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16B-003 (16)
100 BRIDGE RD COMMONWEALTH OF MASSACHUSETTS BP-2021-1937 Map:Block:Lot: 16B-003- 001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-1937 PERMISSION IS HEREBY GRANTED TO: Project# ROOF REPAIRS Contractor: License: Est. Cost: 4266 DP CARNEY CONSTRUCTION INC 99798 Const.Class: Exp.Date:08/19/2023 Use Group: Owner: NORTHAMPTON CITY OF J F KENNEDY SCHOOL Lot Size (sq.ft.) Zoning: RI/URA/WSP Applicant: DP CARNEY CONSTRUCTION INC Applicant Address Phone: Insurance: 34 HORSE SHOE CIRCLE (413)543-4803 0 R2WC196742 WARE, MA 01082 ISSUED ON:09/27/2021 TO PERFORM THE FOLLOWING WORK: ROOF REPAIRS 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. Signature: ( 111 • II i >2 I a iI Fees Paid: $ 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 442 tihteM ' RECEIVED The Commonwealth of Massachusetts t. SEP 2 3 2021 Office of Public Safety and Inspections 'U Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling @I PT OF BUILDING INSPECTIONS (l'his Section For Official Use Only) NPORTHAMPTON.MA 0109e Builc,M P rNimtt+ei. t A e Applied: Building Official: 30,2/• 1 q 3.7 SECTION 1:LOCATION 100 Bridge Street Northampton,MA 01060 Prks&Rec Dept modular bldg.(behind JFK Middle School) No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building® Repair El Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use ❑ Change of Occupancy 0 Other ® Specify: Roof Repairs Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No ❑ Brief Description of Proposed Work 1.) Slice open membrane along the two seams where the modular sections are connected (120'). 2.) Install spray foam insulation,filling the open seams in insulation boards. 3.) Cover each slice with a 20"strip off self-adhered EPDM membrane(Firestone Full Force).4.) Re-seal entire perimeter laps using full force sealant. 5.) Re-seal all joint cover patches. 6.) Seal top of pre-fab pipe flashing to pipe using 6"form flash. 7.) inspect entire roof and make all necessary repairs. SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)Sr Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4`❑ A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1❑ S-2 0 U: Utility 0 Special Use El and please describe below: Special Use Description: Northampton Parks and Rec.Building SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ HA IIB ❑ MA ❑ IIIB ❑ IV CI VA CI VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Debris Removal: Water Supply: Flood Zone Information Trench Permit: Sewage Disposal: Licensed Dis osal Site CSI Public 0 Check if outside Flood Zone 0 Indicate municipal CIA trench will not be p required 0 or trench or specify: Cas':ella Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Holyoke,MA Railroad right-of-way: Hazards to Air Navigation: MA Historic Cornrniv.inn Review Pwc ss: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: — SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner City of Northampton 210 Main Street Northampton,MA 01060 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Patrick McCarthy 413 _531 _8929 _ pmccarthy@northamptonma.gov Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: D.P.Carney Construction,Inc. 34 Horseshoe Circle Ware MA 01082 Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑. Otherwise provide cunstruction csntro1 forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) N/A - Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor D.P.Carney Construction,Inc. ii Company Name �.6 \� Daniel P.Carney CS-099798 Name of Person Responsible for Construction License No. and Type if Applicable 34 Horseshoe Circle Ware MA 01082 Street Address City/Town State Zip 413_543-3150 413-575-8047 dpcarneyroofing@gmail.com Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:t•VC'i}i i:5`COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes in No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building Roof Repairs $ 4,266.00 Building Permit Fee=Total Construction Cost x_(Insert here 2.Electrical $ appropriate municipal actor)_$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ $4,266 00 (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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. Toann Carney President 413.543 - 3150 9/22/2021 Please print and sign name Title Telephone No. Date 34 Horseshoe Circle :;) Ware MA 01082 dpcarney45&comcast.net.._._ Street Address City/Town Stale Zip Email Address Municipal Inspector to fill out this section upon application approval: / / 2(JZf Name Da to CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SE I BACK FRONTAGE City of Northampton r, �v:k i,, j Massachusetts �w: '„ � DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building �.^-7,- Northampton, MA 01060 • T: „; 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: _686 Main St,Holyoke,MA 01040 The debris will be transported by: Name of Hauler: All Waste Removal. Inc. 1 Signature of Applicant: Date: 9 ,-- ) rt..\ The Commonwealth of Alassoehttserts ' Department of Industrial Accidents I Congress Street,Suite 100 7-- •• e Boston,MA 02114-2017 www,mins,goridia 11M kers' t'ompensation Insurance Arfidat it: BuildersiControttorsiElectricians/Plumbers. 10 BE I-11.ED 11,I Fill HE PERN11-t Annlie AIR Inft.4rin thin PIANt',.Print Lailitils, Name I -.. D.P. Carney Construction, Inc. Address; 34 Horseshoe Circle CitrdStatt:Zip: Ware, MA 01082 Phone (413) 543-3150 )ati alt Nicrplo)ft*: flu dintikqti latt• k: 1 pi of project(required): 15 1,„ 7 Li X. 9. 0 D.., • '.,r1 i r.)iJ 131.1.,idIng addition 4.0 vat . ; 1 V,:ttl _ mfttk.1.,Mrk, baNt, 0 El tncl repairs or additions . SEtpkTi...k.*. 1 2_0 Plumbing repairs or additions Mt'MONA 1 C • I 3.MRoof iepaits „ „.!. -3Pte, 14. 0 tier_ '-1 . • 04:1,411:1,,i.04':root Asttbraa • ottt.t I am an employer that is I,r :dike workers compensation iftfurencefirr my employees. Below is the policy arid fob Nile information. Cunipaay Na:11e: Guard Insurance Group Pky or Self-ins.Lie. R2WC196742 Ekptrattzlt Date 11/15/2021 Job Address: 100 Bridge Street City"Statc4Zip: 01060 Attach a copy of the storkers'compensation patky declaration page(St otidtig the policy number and expiration date). x col, _ _ MGL e. 152. ;,,25A is a criminal siolation puti4hable by a line up to S1.500,00 • . - • L. it asi.f‘II ponal:i:..ys n thz form of a STOP WORK ORDER and a fine of up to N250.00 a tL: 1he 1..:or. A oi [his sz...rtement tray be fora arded to the Ofltce of Im estigations of the DIA for r age erifisatim. I ilia hereb_r 4:citify under the pa; f o, a Ale of p tat t e information proJideil abose is trite and corn. - 9 3Q. . oa(413) 543-3150, 11 Official tilt Oittr. Do not write in this area,to he coa.i,,r.led by city or town official 11 Fitt or Ttron: Permit/License# Issuing Authorit:s (circle one): I.Board of Health 2.Building Department 3.C.ityrrft1411 Clerk 4.Electrical Inspector 5.Numbin limpet-tor 6.()flier ('ontact Phone#: Initial Construction Control Document ';It a, To be submitted with the building permit application to,, a s pf Registered Design Professional �N� % for work per the ninth edition of the 44, .} Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Date: Property Address: Project: Check(x)one or both as applicable: New construction Existing Construction Project description: I MA Registration Number: Expiration date: ,am a registered design professional,and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerningi: Architectural Structural Mechanical Fire Protection Electrical Other. for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780. CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code_ Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a 'Final Construction Control Document' Enter in the space to the right a"wet'" or electronic signature and seal: Phone number: Email: Building ing Off cio?Use 0/4 Building Official Names Permit NO.: Date: Note 1.Indicate s,_ih a_n'x'Project dean plans,computations and specificat ons that; -.1 prepared or c ectl su_ert d If'other'is chosen,pro-.-de a descr p icn. Version O1 Ol :l$ Appendix 1 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire AIarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing(include local connections) 9 Gas(Natural,Propane,Medical or other) 10 Surveyed Site Plan(Utilities,Wetland,etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investigation 16 Energy Conservation Report 17 Architectural ACLess Review(521 CMR) 18 Workers Compensation Insurance X 19' Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having juri.diciton. Registered Professional Contact Information N/A Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date - Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Please follow this link for ci,nstructioncontrol forms to be used by Registered Design Professionals. -may DPCARNE-01 ANGELA A`„CP�`� CERTIFICATE OF LIABILITY INSURANCE DA E(MMI 9/22/2021 DIDAWY) 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 i CONTACT Angela NAME: DiAugustino Phillips Insurance Agency,Inc. 97 Center Street (A"cc,,N Ext): (413)594-5984 ,FAX No):(413)592-8499 Chicopee,MA 01013 ADDRE5s:angelatphillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC INSURER A:Kinsale Insurance Company 38920 INSURED INSURER B:Selective Ins Co of Southeast 39926 D.P.Carney Construction,Inc. INSURER C:Guard Insurance Group 34 Horseshoe Circle INSURER D: Ware,MA 01082 INSURER E: I 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 ADDL SUER POLICY NUMBER ; POLICY EFF POLICY EXP LIMITS LTRINSD WVD :(MMIDDA"YYYI (MM/DO/YYYY) A X COMMERCIAL GENERAL LIABILITY 'EACH OCCURRENCE S 1,000,000 CLAIMS-MADE I X, OC C UR 0100041217-5 I 8/1/2021 8/1/2022 DAMAGE TORENTED 100,000 PREY R TO Turrencel S 0 MED EXP(Any one person) S X $5,000 Deductible 1,000,000 PER DV SONALBAINJURY $ GEN'L.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X I FEc 1 LOG PRODUCTS_COMPIOP AGG S 2,000,000 OTHER: S B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea a rJdenl) $ _., X ANY A.UTO A 9094953 8/1/2021 1 8/1/2022 BODILY INJURY(Per person) S OWNED I_ SCHEDULED AUTOS ONLY I AUTOS I BODILY INJURY(Per aWdent) $ — UROS ONLY i NA OED OLY PROPERTY(DAMAGE (Per sealant) $ 1 $ A X UMBRELLA LIA8 X OCCUR I EACH OCCURRENCE S 5,000,000 EXCESS LIAB CLAIMS-MADE I 10100054375-4 8/1/2021 8/1/2022 I AGGREGATE $ _5,000,000 DEC X RETENTIONS 0 ;Prod/Comp Ops $ 5,000,000 C WORKERS COMPENSATION X PER 1OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN R2WC196742 1 11/15/2020 11/15/2021 1,000,000 ANY� PPriPRIIET�,RIPARTNER/EXECUTIVE I E.L.EACH ACCIDENT S (Mandan/M inNPR EXCLUDED? I Ni NIA 1,000,000 E.L.DISEASE-EA EMPLOYEE $ I If yes,describe under 1,000,000 I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S B Installation Floater S1985457 8/1/2021 8/1/2022 Limit 107,000 1 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,A dditk.al Remarks Schedule,may be attached if mu,e space is required) RE:Roof Repairs-City of Northampton JFK Middle School Modular Building CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN C trio orthamy ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main St. Northampton,MA 01060 AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts t Division of Frc essior}al Licensure 4` Board of Building l agulatinns and Standards CS-09979$ E pires:08/1912023 DANIEL P CARNEY f; 34 HORSESHOE CIRCLE WARE MA 01082 4` Commissioner `.1a Construction Supervisor Unrestricted Buildings of any use group which contain less than 35,000 cubic feet(951 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.govldpl 5Cre F0/72a� G W1�'1 'l2 L" 4 ✓' Q,.'k1'L2 �!.AJ E's' _ Office of Consumer Affairs and Business Regulation 1000 Washingt ,n Street- Suite 710 Boston, M ac�husetts 02118 Home ImprovementtraCtor Registration — Type: Corporation i z Registration: 121178 D.P.CARNEY CONSTRUCTION,INC. ,`, Expiration: 04/11/2022 34 HORSESHOE CIRCLE �= ,s-= WARE,MA 01082 •; Update Address and Return Card. SCo.1 0 2maest7 Office of Consumer Affairs&Business Rsgulefion HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE(ortwration before the expiration date. If found return to: ,, pxpiratton Office of Consumer Affairs and Business Regulation - ,-04/11/2022 1000 Washington Street -Suite 710 a . Boston,MA 02118 D.P.CARNEY Fill,INC. /� 3 DANIEL P.CARNEI� 34 HORSESHOE CtE- '^ 1/ WARE,MA 01082 Undersecretary ot val • 'Without sig CONSTRUCTION CONTROL WAIVER From: D.P. Carney Construction, Inc. 34 Horseshoe Circle Ware, MA 01082 To: Jonathan Flagg Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, I request that you grant a modification to waive the requirement for construction control of the project at Roof Repairs at the Park& Rec. Dept. Modular Bldg. 100 Bridge St.,Northampton, MA 01060 because the work is of a minor nature, will not affect structural elements, health, accessibility, life or fire safety, and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, \ oann Carney, President