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24C-007 (2) 281 PROSPECT ST BP-2018-1244 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.Block:24C-007 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Cateeorv:Deck BUILDING PERMIT Permit# BP-2018-1244 Project ft JS-2018-002217 Est. Cost: $15050.00 Fee $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: INTEGRITY DEVELOPMENT & CONSTRUCTION INC 90514 Lot Size(so.li.): 10628.64 Owner: PRASHAD VIJAY&ELIZABETH ARMSTRONG Zonine URB(100t/ Applicant. INTEGRITY DEVELOPMENT & CONSTRUCTION INC AT. 281 PROSPECT ST ApplicantAddress: Phone: Insurance: 110 PULPIT HILL RD (413)549-7919 Workers Compensation AMHERSTMA01002 ISSUED ON.512312018 0:00.00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT6X11 DECK 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: FeeTvoe: Date Paid: Amount: Building 5/23/2018 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner rD ;I J-Y! s File k BP-2018-1244 Pty Y) APPLICANT/CONTACT PERSON INTEGRITY DEVELOPMENT&CONSTRUCTION INC ADDRESS/PHONE 110 PULPIT HILL RD AMHERST (413)549-7919 PROPERTY LOCATION 281 PROSPECT ST MAP 24C PARCEL 007 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tyoeof Construction CONSTRUCT 6X11 DECK New Construction Non Structural interior renovations Addition to Existine Accessory Structure Building Plans Included: Owner/Statement or License 90514 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 Perini[DPW Storm Water Management Demolition Delay - /, / S 23 1P,' Signature of Building Official 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. Ottleartment use a* 'k4 4 City of Northar"I" B"Ids pi Building Depa rtme I MAY Z 212 Main Si Room 10 Northampton, M Nunn 01) 0 A0 phone 413-587-1240 rax 413-587- Afff!5�' 00*W�Mu MUM M. APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.11 Prol Addra. This sMion be be completed by office 7-%1 VV&�- mop 2'1-( Lot W-1 Unit ?–V PA4,L,f PIA ol"' zone 0 q-9 Ovelday District-__ Be,SIL Distild CIS also — SECTION 2-PROPERTY(YWNERSHIPIAUTMOMZFD AGENT 2.1 Owner of Record: Zurr�tMadw,,Addl v All Telephone W"wpe 2.2 Authorized Agent: alwm Name{F�nnt ) Oureent Mailing Adiliess: Sgna Telephone SECTION 3.-ESTIMATED CONSTRUCTION COSTJ I Item Estimated Cost tDodars)to be Official Use Orgy _Completed bV th)"it 5pplica nt 1. Building 0 (a)Budding Permit Fee Z Electrical (b)Estimated Total Cost of Cans—twOon from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection 6. Total=(1 +2+3+416) Check Number This Section For Official Use Only Building Permit Number Date I issued Signaturs: Suhang CommissionarAnspedw of Buil6ngs Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Comp[ . Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning IDis column in be filled in by Building Deponent Lot Size ITD 50D__, Fronto e Setbacks Front 53 � Side L,.. R:...3 L:_R! Rear Building Height Bldg. Square Footage Open Space Footagen F.6 _ (Ian—musbF lds&p. of .6 I nm7, 01 U .1 rlu #of Parking Spaces A. Has a Special Permit/Variance/Fundi g ever been issued for/on the site? V�1 NO O DON'T KNOW YES O IF YES,date issued:i IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page � and/or Document#I j B. Does the site contain a brook, body of water or wetlands? NO `d 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 © NO 0 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 0 IF YES, describe size, type and location: E. Will the consbuction activity disturb(clearing,gratling,ma�cavatioq or filing)over 1 acre oris it part of a common plan that will disturb over 1 acre? YES O NO IV IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check allapplicable) New House ❑ Addition Replacement Windows Alteralion(s) ❑ Roofing ❑ Or Doors 0 J Accessory Bldg. ❑ Demolition ❑ New Signs [131 Decks [02 Siding[01 Other[M Brief Daon of Proposed Work: Co sNou _, Ae y aS tpr�dcS6 6,X it Alteration of existing bedroom_Yes ✓ No Adding new bedroom Yes I/ No No Attached Narrative Renovating unfinished basement Yes Plans Attached Rall -Sheet ea.if New haus at diff to exIsOnat housing, Ithalblowift '. a Use of building: One Family V Two Family Other b. Number of rooms in each family unit: Number of Bathrooms h Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? I Method of healing? 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, dootlplain_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 CONTTRRRAC�T�O�R�APPLIES FOR BUILDING PERMIT I, ertyus Jvl til !/yl' "�' rii' as Owner of the subject property -'}}^^ I� he authorize T r'. �F.v G'a rn� b 'n Vcu[.en t o my half II m r ive worldauthorized by this building permit application. gr ature of Ownner Oat. I, as Owner/Authorized Agen hereby tleclare 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. he,, (.O Print Name ` Q Signature edAgent Date SECTIONS-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Nam.or License Holder: A,\,&,(.,y- (:S-OU }A4 Licen a Number Atldress Expiration Date _ Di/iv a jzlf �/yv SignatuTe Telephone 9.RMhftmd Ndrei!?inprbMiVew6E"a1d1Yp.'iors ,€r, ;,; , Not Applicable ❑ ^9ui4� ���Cr�er� �i X091 Company Na �® or Reg'stration Number 4�D ,� ,, W,/// 1f411) 9119 Address [[ Expiration Date -Telephone/ �, SECTION 10-WORKERS'COMPENSATION.INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(8)) Workers Compensation Insurance aR'davit must be completed and submitted with this application.Failure to provide this afidavil will result in the denial of the issuance of iha buildjng permit. Signed Affidavit Attached Yes....... No...... ❑ City of Northampton Massachusetts ~' is DEPARTMENT OF BUZr.DING INSPECTIONS 212 Bain atzeet • Municipal auilaing Northampton, eA 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 he 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 with a corporation or LLC, that entity must be registered. Type of Work: �QW e Est. Cost: Address of Work ZQi( LSI/�--� Jt . �'r c.,a/J�oa rl A a060 Dale of Permit Application: S1Z 512012 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.G.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: 5127Li Z +z� 04�rlao _+�s+Hrl:, —A� (-K Qltiti 118621 Date i Contra for Name HIC Registration No. OR: Notwithstanding the above notice,l hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton Massachusetts is 3 OHPAH� OF HOILDING INSPHCO'I0N9 212 [Nin Btnaat a icipai Building t '1 Nontbe tan, [ 01060 »1 Massachusetts Residential Building Code Section I I O R5.1.2 Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section I I O R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR i 10.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor 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 hire to perform work for you under this permit. City of Northampton Idassachuaetta 4 „t S ` DEPARTMENT OF BDILDiNG INSPECTIONS 210 Win Street 6N itipal Building �4 Soxthe ton, N 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: �j:'(yf e4 tnyc \1 (Please print house number and eet name) Is to be disposed of at: (Please print name and location of faclity) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name abd Ad ess) Signa ure of Permit Applicant or Owner Dale 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 oflndustrialAceidenly I Congress Street, Suite 100 Boston,MA 02 114-2 01 7 www mass govAlia WWrturkersc`Cornpensatichn Insurance Affidavit:Builders/Conlractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Norrie(Business/OManizalioMndividual): ' Ce hit•In Int . Address: Iw i� r City/State/Zip: hA 6(aoZ Phone#: ` tJ1s3xJq-7N 9 Are you an employer?Check the appropriate box: Type of project(required): I.Cdlamaemployerei1h �Z_ enifle ea(Ihlland/,.....time)." 7. ❑New construction 2❑I nm a sole proprietor or pannenhipard haven,employees working for me in Remodeling say any rapacity.IN,workers'cmni imicanw requited.] 10 l am a homeowner doing all work my self,[No weaker, s p.insaranecreqcaptured.]. 9. ❑Demolition 4 r 1 usu homeowner and will belching connectors to wnduct all weareve any property 1 will 10❑ Building addition cusure oral an contractors either neve workersm�e, penaadon insurance or are eel, IL❑Electrical repairs or additions propriewrs wish tic eivployeee 12.❑Plumbing repairs or additions 5 I am a gcnerai ooavazmr and l an havehirthe apl}co2racnoR IIAed on Ne auazhW aheel. TM1rse wb-conlreclon have<mpl.yees end M1evc workers'wmp.inaumime.: 13.❑Roof repairs b.❑We arc a ownsaaliec and ila.mwrs have exercised their iigM1l ofc worpnion per MGL c. 14.❑Other 152,§I(4),and we have no emplcyees.(Now.d:er,comp.insurance mammal 'Any applicant that mocks box 0 must also fill out the section below showing their workers'compensation policy infotmatien. 'Homeowners who sobmil this afildsocu and e.,in,they are doing all week and then line consist cotnra<tu s must submit a new affidavit indicating such. :Coummtors chat clack this hex mint attached ea addithnal sheet showing the acme me the sun-connecters and snare whether.,ooh those entities have employees_ Ifthe sub-contramms have employees,they must provide their werkers'cump policy comber. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. AA 1�y7 s�44 Insurance Company Name: '',n,I'' I '141\I pp tr p Policy#or Self-ins. l.ic.#: QY�'NZ n��f,I�OBb 2Z.1{ �olp� Expiration Date: 4Ozark9 Job Site Address; 'Z.�� PtoS L SF .NOf wn Oxon CityBtate/Zip: �(edo Attach a copy of the workers'compensation policy decla afiumber an e nn page(showing the policy nxpitionradate). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a time up to$1,500.00 and/or ono-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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. !do hereby cer[ijy der Poe pains caudd isenal/ties ofi erjury'that the information provi�deed ahovpe is true and correct. Signature /�li�/�+LCA (�/ Z-- D t 7�23�IA Phone#: 4 k)'5'i 9—1 91 9 Oricial 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#: acoird CERTIFICATE OF LIABILITY INSURANCE °"044n1191" s12rz01e 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 Ne certificate holder is an ADDITIONAL INSURED,Ne policy(les)must have ADDITIONAL INSURED provisions or be endorsed. N SUBROGATION IS WAIVED,subject to Ne terms and conditions of the policy,certain Policies may require an endorsement A statement on this cerNfleate does not confer rights to Ne certificate holder in lieu of such andomenumt(s). PBODUCBHAME'TALI Andrea Feeley Webber S Grinnell PHDNE (413)586-0111 uc X11. (413)506-8481 AICIL tl 8 North King Street FDDREss: afeeley(✓gMebbelandgrinnell mm INSUREMIRAFFORDING COVEMGE NAIL. Northampton MA 91060 eir AtRIMPRUCODn 41360 A: W.U. INSURERS: A.LM.MutuaNA.I.M. Integnry Development antl ConaVuc[ioq Inc. IrLSURER c: Ann Anna and Heidi INSURER D: 110 Pulpit Hill Road Ix3UREa E' Amherst MA 01002 IHSBRER P: COVERAGES CERTIFICATE NUMBER: Exp 4/2019 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORT-E POLICY PETUOO INDICATED. NOTIMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT IMTH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANU CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. F ttrF CF INSURANCE IxsO PIXICYHUNBER MNn%UYVYY MM Y rIMIR RCIAL GFHEggL W&Litt EgLX WCURREHCE E 1,900,000 IMSMAOE OCCUR PREMISES Ea marretce S 100,000 ME°E%P IAn ore cersonl E 5,000 0500065625 041102018 04/10Q019 pER6orvAL anov lNJunv E 1000000 GATE LIMITgPpLIES PER: GENERALAGGREGATE b 2.000,000 ❑PET ❑L� PRODUCTS-COMPIOEAGG S 2,000,000 :E1.4un Y Ea MNEU51NGLE LIMIT E 1000000 TO BODILY INJURY neer Person) E UY SSCCHE,UTEDDULED 1020051526 04/10/2010 04/102019 eCCav NULX1IEH.PX-Q ENON-OWMEO R FE den OAMA E E ONLY x A. ONLY UndermnHad motorist S 100,000 uMaRELLA LIPS ".•"••"�"•••bW' • • 1000000 X OLOVR FAGH OLCVRREXLE E A EXCESS LIAR LWMSMAOE 4600065628 04110/2010 04/10/2019 AGGREGATE S 1 o00p00 OED REIENTIW 8 10,000 E WOHYPS.COMPENSATION STPTVTE ERw AND EMPLOYERS LIABIptt ANY PROPRIErORIPARTXENE%ECUNVE V N EL EAGN AOCIOENT E 500,000 B OFFICEWMEMEEREXC410ED, NIA WMZBOOBC06224201 NA 04110/2018 04)1012019 m a"BarinNMl EL.DISEASE-FAEMPLOYEE $ 500000 .yes ee,meeuneer 500,000 DESCRIPTION OF OPERATIONS below BE 05FASE-POLI E OESCRIPPON OF ORERAnWS I LOCATIONS I VEHICLES(ACORN 101,Acker MSol SOab q mry be atlli a More Reer bHii CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Evitlence M Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATVE ©ISSB-2015 ACORD CORPORATION. All rights reserved. ADDED 25(20161031 The ACORD name and logo are registered marina of ACORD