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38A-148 (8) 23 MOSER ST BP-2020-0681 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38A - 148 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADD BATH BUILDING PERMIT Permit# BP-2020-0681 Project# JS-2020-001165 Est.Cost:$24854.00 Fee:$163.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: WRIGHT BUILDERS 106505 Lot Size(ss .ft.): Owner: MARK JENNIFER Zoning: PV Applicant: WRIGHT BUILDERS AT. 23 MOSER ST Applicant Address: Phone: Insurance: 48 Bates St (413) 586-8287 (116) Workers Compensation NORTHAMPTONMA01060 ISSUED ON.12/3/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.-NEW BATHROOM IS BASEMENT & RENO 2ND FLOOR BATH 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: FeeTvpe: Date Paid: Amount: Building 12/3/2019 0:00:00 $163.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 4 Department use only City of Northamp n Status of lermil Building Departm nt NOV 2 7 gwCut/ rive y Permit 212 Main Stree Sewer/Se tic A ilability ;{ Room 100 Sol bility Northampton, MAO 06WEPT.OF BUILDING TWgle�s of Stru tura) Plans NORTHAMPTC, phone 413-587-1240 Fax 41 - - 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 Lot ' -' Unit 23 Moser Street, Northampton MA 01060 Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Jennifer Mark 23 Moser Street, Northampton.MA 01060 Name(Print) Current Mailing Address: 413-824-9872 J — �— �/ Telephone Signature 2.2 Authorized Agent: Ill t I sl Cao C Na e( int 9r' V-fbwff Current Mailing Address: /� f 3 5 g(o �q n t Telephone / SECTION 3 -ESTIMATED CONSTRUCTION COSTS �. D 06. Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building �f. I O �. (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of 1IYY'' r Construction from 6 3. Plumbing 0 `3 Building Permit Fee '.�� C� 4. Mechanical (HVAC) 5'D AA, 5. Fire Protection 6. Total = (1 +2+ 3 +4 +5) Check Number This Section For Official Use Only Building Permit NumbeIIsssued: Signature: I-=D3 Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be De Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in b Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&pave parking) #of Parkin aces Fi o .lume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT 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 DON'T KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained O , 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 0 NO (9--- IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, excavaUan, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑� Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [[J] Decks [Q Siding [[3] Other[[3] Brief Description of Proposed Work: L Dj N� b 0 Er, b ly eNVQ 1>GE Alteration of existing bedroom Yes No Adding new bedroom Yes ` No (? 1-4 (::�i_R' Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the follo7win77 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. Dimensions e. Number of stories? f. Method of heating? Firepl s 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 wetlan Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar fl below finished grade k. Will building conform the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SEN 7a -OWNER AUTHORIZATION -TO BE COMPLETED WHEN NE" AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property Ann Monica Ledwell/Wright Builders, Inc. hereby authorize to act on my behalf, in all matters relative to work authorized by this building permiappli tion. C Signature of Owner Date I �Q� , �l^1 X11 U3l�I(`e�j I C• as Owner uth d Agen ereby declare that the statements nd infor ation on the foregoing application are true and accurate,to the best of my knowledge and-belief. Signed under the pains and penalties of perjury. 1nL- r t Name r A'W Rmtrn 'Sigr6fuilelof Owne/Agent V - Date SECTION 8 -CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Ann Monica Ledwell/ Wright Builders License Number 48 Bates Street, Northampton, MA 01060 CS-106505 A ress Expiration Date qfiklfo�y W; 11/1/2021 sig41614 Telephone 413-586-8287 9. Re istered Home Improvement Contractor: Not Applicable Eli h—� 1 COMIDany Nome Registration Number -! Jm� 101536 Address Expiration Date Telephone Ol(J `g� 06/26/2020 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 DEPARTMENT OF BUILDING INSPECTIONS c� 212 Main Street •Municipal Building 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: J3 Rr3,<�Q-rarlp-k--K N1 UA Am n&n (Please print house number and str et name) Is to be disposed of at: V4 1'n E&Ac1 ff&M rurt �)W�M (Pleas print na a and\[pAon of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) I k)jq Signature of Permit App scant 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 1 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): It& Address: If 8 City/State/Zip:1yo 01 o (b Phone#: 3! 5TL__t a'1 ? Are you an employer?Check the appropriate box: Type of project(required): 1.[J I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.M 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. Demolition 3.M 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 I I.F]Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.f�fI am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[:]Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 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. A' w w`(�,� Insurance Company Name: k' �' I 1'� ��v - `G Policy#or Self-ins.Lic.#: M cc, �0 o d,d D o S3 -44/&A—Expiration Date: Job Site Address: fe-tL— Sr City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).6/p,(,0 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 andpena707�� ' ss ofperjury that the information provided aboove is true and correct`Si ature: k ate: I1 Phone#: p�< <3� 6 o D-T 7 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 O® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DDIYYYY) 03/11/2019 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 Duval,CISR Elite Webber&Grinnell PHONE (413)586-0111 FAX (413)586-6481 . No Ext: A/C,No): 8 North King Street E-MAIL ) @ duval webberand rinnell.com ADDRESS: 9 INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA: Arbella Protection 41360 INSURED INSURER B: MA Employers/A.I.M. Wright Builders,Inc. INSURER C: INSURER D: 48 Bates Street INSURER E: Northampton MA 01060 INSURER F: COVERAGES CERTIFICATE NUMBER: Master 2020 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDNY MM/DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A 8500068268 03/01/2019 03/01/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑JE° LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Employee Benefits $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED 1020070845 03/01/2019 03/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS X HIRED X 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 03/01/2019 03/01/2020 AGGREGATE $ 5,000,000 DED I X RETENTION$ 10,000 $ WORKERS COMPENSATION X1 STATUTE ORH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBEREXCLUDED? N/A MCC20020005342018A 03/01/2019 03/01/2020 (Mandatory in NH) E.L.DISEASE-FA EMPLOYEE $ 500,000 If yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I 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 r ^� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor �S-106505 Expires 1110112021 It ANN MONICA LEDWELL 28 ROBIN RIDGE DRNE „ FEEDING HILLS MA 01030 ems. Com w issloner Office of Consumer Affair 2nd Business Regulation 1000 Washington Street o Suite 710 Boston, ausetis 02118 Home @eir��u�0� tm oc Regist anon Type C, tan "Iz� Registsban: 10 536 WRIGHT BUOLDERS, INC. w! ,�- E)ml mdan: 06125/2020 48 BATES ETRE I �' NORTHAMPTON, MA 01060 I� -� 4 - U !ba Address and Return Card., SCA 1 U 20PJ-5117 - �� a��¢J arieSe�fs Office cif Corisarner Affairs&Business Reguizfian HOME IMPlaEA1T CONTRACTOR Registration vaiid fur indirriduai use anb\y rcora icn before the expirsdondke. If 1bund re-turn to: R Exr3iratior Office of C.onsurnev . and Susarmss Requiation _ 06/252020 1000 Washington ._ -Su t¢710 WRIGHT BUI 0— l3a�en,�A 02 $: JONATHAN IX V �r 48 BATES STRE �rCf NORTHAMPTON,MA 01060 Undersecretary � valid without signature y i New 3/4 Bath o PIS' Demo: Plumbing: am Rif 2 Remove existing vinyl plank flooring & ceiling above Aker NS48 4 piece shower. No seats L � WO1 !� Cut concrete slab for new plumbing Gerber Hinsdale sink er IS IQ 0! Gerber Hinsdale toilet w/elongated bowl and wood seat Framing, insulation and drywall: Ejector pump z m 2x4 walls The existing sewer line outfall is above the slab by about 1' Mill o N 1/2" MR Drywall at walls and ceiling 9m HVAC: m md-5r,0, aooSr,F Finishes: Connect to existing Venmar ERV for ventilation Z3 Marmoleum Sheet Flooring to Iloilo p Standard no VOC aint Electrical: W. $ E56 Door Casing, Flat 1x4 sides with 5/4 x 6 Top Remove existing ceiling light o WYE Baseboard Casing, 1 x 4 Relocate existing Smoke/CO Detector o� W X-0" x 6'-8" Door Jeld-wen Atherton Install VonHaus electric wall mounted heater m 0W 5K.E�oo Door Hardware, Schlage Accent, Satin Nickel Install owner supplied light/night light ceiling fixture m � Install owner provide mirror and bath accessories Install owner supplied wall lights at sink Na ass=iso Owner: Jennifer Mark _ Elec Panel Sump Unit 2A III , 0 ( closet ' I I I 23 Moser St UP sewer Northampton, MA 01060 I 1 I Line Project Name: New sprinkler The Upper Ridge oMechanical Building A }----- - _ ----- head Room - - - - - - - - - - - - - - - - - - - - - - - - - - - - �-- ;s o? Drawir>Fg Name: Existingenclosed HVAC s s__ duct 6'-11" above sco' -1 New Bath rn, New Floor Plans finished floor Roomcircuit Remove and reset O Relocated existing O _O ERV in the same day -- ----- = Smoke/CO Detector - � - to facilitate the ew - ERv I cutting of the Date: 10/11/2019 Revisions: concrete Trench for plumbing 11/01/2019 Existing sprinkler Flat framed wall 8 1pumpjector --- - 11/18/2019 -H heads with storage shelfsI O ERV Vent --- New gas line to kitchen stove. Patch U VonHaus electric heaterN Scale: +- _ i and match ceiling light & night light fixture I or as noted. — -- ---- - __._ Approvals: BASEMENT PLAN Sht No. Sheet 1 of 3 o OZ n. "'�acuT7 �Wi Finishes: N �z E�� Install new cabinets and counter lug W s oao Upper Cab LU Remove and replace failed upper cabinet door ¢ mos Convert existing spice cabinet to baking pan storage Fabricate and install floating shelfs �otj1Fio Floating Maple Shelf Q m o 6-0 HVAC: Remove and replace micro-hood with new owner provided hood Counter and Backsplash _ n soo o moo} n Plumbing: v, a zW Install new gas line to owner provided stove Lower Cab W maW� Electrical: Maple Trim, Typical Sides and Top �s ya ap WiO`� Disconnect existing micro-hood and connect new vent hood m !RILL f m (7aZy0LL° Kick m m o�uc°ia�Z� Qp N»U�N� m— WVO/-k UV o7?c>n - -- - — - — ' — _ owner. o o Unit 2A 23 Moser St Northampton, MA 01060 i Project The Upper Ridge J i New cabinets,counter and Building A II 1 blind mounted shelf 19 1/4" ide f # j 10" Dee Il! 1 , Drawing Name: `^ I 8'-0" Hig Floor Plans N N zo D i - Date: 10/11/2019 Revisions: Remove spice rack and modify I I1 i s pullout to be hinged door I 11/01/2019 I C Install blind . i11/18/2019 mounted maple C Cal v shelf above Remove&replace upper cab door Install new gas line to stove Scale: / 1-0„ „_ . 4 or as noted. —J--_-- -- N Approvals: ----------------- 1sT FLOOR PLAiVFS­ht _ No. Sheet 2 of 3 o P3 z tD O y2U��� O C FOW� m <U2 o s� � (n p ZSaZ�U New tub, shower head, tile surround and frame less shower door U) v m QT Demo: Plumbing: W§ Remove existing tub insert New shower control and head mo Woao See option for wand o =off Finishes: m Ss Standard no VOC paint for walls and ceiling o �g Tile surround including niche Frameless shower door 0 N m �WU1K< Y+r ,m.{{J p N O t m GwWw a LU UST J.! 5> �� �� zz loom io= O1F dOQu mP $�P~U� mooz Fii u m— iu G�'t'Um Owner. Jennifer Mark Unit 2A o j V o 23 Moser St o - Q U —?� Q Northampton,MA 01060 --- a i Project Name: co The Upper Ridge df� Building A I i '--- _� - -- - W ' Drawing Name: 1 E 2Q p v E Floor Plans o� � V-� O � # I M c M � c EmQ, Date: 10/11/2019 _ _ - Revisions: 11/01/2019 New tub,shower head,the 11/18/2019 surround to ceiling,niche and frame less shower door. Shower door comes with the ! m tub. Install by finish o_ carpenter. Scale: o 4T 4 i I or as noted. -- - �_ Approvals: L04i1 1 i L4164 -- - -- 2ND FLOOR PLAN _---_-- _-- _�_ —___ Sht No. Sheet 3 of 3