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25C-069 (8) 30 DAY AVE BP-2020-0839 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:25C-069 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: KITCHEN RENO BUILDING PERMIT Permit BP-2020-0839 Project# JS-2020-001444 Est.Cost: $13000.00 Fee:$100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JOEL ZIMMERMAN CARPENTRY CS-074318 Lot Size(sg.ft.): 8189.28 Owner: ABDUL-RASOOL HALA Zoning: URB(100)/ Applicant. JOEL ZIMMERMAN CARPENTRY AT. 30 DAY AVE Applicant Address: Phone: Insurance: PO BOX 225 (413) 695-7742 Workers Compensation NORTH HATFIELDMA01066 ISSUED ON:1/27/2020 0:00:00 TO PERFORM THE FOLLOWING WORK:KITC H E N R E N O 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 1/27/2020 0:00:00 $100.00 212 Main Street, Phone(413)587-1240, Fak:(413)587-1.272 Louis Hasbrouck—Building Commissioner Version 1.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: 1,.�•�� Building Department Curb Cut/Driveway Permit - 212 Main Street Sewer/Septic Availability X14ji Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans pz of p ne 13-587-1240 Fax 413-587-1272 Plot/Site Plans N°qTq ti Other Specify APPLICA .a IST UCT, 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 �p Lo' Ave Map Lot V&q Unit �0 r.-a-rr► P x 0 M�! O an t; Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Plu;,>r4;eq-1 Ln«►r Rvz. , NIL'r-}iU-11A,16er:4, N-j c,cL r1 Name(Print) Current MailingAddress: e i - Signatur -'"''j� Telephone 2.2 Authorized Agent: PO Name(Print) Current Mailing Address: _ Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical _ (b) Estimated Total Cost of Construction from 6 3. Plumbing Sooc Building Permit Fee 4. Mechanical(HVAC) too 5. Fire Protection 6. Total= (1 +2+3+4+5) $13.c'o0 Check Number This Section For Official Use Only Building Permit Number nl n� , Date Issued Signature: Building Co missioner/Inspector of Buildings 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 ❑ Demolition V] Repairs V] Additions ❑ Accessory Building❑ (Exterior Alteration Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑ Brief Description Mai be cls dl"E" 1-11AIst T Y i+J19 n . i h s o ta4e where Of Proposed Work: udcd , c� P\uw. k; c11a h . nc ,-ALS nrid ocnnIrl n� � L�C�raorls o cifc SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE Assembly ElA-1 ElA-2 ElA-3El1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hicih Hazard ❑ 3A ❑ 11 Institutional ❑ I-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: Proposed Use Group: 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) e- 1s1 2nd 3"d 4m 4�' Total Area (sl) i Total Proposed New Construction (sf)� 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: Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑ Version 1.7 Commercial Building Permit May 15,2000 EECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes ® No SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN 'OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize Jo e Z.Yn wee to act on my behalf, in all matters relative to work authorized by this building permit application. 1,� l / 1Z zozo Signature of Owner Date 1, Of i ilk X71 % ^✓ 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. P � Print Name Signatur of Owner/Age t !, Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: 0 aef D -7 Y 07 1/ 3 P-6 License Number Address Expiration Date �l� 9 77�� Sign ur 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 0 No City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste 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. Address of the work: 30 na,, kv.L The debris will be transported by: vsp, P-QtLkC-I1 n 0. The debris will be received by: vspr N0.A„� P-e(�Illivkck Building permit number: Name of Permit Applicant -- ) 0-42 o-42 1 Z ,'47en Date Signature of Permit Applicant JOEIZIM-01 BWILLETT ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDlYYYY) _ _ 1/21/2020 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 Valerie Carrier NAME: Whalen Insurance AgencyPHONE 71 King Street (A/C,No,Ext):(413)586-1000104 Ate,Nc;(413)585-Ml Northampton,MA 01060 -AEbmpfRIEss,valerie@Whalenlnsurance.com INSURER(S) AFFORDING COVERAGE NAIC X INSURER A:Utica First Insurance Company 15326 INSURED INSURER 8: Joel Zimmerman DBA Joel Zimmerman Carpentry INSURERC: PO Box 225 INSURER D: North Hatfield,MA 01066 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. INSR LTR TYPE OF INSURANCE AODL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1'000'0w CLAIMS-MADE a OCCUR ART-5089597 03 81,3/2019 81,3/2020 DAMAGE TO REMISESE,ENTED $ 50,000 MED EXP(Any one $ 5,000 PERSONAL&ADV INJURY 1'000'0 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY 1:1 jF&T F1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUpT.�OpSyyry p BODILY INJURY Per accident $ AUTOS ONLY AUTOS ONLY Pfgrd OPERnt AMAGE $ UMBRELLA LIABOCCUR EACH OCCURRENCE EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION SPTART'TE OTH- AND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N IA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 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 issued as evidence of insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City P ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street 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 Commonwealth of Massachusetts Division of Professional licensure Board of Building Regulations and Standards Constram6io"Aervisor CS-074318 EDires:02/01/2021 I. JOEL D ZIMMERMAN PO BOX 225 NORTH HATFIELD MA 01066 >� Commissioner .moi Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Registration Exairation Office of Consumer Affairs and Business Regulation 128929 06/08/2021 1000 Washington Street -Suite 710 JOEL ZIMMERMAN Boston,MA 02118 D/B/A JOEL ZIMMERMAN CARPENTRY JOEL D.ZIMMERMAN 340 WEST ST NORH HATFIELD,MA 01066 Undersecretary Not NiWia without signature \ The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/Individual): J-o-e— t /1y Address: Po 3 UX �-�� bort f t City/State/Zip: Phone#: /-// -7 0/y 7 7 y 2 Are you an employer?Check the appropriate boa: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. New construction 2.12]1 am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.M I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 1 Demolition 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.©Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.❑I 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.: 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 employee& Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct ` 1 .2y r2 Signature: 4&4J ��'v2��il�2yr��� Date: Phone#: 13 61 9 Sz 7 7-' Z 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#: B�.c 8ad�rv� •• 0?0-m E&S;V Oe-11 for plum6i i ac.c.css r r"cmovc im ar� plwslMtr on res� c�' Lj�ll s &oA nc.� ` dr��.�11 � •lcim on �a.11s �t.�n.A ce.►1 i�� I F � (3tjra0rrt optn t�or-1•h WAil Ap &AA '�hsutl�:or. <<rRoMt 4,r'tw% avid. plA-s4c.r eh i�e 0 nc„J AvZZ4a.11 AAA ir',m ori we..A . end cul I K•� add sw i" �Or O'"Ova.1 1.��►+ U ���c� t Plvw�.bi.1 rL 1vtn�lo ki�c.1.s.v� QCs �.oc�t _ 4lrwan a t1tc�+-�cr�1 wherL c�. M,��w.<,.1 Stiv% Back • 110+1 OrPAOFP « C tial 0000"s �C o RGI GAPAr e.wo+C9 37S. v C I2 EAS-T WALL 2 v tt movt +aai 1 "' Firm* '�i H WALL scc pa�c 2 btdroo� 6 12 6 5 e q 1 1 L Z Tvu5,z 4.0sels Will los. rcrnovJ to (KAIct room r^ ' I(Arij4(Yc.ALq- '1V\ +�f kl SCA PGC�t. Z. K ��h�n s t Pa-,y 2 To Dining Room reMok �, a� -II -T 54.50in c To Bathroom N 10025in 7d a ki c�rtn Pantry j6land C in �r C Z fern ove 3O wo�s�ne� N c for loui 1}-ire 1" Floor Kitchen wall _ 55.26in v►e..v � c caall }�Q Wo�1l ;n5}al� nem back Aocf o To Bedroom 1 bu,l I f r\e.vJ OS L C) ('eYy�pVt eawr n4aA 1NS010JiOr) cIle 22.25in. o t,� lnoo� 5 r.�lnere n�zd� N O\1 CY4 '6-;ld la-y o u 6 ii To Back Hallway P01`�e 4 �t • �� I f • � v j.1 y V� ! Y, ,