Loading...
35-248 (9) BP-2021-1821 15 LADYSLIPPER LANE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 35-248-001 CITY OF NORTHAMPTON Permit: Addition PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2021-1821 PERMISSION IS HEREBY GRANTED TO: Project# Contractor: License: Est. Cost: 214411 WRIGHT BUILDERS INC 115196 Const.Class: Exp.Date:05/31/2024 Use Group: Owner: CHEUNG FLOYD &SHERI Lot Size (sq.ft.) Zoning: WSP Applicant: WRIGHT BUILDERS INC Applicant Address Phone: Insurance: 48 Bates St (413)586-8287(1 16) MCC20020005342020A NORTHAMPTON, MA 01060 ISSUED ON:11/01/2021 TO PERFORM THE FOLLOWING WORK: BUILD ADU ONTO EXISITING HOUSE 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. Signatur': 4 >2 • 3- I 61 Fees Paid: $1,393.67 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildine Commissioner File #BP-2021-1821 APPLICANT/CONTACT PERSON:WRIGHT BUILDERS INC 48 Bates St NORTHAMPTON, MA 01060(413)586-8287(116) PROPERTY LOCATION 15 LADYSLIPPER LANE MAP:LOT 35-248-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED R e.- ' .i DATE ZONING FORM FILLED OUT Building Permit Filled out }j Fee Paid $1,393.67 OP � ' Type of Construction: BUILD ADU ONTO EXISITING HOUSE New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement orLicense 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved �t[�Additional permits required (see below) //''�� PLANNING BOARD PERMI QU wIRED UNDER:§ 6 , 11 II Intermediate Project: Site Plan AND/OR Special Permit With Site Plan MajorProject: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic ApprovalBoard of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay Q I q Sig :ture of Building Official / Date Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. • RECEIVED AUG 3 1 2021 The Cot Won trof evizei IONS Board of But T T itdacds FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two Family Dwelling This Section For Official Use Only Building Permit Number:61` 1 -I I Date Ap Iied: I , 0 II i Building Official(Print Name) Signature I 'Dake SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 15 LQf pl;nptr Lune_ 35 PY8-OO 1 1.la Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: wsP wsP s41 lay 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 a0% etr /5 ' 15' min. oho • 20' min. 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Zone: _ Outside Flood Zone? ,tom Private❑ Check if yesjS Municipal 0 On site disposal system A SECTION 2: PROPERTY OWNERSHIP' _ 2.1 Owner'of Record: HDyyd Ghee,t/ Not*atyhn' � &. , f77 O 60 O Name(Print) City,State,ZIP /S Lady S k ips c L u'lc, rGhe -tin 6 Sm' . e CPU No.and Street Telephone VEmail Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction,Z Existing Building JB Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition a Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: I3u t idi i a u ADv i 4 o eic,s f:A I ',Owe. S-1•ti0li o 14 ye,./1 - /G; cAit,4 13,404raovr., Rt,,tr'oo►� • Cdiis ✓.. -1iuv, c7-4 (7t...I SGr�vi pvrc.ln 4v J o`K. ` t!D k boercJs, ar►J2 ra.'( Ca pS) SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ /79 Dd/ 1. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ i0,/5,r 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ !O, Or 2. Other Fees: $ 4.Mechanical (HVAC) $ 9 D ,5 List: 5.Mechanical (Fire /� Suppression) $ 2CrP Total All Fees:$ 43.61 Check Noeck Amount: �l Cash Amount: 6.Total Project Cost: $ see included ❑Paid in Full 0 Outstanding Balance Due: City of Northampton /W E :.�,_ Massachusetts w=s.... .1N * y DEPARTMENT OF BUILDING INSPECTIONS y, • \ ` 212 Main Street • Municipal Building J�., b� Northampton, MA 01060 '1:s•" • 7‘1�C PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW 1 &2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES, FENCES, GROUND MOUNTED SOLAR, ETC. I. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specifications of proposed work. (Digital and hard copy) 3. Site plan with location of proposed structure(s)and set backs. 4. Construction Debris Affidavit filled out and signed by applicant. 5.Worker's Compensation Insurance Affidavit filled out and signed by applicant. 6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance. 7. Energy Conservation Compliance Certificate (new/replacement windows). 8. Home Owner's License Exemption Form filled out and signed by Homeowner (if applicable). 9. Note any Conservation and/or special permit requirements (if applicable). 10. Driveway Permit (if applicable). 11. Proof of Water and Sewer entry fees paid (if applicable). 12. Trench Permit -public land by DPW/private land by Building Dept. 13. Stretch Energy Code -all new construction will require a HERS Rater Affidavit to be submitted with permit application before issuance of permit. 14. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton. • I SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C5 -I15116 5/3,la4 Qy,,it CruM,eu(( License Number Expiration Date Name/of CSL Holder List CSL Type(see below) 4J LISa 5-fate 5+2e4 No.and Street Type Description 13�4G�1Q��ow✓1 01007 U Unrestricted(Buildings up to 35,000 Cu.ft.) 7 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding 802-233-9062 SF Solid Fuel Burning Appliances t//3- 586,- 81 RCrar+ceai ( kw."' -8•�%de . cten I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) /D/53(0 b Z IAlf°i4 s'1 4 Pj, 1. Q 5 Zile- 0►7R a+l GA.jki HIC Registration Number Expiration Date HIC Canpany Name or HIC Registrant Name gig 'e S 5-Ike L j N1419141(7 i '. A l -,,/4r'5 cool No.and Street Fail address vor-It444o , �A otol�o 4/3- 5ae-8a 87 City/Town,State,GIP 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 ,4Q 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 Wt 4 14 13,.;l d e/5 Tr.G to act on my behalf,in all matters relative to work authorized by this building permit application. Floyd Cheung X 8/27/21 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 true and accurate to the best of my knowledge and understanding. Floyd Cheunq x 8/27/21 Print Owner's or Authorized Agent's Name(Eleonic 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.) ad k I ' Habitable room count /D Number of fireplaces 3 Number of bedrooms 'I Number of bathrooms a Number of half/baths 1 Type of heating system p; ( Number of decks/porches 1 Type of cooling system Enclosed Open )( 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN MAP: 35 LOT: a 8- oo LOT SIZE: 55 4r 6T 7 5c,44 REAR LOT DIMENSION: / 41• 66 REAR YARD ° SIDE YARD l5 See Attached SIDE YARD Site Plan FRONT SETBACK a 0 FRONTAGE /t 5 t I The Commonwealth of Massachusetts ), iiii r Department of Industrial Accidents —11= r4 1 Congress Street,Suite 100 ? =• = - t Boston,MA 02114-2017 lt"htlw.tna.ss:got dia 11'u1kcrs'Compensation Insurance Affidavit:Builder 'C.ontractors/Electriclans/Plumbers. '1'O BE PILED)WITII THE PERMITTING AUTHORITY. Aultlicant I II formation Please Print Legibly Name(Busincs Organiration/lnditiduul): bye)q{/L'�' Bv,I(�ei 5 in C._ /.111444a*1 IA/!1 q h'I — Address: y 6 3cc-Fe.S 5'I `J `/ City/State/Ztp:A/af'li'onp bn/ piil oioe o Phone#: 11/3- 58(9-8 a 8 7 Aretntu an employer?Cheek the appropriate bon: Type of project(required): 1.0I ant a employer with 2 0 employees(full andbor part-thriel.• 7. 0 New construction 20 1 am a sole proprietor or partnership and have no eitiployet. working forme in K. 0 Remodeling any capacity.[No workers'comp.insurance acquired_) 9. ❑ Demolition 301 ant a lummowner doing all work myself.[No workers'comp.iluurauee rnlsuiettl_i" 4.01 ant a honrv"ai ter and will be hiring contractors to conduct all work on my property. I will 10FI Building addition Otsure that all ctiruraclurs tither have w+o rkcra•compensation insurance or acre side I I.1231 Electrical repairs or additions plSlptistor3 with no rhnpluyecs' 12.r®'t Plumbing repairs or additions S2I I Ant a ger enal contractor and 1 have kited the sub-contractors listedd on arc taitaelod sihe't_ I t 1 ROdI'repairs These hub-contractors have employees and hate workers'comp.insurance.- �.7 ISO We are a. rporrtiuu and its officers have exercised their right of exernptiiat per MU.e. 14.❑Otter 152,31(4).and we have no employees.[No workers'comp.insurance required] "Any applicant that ehoeks but ri rust also fill out the section below showing their workers'cunnpenoatiun policy information. t tloameowiacrs who submit this affidavit Embattling they are doing all work and then here outside rtrmmetors moist submit a new affidavit indicating such. ternametors.that cheek this box moo attached an additional sheet showing the manse of the Sautla-.emnrl tors and state whether or not those entities have employees, lithe sub-contractors have employees.they must provide their workers'esinm policy number. I area an employer that is prodding workers"compensation insstronce for eery employees. Below Is the policy and Job site information. Insurance Company Name: A . _'. M 119 4,f✓k 1 Tn 5 f o . NA IC ti 33 is-8 Policy#or Self-ins,Lie.#: MCC- Ao?-hoot 5. 9 -Zo Zu A Expiration Date: 3///Z.2- Job Site Address: /S 1.0(Jy lb py er Lime City/StateiZip:/t/orJtuwl,/gt'►t P1i4 01060 Attach a copy of the workers'contpensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requited under MGL c. 152,§25A is a criminal violation punishable by a tine up to$1,500.00 ari&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 herebl,cert f`r/��� .1e pains and penalties of perjury that the information provided abot c is true and correct • Stenhtaue: r1/1�1� Date: 8/�/z Phone#: y►3- s' -- 8987 - Offcirtl use only. Do not write in this area,to be completed by city or town officiaL City or Town: Periuitil.icense# Issuing Authority(circle one): 1.Board of health 2.Building Department 3.CitylTownClerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: I City of Northampton 'o Y. M, a �9 .. .`s). /°}'- �;.' Massachusetts DEPARTMENT c'� I• DEPARTMENT OF BUILDING INSPECTIONS �'. g` 212 Main Street • Municipal Building y�.,, c. ,. fix- Northampton, MA 01060 ��NiY ��, 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: /v/A The debris will be transported by: Name of Hauler: Don (iv 1�k le, 7f Li`Iri„j LL C. Signature of Applicant: Date: rS/0i a b WRIGBUI-01 KAYLA ACC;PRO' CERTIFICATE OF LIABILITY INSURANCE DAT3YYY) �'� 3/11/2021/2021 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 Iie(J of such endorsement(s). PRODUCER CONTACT Kayla Marie Drinkwine Phillips Insurance Agency,Inc. n/c°°,No,Exl 413 $94-5984 FAX 97 Center Street ( . ):( ) I(A/C,No):(413)592-8499 Chicopee,MA 01013 miss,kayla@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC N INSURERA:EMC Insurance Companies 21415 INSURED INSURERB:A.I.M.Mutual Ins.Co. 33758 Wright Builders,Inc. INSURER C: 48 Bates Street INSURER D: Northampton,MA 01060 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) IMM/DD/YYY)'I LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6D18616 3/1/2021 3/1/2022 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL$ADV INJURY $ 1,000,000 GEN'L AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X I POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: EMPLOYEE BENEFI $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO 6Z18616 3/1/2021 3/1/2022 BODILY INJURY(Per person) $ — — OWNED SCHEDULED — AUTOSRE ONLY _ AUTOS E BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONLYY ROPERTY DAMAGE (Per PERT accident) $ $ A X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 I EXCESS UAB CLAIMS-MADE 6J18616 3/1/2021 3/1/2022 AGGREGATE $ 5,000,000 I DED X I RETENTIONS 10,000 $ B WORKERS COMPENSATION I X PPERTUTE ERH AND EMPLOYERS'LIABILITY MCC-200-2000534-2020A 3/1/2021 3/1/2022 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? n N/A (Mandatory fn NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more spaco is required) Florence Bank is listed as Additional Insured where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Florence Bank Florence Main Bank ACCORDANCE WITH THE POLICY PROVISIONS. 8treet Florence, MA 01062 AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • Permit Cost Sheet Project Name: Cheung 15 Ladyslipper Lane Florence, MA 01060 1. Deductions 2.Sales Cost 5.Cost of Permit $18,000 Design Total Customer Sale $258,882 Total rounded up to 1000* $161,000 $1,800 Final Cleaning Deductions* $44,471 Divided by 1000* $161 $300 Office Supplies Town Multiplier $10 $120 First Aid 3.Sales Cost After Deductions Product* $1,610 $8,000 Painting Total* $214,411 Town Additions $0 $3,000 Rubbish Building* $179,031 $1,100 Temp Toilet Electrical $10,155 TOTAL PERMIT COST $1,610 $2,101 Permits Plumbing $16,000 $2,500 Engineering Fee Mechanical $9,025 Key $3,000 Septic Design Fire Protection $200 * =Autofill $1,500 Spetic Permit- Inspect $1,500 Landscaping 4. Estimated Cost For Permit $1,550 Third Party HERS 0.75 of Sales Cost Total Cost for Permit* $160,808 Building* $134,273 Electrical* $7,616 Plumbing* $12,000 Mechanical* $6,769 Fire Protection* $150