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36-403 (7) BP-2022-0303 54 EMERSON WAY COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 36-403-001 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-2022-0303 PERMISSION IS HEREBY GRANTED TO: Project# 2022 EXTEND OUT WALL Contractor: License: Est. Cost: 42300 KEITER BUILDERS INC 102457 Const.Class: Exp.Date:06/20/2022 Use Group: Owner: TOLL LIBERTI,RITA& GERTRUDE B Lot Size (sq.ft.) Zoning: SR Applicant: KEITER BUILDERS INC Applicant Address Phone: Insurance: 35 MAIN ST,2ND FLOOR (413)586-8600 MCC20020005382021A FLORENCE, MA 01062 ISSUED ON:03/30/2022 TO PERFORM THE FOLLOWING WORK: EXTEND EXTERIOR WALL BY 4 FT. 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 p• , I • Fees Paid: S273.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner File #BP-2022-0303 APPLICANT/CONTACT PERSON:KEITER BUILDERS INC 35 MAIN ST,2ND FLOOR FLORENCE, MA 01062(413)586-8600 PROPERTY LOCATION 54 EMERSON WAY MAP:LOT 36-03-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $273.00 Type of Construction: EXTEND EXTERIOR WALL BY 4 FT. New Construction Non Structural Renovations )C Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INrORMATION PRESENTED: J Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR SpecialPermit With Site Plan Major Project: Site Plan AND/OR SpecialPermit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 3 /3 0a Sin ature of Building Official Date Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. RECEIVE D The Commonwealth of Massachusetts Board of Building Regulations and FOR `` 't Massachusetts State BuildingCode 780,13A NG ry APEciroN, MUNICIPALITY :•.u: oso Building Permit Application To Construct,Repair,Renovate Or Demo is$a-- Revised Mar 2011 One- or Two-Family Dwelling This Section For Official Use Only Building Permit Number:gP--2o22^0303 Date Applied: 1; . 't , .g . 3 3v BuildingOfficial(Print Name) Signature D--� g SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 54 Emerson Way (O I.1 a Is this an accepted street?yes no 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 Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Check if yes® Municipal y On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP 2.1 Owner'of Record: Rita Liberti & Gertrude Toll Northampton, MA 01062 Name(Print) City,State,ZIP 54 Emerson Way g8t011(a�sbcglobal.net No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'-(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) 0 Addition Irl Demolition ❑ Accessory Bldg. 0 Number of Units Other ❑ Specify: Brief Description of Proposed Workz: Extending exterior wall by 4' on a newly constructed home SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building $ 40,000 1, Building Permit Fee: $ 273 Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 800 a Total Project Costa(Item 6)x multiplier 42 x 6.5 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ 1,500 List: 5.Mechanical (Fire Suppression) Total All Fees:$ Check No.1,61-4 Check Amount'Z?3 Cash Amount: 6.Total Project Cost: $ 42,300 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-102457 6 20'22 Scott Keiter License Number Expiration Date Name of CSL Holder List CSL Type(see below) i' ,c;tstnin ctrPPt No.and Street Type Description Florence.MA 01062 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-586-860t- e.er(22'keiterbu;.iders coin I Insulation Telephone Email address D Demolition A D A µ 5.2 Registered Home Improvement Contractor(HIC) Keiter Builders, Inc. 175168 4128'2� (��ly..LiQa-c HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 35 Main Street skeiter@keite,rbuilaers.com No.and Street Email address Florence. MA 01062 416-�65-8600 City/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 Q No EI SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Keiter Corporation to act ga,my behalf,in all matters relative to work authorized by this building permit application. See attached signed contract Print'Owner's Name(Electronic Signature) Date SECTION 7b: OWNER1 OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information co r}t ined in this application is true and accurate to the best of my knowledge and understanding. Air/6�i/`- Prnsicier:t, KC Hint Owner's or Authorized Agent's Name(Electronic Signature) 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 HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at tsunv.mass.aov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq. fr.) (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" I trudy I r\._______:171 , 1,..7, E 0 O co c w . '.1-7)--- --- -1.- rt,.. L 115'-11" 1'-1' 9'-0" _____ 1 _\_____ O O 0 t D-12 N V N \ -I. . u N. ef . ((fr Relocate existing door to Relocate existing windows to O new wall new wall Slat -- FIRST FLOOR PLAN - Sunroom Expansion \ Scale: 1/4" = 1 -0 0 5 10 FT f BUILDERS Proposed Residence at 54 EMERSON WAY Florence, Massachusetts ,Inq...IM..a.,.....I" u�ro..�_,r..11.n,.,,n...nnao:,:�b.rro~..I...I:•��a«m:ama .ur�•:M 1�..Uecum.nU.M M.II r.Uln M oomm.n I.w..Ulurory.nG o1Mr nurnU rlp�U.IncluOnp m.c.pyrgM. Az, City of Northampton Massachusetts k a_ *pia, >' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building F Northampton, MA 01060 as'�-y�. �i�'` 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: Valley Recycling The debris will be transported by: Name of Hauler: Valley Recycling Signature of Applicant: : '>Ty-- Date: 3/25/22 Ls\ The Commonwealth of Massachusetts Department of Industrial Accidents @ti ii 1 Congress Street,Suite 100 _. �; Boston,MA 02114-2017 ° . '~ 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/0 Dganization/Individual): Keiter Corporation Address: 35 Main si•e€.c City/State/Zip: .ir,Trice MA 01062 Phone#: 4.1 586-8600 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 48 employees(full and/or part-time).* 7. 0 New construction 2.0 I am a sole proprietor or partnership and have no employees working forme in g 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 0 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Ro of repairs These sub-contractors have employees and have workers'comp.insurance.: 6.0 We area corporation and its officers have exercisedtheir right of exemption per MGL c. 14. X❑Other 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. t 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: AIM Mutual Policy#or Self-ins.Lic.#: MCC20020005382021.A Expiration Date: 6 '1.2022 Job Site Address: 54 Emerson Way City/State/Zip:Northampton 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 ce fy under the pains and penalties of perjury that the information provided above is true and correct '.1 Sienature: U ,-,- Date: 325 22 Phone#: 4'3-586-8600 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MM/DD/YYYY) AFRO CERTIFICATE OF LIABILITY INSURANCE 06/16/2021 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 Cyndie Henderson CISR,CPIA NAME: Webber&Grinnell PHONN Extl: (413)586-0111 FAX No): (413)586-6481 8 North King Street E-MAIL chenderson@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INsuRERA: Selective Ins Co of S Carolina 19259 INSURED INSURER B: MA Employers/A.I.M. 12886 Keiter Corporation INSURER C: Attn:Scott Keiter INSURER D 35 Main Street INSURER E: _ Florence MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER: Master Exp 2022 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 - -ADDCSQBR -- POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO REND CLAIMS-MADE X OCCUR PREMISES Ea occu ence) $ 500'000 MED EXP(Any one person) $ 15,000 A S2265567 06/01/2021 06/01/2022 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000,000 POLICY ECT LOC PRODUCTS-COMP/OP AGG $ 2.000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A - OWNED SCHEDULED A9105217 06/01/2021 06/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) Medical payments $ 5,000 • X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A - EXCESS LIAB CLAIMS-MADE S2265567 06/01/2021 06/01/2022 AGGREGATE $ 5,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION X STATUTE X ERH AND EMPLOYERS'LIABILITY YIN 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA MCC20020005382021A 06/11/2021 06/11/2022 E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 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 HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ""Evidence of Insurance"" ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 12 30-YR ARCHITECTURAL 4-4 ASPHALT SHINGLES,TYPICAL 2ND FLOOR CEILING . \ l i f I I ' 1 �8 I 11 I I Il !_ i Ii 1 1 t- i' 4— — _1=41 4-4 4- t , -- ,f 4 .,-,—r--,—. -..-.-L 1_.F 1 i .- I' 1 t1 1 1. i — — — I I METAL ROOFING AT SWNROOM ' �I I �� 1 I 1 -I 1ST FLOOR CEILING f''s \ L. / \ \ / V '� { 144X80 GLASS \ \ / DOOR / // TEMPERED, \ ( // I MPERE� / NSULATED, \ / ' _OW-EARGON \ / e'� =I_LED `, GRADE,varies REAR ELEVATION (SOUTH) ' SK2 � Scale: 1/4" = 1'-0" 0 5 10FT ' B U I L D E R Sc The rear(south)elevation at the Sunroom&Breakfast Nook should Proposed Residence at remain"similar"--only the pitch of the metal roof above would differ. 54 EMERSON WAY Florence, Massachusetts .n,I,nnaln,.�an..,MII IMu.�M.cnn,,.u,Ie pp,po...ens..IM,gn.,�.�..ann...anl.n,lantl employtle�tl M Jotly! N.. I 6 Oaagn,LLC la eHluetl In Me,peca Mler.T e♦rchMm,Mll M tleemetl IM euNor M.Mu omen,mtl,.JI nlaln M common lar,atelulory antl enter nunetl n0.n,Inclutlinp Me capyrlpM. LINE OF OLD ROOF STANDING SEAIV METAL ROOFING AT addition existing I SUNROOM new pitch _ T.O.W. —12 lam/ ia_t, 2nd 3.5 I i—�� - jam, �-_•— — T.O.W. faarrl at nvl _ag11 %I�ii/11/.1fit1111/1/1 _ i4 - MATCH EXIST. `�_ ww��w OVERHANG& \1 A -- Ce PROFILE @ NEW EXTEND EXPANSION PANELING IN \ AmmillIMIIIIIIIIINNtem ADDITION m RELOCATE r EXISTING DOORS .c _ 2x6 i l &WINDOWS INTO ao ) EXTERIOR WALL OF NEW ix ADDITION EXTEND FLOORING IN .1 SECTION AT PROPOSED ADDITION 1st I II SUNROOM EXPANSION }� NEW 2X FRAMING SCALE: 1/4" = 1'0" T.O.W. II ! 4 0 5 10 FT SPRAY FOAM AT l RIM JOIST Approx. Grade 2-1/2"THERMAX = RIGID INSULATION CONCRETE AT INTERIOR OF FROST WALL& I FOUNDATION FOOTING AT I ---—T— WALL,R-15.8 EXPANSION, BOT.OF FTG. PROVIDE THERMAL min.4'0"BELOW 2"CONC.SLAB IN - BREAK AT GRADE ADDITION CRAWL PERIMETER OF SPACEW/GRAVEL& SLAB-1"OR2" VAPOR BARRIER, RIGID INSULATION Basement BELOW Bot. Footing r I71O ----=_,— BUILDERSc' I Proposed Residence at 54 EMERSON WAY Florence, Massachusetts nrmnne.annr.M1.IlaM1.n..ebr.en nn,nr"n..."n"..M.=Isn.aoreti.NenN...e...n,.r.a or,a M1r peer e,rn,a N.mu,ae.,a o„'an.uc i,Nn,.e M M,,e.n xie"..,.rcmncr,n,ll n.a„m.e m. ,urnor el rM1,,,eecum,nl,,ntl,nNl r,l,ln,ll common,w.,lelulory,ne orn,r nurv,e rlpM1r,.Incluaing M,covYagm.