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29-174 (8)
BP-2022-0318 81 DEERFIELD DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-174-001 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-2022-0318 PERMISSIONIS HEREBY GRANTED TO: Project# 2022 DOORS Contractor: License: Est. Cost: 151250 EXTERIOR ASSOCIATES INC 113456 Const.Class: Exp.Date:07/23/2022 Use Group: Owner: M CALLAHAN DAVID A&BETH Lot Size (sq.ft.) Zoning: WSP Applicant: EXTERIOR ASSOCIATES INC Applicant Address Phone: Insurance: 408 SOMERS RD (860)978-5911 WC9097314 ELLINGTON, CT 06029 ISSUED ON:04/01/2022 TO PERFORM THE FOLLOWING WORK: INSTALL 2 ENTRYWAY DOORS, NO STRUCTURAL CHANGES 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 ' I Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 • Office of the Building Commissioner The Commonwealth of Massachusetts , id ;`-. Board of Building Regulations and Standards FOR Sri —� Massachusetts State Building Code, 780 CMR t MUNICIPALITY USE o --4uilding Permit Appltcauon To Construct.Repair, Renovate Or Demolish a RevtseS Afar NM o Qiw-w fl wi vo.F ih>DHr11/ng ^ [� ThisSection For Official Use Only Butldiag,Pet it tt er. l°Zozz-03 Date Applied: BuildingI rf , -P.! &as, F.. -2: z/-/-z,2z ..Official�U��____._ , ., (Print Name) Signature Da lc SECTION I: SITE INFORMATION 1.1 Pro erty Addreso: 1.2 Assessors Map&Parcel Numbers 29 —r74'— 00 1 I l a Is this an accepted wtreet?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 1 WS P . ,1?7. cr _. zoning!Isom Proposed Use Lot Area IN fit Frontage{fil .. 1.5 Building Setbacks (ft) Earn Yard Side Yards T___._____ v_. Roar Yard Required Provided Required 1 Provided I Required Provided I.b Water Supply:(11.G.1.c.40.450 1,7 Flood Zone Information: 1.8 Sewage Disposal System:" Zone: Outstdt Flood Zone' • Public.❑ Private i check ifwsD ` Municipal❑ On m u disposal system CI __ �._ _.__r. �,�.H __ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Namr{ ritu} (try• State-ZIP No.and Street Tctepltone Email Address SECTIONS: DESCRIPTION OF PROPOSED WORK'(check all that apply) . New Construction❑ Existing Building CI Owner-Occupied ❑ ' Repars(s) © A.eratton(s) ❑ Addition 0 Demolition ❑ Accessory Bldg.a ; Number of Units I Other la St ecifv-Doors _ Brief Description of Proposed Wo SECTION 4:ESTIMATED CONSTRUCTION COSTS Estimated Costs: Offklal Use Only (Labor and Materials) I. Building g I. Building Permit Fee:S Indicate haw fee is determined: 2. Electrical Standard City Town Application Fee $ ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing S 2. Other Fees: $ i 4. Mechanical (IIVAC) S List 5. Sup a gilann) (Fire $ Total All Fees S q 0,-- pp Check No.N224__Chcek Amount? 0.°�Cash Amount: O.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: T�. SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 113466 7/23/2022 Kyle Nielson License Number Expiration Date Name of CSL II loftier List CSL Type(see below)_R __ . _ 4418 Somers Rd. ----- Tvpe De is ription No.and Street II '. 11111041 u led(11iiddiiiss up to I';Am:ten.II) Ellington.CT 08029 R Restricted tJ 2 Family Dwwdliisi Curious. State.ZIP hi Masonry RC' RoofmgCovenng W'S t Window and Siding SF Sot id Fuel Burning Applianoes 880-978-5911 OFFICE@EXTERIORASSOCtATES.COM 1 Insulation Tdaplione Email address I) Demahuun 5.2 Registered Monte Improvement Contractor(HIC) tp3t75 M28/2073 Exterior Associates, tic, ______� hill Registration Nutmla�:rExpiration Date ill('C'oinlxin Name or t}ll( Rip iirattt Nana 408 Somers Rd. _-�_— OFFICE itEXTERIORASSOCIATES.CO41 No.and Strevi Erma address Ellington,CT06029 860•987.5911 City!Town.State,ZIP Tel whoa* SECTION in WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.g 25C(b)) 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 o f the buikltng permit. Signed AI'fidarit Attached? Yes .. .. . .Bit No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED MI E N OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject p operty.hereby autbonze Este rior Assoc Mies. Inc. to act on my behalf.in al tatters relative to work authorized by this building permit application P s N ectronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECL4.RATION By entering my name below,1 hereby attest under the pains and penaltieso f perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. David Callahan IIIIIIIIIIIIIIIIIIIII Prut°ester's Of Authorized A tent's Name ti tr au:Signalut.l Dale NOTES: I, An Owner w o 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(111C)Program),will nor have access to tb arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found al www.mass.zovfoca Information on the Construction Supervisor License can be found at www,rnlius.ttovldps 2. When substantial work is planned.provide the information below: Total floor area(sq. ft.) (including garage.finished bayemerL'atttcs.decks or porch) , Gross living area(sq. f.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number oflnlf'baths Type of beating system Number of decks'porches Type of cooling system —___ _____ Enclosed Open _ 3. "Total Project Square Footage"may be substituted for"Total Project Cost" Client#:98251 EXTERASC DATE(MMIDDIYYYV) AC(•)1"®,,., CERTIFICATE OF LIABILITY INSURANCE T MMI2021 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Lynn M. Paparazzo Starkweather&Shepley (CT) PHONE _ FAX 860-709-9354 P y _(Ale,No,ExI):860 5$3-0943 _ qle No_ Insurance Brokerage, Inc. E-MAIL IPa arazzo starshe .com PO Box 549 aooauss: P @ p ------- ___ INSURER(S)AFFORDING COVERAGE_ _NAIL fl Providence, RI 02901 0549 -- Selective Insurance Co of New England 11867 INSURER A: ._,______—...�_.__ __._._...____-_—_______ 9 INSURED INSURER B _. Exterior Associates, Inc. ..._—.___ .._..._-._..__-.._..._._.---_...---._.—___._..--__.__.....--------.------- 31 Overbill Road INSURER C: _.__..—__— Ellington, CT OG029 INSURER D: _.__.........._......_..___.__.___...._-_._.-....__.__..__—...---- INSURERE: .._._.._______..._......._......__._..._..._..._.—.-_...._-__._._. --_ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 'rI-IE 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 DE 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 I-IAVE BEEN REDUCED BY PAID CLAIMS. INSR AUDL SUER POLICY EFF POLICY EXP • LIMITS _ L7R TYPE OF INSURANCE INSR WVD POLICY NUMBER __--(MMIDDIYYYY}_(MMIDD YYYY}_I--� A X COMMERCIAL GENERAL LIABILITY X S2442015 04/01(2021 11114/2022 EACH OCCURRENCE __— 51 O, 00 000 DAMAGE TO RENTED S 5O0 OOO ,.._-__I CLAIMS-MADE I. XI OCCUR PREMISES(Ea°ccurrened_ .- ,___ _ ....... ........... ........__ ..._-_......___.. _MED EXP(Any one person) _ S 15,000 — PERSONAL&ADV INJURY S 1,000,000 GENI'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE 52,000,000 XI POLICY I X ..IIEC LOC _ — I,--_I ' PRODUCTS-COt<�IPtOP AGG S2,000,000 I OTHER: S AUTOMOBILE LIABILITY S2442015 COMBINED SINGLE LIMIT 0,000,000. A )( 04/01/2021 1111412022(Ea ncemer ____.._._ .._.... . X ANY AUTO BODILY INJURY(Per person) S • OWNED I SCHEDULED ' AUTOS ONLY _ AUTOS BODILY INJURY(Per occident) S IiIREO NOPI-04VIJ0 PROPERTY DAMAGE 5 _.....__._.—_ X AUTOS ONLY X AUTOS ONLl' ,(Per occident)..„_.__._- S A X UMBRELLA LIAR I X OCcuR 1 X S2442015 04101/2021 11/14/2022 EACH OCCURRENCE S2 000 000 EXCESS LIAB CLAIMS.MADE AGGREGATE 52 000 000 {{ j___f RETENTIONS.- _ 5 WORKERS COMPENSATION -�-�PCR OTH- A AND EMPLOYERS'LIABILITY YIN WC9097314 11/14/2021 11/14/2022 h_IsioT_u.T.E-_�..__�EL�I ANY PROPRIETORIPARTNERIEXECUTIVE`-'- E.L.EACI_I ACCIDENT _ ! (Mandatory In NH) E.L;DISEASE•EA EMPLOYEE 5500,000 II Yes,describe under _ --- DESCRIPTION OF OPERATIONS bolovi_ _ B.L,DISEASE•POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddllIonal Remedy;Schedule,may be altochad If moro space Is required) Home Depot USA, Inc., dba THD At-Home Services, Inc.,its parent,affiliates and subsidiaries are added as additional insured including On-Going & Completed Operations as required by written contract/agreement CERTIFICATE HOLDER CANCELLATION Home Depot USA, Inc„dba THD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN At-Home Services, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. Home Services Compliance C-11, 2455 Paces Ferry Road AUTHORIZED REPRESENTATIVE Atlanta, GA 30339 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #51811758/M1808232 CTLMP -- The Commonwealth afMassvckuseffs • .Oepartfiret i of Industrial Mccirde zts ;;; �';'_~ .1 Congress&Teel,Suite,100 tF •.?'=.`J(+�(f, .Boston, l'tli 0.2114 2017 5 �r ..�.�ye,';" www tnrss.go /d/a L• 'tiros-hers'Compensation Insurance Af$tdnvit;Builders/Coritr'actors/Giacfricialus/Plnnzhers. TO RE FEUD WITH TEE PERMITTING iI,OT ORTTY. AprtlicantxntOrntfition Please Print Ltgligy Name(]3usincegorganiration/Indiv'.dual): EXTERIOR ASSOCIATES. INC. ' Address: 408 Somers Rd. City/ tato/Gip: Ellington,CT 08029 Plon.e#: 860-978.5911 ...-. Aar.you an cmpinyer7 CAcmilt the appropriate host — ' Type of project(rcquired): 1,F1 I am a cr.ployer with 12 _employees(dill and/or parr-time).* 7. E'New cuJ stnic tun 7.n I OM aoic tmro tutor or permcrrhip:tad have no ontploycoa working forme in 8. ElRomodeliug any capacity,(Isle workout'ramp.insurance;rcgrured] 9. 0 Demolition 3.0r ant n homeowner doing all work myself,(No worker'corium.insmecc,crguircd.1 t [-11 • A,0I am a homeowner and will be hiring emulators to conduct:all work en soy property, t will iS t Mating addition coon"that all contracts=either have workers'compensation insurance or are sale 1.1.0 I:}lectrical repairs or additions pzrprlutors with en employees. 12.0Pituubingrepairs or additions So I am a general cot actor and Lava hired Ito sob-coatraeIo a listed on rho attached sheet • 13.oRoo repairsThcyc suh-contractors have cmpioyets sad have worknia'comp,roan at;t:te,4 • 14.0 Other 6.r We are a automatics 11nd its officers have cscroiand their right of exemption per MC&c. - i 152,§f(4),taad woo hove no employees.CNo workers'cn up.inmate acquired.] *Any applicant that oheuks box i:l.trust also fit out the section holow abowing their-Workers'cotnpuuidion policy infotnietion, l ,etneownern wiio submit this affidavit indicating they am doing all work earl then hire mishit)cantramorn'meat submit a new a`.ftdavit indicatlzmg such, %ontmcto;r that chuck this F DX M uyt attached en nerd tional sited showing the nnma of the sub-contactors anti state whether or not those aunties hayo c:nployecs. .if the suircertrac;oir,have employees,they must pyritic their warkets'comp.policynumber. I am an employer that is providing workers'compensation sation insurance•tor ny employees. Below is the policy and job site • ii forrrratton. zutance Company Name:B erkley Insurance Co. — • ?oiioy fi or Self- W ins.Lie.ii: BNUC013857° �Y� Expiration.bee: 1i?14J2 Sail Site Address:IIIIIIIIIIIIIjll. City/StatelZip: CjC Qa Attach a copy of the workers' conysalon poi cv declaration page(showing the policy ntu m er'au cai�ir.'a Zen date . Failure to ammo coverage as required tinder MCI.c.'152,§2.5A.is a criminal violation,punishable by a line up to$1,500.00 • and/cur one-year imprisonment,as well as civil penalties in the fotnn of a STOP WORK ORDER and a lino()fop to$250.00 a day against:the violator.A copy of lhis statement may he!:orsvarded to the Office of Investigations of The DIA.for insurance coverage verification. .I do hereby certify reinter the pains arul nenalties of perjury that the htfornation provided above Is true end correct. Signature: Dennis Audet ". mite' •_ rho rtc)f: 860-978-5911 ,. Official use only. Do not write in this area, to be completed by city or town official, City or Town:,. .., _ Perna.itll icertstt# ._ -- ' Issuing Authority(circle ono): i.Board o.tllealth 2.Buiidittgl)epartment 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Isnspec;tnr 6.Other ContactPerson: Phone it: oromonwe&th of Ma! sactitl<setts I 5 ivI ton of.Professional 1.4censUU , Board Of w 'd r R�utat +ns .ar d tan k ' .' '# 4 `'' w -*s it" ''s,, /2 J 2 NWLSE „ -, , LANZ `` 9:` � ''err r i, ELLIt4GrT'O c . ''1 4e1 N:0 7.Fj f, I �4 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporaticn Registration 103175 EXTERIOR ASSOCIATES ING Expiration 04l28/2023 31 OVERHILL. Rl1 ELLINGTON, CT 0E020 Update Address and Return Card. Otfico of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Ut!no,oltnn boforo the oxpiration date. If found return to: gegiutrrtion EXIBratifL Office of Consumer Affairs and Business Regulation JG31 75 01'28 2023 1000 Washington Stroet •Suite 710 EXTERIOR ASSOCIATES INC Boston,MA 02118 .)31 OVERHILL Rq ;,.,r Sr1. J ELLINGTON.CT o6071.t Not vatt'd without signature Undersecretary