The URL can be used to link to this page

11-002 (21) B P-2021-2180 0 HAYDENVILLE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 11-002-001 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-2021-2180 PERMISSIONIS HEREBY GRANTED TO: • Project# BUILDING FOR VALVE Contractor: License: Est. Cost: 289680 G&G CONSTRUCTION INC 102551 Const.Class: Exp.Date:02/12/2023 Use Group: Owner: NORTHAMPTON CITY OF SMITH SCHOOL Lot Size (sq.ft.) Zoning: RI/RR/WSP Applicant: G&G CONSTRUCTION INC Applicant Address Phone: Insurance: 53 TURNBULL ST (413)543-6002 08WEAAF2N6C SPRINGFIELD, MA 01104 ISSUED ON:11/15/2021 TO PERFORM THE FOLLOWING WORK: BUILDING FOR VALVE 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: Fees Paid: $ 212 Main Street,Phone(413)587-I 240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED r, . ,_ UU 5 usetts zUZT The Commonwealth of Massach Office of Public Safety and Inspections � ' Massachusetts State Building Code(78i1 2MR'FPT.OF WILDING INSPECTIONS Building Permit Application for any Building other than a One-or Two-Paictit .11JhvvtiMAg _1 (This Section For Official Use Only) - --- Building Permit Number:: Date Applied: Building Official: t 1_ SECTION 1: LOCATION p �/ r1 iiiiiLkiki _gt2Azl_____N No.a t Street City/I owl Zip Code Name of Building(if• .plicable) Assessors Map# Block#and/or Lot # 44°55 l Jo... 410 404 It tv 11'. (ea.i. SECTION 2:PROPOSED WORI5, I Edition of MA State Code used.................... If New Construction check here of or check a 11 that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other C'Specify: tft . r%c4 Are building plans and/or construction documents being supplied as part of this permit application? Yes ctf No 0 Is an Independent Structural Engineerhang parr Revii w}•. uired? 1 ! t il jj ,Yes 0 p >o C3/ Brief,J cription of Proposed Work:....r._t4....._+I_.p.._t...G.>1<...i!f.(............ .i.L..K_.L t tat Loki 9 1 it !_t.-.-..__.l......1 i!.i c_ 4 - s e r 4 to, V _ 2_ ttrsr ....... lrtistcc__. .C�u _!! fret....I..2...-_t�t.L. ........ 70 t yr i S i►. 3.1.f.11.1 + (..._......_� UR.[�. _.�.......�_ i 2- i .....t',.tti�... .L..tA.t-�+..�.. _1!'Or! C.al.ritc� 'yam S !`r' 4 L�Yl-daGT a'! r .S a J 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) ❑ Existing Use Group(s): Proposed Use Group(s):_, ._, .. SECTION 4 BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 1 2.21 Total Area(sq.ft.)and Total Height(ft.) 224 ..,log SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 l E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-I 0 11 ❑ 1-1-3 0 H-4 0 1-I-5 0 I: Institutional 1-1 ❑ I-2❑ 1-3❑ 1-4❑ M: Mercantile 0 R: Residential R-ID It-2❑ R-3❑ R-4❑ . S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB 0 IIA ❑ LIB ❑ IIIA ❑ IIIB ❑ IV 0 VA 0 VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public LEI Check if outside Flood Zone al Indicate municipal A trench will not be Licensed Disposal Site 0 required 0 or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 6 Railroad right-of-way: Hazards to Air Navigation: MA IIisttnic Commission Review hroces.: Not Applicable 13/ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No It 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?: 40 ._Special Stipulations: __—__.... Design Occupant Load per Floor and Assembly space: S /� PO� ate, SECTION 9: PROPERTY OWNER AUTHORIZATION Nine mod Address of Property Owner C� - - Not< la h ow a5 L, L5t'ret N.,444,7,_i_vi, ..k of 0 6 o Name(Dint) No.and Street City/Town Zip Property Owner Contact Information: Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: . 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 O. Otherwise provide conslrut_tioo a>..rot,forms(see section 107 in the code)as required. 10.1.Registered Professional Responsible for Construction Control (the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor C1''IA,G—i'4441L _ C'om any amen ' _. .. {_s.L.1.r_L.o$GoriC a-(L4.5 - l D 1 _.. Name of 1',rson Responsible for Construction LIcensc•No. and Type if Applicable 5 3 4 t~e n L k t/l, Slut r;h ;� .,, nn,4 Q�_..l_D 4 Street Address I Cit., own i State Zip 913-543_ Goon. 413 -Sy&- 20_ a cabs... wish. cow• — ..- Telephone No.(business) Telephone No.(cell) e-mail address _ SECTION 1.1:I.V01R_krrh•(Oylt'FN'�v 1ION Iy5UUR'vN .[-_ArF;ir,>,� �[IEE(M.G.L.c.152.§25C(6)) ~ A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and , submitted with this application. Failure to provide this affidavit will result in the denial of the ssuance of the building permit. Is a signed Affidavit submitted with this application? Yes DI No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ a Q 11._ .$ . CO 1. Building $ I 3 oo 0 �• Building Permit Fee="Total Construction Cost x,.,,,,_,___.(insert here 2. Electrical $ 15 412 00 appropriate municipal factor)=$ . 3.Plumbing $ , 0 I 6�2W U a 4.Mechanical (1-iVAC) $ 3,� 174. 00..,.......S? Note:Minimum fee=5 (contact municipality) 5.Mechanical (Other—__.._ $ 5� ?a 3•_( ..._....__.. Enclose check payable to • 6.Total Cost $ a.0 R co gO,(� (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 understandin . oam•tS rftt± t 413 543-4.02......_..i ._4S /Zv21 Please p 'nt a{ad sign oat Title Telephone.No. Dat 3 ert.L4 1t _s) rt .� ran �r� �4 4. _ 0 ( _ jelComt..e' e 1�5w, Gop- Street Address Citit)Town State Zipmait Address I 4►' ,` I VIGAI Municipal Inspector to fill out this section upon application approval: � ��i a . � :' * P i Name (i .Dat The Conintonwealth uf llossoehusetts Department of Industrial Accidents ,0 -11441-tigi i I,. I ConrevA Street,Suite 1110 Batton, MA 02114-201 7 A.„. www.inflAs.goivilia orkers t'OM prnmition Insurance.‘MO avit-tiaildri s.1`tattrartorsitieetricionsiPlutuberK 10 HE FILED WWII IIE PLRSH'EliNG At It101t1I'L AppIliclint ItifinitiatIIM Pleas-e Prin I 1.ettihis ..—, Naille i HUM£W.h,,:*t..:.114W-Alial butt..., . ci E Address: 5 3 iiiverl..12 LAV i r(t+. .. ....... ..... _ City,stilt e.I iii:_5, ,0 r,'..t/(4 1/ Al A al.04 Pikliie rt._413_5 4137(2,...e 2- ........... . . .... Are)eu Ala employ Le.'(11.....L the tprititrilltt•hut: 1,pe of project(required): 141 tat tt vtup; , . , ,.;,t,PAI>:ft.y.t,,toll and,,l-z pait-tirmi. i 7. El New eonstructinn ,.:41111 Anil hit,,L.:me etziployx.v,,,,ri,th5 int•talg.gr4 1 X. in Remodeling I '9. 0 Demolition AO Vo.tri.mytk.-11.';No v..oti‘er,'c.enc. meat-wee tapettai r ma Building addition 4.0 I Ant a itt.t.tWAMItt.,2:nut w:.I _ ,, ..'_ ,i.. ..totultict ttlt 1,otk ttn my plegetty I eat ehAtre lad,ill C$11,(TAt-ittlat.CI:1,3 eta',A..al.. .. t •,,::',..:1 Ai it-tAll145,,,,itl a A.:Utic: f I I LieLtrh.di repans or additions ptoptteittv,4 kit RIO ettlittt.4.ya.% I sl I 411.11:1 etillAttll atatiltlialtit Anti I 11.,1%t;heal L'he..,...1, . 1,:....'..L .:L.-=,i.Is,i,iititilOtt ltittXt 4 .2.,D, Plumbing repairs rii additions : I 3.0-Rouf repairs . •vi tei e.-tio••• "a ie.r- tt 3(sof Meratn 5.}.. Lc, itriA Olin I 4,0 Oth Li er. is We AM A,ittittlVAIIVA SAW 4i,btlikerst hui.e.exeL c.b.al ewe rtgle.t1<.:=,.'r.;,,,lttl pet i52...§ii4),und ue hee,e tio aneloyeelL[No V+Ltrit3to'ei Wirt,MAW(a:ts,t aqouvill *My am/went that dt.,els INa.PI smot Atm WI ute the teams,below.110*tog thettl tkoria.,`eeeteematon whey tatantal , 'iiietnemanea wile.hbentl thu&.ettatett testuretteg they erected%ail*oil estd then.tree'mama,:4/-att-tElt,:lsat.Raba AttkItViti a: .. ,l: ,.,it lltalt:aittit ltr.till- It orllimat.t.t.arui ato.it taw Ins atria iiiiiidsaa Int eti.thoosi.heet ottoN hog the rank:et rite,,vh-eonta,Ler=iititi ant wit,:ii.'“:: w it.i!L.',--itthlet,11214t • clopktyee, if the sais•euriusterars List.emplOtxt,they rilugl pumice:we Aleta,'...:Jrup.Ik‘hs...:y blittallet I din an employer thin il providing workers'compensation insurance far my employees. Below is the poliey and job site information. • inAtidilec Ciunpany Natric:11144,L4a Car, a/Ad/a Policy :4 or Self-ins.LAC.t: l::it.iiiration Date: Job Site Address: t'ity State."Zip: ..................... Attach a rop)of the Ikarkerii*compensation polir:v declaration page IshwAing the policy number and expiratiati date). Foliure to seethe'int crag,:as pertainoil litliki Wit, C. 152, §2.5A is a criminal iolation punishable by a fuse up ta S1,500.00 and'iir ont. year imprisonment,as well as cot 11 penalties in the form of,i STOP WORK ORDER and a fine of up to S250.00 it day ago-Hut the violator, A.copy ul this statement may be forwarded io the Otlice of Envelittgattons of the DEA for Insurance coverage.‘critication, i do herein,certify under the pains and penalties ofperjary that the infOrinotion provided above is true and correct. SitiffiliU1,,: ......---- 1/.lz.* I.i 0 C 2-0 a i Mune :: 4 -s4j:r 3- boo 2- K.,/ • Official use only Do fiDi write in do\area,il,he completed by city fir own Vida Cit.s or'Fowitz _ Permitil.icense ................. ........,_ Issuin•g Authurii y(envie tine): I.Huard of Health 2.lio actin„,Depart turni 3.t its/foss n Clerk 4.Het-Arica!Inspector 5. Plumbing Inspector 6.()Hier (`on bid Person: Phone#: • Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for it per the ninth edition of the Massachusetts State Buildthg Code, 730 CAVRT, S-ection 107 Project Title: Date: 11/05/2-*7-1-1 Lted s ()fessvire, geckw Vidilt, Pelpedfilevi. Property Address: ei4 load. Project: Check(x}one br 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 concerning=: 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 generall'- 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 750 CMR 107 When required by the building official, 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: ---- Buirsiing Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an project dez4n plans,computations and specifications that you prepared or directly supervised If'other'is chos.en,provide a description Versim 01_01_2018 City of Northampton .:7fAtrik, 1. A 411' ( Massachusetts , I t DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building . 1 Northampton, MA 01060 , '"7-4 --- CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION ANT) RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, 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: 11...14EA3 .K.s-nal The debris will be transported by: Name of Hauler: - CO vIS L,C----i44/1 / Signature of Applicant: r------7-7.*7: 7___ Date: ii i 5 in QDivision of Professional Licnnsure • - .,f Building Requl-i, •a CS-102551 Expires 02/12.2i CARLOS GONCALVES L1°' 53 SUSAN DRIVE LUDLOW MA 01056 Commissioner • 11 Licensee Details Demographic Information Full Name: Carlos Goncalves Owner Name: License Address Information City: LUDLOW State: MA Zipcode: 01056 Country: United States License Information License No: CS-102551 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 2/4/2021 Issue Date: 6/3/2009 Expiration Date: 2/12/2023 License Status: Active Today's Date: 11/10/2021 Secondary License Type: Doing Business As: Status Chan a Reason: License Renewal Prerequisite Information No Prerequisite Information No Available Documents ACORO` CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 6 14/2021 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 CONTACT NAMF: The Dowd Agencies, LLC PHONE Suzanne R.MllnarClk FAX 14 Bobala Road (NC.No.ExL):413-437-1042 (A/C,No):413-437-1442 AIL Holyoke MA 01040 ADD SS: Smlinarcik@dowd.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Hartford Fire Insurance Company 19682 INSURED GEGCONS-02 INSURER B:Trumbull Insurance Company 27120 GEG Construction, Inc. 53 Turbull St INSURER C: Hartford Casualty Insurance Company - 29424 Springfield MA 01104 INSURERD:Twin City Fire insurance Company I 29459 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:661832939 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 SUBR POLICY EFF POLICY EXP LIMITS LTRINSD WVD POLICY NUMBER (MM/DD/YYYY)!(MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY 08UEABA8745 3/15/2021 3/15/2022 EACH OCCURRENCE $1,000,000DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $300,000 MED EXP(Any one person) $10,000 — PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY X JECT X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 08UEABA8746 3/15/2021 3/15/2022 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ C X UMBRELLA UAB X OCCUR 08RHABA8910 3/15/2021 3/15/2022 EACH OCCURRENCE $2,000,000 - EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X I RETENTION$iDnnn $ D WORKERS COMPENSATION 08WEAAF2N6C 3/15/2021 3/15/2022 X PER STATUTE ERH AND EMPLOYERS'LIABILITY Y/N N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) As per written contract The City of Northampton and Tata&Howard 67 Forest Street, Marlborough, MA 01752 are additional insured's with respects to general liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Northampton 125 Locust Street Northampton MA 01060 AUTHORIZED REPRESENTATIVE -, t ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD