Loading...
28-045 (4) 69 CAHILLANE TER BP-2018-0997 GIS 4: COMMONWEALTH OF MASSACHUSETTS Map:Block: 28 -045 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2018-0997 Project# JS-2018-001809 Est.Cost: $33975.00 Fee:$40.00 PERMISSIONIS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NORTHEAST SPECIALTY CORP 103713 Lot Size(sg. R.): 10018.80 Owner. BYRNE DONNA G&KEVIN 1 Zoning: Applicant: NORTH EAST SPECIALTY CORP AT. 69 CAHILLANE TER Applicant Address: Phone: Insurance: 148 DOTY CIRCLE (413) 739-4333 WC WEST SPRINGFIELDMA01089 ISSUED ON.4/3/20I8 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL STONE COATED METAL STEEL ROOF WITH GUTTERS DOWNSPOTS AND GUTTER SHIELD 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 4 Foundation: Driveway Final: Final: Final: Rough Frame: Gas: FireDepartment 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: FeeTVpe: Date Paid: Amount: Building 4/3/20180:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Kir_ Department use a* City of Northampton Status of Plural: Building Department Cum CutlDriveWay Permit ' ` 212 Main Street Seanar/Septic AvaMabili Room 100 WatedWeg Aveilapilily Northampton, MA 01060 Two Sets of Structural Plans��,1 phone 413-587-1240 Fax 413-587-1272 PlotS ide Plans APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENVA EMO SH A O E TWO FAMIILLY DWEELLLING SECTION 1 -SITE INFORMATION w I SP- I a + q 1.1 Property Address: oevr cr a: r; to be completed by office Map 7 T Lot 6115' Unit 69 Cahillane Terrace, Florence MA 01062 Zone overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record; Kevin&Donna Byrne 69 Cahillane Terrace Florence MA 01062 Name(Print) Current Mailing Address: 413-537-3576 Telephone Signature 2.2 Authorized Apent: Matthew Harrison 413-739-4333 Matthew Harrison 413-739-4333 Name Pr t Current Mailing Atltlress. Matthew Harrison 413-739-4333 Si Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 33975.00 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee I ' 4. Mechanical(HVAC) 1tN-I� J"u 5. Fire Protection 6. Total=(1 +2+ 3+4+5) 1 33975.00 1 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Sectional. 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 arra more bldg&paved strain #of Parking Spaces Fill: (volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'TKNOW Q YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DON'T 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 O 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 O 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 O 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 ❑ Addition ❑ FRep)laoirsnenteWindows Alteration(s) Roofing Q Accessory Bldg. ❑ Demolition ❑ Signs [0] Decks [[] Siding [O] Other[[J Brief Description of Proposed Install smneconled metal steel roofwirh guuus downsyouts and goner shield Work: Alteration of existing bedroom_Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.If New house and or addition to existing housina. 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? J. 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 attache I7 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 CONTRAC/T-OOR�APPLIES FOR BBUILDING PERMIT I, K.Pucr O" �t1 t77.\YY-\sem as Owner of the subject progeny Nescor/ hereby authorize to act on my behalf, in all matters relati to work authorized b this building permit application. Sig nal(urref 4T `hh`e�r 1r�' Date I• \ t ` ` ` `��\S� 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, rrr o Print Nam Sign ur wner Agent Da SECTIONS-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Hold,, Matthew Harrison (- RNS( License Number !!! 148 Doty Circle West Springfield MA 01089 09/06/2019 Address Expiration Date 413-739-433 Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ N)&rr F_ca1 sol}u C's�n n�11'i Company Named Registration Num er ►�� Do C'► tr��, 7l t t Address �/�r-� /� Expiraho Dat LO npzt tt, , ' !! ', C as Telephone 7 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....... No...... ❑ City of Northampton +' Jr Massachusetts mi c z DEPARTMENT OF BUILDING INSPECTIONS SJ 212 Nain Street • Municipal Building Northampton, MB 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted "wiithra corporation or LLC,that entity must be registered. Type of Work: �W—k1ROUT— Est. Cost. � 6-0-0 Address of Work: Cpq j C4-h ( l(elkyX S6 1'CS'I'• PUt'P� ry-w, Date of Permit Application: 1 I a)1 p I hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): _Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.C.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner. VJe Scar 103-113 Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton Massachusetts m z DQEPANTMENT OF BUILDING INSPECTIONS 212 Main street •Nux,ici 1 euilain s• Pa 4 1 Nps Northampton, NA 01060 Debris 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. The debris from construction work being performed at: (Please print house number and street name) Is to be disposed of at: (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: L15B pits �T ompany Name and Address) nature or wner Date \ If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. \ The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston, AM 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. ADDlicant Information Please Print Legibly Business/Organization Name: North East Specialty Corporation Address: 148 Doty Circle City/State/Zip:West Springfield MA 01089 Phone #:413-739-4333 Are you an employer?Check the appropriate box: Business Type(required): I.❑� I am a employer with 50 employees(full and/ 5. ❑Retail or part-time).* 6. ❑Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no Z Q Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers'comp. insurance required] 8. ❑ Nan-profit 3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §1(4),and we have 10.❑ Manufacturing no employees. [No workers' comp. insurance required]' 1 I E] Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees. [No workers' comp, insurance req.] 12.0 Other `Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information "If the corporate officers have exempted themselves,but corpotntion has ether,.pinyca,,a workers'compensation policy is required and such an mgmao,d ion should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name:AJLM Insurer's Address: 148 Doty Circle City/State/zip: West Springfield MA 01089 Policy d or Self-ins. Lia #VW60003962-2017 Expiration Date:07/09/2019 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 e. 152 can lead to the imposition of criminal penalties of fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of 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. 1 do hereby cer f. unndeeerr the paaiins and penal 'es of perjury that the information provided above is true and correct. S' t ��LfN�f � D to Phone#: 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.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone it: www_mass gov/die 3/27/2018 Details Thu Ofmfel website of Nn FxeUrfl,c Office of Pubiie Safely and S%irlty([OPSS) M,'iss.Gov Hmne Sulu Agencies ensee Details Demographic Information Full Name: MATTHEW S HARRISON owner icense Akddress information NZip yBeckette: MA code: 01223 nti-T UNtediii iceL�nTorma ion License No: CS-081031 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 10/20/2017 Issue Date: Expiration Date: 9/6/2019 License Status: Active Today's Date: 3/27/2018 Secondary License Type: Doing Business As: atus Change Rghas n: License R ewal rerequisi a norma ion No Pr ere visite Information Close Window_ ©2011 Commonwealth of Massachusetts Site Policies I Contact Us huo//Au,on— h,Ntame.usNeriecation/netails.asox?aaenev id=1&license id=270018& 111 NESCO-1 acoizo CERTIFICATE OF LIABILITY INSURANCE LATE,Mof YYY' �� 03/(2012018 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 have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certaln pollcles may require an endorsement. A statement on this certificate does not confar rt. hts to the certificate holder In lieu Clench endorsements. PRODUCER 413-737.5359 122MADT J Raymond Lussier Ins Agcy Inc J Second Lusslorins Agcylnc PRO Be 413-737-5359 FA% 413.732-2027 181 Park Avenue,Suite 8 (AIC,No,Exg, IAIQ Na)'. PO BOX 499uss er nsurance.com West Springlleld MA 01090.0499 J Raymond Luss{er Ins Agcy Inc me RE DINCOVERGaE NAI + INBURERA I COLONY I1,15URANC E CO INSURE.Northeast Specially Corp INPUSERa:A.I.M. Mutual Ins.Co. Nescor .Safety Insurance Com pang 39454 148 Dory Circle rvauaER c. W est Springfield,MA 01089 INsuaER o _ INSURE0.E: INSURER,'. COVERAGES CERTIFICATE NUMBER, 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 IN ICATEO. NOTTNITHSTANOING 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR rypE OF IMBALANCE A°DLeINSO a POLICY NUMBER POLICY EFF POLrYE%P LIMITS In I A )( I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 c-AIMsMmE OOCCUR 101 PK00094179.00 0311812018 03M812019 DAMAGEiOREMED $ 100,000 RED RAP An0 1 5,000 PERSONAL 6 ADV INJURY f 1'000'000 GEN L AGGREGATE LIIMOI'I APPLIES PER GENERAL AG GREGATE 5 2'000'000 X POLICY jEci LOC Pq D i mPl PA 2'ODO'ODO OTHER C ALMOMOEILE LIABIOTYOMBINED EINGIE LIMIT $ 1,000,000 ANY AUTO 2433825 0311112018 03111/2019 BODILY INJURY ITO Dorson AVpTF0n900NLY X ACHO'DIyUy"G BODILYgNNJURY PRacUEpm $ X ALTOSONIY X PDTOSONMY PPe0ie61eBn1 AMAGE $ UMBRELLA LIAROCCUR EACH OCCURRENCE 3 EXCESS LIPS CLAIMS MAGE AGGREGATE $ pyDED RETENTIONS B YN°EMPLOYER9ELIABTLIT' X' PER OTN- C6003962-2011 07109/2017 0710912018 100,000 ANY PROPRIETORIPARBILITY .CLIIIVE YIN EL.EPCM ACCmENi $ (�.I:�IM Ln)M F Exuuoeov N❑ NIA 100,000 E L.N5EASE,EA EMPLOYEE 4 u e:awc,n maN 500,000 SCRIPTIDN FOPERATI N elmv EL.DISEASE POLICY LI MIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACOR°1°1,ADIIII—I A-1,G,IIBDI.,may E,tl l¢M1etl 11.....peal le N RIIINal CERTIFICATE CUSTOME SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE W ITX THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE s � ACORD 25(2016103) 01988-2015 ACORD CORPORATION. All right,reserved. The ACORD name and logo are reglatared marks of ACORD �� C�?.ZZ�?ZCVYI/t(J't,, O�C.�C'�GY/J�JCZ4iGiv,�t�/�iU.L 19F, Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 103713 Type: Private Corporation Expiration. 7114/2018 Tr# 419291 NORTH EAST SPECIALTY CORPOIRATION SHARON TARIFF 148 DOTY CIRCLE WEST SPRINGFIELD, MA 01089 1 Update Address and return card.Mark reason for change. E] Address 0 Renewal � Employment 11 Lost Card .1 �i 20M 05/11 C Im,,AIfaBuxin.�g 1o'O"' `�'� Offae o(Co sumer Atfmrs�Business RegnlaHou License or registration valid for Individual use only /7 HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 1 Registration ' 103713 Type: Office of Consumer Affairs and Business Regulation Expiration 7/14/2016 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 )RTH EAST SPECIALTY CORPORATION -.SCOR 1ARON TARIFF 8 DOTY DIPOLE EST SPRINGFIELD,MA 01089 Undersecretary Not valid without signature