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32C-166 (33) BP-2022-0047 196 PLEASANT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-166-001 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-2022-0047 PERMISSIONIS HEREBY GRANTED TO: Project# 20223 OFFICES Contractor: License: Est. Cost: 24000 JOHN FERRITER CS061398 Const.Class: Exp.Date: 10/17/2023 Use Group: Owner: MANHAN NARROW LLC Lot Size (sq.ft.) Zoning: " CB Applicant: JOHN FERRITER Applicant Address Phone: Insurance: 223 SARGEANT ST (413)586-9680 HOLYOKE, MA 01040 ISSUED ON:01/25/2022 TO PERFORM THE FOLLOWING WORK: BUILD 3 INTERIOR OFFICES IN 2ND FLOOR SPACE 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: (. 1 • 2 ''a • I ' Fees Paid: $168.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Bui mg Permit Number$Q ZD27.-•col Date Applied: Building Official: SECTION 1:LOCATION L(N ?leasaNt S7 A riHFYH+p70N Ilk o1460 (Es cowvpvijl2s " 13vild,.�c) No.and Street City/Town Zip Code Name of Building(if applicable) 32G L64 001 4611.0 241gj Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below Existing Building b4 Repair 0 Alteration 131 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes fir No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No 0 Brief Description of Proposed Work f3UILp 3 !Ni£121Oµ 0 Ff/CES [N 2AI P FL SP6CE 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): f3 Proposed Use Group(s): g ' N° CHANGE - SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) y. NO Cfl/}N jy£ Total Area(sq.ft.)and Total Height(ft) No c N/knr&F SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2❑ Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business ki E: Educational ❑ F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2❑ H-3 0 H-4 0 H-5 0 I: Institutional I-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2❑ R-3 0 R-4❑ S: Storage S-1❑ S-2 0 U: Utility 0 Special Use❑and please describe below: Special Use Description: SECTION&CONSTRUCTION TYPE(Check as applicable) IA IBD IIAD IIBD IIIAD IIIBD WO VAD VBD 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 Check if outside Flood Zone 0 Indicate municipal A trench will not be Licensed Disposal Site❑ Private Elor indentify Zone: or on site system CIrequued§or trench or specify: permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable.N Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed CI Yes 0 or No tr Yes 0 No,131 Afbf SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: 61 Use Group(s): g Type of Construction: I V Does the building contain an Sprinkler System?: E6 Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner /NANHAN NA1211e,J yo iNOW1AS D006 (WA s Ici6 P(, SAn7T ST !•1aYTH(AMPT.on) MA- Name(Print) No.and Street City/Town Zip Property Owner Contact Information: dwnit;rL 113 _31,0 _ 3di8 1/3 _CAS-Obit dou I se 'fdeuyfas circlitiEa is , covr. 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 D. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) (rlo►nas Dovwco /6l2040-Ec i _113'5$5-•o(041) tiovy Iar CP +clovSlAs G rcHIrLc,i c 61.14 Name(Registrant) Telephone No. e-mail address Registration Number I46 FleaSat'} sT (JeR.71-11i►,np7ory MFr 0(060 Aluu.frt' c1 $ •31 •2'L Street Address City/Town State Zip Discipline Expiration Date 10.2 General Co ctor 3 ..0. ..z... ., Company Name , ��� {�C. `����� 3M-�F .-T CS-06I 3 Name of Person Responsible for Construction License No. and Type if Applicable 22 3 51.6..e.0 . Sd i L jo ',mt.,. Otto o Street Address City/Town State Zip __ 413-5$6 4(6bc) c ,a.L . Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the • uance of the building permit. Is a signed Affidavit submitted with this application? Yes the 0 SECTION 12•CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$Zili OOD 1.Building $ l o{,000 ° Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ 3,0 0 0 appropriate municipal factor)_$ . 3.Plumbing $ 0 4.Mechanical (HVAC) $ 0 Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other)Ser,,,klcr $ 2,00 Enclose check payable to 6.Total Cost $ 2',00 0 (contact municipality)and write check number here #'2 53 2 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I he by attest under the pains and penalties of perjury that all of the information contained in this applicati. • true and accurate a best of my knowledge and understanding. c . aititi E ice- - OlanYi - `10-ret, °(,( J z2, Please print and sign nam Title Telephone No. to ZZ3 Sit•eC i 5V. tjP1- Dom- (Wld 0toC J 1 4' tvtki,...caw. Street Address City Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: I 1 ' r ► 1/1, I/ -/ a Name Date City of Northampton Massachusetts �. * w t DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building — S Northampton, MA 01060 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`l.t � Lt ( 06- The debris will be transported by: Name of Hauler: J 10� 74t_P-t�i iZ. Signature of Applicant: Date: I/Z(ZZ The Commonwealth of Massachusetts ma= =um Department of Industrial Accidents 1 Congress Street,Suite 100 1,= =Z2 ^ — Boston,MA 02114-2017 www.ntass.govidia 1%ushers'Compensation Insurance A1Tidas it: Buildersi(:ontractors/EiectriciansiPlumbers. TO BI FILED‘1I I It HIE PF.R.11111111;AUTHORITY. ADDliMint information Please Print Legibls Name r.BusinessUrganization I nd t vidua I): * 1 0 Address: ST. CityiStateaip: A/4- &. j71174Q ['Ito' e tre yam an employer?Clerk the appropriate WI: Type of project(rtglidreil): a empker with _employers(full orator part-timer.' 7. 0 New construction 221..iima sole proprietor or partnership and have no employees working for me sn B. CO:modeling any capacity.[Nu workers'comp.insuraniat required" 9. Ei Demolition i am a homeowner doing all work myself.(No workers'comp.imurance requirecti 10 0 Building addition 4.0 1 atss Isueneyowsset and will be hiring contractors to conduct all work.on toy peopotty.. I will entiUSt that an ioatramas either lave workers ceemensation Orisiztaraz or are sole I I. Electrical repairs or additions pesiprWthyrs with nu erripkiyixii. 12.0 Plumbing repairs or additions SO I am a general curnmetur and I have hued the sub-contracturs hated on the attached sheet_ 130Roof repairs Mime arab-sumanstrors have employee*sod have worker*.comp.inauranor.: 14.o.0 0 Othes we are a omparatrun and ita offieets have exercised their right of exemption per c. 152,410),and we have nu anpluyees.Nu%takers'comp.insurance require& 'Any applicant that checks box Mutt 1.1,u iril out the section below showing their winters curammstition policy infirrniation.. t Homeowners who submit digs affidavit indreahng they are doing all work and then hire outside contractors mug-submit a new at)id4v it milicamig such. tCuotractois that duck this boa mug sat.ael-..711 are. .1dstiursal Jure(showing the mute of the sath-contractort and nsnr whether iv not theiae smitittes have orsplu:,,,et-1 If the lub-euniractun.lust ecs. is must pre,.We their wurkrra.esymp.ptmis nurnba . „ I am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job site information. insurance Company Nam: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City'StaktiZip: Attach a copy of the workers'compensation policy declaration page(showing the policy somber and expiration date). Failure to secure coverage as required wider Mal c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 and.'or one-year imprisonment,as well as civil peniilties in the form of a STOP WORK ORDER and a fine of up to$250.00 a do against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cos 1.3"age N.en tiCa UM. I do hereby cry under the pains and penalties of perjury that the information provided above is true and correct. Si attire: Date:Phone#: Aid —5?)6— L.D Official use only. Do not write in this area,to be completed by city or town official (Its or 1 I.11A n: PermitiLicensr# Issuing.%uthorit:i tcircle one): I. Board of Health 2. Building Department 3.Cityetown Clerk 4. Electrical Inspector 5. Plumbing Inspector b.Other Cozumel Person: Phone#: Initial Construction Control Document �° To be submitted with the building permit application by a ' Registered Design Professional for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 DFFI(E gvIL - OUT 2No FL Project Title: Date: ( • 14 •22 Property Address: IA(, p(, h-i H tt Nn P To 1" Mpt . Project: Check(x)one or both as applicable: New construction Fxi's ng Construction Project description: --�� iF-torv"4s Povu(,A s (c544 s -3( 2I- 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 concerningl: X 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 lull iiction 04%rol Document'. Enter in the space to the right a"wet" or '21k. electronic signature and seal: " Phone number•• 412, 5 5 0(� 1 Email: dove; )&.s e { aovlas a 1 :� cow, � Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen,provide a description. i'eriion 01 Ol 2018 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 t• l 4 • 21- 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(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 Access Review(521 CMR) 18 Workers Compensation Insurance 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 jurisdiction. Registered Professional Contact Information dovrlat 8 r ovctic.t Arcini+tci"1CO" 1Hey+ qs l�ev4 `as 4113-54 - 0641 6144 Name(Registrant) Telephone No. e-mail address Registration Number la [, p(,EAcaNT 4 i NOW-7r1Armp i aN NIA C104 ( At2`t-tirEcr g•31 2z 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 construction control forms to be used by Registered Design Professionals. '4C o CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DD/YYY() �-' 01/25/2022 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 poiicy(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 NAME PHONE FAX Russell Bond&Co.Inc. No Ext1: (A/C,No): 295 Main Street F i AiL ADDRESS: Suite 866 INSURERIS)AFFORDING COVERAGE NAIC A Buffalo NY 14203 INSURER A: Colony Insurance Company 39993 INSURED INSURER B: John Ferriter INSURER C 223 Sargent Street INSURER D: INSURER E: Holyoke MA 01040 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. (NSA _ TYPE OF INSURANCE t T POLICY EFf POLICY EXP ,NSD WVD POLICY NUMBER (MMIDDfYYYY) AMMIDDIYYYY). LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE Ei OCCUR PREMISES iEaQcf rrencer ,$ 100,000 MED EXP(Any one Larson) $ 5,000 A 101GL006340305 09/26/2021 09/26/2022 PERSONAL S ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: i GENERAL AGGREGATE 2,000,000 Et° n xl POLICY LOC PRODUCTS-COMP/OP AGG $ Included I OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED ` SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ — AUTOS accident: _ S $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ 'WORKERS COMPENSATION PER 1 OTH- AND EMPLOYERS'LIABILITY YIN 5 fATUTL I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N N t A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE?=. $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) , CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. C/O Kim Building Dept Puchalski Municipal Building 6AUTHORIZED REPRESENTATIVE 212 Main St Northampton MA 01060 'U Q,kl�✓ r'X. ,P../?..,_ I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD