Loading...
25A-037 (4) 46 MARSHALL ST BP-2017-1250 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25A-037 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2017-1250 Project# JS-2017-002092 Est.Cost: $2000.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: PAUL SCHMIDT 103635 Lot Size(sq. ft.): 5270.76 Owner: ALLEN REBECCA Zoning: URB(100)/ Applicant: PAUL SCHMIDT AT: 46 MARSHALL ST Applicant Address: Phone: Insurance: 24 CHESTNUT ST (413) 247-5739 WC HATFI ELDMA01038 ISSUED ON:5/3/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:458 SQ FT 7" LAYER R-26 ADDED TO OPEN ATTIC SPACE, AIR SEALING AS NEEDED 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: O1: 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 5/3/2017 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-1250 APPLICANT/CONTACT PERSON PAUL SCHMIDT _. ADDRESS/PHONE 24 CHESTNUT ST HATFIELD (413)247-5739 PROPERTY LOCATION 46 MARSHALL ST MAP 25A PARCEL 037 001 ZONE URB(I00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Lic(0 Fee Paid Building Permit Filled out Fee Paid TyneofConstruction: 458 SO FT 7"LAYER R-26 ADDED TO OPEN ATTIC SPACE,AIR SEALING AS NEEDED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 103635 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 +n •la -; Sign.' ilIda Date r2 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. citr of t4orthempton Making Department 212 Main Strad Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 _1..■,.'i ..ai.I«r,;:'j:;4n W_4rc#c:o.�1-#so:;•.l\rl..;4 . e.:,ai._. - i . It . '. - 037 cleffestaidest y� /2/b eE./ 5+ 3 n/� N G�mp1 oJJ MA" ti ; h.ee-4_, y4 l LeAY "77/0 MIa.Sha ii �t Nerve(Print) I'.Yrlela See_ CLcktid. %3 g ep S a 0 Bgneas Name(Pint) Current Malting ; iCAL2X2Tom737 Item Estimate!Cost Moan)to be aljljalailialas— mmaaeeaWaamnfao t 1. suiwiag .000 2 Electrical _ 3. Plumbing 4. Mechanical(MVAC) 5. Fre Protection ,�dY 6 TcO1=(1 +2+3+4+5) ...Zappe) . cti - 'Y' Section 4. ZONING AU Information Must Be completed.Permit Can Be Denied ore To$ia ptete Information Elden g, Permed Required by Zoning This tort u to be NW in by Building Deportment Lot Size Frontage �___ Setbacks Front _ __ ....T. Side Building Height _ _ Bldg.Square Footage ,_........_ a� .,.___ _,..__. ._.__. Open Space Footage (Latammmua wdg&pav i ...._._: aaridue #of Parking Spaces _.__. ' ._.__: _m. ___ . _._.._ . __. . FDDi A. Has a Special Permit/Variance/Findi been issued for/on the site? NO 0 DONT KNOWreYES 0 IF YES, date issued:- IF YES: Was the permit recorded at the Regi ry of Deeds? NO 0 DON'T KNOW YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW el YES 0 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 0 NO 4"'"--' 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 Q' IF YES, describe size,type and location: . E. VAII the construction ac$ tty disturb([(�'`� rg,grading, or filling)over I acre oris it ped of a common plan Mat will distwb over 1 acre? YES V NO IF YES then a Northampton Storm Water Management Permit from the DPW s requaed. SECnot4 5-DESCRIPIMINDFCEIGRWAVORIChiskettasattablM New House ❑ Addca1 ❑ MikaieCementAlndcras AISmNs) 0 Roofing p Or Accessary fig. ❑ DenwNlon El New Sign t[]7 Deas [q SW4hlg�3 OBhels� �.�+C..ditdro c 7 Iffier Desolation of Wodc 7SW SPI stA-, 7"Ce y'r f . LI CO aficiFd W U pan A--1-115 A-1 t Meridian of sedating bedroom_Yes No Adding new bedroom Yes ✓r No 'S'� � MeridianMeridian c1 Attached Narahve Renovating unfinished basement Yes NV o Amid- PtaisMached Rag -Sheet a Use of bullang:One Farcy Two Family Other b. Nanber of rooms in each faintly unit Number of Bathrooms C. Is there a garage ate? d. Proposed Square footage of new construction. .Dimensions e. Number of stories? 1. Method of heating? Fireplaces or Woodslrnes Number of each g. Energy Conservation Compliance- Mmsdedc Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft of wed? Yes No. Is construction within 100 yr. floodplain_Yea No j. Depth of basement or cellar floor below grade k WWI building oanfann to the regulators? Yes_No. I. Septic Tank City Sewer_ Private well City water Supply_ SECiiONya-onERAUTH0 4110N-TO WHEN OWNERS MEW OROOMMeatfORAPtettES-PoitatitatePenen. as Owner of the subject Papacy ' ' 11.yy�D /7 hereby authorize 5)S k—.• Y�t0Y1.-w1011. erVerY7Crl� L.t1-uC 'LSI to act on my behalf,hinial matters r lefivs to by this bending pennfl n. rJG-C� lute r cam+--+�w-c� - of Dee —pu'/ .moi.! ,nf dt& as Ovi erfAUNorized Agent hereby declare that the statements and information on the foregoing applcatcn are true and accurate,to the best of my knowledge and belief. Signed under the pairs and penalties of perjury.-Rau/ vru d-t Print Nara ��� Pale 1 _..�_._ _LL �.r -..:•._ Not Applicable 0 dA- License Number 0 )9 JI 12_ in . �aW?cL d , of o : Ott Address ha n �. 41 - a� -5 E� Date Telephone Not Applicable ❑ CAL_ 7451 'S ComosenIrne Registration Number 1'_ >L w re F- rfion Date at —h,-F-Jii e.1 d i rnft C L 0381 TeiephcneV/ .,iq/7.573' Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit wilt result in the denial of the issuance of the?permit Signed Affidavit Attached Yes @'7 No ❑ The current exemption for"homeowners"was extended to include Owner-Combed IAsabses 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.COR 780. Sixth Edition Section 198.33.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which them is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm stmctmes.A person who oonedacts more than one home in a two-ver oohed aka not be considered a homeowner. Such"homeowner"shill submit to the Building Official,on a form acceptable to the Building Official.that behrhe shall be DakfiliSSAYSSELM&IDEED3101325*—DIESSMIESEDIEWIL As acting Construction Swmervbor 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 hive to perform work for you under this permit. The undersigned"homeowner cetti5es and assumes responsibility for compliance with the State Building °'1e,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature RISE80 Shawmut Road, Unit 21 Canton,MA 02021 1339-502.6335 ENGINEERING' www.RlSEengineering.com OWNER AUTHORIZATION FORM i, Th ecce,. -Q I. Icr,�j (Owner's Name) owner or the property located at '—I N1rNitA (Property Address) CSIA v;v z-a� M± Cr (C (, Th, (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. This form is only yyvalid with a signed contract. y.1 Owner's Signature Date City of NOTtbaliptOn lisseaciantts Cfr 212 Ilsta Slat • 11222124411 26212•221222, In tate Proper/1 Address: Centracter Pad 1 Mick /damnimes....aa.: e •Se e sr • hi ••• 21-11C- ' Address: 4; SVre_ek City,State: Paaitha 0 1p.a& Phenix wi 1-673 remerrej-i, Address: -Q/O /Yktc.cJvzji ¶ F Cdy,State: A/zP m - o(c I,—all fx•V.trn iark (contra*Meet and Item that its balding I intend to Matide dem not fateneny epstak*nab and tube)fling in the spaces to be froulated and that I have trovidattilie Nonni),cane a copy elititalltarit Coning:tor algraiture,41‘k Date (9e-- /7 The Commonwealth of Manachusetts • _ - Department of Industrial Accidents Office of Investigations PA =:. 600 Washington Street 4",z1:4=-._ Boston, 414 02111 r: www.mass,gov/did Workers' Compensation Insurance Affidavit: Builders/t ontractors/Electriciaus/Plttmbers Applicant Information Please Print Legibly ,tore (?homest lrgaturanon.(Mr\ dua;:: SOL Home Improvement Contractors, Inc Address: 24 Chestnut Street ( it State Lip: Hatfield.MA 01038 Phone 2: 413-247-5739 Are you an employer?Check the appropriate hoc Type of project(required)'. E r r as cue: : name tr and I I slat I ant a emp:ov er with S _ h. r1 Nets construction employees(fun mtd.or panrime>.` used( : tt mHors r __ice proprietor or partner- th ate heo sheet + t_y Remodeling lam a sole prop ship and have no employees ihsun-contractors have' g, EI Demolition tt°Pang for me in an c dein. nap: 'anlht workers' > ap" ( n 0 Nuildfng addition [No workerscamp- insurance caee :tp :: :r n A e WC frIltwat“ and es I 10.[x'- Glmtrical repairs oraddiorms reff offal i am a homeowner doing ail work 'ffitrthris . rased their 11,0 Plumbing repairs or additions m !1 . tight at exemption per M(11 ysel [No tsorkers comp _ 12.0 Roof repairs insurance required I ` c yli4t and we have no ntplocees f'so workers I5 (cher_ comp Insurance featured t. Um rppttant that check>Ms el must Mos ill dor the sesta n et s n who mformnon. ..a14:1;.h. submt thuen:dafl indicative the Are doom s . t]dr ter•must mbmu a nes atlydas it indicating such : decrm that check shit box must attached an additional shou Moss ng raw .:he Aura-etnaanon and sane u•hethcr of but time entities hate mplm cm I l the sub_canma'wrs time emplrnecs lie' mus:pruvfdc:Iwr 'A.,rAen comp polonumber. I an,an employer that is prnvidh g worken'compensation insurance for an employees. Below fs the policy and job she information. Insurance Company 'same Selective Insurance Co i't.lic% or Self in. t t:. WC9024456 Expiration (Yate 2/2312018 Joh Sire Address:_ v-!shaft moi'. __ !-ity:'Stater-ip:-Cl /Y 4 , av4 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). r2tiurc to secure covdrage as required under Section 25 \of\lr L can (cad to the unposition of criminal penalties of a rine up to$1,500.00 arnica-one-year imprisonment as twit as ea:I penalties in the form of a STOP WORK ORDER and a tine .d up to S:256 00 a da against the violatr. Be advised that a copy of this statement may be forwarded to the Office of ins estigations of the DR for insurance coverage veri fi.ation. f do hereby cera oder t pains and penalties of perjury that the information provided above is true and correct si talaturti .G Date 4ac9--//7 Phone 5 Official use only. Do not write in this area,to he completed hy city or town official Cin or Town: Permit/License# IIssuing Authority(circle one): ^ 1.Board of Health 2.Building Department .3. ('it}iTown Clerk 4.Electrical Inspector S.pfembing Inspector 6.Other Contact Person: Phone#: AccoRn CERTIFICATE OF LIABILITY INSURANCE DATE ;"' 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 pollcy(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). PRODUCER CONTACT Cynthia Henderson, CISR NAME: Webber 6 Grinnell INC Ho Etl: (413)$86-1]111 -lug N I {4131586-6481 8 North King Street noDRBS.chenderson@webberandgrinnell.com INSURERIS)AFFORDING COVERAGE NAIL Northampton MA 01060 INSURER A:Selective Ins Co of S Carolina INSURED INSURERS selective Ins Co of Southeast _ 39926 $DLHeine ImpLOveOent Contractors Inc. INSURER C 24 Chestnut Street INSURER D: INSURER E'. Hatfield MA 01038 INSURER F: COVERAGES CERTIFICATE NUMBERIaster 2017 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. / ADSUER -- _. - POLICY EFF POLICY EXP LTADM TYPE OF INSURANCE IN9p WVO POLICY NUMBER IM WDNYYYYI'.IMWOOryYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH GE1OCCURRENCE _ 5 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE REM$E a oNcc4ErrreenceI..—+".. 100,000 62200065 2/1/2017 2/1/2018 MED EXP Piny one parson/ 5 10,000 PERSONAL 0.ADV INJURY 5 1,000,000 GENE AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 PRO- X POLICY JECT LOC PRODUCTS-COMP/OP AGO 5 3,000,000 _..__ OTHER 5 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 1,000,000 (Ea added]} A NY AUTO BODILY INJURY!Per person/ 5 ALL OWNED X AUTOS A9100328 UTOS A9100328 2/1/2017 2/1/2018 BODILY INJURY(Per acciden0• X HIRED AUTOS X NON SRMEO PROPERTY DAMAGE AUTOS (Per emoen>l Underinsured motorist Bl split 6 100,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 A EFCE5511AB CLAIMS-MADE AGGREGATE 5 3,000,000_ DED X RETENTIONS 10,000 52204065 2/1/2017 2/1/2018 WORKERS COMPENSATION X PER X OTH- ANDEMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE IEXECUTVE EL EACH ACCIDENT S 500,000 OFadatory in ER E%GWOEO] Y NIA B (mandatory deoryln NN) wC9D2<456 2/23/2017 2/23/2018 E1DISEASE-EA EMPLOYEE 5 500,000 ItyesRescnoe under ------ DE6CRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Romans Schedule.may be attached it more space Is required) The workers Compensation policy does not include coverage for Paul Schmidt, Kendrick Dempsey and Douglas Schmidt. Columbia Gas of Massachusetts is hereby named as Additional Insured per written contract with respects to General Liability S Auto Liaiblity, for work performed, and per the terms and conditions of the policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Columbia Gas of Massachusetts THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 4 Technology Drive Ste 250 ACCORDANCE WITH THE POLICY PROVISIONS. Westborough, MA 01581 AUTHORIZED REPRESENTATIVE AZ /IR C Iieadelso:1, CISR/CIN et WR. ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 or)1M1,