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23D-154 (4)
130 HINCKLEY ST BP-2021-1533 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23D- 154 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CON'IRAC 1 ORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2021-1533 Project# JS-2021-002549 Est.Cost: $12000.00 Fee: $78.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JOSEPH DENETTE 113824 Lot Size(sci. ft.): 44431.20 Owner: SNYDER JOYCE ANN Zoning: URB(100)/ Applicant: JOSEPH DENETTE AT: 13.0 HINCKLEY ST Applicant Address: Phone: Insurance: 102 ALDRICH ST (413) 563-5759 SOLE PROPRIETOR GRANBYMA01033 ISSUED ON:7/1/20210:00:00 TO PERFORM THE FOLLOWING WORK:10X12 SCREEN PORCH 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. I • ).2 VAIIT Certificate of Occupancy Signature: ' �/ FeeType: Date Paid: Amount: Building 7/1/2021 0:00:00 $78.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner RECEIVES.:.; - ; 1 I The Commonwealth of Massachusetts JUN 2 4 2021 Board of Building Regulations and Standards FORMassachusetts State Building Code, 780 CMR 1VUAIICIPALITY DFPT OF GUilf)IN,INISPFC'iONS USE Building Permit Application To Construct, Repair, Renovate4W15�615 1^°o'e soBevised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number:6 P• Z1 —/,S'3 Date Applied: a, Building Official(Print Name) ►gnature �� to SECTIO 1: SITE INFORMATION 1.1 Proper Address: 1.2 Assessors Map& Parcel Numbers /30 Alex ji .239 a30-/sy-OD/ 1.1 a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: A-ro/We. .d2 Si l 74‘,.-74 /.va Iefj/515 ,' f . 5 Zoning District Pro sed Use Lot Area(sq ft -'/, '. Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public El Private El Municipal Outside Flo . Zone? Munici al On site disposal system 0 Check if yes��, p p° SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Reco d: J b.-4c - A 5 t,Lr2— 41.b L ncs., IYlcL- o i o roZ Name(Print) City,State,ZIP 130 }-E t.n UA. Sk 4 13-5&4 - 114 )61 SYv‘a tAct 1 a,\NZ, Co(Y1 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK' (check all that apply) New Construction ❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition Ia Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': /6 ')(/s' Sc/ .) POrcdc a,f ttr.,- 9 Art4.$i' . SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 42, OI+Gt 1. Building Permit Fee: $ Indicate how fee is determined: 0 Standard City/Town Application Fee 2. Electrical $ '" 0 Total Project Costa (Item 6)x multiplier x 3. Plumbing $ ,rh9 2. Other Fees: $ 4. Mechanical (1 VAC) $ ,v//X List: 5. Mechanical (Fire $ Suppression) n t Total All Fees: $ Check No.11(5. Check Amount: �� Cash Amount: 6. Total Project Cost: $ A?) tz,t) 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Cs 3yav �� t Vei'e License Number Expiration ate Name of CM.,Holder /V 42 gkeel W List CSL Type(see below) No.and Street Type Description �r��ax �` O/D J 23 U Unrestricted(Buildings up to 35.000 cu. II.) City/Town,StZI>S R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 0.3-5 3-S7fl eketiep��,, mat/.COM I Insulation Telephone Email :a a ess D Demolition 5.22RRegistereed Home Improvemeentt Contractor(HIC) /96/g7 cs 7 ACV Its--ep * /,e~//v HIC Registration Number xpiration Date HIC CompanyName or.I-JC Registrant N e / /o a /dr, # .S7'c hie ctfen ,Rs�'/'ia1mr ,t/con7 Ng,and Street Email address City/S , /17A . ev43.7 c//3-$63-S-7S9 ,'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 No .❑ 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 Jte'A, z to act on my behalf,in all matters relative to work authoriz by this building permit application. � f S G Si L . jlgr 2--(Print OWner's Name(1�1 me 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 true and accurate to the best of my knowledge and understanding. p- Ctrs 57-74, , s f(C f 2. Print Owner's or Authorized Agent's Name(E ctro c 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.) /A) ff- (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 v 3. "Total Project Square Footage"may be substituted for"Total Project Cost" i I City of Northampton el1-44 l Massachusetts - L i. y '/�{1 _1 ` DEPARTMENT OF BUILDING INSPECTIONS ," �.o. ' 212 Main Street • Municipal Building Northampton, MA 01060 145. ,t". HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, l'-f, 2.02_I 11 (.4 1171,1 3174/ l r— (insert full legal name), born ,, (insert month, day, year), herein]depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualifij for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this .1171 day of /) kw/ , 20 2-/. C. L� ��,--, tit../ (Si lithe)lithe) U( The Conuuonweulth of Massachusetts =1 Department of Inrtt�striu1 Accidents �.L" kr ,_ �� 51 1 Congress Street,Suite 100 -_,i Bo,tt►n MA Ott Est www nrass gov/die 11 orkerv'Compensation Insurance Affidavit: Buildere/'Vuntr*ctur ElectririansiPlumbrr s. 10 BE 1,11.Ei)Willi'III PENNII f17N41;AU1110K1 11. Applicant information h �- / Please Print Let:ib Name:licit-aaac.s a it anajat:.),.ti:da+.i.lu.alt- VQS1.ph ?,"(� Address:70v; f9/1// 1) : City/State/Zip 6,72„E„ /%' 0/033 Phone#: "51/3- .-6.3 .5-I5-9 Ant.an.mill. vr'Check tti a WINO/latr IMO%: 1'ypeof project 4rvqui red 1 I...2 I 3311 a employ r with cngnloyees iiidi Anatol part-dame}.' ]. New ctrtI.Iruclion �t I Jn9 a!K3k 11410pr•i,.M.tr ate g ernes kiln ask!h 1.VW c^mttkeysx.*tilt MI! k r ow Hi 8. O Remodeling �1 my capacity.thin wa!riara'comp.insurance required. 9. El Demolition i 71 1 aln a homoo rerd.nng It WO&myself:lNu w'ulk.es'cough.insui ince required.] i.�I am hlnauvwlwr and will be hu art cart -toss tan conduct all wit.,tin my twuputy. I will 1 t1 A Building addition ensure that all contractor,either have wenkcrt'compensation Miura ace or ane vat.: 91.1:::1 Electrical repairs or additions prupriet.as with net employee,. 12.0 I luttthing repairs or additxms I and a}moral colatl:it:i.,r and I have lima file slap-c.aatta.tura hsu.i ,31 the attached sheet. 130 Root repairs ilk,.nits-,:o lta.i.tr ilAVC 43111 hly1X%Ancl b11024: Orke ,ra'comp_11a, =KV.: 1..❑()deer I,Q 1#i,ate a corporationand 11s.vlliccr,have c><.rci+cd their right of c',minticnr per MO..... _.-----_---_. t i2.(tot,and we hake feet:ltaploycc. !No«;Ater,'comp.insula,:.c regullcJ.i ''.Any applicant that check,box#I emcee also 1i1l colt the welkin below dux.,am their workers'ctlngxnteatatm policy nrtiwanation. 'a I loincoonict1a who'oilman dna affiltrcit indicating they Ar..hairrgt all w.1r&end then hie outside c.nalr.x Wes roust submit Anew affidavit indlutlnt^such. :(';>nlractura that check this bon anise AWN:.(an additional Jacut showing the mane a»t'tlkc stile-esnrtrackw%anad state wcls..hci.rod not those entities have :i,:,I.sn.. If the h actors have einpl ycc.they nwst picycidethetr %Nori.rr,'.r asp.tw>lrcy number. I um an employer that is providing workers'compensation insurance for my employees_ Below is the policy and job site in/ilrmatiun. Insurance Company Nance._ Policy#or Self-ins_Lie.fit: Expiration Date: Joh Site Address: ('ity.StatelLip. __. Attach a copy of the workers'cumprusatiun policy detlaratiun page(showing the policy number and ei.piration date). Failure to secure coverage a..required under MGL c. 152. ,:,,25A is a criminal violation punishable by a tine up to$1.500.(Nl and/or one-year imprisonment,As well as civil penalties in the form of a STOP WORK ORDER and a line of up to$2500I a day attains"the violator.A copy of thus statement may be tinrwardcd to the O$ice of Investigations of the DIA fur insurance coverage verification. I do hereby certif?ender the pains and penalties of perjur t that the in formatiotr provided above is true and correct_ Signature: [ d . 0j st Date: 6,c7 c5�/�-4 9) Phone b: 9//..'s'- 5-6":3-5-,S 5 Offkial use only. Do not write in this area.to be completed by city or town official ('its'or Town: l'ermitrl.ierase St Issuing Authority(circle one): I. Board of Ilealth 2.Building Minn-intent 3.Cityil osen( krk 4. Electrical Inspector 5.Plumbing Inspector 6.Other ('nntact Person: Phone$: City of Northampton ,..-r4:4\ .. Massachusetts ;� kt ' r DEPARTMENT OF BUILDING INSPECTIONS '..a• 6� .� 212 Main Street • Municipal Building — Northampton, MA 01060 't!,,. �%'\ ti -1,. 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: /474 ,ezzc rinr9 .35/&37 �ari y.747kJ '4 The debris will be transported by: Name of Hauler: clsc�A . ztT J�9,17e-744 Signature of Applicant: ��/ Date: 031/..q.z.z/ • V-7' sP .�' �_�aJ��l?t � �/ ems.wr.af-sr. I �rw. 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" , Client#: 22843 DENJO2 ACORD..., CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYV)4121/2021 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 CONTACT Samantha DeSantis Baerman-Jubinville Ins.Agency PHONE(A/C,No,Ent):413 538$293 FAx No): 413 538-5970 (I11C, 39 Lamb Street ADDRESS: samanthad@jubinville.com P.O. Box 789 INSURERS)AFFORDING COVERAGE NAIL A South Hadley,MA 01075 INSURER A:Preferred Mutual Insurance Company INSURED INSURER B Joseph E. Denette INSURER C: 102 Aldrich Street INSURER D: Granby, MA 01033 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 EFF POLICY EXP LIMITSLTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY BOP0100728322 02/01/2021 02/01/2022,EACH OCCURRENCE51,000,000 PREMISES(F X COMMERCIAL GENERAL LIABILITY ENTxtence) $50000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEM_AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 PRO- POLICY JECT LOC — $ AUTOMOBILE &� COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident), $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S _ DED RETENTIONS WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (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(Attach ACORD 101,Additional Remarks Schedule,if more space is required) These are the limits at policy inception CERTIFICATE HOLDER CANCELLATION Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Inspector ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main St#100 Northampton, MA 01060 AUTHORIZED REPRESENTATIVE L4 If R. ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S32509/M32508 SBD Commonwealth of Massachusetts ' t " - Division of Professional Licensure ! Board of Building Regulations and Standards • Cons�wdtI rvisor. ii CS=1.13824 - pires: 12/30/2022 JOSEPH E DENETTE , 1. • 102 ALDRICWSTREET ;. _ *GRANBY MA-Q1033 i}1!S•1:.1°` - 1 Comrftissioner / �-N. .fie Wim..""°wa _ p{ryoe oY Consumer Affair&�siness Reguiation HOME IMPR dCOINTRACTOR aggilagfte= 0711F 17 zdi- • JOSEPH DEN n 5/2021 i JOSEPH DENETTE --j�- CG :' 102 gLDRICH STRE G BY,MA 01033 Undersecretary t 7/1/2021 City of Northampton Mail-Screen porch Hinckley St. Iit 11 Gity of ' _Cr Northampton Jonathan Flagg <jflagg@northamptonma.gov> Screen porch Hinckley St. Joseph Denette <thedenettes@hotmail.com> Fri, Jun 25, 2021 at 8:07 AM To: "jflagg@northamptonma.gov" <jflagg@northamptonma.gov> , " _� t,,44,,, , , *fir, ..�' a" gym'<a,,y �9 . .,fir+,: .,, y ,z '` ` -2'z '.,;. ;,,, ° r, t ;• .Sys 4 , R g i \ .t «< �` •r, x •' red ` https://mail.google.com/mail/u/0?ik=e5d 1685713&view=pt&search=a 11&permmsgid=msg-f%3A 1703540518538009624&si mpl=msg-f%3A1703540518538009624 1/3 7/1/2021 City of Northampton Mail-Screen porch Hinckley St. _ I } r ! � Y • , 404 .34 Any questions please give me a call. Thanks Jie 2/3 https://mail.google.com/mail/u/0?ik=e5d1685713&view=pt&search=all&permmsgid=msg-f%3A1703540518538009624&simpl=msg-f%3A1703540518538009624