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24D-323 (4) 155 PROSPECT ST BP-2019-0282 GIs#: COMMONWEALTH OF MASSACHUSETTS MW:Block:24D-323 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Porch Repair BUILDING PERMIT Permit# BP-2019-0282 Proiect# JS-2019-000473 Est.Cost: $11975.00 Fee: $78.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: WRIGHT BUILDERS 060378 Lot Size(sq.ft.): 4443.12 Owner: DOMINGUEZ KATHRYN Zoning:URC(100)/ Applicant: WRIGHT BUILDERS AT. 155 PROSPECT ST Applicant Address: Phone: Insurance: 48 Bates St (413) 586-8287 (116) Workers Compensation NORTHAMPTON MAO 1060 ISSUED ON:9/10/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-FRONT PORCH REPAIRS 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 9/10/2018 0:00:00 $78.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0282 APPLICANT/CONTACT PERSON WRIGHT BUILDERS ADDRESS/PHONE 48 Bates St NORTHAMPTON (413)586-8287(116) PROPERTY LOCATION 155 PROSPECT ST MAP 24D PARCEL 323 001 ZONE URC(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 Typeof Construction: FRONT PORCH REPA New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 060378 3 sets of Plans/Plot Plan THVFOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: V 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 Permit DPW Storm Water Management Demolition Delay /LJ--,t-J ? 9 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. CC CC \ 'c GCC 1� C� Department use only Cit of $rth mpt n Status of Permit: SEP Bulkiil ®ep rtme t Curb Cut/Driveway Permit 212 Main S reet Sewer/Septic Availability ' I Q Water/Well Availability R . DFPT OF Wr2�ILDING P- NOR7I I}IO 6 60 Two Sets of Structural Plans p one 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office ��. Map OZ y1t Lot it Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) '/ �� ^A� ( i�a�L( j(t� Current Mailin Add rrs- �(r. ,- , �r- H n � J — Telephone rj a )gIrt,re 6S 2.2 Authorized Agent: W 6OaK ( bei-8 &1 rmP� G-kUDJ�rc� �tS Q�� ST,LN o (L-mmmr� Name(Print) Current Mailing Address:2 y� Signature Telephone SECTION'3-ESTIMATED CONSTRUCTION COSTS (?j� �C .5b : '7$� Item Estimated Cost(Dollars)to be Official Use Only com feted by permit applicant 1. Building I I �1 (a)Building Permit Fee � I � 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee / 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+ 3+4+5) ( , Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) s^ .� L'�u .. g '+ r Wj-tyj�'� t;�(1'ST 06r- b-' ` rjj— 61 f-4-W Section 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' y Building Departmen Lot Size Frontage Setbacks Front Side L: R: L: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking S es xume &Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW 0-1V YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW Q YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q , Date Issued: C. Do any signs exist on the property? YES © NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO Nec IF YES, describe size, type and location: ' E. Will the construction activity disturb(clearing,gradin ex ation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. s SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding[0] Other i Brief Description of Proposed � pp Work: P K� Alteration of existing bedroom Yes_XNo Adding new bedroom Yes ^ No Attached Narrative Renovating unfinished basement Yes _ No Plans Attached Roll -Sheet 6a.If New house and or addition to existing housing, 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? d. Proposed Square footage of new construction. Dime ' ns e. Number of stories? f. Method of heating? F' places 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 ands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement o lar floor below finished grade k. Will buildi onform to the Building and Zoning regulations? Yes No. I. S is Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT h � � O -Q as Owner of the subject property hereby authorize to act on my behalf, in all mtt to work authorized b this building permit application. ,'0�� l3�( ey Signature of Owner Date as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my� cTn�ec gee def. Signed under the pains and penalties of perjury. Print Name Q� � 41 O ( O Q Signature of 6r/Agent Date j SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder q'N'r 10 ( 630f License Number 'fr B A- Sfi. N o �tvN /0-s—1 I g Address Expiration Date Signat e Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ W Al q]-rr l b 1 S3 Company Name Registr tion Number !!tg g kly--s sr, N o / Address / p Expiration Date Telephone 13 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 f.: vt S N; DEPARTMENT OF BUILDING INSPECTIONS y i# 212 Main Street • Municipal Building Northampton, MA 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 with a corporation or LLC,that entity must be registered Type of Work: 46 K E e ell 11" Est. Cost: Address of Work: 1 Date of Permit Application: 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: Dae U ContractorName, 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 l�- w DEPARTMENT OF BUILDING INSPECTIONS x, 212 Main Street •Municipal Building vS cD� Northampton, MA 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: I Y� Pf-or>Ptf-r St 00E-wt rvo o (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: (Company Name and Address) 1&"W4,4,�LW fj��� �U I Sighdture of Permit AlSplicant or Owner 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. t_ � . The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information ^ Please Print Legibly Name (Business/Organization/Individual): Vi� 1 (fib t"�'�D� Address: g Jg ATV,� 41 City/State/Zip: p M 0 0(oD Phone#: t/3' �' g 0 Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.F_1 I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.7 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.�Roof repairs hese sub-contractors have employees and have workers'comp.insurance.t O� __ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.� �Other p_p�L�p��� 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. :Contractors 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-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �', I• M. M u"rU p Policy#or Self-ins.Lic.#: MCG 4 a'D 6 �3 a'01 O JA Expiration Date: �.. Job Site Address: I P_ocp r,f4- sr • City/State/Zip:N 0 01 M/t Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).0/61�D 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 under the pains andpenalties ofperjury that the information provided above is true and correct. Signature: 1, Date: d Phone#: 3 .--r,�rl 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#: ACo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/22/2018 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(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject 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 CONTACT Jenna Rodrigue,CISR Elite NAME: Webber&Grinnell AICNo Ext); (413)586-0111 (AC, A C No: (413)586-6481 8 North King Street E-MAIL jrodrigue@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Arbella Insurance Group 17000 INSURED INSURER B: A.I.M.Mutual Wright Builders,Inc. INSURER C: Attn:Jonathan Wright INSURER D: 48 Bates Street INSURER E: Northampton MA 01060 INSURER F: COVERAGES CERTIFICATE NUMBER: Master 2019 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 CONTRACTOR 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 CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 OCCUR PREMISES Ea occurrence) ccurrence $ 100,000 CLAIMS-MADE � MED EXP(Any one person) $ 5,000 A 8500068268 03/01/2018 03/01/2019 PERSONAL BADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 rlX POLICY ❑ PROJECT ❑LOC PRODUCTS-COMP/OP AGG $ 2'000'000 OTHER: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED 1020070845 03/01/2018 03/01/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident PIP-Basic $ 8,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE 4600068266 03/01/2018 03/01/2019 AGGREGATE $ 5'000'000 DED I X1 RETENTION $ 10'000 �/ $ WORKERS COMPENSATION O H STATUTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBEREXCLUDED? N/A MCC20020005342018A 03/01/2018 03/01/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Informational Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1, , --�) - _Q ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety �. Board of Building Regulations and Standards •, License: CS-060378 Construction Supervisor LINDA M GAUDREAU 157 MAIN ST#4 EASTHAMPTON M i Expiration: Commissioner 09/25/2018 TO c819i20' office of consumer Affairs&Business Regulation-Mass.Gov 8 CitylTown State Zip code to view complaint history. You can also view arbitration and Guaranty Fu �er'gtfa:. Un`MaSS•Gov Of ffal C0/7 Rug . ' is Horny / Cipro t. ' To search v�' � by re9istr Search by Re ati°n n4fiber 0 ntrac enter he tor g�stration N4 the re9istrati tuber 1 °n e`er�s fr t You must click 0153 n4fiber in the to a t io the ..Se e arch xtbo Search by R Re9istr x bejoW Lip Se egistrant C ant„button to SearchSearch and click the Sear Search orh ch• Mips://services,oca.state, by Re pan.n by n button. ma.us/"ClIcensee//Sgsstrant Cast n e a`ne or location. pk ame } �e k �,�i I14 :°S. �. i 9 I r P e\\a tK �asem�,e p 29 A cV6ng �\ Replace d decking lat ,1c�5?`ra�c{` n eve T r ex &Sta�C No< r �' porch f\oocrk reo-a A I p q Office of Consumer Affairs&Business Regulation-Mass.Gov Office of Consumer Affairs and Business Regulation t OCABR Home Improvement Contractor Registration Lookup To search by registration number, enter the registration number in the textbox below and click the 'Search' button. Search by Registration Number 101536 Search You must click the "Search Registrant" button to search by name or location. Search by Registrant Company name Search Registrant Search by Registrant Last name https://services.oca.state.ma.us/hicAicenseelist.aspx 112 i t Office of Consumer Affairs&Business Regulation-Mass.Gov City/Town State Zip code Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list is current as of Wednesday,August 8, 2018. Search Results PPq istri rpt,.., RFSPONSIBI..F RFGISTR = t>i IPA it: ► ~4UM WRIGHT BUILDERS, INC. Wright, Jonathan 101536 48 BATES STREET 06/25/2020 Current Northampton, MA 01060 Site Policies Contact Us U 2012 Commonwealth of Massachusetts. Mass.Gov® is a registered service mark of the Commonwealth of Massachusetts. 8/29/18 - We are awaiting the renewed HIC License ... coming in the mail https://services.oca.state.ma.us/hic/licenseelist.aspx 2/2 .� i r � Replace existing porch windows with new Pella Proline insulated casement windows. U-Value 0.29 a' r - Replace decking with 8/28/18 new Trex decking (at Front Porch Repairs porch floor & stair Dominguez Residence treads) and replace 155 Prospect St several misc rotted porch trim pcs Northampton, MA 1 - r