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29-325 (3) 333 ACREBROOK DR BP-2019-0561 GIs 4: COMMONWEALTH OF MASSACHUSETTS Meo:BIOCk:29-325 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category,New Single Family House BUILDING PERMIT Permit# BP-2019-0561 Proiect# JS-2019-000914 /rr(fifi Est.Cost,$110000.00 Fee:$1210.00 PERMISSION IS HEREBY GRANTED TO: )OA /� Const.Class: Contractor: ense: Use croup: VADIM SOLOKHIN 108809 Lot Size(so.ft.): 25700.40 Owner: DZHENZHERUKHA VIT Zoninv: Applicant: VADIM SOLOKHIN AT: 333 ACREBROOK DR Applicant Address: Phone: Insurance: 32 MARLENE DR (413)579-1379 SOLE PROPRIETOR FEEDING HILLSMA01030 ISSUED ON.212212019 0:00.00 TO PERFORM THE FOLLOWING WORK:DEMO EXISTING BUILDING &THEN CONSTRUCT NEW 2 STORY SFH 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 Signals"; FeeType: Date Paid: Amount: Building 22220190:00:00 $1210.00 212 Main Street,Phone(413)587.1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 333 ACREBROOK DR BP-2019-0561 GIS 0: COMMONWEALTH OF MASSACHUSETTS Map: J.(&k:29-325 CITY OF NORTHAMPTON Lot: PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categorv:New Single Family House BUILDING PERMIT Permit 0 BP-2019-0561 Project 9 JS-2019-000914 Est Cost: $110000.00 Fee:$1210.00 PERMISSION IS HEREBY GRANTED TO: Const Class: Contractor: License: Use Group: YEUGENEY SOLOKHIN 108714 Lm$ize(sp.ft.): 25700.40 Owner: DZHENZHERUKHA VITALY Zoning: Applicant YEUGENEY SOLOKHIN AT: 333 ACREBROOK DR Applicant Address: Phone: Insurance: 170 TIMBERIDGE DR (413)485-8556 WC RUSSELLMA01071 ISSUED ON.212212019 0:00:00 TO PERFORM THE FOLLOWING WORK.DEMO EXISTING BUILDING &THEN CONSTRUCT NEW 2 STORY SFH 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: Gu: Fire Department Fireplace/Chimney: Rough: qL 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: Fe:eType: Date Paid: Amount: Building 2/22/20190:00:00 $1210.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019.0561 APPLICANT/CONTACT PERSON YEUGENEY SOLOKHIN ADDRESS/PHONE 170 TIMBERIDGE DR RUSSELL (413)485-8556 PROPERTY LOCATION 333 ACREBROOK DR MAP 29 PARCEL 325 001 ZONE N THIS SECTION FOR OFFICIALLISE ONLY- PERMIT. PPLI KL T ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildina Permit Filled out Fee Paid T fConstruction: DEMO EXISTING BUILDNG AND NEW STORY SINGLE FAMILY HOUSE New Constructii v 18 LA Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 108714 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED N o 1< INFPRMATION 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 Permit DPW Storm Water Management Demolition Delay Signature of Official Date I 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. 333 ACREBROOK DR BP-2019-0561 GIs#: COMMONWEALTH OF MASSACHUSETTS May,Black:29-325 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categorv:New Single Family House BUILDING PERMIT Permit# BP-2019-0561 Project# JS-2019-000914 Est.Cost:$110000.00 Fee:$1210.00 PERMISSION IS HEREBY GRANTED TO. Const.Class: Contractor. License: Use Group_ YEUGENEYSOLOKHIN 108714 Lot Sizeisa.ft.), 25700.40 Owner: DZHENZHERUKHA VITALY Zoning: Applicant. YEUGENEY SOLOKHIN AT. 333 ACREBROOK DR Applicant Address: Phone: Insurance. 170 T MBERIDGE DR (413)485-8556 WC RUSSELLMA01071 ISSUED 0M111Z1018 0.00.00 TO PERFORM THE FOLLOWING WORK., DEMO EXISTING BUILDING ONLY: FULL PERMIT PENDING PLAN REVIEW POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: See : Meter: - - -� Footings: Rough: -Ruugh: House# Foundation: Driveway Final: Most: 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: Q FeeTvpe: Date Paid: Amount: lat:ry t to Y (' N Building 11/7/20180:00:00 $1210.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck-Building Commissioner Department use only -rrr. City of Northa pto of P it Building Depa me t Curb .1 D vew y Permit 212 Main S eet OCT 3 0 20 lie Availability sse/Sep Availabil Room 10 Ware ell vailabiliry Northampton, M Ot Is Structural Plans phone 4l&587-1240 F x4� P N,W n IeP ns _ Other SpeaN APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address'. At Lot section to be completed by office333 �CfL,�2"DO F D6- Map Lot �"�6 Unrt Zan. Overlay District Elm St District CB Dismct SECTION 2-PROPERTY OWNERSHIPIAUTHORWED AGENT / // T /� �/,//� 2. r card: YXI rh �K K( & A4 /O (� Name(PnnO Cure-Maili e Telepho�— Slgnature 2.2 Authonzed Aaent: Name(Prim) CuneM Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed bpermit applicant 1. Building 'so ^' aJ (a)Building Permit Fee 2. Electrical aSr��..\\ e0 (b)Estimated Total Cost of Construction from 6 3. Plumbing 4)1-D Building Permit Fee li 1 D 4. Mechanical(HVAC) W DD 5. Fire ProOL)6 tection 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number. Date Issued: Signature: Buiding Commissioner/Inspedor of B.Idings one Clo EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING An Irdormation I@rst se Completed.Permit Can Ise Denied Duero Incomplete Information Existing Proposed Required by Zoning This column w be fined m by Building ceramicist Lot Size Frontage Setbacks Front Side L: k: L: R: Rear Building Height Bldg.Square Footage Open Space Footage P4. ilu[.mmu.bids @ pavcd #of Parking Spaces Fill: rolmne @ xuntion A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW O YES Q 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 pemnit 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. VAII 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,men a Northampton Stoma Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alterations) Roofing Or Doors 13 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding[0] Other[Dj Brief Dpp��cription of l RoSpd 1 / Work:50,iun C%fs�rt�Y. ""Ls,— /AyJ LAI: A'aw O� 4f�� -nn( FI Q Alteration of existing bedroom_Yes_No Adding new bedroom Yes _No tive Attached NarraRenovating unfinished basement es No Plans Attached Roll -Sheet Sa. If New house and or addition to existing housing, complete the following a. Use of building_One Family v/ Two Family Other 1 b. Number of rooms in each family unit: Number of Bathrooms � YL c. Is there a garage attached?—A�— / d. Proposed Square rootage of new mnswction. J.9 y�Dimensions a� X r� l ill `f0/U e. Number of stories? f. Method of heatal off Fireplaces or Woodstoves_h,10 Number of each-_ g. Energy Conservator,Complisince. Masscheck Energy Compliance form attached? h. Type ofconstruction W 41 623all! I. Is construction within 100 R of wetlands? Yes _No. Is construction within 100 yr. floodplain_Yes_No I. Depth of basement or cellar floor below finished grade 7+ 5 k. Will building conform to the Building and Zoning regulations? Yes_No. I. Septic Tank City Sei Private well City water Supply SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, r as Owner of the subject Property /I// hereby authorize Y 1 ✓ t to ac[on rs relafive to work authorized by this building permit application. /D- O�-/8 Signature of Owner Dale I, f A, as Owner/Authorized Agent hereby declare that Me statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Sign u der the pains rid penalties of penury. r lM /L Print Name Signature of Owner/Agent - Dal �r SECTION S-CONSTRUCTION SERVICES 8.1 Licensed Conslructlon Supervisor: / �,/'�(/ /- Not ACpplic bbla 0 Nameof License Holder: emej,r11V ✓/J/Il� W —fu18 7I J License Number t w. dir JzuS,.01j0)0 Atltlreas Fxpration Dale 3S6 /a - �R c7r� Sign Telephone S.Realstared Home Imonovement Contractor: Not Applicable ❑ Comoanv Nam@ Registration Number Address Expira0on Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152,§2SC(8)) 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...... ❑ 9 tct e ne y So t o �( SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construcn rviaor:tioNot Applicable O I Name of License Noldnuc O 8 ( CS—102 0 07 �� License Number x / 010 027-r 9 - ,2 220 Md.. Expmelon Dale /3 - TelepoKe 9.Real r n elm r n a r: Not Applicable 13 a�,Nn _ ,v� r939 aS Comoanv Name Registration Number ar llfr 'rPd✓l c `i'lA 0--09 - �D3L7 Address Erltriration Date 0103 a Telephon -r3 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L a 15],S ZSCIW� 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...... ❑ /1 COM �✓!!( � /v` L' hah� SECTION s-DESCRIPTION OF PROPOSED WORK(check all applicable) Now House ❑ Addidon Replacement Windows Alleration(s) ❑ Roofing Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs j0] Decks [p Siding(01 Other 1p] Brief Description of Proposed Work: Alteration of wasting bedroom_Vas_No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet w. If New house and or addition to existina housing, complete the following a. Use of building One Family Two Family Other b. Number of rooms m each family unit: Number of Bathrooms c. Is there a garage attached? d. 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 aftached? 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 I, as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date I, as OwnerfAuthorized 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. Print Name Signature of OwnerlAgeM Date Mice M consumer Main 6 Bus r.se Rel HOME IMPROVfSMENi CONTRACTOR T kr l d.dttalR2gMUjjkjj�—. - Expiration ill il .12/09/2020 VADIM SOLOKI9 VADIM SOLO.flk: =.= \FIGQeP- 32 MARLENE DR. C FEEDING HILLS,MA 01030 Undersecretary 'WITCorllmonwea0h of Massachusetts Division of Professional L'censure Board of Building Regulations laegulations and Standards COnstHLOW uperVI60r CS-108809 < EAlires: 08/19/2020 J _ VADIM SOLOKHIN z 32 MARLENE BR FEEDING HILLS.MA Ot ``� ■ I!i/(S'li0n�� Commissioner /� Aa CRY p as Louis Hasbrouck<Iasbrouck@northamptonma.gov> Demolish 333 Acrebrook and HERS Raters 1 message Louis Hasbrouck<Iasbrouck@northamptonma.gov> Wed,Nov 7,2018 at 1:24 PM To:arkbuildtech@yahoo.com Yeugeney, You can demolish the house at 333 Acrebrook Drive. I'll review the building permit and let you know what I find. You do need a HERS rating on the house.Here are a few names. Adin Maynard His and HERS Energy Efficiency 12 Perkins Ave Northampton,MA 01060 413.658.8784 info@hhefficiency.com Jamie Callan Mad Turcode Powerhouse Consulting 479 West Street Amherst,MA 01002 (413)230-3043 Jamie@powerhooseenergyconsulting.com Center For EcuTechnolDgy 320 Riverside Drive Florence,MA 01062 413-566-735D info@cetonline.org Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 once (413)587.1272 fax Building Permit Fees 333 Acrebrook Drive New House Square Ft Cost/Psf 1008 1st $0.50 1008 2nd $0.50 2016 $0.50 $1,008.00 1008 basement $0.20 216 Porch $ 20 144 deck $0.0.20 1368 $0.20 $273.60 10 Permit Fee $1,281!0 �� City of Northampton ( Massachusetts I DEPANTNENT OF BUILDING INSPECTIONS 212 Nein Street a N Cepa Building Nor� ton, M 01060 Fee Calculator for Residential Properties Location : ?� �j?j A"c.Lin-)o4— Dr a Xa-rAj" , `f Square Footage Amount Basement @ .20 ' LO qo� IST Floor @ .50 /� 2"d Floor @ .50 q �v /9L '/2 Floors, Finish Attic, Garage @ .20 Deck / Porches @ .20 Total : �JS� City of Northampton Q'� Massachusetts �5. 212xENTOFNOZSDZNi INSPECTIONS213 Main Sthu aMunicipal Bvildinq Northavgrton, !A 0306 �hC 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 property licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 333 fTcrcl,,k 4- (Please print house number and street name) Is to be disposed of at: t aA ItIK4,— ad '&-c /, I )�C (Please print name and location facility) Or will be disposed of in a dumpster//onsite rented or leased from: J4 4xlf?�� (Company Name a dress) S plicant 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. The Commonwealth of Massachusetts Department of Industrial Accidents ! Congress Shed,Suite 100 Boston,MA 01174-10177 www mass.gov/dia V%A others'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeiblv Name(Busineu/Orgmimriordlndividua0: t4/ Address: % $/(T City/State/Zip: r/ 010 Phone#: �3 — Are you anemployee+Cmdione. pruee bur: Type of project(required): I.E3 larn.employer wiM empmyea(full mdlofpm-time(.' 7. New construction 'Zorrat a sokp a,misor or parmnaup and nave on employes working fm mew g. ❑Remodeling my ea,may.[No workers'mmp.imurma "mod.] 3.F 1 am a homeowner doing all work myself[No workers'comp.insurance ox,mod] 9. PrDCmalltlun 4.[]l em a homeowner and will be hung com ion m conduct all work on my property. Iwill 10 X Building addition emure that all covaims chin have wpdcni com en nen irmmmce mare rale 110 Electrical repairs or additions pmpnemrs with m employers. 12. Plumbing repairs or additions s 1 eon a general ual comacmrand 1 have Hired b naacmrs listed on Me soothed shi. 1 .Roof repairs Thesubtionrrmmn hes ave employeand haveve worworimuor kers'comp. nce. 6.[—]We omaearomnm and its officers have cxmmd drew right ofeaempnon pm MGL a 14.❑Other 152,41(4),and we have m employees.[No workers'camp.wumnec reau rwit 'My applicant Mat checks box rot men also fill out the section below showing den workers'compemmon policy infibownm. t Homeowners who,Mm,Nis affrdavil indimmg Mey are doing all work and Men hose.rookie conmcbrs amt submit a new eRdavig indicating smM1. :Connors Mal check nor for wort.[red an additional sheet showing Me more of Me sub-conmewrs and sate whether or not n0-enotes have emplovees. Ifdre submnmcmrs have employers.M<y orrut provide Mur wmkers ramp. In,numb I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. /1 ,1 -TA CQ Insurance Company Name: t_P_/7 �r Policy#or Self-ins.Lic.#:� — /Q V — O3 is J I t Expiration Date: ,0.o O — —/p1OI qyy) li Job Site Address: 333 CYC t`k)� City/SlatdZip: /(/pyr au,p70n / Attach a copy of the workers'compensation policy declaration page(showing the policy number and esptr don date} Failure to secure coverage as required under MGL c. 152,g25A 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 t may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify a sables ofperjury that the information provided above is aue and correct Si azure: Date: o- O T Phone N: yj3 S7 9 —/'3 Official use only. Do not write in this area,to be completed by city or town offchai 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined w"...every person in the smite of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant therein shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shag withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to you situation and,if necessary,supply sub-contractcr(s)name(s),address(es)and phone number(s)along with their cer ificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensmion insurance. If an LLC or LLP does have employees,a policy is required. Be advised thin this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be rammed to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Sheet, Suite 100 Boston,MA 02114-2017 Tel.#617-727-4900 ext 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23.15 www.nums;.gov/dia Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartmems and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)Ames"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers compensation insurance. If an ILC or LLP deer have employees,a policy is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that most submit multiple permitAicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit, The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street Boston,MA 02114-2017 Tel. #617-727-4900 ext 7406 or 1-877-MASSAFE Fax#617-727-7749 www.mass.gov/dia Fwm RwisN 02-21-IS City of Northampton ✓f Massachusetts L DR r'BNOF BUILDING INSPECTIONS 212 Nei �\ ,{ 213 n 9r •* Municipal 9uilding , NertheRGon, nk 01060 O 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. Prim to performing work on such homes,a contractor most 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 preexisting owner-0ccupied building containing at least one but not more than tour dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:Lf the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: Est.Cost: Address of Work 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 owneroccupied 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: Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, 1 hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton "� Massachusetts 212 .—S OF B- .LD G INSPECTIONS 1y 312 Mal. Street • Municipal Builtling \ Norttamp t.n, IA 01060 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 110.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 I O.RS, 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. ArcGIS Web Map ao o� 9® €D CD 03 an w CP 0 ® VfJ [ on im Em cm a Em cm cm C7T7 em a WD C3 m MY AG11p101r. Louis Hasbrouck<Iasbrouck@northamptonma.gov> illisiRe: IECCUAI5 0580_Vadim Folokhin_333 Acrebrook Dr Northampton DRAFT 1 message Louis Hasbrouck<Iasbrouck@norlhamptonma.gov> Tue,Jan 22,2019 at 6:24 PM To: arkbuildtech <arkbuildtech@yahoo.com> Cc: Kevin Ross<kross@northamptonma.gov>,Tiffany Ingalls<demo@buildingwreckers.com> Vadim, This is good. I did have a question; are you going to reuse the foundation? I thought you were. If not,you need to have the gas shut off at the street and get us a letter;also a letter from the electric company saying the power has been disconnected, and you need to contact the sewer department to find out what you need to do to cap the sewer. Call me if you need more information;413-587-1240. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587.1240 office (413)587.1272 fax On Tue,Jen 22, 2019 at 12:24 PM arkbuildtech <arkbuildtech@yahoo.com>wrote: Sent from my Samsung Galaxy smanphone. —Original message— From: Paul D<pauld@noonanenergy.com> Date: 1/16/19 2:32 PM(GMT-05:00) To:arkbuildtech@yahm.com Subject: IECCUAI5 0580_Vadim Folokhin_333 Acrebrook Dr–Northampton DRAFT Hello Vadim, Projected rating report for 333 Acrebrook Drive. If you have any questions feel free to contact me. Best regards, Paul DellaTorre Noonan Energy Corp. 413-427-2423 Quick Analysis Property Organization HERS Vitaly dzhentuerykha Noonan Energy Corp ProjectedWorstCase 333 Acrabrook Or 413.427.2423 Rating No:0073-0580 Northampton, MA 01062 Paul J. De laTorre Rater ID:8776762 Registry ID: Weather.CMctpee,MA Builder Vad rn Folokhin Colonial Vadim Folokhin HERS 0073_0580 Vadim FolokMn 333 Acrebrook Projected Rating: Based on Plans - Field Confirmation Required. PFo;FaPns EPA ENERGY STAR 3.0 Topics Fails EPA ENERGY STAR 3.1 Fails EPA ENERGY STAR 3.2 WA, OR Fails Tax Credit Fails DOE Zero Energy Ready Home Fails HERS Index(with IAF) 55 IECC 2015 ERI 55 IECC 2018 ERI 55 WH Infiltration Natural ACH 0.16 ACH50 (Pa) 3.OD CFM50(Pa) 1152 ELA(sq.in) 63.2 SLA 0.00015 CFM50/sf shell 1) 0.21 WH Ventailation (continuous) FT Type Exhaust Only Asls (equiv. dm) 80 62.2-2010(dm) 59 62.2-2013(dm) 78 REM/Rate- Residential Energy Analysis and Rating Software v15.7.1 This infomution does not constitute any warranty of energy cats or savings. 0 1985-2018 NORESCO, Boulder,Colorado. Page 2 of 2 Quick Analysis Property Organization HERS Vitaly dzhenzherykha Noonan Energy Corp ProjectedWorstCase 333 Acrebrook Or 413<27-2423 Rating No:0073-0580 Northampton,MA 01062 Paul J. DeRaTore Rater ID:9776762 -QJD.dt� - Registry ID: Weatheffircopee, MA wider Vadim Folokhin Colonial Vadim Folokhm HERS 0073_0580_Vadim Folokhm 333 Acrebreok Projected Rating: Based on Plar Feld C squired. Design Load (kBtu/hr) Total Area (sq ft) Heating 320 Dori 60.0 Cooling 149 Celhng 10D8 Skylight 0.0 Annual Load (MMBtu/yr) Duct 1123.2 Heating 49 2 Cooling 1.0 Ratios Water Heating ll.i Window-toWall 0.105 Wind,, to-Floor 0.078 Annual Consumption (MMBtu/yr) Hearing 52.6 Window Area by Orientation (sq ft) Cooling 0.8 North 95.9 Water Heating 3.1 heart 0.0 Lights a Appliance 24.5 37.2 Photovoltaics -0.0 art 0.0 Total 81.1 So 92.6 n 1) So t 0.0 Annual Energy Cost ($/yr) 010 Heating 703 North FT 0.0 Cooling - 36 -. Water Heating 132 Codes Lights B Appliances 863 IECC 2018 Performance Fails Photovoltaics -0 IECC 2015 Performance Passes Service Charges 177 IECC 2012 Performance Fails Total 1912 IECC 2009 Performance Fails Total Area (sq ft) IECC 2006 Performance Fails IECC 2004 Performance Fails Conditioned Space 2880 Iowa Code Fails SheN Area 5400 Above Grade Shell Area 3672 Minds Code Fails C Illinois Code Passes Foundation Wall 1024.0 NY-ECCC 2016 Performance Fails Slab Floor %0 North Carolina Cade Fails Floor 0 Rim Arid Band Joist 256.0 North Carolina HERO Fails Above-Grade Wall 2152.0 Programs Window 225.7 EPA ENERGY STAR 3.0 Fails RENJRate - Residential Energy Analysis and Rating Software v15.7.1 This information does not constitute any warranty,of energy costs or savings. 01985-2018 NORESCO, Boulder,Colorado. ENERGY STAR v3. 1 Home Verification Summary Property Organization HERS VIM(y dzhenzherykha Noonan Energy Corp ProjectedWorstCase 333 Acrebrook Dr 413-427-2423 Rating No:0073-0580 Northampton, MA 01062 Paul J. DeRaTone Rater ID:8776762 �. CgDezr... Weatier:Cwcopee, MA guilder Vadim FotokMn Colonial Vadim FolokMn HERS_0073_0580 Vadim Folokhin 333 Acrebrook Projected Rating: Based on Plans - Field Confirmation Required. Building Information Rating Conditioned Area (sq n) 288D HERS Index 55 Conditioned Volume (obit ft) 23040 HERS Index w/o PV 55 Insulated Shell Area (sq ft) 5400 HERS Index Target 60 Number of Bedrooms 3 HERS Index of Reference Design Hone 60 Housing Type Single-family detached Size Adjustment Factor 1.00 Foundation Type Conditioned basement This home DOES NOT MEET the EPA's requirements for an ENERGY STAR[lane. HERS Index w/o PV—HERS Index of Reference Design Home AND HERS Index—HERS Index Target to comply. Building Shell Ceiling Blown,A 1 Window Type .30.30. Seal c Window U-Value: 0.300, Vaulted Ceiling None "ndow/VMU Ratio 0.10 Above Grade Walls R210"U=0058 Infiltration Type)Blower door Found. WaRsiCond) R10,2 Continuos R 10: , Infiltration Hig: 3.00 CIS: ACH50 Found. Walls(Uncond) None get Uade 30.00CFM@ is Floors Now Out kage 60.00 CFM @ 13 Slab Floors'Unirsulated"' .663 Mechanical Systems Heating Fuel-fired air distribution, 57.0 kBwh,95.1 AFUE. Cooling Air conditioner, 24.0 kBtuh, 13.0 SEER. Water Heating Heat pump, Elec, 3.55 EF. Programmable Themrostat Heat=Yes; Cool=Yes Ventilation System Exhaust Only: 80 dm, 14.0 watts. Lights and Appliances Interior LED Lighting (%) 100.00 Clothes Dryer Fuel Natural gas Refrigerator(kWh/yr) 691.00 Clothes Dryer CEF 2.32 Dishwasher Energy Factor 0.46 Clothes Washer LER 704.00 Ceiling Fan(cfm/Watt) 0.00 Clothes Washer Capacity 2.87 Range/Oven Fuel Naturalgas Note:Where feature level varies in home,the dominant value is shown. 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