The URL can be used to link to this page

06-010 (8) BP- 022-1369 595 HAYDENVILLE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 06-010-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-1369 PERMISSION IS HEREBY GRANTED TO: Project# windows Contractor: License: Est. Cost: 1500 KEVIN R SCHNELL CS-109600 Const.Class: Exp.Date: 10/19/2023 Use Group: Owner: J GREGORY, SETH H&ANGELA Lot Size (sq.ft.) Zoning: RR Applicant: LIVEWELL HOME IMPROVEMENT LL Applicant Address Phone: Insurance: 33 LAUREL MOUNTAIN RD (413)409-2929 WCC-500-5024695-2022 WEST WHATELY, MA 01039-9604 ISSUED ON: 10/31/2022 TO PERFORM THE FOLLOWING WORK: REPLACE 6 BASEMENT WINDOWS 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: ^ .; • f • I Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner SI, The Commonwealth of Massachusetts Y, Board of Building Regulations and Standards FOR �" Massachusetts State Building Code, 780 CMR MUNICIPALITY USE ro Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 ry One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: ► / AA •/3&7 Date Applied: /ti,� 7Z5 I/22 *3)-2 Z Z Building Official(Print Name) Signature Date j SECTION 1:SITE INFORMATION 1.1 Pro er Addr s: 1.2 ssessors ap&Parcel Numbers 1 H�Xaen�1lle g("ed ,-ar -ooi 1.1a Is this an abcepted street?yes no Map umber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard 1 Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private CIZone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 24 Owner'of Record: 4146le 6 r1• My —L9eis, M4 0105-3 Name(Tint) City,State,ZIP ' I Cl 1401)(Ce-CO tr-Ne Qce 1 - ---(W:i' c`"9.1g2l1d"r e51444i Cool No.and Street Telephone • it ddr ss SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition j❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: I— Brief Descriwiion of Proposed Work': R p P lac p C (I(-Pvl 94 S up D ii�p& bG Se irI P i�1 n W O E'V S [ SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ ( 5 0 0 1. Building Permit Fee: $ (j ndicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All Fees: $ Suppression) OC) Check No.to(3 Check Amount: Cash Amount: 6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.11 Construction Supervisor License(CSL) /' S r `K` C"k'1 tc`e�{�'i l S h �� License Number?Coo Expir 'on ate Name of CSL Holder � it "3 " 6l U P.00 List CSL Type(see below) _ Li No.and Street Type Description W 5 f h ci f-4 y 4 Q 103 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding �1 /' /l (� I f 11 SF Solid Fuel Burning Appliances O(3 ©f�Q O f P(C ( i l JI V"ell Vori e I Insulation Telephone Email address T-wl Oiet4 )of— D Demolition 5.2 Regi,tperr d Home Improvement Contractor(HIC) -(f) ►✓) .) (Li / L!v P V" (( 14 owl l' WI P r OV fV)1 HIC Registration Numberit ion Date HIC Company Name or HIC ReIstrantWiC Na `'33LAvre,1 I/i Nr Street LA) (NA ^ "-„/y(N-n 4. n(O;� q(3`l,of-gay Email address City/Town,State,ZIP �l ' 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 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 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. K-eu i Sc h h-eI( (O [J ).- Print Owner's orAuthorizedAgent's Name(Electronic Signature) ate NOTES: I 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contradtor (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 four 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 porch) 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 1 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton �tMgMp Massachusetts �? 4._ 44, DEPARTMENT OF BUILDING INSPECTIONS �. , 212 Main Street • Municipal Building Northampton, MA 01060 s�w . ,,O 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: � - ( ;15-`-1- holm f o n pj The debris will be transported by: t IIName of Hauler: � �� e UJ-e Signature of Applicant: Date:/0/2-?-7 -19\ The Commonwealth of Massachusetts a Department of Industrial Accidents -�= 1 Congress Street,Suite 100 '�=1= Boston, MA 02114-2017 -,y www mass.gov/dia 11 uikers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. It)BF.FILED%%I III THE PERMUTING AtrTHORITn. .lnnlicant Information ( ) Please Lttbly Name 1 Husmess O garttratwaflndividual):_..C. I'.l.P �l/ `e I( Ho 0/.e. k/v}protieLNI 1' Address: `5 L- et(/ r e ( A i 2 ti city/stateizip:Lie sI Li hate( , M401 #: 413 - (lo q -a. s;, 7 Art vim as errolayert Cheek t►r iarr bus: Type of project(required): Iam a coifs with employees(full and or part-time)' .1 7. New construction I am a sole pnrpndor or prutnership and base no employers working for me in S. a Remodeling am capacity.(No workers'rump.insurance n^yuired 1 9. ❑Demolition 3 VJ I am a hurnsiow net doing all(suet myself.(No wurkus'comp.insurance required(' 4.0 I am a unicvwtc tt r and will be heroes sur -a tors to conduct all work on my property I will ID a Building addition h enaurc that all c.mtrreturs either has':workers'compensation unurance ix are sole 11.a Electrical repairs additions pupnetun w ith no employers 12.0 Plumbing repairs additions 3C3 I am a genera]contractor and I base hired the soh-contractors listed on the attached sheet. These sub.eontractors has.:employees and lust:workers'comp.insurance.: 13 Root'repairs 14.0Other 6.0 we arc a corporation and its ufrseers has a exercised Lbw nght of exemption per 1116E c. — 152. 1(41.and Y.i.haw no employees.(No workers'comp.insurance required.J •.Any applicant that checks box a l must also fill out the section below show ing theft workers'compensation policy information. r Iiumcvwners who submit this athidasit indicating they*redoing all work and then hue outside contractors must subnut a new aflidas it indicating such. 4.onuactors that check this bus must attached an additional sheet showing the name of the sub-contractors and gate whether or nut those aUitiet base einpluyees. If the sub-e.ntracti.es base employees.they must pros ids.thou workin'sump.policy number I am an emploter that is providing workers'compensation insurance for tny employees. Below is the policy and job site information. Insurance Company Name: ilifl v4ci u I Th 5 U iq VI(f,,E) CD /c( 3 Policy#or Self-ills.Li c.#: W(X—5(90—5Qa G f a rj, g - paZ Expiration Date: G! lob Site Address: .91 vf fj G1 y(it f0 v (' ((`e Ac.e City,'Statezip:Alit. - 9&5 M it_O l o' -3 Attach a copy of the workers'co nsation policy declaration 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 tine up to$ ,500.O0 soul or one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DR for insurance coverage verification. l do hereby certify under the ins and penakies of perjwy that the information provided above is true and correct Si'nature: / /, Datc 1 Phone x: v( /3— �( O 9 -).. y 1 Official use only. Do not write In this area.to be completed by city or town official City or Town: Permit/License it Issuing Authority(circle one): I. Board of Health 2. Building Department 3.('ih riown Clerk 4.Electrical Inspector 5. Plumbing I 6.Other Contact Person: Phone a: �...miN KEVISCH-01 LZAPKA A�ORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM!DD/YYYY) 7/7/2022 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 FQTFACT Whalen Insurance Agency PHONE No,Ext):(413)586-1000 FAX 413 585-0401 71 King Street (�.Mp�� (A/C,No):( ) Northampton,MA 01060 ADDRESS:info@Whalenlnsurance.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURERA:Main Street America Assurance 29939 INSURED INSURER a:A.I.M.Mutual Insurance Co.____ LiveWell Home Improvement,LLC INSURER C: 33 Laurel Mountain Road INSURER D: West Whately,MA 01039 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD ME) POLICY NUMBER (MM/DD/YYYY1 (MM/DD/YYYY) LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR MPJ8858A 3/28/2022 3/28/2023 DAMMISES j):a AGE TO RENTED oocurrertce) $ 100,000 PRE MED EXP(Any one person) $ 10,000 PERSONAL ii ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY (Ea as cideent)INGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) ,$ OWNED SCHEDULED AUTOS ONLY _ AUTOS BODILY INJURY(Per accident),$ _ AUTOS ONLY �__, UTS NON-OWNED PROP�E� ntDAMAGE $ ONLY (Per ) ,$ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE ,$ DED RETENTION$ S B WORKERS COMPENSATION .PER OTH- AND EMPLOYERS'LIABILITY Y/N F STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE WCC-500-5024695-2022 4/5/2022 4/5/2023 100,000 OFFICER/MEMBER EXCLUDED? l N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate issued as evidence of coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY p ACCORDANCE WITH THE POLICY PROVISIONS. Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE //�� ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SUM■►� TX SUM LIVE KELLY-FRADET LUMBER sued it Better. wrww.kNfyfradetcan, DA VE RICHTER 92 PROSPECT ST,,,ENFIELD,06082-3441 QUOTE BY : Dave Richter QUOTE# : JW211001E9A-Version 0 SOLD TO : GREGORY,ANGIE SHIP TO • PO# • PROJECT NAME: Gregory Ship Via : Ground REFERENCE . U-Factor Weighted Average: 0.3 SHGC Weighted Average: 0.31 LINE LOCATION BOOK CODE NET UNIT QTY EXTENDED SIZE INFO DESCRIPTION PRICE PRICE Line 1 Frame Size: 31 x 12 1/2 Rough Opening : 31 1/2 X 13 Builders Vinyl Sliding Window 2 Panel Pocket/Replacement,White Ext/White Int,XO(LH)Vent Width= 15 3/4, Energy Saver SunStable Clear Argon Standard Screen with Fiberglass Mesh, White Int Hardware,Cam Lock(s), 1 Lock, *Does Not Meet Egress*, , Clear Opening 12.1w, 9.6h, 0.8sf, Slope Sill Adaptor,Loose,Head Expander, US National-AAMA PG20,DP+20/-20, U-Factor: 0.30, SHGC: 0.31,VT: 0.59, CR: 55.00, ER: 20.00, CPD: JEL-A- 176-08971-00001 PEV 2022.2.0.3980/PDV 6.767(06/08/22)PA Viewed from Exterior. Scale: 1/2"=1' 6 Total Units: 6 cust-46778 Page 1 of 1 (Prices are subject to change.) JW211001E9A(Ver:0)- 10 98/2022 3.43 PM Common rn weatth a'Massachusetts Division of Occupational Licensure ¢` f Board of Building Requlattons and Standards Cons MM Sktinrvisor .r C5-109600 a Fires: 10f19f2023 KEVIN SCHNpLL 33 LAUREL MOUNTANI! WEST WHATE{-Y MAtip t Comml>:sloner .:,.:' r . �7+ et,;rlt /Z' f!l'/ll///('////'/'////// 1 ///J/1( Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC Registration: 181146 L.IVEWELL HOME IMPROVEMENT LLC. Expiration: 07/08/2023 33 LAUREL MOUNTAIN ROAD WHATELY, MA 01039 Update Address and Return Card. A 1 tS 20M-O5 17( EpOrM ' Oyu �G n HOME I RVEe f N7R Registration valid for individual use only TYPE:LI C before the xp' ation date.,,If ound return to: Reg1gtra.tion Expiration Office of n mer ' s d Business Regulation 181146 07/08/2023 1000 i on r - tide 710 LIVEWELL HONE IMPROVEMENT LLC. Bost 2 8 KE VIN SCHNELL' 33 LAUREL MOUNTAIN ROAD f "" ' .'+ yYHATELY,MA 01039 Undersecretary of valid without signature