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24D-250 (3) BP- 022-0934 88 CRESCENT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-250-00I 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-2022-0934 PERMISSION IS HEREBY GRANTED TO: Project# RENOVATIONS Contractor: License: Est. Cost: 37000 GEORGE PROPANE 075223 Const.Class: Exp.Date: 11/27/2022 GEORGE, MICHAEL G. & GEORGE-B RRY, Use Group: Owner: KRISTEN E. Lot Size (sq.ft.) Zoning: URC Applicant: ROBERT WALDEN Applicant Address Phone: Insurance: PO BOX 604 (413)695-0539 GOSHEN, MA 01032 ISSUED ON:08/10/2022 TO PERFORM THE FOLLOWING WORK: RENOVATION 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 VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: i > I II' . .• r . Fees Paid: $241.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner I9ECEIV E O The Commonwealth of Massachusett R ..,01 Board of Building Regulations and stand$rdsA�G - 5 2022 IPALITY Massachusetts State Building Code,:780 .MR SE Building Permit Application To Construct, Repair,Ren:Wat evisegl Mar 2011 ^. "P One-or Two-Family Dwelling ^n7HA__ -_,,T a n,o lCTIONS I This Section For Official Use Only Building Permit Number: ft)"...)?..—R 3 ci Date Applied: 4 I i'1 .2.0 g 0 n Q 4,1 g. BuildingOfficial(Print Name) Signature &� SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 88 Crescent St.,Northampton,MA 01060 24D 24D-250-001 1.1 a Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: URC Single-family residential 16,735 sq ft 110 ft 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 loft 142ft loft L17ft/R5ft 20ft 5ft 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public El Private 0 Zone: Outside Flood Zone? Municipal El On site disposal system 0 Check if yes® SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Michael George Northampton,MA 01060 Name(Print) City,State,ZIP 88 Crescent St. 413-626-9449(cell) mgeorge@georgepropane.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building ID Owner-Occupied 13 Repairs(s) ® Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units 1 Other 0 Specify: Brief Description of Proposed Work2:Renovate kitchen. Replacement windows. Repair front&side steps. Insulation. Replace 3 exterior doors. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 15,000.00 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 8,000.00 ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2,500.00 2. Other Fees: $ 4. Mechanical (HVAC) $ 11,500.00 List: 5. Mechanical (Fire $ Suppression) Total All Fees Check No. 61�.C) heck Amount: 54\ 6.Total Project Cost: $ 37,000.00 0 Paid in F Il 0 Outstanding Balance Due: W:&/ S"7-C1 CE)—,r-. J ec r�a -s' rat SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-075223 11/27/2022 Robert Walden License Number Expiration Date Name of CSL Holder PO Box 604 List CSL Type(see below) U No.and Street Type Description Goshen MA 01032-0604 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-695-0539 nedlawn@hotmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 08/03/2024 Robert Walden 162073 HIC Registration Number Expiration Date HIC Company Name or MC Registrant Name PO Box 604 nedlawn@hotmail.com No.and Street Email address Goshen,MA 01032 413-695-0539 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 t?9 No 0 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 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 ame to ,I hereby attest under the pains and penalties of perjury that all of the information contained in thi• . .plication is true and accurate to the best of my knowledge and understanding. Michael George k/5 iaa Print Owne • Authorized Age f s Name(Electronic Signature) Date NOTES: 1. An :wner 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 MC 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.) 1,922 sq ft (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) 3,364 sq ft Habitable room count 10 Number of fireplaces 2 Number of bedrooms 4 Number of bathrooms 2 Number of half/baths 2 full Type of heating system gas,hot water Number of decks/porches I Type of cooling system mini-splits Enclosed x Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton Massachusetts 41r' c a tG 41* DEPARTMENT OF BUILDING INSPECTIONS y`• q�p � 212 Main Street • Municipal Building J` C' Northampton, MA 01060 J� •• ��®C 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, 234 Easthampton Rd., Northampton, MA 01060 The debris will be transported by: Name of Hauler: George Propane Inc Signature of Applicant: Date: S ,�% The commonwealth of Massachusetts Department of Industrial Accidents sy I Congress Street,Suite 100 miacs�4�. Boston, MA 02114-2017 • rv'iaw:mass.gor/dia Workers'Compensation Insurance Afftdaa it: Buildersl'ContractorslEkctricians/Plimtbtr,_ TO TBE FILED WITH THE PERMITTING AUTHORITY. Applicant Information /�'' Please Print Leeiblr Name(Rusin s Orranrzatiotttlndtvidual); 6>L�lg- Pjwp � /A/ c , Address: 3 6 &oes m 7(244 L tees7 P6 ,JOX / 01 City/State/Zip: a os- /'Yin O/03-1- Phone #: �//3 —a&8-8361O Art you rn employee Cheek th''ellappenprlatc ba: Type of project(required): 1.®I am a employer with 3 V employees(full an&or part-tirtra).• 7. 0 New construction 20 I am a sole proprietoror paatrevaltip and have no errplvyevrs worsting fur ma in $_ 0 Remodeling any capacity_[No workers'comp.uturanex requiretd_) (� 9. p Demolition '1-.d 1 am a lurnauwvu:r doing all wort myself.[No workers'comp.insurance required.]" 4.0 I am a hunxrwncr and will he hiring contractun w eunduct all work on my property- I will I 0 O Building addition n ensure that all contracture either have workers'evmpensanun insurance or are sole I i.®Electrical repairs or additions proprietors with nu employees_ I2.SPlumbinb repairs or additions 5.0I am a ueneral contractor amid 1 have hired thesub-cuntnxtors listed un the attnilred sheet_ Thesesub-contractors haves employees and have workers'coup.insurance.; 130 Roof repairs 6.0 We are a eniporatiun and its officers have exercised their right of exemption per tail I 4. Other 152,*1(41,and we have nu employees.[No workers'comp.insurance required.) *Any applicant that checks but itl must also till out the section below showing their wormers'compensation policy information. i'homeowners who summit this affidavit intim:minu they arc doing all work and then hire outside contractors must submit a new affidavit indicating suck :Contractors that check this box mesa attached an additional sheet show ing the name of to subcontractors and state whether in riot those immies have employees,_ if the sub-cuntracturs ha e ma-.they must pn,e ielr their u orkcrs euanp.pulley number. I recce an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 1-leg ye-LL)e-s /nl 4]67 1,1/1 n/ Cp Policy#or Self-ins. Lit:.#: C()f F 756 7/(0fie'/g' Expiration Date: D576)//a9.3-2 Job Site Address: $' C e&S-C /V/ Sr City/State/Zap: /10e7ii-thrP•J/1ii¢0/D62O Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiratioi`i date). Failure to secure coverage as required under NIGL c. 152, §25A is a criminal violation punishable by a tine up to S 1,5(X).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 S250.00 a day against the violato A copy of •statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ido hereby certify under a pains nd penalties of perjure that the information provided above is tare and correct. o t. Sienauure: I Date: 8 I s I a,:). (;c) Official use fret►'. Du not write in this area. to be completed by city or town ref/it i it ( its or Town: I'ermit/License Issuing Authority (circle one): 1. Board of Health 2. Building Department 3.('it}'frown Clerk 4. Electrical Inspector 5. Plumbing Inspector b. Other Contact Person: Phone#: Cptt nes naeaen ca Meeseceur ene i r,ee oe of Pro eHHOSel LMtasuse r r Hoard W SuiMWq Repui0Rone and Snood:as Construhtt r4601trvMor CS-075223 Edylienet 11270202a. ROBERTT j } 2 MAIN STIP.G OQ d GOSHEN MA+1012. # .�4 w s . Comn.,-..1ef '"'rt.%, x'';i`.,,,,,., . THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affaits anc1 Business Regulation 1000 Washingr tt Suite 710 Bostory,i t ssacht?s 1,"Q2118 Home Im ro = ei istration X 1�l� t .J ee eeeee+- _ (T S"'\Type. Indtvtdual a' �. } aion' 162073 t..' ROBERT WALDEN _ E�',ion. 0&03f202a P.O.BOX 604 S' GOSHEN,MA 01032 „ ""` Update Address end Return Cad. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Alfafes 6 Business Regulation Registration valid for individual use only before the t HOME IMPROVEMENTcoNTRACTOR expiration date if found return to f rfPE:-4adivadudl Office of Consumer Affairs and Business Regulation R BlItte 04' i r1 1000 Washington Street•Suite 710 1611T 01d: 4 Boston.MA 02118 ROM RT WALDEN t K {r c.y ROBERT T.WALDEN tir, a1 ^,.��...---- --- --, -fir�v=' Undersecretary Not valid without signature r,.. , GEORPRO-01 MMACBEY ACORO CERTIFICATE OF LIABILITY INSURANCE DATE DYYYY) 8/4/2022 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 Megan MacBey NAME: AssuredPartners New England,Inc. PHONE I FAX One Monarch Place,12th Fir (A/C,No,Ext):(508)506-5534 (A/C,No):(508)506-5534 Springfield,MA 01144 Miss:Megan.Macbey@AssuredPartners.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Charter Oak Fire Insurance Company 25615 INSURED INSURER B:Travelers Indemnity Company 25658 George Propane,Inc. INSURER C:Travelers Property Casualty Co.of America 25674 P.O. Box 102 INSURER D: Goshen,MA 01032 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR Y6608K475654C0F22 5/1/2022 5/1/2023 DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 0 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY !VT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER EBL AGGREGATE L $ 2,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO BA2T0807232214G 5/1/2022 5/1/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $ HIRED ONLY NOON-Q ONEDD PROPERTY DAMAGE Per accident) $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE CUP8K7567162214 5/1/2022 5/1/2023 AGGREGATE $ 2,000,000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN CUP8K7567162214 5/1/2022 5/1/2023 1,000,000 ANY �FFICER MRMBER EXCLUDED?ECUTIVE N N/A E.L.EACH ACCIDENT $ (Mandatory m ) 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 I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Coverage INCLUDED: GL Coverage-Blanket Additional Insured per Form CGD246;Additional Insured Primary&Non-Contributory per Form CGD246;Waiver of Rights to Recovery Against Others per Form CGD186; Auto Liability-Blanket Additional Insured per Form CAT353;Waiver of Rights to Recovery Against Others per Form CAT353;MCS-90 Filing;Additional Insured Primary&Non-Contributory per Form CAT474. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mike George ACCORDANCE WITH THE POLICY PROVISIONS. 88 Crescent St Northampton,MA 01060 AUTHORIZED REPRESENTATIVE .11I _,.9'lik0 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Do not re ev until final ins.ection• b coda official. ENERGY STAR'Certified in H ghlighted Regions Certifie ENERGY STAR dans les r gions en surbrillance Canada111It ER/RE26 0 energi/star.gc.ca IPP".711 \,:-: dilirlY ENE'GY STAR 0 \,..4 vs .drtRiWiGrtifN U.S. �.U. . o Illk '""� ® enerclystar.gov ' 'mod N J DO NOT REMOVE UNTIL FINAL INSPECTION/NE PAS RER AVANT L'INSPECTION FINALE ri American Craftsman NERC f iii>''!�' by0�PlyGen WINDOWS•DOORS l National Fen.Stiatbn CPDp S I L-N-61-00668-00001 Rating Council• 8601 Double Hung Vinyl Dual Glazed •'(IFIED None Argon Fill Foam Insulation ENERGY PERFORMANCE RATINGS U-Factor Solar Heat Gain Coefficient 0 . 30 I 1 . 70 0 . 44 (U,S,/I•P) (Me{ric/SI) ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 53 Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product performance. NFRC ratings are determined for a fixed set of environmental conditions and a specific product size. NFRC does not recommend any product and does not warrant the suitability of any product for any specific use.Consult manufacturer's literature ftr other product performance information. Nww.rlfrc.org ■- WINDOW&DOOR Licensee 440—H-071 MANUFACTURERS ASSOCIATION I I \/I /D M A Silver Line Windows 8601 Double Hung Vinyl Dual Glazed None Argon Fill Foam Insulation Hallmark Certified Manufacturer Stipulates Certification to the fdbwing standards www.wdma.com STANDARD RATING Class LC-PG40 Size Tested 36 x 62 in RAMA/WDMf/CSA 101/I.S.2/A440-11 iii FL 14996 I ' Glazing 2.2 mm Single 5tr AN Outer/ 2.2 mm Single Sir AN Inner el _ Complies with HUD UM Bulletin 111 2644,3819.1.6 vets or ecceade CEC i IECC Air Infiltration Requirements of 0.3 CFM/sq.fk. r lower. WDMA Hallmark Certification Program