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24A-066 53 RIDGEWOOD TER BP-2017-1470 GIS a: COMMONWEALTH OF MASSACHUSETTS Map:Block:24A-066 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: KITCHEN RENO BUILDING PERMIT Permit# BP-2017-1470 Project 4 JS-2017-002449 Est.Cost: $394000.00 Fee:$260.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: BARRON & JACOBS 60475 Lot Size(sq. ft.): 8232.84 Owner: BURWELL REBECCA A Zoning: URB(100)/ Applicant: BARRON & JACOBS AT: 53 RIDGEWOOD TER Applicant Address: Phone: Insurance: 70 OLD SOUTH ST (413)586-8998 Workers Compensation NORTHAM PTONMA01060 ISSUED ON:6/20/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:KITCHEN REMODEL 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 6/20/20170:00:00 $260.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-1470 APPLICANT/CONTACT PERSON BARRON&JACOBS ADDRESS/PHONE 70 OLD SOUTH ST NORTHAMPTON (413)586-8998 PROPERTY LOCATION 53 RIDGEWOOD TER MAP 24A PARCEL 066 001 ZONE URB(I00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST E. _ REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �( Fee Paid apeof Construction: KITCHEN REMODEL New Construction Non \ j Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 60475 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION' OR� PRESENTED: U.vpproved 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 D-mol '.•-Delay re . Dui di g fficial 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. ,� 7 ' Cit of Northampton 4 + �` iss, � '47% Y P P ; Building Department °� *,ark ��� 212 Main Street � t ���'-k ii'r'' Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address. ��T/hi�ss�Icompletedsection to be completed by office 53 ROTuOcc( Ierra(Q. Mop 01'717 Lot 0 I-i' Una No(oaimbn MA Olo(oO zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Re.6e(Ca ?unWOd 53 RctQQeiu'rnd 'Trrnre , Nor JhampfnM,A Name(Print) Current Mailin Aarey,s' OWL 0 4/3 — �513 YoGo See AFiacheck arireemeni pq. 13 i{em B Telephone Signature 2.2 Authorized Agent: 130.3tnr e 7 065 70 ad SULYh SF , Ncd phn MA QIOlcO Name(Print) / Current Mailing Address' Hi3 - 58(e 8498 Sign."re 7 - Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $ 3`1 ,05$,Co (a)Building Permit Fee 2. Electrical a yds (b)Estimated Total Cost of Construction from(6) 3 Plumbing ,m-13(e 00 Building Permit Fee 4. Mechanical(HVAC) 4 0 5. Fire Protection 6. Total=(1 +2+3+4+5) I3(1,400-CO Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date Ihasbrouck @ northamptonma.gov EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING AU Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by No C4rtngeA to Plishn5 cr:{lpnnt Building Deyanment Lot Size Frontage Setbacks Front Side L: R: L:._ Rr_ Rear Building Height Bldg.Square Footage % — Open Space Footage °o — (Lotarcaminusbldg&paved _ parking) k of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DONT KNOW 0 YES 0 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 tt B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW O YES O 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 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 Rl 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 O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House n Addition ❑ Replacement Windows Alteration(s) Roofing El Or Doors C Accessory Bldg. ❑ Demolition ❑ New Signs [CO Decks [CI Siding[C] Other[C] Brief Description of Proposed Work: At mnvc 1 nor -111u(URI NatA to lliKhe rerr[prlts Alteration of existing bedroom Yes X No Adding new bedroom Yes K No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll -Sheet calf New house and aT 8dS00 to Sham hausina.annotate the toKowbfli: 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 IIP he(C(), Bunk1P II ,as Owner of the subject property I1 ,Q hereby authorize RQCrf;r� " -1-abb to act on my behalf,in all matters relative to work authorized by this building permit application. ?v' n+tarhed (lctcevment- pc[. 3 Hem a Signature of Owner Date I, C rkns *aLObS ,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. Chas Tnrobs Print Naam(ree Signature of Owner/ en I� ��1)� SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder Chc'Is InretS. CS — C(p Qy}s License Number -1(1 cI� 5cuth Si- , Nor}hampthn , MR OIOOU (( Ho I ao) x Address Expiration Date / X13 7�a �49R Signature Telephone 9.Redistrict Horn ieOtovaowrt Contractor - • - Not Applicable ❑ Bifirm g Tatch Assocakc5Inc IOMOci Company Name Registration Number 10 Otcl SoJk 51 , IVctikamptLn MR MOO Cly 19)3 JO) Address Expiration Date Telephone 413"586-3493' 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 S, No ❑ SIGNATURES By signing below,you agree to items A, B and C. DO NOT SIGN THIS AGREEMENT IF THERE ARE ANY BLANK SPACES. A. Alternative Dispute Settlement(Arbitration Clause):The Seller and the Buyer hereby mutually agree,in advance,that in the event of a dispute concerning this Agreement,the parties shall submit such dispute to a professional,state-approved arbitration service(cost, if any,to be paid by the submitter)prior to either party proceeding to legal action in the courts. B. By signing this agreement,you,as the owner of record,are hereby authorizing Barron&Jacobs Associates Inc.to act as your authorized agent in all matters pertaining to the building permit application. C. This is a binding Agreement. You may not cancel it except as stated. This Agreement coven and supersedes all conversations, statements and agreements,expressed or implied,between the parties,their agents or representatives. �Ufl 08 WOW !/ 1 y- You,the Buyer,may cancel this transaction Buyer Date at any time prior to midnight of the third business day after the date of this transaction. See the attached notice of cancellation form Buyer Date for an explanation of this right. Seller retains an equal right to cancel. A s 3/2y/)' B on&Jaw s epresentative Dat f ♦***,********4********************************hitt*****************************♦****4******* Contact Information Office Manager: Sandy Scavotto Office:413-586-8998,x100 ❑ Chris Jacobs,President CT HIS#0554397 Cell phone:413-250-6677 Home phone:413-665-9113 Office phone ext: 103 M Adam Skiba,Director of Design Cell phone:413-923-7003 Home phone:413-610-0660 Office phone ext: 106 Purchase Agreement Page 23 of 23 Google Maps 53 Ridgewood Terrace Jackson Street Elementary School 0 tURIdgmeal Tree „.” "°^d4¢, Paradise City pleaswois " . . QBµ Google *, 8 Map data©2017 Google 100 hu .w' - 1 53 Ridgewood Terrace Northampton,MA 01060 CJAie anin n(yea/t4 o/b '/ z iackeieeG. °e=-, Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 100809 Type: Private Corporation Expiration: 6/23/2018 Tr* 419291 BARRON & JACOBS ASSOCIATES, INC. Cecil Jacobs - 70 OLD SOUTH STREET - — NORTHAMPTON, MA 01060 Update Address and return card.Mark reason for change. SGi 0 2041-0911 Address _ Renewal _ Employment Lost Card e 'Gm mo.,.,,ee/f/r f^1ff.e:udessii Office of Consumer Affairs&Business Reguhrion License or registration valid for individual use only a: HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: m Registration: 100809 Type: Once of Consumer Affairs and Business Regulation Expiration: 6/23/2018 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 BARRON&JACOBS ASSOCIATES, INC. Cecil Jacobs 70 OLD SOUTH STREET NORTHAMPTON,MA 01060 Undersecretary Not valid without signature Massachusetts Department of Public Safety IFBoard of Building Regulations and Standards license: {S-016473 Construction Supervisor h 01.0 scrum RT x4R71M,4TOR alA • rr —M l A— Expiration: Commissioner tai Wan P7.4' • Y l Pte.{I s asp y. . .i.� ,; -- 3 A F F E O' .A TV` I �1�. .. in accordance withthe provis;ons of MGL c 4J, §54. I acknow[edge, as a condition of the Building permit, a[i debris resulting from construction acrvfy governed by this Building Permit shat' be disposed of et EY (?-oto Fa — — -- (NAME OP FAC6LIT1 -- -- — a property liven ed solid waste faafiiy, as derined , ,, C lit §1 `c> 62 I PRINT DR TYPE -L1 G .N. O '-rATiO.'>: GCGi - .TA0)JLi .,.f CF PERMIT APPLIC4NT) TY E OF M.4:EPi:L TO BE DJSPDSED OF? (PROPERTY ADDRESS) _-- ( jj L'd C:7.11 I C7 Lt,L AC Rd CERTIFICATE OF LIABILITY INSURANCE DATE OBU O1Twl 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(SI, AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the polley(ies)must be endorsed. If SUBROGATION IS WAIVED,sub*ect 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 Mena Adina Edge tt Webber b Grinnell An ow rm. (413)586_0111 _1 jcAi N,I.1a1315eaceel 8 North King Street XMAX aedgettewebberandgrinne11.COM I ISURER'SI AFFWOING COVERAGE NRC•_ Northampton MA 01060 — _ 1INSURER A Hain Street America/HSA 29939. INSURED INSURER B HGM/HSA Barron b Jacobs Assoc. Inc. ''wBUREpC A.LH. !Rattle l/A.LH. Attn: Cecil R. Jacobs INSURER 0 70 Old South Street INSURER Northampton MA 01060-3833 I INSURER F: COVERAGES CERTIFICATE NUMBER:BAp 03/10 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 NMICH 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. WypT 100.i8UM SOCY EFF I PIXICY EV LTRI TYPE OF INSURANCE ILI µyy SOUCY MAMA ISISLOMWYNT IMMOIXYWYI LIMITS IX COMMERCIAL OENEPAL LABILITY EACH OCCURRENCE 1 1,000,000 -..._I CW MS-MAOE • X -DTATOZETGRENTED A OCCUR v?AfMISESLFE_o02,n¢;A3 1 500,000 NF[80490 3/9/2017 3/9/2018 MED EXP(Any qw peronl 1 10,000 PERSONAL AADV INJURY 5 1,000,000 IGENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE IS 3,000,000 X SOUCYI`:jEOT _� LOC PRODUCTS•COMP/OP AOC l 1 3,000,000 OTHER • Emu '1 10,000 AUTOMOBILE l3AmV1Y • "• EMBINEOSINGLE LIMIT y B I, ANY AUTO BODILY INJURY(Per parson) S 1,000,000 ALL OWNED SCHEDULED K AUTOS M1rB049O 3/9/2017 3/9/301e • PROPERTY 9INJUIPervnaen0 $ ]( IAUTOS NON-OWNED • DAMAGE HIRED AUTO _ P 1_ _ __ S,_ { Medical payment $ 5,000 •UMBRELLA LAD X :OCCUR EACH OCCURRENCE S _ 1 000,000 :EXCESS LaB IXPIMSMADE AGGREGATE 5 1,000 000 ":DED X RETENTIONS 10,000 0228049103/9/201] 3/9/2018 3 WORKERS COMPENSAMON XII PER DTH- YIN. • STATUTE TER ion'PROPRIERPARTNER/EXECUTVE - EL EACH ACCIDENT 1 500,000 t., CFFIOFRMEIABEBER EXCLUDED/ '_N •NIA, IM/MMa1M'In Nm I Tam80 OS 3652017A 3/1/2017 3/1/30181 E L DISEASE_EA EMPLOYEE S _5010000 DESORPTION uOF OPERATIONS Wive I EI DISEASE-POLICY LIMIT 1 500,000 CESCRYTCN OF OpERARONS/LOCATIONS/VEHICLES(AGGRO Ult.AO]MwI Remit SCMEW,may be a Gh.d If more apace Is mweew CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTAIIVE // W Gi_nnel 1, CPCJ, CIC X+�ll � - 'OO V O 1985-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025noun,i The Commonwealth of Massachusetts Department of Industrial Accidents tri_EL Office of Investigations aia;,e J 600 Washington Street Si.!Et= Boston, MA 02111 et, www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information {[ }' p Please Print Legibly Name(Business }rganization/individual): I(1YlCY{ $ hiCh,li Acconao inc Address: TO OL k n Ci /State/Z9 t7. F: NOe\ \31wi MA 0IO60 Phone #: 4113- 58tpA193:..... Are you an employer? Check the appropriate box: Type of project(required): I.EA I am a employer with 13 4. ❑ I am a general contractor and I 6 9 New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.= ® Remodeling ship and have no employees These sub-contractors have 8. 9 Demolition working for mc in any capacity. workers' comp. insurance. 9. 9 Building addition [No workers comp.insurance 5, 0 We are a corporation and its I0.9 Electrical repairs or additions required] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.❑ Plumbing repairs or additions myself. [No workers' comp, c. 152, $1('4).and we have no 12.9 Roof repairs insurance required.]t employees. [No workers' 139 Other comp_insurance required] 'Any applicant that checks box#1 must also fill out the section below showing their workers compensation policy information. Homeowners who submit this affidavit indicating they arc 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 suh.contractors and their workers'comp.policy intbrmation. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ! . F. M - Mutual 1 Pe T. Policy#or Self-ins. Lie. #: k(1Kn(1Q(o7j- rj(n ,act -f ......_ Expiration Date:_3 I jdOI Job Site Address:53 R1(tsGl(RG(j �1IPYGOCQ City/State/Zip: Nr.ri hon lnt AIR QIO(uct 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 MGI,c. 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 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 DR for insurance coverage verification. Ido hereby certify under the p and penalties of perjury that the information provided above is true and correct. Si r attire: Date: Phone ft; y13'5962-3l c 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#: