Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
32C-047 (36)
110 PLEASANT ST BP-2020-0812 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-047 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT. Permit# BP-2020-0812 Project# JS-2020-001403 Est.Cost:$154000.00 Fee: $1103.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: DIXON INC 097645 Lot Size(sq.ft.): 9713.88 Owner RESINATE OF NORTHAMPTON Zoning: CB(l00)/ Applicant: DIXON INC AT: 110 PLEASANT ST Applicant Address: Phone: Insurance: 361 WEST MAIN ST (508) 393-4411 WC NORTHBOROUGHMA01532 ISSUED ON.112112020 0:00:00 TO PERFORM THE FOLLOWING WORK: Buildout Retail Cannabis Store 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 1/21/2020 0:00:00 $1103.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner .�� Z ► { 0 P1,611SAN-V Tr Version 1.7 Commqftja�]Building Permit May 15,2000 Department use only City of Northampton �� Status of Permit: Building Department �`�� Curb Cut/Driveway Permit - 212 Male Street qj9 Sewer/Septic Availability Room 100`1 S Water/Well Availability Northampton, MA 01,0�v � Two,Sets of Structural Plans phone 413-587-1240 Fax 41 5877; 72 pt/ C PSite Plans 58"T71 ,72 Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANG 'Fi ( E OR.000UPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO,F MILYDWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office ((0 pL6A$AWV Map Lot 0c./-7 Unit NO rLTA AVvXP T6 Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Signature Telephone 2.2 Authorized Agent: PWtQ 36.1 f,✓est M'I' v' S} _,ti6NJA6YOu Name(Print) Current Mailing Address: -)osS7y-6g6-5-)0-5- Signature ignature Telephone SECTIO 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 Building Permit Fee 4. Mechanical(HVAC), 5. Fire Protection 6. Total=0 +2+3+4+5) Check Number creor1rc This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date 3 �s10 jjl'�Gam- (' Versionl.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❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work: 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: Pro posed 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(so 1 St 1 1St nd 2nd 2 3rd — 3rd 4th th 4 Total Area(so Total Proposed New Construction (so 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 ZoneE] Municipal ❑ On site disposal system❑ Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front j Side L: R: L. _ R. Rear Building Height Bldg. Square Footage 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 0 DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW YES Q IF YES: enter Book Pageand/or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 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 0 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 0 NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version 1.7 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 Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number L...._..--- -- 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 V1 Noy) Not Applicable ❑ Company Name: Responsible In Charge of Construction Address i ature Telephone Version 1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes Q No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 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 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. Si ned under the pains and penalties of penury. Print Name Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction'Supervisor: Not Applicablel❑ Name of License Holder: 1�11�_�c >Cc7-1 CS - OQ /-7U y License Number _. 361 ►,ci, Address Expiration Date '17q V16 —)X05" g a r 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 No 0 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.- The ork:The debris will be transported by: The debris will be received by: Building permit number: Name of Permit Applicant Date Signature of Permit Applicant AC p ® DATE(MM/DD/YYYY) ARE) CERTIFICATE OF LIABILITY INSURANCE 03/04/2020 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(les)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). CONT CT PRODUCER NAME: Kristin Caporals The Hilb Group of N.E.,LLC dba Mackintire Insurance PHONE (508)366-6161 FAX (508)366-5202 A/C No. o Etl: A/C No): 11 West Main Street ADDRESS: kristlnc@mackintire.com INSURERS)AFFORDING COVERAGE NAIC t Westborough MA 01581-1931 INSURERA: Middlesex Insurance Co 23434 INSURED INSURER B: Western World Insurance Co. 13196 Dixon Inc.,General Contracting INSURER C: 361 West Main St. INSURER D: INSURER E: Northborough MA 01532 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. INR AIJUL TYPE OF INSURANCE LI Y EFF P LI Y EXP LIMITS LTR INSD WVD POLICY NUMBER MWDD/YYYY MM/DDMlYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ©OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 15,000 A A0092653003 12/31/2019 12/31/2020 PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY ®JE� LOC 2,000,000 PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ AOWNED SCHEDULED A0092653004 12/31/2019 12/31/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Medical payments $ 5,000 X[AND UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,000 AEXCESS LIAR CLAIMS-MADE A0092653006 12/31/2019 12/31/2020 AGGREGATE $ 6,000,000 DED RETENTION$ 10,000 $ RKERS COMPENSATION EMPLOYERS'LIABILITY STATUTE ER Y/N 1,000,000 A PROPRIETOR/PARTNER/EXECUTIVE N/A A0092653005 12/31/2019 12/31/2020 E.L.EACH ACCIDENT $ICERIMEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Leased/Rented Equip $300,000 A-Inland Marine-A00926530002 B Contractors Pollution EVP1002440-00 12/31/2019 12/31/2020 Each Occurrence $6,000,000 Aggregate $6,000,000 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 Town of Northampton Building Deptartment ACCORDANCE WITH THE POLICY PROVISIONS. Puchalski Municipal Building AUTHORIZED REPRESENTATIVE 212 Main St. Northampton MA 01060 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD resi nate Peter DeCaro Chief Executive Officer Resinate, Inc. 120 Gilboa Street Douglas, MA 01516 March 4,2020 Mr. Hasbrouck: Pursuant to our discussion on March 2, 2020, Resinate is terminating our A1A Contract with Marois Construction. Moving forward, Resinate has retained the services of Dixon General Contracting. Dixon General Contracting will provide the necessary oversight on the project including the supervision of all subcontractors on the project. Thank you, P&141 pdz2d .B Peter DeCaro CEO resinate 1 120 Gilboa Street Douglas, MA 01516 1 (508)864-8150 www.iresinate.com The Commonwealth of Massachusetts Department oflndustrialAccidents _ _ Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Dixon Inc Address:361 West Main St City/State/Zip: Northborough, Ma 01532 Phone #:508-393-4411 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 30+/- 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑■ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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: Middlesex Insurance Co Policy#or Self-ins. Lic. #:A0092653005 Expiration Date: 12/31/20 Job Site Address: ��O PIeC,Sw► } City/State/Zip: ✓1°r_A10i`1P+0v 1 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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. Signature: %� Date: Phone#: 5083934411 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#: r Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constrtitti �dpqrvisor CS-097645 E*pires: 07/15/2021 PHILIP J DIXON 361 WEST MA1N ST �f "° NORTHBOROUGH M 2-!" Y Commissioner