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36-391 BP-2022-0449 148 EMERSON WAY COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 36-391-001 CITY OF NORTHAMPTON Permit: New Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FjJND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0449 PERMISSIONIS HEREBY GRANTED TO: Project# NEW HOUSE Contractor: License: Est. Cost: 325000 SHAUL PERRY 065400 Const.Class: Exp.Date:06/25/2022 Use Group: Owner: CORPORATION SUNWOOD DEVELOPMENT Lot Size (sq.ft.) Zoning: SR Applicant: SUNWOOD BUILDERS Applicant Address Phone: Insurance: 84 POTWINE LN (413)259-1000 WMZ80080056582021A AMHERST,MA 01002 ISSUED ON:05/13/2022 TO PERFORM THE FOLLOWING WORK: 2420SQ FT SINGLE FAMILY HOUSE 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: • 6 _y2 - Fees Paid: $1,681.30 212 Maim Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts W Board of Building Regulations and Standards MAY 1 1 2022 FOR Massachusetts State Building Code, 780 CMR M1INIGIPALITY USE Building Permit Application To Construct, Repair, Renovate Of Demolish a \Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: (5/1' 2.2...- iy Yr Date Applied: i JI,c ► (r , �' to ii Building Official(Print Name) I Signature I --� e _ SECTION 1:SITE INFORMATION 1.1 Pr ert ddress: 1.2 Assessors Map&Parcel Numbers /fd vso17 Wayc2o/1'f) c36 c39( 1.1 a Is this an accepted street?yes,- no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: "IR //cif /0.3' Zoning District Proposed Use Lot Aka(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided /CO' /d0' 68' 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private 0 Zone: Outside Flood Zone? MunicipalAOn site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2 Owner'o cord: �.�! //ifU'/ � /1r1 Of/0001 Name(Print) i City,State,ZIP i. 8if .2O/Wine- e/ 0-,d9'9-/000 t uit ✓ood ccoarco4 vtr./ No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New ConstructionJl� Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition t❑' Accessory Bldg. 0 Number f Units Other 0 Specify: Brief Des i tion pf Proposed22Work2: ' ooM, V r pryY w/ Or Q '�ia/ ninnQ SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ „/�Q00 1. Building Permit Fee: $ Indicate how fee is determined: �""' 0 Standard City/Town Application Fee 2.Electrical $ per' 000 0 Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ 000 2. Other Fees: $ 4.Mechanical (HVAC) $ 10 000 List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ go Check No.31 b I Check Amount:1 v' ' Cash Amount: 6.Total Project Cost: $3074000 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) (6/-0/(/00 Pa,'AA)/ License Number Expi anon ate Name of CSL Holder PpTyVi!/ JCijaoc/ List CSL Type(see below) No.and Street Description 6` 001 Unrestricted(Buildings up to 35,000 Cu.ft.) �/�� 0 Restricted 1&2 Family Dwelling City/Town,State,2I M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 1/5 A/�Q`-/00D �i9ffWOOCI C CO/J"1eru/fi I Insulation Telephone Email address D Demolition 5.2 Registered Home Im roveme2t Contractor(HIC) /^p 2 01/ (�(>/114 00J c>i/U''CJS HIC Registration Number p. tion Date HImpaitylklame or HI Registrant Name il1Ufrorici euftwood&CO/Y7G061 No.r Xe t// D/OO� / 0 -V0 o Email address 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 No 0 SECTION 7a:OWNE AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize 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 her:.y atte t under he pains and penalties of perjury that all of the information contained in this application is tru, and a., urat t the best of my knowledge and understanding.il ek Print Owner's or Auth ized9'. Name(Elec onic Si ture) 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 www.mass.gov/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 f Number of bedrooms Number of bathrooms j Number of half/baths Type of heating system Number of decks/porches OI Type of cooling system Enclosed Open o[ 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: (39( LOT SIZE: 4080 REAR LOT DIMENSION: 6 r/ REAR YARD 6 r/ SIDE YARD 1/0 r SI E YARD A6 XQ( W it'i v I 3 /f- FRONT SETBACK FRONTAGE /al AI City of Northampton Massachusetts Gy 5 �F DEPARTMENT OF BUILDING INSPECTIONS r4. o (p 212 Main Street • Municipal Building %);*.may Cb f--'° Northampton, MA 01060 �sbjy�j�0 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: ,gc S cr'eC� 0010 Location of Facility: Z.14.,i Xc,/yritt " Gel ArAirr tort rc/ Wori //'l The debris will be transported by: Name of Hauler: evrrv✓ooI Zudric..r'S Signature of Applicant: Date: _ . The Commonwealth of Massachusetts wow h Department of Industrial Accidents m 1 Congress Street,Suite 100 Boston,MA 02114-2017 , www.massgov/dia Walters'Compensation Insurance Affidavit.Bnilders/CTractorsillectr rinnstPlumbers. TO BE FILED WITH 111E PERMITTING AUTHORITY. Applicant Information Cl � � Please Print l.eltibi► Name(Kusincss�'ckganizatonlndividual): giill won ui et'S Address: • CityfStatelZip:y�� r cce4/ Ai O/OOp/ Phone#: c3 ' 9-/000 :frig wrw>W MOO!,Or?Chrrk the appropriate hot: Type of project(required): am a cngilo ict with employees(hull and w part-tim}' 7. Q New construction y t l ant a sok proprietor or IY.nanen hip and haw no employeesKorknir for nye in g. 0 Remodeling L•f any capacity-[No o'Orken.ctnnp.insurance it:quir s:LI 9. ❑Demolition 3.a 1 am a bo nRti"u i.a.Lang all wont myself(No uuttm'comp.irnnranee required"" le Building addition 4.0 l am a lrinrwuncr and will tic hiring corarntors to conduct all work on my propv:rty. I will 1m41n:that all contractors either(mire%oar a-compensation ignorance or ant sole 11E.]Electrical repairs or additions prorpricturs with no employees_ 12.0 Numbing repairs or additions Kin I lima general contractor and I love hued the soh-cuntrxewrt hstal rm the attached sheet The*: 13 Roof airs srb-cmm haw traeturs ha ctitrployecs arnl love wrigglers-cusp.ignorance_• 14.0 Other b. Wean&corporation and its cameo.have c.xcnnscd their right of ctcnrpum per WI_e. 132,41(4).and we have nu employees.[No worker;comp_insurance rcyuinaI l 'Any applicant that dirks box#1 mrmu also fill out the section below slowing their winters'oompensrimt policy infowroarirn. "thnncvwarts who submit this affidavit indicating they arc doing all work and then hire outside emigration'Host submit a new affidavit indicating:suck Contractors that cheek this bus must attached an additional sheet showing the same oldie s ca mmetorsajd state whether or out those amities have employees_ 11 Mc sob-contractors have ergiluys,es,they mint prosaic their workers`comp.policy number. l am an employer that is providing workers'compensation insurance for my employers. Below is the policy and job.site information. Insurance a Company Nate: W f rat/` c Policy#or Self-its_Lie_#: f l{f/41-5OOOa5. (5Sd0pf/A Expiration Date: 000104. Address:lob Site Addr : /iO U niorl IYa 44,..)Cfr City/State/Zip: ,i 10/O/(O 0 Attach a copy of the workers'compensatiot'p liar I page(showing the policy number sad espi ration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to 81,500.00 and'or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$2.50.00 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 molder ad penalties of perjusy that the information prorlided above Is rue and correct Signature: Date: il/C r�� Phone#: ?/3 �-� Official use only. Do not write in this area,to be completed by city or town of icint City or Town: PermitiLicense# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: AC RL CERTIFICATE OF LIABILITY INSURANCE DATE(MM DD YYYY) 04/26/2022 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 CONTACT Kathy Parker NAME: Webber&Grinnell PHONo,Exn: (413)586-0111 FAX No): (413)586-6481 8 North King Street E-MAIL kparker©webberandgrinnell.Com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Selective Ins Co of Southeast 39926 INSURED INSURER B: Selective Ins Co of S Carolina 19259 Sunwood Builders,Inc.,DBA:Sunwood Development Corp. INSURER C: A.I.M.Mutual/A.I.M. 33758 Attn:Shaul Perry INSURER D: 84 Potwine Lane INSURER E: Amherst MA 01002 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2242618181 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,DAMAGE T 000 CLAIMS-MADE X OCCUR PREMISESO(EaENTED occurrrence) $ 500,000 MED EXP(Any one person) $ 1 5,000 A S239905501 03/04/2022 03/04/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO- , LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED N/ SCHEDULED A9108082 03/04/2022 03/04/2023 BODILY INJURY(Per accident) $ AUTOS ONLY /• AUTOS X AlTOSIRED ONLY X AUT NON-OOS ONWNEDLY PROPERTY DAMAGE (Per accident) $ A Medical payments $ 5,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE S239905501 • 03/04/2022 03/04/2023 AGGREGATE $ 1,000,000 DED X RETENTION $ 0 $ WORKERS COMPENSATION PER I OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 500000 C ANYETOR/PARTNERIEXECUTIVE N/A WMZ80080056582021A ' 05/22/2021 05/22/2022 E.L.EACH ACCIDENT $ , OFFICER/MEMBER EXCLUDED'? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 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) City of Northampton is listed as additional insured with respect to liability as per the terms and conditions of the policies. 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. 240 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 111,�.-D r� ^-�`Y I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Home Energy Rating Certificate Rating Date: 2021-01-28 III Registry ID: Projected Report Ekotrope ID: lLVJnB7L HERS° Index Score: Annual Savings Home: 39 Your home's HERS score is a relative idi( Emerson Way performance score.The lower the number, 4,926 2 6 Florence, MA 01062 the more energy efficient the home.To Builder: learn more, visit www.hersindex.com *Relative to an average U.S.home Sunwood Builders Your Home's Estimated Energy Use: This home meets or exceeds the Use[math] Annual Cost criteria of the following: Heating 14.0 $612 2015 International Energy Conservation Code Cooling 0.6 $25 Hot Water 2.7 $119 Lights/Appliances 30.3 $1,275 Service Charges $0 Generation (e.g.Solar) 0.0 $0 Total: 47.6 $2,031 HERS Index Home Feature Summary: Rating Completed by: ,� Moretram Home Type: Single family detached nw Model: N/A Energy Rater: Rachel Baton Existing 1ao Community: N/A RESNET ID 1726523 Homes ,� Conditioned Floor Area: 4,175 ft2 Rating Company: Power House Energy Consulting 110 Number of Bedrooms: 3 PO Box 9571,North Amherst,MA 01059 uo 413-835-5162 Reference Home 100 Primary Heating System: Air Source Heat Pump•Electric•3.05 COP •o Primary Cooling System: Air Source Heat Pump•Electric•21.5 SEER Rating Provider: Energy Raters of Massachusetts e0 Primary Water Heating: Water Heater•Electric.3.75 UEF 2 Woodlawn Street Amesbury,MA 01913 70 978-270-3911 �,.•• House Tightness: 2 ACH50 so Ventilation: 71 CFM•50 Watts 4, Y•it 13' *o,—.• 39 Duct Leakage to Outside: Untested Ms Nome Above Grade Walls: R-28 ' a.••-'fi ' 10 , /� �?;.. so Ceiling: Attic,R-59 ac�le/ Bate,i. Zero Ene Home o Window Type: U-Value:0.23,SHGC:0.21 Rachel Balon,Certified Energy Rater ,:a'SPIShf' sip, Lea n,., Foundation Walls: R-18 Digitally signed:1/28/21 at 12:41 PM ekotro e Ekotrope RATER-Version3.2.4.2601 The Energy Rating Disclosure for this home is available from the Approved Rating Provider. This re••rt does not constitute an warran or•uarantee. i City of Northampton `T`' '&(s '' -' Massachusetts „,, _ t DEPARTMENT OF BUILDING INSPECTIONS x 21.2 Main Street • Municipal Buildingy Northampton, MA 01060 Fee Calculator for New Residential ConstructiotO�NLY Location : 1i/8 ‘fere0/7 Vail, a/, io,�,., 4r � Square Footage Amount Basement @ .20 .106 1(319,0 1ST Floor @ .50 _/Z96 oo 2nd Floor @ .50 61( .•. 'f/0`So '/2 Floors, Finish Attic, Garage @ .20 616/0 4 8 od Deck / Porches @ .20 M8 /0 `° Total : it,/,6f.(3a Raptue Ai- # g(t 0 (Ckekdide) OUP #/0� 90 iti it