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18D-053 (15) UNITS 1110,2110, 5110-80 DAMON RD BP-2005-0462 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18D-053 CITY OF NORTHAMPTON Lot: -009 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL C.142A) Category: BUILDING PERMIT Permit# BP-2005-0462 Project# JS-2005-0612 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 Zoning:GI Applicant: INTEGRITY DEVELOPMENT & CONSTRUCTION INC AT: +N fl5 1 1:-3. I U SO n•MfN Rf 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 RENOVATION KITCHEN/BATH POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Builuing Inspector Underground: Service: Meter: Footings: Rough://1 `t '&,A8 Rough: i //ls/a q House# Foundation: / Driveway Final: ( 1012� Final: 09s'f3 Final: 1s //. ', Rough Frame:0 J g- Gas: Fire Department Fireplace/Chimney: I;: gh: pi1: Insulation: Final: Smoke: Final:O 1 r� _ 5-, THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Receipt No: Date Paid: Check No: Amount: Building 10/27/04 0:00:00 10111 $105.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo � r?// d � v� � '" �� 'vs�1 he/,s/l� � File#BP-2005-0462 APPLICANT/CONTACT PERSON INTEGRITY DEVELOPMENT&CONSTRUCTION INC ADDRESS/PHONE 110 PULPIT HILL RD AMHERST (413)549-7919 PROPERTY LOCATION UNITS 1110,2110,5110-80 DAMON RD MAP 18D PARCEL 053 009 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 /0/// /05=— Typeof Construction: INTERIOR RENOVATION KITCHENBATH 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 BASED ON IVAMATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit 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 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 'ssion L Z.0o 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. Versionl.7 Commercial Building Permit May_15,2000 1 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 APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE Ti4 11e5£OR OCC-UPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION '1� \`' 1.1 Property Address: I I ; L ').-1 I I 0 This section to be completed by office v .) )3 CY�C�LyY 1 rC=( I Map Lot Unit Zone — `` _`�_____ __ Overlay District _ IK)Cxk- ifAAIN.0`1.5 Ati4 e-1 aCe7 — __ Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: __ NR it k 8\I �c. Name(Print) Current Mailing Address: �M� Signature Li' ---`� -- 2.2 Authorized Mont: -s R- cx yik _ _ Name(Print) Current Mailing Address Signature __4` Telephone - _______ SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be 1 Official Use Only completed by permit applicant 1. Building 4 (a)Building Permit Fee 2. Electrical U (b) Estimated Total Cost of Construction from(61 3. Plumbing ,_,9_..4 2 I.)E, l00 Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) 72.2 ' ' Check Number 2/II 05--- This Section For Official Use Only Building Permit Number:___.__ . _____ ____ Date Issued: Signature: Building Commissioner/Inspector of Buildings bate: • • • ` Version1.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations Existing Wall Signs Existing Ground Signs Additions❑ Roofing 0 0 ❑ Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ] 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 28 0 F Factory ❑ F-1 0 F-2 0 2C 0 H High Hazard 0 3A ❑ I Institutional 0 1-1 0 1-2 0 1-3 0 3B 0 i M Mercantile 0 4 0 R Residential g R-1 ❑ R-2 CI R-3 r 5A 0 S Storage 0 S-1 0 S-2 0 5B Igf 1 U Utility ❑ Specify: M Mixed Use ❑ Specify: 7 S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Q 5UV.O.A"i VI (AS - Proposed Use Group:_ �E v(e_►'\�� ______ Existing Hazard Index 780 CMR 34):- k) /A __-- Proposed Hazard Index 780 CMR 34): T /A ______ SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) St 181--- ------- 1 — ------ 2nd A \ —_ 2nd_ '\ j - 'v rd V A 3rd 3 --- -- -- 4th 4d---- -- - -- - 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: Public 0 Private 0 Zone:_ ___ Outside Flood Zone 0 Municipal 0 On site disposal system 0 • • Version1.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by N I ) ; Building Department 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 A 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 0 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: • Version1.7 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 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: T_1-l.' .r`t A M 62� Not Applicable ❑ Name(Registrant): MA- 1 b 2- I R ish on Nu ber Address G Q ---- -- Cfl -/ag(p Date Signature Telephone 9.2 Registered Profe al Engh'eer(s): ) - / -- ------ Name Area of Res —pon5ibility Address — __ — --T Registration Number — Signature Telephone Expiration Date— — Name — —Area of Responsibility Address — — Registration Number— — Signature —T __ Telephone Expiration Date — — Name Area of Responsibility Address - —— - - — Registration Number Signature Telephone Expiration Date Name - — — Area of Responsibility - -- ---------- - -- -- --- - Address — -- -- — —Registration Number — — — Signature Telephone Expiration Date 9.3 General Contractor / Company t P--et'�-�-Fip ,-I' I1 + ( S -V C I V1(_ Not Applicable 0 Company C�Bame: , 5Ce Responsible In Charge of Construction /� 1/0 2c 2L p IF HILL +�) /ACM K 1 T, ,A, coo Addre is 17/q"1-9) 1 Signatu' 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 ❑ No 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 -- _r_— — I, ` . re+nit;S 3 I. _642. el Q ��a.ea vd for f `b t'\G W f1 ,as)dvnne Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Pri t Name ----------- ----- Signature of weer/Agent —�� Date �— — ---- — SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisq`r: Not Applicable 0 Name of License Holder:TC) { Jam- Sd? C ` t'5-'1 to-71-2 License Number (I 0 Pv -c' T H Mt-L., E_D AN-1 -P2S j/ D/oo� 2— 6�l ��'4' — — Expiration Date (//3- s��- ) 9 re Telephone CTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) I 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 -R No 0 • 4(1tAn P).. /.. oy „4� ` t lti (rill of {orthampfon • 1 __- A f ,aIioancfinsc(ta' DEPARTMENT OP BUILDING INSPE IONS 212 Main Strcct ' Municipal Buil,'ing Northampton, Mass. 01060 tat' WORKER'S COMTENSATION l:,NSURANCE AFI' DA.Vj1T (li ccusX.Ipermi tfcc) with a principal place of business/residence at: ?C&LPIT f-t[C..c. A[(�..�.'.-��T 11 a*1 ,hone#) 591—7) `-1 l 9 (svt~ici ty/statL/D p) do hereby certify, under the pains and penalties of perjury, that I tin an employer providing the followine'Iworkcr's comoen adon coverage for my employees woridng on this job: • • • PR 3- y/icy/oS--• (Lasurin Company) (Policy Nu r) (E;-picaL on Datn) • • ( ) I am a sole proprietor, general contractor or homeowner( ;tie one) and have hired the conn-actors listed below who have the following worker's opeasadon policies: Manic of Cons^cior) (Insurance Company/Policy NNtumkr) `Expirduon Datc) (Name of Contractor) (ls-w—nec Company Policy Nuincbr) (Expiration Date) • • • (Name of Couuracio,) (Ltisurancc Compare}'/Polk}• Z`i;JJslk r) (Expirdon Date) • • (Name of Contractor) (Insurance Company/Policy Numbrr) (Expiration Datc). (attach_d�i�ocoi dia-c fnccatry to into&infocm..ioo pertaiaains to.IJ ooazr-_c.o ) { ) I am a sole proprietor and have no one worid.ng for me. ( ) I am..a home owner performing all the work myself. NOTE:plea be.narc,..wtti: heecowocrs wbo ctnplay petoos to do r-, • e=r-.:e,00 c mpav work oa t d.•rtt:_•of ant more tbeo ` ,o tares is which the bomoowocr maid=or co die crounca zppurten_m tbmmo t.-s oor .lty ecc:rd.-ol to be c itploye-s undo the wskk r•r"T-pm-- tioa Act(GUI52 n l(5)).applinatjoo by.homeowner lc:a lies_-or permit mmy cvidmoc the k- i to of m r loyx uod.r dto Worcort Compooa.tioa Act_ I uod:at.ad that a copy of thi.cntcor.ca m,ty b.for-..carded to the Ow.mm=1 of]04 ,i.i der'0I5oa of Ir�ur,oc*for tli,. oa vcirestioo and th t L•ihac to senor lt:ovctyb-o trncSr•section 25 A of MOL 152 as to the im;Ositioa orciatin l pm (tic of a fix oftW to SI500.00 and/or iampri oaomt o(up to ore yrvr cod civil pm.Pua is the form of Stop Work Ordc tad a a=o .00 a day tptintt me For dcpart .==-sJ u.c only __Permit rlttmbcr Map: Lot S • Si riot:of Lictnscc/Pccrniucc e I N T EGR IT Y DEVELOPMENT & CONSTRUCTION, INC. River Run Apartments 80 Damon Road, Northampton Scope of Work: UNIT 1110 UNIT 5110 Carpentry: Carpentry: Remove entry closet wall and door Replace kitchen appliances New wall/beam in kitchen Replace kitchen cabinets & countertops Replace kitchen appliances New plastic laminate backsplash in Replace kitchen cabinets & countertops kitchen New plastic laminate backsplash in kitchen New sheet vinyl in kitchen New sheet vinyl in kitchen New carpet throughout New carpet throughout New paint throughout unit New paint throughout unit Install four vinyl window blinds Install four vinyl window blinds Plumbing: Plumbing: New kitchen sink & faucet New kitchen sink & faucet New toilet New toilet Electric: Electric: New kitchen light fixtures Relocate electrical panel Two new the ostats New kitchen light fixtures New GFCI outlets above countertops Two new thermostats UNIT 2110 Carpentry: New carpet throughout New plastic laminate backsplash in kitchen New paint throughout unit Install four vinyl window blinds Plumbing: New kitchen sink & faucet Electric: Two new thermostats 110 PULPIT HILL ROAD •AMHERST,MA 01002 VOICE:413-549-7919• FAx:413-549-7918 INFO@INTEGBUILD.COM •WWW.INTEGBUILD.CO, i • • • y • • - -- ---- - - -• - `� `•"'� INTEG-1 l 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 No'rth Pleasant Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Amherst MA 01002 phone: 413-256-8541 Fax:413-253-9764 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Acadia Insurance Company INSURERS: Travelers Property Casualty 39357 Integrity Development& Construction Inc. INSURERC: TPA Associates, Inc. 110 Pulpit Hill Road INSURERD: 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. INK AUU'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSRD TYPE OF INSURANCE (MM/DD/YY) DATE(MM/ODIYY) GENERAL LIABILITY EACH OCCURRENCE $ 1000000 UAMAGt I U KtN I W A X COMMERCIAL GENERAL LIABILITY CPA007588711 04/10/04 04/10/05 pREMISESkEaoccurence) $250000 1 CLAIMS MADE X OCCUR MED EXP(Any one person) $ 5 0 0 0 PERSONAL&ADV INJURY $ 10 0 0 0 0 0 GENERAL AGGREGATE $2 0 0 0 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY PRO- JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO 810548H7006C0F04 02/12/04 02/12/05 (Ea accident) ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $250000 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 $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WC SIATU- OTH- WORKERS COMPENSATION AND TORY LIMITS ER C EMPLOYERS'LIABILITY WC7684436 04/10/04 04/10/05 E.L.EACH ACCIDENT $ 100000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED7 E.L.DISEASE-EA EMPLOYEE $ 100000 If yes,describe under SPECIAL PROVISIONSbelow E.L.DISEASE-POLICY LIMIT $ 500000 OTHER A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS CARPENTRY - RESIDENTIAL PROPERTY DIRECT EMPLOYEES ERTIF!CATE HOLDER CANCELLATION INT1-',G1S1_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANcELLFn REFORETHE EXP-1RATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN INTEGRITY DEVELOPMENT & NOTICE TO THE CERTIFICATE HQLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL CONSTRUCTION INC. IMPOSE NO OBLIGATION OR LIA ILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 110 PULPIT HILL RD AMHERST MA 01002 REPRESENTATIVES. I AUTHORIZED REPRESENTATIVE 41 JO B' I Janet P. Trudeau a � 'Y` ' .CORD 25(2001/08) ©ACORD CORPORATION 1988 • . 4 ' License: CONSTRUCTION SUPERVISOR Number: CS 059672 B i rth date: 06/07/1,950 Expires: 06/07/2006 Tr.no: 25578 Restricted: 00 PETER W JESSOP 110 PULPIT HILL RD 79/ AMHERST, MA 01002 Commissioner Boar of Sui( n'g eg Tatiotis a d aniards-" 1114171% HOME IMPROVEM NT CONTRACTOR -el Registration: 118g41 Expiration: 1/20/2005 Type: Priv.to Corporation INTEGRITY DEVELOP&CONST I C PETER JESSOP 110 PULPIT HILL RD AMHERST, MA 01002 Administrator