Loading...
32C-020 (12) BP-2022-0137 17 PLEASANT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-020-001 CITY OF NORTHAMPTON Permit: Demo PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0137 PERMISSION IS HEREBY GRANTED TO: Project# 2022 DEMO WALLS Contractor: License: Est. Cost: 2000 KEVIN R SCHNELL CS-109600 Const.Class: Exp.Date: 10/19/2023 Use Group: Owner: J BARC INC Lot Size (sq.ft.) Zoning: CB Applicant: LIVEWELL HOME IMPROVEMENT LLC Applicant Address Phone: Insurance: 33 LAUREL MOUNTAIN RD (413)409-2929 WCC-500-5024695-2021 WEST WHATELY, MA 01039-9604 ISSUED ON:02/14/2022 TO PERFORM THE FOLLOWING WORK: REMOVE WALL(S) IN REAR OF STORE 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 (. • i, . > • CI 1 • , 1 Fees Paid: $100.00 212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner -T, m IF m 7 The Commonwealth of Massachusetts /1 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 u u d (This Section For Official Use Only) (Buifclir►g 4uit Number:l3Z022-D 137 Date Applied:?J11/ZOZ-2. Building Official: —_ SECTION I:LOCATION VeaSaHti—r3' tiorf414Mptol f414- 0I060 DOWti ),u Souxlds d Str 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 0 Repair 0 Alteration 0 Addition 0 Demolition $(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 0 No Et Is an Independent Structural Enginjg Peer Review required? Yes 0 No. Brief Description of Proposed Work: fl t°10 D V i ny c r irk 11 CS) r r r P q( )-ore. 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) 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 0 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❑ 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 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 CI IB ❑ IIA ❑ IIB ❑ IIIA ❑ IUB ❑ IV CI VA 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's Check if outside Flood Zone r. Indicate municipal II( A trench will not be Licensed Disposal Site[ Private 0 or indentify Zone: or on site system 0 required for trench or specify: permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable k Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No. „ 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 Prope Owner Toseph 61U MIN ft 3GICh� l s 4/Orlh4rn1)ton,414 0106O Name(Print) No.and Street City/Town Zip Property Owner Contact Information ti_3-ko_- (6 5 f d oo +ow Je b to oelf 1�fay► j". Title Telephone No.(business) Telephone No. (cell) e address CO h'\ 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 C. Otherwise provide construction control forms see section 107 in the code as re.uired. 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 i.1vcAtell 1/Dine Tlin prd verllth.-/-- Company Name 6chnlell Name of Person Responsible for Cons ction License No. and Type if Applicable "33 Lau re/./b1ou 1gjn Rd. �1ti- 1i if 010f3 Street Address ei7 City/twn State Zip CIO -g01)-Nq ‘% W13 -1 - 8iq4) o( R e( l ,ve 'Il POMP fqrcIVPmevil: em 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 issuance of the building permit. Is a signed Affidavit submitted with this application? Yes 0 No CI SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor 0V l C and Materials) Totaonstructi Construction Cost(from Item 6)=$ 1.Building $ '(;)\000 Building Permit Fee=Total Construction Cost x_(Insert here 2.Electrical $ appropriate municipal factor)_$ . 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ (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. 4 01'/i vw (oh i 'Uo ? o j Pct A ilu y ev Gl -d:3T f'-I'i 1 2--9- Plea e mint and,sign mope Title Telephone No. Dat qII befrc�(A-ea 5fi soutl^ g ®G?4 01015 ilGttirto fiveweilkowe. Street Address City/Town State Zip Email Address j W)pru.k. Alt,1'=tom Municipal Inspector to fill out this section upon application approval: 40I ' sl 1 0 __� Name U I Date City of Northampton ,OQ1 H AMpTO\., ._"�. SIG, Massachusetts ��2 < DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building yv�, cam tir 59 Northampton, MA 01060 f -. `10 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: L C1 11 kOC yC h ✓I The debris will be transported by: Name of Hauler: iUeUtQt Uoi e movie VoBYI Signature of Applicant: Date: 2/42/21_ -9 e Commonwealth of Massachusetts ' Division of Professional Licensure ()R_ I 0 0-70 49 y Board of Building Regulations and Standards ConstritethSnitttpervisor OSHAECENTE ION CENTER Via CS-109600 Expires: 10/19/2021 This card certiftes''hat- KEVIN SCHNELL KEVIN SCHNELL 33 LAUREL MOUNTAIN ROAD WEST WHATELY MA 01039 has completed a 30-Hour OSHA Hazard Recognition Training for the Construction Industry. ,()Asl ko` ,u 02/23/2016 .. Commissioner AJce�.c. l�/1 Dire. Jeffrey Pairan Trr,mar:TaytarSikes Grad atr e.74 raM/ t?zePeade �a � Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration • Ty e: LLC eC - ` Registratio : 18114 LL HOME IMPROVEMENT LLC j :4�tl 33 LAUREL , , 33 LAUREL MOUNTAIN ROAD - ,� Expiration. 04/ 2021 ]` WHATELY,MA 01039 Update Addre and Return Card. ;CA 1 0 20M-05/17 0M + V Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid f ndividual use only TYPE:LLC before the expirat date. If found return to: Registration gxpiration Office of Consu r A irs and Busin ss Regulation 't811 04/11/2021 One Ashburt lace Suit 1301 LIVEW ELL HOME.►.MPROVEMENT LLC. Boston,M 108 KEVIN SCHNELLa 7,2����£. 33 LAUREL MOUNTAIN ROAD WHATELY,MA 01039 Undersecretary t ithout signature Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC LIVEWELL HOME IMPROVEMENT LLC. Registration: 17 33 LAUREL MOUNTAIN ROAD Expiration: 07//088/2/2 023 WHATELY, MA 01039 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 181146 07/08/2023 1000 Washington Street -Suite 710 LIVEWELL HOME IMPROVEMENT LLC. Boston, MA 02118 KEVIN SCHNELL 33 LAUREL MOUNTAIN ROAD za. ti WHATELY, MA 01039 Undersecretary Not valid without signature The Commonwealth of Massachusetts 1 �_�I_o, Department of Industrial Accidents .41 •r =t?I/1.=. l Congress Street,Suite 100 ="R;;= Boston,MA 02114-2017 t•• 4 www.mass.gorr/dia %t"uskers'Compensation Insurance Afiidasit:Buildersl('ontractors/EkctriciansfPlumbers. 10 BE FILED %I1'l1?IIE PERMITTING Al'1'HOR11A. Applicant Information Please Print Leeibh • r Name(Business'O rganization:individual►: t- 1 V e f t.r I do m e ZYn p i on eh 1 Adds: 33 Lau re l 'tilt Ade- City/state/zip:Lt4t W tAU 0toci'j Phone#: tit 1 j - CIO q -Msa`q Are y.n as employer?(hark r►e a prime ens: T)pe of project(required): 1 I am a carpksyec with. M employees l lull and or part-tits).' 7. 0 New construction 2 1 am a sole proprietor or paraaerahtp and have no employees soricutg tar re us B. Remodeling any capacity ['.0 workers'comp.soutane required.] 0 I am a homeowner doing all work myself.tNo workers'curry unurance mutated 1' 9. Demolition 4.0 I am a homeowner and w be hiring eo nir'actors to conduct all work on my property. I aifl IU Building addition m ensure that all contractors either trite workers'compensation insurance or are cola I 1 a Electrical repairs ur additions proprietors with no employees 12.0 Plunsbing repairs or additions 50 I am a moral contractor and I has t hoed the sub-euntractun hated on the attached sheet 13.QRoof repairs These sub contractors hate cmpkosem and hase workers'comp.rasurance.• 6.0 w e are a cutpuration and its officers hat a exercised thew right of exemption per ht(,L e. 14.0Other --------_ 152.41(Ih.and we have no employees.[tio couriers'comp.insurance required.] 'Any applicant that chocks bus a I must also fill out the section below showing then workers'compensation polity udorinatiun. 'Homeowners who submit this aflid astt indicating they arcdoing all Mork and then hire outside contractors must subirut a new affidavit indicating such. :C'ontracWr%that check thus bus must attached an aidutionud short show tag the name of the sub•couracters and state w hither or not those entitles have employees If the sub-contractors have employees.they must provide their vvrkes'esrmp.policy arrrrber% I am an employer that is providing natters'catttlpensatiar hwsrratrce for nip ewers. Deb*is Abe poky end jab site information. C; f� p Insurance Company Name: M.dI f 1 `1 lifie 4 w &itCA T7e �vci h( e Polic. .or Self-ins.Lie.#:/A P J '? ij Expiration Date: 3A j?‘.2— Job Site Address: al , 0 Pi 104 / J CityState"Ztp:ij,(j-h (4 ityl pia)1 Af#0/060 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration Witt). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1.500.(X) anl'or one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a line of up to S250.(K)a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage venfication. s. ••,`v e I do hereby cer fl nder the pains m mantes of perjary that the information provided a is tr a and correct. Sti<natur -Date: a tO� Phones: 44( r ��-7 -t7l/ Official use only. Do not write in this area,to be completed by city or town official ('its or Town: Permit/License Si Issuing Authority (circle one): 1.Board of Ilealth 2.Building Department 3.City rlown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone a: /"1 KEVISCH-01 LZAPKA '4r..-- CERTIFICATE OF LIABILITY INSURANCE DATE(M/202YYY) 1/28/2022 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 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 CQNTACT N E: Whalen1 Insurance Agency PHONE I FAX ,No):(413)585-0401 (A/c,No,EA:(413)586-1000 Northampton,MA 01060 miss:info@Whalenlnsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance 29939 INSURED INSURER B:A.I.M.Mutual Insurance Co. LiveWell Home Improvement,LLC INSURER C: 33 Laurel Mountain Road INSURER D: West Whately,MA 01039 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 TYPE OF INSURANCE IN O SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS jMM/DD/YYYYI tMM/DD/YYYYI A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR MPJ8858A 3/28/2021 3/28/2022 °REM sE3 EI:Eoccur encel $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY fits- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LU\BILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOS ONLY _ AUTOSp Ep BODILYO INJURYp (Per accident) $ AUTOS ONLY _ AUTOS ONLY (Perr a�ident)AMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LABILITY STATUTE ER Y/N WCC-500-5024695-2021 4/5/2021 4/5/2022 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ ' pFFI Bator EMBER EXCLUDED? N/A E.L.DISEASE-EA EMPLOYEE,$ (AAandatory fn NH) 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate issued as evidence of coverage 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 ty p ACCORDANCE WITH THE POLICY PROVISIONS. Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE All /hL I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BUILDING DEPARTMENT DEMOLITION PERMIT SIGN-OFF SHEET Date: Address: Building Use: Owner: Phone: Owner's Address: UTILITY CUT OFF (Signature of Authorized Representative of Utility Department required) As required by the Massachusetts State Building Code (780 CMR), a permit to demolish shall not be issued until a release from the utilities is obtained, stating that their respective service connections and appurtenant equipment have been removed or sealed and plugged in a safe manner. Eversource (Gas) Signature Title National Grid (Electric) Signature Title DPW (Water) Signature Title DPW (Sewer) Signature Title DPW (Storm water) Signature Title DPW (Tree Warden) Signature Title DPW Director Signature Title Historic Comm. Review Signature Title ASBESTOS REMOVAL All residential, commercial and institutional buildings are subject to Massachusetts Department of Environmental Protection (MassDEP) asbestos regulations at 310 CMR 7.15. Therefore, owners and/or operators (e.g. building owners, renovation and demolition contractors, plumbing and heating contractors, flooring contractors, etc.) need to determine al asbestos containing materials (ACMs), both friable and non-friable, that are present at the site, and whether or not those materials will be impacted by the proposed work, prior to conducting any renovation or demolition activity. Examples of commonly found ACMs include, but are not limited to, heating system insulation, floor tile and vinyl sheet flooring, mastics, wallboard,joint compound, decorative plasters, window glazing, asbestos containing siding and roofing materials and fireproofing materials. Failure to identify and remove all ACMs prior to its being impacted by renovation or demolition activities, can result in significant penalty exposure, and higher dean-up, decontamination, disposal and monitoring costs. A DOS certified asbestos consultant must be contracted to determine if asbestos is present and whether removal/repair is necessary. If the building is a state owned facility, contact DCAM and DOS. DOS provides a list of licensed asbestos abatement contractors and consultants. You may wish to inquire if a contractor has any history of violations. Only DoS licensed and DOS certified asbestos abatement contractors and consultants may be hired to perform asbestos related work in Massachusetts. Received by: Print Name Title Signature Date