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24B-079 (60)
73 BARRETT ST UNIT 5170 BP-2020-1102 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24B-079 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Deck BUILDING PERMIT Permit# BP-2020-1102 Project# JS-2020-001851 Est. Cost: $1600.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JONATHAN DEVINS 083221 Lot Size(sq. ft.): 785822.40 Owner: HATHAWAY FARMS TOWNHOMES LIMITED PARTNERSHIP C/O SPEAR MANAGEMENT Zoning: URC(100)/WP(7)/ Applicant: JONATHAN DEVINS AT. 73 BARRETT ST UNIT 5170 Applicant Address: Phone: Insurance: 73 BARRETT ST SUITE 2000 (413) 586-1405 (5) WC NORTHAMPTONMA01060 ISSUED ON.5/4/2020 0:00:00 TO PERFORM THE FOLLOWING WORK 12 X 15 DECK POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Ser-Oce: 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 5/4/2020 0:00:00 $100.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner r Version 1.7 Cercial BuildinPemitM --l ~R rvo*M-,F- e City of Northampton Status of liermiL• Building Department Curb Cut nvew y Permit r AY - 1 2020 212 Main Street SewerlSe tic A ilabi - 4 Room 100 WaterMgJll Av ability i Northampton, MA 01060 Two Setsbf s DEPT.OP BUILDING,INSPECTIONS PT.OP BUILDING INSPECTION$ s N RTHAMPTON.MA 01060 phone 413-587-1240 Fax 413-587-1272 PlotlSite dans TOP 13 ILDf N —QPTL4A WX N.MA 01 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 73 134rrett Ji- Apii, 6-170 Map Lot —r Unit NortilkMefonl MA 010 Go Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIWAUTHORIMD AGENT 2.1 Owner of Record: H4 � rrns T��h es L,P 73 -&rre$ S4ree+ Ski+e aoob t%jw&ar,pkaMA Name(Print) Current Malting Address: 413 -3t6-1405 Signature Telephone 2.2 Authorized Agent: �LY✓4HrW f7e✓i.�r �tsi�/::.v! Af4,j4-lcJ ei 73 BCrre{f Sfree4- 5•.4c ?Ow NorAr.—P+eNMA Name(Print) Current Mailing Address: 413-.SB(o -1 yaS Signature - Telephone SECTIO -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 Constructlon from 6 3. Plumbing Building Permit Fee #1 4. Mechanical(HVAC) 5.Fire Protection 6. Total-(1+2+3+445) Check Number This Section For Official Use Only _ Buildinn pew it NiuwrtV Date i X20— /oz Issued �. y.2026 Signatu A0 Buil ' issioner/lpspeetorofBuildings Date Version l.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.' .old;.�� , 1;2 Y i5 c(er.k M4 of f1l a b.,e r al' Of Proposed Work: +ke e4p-rt0.%e-?+ for res;4t I+ HSe SECTION 6-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A.1 --E] -- A-2 ❑ A-3 131A ❑ _ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 38 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) 1 at ,1,nud 200 L 3n0 3rd 44' 41' Total Area (sf) 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[:] _ Versionl.? Commercial Building Permit May 15,2000 S. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in 155- Building yBuilding Department Lot Sime Frontaee _ Setbacks Front Side L: R: L.—R: Building Height Bldg.Square Footage — - % Open Space Footage % (W area minus bldg&paved nri OO #of Parking Spaces Fill: (volume&Lotattion) A. Has a Special Permit/Variance/Finding ever been issued forlon the site? NO I& DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 9 DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO is DON'T KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES I* NO O IF YES, describe size, type and location: fwo e.,lrk-+cc .f/jNs cry 3., D Are there any proposed changes to or additions of signs intended for the property ? YES O NO 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 • IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version]-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 36,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address - - --- Expiration Date Signature -- Telephone 9.2 Registered Profeeefonal Englneer(a): - — -- Name Area of Responsibility Address J Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address __- Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address — Registretion Number Signature — --- -- Teleptwne Expiration Date Name -- Area of Responsibility Addreas — —-- — Registration Number Signature Telephone Expiration Date 9.3 General Contractor Not Applicable ❑ Company Name: Responsible In Charge of Construction — Address 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 O No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 071 s � C12- /C S �?�4�II� as Owner of the subject property hereby authorize0 4 �� Ve✓t.rJ S to act on my/byhalf, in all matters relative to work authorized by this building permit application. (10 -4" aGa a Signatur6 of Owner Date I, oo-CAka-J 7)e ,-s 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. faNK fh4� )elr;j.s Print Name `ro7f- o�d� G SignatT6 Zf Owner/Agent Date SECT ON 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: /it ti^' �e✓�,✓ ,5 C s - © $ a License Number 7.3 23cffe tt Sl,ee-1 2coo gLao /aoa Address Expiratio Date -//3-f�E /yos Sig a re 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 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia DATE(MMIDDNYYY) AC"R DI CERTIFICATE OF LIABILITY INSURANCE 08/06/2019 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(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). PRODUCER CONTACT Michael Bonacorso NAME: Bonacorso Insurance Agency,Inc. PHON IAIC. E : (781)937-3200 ac No): (781)937-3202 10 Cedar Street E-MAIL michael@bonacorsoins.com ADDRESS: Unit#32 INSURERS AFFORDING COVERAGE NAIC N Woburn MA 01801 INSURERA: Associated Industries of Massachusetts Ins Co. INSURED INSURER B: Hathaway Farms Townhomes,LP INSURER C: c/o Spear Management Group,Inc. INSURER D: 575 Southbridge Street INSURER E: Auburn MA 01501 INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 Master 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTE CLAIMS-MADE D OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 1:1 PROJECT ❑LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N 500'000 A ANY PROPRIR/PARTNER/EXECUTIVE � N/A WMZ-800-8006102-2019A 07/26/2019 07/26/2020 E.L.EACHACCIDENT $ OFFICER/MEMBMB ER EXCLUDED. (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/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 Spear Management Group,Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 575 Southbridge Street AUTHORIZED REPRESENTATIVE Auburn MA 01501 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents 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 Legibly Name (Business/Organization/Individual): 1141 6LdC_/ i+,n.s /OWr��iah�s iJ Address: Z? T4,refs 5_- e 1:P000 City/State/Zip: ArlhoAplori IU& 0/o60 Phone#: Are you an employer?Check the appropriate box: Type of project(required): I.:K I am a employer with�6 employees(full and/or part-time).* 7. ❑New construction 2.❑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. El 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 arc sole 1 1.❑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. 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: A-TA4 jq,41,,,,c/ Policy#or Self-ins. Lic. #: VJM Z —$00 — 06/Oa "do/y f}Expiration Date: 7X2611,90.1 D Job Site Address: ! -94 r ire -H 511 ee+ City/State/Zip: Mr 1h cm o low R 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. Signature: Date: Phone#: 6 alb, — —f-06 — /Yds- 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#: 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: T73 -Bc�rre4j- cSfree4 The debris will be transported by: ( ,seas W4s+Q The debris will be received by: C4 se 114. 0 Building permit number: Name of Permit Applicant DateSig nature of Permit Applicant D �. LJ 5183 5153 1 6 Laundry 5155 5154 & 2 5182 5156 Storage 5181 ' 14 5180 17 6199 6198 6197 6196 _ 18 5170 5171 5176 5177 )168 5169 15172 5173 5174 5175 5178 5179 o 620 6200 6201 6204 6205 /G O 6202 6203 v ` ti '0 V Jonathan Devins From: vztpositivenotification@verizon.com Sent: Monday, March 30, 2020 1:31 PM To: Jonathan Devins Subject: 20201401820 for Verizon Member Code RJ VERIZN Dear Excavator, Your request to locate Verizon facilities for the ticket identified above has been reviewed. The extent of work described in the request noted above has been compared with our facility records. Verizon has determined that the excavation location and scope of work you have identified does not conflict with our underground facilities. If you have questions or have additional information where you feel Verizon's underground facilities are in the excavation area, do not hesitate to contact our National Facility Locate Call Center at 800-492-3100. Thank you and remember to dig safely! Please do not reply to this email as the account is not monitored.