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31C-022 (2)
BP 2022-0986 91 OLANDER DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31C-022-001 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-2022-0986 PERMISSIONISHEREBYGRANTEI TO: Project# REPAIR Contractor: License: Est. Cost: 13059 WRIGHT BUILDERS 065521 Const.Class: Exp.Date:01/25/2024 Use Group: Owner: K WRIGHT JONATHAN A& MARG ..ET Lot Size (sq.ft.) Zoning: PV/SG_a/SG b Applicant: WRIGHT BUILDERS Applicant Address Phone: Insurance: 48 Bates St 413586-8287 MCC20020005342021A NORTHAMPTON, MA 01060 ISSUED ON:08/15/2022 TO PERFORM THE FOLLOWING WORK: REPAIR GARAGE ENTRY 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 j • 4 , I • Fees Paid: $91.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildine Commissioner r RECEIVED AUG1 5 2022 The Commonwealth of Massachusetts • wn Board of Building Regulations and Standards FOR ! Massachusetts State Building Code, 780 CMR MUNICIPALITY � DEPT.OF BUILDING INSPECTIONS USE • rgiiitriArtitAPIfilillication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 6P- a a,qC� Date Applied: IX. ,b" * •ti Building Official(Print Name) Signature SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 91 Olander Dr 31 C 31C-022 1.1 a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: FFR Residential 9801 98.76 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 N/A N/A N/A 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public X Private 0 Zone: Outside Flood Zone? Municipal jiQ On site disposal system 0 Check if yesN SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Jonathan Wright Northampton, MA 01060 Name(Print) City,State,ZIP 91 Olander Dr 413-535-3411 jwright@a wright-builders.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) X Alteration(s) 0 Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other ❑ Specify: Brief Description of Proposed Work2: Repair garage entry and door of existing single family home after impact accident. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 13,059 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) S List: 5.Mechanical (Fire Suppression) Total All Fees: $ a (� Check NO .7RC ieck Amount: ( 1 Cash Amount: 6.Total Project Cost: $ 13,059 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-065521 01/25/2024 Steven F. Barrett License Number Expiration Date Name of CSL Holder 97 Federal St List CSL Type(see below) U No.and Street Type Description BeI hertown, MA 01007 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 413-535-5999 sbarrett@wright-builders.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) WrightBuilders, Inc. 101536 06/25/2024 g HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 48 Bates Street akelly-niziolek@wright-builders.com No.and Street Email address Northampton, MA 01060 413-586-8287 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 X No .❑ 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 Wright Builders, Inc. to act on my behalf,in all matters relative to work authorized by this building permit application. Jonathan Wright 08/12/2022 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Claire DuSell, Wright Builders, Inc. 08/12/2022 Print 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 contr.ctor (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 fo i d 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 porc ) 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" City of Northampton 9 oti N5 S� Massachusetts 4t'S .ice. ( � ; �. `;' DEPARTMENT OF BUILDING INSPECTIONS �'. er,, 212 Main Street • Municipal Building Jy Ca Northampton, MA 01060 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, Easthampton, MA The debris will be transported by: Name of Hauler: Wright Builders, Inc. Signature of Applicant: Claire DuSell Date: 08/12/2022 The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 :„ �_ Bustin, MA 02114-201 i www.ntass.gov/dia mnss.gov/dia %rosters'Compensation Insurance Affidavit:Huilders Centrnctors1EkctrkiansIPlunshers. TO BE FILED'11,i I it l Ili:Ipt_IiMI1TING AllTIlIOIUTIL Amanita Inform Lition Pleas Print I.cp�ihlr Name(Hosioesstorgzamattonito➢a➢,tm:➢ua: Wright Builders, Inc. Address: 48 Bates Street City Zip: Northampton, MA 01060 Phone#: 413-586-8287 Otlit an etnttlin rr) .hrck ihr appropriate b.t Type ol'project(required): 1.0 I am a elalpl,nsr xxoh 21 anti011 pail-titnic} 7. New construction alai a sole rcuprictaa ui rartmaship and hate rtu entplutiex%narking fur naC an 8. Q Remodeling air_k capacity..[Nu t4 camp.nsurarn rer{trnutj 9. D Der➢➢ohtaon fi D I am a luuln-rn net tluim all work ama ell.IlVu itta a i/n4l_insucmce req uin:d.l' 18❑ 13ui1tl.ini. addition -I.®I am a ltima:on:a:and nil'be hiring 4131141t➢nacturs.het cundmd ale nark on m%pttupcaty- I nill uuurc alai all contractur:,either lukc voltam`cu inigre7t atitmt nsrranca cs ate mile 11.0 Electrical repairs per:additions pi-omicron.wlth ell,iitiplu,,ecs.. I2.0 Plumbing Tons or additions S=I am a general euntracwr:nal I have hind the stub-cerntracwan,listed un the attached sheet_ These W stab-euntracn hake katipluyees and have u, s nc+urker castmp. uranue_ l 3 Raurepairs 14.®Other Replace garage door &.�14'c arc a corpuratinn and its aattic4.nu fax c coariscd theta right of c.acmpaicvr per 1NCiL e. -- 152.41(4).mot we have nu ct>lel hives.[4lt.+ urku n'avamp.insurance requita l Any applicauut than cheeks box al emua alit tilt our the_sorainn belt i.lhuwtnr their 11.urkcas'romperoatiaa pultcw arleaarlatiacr. *Ile+mcoss nca s is bu suhinii this attuli,it ul,licaunc th-y an:gluing all nod.and than hire uiuisiiic cuntracttrs mini submit a men at➢Lda4 at an:lli`tunic suck ICumtaacturs that check this bas amuse act vInnJl an aulalnruunal sha.l shc+tsimx doe name tptduc +croturactura and sta➢c wlui➢her un ml:rt tuee canulica lu:asrr ca:Iploxec-s_ It the sub-contractor.fuse car ilovucs.thc' mug provide their wurkcrs'map.policy ntunbt r. I um an employer that is providing wori,ers compensation itrsa must for my eaployems. Below is the policy and job site information_ [„btt,2ttryl'Co„apa➢his Nacre: Massachusetts Employers Insurance Company Pul,t:y tie Sclt=itn. LW.;: MCC-200-2000534-2021A Expiration Date: 03/01/2023 Job Site Address: 91 Olander Dr. city, Yeiz p:Northampton, M/ 01060 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expilrtIthion dote). Failure to secure Cov era➢ge as required under ;9i.;1_c. 152,§25A is a criminal violation punishable by a tine up to IIS 1.500_00 and or one-year impnsonnldnt,as well as ci k..it penalties in the forma ofa STOP WORK ORDER and a tine of up to S250.00 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. l do hereby certifi'utttlir the pains and penalties ofperjury that the information provided above is true wit!correct ;iiiijtuic: Claire DuSell 1 .Lt 08/12/2022 1"[Lulea, 413-586-8287 Official use only. Do that write in this arwa to be completed by city or town tWiciaL_ C i0. or Toes it: Permit'License#w Issuing.tuthorits (circle one): 1. Board of I lea]th 2.Building Department 3.('il}1''1`ttvvn Clerk 4.Electrical laspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ___....'....4N WRIGBUI-01 KAYLA ,4CORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �� 2/28/2022 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 Kayla Marie Drinkwine Phillips Insurance Agency,Inc. PHONE Fax 97 Center Street (A/C,No,Ext): (413)594-5984 I(ac, 0),(413)592-8499 Chicopee,MA 01013 ADDRESS:kayla@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:EMC Insurance Companies 21415 INSURED INSURER B:Massachusetts Employers Insurance Company Wright Builders,Inc. INSURERC: 48 Bates Street INSURER D: Northampton, MA 01060 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. INSRLR TYPE OF INSURANCE ADDL SUBR W POLICY NUMBER /YPOLICY EFF POLICY EXP LIMITS JNSD VD (MM/DDYYY).(M D/M/DYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6D18616 3/1/2022 3/1/2023 DMMGOE Ra EoNTErD ce $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X JE f LOC PRODUCTS-COMP/OP ACG $ 2,000,000 OTHER: EMPLOYEE BENEF( $ 1,000,000 A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY _(Ea accident) $ 1,000,000 X ANY AUTO 6Z18616 3/1/2022 3/1/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE _ $ 5,000,000 EXCESS LIAB CLAIMS-MADE 6J18616 3/1/2022 3/1/2023 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N MCC-200-2000534-2021A 3/1/2022 3/1/2023 STATUTE ER 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A FIC t/M in NH) E.L.EACH ACCIDENT $ OF EXCLUDED? 500,000 E.L.DISEASE-EA EMPLOYEE $ 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) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts I j Division of Occupational Licensure 1®� Board of Building Reggulations and Standards I'1 Consttton1f S ,rvisor I CS-065521 pires:01/25/2L2 'STEVEN F BARRETT t 97 FEDERAL ST o PO BOX 503 , } BELCHERTOWN MA 01007 tJ Commissioner c ct, t i5'. tiCrnc A.. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts=z02118 Home Im•rovement Contracfor Registration Z rR ` r Type. Corporation 1 1---..'egi5tration: 101536 WRIGHT BUILDERS, INC. rrt -^ Expiration: 06/25/2024 48 BATES STREET a =..:.. ■ NORTHAMPTON, MA 01060 , E om" eft 44, r1A ss$ Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Corporation Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 101536 06/25/2024 Boston,MA 02118 WRIGHT BUILDERS, INC — ;_ ywy r . SETH LAWRENCE-SLAVA F-��" / L 48 BATES STREET �' �� ' . Gi' NORTHAMPTON,MA 01060 �'�c'�� Undersecretary Not valid without signature