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25C-004 (7)
BP-2022-0090 124 NORTH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25C-004-001 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-2022-0090 PERMISSIONISHEREBYGRANTED TO: Project# BATH RENO Contractor: License: Est. Cost: 14540 MICHAEL PARKER 085411 Const.Class: Exp.Date: 10/17/2022 SPEYER SVETLANA L/E MCCREANOR, RIMMA Use Group: Owner: JACQUELINE Lot Size (sq.ft.) Zoning: URB Applicant: SHARPLINE CONSTRUCTION Applicant Address Phone: Insurance: 17 COSGROVE ST 4132461071 WC315386141011 EAST LONGMEADOW, MA 01028 ISSUED ON:01/27/2022 TO PERFORM THE FOLLOWING WORK: BATH RENO 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: .; • . f Fees Paid: $94.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner I The Commonwealth of Massachusetts i kt Board of Building Regulations and Standards JAN 2 6 2022 F R t' MJNI IPALITY ;� Massachusetts State Building Code, 78�0 C R 1 SE Building Permit Application To Construct, Repair,Renovate9 3e -�-- ��isec Mar 2011 One- or Two-Family Dwelling �+,'a ,� raa 'o�s This Section For Official Use Only Building Permit Number: " 0,?o " 9'0 1 Date Applied: BuildingL i ;I 0 Cri ' „ da Official(Print Signature V Date Name) SECTION 1: SITE INFORMATION 1 I Pr perty Address: f 1 2 Asse so Map&Parcel Number 1 iSf ; t i t . ", ��, �� ________ 1.1 a Is this an accepted street?yes ✓`/ no i Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 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 i Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public 0 Private 0 Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2. -nee of Record fietitecii Air let,..etairivir,...N c1` Ainzia(nomd, .441.4 oebo City.State,ZIP iame I(Print), � � r.�"�. j,�-.�'-�5. c�f ..1ctC�e�t�. C'c"�'�°,�rt t'Y_ +��„r ( No.and eet Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) El' Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2:—01-14 SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item (Labor and Materials) - Official Use Only 1.Building $ / l `"17r - 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ < 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees�$ _ c� Check No.10'/ Check Amount: Cash Amount: 6.Total Project Cost: Si/X. 3-P - 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES i‘iii 5 I Construction S rvisor License(CSL) 'i{. 't#'9 G-i-- V6 --.., License Number Expiration Date Nun of Holder t 't ?S�'"1 RaWV/e C List CSL Type(see below) it- No and Street Type Description LA-si- Lo/4e� 646 6 Jttal4 i i as U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 18L2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding �r�f } f SF Solid Fuel Burning Appliances t3) ' All .11Lt,(p it tllc 1�S Gfl /. I Insulation Telephone Email address D Demolition / Registered a Improvement ntractar(HIC) r 7Nj_ // i/, 95 'j-i( .. :'s�o t ) LNN C44 S2 r i iC Registration Number Expiration Date HI�°m Name or HIC Registrant Name �^ g p rd Street t (2/13) Email address ity/Town, 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 4E7 No... 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize 1i/1/C(act 0C-r�4{24— to act on my behalf,in all matters relative to work authorized by this building permit application. 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. (fr1CIf ,rcS ticJ nt Owner's or Authorized Agent's Name(Electronic ignature) + 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 H1C Program can be found at www.mass.govlocn Information on the Construction Supervisor License can be found at ;ww.tnass.gorv'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.) 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 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 1.7 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Michael Parker DBA SharpLine Construction and Remodeling Address:17 Cosgrove Street City/State/Zip:East Longmeadow, MA 01028 Phone #:413-246-1071 Are you an employer?Check the appropriate box: Type of project(required): Lilt'am a employer with 1 employees(full and/or part-time).* 7. 0 New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. El Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.p i am a homeowner doing all work myself.[No workers'comp.insurance required.]1 10 Q Building addition 4.0 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.01 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ROOF repairs These sub-contractors have employees and have workers'comp.insurance. 6.0 We arc a corporation and its officers have exercised their right of exemption per MGL c. 14.QUtI20r 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. +Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Liberty Mutual Insurance Policy#or Self-ins.Lie.#:WC5-31 S-386141-011 Expiration Date:6/8/22 Job Site Address:124 North Street City/State/Zip:Northampton, MA 01060 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/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 hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Date:Si nature: �1 J/2.� Phone#:413-246-1071 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY 1t4, Liberty Mutual INSURANCE AR INFORMATION PAGE 175 Berkeley Street Boston.MA02116 Issued by LM INSURANCE CORPORATION 27243 Policy Number WC5-31S-386141-011 Issuing Office 016C RENEWAL OF: WC5-31S-386141-010 Issue Date 05-29-21 Account Number 1-386141 Sub Account 0000 1. Insured and Mailing Address MICHAEL PARKER DI3A SHARPLINE CONSTRUCTION &REMODELING RISK ID 121711 17 COSGROVE ST EAST LONGMEADOW,MA 01028 Status 01 — INDIVIDUAL Other workplaces not shown above: SEE ITEM 4. PREMIUM- EXTENSION OF INFORMATION PAGE 2. Policy Period: The policy period is from 06-08-2021 to 06-08-2022 12:01 A.M. standard time at the Insureds mailing address. 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500 , 000 policy limit Bodily Injury by Disease $ 100, 000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE END WC 20 03 0613 D. This policy includes these endorsements and schedules: SEE EXTENSION OF INFORMATION PAGE 4. Premium: The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Code Premium Basis Total Rate per $100 Estimated Annual Classifications Number Estimated Annual Remuneration of Remuneration Premium See Extension of Information Page Minimum Premium $ 500 (MA) Total Estimated Annual Premium $ 3,046 Premium will be billed ANNUAL Producer 0004-032384 T P DALEY INSURANCE AGENCY INC 1381 WESTFIELD STREET PO BOX 1150 WEST SPRINGFIELD MA 01090-1150 WC 00 00 01 A ©1987 National Council on Compensation Insurance,Inc. WC 00 00 01 B (CA) Ed. 07/01/2011 All Rights Reserved Page 1 of 1 Insured Copy b T THE MAIN Policy Number: MPP4029M STREET AMERICA BUSINESSOWNERS COMMON DECLARATIONS MAIN STREET AMERICA ASSURANCE COMPANY 4601 TOUCHTON ROAD EAST,SUITE 3400,JACKSONVILLE,FL 32245-6000 ht i Item 1. Named Insured and Mailing Address Agent Name and Address MICHAEL PARKER T P DALEY INS AGENCY INC (SEE NAMED INSURED ENDORSEMENT) 17 COSGROVE ST PO BOX 1150 EAST LONGMEADOW, MA 01028-1907 WEST SPRINGFIELD, MA 01090 Agent Phone No. (413)-788-0971 Agent No. 200518 Item 2. Policy Period From: 03-06-2021 To: 03-06-2022 at 12:01 A.M., Standard Time at your mailing address shown above. Item 3. Form of Business: INDIVIDUAL Item 4. In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. This policy consists of the following coverage parts for which a premium is indicated. Where no premium is shown, there is no coverage. This premium may be subject to adjustment. COVERAGE PREMIUM Section I —Property NOT APPLICABLE Section II — Liability $2,377.00 Inland Marine $175.00 CYBER $43.00 0. Total Policy Premium: $2,595.00 For Coverages subject to premium audit: Annual Audit Applies Item 5. Form(s)and Endorsement(s) made a part of this policy at time of issue: See Schedule of Forms and Endorsements Countersigned: Date: By: Authorized Representative THIS BUSINESSOWNERS COMMON DECLARATIONS AND SUPPLEMENTAL DECLARATION(S), TOGETHER WITH SECTION III —COMMON POLICY CONDITIONS, COVERAGE PARTS, COVERAGE FORMS AND ENDORSEMENTS, IF ANY, COMPLETE THE ABOVE NUMBERED POLICY. BPM D 1 1207 ------ -- ------ INSURED COPY 5}iar-pLine Proposal Construction and Remodeling December 19, 2021 17 Cosgrove Street Job No. 12069-01 East Longmeadow, MA 01028 (413) 246-1071 Proposal Submitted To: Work to be Performed at: Jacqueline McCreanor SAME 124 North Street Northampton, MA 01060 (413) 575-2021 We hereby propose to furnish all materials, labor,and equipment for the completion of the following job(s): Bathroom Remodel Please see detailed Proposal attached All material is guaranteed to he as specified, and the above work to be performed in accordance with drawings and specifications submitted. Any alteration or deviation from above specifications involving extra costs will be executed only upon written order and will become an extra charge over above the estimate. Contractor agrees to perform the above work and complete it in a substantial workmanlike manner,for the agreed upon sum with payments to be as follows: 1/3 due upon acceptance;1/3 due Halfway;Balance due upon completion. Invoices not paid by their due dates are subject to late fees/interest. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Date 12. - 2.t - 2�a ZI Authorized Signature le , 1 Note—This proposal may be withdrawn by us if not accepted within 30 days. License No. 085411 www.sharplineconstruct.ion.com Registration No. 14069 McCreanor,Jacqueline Proposal No. 12069-01 December 19, 2021 Page 2 Bathroom Remodel ❑ Obtain Building Permit(s) ❑ Apply dust and floor protection ❑ Frame for 3' x 2' and 2' x 2'niches; frame floor for drain clearance; add studs where needed; apply blocking for grab bars,pedestal sink and glass doors ❑ Patch floor deck; apply subfloor ❑ Build shower curb ❑ Install waterproof shower pan with lineal drain ❑ Install Hardie backerboard ❑ Patch floor deck; apply subfloor ❑ Apply RedGard membrane throughout ❑ Install customer-supplied shower/tub valve ❑ Apply moisture-resistant sheetrock to walls ❑ Install beadboard with access panel -sink side(*optional—add $500) El Install new customer-supplied pedestal sink and reuse faucet from old sink ❑ Move medicine cabinet ❑ Install customer-supplied tile throughout(ceiling, walls and floor—per photos and discussion) ❑ Prep.,prime and paint walls and ceiling ❑ Patch oak floor with customer-supplied flooring(stain and polyurethane to match as close as possible) ❑ Install baseboard to match(paint) ❑ Apply customer-supplied grout(2 colors)with sealant additive ❑ Install customer-supplied shower doors ❑ Install customer-supplied grab bars El Remove debris Material and Labor: $14,540.00 Attic El Apply dustproof containment(suspected lead)* ❑ Remove and replace 4' x 8' section of plaster with drywall ❑ Scrape remaining wall ❑ Skim and sand ❑ Prime and paint wall ❑ Remove debris Material and Labor: $2,850.00 * Sample will need to be tested for asbestos (cost of test included) License No. 085411 www.sharplineconstruction.com Registration No. 14069