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05-018 115 AUDUBON RD BP-2021-1257 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:05-018 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-2021-1257 Project# JS-2021-002086 Est.Cost:$105000.00 Fee: $682.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JIM R BOYLE 107689 Lot Size(sq.ft.): Owner: KOPPELMAN RACHEL Zoning: RR(100)/WP(27)/ Applicant: JIM R BOYLE AT: 115 AUDUBON RD Applicant Address: Phone: Insurance: P O BOX 241 (413) 586-8010 WC HADLEYMA01035 ISSUED ON:4/30/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:KITCHEN AND 2 BATH RENOVATION, FRAME NEW OFFICE IN BASEMENT • 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: (.as: 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. its • ', Certificate of Occupancy Sit;natur 1YI(J FeeType: Date Paid: Amount: Building 4/30/2021 0:00:00 $682.50 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner APR 2 B 2 /'The Commonwealth of Massachusetts 0 2/ Bard of Building Regulations and Standards FOR '' t`5k,,R,'or ``--:..,_. Massachusetts State BuildingCode, 780 CMR MUNICIPALITY ,9trr���irrr iiv USE 1 i(I1dugt, i r Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 -_ One-or Two-Family Dwelling r This Section For Official Use Only Buildin Permit Number: 6P .' -/ -/?j 7 Date Applied: c—t)l0 IZ55 1/, y-Z9-Z6ZI Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Proeerty dress: e 1.2 Assessors Map& Parcel Numbers 1/5 auckibon va ��L .1 01 Y 1.1a 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(It) 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 0 Zone: _ Outside Flood"Lone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2 Ow e r'g o e O l O dcAf R od::pp L ee c�S, �� 53 N e(Pry ICity,State,ZIP 1 J c udu' are R ci (6)t-) 909-9oa 7 rachel. 40p19 1� md1 /Cbm- No.and Street elephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units O her 0 pecify: "ef I escri tion of Proposed Work': _ice/r)D 1, 1 iC PO a 7Z[)0 Da--I j, ms I QC- all n ca! a ne i c) bc� /�Da S, cif � nS�� / �w e l&)�,u) i)T-c P / 1 Do_sernen Crud >°heLe 09 c�) SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ -75 OW l. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ « �(� 0 Standard City/Town Application Fee 0 Total Project Cost' (Item 6)x multiplier x 3. Plumbing $ a 0. COO 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ — Suppression) Total All Fees: kQ Check N GO W Check Amountash Amount: 6.Total Project Cost: $ \O5 WO 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Constructio Supervisor License(CSL) i Di 1,9$/ I a.5 / Jim R le_ License Number / Expir tion ate Name of CSL Holder 'T»en< a ) I 1 I i qusseIIQS* List CSL Type(see below) No and eet �-f1 TT Description a d i diet a' o l(35 (.J Unrestricted(Buildings up to 35,000 Cu.ft.) 1 Y Restricted 1&2 Family Dwelling Ci /Town,St ZIP M Masonry RC Roofing Covering WS Window and Siding(4 8b- SF Solid Fuel Burning Appliances ae.Sil��Ll}rllel1-COtKP I Insulation Telephone v Email address 1"?e.I D Demolition iRe istered jliome Improvement Contract (HI ) j � �c(� d J (poi? en (l T�,1�C PdS� HIC Registration Number Ekpiration Date mnyaiiror s1(1, .Q(jN e Ill j c rje,s n CD1'l ieo-CGncep ne t- t a c 01 Q (Lit3),57gb35CID v Email address Q i /Town S te,Z 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 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 cr n R 8 O le /Ji Op Cot e pts to act on my behalt';in all matters relative to work authorized by this build permit application. �achel oDpelma.o -I` I1.�i �aoa1 Print Owner's Name 'atonic Signature) 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 true and accurate to the best of my knowledge and understanding. r R . B og le_ uk \ q_Dlaoal Print Owner's or Authori e 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" *Ilf 'F#A7i7)0`)r—I*0+KTro EI7tchei Kitchen Concepts&Design Center,LLC * * �td� 1, ' R j 0: 1 r !{houzz O11celJtS > i ` M�,i h,,i M I N I M M, �� � BBB P.O.P.�Box 202ts 2049 b'IS "'I) 1 , III Vag DREAM a DESIGN DELIVER Hadley.MA 01035-0241 2 0 2 tl e.�tes.tiiigatzti`I :1WIiLI4:iliL'L maiI�I1miairatazi�al PuslNEss CONSTRUCTION SUPERVISORS LICENSE Recognized by the Commonwealth of Massachusetts as a Supervisor. Superior knowledge of Massachusetts laws and code are mandatory. Testing and years of experience are required to receive this license. z. . Commonwealth of Massachusetts +ris Division of Professional Licensure Board of Building Regulations and Standards C o nstruttiohttipervi sar CS-107689 Eatpires: 10/25/2021 JIM R BOYLE- PO BOX 241 HADLEY MA 01035 ____________- t Commissioner Axw.c.)y'4 License#- CS 107689 HOME IMPROVEMENT CONTRACTORS LICENSE Required for remodeling existing property. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:LLC Rnuictration Expiration 193350 1011012022 KITCHEN CONCEPTS&DESIGN CENTER LLC JIM R.BOYI F 117 RUSSELL STREET I; 71,^'.i,' HADLEY.MA 01035 Undersecretary License #-180308 • All licensing information can be obtained through government agencies. Insurance coverage binders and references are furnished upon request. • Office: (413)586-3506 • Fax.• (413)586-8051 • Email: design@kitchen-concepts.net City of Northampton _ ``�ti� lSCirli. ... Ci Massachusetts ? - << �,/ Al. , *: , �, '��ss 4 � ��� DEPARTMENT OF BUILDING INSPECTIONS y '�� ( y jx, 212 Main Street • Municipal Building Ica. Northampton, MA 01060 s[1q"a),j1'� 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: dUrr7p3 l'eA3 Location of Facility: am ir)eas-/- //'-,uC/-f ij The debris will be transported by: Name of Hauler: arrd)er,S /'�C�s / j Signature of Applicant: UT) Boyle,„, Date: Li r b//aC Ig pp 1 The Commonwealth of Massachusetts ►. �, t- „__ ►_ t.I Department of Industrial Accidents ==in;_ I Congress Street,Suite 100 :r r,'fit=f� Boston, MA 02114-2017 � `L+=,l ww mass.gor/dia Workers'Compensation Insurance Aflydavit:Builders/'ontractorsfElectricianslPlumbers. TO BE FILET WITH T'tlg PERMITI1'YC:AUTHORITY. ltiplieant Information , Please Print ',mails Name i Businesst?rgantzaiiotu Individual): �.. --.--- Address: 111 U SSf 11 c am/ Po ocv. a Li ii City/State/Zip: D((35 Phone#: (4i jg 6 -go ! O• _. Are you:an employee caec@ tar hair: Type of project(required): i 121tam a employer with Ai_._ ecitrtlayues(full and or part-time t-' 7. 0 New construction I am a sole propriciuror partnership and hate no eraipktyez'work mg tar an in 8. Igt Remodeling arary capacew.No workers'eianp.insurance required.) I am a lumanowna doing all work myself.[Nu workers"comp.insnraai required"" 9. D Demolition 10 0 Building addition -i.Q l am a home aw ner and w ill be hiring contractors to conduct all wink on my pntpe-rty. I will m ate that all contractors either Lase aurl:c-ts'compensation insurance ur are sole i I. Electrical repairs or additions proprietors w nth no arrployees. l 2.©Plumbing repairs or additions :sfjI am a general contractor and I leas c hind the suer eunuacturs listed on the attached sheet- These sub<uatracturs have cYnployee's and love workers'carp.insurance.: l Roof repairs h.Q We are a evaporation and its officers hate exercised their right of ca errptiatt per Nita.c. 14.❑Other IS!)t(i),and we lase an anpiuyces.No workers"comp.insurancerequrnd.) 'Any applicant that cheeks box sty meat also fill out the section below straw nog their workers'compensation policy information. 'I lonsu wners w bo submit this aff ul asit indicating they are doing all work and then hire outside cwuraetcors mtui submit a new afisdas it ialie-uatg sock :Contractors that check:this boa most attached an additional dial show inLe Elite name of the.sul►.contra:tun and star whether or not those aetities have cnrpluyeea. lithe sub-oatractars base en;t►oyoex.they oust provide their worker:,"wrap.policy number. !am an employer that is providing workers'compensation insrrmice for nsl'employers. Below is the policy and job site information. Insurance Company Name: qa►0LS-IrF 4- dine rIca ass lq 00• .— Policy#or Self-ins.Lie.#: L[f Li co Expiration Date: I 13 I /a C1,.- - Job Site Address: 11 5 CI LlCLU., 0 ) O ad City/State/Zip: Lee cl- Ile G o i O-Z Attach a copy of the workers'compensation policy declaration page(showing the policy number and expation date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 atnifor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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 :ins and penalties of perjury that the information provided above is true and correct ' 4 I 1 h I Z.O- I signature: R. • e ( Date: Phone#: (L ) 55i to- R O‘b • Official use only. Do not write in this area,to he completed by city or tarn official I ('its or Turin: Permit/License# _ Issuing Authority(circle one): I.Board of Health 2.Building Department 3.('it, Town Clerk 4.Electrical Inspector 5. Plumbing Impector 6.Other Contact Person: Phone#: A`ORE1 CERTIFICATE OF LIABILITY INSURANCE DATE (MM2 Y) 02 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 Barbara Van Mourik NAME: Finck&Perras Insurance Agency Inc. Nitro, PHONE (413)527-5520 FAX (413)527-5970 Ea itr 'Exn): Pe (A/C,No): 6 Campus Lane ADDRESS: bvanmouri f'inckandrras.com INSURERS)AFFORDING COVERAGE NAIC 0 Easthampton MA 01027 INSURER A: Main Street America Assr Co 29939 INSURED INSURER B: NGM Insurance Company 14788 ASAP PAINTING INC INSURER C: PO BOX 241 INSURER D: INSURER E: HADLEY MA 01035-0241 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2012104677 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INS° WVD POLICY NUMBER (MM/DDIYYYY) (MMUDD/YYYY) IJMRS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000 TO RENTED CLAIMS-MADE X OCCUR PRDEMISESGE (Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 A MPB49466 05/05/2020 05/05/2021 PERSONAL BADVINJURY $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 XI POLICY JEa LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ 100,000 B --' OWNED SCHEDULED M9B49466 06/20/2020 06/20/2021 BODILY INJURY(Per accident) $ 300,000 AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ 100,000 X AUTOS ONLY X AUTOS ONLY (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PERTUTE ERH AND EMPLOYERS'LIABILrTY Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A WCB49466 01/31/2021 01/31/2022 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/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 ASAP Painting,Inc ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE aadtd. ,1ift ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD itchen Kitchen Concepts&Design Center,LLC * ;►'S I I*�H01 ENO! E EMI E �HUI E �HUI E EMI E houzz OnCi t►S MA 0 03 inrwin G G BBB. Hadley,MA 01035-0241 2 0 2 0 WINNER WINNER WINNER FINALIS7�INALIS7 WINNER usin is° DREAM m DESIGN m DELIVER April 16, 2021 City of Northampton Building Department 212 Main Street, Room 100 Northampton, MA 01060 Subject: Building Permit 115 Audubon Road, Leeds To Whom It May Concern: Enclosed please find our building permit application and payment for the building permit for 115 Audubon Road, Leeds, MA. If you have any questions,please contact me at (413) 586-3506. Thank you, Luau L. era-w Luann L. Brown Executive Administrative Assistant :11b • Office: (413)586-3506 • Fax: (413)586-8051 • Email: design@kitchen-concepts.net /--344" ,( /-17a' / 17$'/ 1 J .n— 8�a ___.__.._ / 7- i y G.)A .449 - /14 "/ e i ( DRY.FRONT pcct ,... ss, ), —, , . .‘,..,- 'I-. T ' b ",. - II :..- 36 ---• tv to N v it com m J/ I a 1 Ch ' i. il c''' -V, 4 0 6'r 28 - _ _69'„. i v co "'f_ t n, _ 102IN ZI .._..._._._.____.__. ________.T___58zo...__- T All dimensions_size designations Kitchen Concepts This is an original design and must Designed: 3/4/2021 given are subject to verification on Design Center, LLC not be released or copied unless Printed: 3/15/2021 job site and adjustment to fit job 117 Russell Street applicable fee has been paid or job conditions. Hadley,MA 01035 order placed. (413) 586-3506 Brian_Rachel BATH - 2-27-21 All Drawing#: 1 No Scale. • -__. _...___-.__ 121 2" __,r / 30" _... _.___43 z _ f.__._.__. .... 48" / 4 11" t " J 3" -/ - I-- _ +-iw 7 �h V W N. O '\.. J O O (. �. -NI , sink - pedestal / 24" / 30" '14;�" / 17 ' can get set at lower or h.d. -< 18 �- CO cv 32" � �� CA) '� N I I < 1 ,- m V42 I B CO (N \ 1. co (r,, 0`) 0 r 42 a" -_.,.24"_. E / : t3 ' /15 / —58 4 ,� —36 2 /. ._ 74" 472,E All dimensions_size designations Kitchen Concepts This is an original design and must Designed: 3/4/202( given are subject to verification on Design Center, LLC not be released or copied unless Printed: 4/29/2021 job site and adjustment to fit_job 117 Russell Street applicable fee has been paid or job conditions. Hadley, MA 01035 order placed. (413) 586-3506 Brian_Rachel NEW BATH smaller tub -2-27-2.1 All Drawing#: 1 No Scale. bat► ,1, 45,6 5,. /1416" 7 t -.)J". I �i�, <__ __ *m [i, h..i -/ $I A.; I r,,,, (00 Lil- ' (I-tjr::,,„, __ ---- , „,,,,,„ 'I' r,isi,;;.;,,,',4,,,,:, 03O V)N WW I ) W co) i 1 ti \ 1 �\ 0 / 39 / 21" _-- , ._._ 6O" All dimensions_size designations Kitchen Concepts This is an original design and must Designed: 4/22/2021 given are subject to verification on Design Center, LLC not be released or copied unless Printed:4/29/2021 job site and adjustment to fit job 117 Russell Street applicable fee has been paid or job conditions. Hadley, MA 01035 order placed. (413) 586-3506 LOWFR GUEST BATHROOM 4-22-21 All IL)rawing ft: 1 No Scale. ,` F:;ram +x; � �.,, Q✓. ye;td., 'n'- °I xet -. • ',?'4,4=',-, i�x'4 ,` f4 • S u>3 '�9:Iti b t' k.,_ ....,,,,, ..... ,...0.,,,z,,,f!` 441.403**i "' , ,;. ".• 7 , , ,. } t f