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24D-054 (8)
BP-2022-1364 17 STODDARD ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-054-001 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-2022-1364 PERMISSION IS HEREBY GRANTED TO: Project# BATH RENO/SIDING/WINDOWS Contractor: License: Est. Cost: 194391 WRIGHT BUILDERS 115196 Const.Class: Exp.Date: 05/31/2024 Use Group: Owner: ROGERS SALTZMAN JEFFREY S & LAUREL A Lot Size (sq.ft.) Zoning: URB Applicant: WRIGHT BUILDERS Applicant Address Phone: Insurance: 48 Bates St 413586-8287 MCC20020005342021A NORTHAMPTON, MA 01060 ISSUED ON: 10/24/2022 TO PERFORM THE FOLLOWING WORK: NEW SIDING/WINDOWS, 2ND FLOOR BATH RENO 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: 1 59„on, Fees Paid: $1,264.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Buildine Commissioner OCT 2 1 2022 SZa The Commonwealth of Massachusetts Board of Building Regulations and Standa FOR —M;JNIC[PALITY Massachusetts State Building Code, 780 eMROF BUILDING INSPECn0NS NORTHAMPTON,MA 01050E Building Permit Application To Construct,Repair,Renovate Or Demolish a RevtseddMar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 6P—?}."*14`f Date Applied: L jj 4! ,b. .34 D_Q� Building Official(Print Name) ' Signature I / D—L-' a SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 17 Stoddard Street Northampton, MA 01060 24D 054-001 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: URB Single Family 8,259 SF 72' 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 10' 12' 15' 16' 20' 70' 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public RI Private El Zone: _ Outside Flood Zone? Municipal III On site disposal system ❑ Check if yes® SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Laurel and Jeffery Saltzman Northampton, MA 01060 _ Name(Print) City,State,ZIP 17 Stoddard Street 413-341-2119 jeffandlaurel@yahoo.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) Ili Alteration(s) El Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: Striping existing siding. installing 2 1/2"zip insulated sheathing and sid ng New window replacements, 2nd floor bathroom renovation. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 144,641 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ 9,750 ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 14,500 2. Other Fees: $ 4.Mechanical (HVAC) $ 25,500 List: ,{,5.Mechanical (Fire $ 0 Total All Fees: Si. 'T Suppression) ( Check No.(.140 heck Amount: -1 Cash Amount: 6.Total Project Cost: $ 194,391 ❑Paid in Full ❑Outstanding Balance Due: _ $194,391 / 1000 = 194.39 x $6.50 = $1,264.00 SECTION 5: CONSTRUCTION SERVICES . 5.1 Construction Supervisor License(CSL) CS-115196 5/31/2024 Ryan Crandall License Number Expiration Date Name of CSL Holder 482 State Street List CSL Type(see below) U No.and Street Type Description Belchertown, 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 413-586-8287 rcrandall@wright-builders.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 101536 6/25/2024 Wright Builders Inc HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 48 Bates Street nwright(a�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 ® 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. ate 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 ate to the best of my knowledge and understanding. Wright Builders Inc 10/13/2022 Print Owner's or Authorized Age ' ame(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 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 fount 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.) 2.303 SF __(including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) 1,722 SF Habitable room count 5 Number of fireplaces 0 Number of bedrooms 3 Number of bathrooms 3 Number of half/baths 0 Type of heating system Mini Split Number of decks/porches 3 Type of cooling system Mini Split Enclosed 1 Open 2 3. "Total Project Square Footage"maybe substituted for"Total Project Cost" City of Northampton sw�Pr .» �?� Massachusetts w� s -..s,��`` 1,1 r iK DEPARTMENT OF BUILDING INSPECTIONS �? ..: , ar 212 Main Street • Municipal Building _ ate Northampton, MA 01060 s/ •, ,,�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: Location of Facility: 234 Easthampton Road, Northampton MA 01060 The debris will be transported by: Name of Hauler: J&J Trucking Signature of Applicant: -golf/ Date: 10/13/22 The Comnrnnll. alth of Massachusetts worm,ra 01 ( Deportment of Industrial Accidents =': l� 1 Congress Street,Suite 100 • =.1z. Boston, MA 02114-2017 � - ys*�wri'mass g►or/dirt 11 corkers'('umprnsatiun Insurance Affidavit Builders("ontrrtetor rEkrlriciaii Pluinht rs. 'ru RI F 1.ED►t II II THE P!1011rrING A1-1.110R11rt'. Applicant Information Please Print Letibilr Name 4Ilusntss.organization ln,liVldittanp: Wright Builders Inc Address: 48 Bates Street City/StatelZip:_Northampton MA 01060 phone#: 413-586-8287 Aro ywttt ma employer?Cheek At appropriate : Type of project 4 required): 1.n I ante employer with 24 ,_ cnrluy'ccs Oa;mid ws parr-tram:h_' 7. CI New construction 20 1 am a sole prupticur ur patrrntasttiP and have nu em¢t[wn ass workiaq lur o n:in S. a Remodeling I att2e c:ap*aciry.['su w,urken'etanp.tnswram a sequin:di 301 ant a la,n teounur doing all work any [No w«lL[Neans:':omit*.mmtur na:in:va ed" g. Demolition 10 0 Building addition 4 .]1 am a ltunA%Aw SILT and w oll t'hi:ut .vrntrrdans i,tvtmdtuct JtL work c,m my ttwr rtt.. I will y� ensure that all c ntratltws:itlu.:I lt.u.' auakm`taus ntrtcahsafw:at ramwrance to am,:sal: I I f] Elc.hrical rvliairs airaddditions pit m-to as w ith nu+trnrlux t:s. 12.1:Plumbing.repairs for additions :Ail I atrt a iti-m,ial wuntsactur and I has:hired the sub-curets utun,total inn Elm:atradhorl sheer. 13. Roof repairs I Ires+:sub-contractors lane ermplutiees and Iwo;. utters'Gomm.insurance.- 14.Elotltci ERV System h.11 1!c an:a ctuparatiu n and its utlfirccrs it t%c exiatised Uncia niglm 1.:Actrtapbon per MR id..c I S2§II4L and us:lease nu en pluyees.[Nu wurL`.rs'etaaip insurance:cumindl *Array applicant that dtecks but 4I rmini also fill nut tltc sot:tiara Inkru slims inn their to urkt_rr,''compensation policy infurtnaiirm_ t Ibwnxv..wtners 7ahu submit this affrdatit indicating thus art doing all[stork and them Ihuc tnatsidc nixttrakturs nnrtsi submit a mete Aida,it irmJ awn.^'.Lil i •t'untractnr:s that cheek this but must attached an au[ahtiunal shun sliaosina•r[ac n:wneOftltt:sattn-coittra.crwrs and slate whw-tl er t',r not tlwse..n:uir:,i a,,, tanpluL,ccs.. lithe sub-eu ttactuas lane empluoixs.this, nano provide their w.urh.:cn,"aummp_pokey nuanbicr_ am an employer that is providing trorAers'compensation insurance for my employees. Below is the polity mu!job site information. Insurance Company Name: AIM Mutual Insurance Co Policy#or Self-ins.Lic. : MCC-200-20000534-2021 A Expiration Date: 3/1/2023 Job Site Address: 17 Stoddard Street CityfState:Zip: Northampton MA 01060 Attach i copy of the workers'compensation policy dednrntior page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,*25A is a criminal violation punishable by a fine up to S11,5011.00 and or one-year imprisonment,as well as civil penalties in the limn of a STOP WORK ORDER and a line of up to i250.1.10 a day against the violator.A copy of this statentrtn grin;: Li.:force arklicd to the Office of investigations of the 1)1A for insurance ei.tx•er t,rc r eritication. l do hereby certify and".the ins and penalties afpc rjrrrt•that the infornrrtrion prinided above is,tweet and correct. Signature: Date: 10/13/2022 Phone il: 413-586-8287 Official use only. Do snit write lit this urea.to be completed by cite or town official ('its or Town: Peitnil license At Issuirr;Authority(circle one): I. Board of Health 2.Building Department 3.City Tow n(jerk 4.Electrical Inspector 5. Plumbing inspector b.Oilier ('ontact Person: Phone#: �"`1 WRIGBUI-01 _ KAYLA ACo/ZO CERTIFICATE OF LIABILITY INSURANCE UATE(MM/D r7Y) `-� 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 ACT Kayla Marie Drinkwine Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/c,No,EXt):(413)594-5984I(A/C,No)(413)592-8499 Chicopee,MA 01013 n oR{Ess:kayla@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:EMC Insurance Companies 21415 INSURED INSURER B:Massachusetts Employers Insurance Company Wright Builders,Inc. INSURER C:_ 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—HE 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—O 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 LINr'S LTRINSD WVD IMM/DD/YYYY) (MMIDD/YYYY1 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6D18616 3/1/2022 3/1/2023 DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ 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 PRO- LOC 2,000,000 JECT PRODUCTS-COMP/OP AGG $ OTHER: EMPLOYEE BENEFI $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) . $ X ANY AUTO 6Z18616 3/1/2022 3/1/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOSR ONLY AUTOSp E BODILY INJURYp (Per accident) $ AUTOS ONLY AUTOS ONLY (Per accl Tent)AMAGE $ $ 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 H AND EMPLOYERS'LIABILITY YIN MCC-200-2000534-2021A 3/1/2022 3/1/2023 STATUTE ER 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 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/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