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18D-035 (40) 48 DAMON RD BP-2020-0827 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18D-035 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERI I)CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2020-0827 Project# JS-2020-001425 Est.Cost: $2500.00 Fee:$100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: COMPLETE RESTORATION SOLUTIONS 108606 Lot Size(sg.ft.): 23783.76 Owner: KERRYMAN PARTNERSHIP zoning:GB(100)/ Applicant. COMPLETE RESTORATION SOLUTIONS AT. 48 DAMON RD Applicant Address: Phone: Insurance: 30 HAYES CIRC (413) 592-2772 WC CHICOPEEMA01020 ISSUED ON.1/22/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-DEMO 1 FT FLOOD CUTS IN OFFICES DUE TO WATER MITIGATION 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 1/22/2020 0:00:00 $100.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Versionl.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit - 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 48 Damon Road Map 18D-035-001 Lot Unit Northampton, MA 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Kerryman Partnership PO Box 60266, Florence, MA 01062 Name(Print) Current Mailing Address: i., Signature Telephone 2.2 Authorized Agent: Complete Restoration Solutions, Inc. 30 Haynes Circle, Chicopee, MA 01020 Name(Print) Current Mailing Address: CA (413) 592-2772 Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $2,500.00 (a) Building Permit Fee 2. Electrical ��� - - �� � (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) W, 5. Fire Protection 6. Total = (1 +2 + 3 +4+5) Check Number a a This Section For Official Use Only Building Permit Number r r Date Issued Signat re: Building Commissioner/Inspector of Buildi Date Version 1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs 0 Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑ Brief Description Demo of 1 ft flood cuts in offices due to water mitgation. Carpet will also be removed and Of Proposed Work: disposed of. SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 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: i Proposed Use Group: i 1 Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1st ist 2nd 2nd 3 rd 3rd L. 4m 4m i Total Area (sf) Total Proposed New Construction (sf) Total Height(ft) � 1 Total Height ft 7.Water Supply(M.G.L. c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone❑ Municipal 0 On site disposal system❑ Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTONZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L:' R: L: R:= Rear Building Height "„ Bldg. Square Footage 7- % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location _._ A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DONT KNOW O YES 0 IF YES, date issued: E� IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW 0.. YES.iv IF YES: enter Book Page; and/or Document#; B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained 0 , Date Issued: C. Do any signs exist on the property? YES Q NO 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 Q IF YES, describe size, type and location: E. Will 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,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES -FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address j Expiration Date Signature E Telephone 9.2 Registered Professional Engineer(s): E Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date l Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Complete Restoration Solutions, Inc. Not Applicable ❑ Company Name: ,Gary Grout Responsible In Charge of Construction 30 Haynes Circle, Chicopee, MA 1020 Ares , - � (413) 592-2772 Signature Telephone Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No O SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, - as Owner of the subject property hereby(Ybi e Complete Restoration Solutions, Inc. to 4 act onlf in all atter elative to work authorized by this building permit application. 12/11/2019 Signature of Owne Date r Complete Restoration Solutions, Inc. , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Gary Grout Print Name 12/11/2019 Signature of Owner/Agent Date SECTION 12 -CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Aaron Murray j CS-108606 License Number 176 Draper Street, Springfield, MA 01108 08/12/2020 Addres� Expiration Date (413) 540-6157 Sig to� Telephone SECTION 13-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 O No 0 "\ The Commonwealth of Massachusetts Department of Industrial Accidents d 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia «'orkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/Individual):Complete Restoration Solutions, Inc. Address:30 Haynes Circle City/State/Zip:Chicopee, MA 01020 Phone #:413-592-2772 Are you an employer?Check the appropriate box: Type of project(required): I.❑✓ I am a employer with 18 employees(full and/or part-time).* 7. ❑New construction 2.❑1 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.❑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.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[:]Roof p repairs These sub-contractors have employees and have workers'comp.insurance.: 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. Insurance Company Name:Zurich Insurance Services Policy#or Self-ins.Lic.#:UBOG2633886 Expiration Date:09/01/2020 Job Site Address:48 Damon Road City/State/Zip:Northampton, MA 0106( 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. Ido hereby certify under the ins and penalties of perjury that the information provided above is true and correct. Signature a Date: Phone#:413-592-2772 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#: A��® DATE(MM/DDIYYYY) � CERTIFICATE OF LIABILITY INSURANCE 12/11/2019 THIS CERTIFICATE IS ISSUED ASA 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 Gail Croake NAME: Borawski Insurance PAHONN Ext (413)586-5011 FAIL No: (413)586-7973 88 King Street,Suite B E-MAIL gcroake@borawskiinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060-3257 INSURER A: Admiral Insurance Company INSURED INSURER B: Zurich Insurance Services ZUR001 Complete Restoration Solutions Inc. INSURER C: Hanover 22292 30 Haynes Circle INSURER D: INSURER E: Chicopee MA 01020 INSURER F: COVERAGES CERTIFICATE NUMBER: Master 19/20 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. INSR AUUL bUt5K POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD VIVID YYY POLICY NUMBER MMIDD/YMM/DDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 DAMAGE TO RENTED CLAIMS-MADE a OCCUR PREMISES Ea occurrence $ 300,000 X CPL MED EXP(Any one person) $ 5,000 A X Professional Liability FEI-ECC-23980-02 08/28/2019 08/28/2020 PERSONAL RADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $ 2,000,000 JECT LOC PRODUCTS-COMP/OPAGG $POLICY [gPRO- 2,000,000 OTHER Trans Poll Liab $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LAB CLAIMS-MADE FEI-EXS-23981-02 08/28/2019 08/28/2020 AGGREGATE $ 5,000,000 DED RETENTION $ $ PER WORKERS COMPENSATION X STATUTE ER H AND EMPLOYERS'LIABILITY YIN 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE FN7 NIAUBOG263886 09/01/2019 09/01/2020 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1000,000 (Mandatory in NH) E .DISEASE-EA EMPLOYEE $ , If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Bailment Coverage C RHN965954 02 08/28!2019 08/28/2020 Ded$1000 350,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 City of Northampton Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 `� �7— ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 164927 COMPLETE RESTORATION SOLUTIONS,. Expiration: 12/01/2021 30 HAYNES CIRCLE CHICOPEE,MA 01020 }}* Update Address and Return Card. SCA 1 0 20M-05/17 • • +f City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance a rovisions of MGL c 40, S54, I acknowledge that as a condition of the building perms -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: ��i {���? -W,,J , ��Or`i�l�� Pig OIe)&Q The debris will be transported by: A'_SSbb*6.;fz.J Bi J"!A i h a� The debris will be received by: " [(A wajy:e� 141Y40 Building permit number: MR- ao�o Name of Permit Applicant �UUsi h !J�V14Pm )t' � A Date Signat r of Permit Applicant 12/11/2019 Northampton,MA:Assessor Database: Northampton, MA : Assessor Database Property Search: Parcel ID: Owner Name. Street Number: Street Name: 48 DAMON RD i SearSlt Reset Property Detail: Parcel 1D: Card: Street Name: Street Number: Zoning: State Class: Acres: Plot: 18D-035-001 1 DAMON RD 48 Automotive Vehicles Sales&Services 0,55 Owner Information; Property Images: Owner Name: KERRYMAN PARTNERSHIP Picture: Owner 2 Name: Owner 3 Name: Street 1: P 0 BOX 60266 City: FLORENCE State: MA a Zip: 01062 Building Information: Grade: B- ,:.. Structure Type: AUTO DEALER/F-SEVICE .. Units: 0 Year Built: 1900 s Building Number: 1 Identical Units: 1 Sketch: _ ID Code Description Valuation: _ _ 1 1s B VSi is - C VSZ 2s Appraised Land: $255,500.00 D VW1 WOK E 066 SUPPORTAREA Appraised Bldg: $403,900.00 20 F 046 AUTO SHOWROOMIO G 082 MULTI-USE OFFICE Appraised Total: $659,400.00 H 046 AUTO SHOWROOMIO 1 047 AUTO PARTS/SERVICI J ODI OVERHEAD DR-WOOI K L02 LOADING DOCK WOt L PA1 PAVING ASPHALT PARI 60 ai 57 10 10 30 9 16 15 C E 26 33 33 30 82 Out-Buildings: Code: Description Units: Year Built: Sizel: Size2: Area: Grade: Condition: PAI 1 1996 0 0 11000 NORMAL(Comm) Building Interior/Exterior Information: Floor From; Floor To: Area: Use Type: Exterlor Wall.: Contruction Type: Heatlnq: A/C: Plumbing: Functional 1 Bl Bl 780 SUPPORT AREA WOOD FRAME/JOIST/BEAM HOT AIR NONE NORMAL 1 01 01 780 AUTO SHOWROOM,OFFICE WOOD FRAME/JOIST/BEAM HOT AIR CENTRAL NORMAL 3 northampton.ias-clt.com/parcel.detail.php?id=18D-035-00110 1/2 12/11/2019 Northampton, MA:Assessor Database: 02 02 780 MULTI-USE OFFICE WOOD FRAME/JOIST/BEAM HOT AIR CENTRAL NORMAL 3 01 01 2496 AUTO SHOWROOM/OFFICE FIRE RESISTANT HOT AIR CENTRAL NORMAL 3 01 01 3020 AUTO PARTS/SERVICE FIRE RESISTANT UNIT HEAT NONE NORMAL 3 The Informatlon delivered through this on-line database Is provided In the spirit of open access to govemment Information and Is Intended as an enhanced service and convenience for citizens of Northampton,MA. The providers of this database;Tyler CLT,Big Room Studios,and Northampton,MA assume no liability for any error or omission in the information provided here. Comments regarding this service should be directed to:jsaratinonorthamptonassessor.us Wed.December 11,2019:11:05 AM:0.16s:10mb northampton.ias-clt.com/parcel.detail.ph p?id=18D-035-00110 2/2 From: To: Louis Hasbrouck Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, 1 request that you grant a modification to waive the requirement for construction control of the project at because the work is of a minor nature, will not affect structural elements, health, accessibility, life or fire safety, and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully,