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42-089 (33) 170 GLENDALE RD BP-2019-0589 GIS#: COMMONWEALTH OF MASSACHUSETTS Man:Block:42-089 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-2019-0589 Proiect# JS-2019-000952 Est.Cost: $99900.00 Fee: $0.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor., License: Use Group: D P CARNEY INC 99798 Lot Size(sa.ft.): 2265120.00 Owner: NORTHAMPTON CITY OF LEACHATE TREATMENT FACILITY zoning Applicant. D P CARNEY INC AT. 170 GLENDALE RD Applicant Address: Phone: Insurance: 34 HORSE SHOE CIRCLE (.413) 967-7124 O WC WAREMA01082 ISSUED ON:11/14/2018 0:00:00 TO PERFORM THE FOLLOWING WORK:PARTIAL RE-ROOF POST THIS CARD SO ITIS 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: Smo e: 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 11/14/2018 0:00:00 $0.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0589 APPLICANT/CONTACT PERSON D P CARNEY INC ADDRESS/PHONE 34 HORSE SHOE CIRCLE WARE (413)967-7124 PROPERTY LOCATION 170 GLENDALE RD (v' MAP 42 PARCEL 089 001 ZONE 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: PARTIAL RE-ROOF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 99798 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: t/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 C::Z� --,� ?t11311 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. lrersiora 1.r' Commercial Building Permit Mai l a,2000 Department use only i City of Northampton Status of Permit_ Building Department Curb CutdG+rivewy Frrrtit - j 212 Main Street Sewerl$eptic.Availability- Room 100 WaterPAtteli A.vadabillty Northampton, MA 01060 Two Sets of Structural flans phone 413-887-1240 Fax 413.587-1272 PlotlS4 dans I Cather Specify! a _ APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING l SEC'nON 1-SITE INFO MATION —Y This section to be camp sled by office I A Property Address: , { ?O Map (� Lot Emit 170 Glendale Read Northampton, MA zone Overlay District Elm St District es District SECTION 2-PROPERTY OWNERSHIPIAUTH 3RIZED AGENT l 2.1 Owner of Record. _ City of Northampton 240 Main Street, Northampton, MA 010.60 Name(Priest) current Mailing Address: _ 413-887-1238 i Signature Telephone 2.2 Authorized Agent: D.P. Camey Construction, Inc, 34 Horseshoe Gircle, Ware, MA 01082 Na (grin',) Current Mai N Address: 413-967-7124 Signature t= _. _._. Telephone SECTI 3_E ,IMATED CON STRU N C TS Item Estimated Cost(Dollars)to be Official Use Only com feted by permit applicant t t 1. Building {Partial Re-roofs $9,900.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of _ Construction from(6) Plumbing � Building Permit Fee s 4. Mechanical(HVAC) 00900 � .�, �6r�Protection $9, 16, Total=(1 +2+3+4+5) Check Number � - This Section For Official Use Only Buiiding Permit Number Date Issued Signature: Building Commissionerinspector of Buildings D de Cures cf5' �C prrl Cas /L V ersion 1.7 Commercial Building Pennit May 15.2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE .......... Interior Alterations M Existing Wall Sions 0 Demolition El Repairs n Additions n Accessory Building Exterior Alteration 0 Existing Ground Sign New Signs M Roofing ES Change of Use E3 Other D Brief Description Enter a bmf description here. Partial re-roof-1.)install furring strips horizontally 2'on center over existing metal Of Proposed Work: roof panels,insam line as existing. 2.)Install a 29 gauge Kynar coated steel roofing system,including all associated trim on the remaining 45'of roof,(starting at section already.) 3.)Install strip sealant in seams of panels. SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP{Check as applicable) CONSTRUCTION TYPE A Assembly A-11 F1 A-2 0 A-3 F7 1A F- b A-4 A-5 ❑ IB B Business 2A 'E Educationai M 2B 'F Factory F-1 F-2 0 2C E3 H K21n, Hazard 3A 1 Institutional 1-1 1-2 1-3 3B M Mercantile 13 4 E3 R Residential M R-1 R-2 R-3 El 5A ,ESStorage S-1 S-2 F1 5B U Utility Specify: M Mixed Use Specify: S Special Use Specify_ COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: - Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 78D CMR 34): SECTION 6 BUILDING HEIGHT AND AREA 1,485 sq. ft. OFFICE USE ONLY BUILDING AW,AREA EXISTING PROPOSED NECONSTRUCTION Floor Area per Floor(sl) 2a 2r 3r Total Area(sf) Total Proposed New Construction Of) Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40, 54) 7.1 Flood-Zone,Information: 7.3 Sewage Disposal System* Municipal [:] On site disposal systerno Public 0 Private ❑ Zone Outside Flood Zone[] 8. NORTHAMPTON ZONING i_7 ComTnercial Building Permit NORTHAMPTON ZONING E Existing Proposed Required b-v,Zoning i 'hlk school to be filled in b-. Building S`cj; artnwni � $fit Size Frontage Setbacks Front Side L,. W_., __ ... i . __ ....�_ _ _.. . Rear i Building Height Bldg.Square Footage �. {.`open Space Footafe % fLot ares tnintn Ndg&I,avetl parking) P of Park,jng Spaces i Fill: V"Anme&'Lotation) A. Has a Special Permit/Variance/ ever been issued forlon the site? 140 DON s KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Spook Page and/or Document B, Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date issued: C. Do any signs exist on alae property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES No IF YES, describe size, type and location: E. VAI 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 ND IF YES;then a Northampton Storm Water Management Permit[turn the DPW is required. Version I.�ComTue'reial Building Vomit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 115(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: - NIA Not Applicable Q Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9. Registerad Professional Engineer(s): -- N/A j Name Area of Responsibility Address Registration Number , ( Sig�rra`_ure Telephone Expiration Date j Marne Area of Responsibility i Address Registration Number Signature Telephone Expiration tate j Nasse Area of Responsibility Address — Registration Nurrrber r Signature Telephone Expiration Tate I game Area of Responsibility Address Registration Number Sign34ure Telephone Expiration Laze 9.3 General Contractor i _... D.P. Carney Construction,_Inc. Not Applicable D Company Name: Daniel P. Carney Responsible In Charge of Construction 34 Horseshoe_Circle,Ware, MA 01082 Address 413-543-3150 X Sig tore Telephone 1%ersionl.7 Commercial Building Permit kfay 151.22000 SECTION 10-STRUCTURAL.PEER REVIEW(780 CMR 110.11) Independent Structurai Engineering Structural Peer Review Required Yes 0 No SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLES FOR BUILDING PERMIT I City of Northampton _ as Owner of the subject property hereby authorize . D.P. Carney Construction, Inc. to acto L half, in all atte relative to work authorized by this building permit application. 'Sign• :sne of ler � I Date City of Northampton .. - ,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- Sign�,q under the pains and penalties of perjury- _ Pii Name q Signet e of fawn FAgent Date CTI N 12-CONSTRU ERVICES 10.1 Licensed Construction Supmis€rr. Not Applicable €1 Name of License Holder Daniel P. Carney CS-099798 License dumber „34 Horseshoe_Circle, Ware, MA 0-1082 8119/2019 -� Expiration Date 413-543-3150 5igrsature Telephone SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M+G.L.c.182,3 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 i3o City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, 554, 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. Address of the work: 170 Glendale Road, Northampton, MA 01060 The debris will be transported by: All-Waste Removal, Inc. United Materials Management, Inc., Holyoke, MA or The debris will be received by: K&w materials&Recycling,138 Palmer Avenue,West Springfield, MA Building permit number: Name of Permit Applicant D.P. Camey Construction, Inc. 11/5/2018 Date Signature of Permit A plicant The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 Tj www.mas,s.gov1dta Workers'Compensation insurance Affidavit:Builders/Contmctors/Electricians/Plumbers. TO BE FILF.,D WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibh' Name (flusiness/Orgartiraion/Individual):D. P. Carney Construction, Inc. Address:34 Horseshoe Circle City/State/Zip:Ware, MA 01082 phone 4:413-976-7124 Are you an employer?Check the appropriate hox: Type of project(required): l.(D I am a employer with 15 _employees(full and,/or part-time).* 7. ©New construction 2.rl i am a sole proprietor or partnership and have no employees working for me in 8, LJ Remodeling any capacity.[No workers'comp insurance required.] 7.D 9. ❑Demolition I am a homeowner doing all work myself.[No workers'comp.insurance required.]; 10 C3 Building addition 4.❑l am a homeowner and will he hiring contractors to conduct all work on my property. 1 will ensure that all contractor either have workers'compensation insurance or are sole l l fQ Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.M l am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 0. Roof repairs These sub-contractor have employees and have workers'comp.insurance l4.�✓ (}titer Roofing 6.n We are a corporation and its officers have exercised their right of exemption per MGL c. ---- t52,§1(4),and we have no employees.[No workers`comp.insurance requircd.l *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. '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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site in formation. Insurance Company Name:Granite State Insurance Company Policy#or Self-ins.Lic.#:WC009930624 _ Expiration Date:11/1512018 Job Site Address. 170 Glendale Road CitytState/Zip:Nhampton MA 01060 Attach a copy of the workers' compensation 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, 1 do lrerebp certif;_eor the painsacrdpe rlf perjury that the information provided utlr�ve is true and correck Si nature: Date: [Phone#: 413 - - Official use only. Do not write in this area,to be completed by city or town offxciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: DPCARNE-01 ANGELA DATE(IMMfDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 1 10131/2018 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 C 2NTACT Angela DiAugustino ME: A ,PHONE Phillips Insurance Agency,Inc. F 97 Center Street (A/C,No,Ext):(413)594-5984 (AfX,N,):(413)592-8499 Chicopee,MA 01013 L!Ab" s%angela@phillipsinsurance.com pIL ---- ......... INSURERI5IAFFORDING COVERAGE NAIC ........... ...................... ..................___.____1fNSURER A:Kinule Insurance Compa y INSURED INSURER B:Selective Ins Co of Southeast ........... D.P.Carney Construction,Inc. INSURER C:Granite State Ins Co 34 Horseshoe Circle _ INSURERD: Ware,MA 01082 INSURER E: INSURER F: 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 INDICATED. NOTWITHSTANDING 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 CLAIMS. ILNTR ADDLSUBR POLICY EFF POLICY EXP 5 INSD WVD POLICY NUMBER LIMIT 3 R TYPE OF INSURANCE IMMIDnr,(YYY MWODNYInO A X COMMERCIAL GENERAL LIA131UTY I i I EACH OCCURRENCE: $ 1,000,000 CLAIMS-MADE [7X 08/0,12019 DAMAGE TO RENTED 10-01000 OCCUR 0100041217-2 08/0112018 PREMISES tEa MED EXP Any one persoo__ g Excluded] PERSONAL&ADV INJURY $ 1,000,000 . qflEGAIE is 2,()00,000 1_ � raerL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY[XI LOC spa- PRODUCTS-COMP/OP AGG S 2,066,0_00 BtIPID Deductibl 6,006 . ............ ;OTHER: ------ COMBINED SINGLE LIMIT $ 1 B OB LE LIABILITY (Ea acadent) $ 000,000 UTOM I Y UTO BODILY y�JA!Ey±Per person X AN A A9094953 08/0112018 0810112019 "'E' SCHEDULED AUTOS ONLY JAUTOS I BODILY INJURY_(EeL accident} 1 PROPERTY DAMAGE HIRED -(n AUTOS ONLY NON-AWNED ED A LiPer a iderd -AUTO ONLY A X I UMBRELLA LIAB X OCCUR I EACH OCCURRENCE $ 5,000,000 EXCESSUAB CLAIMS-MADE; �O10D054375-1 0810112018 0810112019AGGREGATE 5,000,000 DED x RETENTION$ $ C WORKERS COMPENSATION PER TE OR AND EMPLOYERS'LIABILITY �jTAM ER i YIN , WC009930624 1111512017 1111612018 RIPARTNER/EXECUTI E.L.EACH ACCIDENT Is 1,()00,000 ANY PROPRIETO VE --] !CF.ICER 1EM1,1AR EXCLUDED? NIA1 ._�.gy' 1,000,000 n E.L.DISEASE-EA EMPLOYEel$ describe vender 1A66,000 DESCRIPTION KSCRIPTION OF.OPERATIONS below E.L.DISEASE-POLICY LIMIT i B l,installation S1985457 Limit 107,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VE141CLES(ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) RE:Partial Re-Root(1,485 sq ft)Northampton Recycling-170 Glendale Rd.Northampton,MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. David Pomerantz 240 Main St. Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massfthusetts 02108 Home Improvernerit.tContractor Registration - Type; Corporation D.?. CARNEY CONSTRUCTION, INC. Registration: 121178 34 HORSESHOE CIRCLE s _ Expiration: 04J11J2020 WARE,MA 01082 Update Address and Return Card. !_':I�r�i^o.>x.�rtcxuani�n�GY��n�tcxrizrtae%l�i Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:�C=Oration before the expiration date. if found return to: RegistrationExpirati n Office of Consumer Affairs and Business Regulation 121:1.78:;:-;; 04,11 1/2020 One Ashburton Plate-Suite 1301 C.P.CARNEY CONS; F31IG_F:01V;°°ENC. Boston,MA 02108 DANIEL P.CARNEY, 3G 10RSE:S-10E C140 LE � t �-- 102 vatici w i �t si ate Zwz P�`ARE,W1A 01082 re Undersecretary Commonwealth of Massachusetts Construction Supervisor Dwv Sion of Professional Licensure Unrestricted-Buifdingsof.anyuse group which4Mntain Board of Building Pegulalions and Standards less than 36,000 cubic feet($81 cubic meters)of enclosed Cons:nticfiot3r�S iptrrvisor space. CS-099798 E pires:080'19t2619 DANIEL P CARNEY 34 HQR$E sHoE CIRCLE..'' w,' WARE MA 01082. Failure to-possess a current edition of the,Massachusetts. State Building Code is cause for revocation of this license. For information about this license Commissinner ' Call(617)-7'27-3200 or visit Nvww.masstgovtdpl