: 4 -rocs t, keit+a.rhy ' fl (-lark i!r � gal 1-olt .rc.� OI0BP Name(Piing , ^ Current Mailing Address: l{1 n.�p� l///y/1 LIr?- 6J7- ??-76 Signature , t,e1 -"r-Iell ( ,, Telephone SECTION 3`77'•ESTIMATED CONS CTION COSTS Item Estimated Cost(Dollars)to be Office Use(My completed by permit applicant 1. Building CV 5 0, G cc (a)Building Permit Fee 2. ElectricalY,f- (b)Estimated Total Cost of P C� Construction from(6) 3. Plumbing i C Building Permit Fee C) 4. Mechanical(MVAC) P 3S 5.Fire Protection 6. Total=(1 +2+3+4+5) Cherie Number 674/7/ This Section For Official Use Only Building Permit Number Date Issued "Atier5;1024:40. Signet , {/ '.;tro err a.=cior• :uitdinga Date . oe 78G yah azto,e-7 Version!.?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 Demonuon❑ Repairs❑ Additions 0 Accessory 8ugrgng0 Exterior Alteration 0 Existing Ground Sign 0 New Signs❑ Roofing 0 Change of Use❑ Other'7 Brief Description Enter a brief description here. t `i. u-a 4+1( T cd res t3 c .. 4 ret$ os OfProped Work: letJul7Uf . idvwlnt.ww tot( �ri cy SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A-1 0 A-2 0 A-3 ❑ IA 0 A-4 ❑ A-5 0 I 18 0 8 Business ❑ ..—. 2A ❑ E Educational 0 _ 2B ❑ F Factory 0 F-1 0 F-2 0 2C 0 H High Hazard 0 — 3A 0 I Institutional 0 1•1 ❑ 1-2 ❑ I-3 ❑ 38 0 M Mercantile 0 4 0 R Residential 0 R-1 0 R-2 0 R-3 0 5A ❑ S Storage ❑ S-1 ❑ S-2 0 58 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 760 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(so is 2nd r 3b 4u 4th Total Area(sf) Total Proposed New Construction(sf) Total Height(fl) Total Height fl 7.Water SyPpyG. (M. L.c.4g,§54) 7.1 Flood Zone Infonnatlon: ---7.3 S ge 0 osel System: Public`p( Private 0 Zone Outside Rood Zone Municipa On site disposal system❑ Version l.7 Commercial Building Permit May 15,2000 S. 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:�.,_ Real Building Height Bldg. Square Footage / _— Open Space Footage % dot area minus bldg&paved parking) it of Parking Spaces Fill: (volume&Locationl _,.... A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ) DONT KNOW O YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES 0 IF YES: enter Book Page y.,/and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW (3 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained © , Date Issued: C. Do any signs exist on the property? YES Igiffi NO O IF YES, describe size, type and location: 1;eu.(- J (yvjd3ug V t-f c,py,f 7X$ Yv D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NOCK 7 IF YES, describe size, type and location: c_� E. WI the construction activity disturb(clearing,grading, cav ion,or filling)over 1 acre or is it part of a common plan that will distutb over 1 acre? YES O NO to IF YES,then a Northampton Storm Water Management Permit fmrn the DPW is required. Versionl.7 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: MOW Not Applicable E .. Name(Registrant): \, e,`^t n Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): M d 1;4 Name Neva of Responsibility ou{ 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 Tefephono &Oration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General ContractortA- {{tt _ Ct .FlincL CO L"CA-NYC 'l,,r.'C1P1 Not Applicable C) Company Name: �OCPeLR Yc titct e by Responsible In Charge of Construction ' /� .3 X Gl-''1"•141 cc Av., 4 a f G-�'^��'.Lc�oCJ O(O.1g Adt ss • 4 Sig1 re Telephone Version1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) J Independent Structural Engineering Structural Peer Review Required Yes 0 Nose SECTION 11 •OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT � q r �f fl � 7 ""3� � � oc ,as Owner of the subject property hereby authorize 3o LPPL‘ .edy to act on my • .in all matters .work authorized by this building permit application. .a.! n Signature of Owner . '.te �(7SfeL t~•-{ti Ll �y' , 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. Ta511-P Lifw,„to8Y P' Name 411, "� t tf — aOp/ t� 6;7- 7'7' Sign+ re of• er/Agent Date SECTION 12•CONSTRUCTIONBERVICES 101 Licensed Construction Supervisor:( � lex/�� Not Applicable 1:3Normo of License Holder: 'SOCe 13L I /Act.?�Y d ss `ct License Number Cc p r-e ?c ft( 14 et 0 ( 0 p 7 _ aa- 1 ? Extwetnn Date la .11 ..-t Illi - 6 )7- 777K se; um Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L o.182,§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 0 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: 2 COLA-2- ppS The debris will be transported by: L) S H Wel S F The debris will be received by: S A iivn S_., F4 c \ W tl,4b r 6 ( ' Building permit number: �/ Name of Permit Applicant 0 cam(°C, Lc ft f1•P >X• l - 1 ( - ) O 7 • e., Date Signature of Permit Appl" ant The Commonwealth of Massachusetts a.= Department of Industrial Accidents "1i. - Office ofInvestigations i- •el_ 1 Congress Street,Suite 100 ilEf.STI Boston,MA 02114-2017 www.mass.gov/die Workers Compensation InsuranceAffidavit: BuildersfContraators/EtectridanstPlumbers Applicant Information PleaseePrint Legibly Name(Business/Organization/Individual): Ci�� r 1 S \A C.O t{zlci let,cfc -t btr1� Address:? t-nvkk.trs 1L-e. F.C` c4 tat-47 hnlecS4 coi City/State/Zip: tM C5 ( C) 3Q Phone ft: Li( ?- C) c- l ) ?S' Are you an employer?Check the appropriate box: Type of project(required): L am a with [ 4. ❑ I am a general contrasub-contraorctors and I employees and/or have hired the sub-contractors 6. ❑New construction (fullrartrtime)." 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 9I Remodeling ship and have no employees These sub-contractors have s. ❑Demolition working for me in any capacity. employeesaid tatewOrlces 9. 9 Building addition [No worka5 crap insurance comp. insurance. required,j 5. ETWe are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions neat.[No worke5 comp. right of exemption per MGL 12.0 Roof repairs insurance required§`- c. 152,§1(4),and we have no ekdoyes[No workHS ITN ( /er Vitpt -f <oh( comp. insurance required] "Any eiplicat that d'Msbox#t mustnm fill oulthesection Won showing theirwako# cc paeation policy information. t Haneownen who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. temaractonthet check this box must attached an additional shed showing the name oft the sob-convectors and nate windier or not those antics have employees. lithe sub-axtlradarshaearpioyes they mug ptanrbthdr wake:amp.policy ruriw. I an an employer that is providi ng works's' compensation i nsuanoefor my employers Below is the policy and job site information. --{- /� Insurance Company Name._1 ,t` k_S ri"e sirU{S' L%rC( (ii re Cj` ilei fol p-trr Policy#or SelMns.Lie.#:C.0 ^ V y C COO a C? / Expiration Date:\ ()[7` d - r) 0 r7 y�! / Job Site Address: C,rl 7/Li S,T- City/Slate/Zip: [`k r�&ct pi i. la's` ( Qv `-J Attach a ropy of the svorkere compensation policy declaration page(Mowing the poi icy nun$le'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$250.00 a day against the violator, Re advised that a copy of this statement may be forwarded to the Office of Investigations of the DNA for insurance coverage verification. I do hereby toddy um, the pal .:1 d penalties of perjury that the Information provided above is true and correct. 4 i'Ettore: �tL'n/�^} 4_ l �»� ?,5- ...... }r- _ Dale:_ � — (./ — ( 7 Phone#: `t I5 '- j > .- ( 7 3 7 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/rows Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE oDDlis THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the palcypesi must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such edmsem°nt(s). PH000CER CNOA ACT Lisa Lemon AAT Berkshire Insurance Group, Inc. . reset (413)935-1200 I�E6$..fiX No,14131567-5100 138 Longmeadow St. =dm- .lleaonpberkahiseinsnxancsgroup.com IHSS AFFORDNG CDVERAGE I NAM la SA Longmeadow T0I106 IXSURER4:The...Reatinq Groan ...+I _. _. INsuRED INSURERB Safety Snd nui.t' Co. `33618 . ._ Gharista Construction Services, Inc. IxsuRErtc:1PA Insurance Agancv, Inc=.__ 38 Barkness Avenue -- msuR RD: INSURER E• Bast Le _..---..... — vfgmeadow NA OI028 INSUFERF; C COVERAGES CERTIFICATE NUMBERL415543989 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 WON 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. _WYRi r(PEOFINSUPANCE lSp mij IM P9UCYMUMSER PoapM'YYYI IM/MXIMYYYI `— mint X'COMMERCIAL GENERAL LMB3UTY EACH OCCURRENCE 5 1,000,000 A 'L CIAIMSMpUE i R ]DDR I -IIIIZ P ALSOUM Ea $0310 _ 3 300,000 irl r— __ I ASS1026417 5/6/2016 5/6/2017 I MED EPP(ATImn pIYSY) I$ Excluded _ Asr— AIS 1,000,000 _ OENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 : I1XPUN� I EOI LOC �PRODUCTS.COMPOPAGG 15 2,000,000 OTHER. F 13108+ay Ms IS AUTOMODLEW9Ure �CAIIIBINE�Dq$INGfE LIMIT t I AlNAUTO IBODILi YNJURY(Porpemn) IS 250,000 Bf AAG'OB OWNED R lI�Q9 LED 15021567 6/J/2016 6/2/2017 BWII. IMAMS MAY a en0I$ 500,000 X I HMO AUTOS I X I AUTOS O ( PROPERTY MAGE IRI $ 100,000 i i s _....._. uMB1iELLA UAM I OCCUR . EACH OCCURRENCE $ —I sots tots _ I I OLAIMSMADEI I AGGREGATE 6���� [DEO , RETENTIONS I I I I I s WORKERS COMPENSATION • PER 10tH [AND EMPLOYERS WBUTY Y1N YATUjE ER_r_____ ANY PROPRIETOROARTNEWEXECOTIOS In ! I [.E L FAE ACCIDENT (3 1 000,000 G, OTICER/MEMBER EXCLUDER? J N A IWndatory in Nm 0]000253] 6/a12026 6/9/2011 El 05EAe-EA£MR-OYE $ 1 000,000 R Yes destabe AlMer O IDESCRIPTION OF OPERATIONS Estop .I IEC DISEASE-POLICY LIMIT 1 000,000 I i1 1I I I I I DESCRIPTION OP OPER/MONS)LOCATORS/VEHICLES{AC0RV 101,Gild COi Remelts ScAttk,rimy M aMLLd it monspace is requited) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCPJBED POLICIES BE CANCEI1ED BEFORE Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AISINONIZED IEPRESENTAUVE Judi Mabee/JU ""�' ""' "" 1488-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014401) Thu ACORD name and logo are registered marks of ACORD INS02S Mune Massachusetts Department of Public Safety Board of Building Regulations and Standards License:CS-055440 cna t udm=S pe a sor yyY• 3y, JOSEPH A KENNEDY a 18 FOREST ST PO 80X1300 BONDSVILLE MA 01009 (�—•n Expiration'. Commissioner 01/2212018 38 Harkness Avenue Chorista P.O. Box 706 East Longmeadow, MA 01028 Construction Tel. 413-525-1735 Residential 6z Commercial Fax 413-525-2327 Water & Fire Restoration Remodeling I request that you grant a modification to waive the requirement for control construction for the vinyl siding project at 2 Conz St in 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.Thank you for your consideration."Mass Amendments,sections 107.1 allows for an exclusion from control construction for this project" Respectfully, Joseph Kennedy Charista Construction Celebrating Over 30 Years In The Construction Industry