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17A-023 (2) 25 HASTINGS HGTS BP-2019-0019 GIS#: COMMONWEALTH OF MASSACHUSETTS M=Block: 17A-023 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit, Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:window replaced BUILDING PERMIT Permit# BP-2019-0019 Project# JS-2019-000023 Est.Cost: $4277.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group NORTH EAST SPECIALTY CORP 081031 Lot Siu(sp.ft.): 12458.16 Owner: ALEXANDRE MARGARET zoning RI(I00)/URA(100)/ Applicant NORTH EAST SPECIALTY CORP AT. 25 HASTINGS HGTS Applicant Address: Phone: Insurance: 148 DOTY CIRCLE (413) 739-4333 WC WEST SPRINGFIELDMA01089 ISSUED ON:7/3/2078 0.00:00 TO PERFORM THE FOLLOWING WORK INSTALL E DOUBLE HUNG WINDOWS IN EXISTING FRAMEWORK 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 Occuoancv Signature: FeeTvpe: Date Paid: Amount: Building 7/3/2018 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner �n('OGUS Department use only 9 City of Northampton Status of Permit Building Department Curb Cut(Driyeway Permit 212 Main Street Sewe9Sel Availability Room 100 WaWANell Availablgty Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/She Plans Other Spedfy APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION Bo- 9 9 1.1 Property Address: This section to be complete,dG byOffice Map /70il Lot (JX•/ Unit 25 Hastings Heights zone Overlay District Elm SL District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: In 'I 1 25 Hastings Heights Florence MA Name no Current Mailing Address: 413-320-2229 Telephone Signature 2.2 Authorized koent, Name(Print) Current Mailing Morass: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Oficial Use Only completed by perant applicant 1. Building 4277.00 (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) 4277.00 Check Number .� This Section For Official Use Only Date Building Permit Number: Issued' ^7 Signature: / ` S —� Building ommissionedinspectorof Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SCCt,.h 4. 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 (Int area minus bldg&paved Parking)' #of Parking Spaces Fill: volume&Location 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(Gearing,grading,ration,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 Ichack all applicable) New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing E]Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [OI Decks [0 Siding[p] Other[I7] N Work: Brief Description of Proposed install a double hu ing windows in existing fram work /� _ t-cP 9'-� Alteration of existing bedroom_Ves_No Adding new bedroom Yes om Attached Narrative Renovating unfinished basement Yes Ne Plans Attached Roll -Sheet sa.If New house and or addition to existing housing, complete the following: a. Use of building :One Family Two Famili Other b. Number of rooms in each family unit Number of Bathrooms c. Is there a garage attached? it. Proposed Square footage of new construction. Dimensions e. Number of stories? I, Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? In. 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_ CitySewer Private well_ City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT �O.(R�CONTRACTOR APPLIES FOR BUILDING PERMIT I, col as L as Owner of the subject P roperty J V j Nescor hereby authorize to act on my behalf,in all matte r ti to work authorized by this building permit appli atien. Signature of Own L1 Date I, I ���'P 1 �l t-`���I rY1 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. eu t � Print Name OQ Sig er nt Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor. Not Applicable ❑ Name of License Nolder: Matthew Harrison License Number 148 Doty Circle West SPringfield MA 01089 cs081031 Address Expiration Date 09/062019 Signature Telephone 413-739-4333 8.Realsteretl Homo Imam ment Contractor: Not Applicable ❑ Company Name Registration Number z3pz2 , L —) 103713 Address Expiration Date e NC5'�' Telephone 07/14/2018 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.152,$25C(S)) 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 G S \ DEPARZNENT OF BUILDING INSPECTIONS 212 Hain Street Municipal Building Northampton, M 01060 ♦" -g jPO 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 l�construction Gwork being /performed at: \,4fa1��� (Please print house numb6Jr and street naH� Is to be disposed of at: Ir (Please print name and to r hon of facility) Or will be disposed of in a dumpster onsite rented or leased from: ` (Company Name and Address) 4ofe i ppcant or ner Date i pp icant or ner 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 ss StreInduet, Suite 100 nts 1 Congress Street,Suite 100 Boston, MA 0211 4-2 01 7 www.mass.Sov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Orgmimtiorvindividuapt 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 a employer?Check the appropriate box: Type of project(required): 1. am aemployer with 30 employees(full and/or pm-time).* 7. ❑New construction 2.❑l am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.Mo workers'comp insurance required.] 9. ❑Demolition 3,M I em a homeowner doing all work myself[No workers'comp.insurance required.]t 10❑ Building addition 4.❑I ensure homeowner and will hhhave contractorstoconduitsit workce my raproperty. 1will ensure that all contractors either have workers'compensation insurance or are sole LE]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.M I vn a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13 ❑ fp repairs These sub-contmctors have employees and have workers'comp,insurance.: 6,F1 We are a corporation and its officers have exercised area right of exemption per MGL c. 14' Other ` ,,k ,_'�? 152,§1(4),and we have no employees.]No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TConuactors that check this box most attached an additional sheet showing the time of the sub-contracro r5 and state whether or not those entities have employees. Ifthe subcontractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:A.I.M. Policy N or Self-ins. Lic. 4:VWC6003962-2017 Expiration Date: 07/09/2018 Job Site Address: City/State/Zip: ��r"k'v+'Y_� �-C Attach a copy of the workers' compen tion policy lavation 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify t at penalties of 1, that the information provided above is true and correct Sienamre' —� (Qrr if Bate' Phone#:41 333 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/Ltcense N Issuing Authority(circle one): 1.Board of Health 2, Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector b.Other Contact Person: Phone N: 1 NORTHEAST SPECIALTY CORPORATION dlWa NESCOR All home Improvement contractors and subcontractors MA License#103713 engaged in home improvement =,trading unWSS speri 1480oly Clmle • WEST SPRINGFIELD,MA01089 tally exempt from registration by Provisions of Chapter 142A 1.888-NESCOR-1 14888-637-2671 of the general laws, must be registered with the 413-739-4333 Commonwealth of Massachusetts. Inquiries about regisua- nescornow.com tion and status should be made to the OiroctW of Consumer Marrs and Business Regulation, Ten Par#Pima,Suite 5170 Submitted / ,1 Boston.MA 02116-Phone(617)979.8700 To: CI ,rai[e_ Pwory •'� S�Q.-du�!+ ✓(.r•1,J.m� ts2ee_wx_nE �qar IN aa h C� wa lWM,F po speo"NOom.w. I..for woh to N wrlormed YM Muwslo ee�M / L"�,/ . - 1', n, • � I IPir�.¢ CtrrJ "Or h� 2 rro ,,,,, C .1, lIr•4 { .c )_ / AO A{f .wv� 1p _ �� / .((..e�rn Qnl� ( lA /^c' it✓n y �J-'d'!�-)I'1 �� JA -l� p.pl y: CAnerriGlM n4red ryrmne: 1 WCgN$CNEOp LmVeOw rY bynM.PeIXwMrMm.4ne4 blp.de WM d.Y4-IWw.gW.eymgdtlus/.prMmwl.wYn WPW M�i(�pMrMaW ppYMevkm v.p]d G::.'r r ' IawleeaNedw nur.]W avaruww.spare CweeuwY wdrd,Ih.M rrl4Mmnpnp er // Y labt Ta MrMr.Oy.Ww.dpr ea evw ea M u+weuus sue M.wmwMu.nh uulmn oe4ve M rn ra casco p M crarw MwdW,bn nw raua waRp...mer tee.sharp..dMla. rb,em0enb,ea er ane aur.ceroid uewnm,war rw a wnepe,p r.wew of M RdrrMd. WIRMNTY MCaNntbomnb MlMuoM1runaw]YrwWrYW aM1N hen alMeMMMab WwoM1manNleb.pMMd n /r' wma.w4wp YW rgpY •M M rpWNYeO d Yw.yewbnl M M Mill MY edM xr xvMbeY!p w Mler W e i a amp.CweM%M fmPMw.Y.u[ai W etlon..mFbyxs a epMY.4l4pMr.0 MMmm(Wm d Ye NS.PYtliprleew4.MCwpWa Mwl.er Ib O.nwane..wMnin nmp/,repv.avred.belle.aYUY tl a nmpW.npYM w rgpe6 uLn CM BelerN• MmMM Wewm.' e M nmM r0E0se Mre �lum�n mat na�ena Np(y'fcorrp4le�aaadenca with above specilWvons,tar ale sumof; L4 9 J� f n rltariffs r/ '� �. prrmMlroamale re logre: _xl 5 "1 Iuponapniro convrd: NQRTHF.ASESPFQIALTLCORRO Al�TIONW,NESCOR_ NY a CpArpaNMONYd RVMWt �xar-I 12 +woPwnMabnaJIRO IlCIRCLE_ _xIs rupMwrw4awrd WEST SPRINGFIELD,MAOl08g _ 413.739-43p cky SIA .w __x0 1.W mMa wnnww cocoa 103713 wwleaenarIX.wtlwnu.amlmr pepnnuM NO rpVa; µr.pWaMWneM inprMMb MNCMpxth.IrN rpW..eT+n N._mf""T. ` � P.ymep lµerc4b{aMl a mar Mn wrNIN of Ne WI mnrM Pa.a M pW.mrvpraMapaee apeYmwU wbMM wnV.aw M.r rrW\N.dv.rte. AN4p1zK}SeryryY pear Myw oNUMr aYrraWwya.pwJN ONNmYM.N.M pulpanl, satrdaa.ar. Acceptance of Proposal:I have read both sides of iris document and accept the prices,Specifications and conditions stated. I understand that upon signing, INS proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above.You may cancel this agreement a a has been signed by a party thereto at a place other than an address of the Seller,which may be his main office OF branch thereof,provided you notify the Seller M writing at his main officS,ti by Me signing of this agreement.ordinary ent!mad Please refer to the Notcegran,sent eolCa ceaatlon�later Nan midnight of ins third business day fdlowig DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. a1M.run db SyneNn Wla Bill Scanned with CamScanner NESCO-1 4cOizo' CERTIFICATE OF LIABILITY INSURANCE DAOE312 DD 8 0 312 012 0 1 8 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 13ETW�EN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. i IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les) must have ADDITIONAL INSURED revisions or be endorsed, If SUBROGATION 13 WAIVED, sub)ed to the terms and conditions of the policy, certain pDIIDle9 may Inquire an end rsement� A statement on this certificate does not confer rl his tD the cartlflcate holder in Ileo of such endorsement s. PRODUCER 413.7373359 cT J Raymond Lussler Ins Agcy Inc J Raymond Wester ins Agcy Inc Pory ,43-737-3333 Ax 413.732-2027 181 Park Avenue,Suite S ATC, p,Exp. AIC NDC PO Box 400 ❑ 0 u££6f nsufan Ce,com West Springi MA01090.0499 NAI r J Raymond Luss)erins Agcylnc " R IN INsuasa A:COL NY INSURANCE CO INSURED Northeast specialty Corp IN.UR.R,,A,I,M.Mutua In9,C0. 148Nesor INSURER c:Safety lnsur nce Com pang 39454 Yoe tory alcor West Springfield,MA 01089 IN6U0.ER D'. INSURERS: I NSURFRf COVERAGES CERTIFICATE NUMB ER I REVISION NUMBER! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE)NSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTAITHSTANDING 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 LAIMS. mI IN TYPE OF INSURANCE A D POLICY NUMBER PO ICV EFF POI E P LIMIT. A X COMMERCIAL GENERAL LIA.ILITY EALHOCCURRENCE Y ,000,000 CLAIMS MADE O OCCUR 101 P KOOD94179.00 0311812018 1 1 )312019 AMAG TORENTED Y 100,000 M Ana 5'000 PERS°NAL 6A OV INJURY Y 1,000'000 GEN'L AGGREGATE LIj;T APP IESPER: GENERALA GREGATE Y 2'000'000 X POLICY JELT LOD _EEgN CTR.CCMCAOPA 2,000,000 OTHER: C AUTOMOBILE LIABILITY All 1 MEIN DBINGLE LIMIT 1,000,000 AW AUTO 2433825 0311112018 0311112019 SODI Tw OWNED SCH[pULED AUpTEO�S ONLY X` AUp1TVOnSyy BODILY INJURY Par e[tlEenl Y X PLTOS ONLY X AVi050NB �Oa EPa nl AMAGE 6 UMBRELLA WAS OCCUR EACH OCCURRENCE 4 EXCESS UAB CLAIM&MADE AGGREGATE 4 ,DEO RETENTIONS IS B µppTEFI COMPµ'AT ON X PEA TH. ANO EMPLOYERe'LIABI�IT( N VWC6003962-2017 0710912017 0710912016 10Q))) ANY PROPRIETORPARTNER@X£CUPVE EL EACH ACCIDENT s Y OFR(q'E)UMFMBER EXCLUDE% N NIA 100,000 IM 'W EIDISEASEEA EMPLOYEE 4 Umla 500,000 plPTl N OF 1 Y IMIi IS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORDYOY,AtldHlpntl Ramvka 9[Mtlule,may ba ethaM1atl II mon apaat b nqulntll CUSTOMS SHOULD ANY OFTHE ABOVE OEPOLICIES BE CANCELLED BEFORE THE EXPIRATION OATS THEREOF,EOF, Nonce WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVIBIONB, AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks PTA ORD 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 7rp 419291 NORTH EAST SPECIALTY CORPdIATIOhJ SHARON TARIFF ( t t 148 DOTY CIRCLE WEST SPRINGFIELD, MA 01089 Update Address and return card. Mark reason for change. n 'o 20M 06,11 Address Renewal [ Employment L] Lost Card Office of Consumer AfPelre&Business Regale don License or registration valid for Individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date, If Pound return to; Registration 103713 Type; Office of Consumer Affairs and Business Regulation Expiration 7/,4/3098 Private Corporation 10 Park Plaza-Suite 5170 -?- Basic.,MA 02116 )RTH EAST SPE61ALTy CQRPQFrATION ISCOR 12 IARON TARIFF 8 DOTY CIRCLE SST SPRINGFIELD,MA61089 Undersecretary Not valid without signature 5/27/2018 Details The OfOciel Wubs'Ita ct Uie FRHceflVe Office of Public Safety and Securlty(EOPSS) Masa.Gov Horne Stale lyencles ensee Details emographic Information Full Name: MATTHEW S HARRISON Owner Name: icense Address Formation lS ityBecket tate: MA ipcode: 01223 ountry: Urute4tath iceL��orma ion License No: CS-081031 License Type: Construction Superyisor 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 Chance Ripasop: License RewaI Prerequisite norma ion No Prere uislte Information Close Window ©2011 Commonwealth of Massachusetts Site Policies Contact Us hu� h.c.catil.ma.usNer,fcationl0etalla.asox7aoenev Id=1&Ilcense id=270018& 1I1