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24A-022 (4)
83 RIDGEWOOD TER BP-2021-1063 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24A-022 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Bath reno BUILDING PERMIT Permit# BP-2021-1063 Project# JS-2021-001800 Est.Cost: $16500.00 Fee: $107.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: CHRISTOPHER O'CONNELL108508 Lot Size(sq. ft.): 10018.80 Owner: NANCY B SHEEHAN Zoning: URB(100)/ Applicant: CHRISTOPHER O'CONNELL AT: 83 RIDGEWOOD TER Applicant Address: Phone: I►tsurance: 63 WORTHINGTON RD (413) 539-1521 WC HUNTINGTONMA01050 ISSUED ON:3/26/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:RENO BATH ROOM AND RELOCATE LAUNDRY ROOM 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: ' • � • - '.I • FeeType: Date Paid: Amount: Building 3/26/2021 0:00:00 $107.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner _ - _ ____ t J D FL.00�2 P1,61`-� iz AEI VE3 2029 he Commonwealth of Massachusetts Bo d of Building Regulations and Standards MUNICIPALITYR O Ma achusetts State Building Code, 780 CMR FUSE %LNGINECT,ONS.R kermtt A plication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling /� This Section For Official Use Only BuildinnCJ/ Z Permit tN // Number: ►J f%01/-�/C/ Date Applied: (iuI -5, 3.Z -2621 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 s s Map& Parcel N��er 83 83 Ridgewoodod Ter,Northampton,MA 01060 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private ElZone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Nancy Sheehan 83 Ridgewood Ter,Northampton,MA 01060 Name(Print) City,State,ZIP 413-575-3925 nicenancy@comcast.net No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Constructior>r.❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units Other 0 Specify: Brief Description of Proposed Work2:Remodel bathroom,relocate laundry to 1st floor SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $1 000 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $1,500 ❑Total Project Cost;(Item 6)x multiplier x 3. Plumbing $5,000 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fe �q Check No Check Amount: !0'1 Cash Amount: 6.Total Project Cost: $16,500 13 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-108508 06/24/22 Christopher O'Connell License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 63 Worthington Rd • No.and Street Type • Description Huntington,MA 01050 U Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry • RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances • 413-539-1521 ocs413@gmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 184844 5/22/2022 O'Connell Construction,LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 89 Dana Hill ocs413@gmail.com No.and Street Email address Beichertown,MA 01007 413-539-1521 City/Town,State,ZIP Telephone SECTION 6: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 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Christopher O'Connell to act on my behalf,in all matters relative to work authorized by this building permit application. Nancy Sheehan 3/24/21 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is truetr and accurate to the best of my knowledge and understanding. Vega -421 3/24/21 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton 4 , Massachusetts _ e> f A ry DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building v 4, Northampton, MA 01060 s1,31 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: Valley Recycling,Northampton MA The debris will be transported by: Name of Hauler: O'Connell Construction,LLC Signature of Applicant: C�'( n -� Date: 3/24/21 The Commonwealth of Massachusetts Department of Industrial Accidents 1,,,, •• I;> '' I Congress Street,Suite 1017 z Boston, s'fA 02114-2017 www.mass.gov/etia !others'Compensation Insurance Aifidit%it:Builders/('ant;r:actnrsfElectricinnstPlumhers. "clot BE:FILED WI ttl'HIE PLR%1 t I Ilso:At l lltOR1TY, Applicant Information Please Print I:eeibiv Name i fins inesg1lr a tun t tow Individual j: O'Connell Construction, LLC Address: 89 Dana Hill City/State-zip: Belchertown, MA 01007 phone #: 413-539-1521 Art yea an employer?Cheek the appropriate twit: Type of project(required): t.Q I ant a employer with ,2 _._._ennsloyees(fait sndror parr-tirne).+ 7. 0 New construction 20 t am a sole profiritmaror partnership and haw no errasksyees woriiing thr tine in 8. t'"j Remodeling any capacity.[No work insurance inquired," 'coop.insura L15 10 I am a homeownerdoing all*odemyself.(Nu winters'comp.tmuratree regiuriai_[' 9. ©Demolition 40 1 am a homeowner and will he hiring eontracturs to conduct alt work on iny property. I w li 10 Q Building addition cnsum that all contractors either Ifs e wirrl ere'ctrrnlrenaation mainarftti or air!foie II.©Electrical repairs or additions pn.rpntt.m with nu emptonees.. 12.0 Plumbing repairs or additions .5.c:j1 sin a general eontraetur and I have hared the.wb-contractors.listed on the attached shire t. These sub-contractors has a rtttplkyeea and haw*otters'crap.i union, 13. Root repairs ui. h,j we are a eorp oratrun anti its uflicen have exercised their right ofexan you—I per Wt.c. 14.a Other t Si,>ii4),and we halm no of luyeex.[Nu wurl ers'euinp.insarane requotat] 'Any appli aitt that cheeks box c l mt:t aL u ali out the>^d s below showing their*oriel'compensation policy information, t lttnneowners who subtmia taus afi+da+'it nt<lreatirn,they:are doing all work and then here outside crrtaraetues mast subatat a new affsdaeit itsdit7rring such. 4.anerertcua that chock this,box mot attached an ssldrtamat sheet showing the name of the sub-contractors and state wficthe or nut those entities haw ertrplu±��re f`lthe sub-contractors love etnploir >.tows-nfuat prt'rfile t#info Aurkrn'corny.policy number. 1 am an employer that is providing workers'"compensation insurance for my employed Below is the prolicy and Job site Information. Insurance Company Name: Associated Employers Insurance Company Policy 4 or S It-ins.Lie.ter WCC-500-5022695-2020A >. ptratiun Date: 7/28/21 Job Site Address: 83 Ridgewood Ter, Northampton, MA 01060 CityiState'Zip: Attach a copy of the workers"compensation police'declaration page(showing the police number and expiration date). Failure to secure coverage as required antler NMI-c. 152,*25A is a criminal violation punishable by a tine up to$I,5()0.00 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 rtrfortnatits provided above is true and correct Sinature: C�. - D, W-+t% DDat 413-539-1521 Phone#: 413-539-1521. Officio/arse only. Do riot write In this area.to be completed by city or(own offc:ial. ('itt. or Town: Permit/License Issuing Authority(circle one): . 1. Board of Stealth 2.Building Department 3.t'ity/Tossn Clerk 4.Electrical Inspector 5. Plumbing Inspector a G.Other l ('untact Person: Phone-4: AC LJ CERTIFICATE OF LIABILITY INSURANCE DATE(MM,°D,YYYY) 01/20/2021 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 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 04971 -001 NAMEACT : Banas & Fickert Insurance Agency 4971/1/176 Banas&Fickert Insurance Agency iAIC.No.Ext): 4135272700 La(.No: (413)527-0849 63 Main Street EMAIL Easthampton, MA 01027 ADEss: service@thefairwayagency.com INSURER(SI AFFORDING COVERAGE NAIC 8 INSURERA: Associated Employers Insurance Company 11104 INSURED INSURER B: O'Connell Construction LLC --------- -- INSURER C: 89 Dana Hill Road INSURERD: Belchertown, MA 01007 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 REDUCEEDDyBEYppPAID CLAIMS. I�R TYPE OF INSURANCE "I�sRIAIVD POLICY NUMBER (MM/DDIYYYY) (MMI I DI EX YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES(Ea occurrence) CLAIMS-MADE I OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY UpRO- ECT LOC -- -_ -- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) -. ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED accident) $BODILY INJURY AUTOS AUTOS (Per _ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ - j UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED JRETENTION $ $ MR C EMRPS NSATLTY X T TATIU-S OTH- ER ANY PROPRIETORlPARTNERIEXECUTIVEYtN E.L.EACH ACCIDENT $ 1,000,000.00 A OFFICER/MEMBER EXCLUDED? Y N I A WCC-500-5022695-2020A 7/2812020 7/28/2021 ------- ---- -(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000 000.00 If van describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Christopher R OConnell is covered by the workers compensation policy AND Dominic J OConnell is not covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION CITY OF NORTHAMPTON 210 MAIN ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NORTHAMPTON, MA 01060 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD T t DATE(MMIDD/YYYY) ACX)RD CERTIFICATE OF LIABILITY INSURANCE �_. 01/19/21 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 M NAME: Michael R.Banas Banas and Fickert �((E-PHONE Exd: 413-527-2700 FAX No): 413-527-0849 Insurance Agency ADDRESS: mbIu banasinsurance.com 63 Main Street Easthampton,MA 01027 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Union Mutual Fire Insurance Co. INSURED INSURER 8•. O'Connell Construction,LLC INSURER C: 89 Dana Hill Road INSURER D: Belchertown,MA 01007 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 TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF PMIDDY EXP LIMITS LTR INSR WVD., (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 5,000 A BOP0005285-08 09/01/20 09/01/21 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ 2,000,000 POLICY H PECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 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 LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION I PE AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE_$ If yes,describe under 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) CONSTRUCTION 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. 212 Main Street Northampton,MA 01060 AUTHORIZED REPRiS IVE 15 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 2'-/ 1./2'" S'-011 . i Stacked Washer/Dryer • a Replace tub with shower unit G c Frame opening, relocate laundry i\ a S Convert existing door 3 A to barn door r n Replace vanity R ) 1 i. Tall Cabinet I o * ) . 2'-0" 3'-0" 3'-0" . . March 25, 2021 83 Ridgewood Ter, Northampton, i, I heehnBathroom A 01