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17A-105 (5) 320 BRIDGE RD BP-2019-0018 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A- 105 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Category: Siding BUILDING PERMIT Permit# BP-2019-0018 Proiect# JS-2019-000022 Est Cost: $41000.00 Fee: $266.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NORTH EAST SPECIALTY CORP 081031 Lot Siae(sa.R.): 26136.00 Owner: CANIGLIA ANTHONY J&KATHERINE zoning:Ri(100)/URA(100)/ Applicant. NORTH EAST SPECIALTY CORP AT: 320 BRIDGE RD Applicant Address: Phone: Insurance: 148 DOTY CIRCLE (413) 739-4333 WC WEST SPRINGFIELDMA01089 ISSUED ON.7/5/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL CEDAR RIDGE SIDING IN CLAY WITH WHITE TRIM 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 K 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 7/52018 0:00:00 $266.50 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner 5 r a r Department use use only City of Northampton Status of Permit: - Building Department Curb CurUDdveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability \ Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 6P This section to be completed by office 1.1 Property Address: Map 177& Lot_ __Unit 320 Bridge Road zone Overlay Distriq Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Anthony & Katherine Caniglia 320 Bridge Road Florence MA 01062 Name(Print) //]] T7'��////�����,, /J /J Current Mailing Address: 413-566-1865 /�.�r/�-Ct e'4 4 _ Telephone Signature �/ 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 41000.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) 1 41000.00 Check Number .rJ This Section For Official Use Only Date Building Permit Number: Issued: /7 Signature: /' Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This cnlwm to be filled m by Building Dcpmment Lot Size Fronta e Setbacks Front Side L: R: U R: Rear Building Height Bldg Square Footage % Open Space Footage % (Lot area minus bldg At paves! parking) 4ofParking Spaces Fill: (volume&Loemian A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES, date issued: 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# B. Does the site contain a brook, body of water or wetlands? NO O 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 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 aoolicablel Now House ❑7Add'fionlog ❑ Replacement Windows Alterations) ❑ RoofingOr DoorsAccessory Bldg. ❑ ❑ New Signs [O] Decks [0 Siding[0] Other[a Brief Description of Proposed install cedar ridge song in clay with white trim Work: Alteration of existing bedroom_Yes xxx No Adding new bedroom Yes xxx No Attached Narrative Renovating unfinished basement Yes ** No Plans Attached Roll -Sheet ea.If New house and or addition to existing housing. complete the following: a. Use of building: One Family Two Family Other o 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 stones? 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 1. ,as Owner of the subject property North East Specialty Corp hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature ofOmer Data 1 1 1 � •� `r -y/1 , as Owner/Authorized Agent hereby declare that th�temenls and mf rmation on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed a der the pains and penakies of perjury. P nt Na Sof OwnerlAgent Dale SECTION 8-CONSTRUCTION SERVICES 81 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holden Matthew Harrison License Number 148 Doty Circle West Springfield MA 01089 cs081031 Address Expiration Date 09/06/2019 Signature Telephone 413-739-4333 9.Realsterod Home Improvement Contract": Not Applicable ❑ I�o($11 QXP Company Name Registration Number �1C-1 011:0103713 Address Expiration Dale Telephone7-14-2016 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 Massachusetts s DEPARTMENT OF BUILDING INSPECTIONS 314 Main street *Municipal Building J� OD NorNampton, M. 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 pont house nu er and skreet 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: e co, �c&k >' a" � �� C� (Company Name and r s) *�Ofa of Permit Applicant or 04Ker 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 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia 19Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Busineu/OrganiradoMndlvidual)I North East Specialty Corp d/b/a Nescor Address: 148 Doty Circle City/State/Zip:West Springfield MA 01089 Phone #:413-739-0333 Are you an employe l?Check the appropriate box: Type of project(required): I.ES ma employer with 30 —employees(fall andlor purr-lime).' 7. ❑New construction 2.❑I an a sole proprietor or partnership and have no employees working for me in g, ❑ Remodeling any capacity.[No workers comp.insurance required.) 9. El Demolition 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 ❑Building addition 4 ensure ehomeowner and will t e hiring contractors a to conduct all work ce or property. I will ensure Naz all wntmaors either have workers'wmpeusation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12.n Plumbing repairs or additions 5 I an a eneml contractor and I have hired the subcontraclors listed on the attached sheet. These sub-contractoav rs he employees and have workers'remp.insurance: 14. repairs 6.MWe are a corporation end its omcers have exercised their right of exemption per MGL c. 14''1✓IpAher her 5 152,§I(4),unit we have no employees[No workers'comp,insurance required I V *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy informotion. I Homeowners who submit this andiron indicating they am doing all work and then hire outside contractors must submit a new affidavit indicating such. tContmdors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-wnmctors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensmion insurance for my employees. Below is the policy andjob site information. Insurance Company Name:A.I.M. Policy#or Self-ins.Li,#:VWC6003962-2017 Expiration Date:07/09/2018 Job Site Address: ZP'lil�F- City/State/Zip: 1— ffo Attach a copy of the workers'compen tion policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify r e pai nit penaltie jury that the information provided above is true and correct N DateCo�IKIlB Phone#:41 -0333 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#: . Details Page 1 of 1 Licensee Details Demo a hie Information ull Name: MATTHEW S HARRISON ner Name: Lirense Address Information PPuntry: y: Becket le: MA code: 01223 United States License Information _ icense No: CS-081031 License Type: Construction Supervisor rofession: Building Licenses Date of Last Renewal: 10/20/2017 Issue Date: Expiration Date: 9/6/2019 icense Status: Active Today's Date: 6/6/2018 Secondary License Type: Ping Business As: Latus Chane Reason: License Renewal Prere uisite Information No Prerequisite Information http://elicense.chs.state.ma.usNerification/Details.aspx?agency_id=1&license_id=270018& 6/6/2018 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: 7/14/2018 Trp 419291 NORTH EAST SPECIALTY CORP ION SHARON TARIFF L!, 148 DOTY CIRCLE WEST SPRINGFIELD, MA 01089 "�✓Update Address and return card.Mark reason for change. zamasrn Address Lj Renewal I] Employment 0 Lost Card d/,s�omnem umre °�� ati melt Ofdce of Consumer Affairs&B.Busiveta Regnladoo License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration '.103713 Type: Office of Consumer Affairs and Business Regulation Expiration 7(14/4048 Private Corporatloo 10 Park Plaza-Suite 5170 - Boston,MA 02116 )RTH EAST SPECIALTY CORPORATION 'SCOR 1ARON TARIFF I DOTY CIRCLE ESTSPRINGFIELD, MA01W9 Undersecretary Not valid without signature NESCOA ACII CERTIFICATE OF LIABILITY INSURANCE To IMMODNYY") 0312012010 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 ALTI7R THE COVERAGE AFFORDED BY THE POLICIES BELOW. THI5 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SI, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. i IMPORTANT: If the cerllficale holder Is an ADDITIONAL INBURED, the pollcy(es)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 13 WAIVED, sublecl to the terms and condition of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the c ertlficate holder, In Ileo of such endorsement a , 1 PRODUCER 4 3737-5399 GT J Raymond LIIISSIS,Ins Agcy Inc J Pocono Lussler Ins Agcy Inc v"on 813.737. 3„ ,(fL Na A13-732.2027 101 Park Avenue, Suite 0 Wc, b S%0. PO EPA 499 n o uFsHninfro, West Springfiold MA01090.0499 A N 1 a J Raymond Lussler Ins Agcy Inc N9URE ,COLONY IN SURANCE C IRA INeLREO Northeast SPBCIBIty Corp NsuR,,AAM, N1Utaa Ins, Co. Nesoor ,,,,Safety lnsdr TOE Company 39454 148 DOIy Circle I" West Springfield,MA 01089 REa Ow-0.ER SRFUER .'. COVERAGES CER71FICATE 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY 5E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DES$CRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID G�LAIMS. INR I TYPE OF INBURANC6 POLICY NUMBER IPO POLI V % LIMITs A X COMMERCIAL OENERAL LIABILITY EnCH OCCURRENCE S 1' D ' DO CLANS.MADE [X OCCUR 'IDIPK00094179.00 0311812016 0711912010 AMA,,TO flervT o s 100,000 5,000 PERSONA,6 ADV IN RY S 1'000'DOO GEN'L AGGR T LIMIT AP IES PER GENER.ILA GRE ATF 2,000, 00 qqp� 2,000, p0 X POnCY JEL'i LOC R PI P 01.CR AVfOMOBILE LIABILIN Man OSINGL LIMIT 1,000,000 Pym AUTO ryEpU 2433825 0311112018 03111112019 V P R'JEE r RUpTpOpS ONLY X AI,6?gy�rLEpD SOOPEiNJURYYPPer tCdW S X AL'TOSONLY X AOid50"NLA rE(CI&nl UMBRELLALNB OCCUR EACHOCC RR ENC e e10Ee5 Leve DU MS.MADE AG RE ATf 1 ogµDpEpB9 Coy RETpETNIpl10N3 B M[DEMPLOYERSfL'AB11T' V pPFNt PRNOPR�LETOO=RemPRTNEp MCOTIVE �Vy11NN� VWC8003982-2917 0710912017 O710y1201B E.I EACH ACCIDENT 1O 'O01 lmenEaloryTnTM{EXCLUDFDR U NIA El. ISEP E. AEMP YEE 10 '�� II as a.unb.,Meer A 1 T 500,00 RIPl F lO 1 OESCOPTIONOF OPERATIONS I LOCATIONS I VEHCLES (ACORC 101,AJdIIlo1Sl ReRria sahrtlule,freybe elUahoe If Marr Spe<L U r.Mled) III 5RTIFICATE HOLDER CANCELLATION I CUSTOM, TSHOULD ANY EXPIRATION TO THEREOF, N TICE :BLL CANCELLEDRED IN THE ACCORDANCE WITH DAT,POLICY PRO, NONce WILL Be DELIVERED IN ACCORDANCE WITH .,POLICY PROVIBIONB. AUTHORIZED REPRESENTATIVE a x -11- s ACORD 25(201e)03) ®1988.2019 ACORD CORPORATION. All right, reserve The ACORD name and logo are registered mark,of A�ORO NORTHEAST SPECIALTY CORPORATION dIble NESCOR All home Improvement contractors and subcontractors MA License @703713 engaged in home Inprovement contracting, unless specie- 148 Doty Circle a WEST SPRINGFIELD, MA 01089 cally exempt from registration by Provisions of Chapter 142A 1-88&NESCOR-1 1-668.637-2671 of the general laws. must be registered wan the 413-739.4333. Commonwealth of Massachusetts. Inquiries about rename- wvrvtAeaeoronlin0.com [ion and status should be made 4o the Director, Home / � r 1 �1 Improvement Contract Registration. One Ashburton Place. Submnedo,./{� F�J�e�. �y( Room 1301. Boston MA 02108 (617)727-8598 • '-(Jf >NV� L� � III' / -�l ._. AO NAME1 {I-Ja SJd_CCATIONN,1/ E Mk Slpmiee.ttdl cnv mMrwphbpp en 51.w wo , ?M �'.. Air) 1 17 s tz 8 lrrr�}pp fzt �i i�� E qr/ fb e" �, s� _ .a? n>sn 11e$cor✓$r &a, _ Ce �' /(,' Sr`cfr.v � f a wise, 1��ir'sr F�sc�a, Y1-4 {g e a P a r s� /j s,C 6r73 i� 4�7,5?y�re Y7nm�``jl/-'A,(�S4LPLu! 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Wa Propose hereby to fumkh mdtenel are labor-',o,,p eta in acievi ce Min above spoc fir;atons `oNhe suite of: >too)doilars Is (FFIII} Parmem M ba/m dee/v?f�d/x. °AEpon agdnp eonvxt NORTHEAST SPECIALTY CORPQP.ATION mbJa NE$QQR_. Name d CViVffiIOGe99 gndled Regkirdm $IRp BS ' 13._—~_—1 uplaf.pnam ai_�.:�_ : WEST SPRINGFIELD,:MA 01089 413-739-4333 Cdns:ae Anne _ ^.{s���©�t�+,yrwl ea mace l«mr:+tn1�IwR 143713 mnplaew of ao,a uRAarms mnxaa. nag nmapn No f rx.i, NO agreemeK kr Home lmpp emenicmaadhp rwd{aM1ai meure fldam Ngme pl$a_Iw•man ✓ �� epoaitl of more iheporoMim d @aa ttlta iaNraa nice or Vie 01atNMUM"A eapoak ar Rabpants W h"Cp Nx,xv,M,xt M.if>d llcd. autM1@IxPQ.$5Ra� b ONera oo'Nllatwlse o➢IBiR CWIveIYda{'s"adl0edar mak SdM aGwpnwR, - hey^,^ _n`k ne[v^L^r Acceptance of Proposal. I have read both sides of this document and accept the prices specifications and Conditions stated. ! understand that upon signing,this proposal becomes a binding carried You are authorized to do the work as specified. Payment will be made as outlined above lfm4 the buyer, may cancel this transaction at.any time prior to midnight of the third businessday a{ter the date of this transaction. See the separate notice of cancellation form for an explanation of.this right.Phase'refer to the Notice of Cancellation that accompanies this contract; contents.of which are referred to above and Incorporated herein by reference, O NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. r- sinal.,, akG'�l"/�aglwl,re—SrSAF.c,� —_Aa! _L iJ'1!