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31C-081
117 OLANDER 18A& 18B BP-2020-1011 GIS#: COMMONWEALTH OF MASSACHUSETTS MV.-Block: 3 1 c-081 CITY OF NORTHAMPTON Lot: - PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:NEW DUPLEX BUILDING PERMIT Permit# BP-2020-1011 Proiect# JS-2020-001706 Est. Cost: $202000.00 Fee: $1790.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SHAUL PERRY 065400 Lot Size(sa. ft.): 273873.5_5_ Owner: SUNWOOD BUILDERS Zoning:py Applicant. SHAUL PERRY AT. 117 OLANDER 18A & 18B Applicant Address: Phone: Insurance: 84 POTWINE LN (413) 259-1000 WC AMHERSTMA01002 ISSUED ON:3/13/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-NEW DUPLEX 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 Sianature: FeeType: Date Paid: Amount: Building 3/13/2020 0:00:00 $1790.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2020-1011 APPLICANT/CONTACT PERSON SHAUL PERRY ADDRESS/PHONE 84 POTWINE LN AMHERST (413)259-1000 PROPERTY LOCATION 117 OLANDER 18A& 18B MAP 3lc PARCEL 081 ZONE pv THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid son Building-Permit Filled out Fee Paid 1 Typeof Construction: NEW DUPLEX New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 065400 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN ORMATION 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 I T 3 I V ao Sign ure of Building Official 10 Date 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. Department use only r_rsrjY City of Northampton ti Status of Permit: Building Department Curb Cut/Driveway Permit I k „ny u 212 Main Street : 1 ewer/Septic Availability Water/Well Availabilit Room 100 oCoZ y Northampton, MA 01060 0 8(y?� Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 PloUSite 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: !p p This section to be completed by office Alelg_T,/ 1p a Map L Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: NNit int) Curr t Mailing Ad ss: Te ephone 2.2 Authorized Agent: 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 mot 000 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing 1O 000 Building Permit Fee 4. Mechanical (HVAC) r7 ?0 5. Fire Protection 00o 6. Total = (1 + 2 + 3 +4+ 5) 000 Check Number ---14-1 This Section For Official Use Only �,�- a� ��D�/ Building Permit Number: DateIssued: Signature: 'Sz) Va(3 Ulu Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size G �cres Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage 01' 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 DONT KNOW Q YES )07 IF YES, date issued: IF YES: Was the permit r corded at the Registry of Deeds? NO Q DON'T KNOW Q YES IF YES: enter Book 13 013 Page #0 and/or Document# B. Does the site contain a brook, body of water or wetlands? NO X DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q , Date Issued: C. Do any signs exist on the property? YES NO O IF YES, describe size, type and location: CW Xt.5 f ��Mi y �. ��d 001,04 D. Are there any proposed changes to or additions of signs intended for the property ? YES0 gr NO IF YES, describe size, type and location: E. Will the construction activity disturb (clea ' ,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO Q 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) E] Roofing Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [[] Siding [p] Other[Co Brief Desc, tion of pwposed Work: -0 r i ry Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: 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? Q_ d. Proposed Square footage of new construction. Dimensions e. Number of stories? tJ/ f. Method of heating?_T/ kcj Fireplaces or Woodstoves Number of each g. Energy Conservation Compli nce. Masscheck Energy Compliance form attached? 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 O , k. Will building conform to the Building and Zoning regulations? _2� Yes No. I. Septic Tank City Sewer-K— 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, Pcrfy , as Owner/Authorized Agent hereby declare that fa statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed u der the pains and penalties of perjury. tlqllawl cP Print Name 1,9W40 Si na f Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction S ervisor: Not Applicable ❑ Name of License Holder:- 5/ 65 i �D�/�00 4Licenseumb r zafle-l- now DAddress ate - DOD S' na Aoi I elephon 9. Registered Home Improvement Contractor: Not Applicable ❑ gzmog/ Company Name Registr do Number 1, y/'1WDA(" Z. Address / 1 Ex rati n Date Telephone 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 4 s P Massachusetts = ply DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 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. Prior to performing work on such homes, a contractor must 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 pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work:• / yJibo Est. Cost: Address of Work: Date of Permit Application:_3/47 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):6,onwood 3cw_Zn&igv1 omys Av 0,w y Building not owner-occupied / _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, I h eby ap for ilding permit as the owner of the above property: 19 Ida 0 Da er Name an ignature City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building `r 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 au ///;�'Q/or1C�c�/' ,D';, (Please print house number and street name) Is to be disposed of at: "�'W nj (P ase print ameaIT7,otation of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Si u e of Permit Appy a 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 s Department of Industrial Accidents a I 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 Le ibl Name (Business/Organization/Individual): Address: 0, City/State/Zip: OIPV Phone #: �i(3'09'�ODO Are you an employer?Check the appropriate box: Type of project(required): I i am a employer with _employees(full and/or part-time)." 7.�rNew construction .❑I am a sole proprietor or partnership and have no employees working for me in 8. DRemodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.7 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 [:]Building addition 4.[:]1 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 11.0 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.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#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. tContractors 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: _We-�Lol C171r;tMe-Z Policy#or Self-ins.Lich, #:W 1z8oa8o��l.SBdQ/9,w Expiration Date: Job Site Address:��TDf�tr Orlye/ City/State/Zi ZlQf X1060 Attach a copy of the workers' compensation policy declaration page(showing the policy number and Apiration 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 verificati I do hereby certif under ep r s and penalties of perjury that the information provided above is true and correct Si ature: Date: LIAT X000fv Phone#: w-IbAd 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#: AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD/YYYY) 03/09/2020 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 Kathy Parker NAME: Webber&Grinnell HONE Ext): (413)586-0111 A/C No): (413)586-6481 8 North King Street E-MAIL kparker@webberandgrinnell.com ADDRESS: INSURERS)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA: Selective INSURED INSURER B: AIM 33758 Sunwood Builders,Inc. INSURERC: Attn:Shaul Perry INSURER D: 84 Potwine Lane INSURER E: Amherst MA 01002 INSURER F: COVERAGES CERTIFICATE NUMBER: CL203512689 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 AUOL15UUK ICEFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD1YYYY MM/DDfYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �/ DAMAGE 10 REN I ED 500,000 CLAIMS-MADE I e%l OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 15,000 A 02932000 03/04/2020 03/04/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO- ❑ 2,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED XSCHEDULED 02932000 03/04/2020 03/04/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident Medical payments $ 5,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESSLIAe HCLAIMS-MADE 02932100 03/04/2020 03/04/2021 AGGREGATE $ 1,000,000 DED I X1 RETENTION $ 0 $ WORKERS COMPENSATIONPER Y/N OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBER EXCLUDED? � N/A WMZ80080056582019A 05/22/2019 05/22/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 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 ACCORDANCE WITH THE POLICY PROVISIONS. 240 Main St AUTHORIZED REPRESENTATIVE Northampton MA 01060 �Jll ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Home Energy Rating Certificate Rating Gate: 2020-03-13 HIS Projected Report Registry ID: HERS Ekotrope ID: BdNOwjGv HER F: Index • Savings Your home's HERS score is a relative lander Drive 18A performance score.The lower the number, Northampton, A 01060 the more energy efficient the home. i $2,392 Builder: 3 learn more, t • . an averagehome Sunwood Builders Your Home's Estimated Energy Use: This home meets or exceeds the Use EMl3tul Annual Cost criteria of the following: Heating 4.2 $205 2015 International Energy Conservation Code Cooling 0.4 $16 Not Water 2.3 $108 Lights/Appliances 14.8 $681 Service Charges $72 Generation(e.g.Solar) 0.0 $0 Total: 211.6 $1,082 HERSAndex Home Feature Summary. Rating Completed by: µmer�t,xr Home Type: Duplex,single unit Energy Rater:Adie Maynard Model: N/A Community: VHCoHousing RESNE6 ID:9463452 �'� Rating Company:HiS&HERS Energy Efficiency .. n Conditioned Floor Areas 1,008 ft Mailing:12 Perkins Ave.Northampton MA 01050 Number of Bedrooms: 3 4136588784 loo Primary Heating System: Air Source Heat Pump-Electric-3,66 COP Primary Cooling System: Air Source Heat Pump-Electric 18 SEER Rating ProvidenEnergy Raters of Massachusetts Ito2 Woodlawn Street Amesbury,MA 01913 Primary Water Heating: water Heater-Electric-3.55 Energy Factor 978-270-3911 House Tightness: 284 CFM50(0.98 ACH50) Ventilation: 45 CFM-24 Watts .a „o Duct Leakage to Outside: Untested TM%n•+na Above Grade Walls: R-28 ZeroEf= i10 Ceil'i'ng: Attic,R-60 —✓c~ o Window Type: U-Value:0.23,SHGC:0.21 Adin Maynard,Certified Energy Rater Foundation Walls: R-15 Digitally signed:3113120 at 10:31 AM Ekotrope RATER tlt Pl The Energy Disclosure This report does not • • Nome Energy Rating Certificate Rating Date: 2020-03-13 HIS Projected Report Registry ID: HERS Ekotrope ID: x25Nn11L IndexHERSIO • Annual • Home: . • • { performancescore.The lower the b, • r r t 01060 the more energy efficient the home.To Builder: 35 learn more,visit www.hersindex.com *Relative to an average U.S.home Sunwood Builders Your Nome's Estimated Energy Use: This home meets or exceeds the Use IMStul Annual cost criteria of the following: Heating 4.1 $200 2015 International Energy Conservation Code Cooling 0.3 $12 Hot Water 1.9 $87 Lights/Appliances 13.0 $601 Service Charges $72 Generation(e.g.Solar) 0.0 $0 Total: 19,3 $972 HERSAndex Home Feature Summary: Rating Completed by: M—f—P Home Type: Duplex,single unit M Model: N/A Energy Rater:Adin Maynard.. i8 Community: VHCoHousing RESNEi 1C19463452 �a z Rating Company:HIS&HERS Energy Efficiency Conditioned Floor Area: 816 ft to Mailing.12 Perkins Ave.Northampton MA 01060 Number of Bedrooms: 2 Retwence4136588784 Home �� ioo Primary Heating System: Air Source Heat Pump•Electric•3.66 COP Primary Cooling System: Air Source Heat Pump•Electric•18 SEER Rating Provider:Energy Raters of Massachusetts 2 Woodlawn Street Amesbury,MA 01913 Primary Water Heating: Water Heater•Electric•3.55 Energy Factor 978-270-3911 House Tightness: 258 CFM50(1.11 ACH50) a Ventilation: 41 CFM•24 Watts Duct Leakage to Outside: Untested 73 This Hoeg Above Grade Walls: R-28 zero Energy 40 Ceiling: Attic,R-60 i H o Window Type: U-Value:0.23,SHGC 0.21 Adin Maynard,Certified Energy Rater Foundation Walls: R,15 Digitally signed:3/13/20 at 10:33 AM Ekotrope { ekotrope The Energy Rating Disclosure for this home is available from the Approved Rating Provider, This report does notconstitute