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24A-024 (3)
89 RIDGEWOOD TER BP-2021-1382 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24A-024 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: KITCHEN RENO BUILDING PERMIT Permit# BP-2021-1382 Project# JS-2021-002305 Est.Cost: $83784.00 Fee: $546.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: WRIGHT BUILDERS 002612 Lot Size(sq.ft.): 5009.40 Owner: VOSS PAUL B&SUSAN E Zoning: URB(100)/ Applicant: WRIGHT BUILDERS AT: 89 RIDGEWOOD TER Applicant Address: Phone: Insurance: 48 Bates St (413) 586-8287 (116) Workers Compensation NORTHAMPTONMA01060 ISSUED ON:5/24/20210:00:00 TO PERFORM THE FOLLOWING WORK:RENO FOR EXPANDED KITCHEN 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 NORTHAMPTO UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. I: • . . (NT Certificate of Occupancy Signatur: FeeTvne: Date Paid: Amount: Building 5/24/2021 0:00:00 $546.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner 4 The Commonwealth of Massach 2 2021usett FOR Board of Building Regulations and 4andards MUNICIPALITY Massachusetts State Building Code, 7\80 CIVAR,,------- -nowS USE Building Permit Application To Construct. Repair, IketiOy'at Re .iised Mart ar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: gp- Date Applied: A e . LS70 Ya( Building Official(Print Name) Signature Da e SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers VE-Ctkobt> ..V-/ 1.1a Is this an accepted street?yes xno Map Number Pared Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Arca(sq Frontage(it) 1.5 Building Setbacks(ft)kit, NW ())044.v.- -to e,c' i>of-re" AtryAirii- Front Yard Side Yards Rear Yard dr6 *tie. 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: Zone: Outside Flood Zone? Public Private 0 Check if yea5K Municipal IX On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: SOS'6c1J fuL 1\16 t2 714P.rtit•I pvti1/4- °it) ‘,6 Name(Print) City.State,ZIP 1)(1 MAX' V13- 3),t- D-19 S vo ett4A_ No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) Alteration(s)slg Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: (2.EH VF-ti fJ -Po(2- Ai' t?(.1A4--rt> I tu a-0010 i" (4ZS L gr; 1- Va I trkrvv-C 6t-i)LiNe-fm 0 -Dki ims* iusxt. SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials) 1. Building S 3 319 1. Building Permit Fee: $ Indicate how fee is determined: El Standard City/Town Application Fee 2. Electrical grs-. 0 Total Project Cost3(Item 6)x multiplier 3. Plumbing 2. Other Fees: $ 4. Mechanical (HVAC) S List: 5. Mechanical (Fire Suppression) Total AIILFees: $ Check 4.1.4(i Check Amount(19 01.Lash Amount: 6.Total Project Cost: S 'X 3, SYLf 0 Paid in Full 0 Outstanding Balance Due: gt grct Cp•ct 166 5114L. , SECTION 5: CO\STR1 C'T1ON SERVICE : 5.1 Construction Supervisor License (CSL) 0 0 / 9 bi/i2.jt'lfr Vf / 12-0(.7 v.tnrhe: Fs:pirttion Date Name of CSL holder gist lSI T Te lee.halo».) No5 and Street Type D;-sc.iptior. I Unrest! rBu ldind r.i to 15,000 cu. ft) 1\1 q t "N t. AA . l t Regncted iK_'Family Dwelling City Town.State.ZIP "l w1tisonr RC Rodin (uverine ._. — 1111=1 Window and Siding t� SF Solid Fuel Burning.Apphanees I-(113- 1L- '� e.e.,,t/ Uitff t4+-p1111( 6 ,t pj - . l Insulation Telephone E ail address D Demolition 5.2(,R/e@gistereci Home Improvement Contractor(II1C) 6153 lo (/UILI &'?F' " � _.. 1tmeNtf IC Registration Number Expiration Date }i[C C'on p y Name or IC°Registrant\ ere No.and Street ..—. Find_ address- City I own,State.TIP •i eiephonc SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDANT1'(?1.G.L.c. 152.§ 25C(6)) hl orkers Compensation Insurance affidavit must be completed and submitted with this appliearrni Failure to provide this affidavit will result in the denial of the Issuance of the building permit Signed Afridat it Attached? Yesr 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 (�' ' 1,as Owner of the subject property,hcrebt aut})ori7c t kit) to act on y behalf.in all matters relative to work authorized by this building permit app] ' tt<IU eDt1. t n . L �/2. Print Owner's\arne tFiectrcric Sienaturei - Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION 13y entering my name be!osc I hereby attest under the pains and penalties of perjury that all of the information {{f contained in this application is true and accurate to the best of min knowledge and under standing. pp / Print U r e or s Name(Electronic Signature) Date NOTES: 1. An Owner Who obtains a building permit to do his'her own work,or air leaner who hires an unregistered contractor (not registered in the Home Improvement Contractor t HIC:i Program),mill err have access to the arbitration program or guaranty fiend under M.G.L. c. 142A Other important information on the 111C Program can be found at WNt. flOtsS.L Ota Information on the Construction Supervisor License can be found at ee �.,,_itr ts :_a1__(lo 2. When substantial work is planned.provide the internrnum below: Total floor area(sq. ft.) including garage, finished hasemenVanics,decks or porch) Gross living area(sq. tt t I labitahle room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halt baths Type of heating system Number ofdecks/porches Type of cooling system Enclosed Open 3 -Total Project Square Footage"may be substituted for-Total Project Cost" The commonwealth of Massachusetts -• z=1"' — Department of Industrial Accidents ! I Congress Street,Suite 100 Boston, M.-4 02114-2017 1, Iro IVIVIV.mass.govidia ‘Suiters Compensation Insurance Aftidas it: Builders('ontractors/Electriciarisll'Iumber. 10 BE 1:11.1..t)1%I H I 111-, l'f.R1111'11N(;Al 111()R.11) ADDliCIMI Information Please Print g . Name 11 Utittle$51.lrganuat ion Ind uvula!V 6-1-1-1" 15-1.11 (-/P Address: P41-te • City/StatelZip:po 9-1- 4-.PeltAttorsidx4k- 0(0 0 Phone#: I" Li - ra-g-) -- Are t um aa rittplin re!Cheek the appropriate hot: Type of project(required): 1.3 1 am a tnsIo5er stth ernrit,yeen011ii mutat part-tune! 7. El NeW eongruction 2.0 I am a sole pevtwicka to partncrilip and have nu empioyem werkint, fur me In X. Remodeling am,capacit!,„(No V*tickers comp.miunince rectimcd.1 9. Demolition tfa I am a hoinooKno doing all*yds. (No stLert cony,.uourance required.] g Building addition 4,0 1 am a lautakam tier and will he hiring contracion,io conduct all*mk on my property. I veil! immure that all eintuactors either hate winter,'OiliTqwitsalfue insurance tn are style IIa Electrical repairs or additions proorissors with net employees 12_13 Plumbing repairs or additions 1'.71I am a 1..elleial etnniador and I have hued the sub-contractors hso.d on the attached shed. I 30 Roof rspairs These suh-emtractors employern.and have comp.in.-imam:1: 4.Ei°diet 6.C3 We are a cotporsiiim and its officers hate exceclicil their right of ei.cmptain pet Mt c. 132. 1441.and we has...no employer",No*ration.'comp insurance required •An i applicant that clocks b iii Inuit also lilt out the wrinna ivlow show in then ken *atflipCM61111110 pote.s iidoemation. Itoincowners who submit dui atitdayvi mdteaung they arc doing all stork and then hue outside contractors must stannitn a ncit affulai it miticaung such. Icon/moont duet check this box,must attached an additional sheet Atm my the name of th suh-coraractori,and st.iIc whether iw not lirtnc entitle,hate employees lithe suf.-contractor%has,:employees.they must proside their unr‘cr,.`,,ornr I ant an employer that is providing, workers ctimpensation insurance frir my employees. Beliirc is the policy and job iie information. Insurance Company Name: PS • . /\/1 1)11)/11,/ 1 .jc . Ct • #or Self-ins. L. #:AA CC">00-31006C 3114 0 ?"0 11/4- Expiration Dale: 3/ A Job Site Address: F9 1 4 P(rV-IAJt-Db • Cityistate-/_p Pi tfe Attach a copy of the workers'compensation poke, declaration page(showing the polio number and expiration data Failure to ss.eure 1:Overage as required under NiGL c. 132. S X is a criminal violation punishable by a line up to S I.500.(0 and'or one-year Imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a line of up to$250.(10 a day attains'the violator.A copy of this stateinent may be forwarded to the Office of Ins estigatissns of the DIA for insurance coverage verification. 1 do herr*.certify under the pains and penalth.v of perjury that the information!provided above is true and carret-t. Signature: 5-11,L,,t)e,“ 1).„, Phone A% 13 - Official use only. Dv not write in this area. to be completed hy cite or town official (Ti or or Town: Perinitil.icense Si Issuing.1uthority (circle one': I. Board of health 2. Building Department 3.CO 1 ovi ri Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other ('ontact Person: Phone a: -•-" "4,„} WRIGBUI-01 KAYLA A c-dmr3 CERTIFICATE OF LIABILITY INSURANCE OATE(MM10D(YYYY) 311/2021 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 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 c TACT Kayla Marie Drinkwine Phillips Insurance Agency,Inc. i PHONE FAX 97 Center Street tare No,EztI:(413)594 b9$4 I(A1C,Nol:(413)592-8499 Chicopee,MA 01013 E-MAIL s;kayla philli sinsurance.com INSURERS)AFFORDING COVERAGE NAIL* INSURER A:EMC Insurance Companies 21415 INSURED IINSURER B:A.I.M.Mutual Ins.Co. 33758 Wright Builders,Inc. l INSURERC: 48 Bates Street INSURER D; Northampton,MA 01060 INSURER S: 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 INSURANCE1ADDL SUER POLICY EFF I POLICY EXP LTRIINSD-WVD POLICY NUMBER (MMIDD/YYYY) IMM/DO/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I X OCCUR 6018616 3/1/2021 3/1/2022 pREM SES tEa occE�r<r �l $ 600,000 MED EXP(Any one person) $ 10,000 PERSONAL 8 AMINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER_ j € GENERAL AGGREGATE $ 2,000,000 X POLICY X J [ 1 LOG ( .PRODUCTS•COMP/OP AGG $ 2,000,000 OTHER 1 EMPLOYEE BENEFI $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED E SINGLE LIMIT $ 1,000,000 X ANY AUTO 6Z18616 3/112021 3/1/2022 BODILY INJURY(Pet person) $ OWNED SCHEDULED AUTOS��p ONLY _AUTOSpOO EE BODILY INJURY(Per acudenl) $ AUTOS ONLY AUTOSWNONLDY PROPERTY DAMAGE r $ ) $ A X UMBRELLA LAB X OCCUR , EACH OCCURRENCE 1 5,000,000 EXCESSLIAB CLAIMS-MADE 6J18616 3/1/2021 3/1/2022 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION x PER OTH- 7 AND EMPLOYERS'LIABILITY , STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN MCC-200-2000534-2020A 3/1/2021 311/2022 E L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N N/A (mandatory in NH) EL DISEASE-EA EMPLOYEE $ 500,000 I yes describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATORS I LOCATIONS i VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mole apace is requitedl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Co-op Power,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 296 Nonotuck Street#4 Florence,MA 01062 AUTHORIZED REPRESENTATVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD City of Northampton tX. Massachusetts - • S. tr A * DEPARTMENT OF BUILDING INSPECTIONS 4 # f -0 212 Main Street • Municipal Building yooli011et Northampton, MA G1060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, SS4, 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: VA-Gut-17 The debris will be transported by: Name of Hauler: ktA-e\i\H-C e'L-1.- 14 0 USA LuPc-&-ft" Signature of Applicant: i‘ Date: C1)-° ii LP 4-1,11c/b4