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18D-053
UNITS 3110,4110,6110-80 DAMON RD BP-2005-0461 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18D-053 CITY OF NORTHAMPTON Lot: -063 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL C.142A) Category: BUILDING PERMIT Permit# BP-2005-0461 Project# JS-2005-0611 Est. Cost: $22850.00 Fee: $105.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: INTEGRITY DEVELOPMENT & CONSTRUCTION INC 059672 Lot Size(sq. ft.): Owner: NORTHAMPTON 811 INC 7oninc,: Gi Applicant:_ INTEGRITY DEVELOPMENT & CONSTRICTION INC AT: UNITS 3110, 4110, 6110 - 80 DAMON RD Applicant Address: Phone: Insurance: 110 PULPIT HILL RD (413) 549-7919 Workers Compensation AMHERSTMA01002 ISSUED ON:10/27/04 0:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR RENO UNITS 3110, 4110, 6110 KITCH/BATH 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final:dK G ,7`-05- 414 THIS PERMIT MAY BE REVOKED BY THE CI Y OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. 7 .64— Certificate of Occupancy Signature: ....,_.. ..,..e4c...del ,..frr' ' FeeTvpe: Receipt No: Date Paid: Check No: Amount: Building 10/27/04 0:00:00 10211 $105.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo File#BP-2005-0461 APPLICANT/CONTACT PERSON INTEGRITY DEVELOPMENT&CONSTRUCTION INC ADDRESS/PHONE 110 PULPIT HILL RD AMHERST (413)549-7919 PROPERTY LOCATION UNITS 3110,4110,6110-80 DAMON RD MAP 18D PARCEL 053 063 ZONE GI THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Adil t/US Typeof Construction: INTERIOR RENO UNITS 3110,4110,6110 KITCH/BATH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 059672 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION :ASED ON INFORMATION PRESENTED: Approved _Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permi With Site Plan Major Project: Site Plan AND/OR Special Permit 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 wer 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 Commis ' n /d Z,G �'6 p Signature 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. I • Version 1.7 Commercial Building Permit May 1.5.2000 Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans. Other Specify APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHAN USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE 0- ►yFAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address: 3 I / iff(U - This section to be completed by office �LJ�.t'Y�l6Y1 WIC) Map _ _ Lot_ _Unit — 0 ',„ _ � � Ls CD( Zone _ Overlay District �r� Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Signature Z„ i 12 Telephone 2.2 Authorized Agent: Name(P" t) Current Mailing Address: sCs Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building a 1 t oo° (a)Building Permit Fee 2. Electrical 5--° (b)Estimated Total Cost of Construction from(6) 3. Plumbing D D Building Permit Fes 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3 +4+5) a 2 t ?5 C) Check Number /0,2 // This Section For Official Use Only Building Permit Number: __ Date Issued: — —_ Signature: Building Commissioner/Inspector of Buildings bate: —� • Version1.7 Commercial Building Permit May 1'-,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations h‹, Existing Wall Signs Existing Ground Signs Additions 0 Roofing 0 0 0 Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] 0 Accessory Building[ ] Repairs [ ] SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 0 A-2 0 A-3 0 1A 0 A-4 0 A-5 0 1 B 0 B Business 0 2A 0 E Educational 0 -w. 28 0 F Factory 0 F-1 ❑ F-2 0 2C 0 H High Hazard 0 3A ❑ I Institutional 0 1.1 0 1-2 0 1-3 0 3B 0 M Mercantile 0 4 ❑ R Residential 0 R-1 0 R-2 ❑ R-3 5A { 0 S Storage 0 S-1 0 S-2 0 5B. . ) U Utility ❑ Specify: M Mixed Use ❑ Specify: -- — -_—r~-- S Special Use ❑ Specify: T— - --- COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: `; C 1ALC L_� Proposed Use Group:_ 1��SLcO dv'l:t c. Existing Hazard Index 780 CMR 34): p,It# Proposed Hazard Index 780 CMR 34): 04 _ SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1st 1 s1_— 2nd 2nd —— _ _As jliT___ lA-H Total Area(sf)_ __ Total Proposed New Construction(sf) _ __�^ _ - "- _—___ _____ Total Height(ft) Total Height ft------------------- 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: 'ublic 0 Private 0 Zone:____`_._. Outside Flood Zone 0 Municipal 0 On site disposal system 0 Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning I v N ( A/ uis columnbe filled in by `�' BuildingDepartment rtmentt Lot Size Frontage Setbacks Front Side L: R L: R: Rear Building Height Bldg. Square Footage �. Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES_ No IF YES, describe size, type and location: • • Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 118(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE), 9.1 Registered Architect: JA_ry\,�p J c )2 Not Applicable,/ ❑ Name(Reglst t): -- _'/-W 'le Z, R l 6)( /Cq� V (�^D �C /�►�0 (ad Registration Number Address E C S)3/Q5— (0_log 4 Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): 1 Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date __— Name — �— Area of Responsibility Address '--__—__.� _ '-� •""`- Registration Number Signature Telephone Expiration Date Name — — a of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility �~ Address Registration Number — —�— Signature Telephone Expiration Date 9.3 General Contractor t_r 12t-k (g-K-41)1X_,47-1ErN Not Applicable ❑ Compar i Nam _ >ff5 SC Responsible In Charge of nstruction Address I p� Signature Telephone . Version1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No f/3v SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS 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. Signature of Owner Date I, 1 Y N(J•l 'O S ? PylA'Ma*n __ _TT _,as Owner/Authorized Agent herebydeclare that the statements and information on the foregoing application are true and accurate,to the best of myknowledge 9 e9 9 pp 9 and belief. Signed under the pains and penalties of perjury. id 04-0\6 Print Name Y1� r10,(\ Sk t A .--1)- (\C--- Tv:" Q yj vvot r), 4-.11C'eur:77e c Ar-i--- t Signatur of Owner/Agent _ Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder; `p-arc- sc� C J e s'-i (" 't" `' License Number v PiAA p. 1- 44(,[( Pi A-vvv i-t c oOZ c / io i Ad IExiratlon Date re Telephone SECTION 13-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. r Signed Affidavit Attached Yes No 0 o4iiw.rnT0 r.. ti • R� I _ (rii� rxfNaz-fliailt}�fol 1 _ -= ig��1 E • �1aaanrh rttrlla' _ o DEPARTMENT OP BUILDING INSPE IONS tj • 212 Main Street ' Municipal Buil.ing Northampton, Mass. 01060 «rOR R'S COMTENSATION 'ft SURAN a A1'IL)A.Vj1Y • • (li ccuscdpermi tttx) •with a principal place of-business/residence at: /a, Vi. l pH} , jk r , 6A,4i obi',hone') Y-3—SZI 'T-1 (sa•c-...t/ci ty/suixf zi p) do hereby certify, under the.pains and penalties of perjury, that ( I am an employer providing the followine!worher's compensation coverage for in? • employees woring on this job: • A- A-556X-La-�S . vim (o 6 y`13(Q c//v o S' (insu_r-n co....-) (Policy Number) i uon g2.t.e fry ) . ( ) I am a sole proprietor, general contractor or homeowner(ci cie one) and have hired the col:mactors listed below who have the followioR worker's compensation policies: (Name of Coritracior) (Ins.urancc. Company/Policy Numixr) (Expiration Date) (Name of Couaactor) (L11Si172_ncc ComoaawPottci' Number) (E oiration Daie) , (Na-Me of Cotm-acior) (Insurance Compan}'/Policy Numbu) (Expirdon Date) , (Name of Contractor) (Lnsuranc Company/Policy Number) • (Expiration Date). (eIIaCh zoldit:ocmi Mcc„ir ncocz+-'y to¢lots&infocLviloo pcidiaing to di c -oc.ora) — ( ) I aril a sole pFoprietor and have no one worid.ng for me. ( ) I am:a home owner performing all the work myself. NOTE:plesc be.Vr4rt:tt,i M•1^..le ucca)cov.mcm va'b0 employ pc-tom to do .fr-«^„v-r i..-s.•e»a c tcpau,.-or- on a dwcaMs of aot morn the Lace=RI in u'sich the bomoowoc raids oc oa rho avuacS apportca_m tbeeo -r Cot cm....11y.x*r3--od to be c irploye-t uode the v ccS;d:c ---tioa Act(GUI 52Sz 1(5)),:.pplin000 by a homeoa-oa f- a lio.�_or po7nit ri:y c-idma thc Icgal rtalu of as ooployx uodcr tLo Workrea Coc r,o, lioa Aar-, I uadcsiaad tha a Copy ofthia mt®cm may ba forwurdod to tbo Doso.rtrocor afln4arrial •-dessv'o1Loe of tr=r-'oco for tho eovozsc veilotioa aad th_t f_ilt=to soarrr'covetysa'me,-SOC:1ion 25A of MOL 152 roo - .to the inzpositioa of aimiaal pn-,oie2 •'o s a of a fux or up to S 1. 00.00 tinder r on, pt a(up to 0cc yc1 and civil pa d is .Mc form of a Slap Work.orrC and a fans o(5109.00 a d_y i.p.inst me For•-. u,e only _. Pcr it umber l\ lot' tgnature ofLia�t_scc/P 'tics Este -- .,J • I N TEGR I T Y DEVELOPMENT & CONSTRUCTION, INC. River Run Apartments 80 Damon Road,Northampton Scope of Work: UNIT 3110 UNIT 6110 Carpentry: Carpentry: Replace kitchen appliances Replace kitch-n appliances Replace kitchen cabinets &countertops Install four vinyl window blinds New plastic laminate backsplash in kitchen New sheet vinyl in kitchen Plumbing: New carpet throughout New toilet Repair ceiling texture New paint throughout unit Electric: Install four vinyl window blinds -none- Plumbing: New kitchen sink & faucet New toilet Electric: New kitchen light fixtures Two new thermostats UNIT 4110 Carpentry: Replace kitchen appliances Replace kitchen cabinets & countertops New plastic laminate backsplash in kitchen New sheet vinyl in kitchen New carpet throughout Repair ceiling texture New paint throughout unit Install four vinyl window blinds Plumbing: New kitchen sink& faucet New toilet New bathtub surround Electric: New kitchen light fixtures Two new thermostats 110 PULPIT HILL ROAD•AMHERST,MA 01002 VOICE:413-549-7919• FAx: 413-549-7918 INFO@INTEGBUILD.COM •WWW.INTEGBUILD.COM , r ' e t ( < • Y i r • r.k I R — � - -- - - - - -- -- - — INTEG-1 I 04/12/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Blair, Cutting & .Smith Ins. • ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Div. of Neighborhood Insurance HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 7 Nor tti Pleasant Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ainherst MA 01002 Phone: 413-256-8541 Fax:413-253-9764 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Acadia Insurance Company INSURER B: Travelers P*operty Casualty 39357 Integrity Development& Construction Inc. INSURERC: TPA Associates, Inc. 110 Pulpit Hill Road INSURER D: Amherst MA 01002 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADU'L POLICY EFFECTIVE POLICY EVIAATION LTRJNSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY CPA007588711 04/10/04 04/10/05 PREMISES Eaoccurence $250000 1 CLAIMS MADE X OCCUR MED EXP(Any one person) $5 0 0 0 PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 7 POLICY a PRO- JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO 810548H7006C0F04 02/12/04 02/12/05 (Ea accident) ALL OWNED AUTOS BODILY INJURY $250000 X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ 500000 PROPERTY DAMAGE $ 100000 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 1 CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND VVCS I O I H- �TORORY LIMITS ER C EMPLOYERS'LIABILITY WC7684436 04/10/04 04/10/p5 E.L.EACH ACCIDENT $ 100000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CARPENTRY - RESIDENTIAL PROPERTY DIRECT EMPLOYEES .7.:ERTIF!CATE HOLDER CANCELLATION I1 TEGR- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCFLLED-BEEORESHEEXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN INTEGRITY DEVELOPMENT & NOTICE TO THE CERTIFICATE HO_DER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL CONSTRUCTION INC. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 110 PULPIT HILL RD AMHERST MA 01002 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 6 r Janet P. Trudeau - C., 1CORD 25(2001/08) ©ACORD CORPORATION 1988