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10D-040 BP-2022-1003 99 WATER ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 10D-040-001 CITY OF NORTHAMPTON Permit: New Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-1003 PERMISSION IS HEREBY GRANTED TO: Project# NEW HOUSE Contractor: License: Est. Cost: 430000 ALLEN GUIEL CS-054248 Const.Class: Exp.Date: 04/12/2024 Use Group: Owner: J. ERICKSON, SARAH Lot Size (sq.ft.) Zoning: URB Applicant: GUIEL CONSTRUCTIONJ. ERICKSON, SARAH Applicant Address Phone: Insurance: 63 CHESTERFIELD RD 412-268-9200 6S6OUB-9F66069 WILLIAMSBURG, MA 01096 588 MAIN ROAD CHESTERFIELD, MA 01012 ISSUED ON:11/17/2022 TO PERFORM THE FOLLOWING WORK: NEW SINGLE FAMILY HOUSE 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: lAry Fees Paid: $1,615.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts FOR Board of Building Regulations and Standards 4/: IMassachusetts State Building Code, . 80 CMRA�G 1 7 2022 MUNICIPALITY JSE Building Permit Application To Construct,Repair, I eno Qr Demolish a Revise4l Mar 2011 One-or Two-Family Dwelling DEPT.OF F;UiI_DING INSPECT ONS I NORT-4 PTO AAA 0+fl6J n This Section For Official Use�iil ` Building Permit Number: &Y�? -'MO - _ Date Applied: 1 S 4 1 . .. :I . . . , : )) 17 Building Official(Print Name) Signature Da e I SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 99 Water Street 10D 040 1.1 a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: URB SINGLE FAMILY 17336 100 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' 17 15 16 20 120 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private❑ Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: 1 �+ SARAH ERICKSON C l,e-s'f e--he lot, ki A. PIP( Name(Print) City, State,ZIP 588 op,.,•-► i. Gl elep a:7-3S�i v Ea eri c�Sovi&3 / w.co ) No.and Street ' hone Emalf Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units 1 Other 0 Specify: Brief Description of Proposed Work': BUILD NEW SINGLE FAMILY HOUSE I SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $373,500 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $19 000 0 Standard City/Town Application Fee I 0 Total Project Cost'(Item 6)x multiplier x 3. Plumbing $17,500 2. Other Fees: $ 4. Mechanical (HVAC) $20,000 List: 5. Mechanical (Fire $ Total All Fees:$ Suppression) , i !,r;Cash Amount:Check No.07 yl�Check Amount: lu 6.Total Project Cost: $430,000 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 054248 04/12/2024 ALLEN GUIEL License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 63 CHESTERFIELD ROAD Type Description No.and Street WILLIAMSBURG,MA 01096 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 SF Solid Fuel Burning Appliances 413 348 9154 allen©guiel.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 104444 07/13/2024 ALLE GUIEL HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 83 CHESTERFIELD ROAD allen c@guiel.com No.and Street Email address Williamsburg,MA 01098 413 348 9154 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 0 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 ALLEN GUIEL to act on my be!half,in all matters rela' to work authorized by this building permit application. SAX n.✓1'1 01"-t G(L S 1 Print Owner's Name(Electronic SlIgrr ure) G ( 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 ap ' ion is tru d accur o the best of my knowledge and understands g. ALLEN GUIEL 5 I, OD. Print Owner's or Authors d Agent s ame(Electronic nature) 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 registlered 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 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.) , 3419 (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) 2450 Habitable room count 7 Number of fireplaces 0 Number of bedrooms 4 Number of bathrooms 2 FULL Number of half/baths 1 Type of heating system ELECTRIC HEAT PUMP MINI SPLIT Number of decks/porches 2 Type of cooling system ELECTRIC HEAT PUMP MINI SPLIT Enclosed 1 Open 1 3. "Total Project Square Footage"may be substituted for"Total Project Cost" Home Energy Rating Certificate Rating Date: 2022-07-15 HIS Projected Report Registry ID: HERS Based on Plans Ekotrope ID: YLeeE3zL HERS® Index Score: Annual Savings Home: Your home's HERS score is a relative 99 Water St 4 performance score.The lower the number, 6 046 Leeds, MA 01053 the more energy efficient the home.To Builder: learn more, visit www.hersindex.com *Relative to an average U.S.home Allen Guiel Your Home's Estimated Energy Use: This home meets or exceeds the Use[MBtu] Annual Cost criteria of the following: Heating 18.9 $1,330 2018 International Energy Conservation Code Cooling 0.6 $43 Hot Water 2.4 $170 Lights/Appliances 20.2 $1,422 Service Charges $84 Generation(e.g.Solar) 0.0 $0 -Total: 42.2 $3,048 HERS Index Home Feature Summary: Rating Completed by: Nominally Home Type: Single family detached tw Model: N/A Energy Rater: Adin Maynard Existing i<a Community: N/A RESNET ID: 9463452 Homes k 1O Conditioned Floor Area: 2,634 ft2 Rating Company: HIS&HERS Energy Efficiency t2O Number of Bedrooms: 4 57R Adams Rd.Williamsburg,MA 01039 10 4136588784 Reference goo Primary Heating System: Air Source Heat Pump•Electric•11 HSPF Home 90 Primary Cooling System: Air Source Heat Pump-Electric•19 SEER Rating Provider: Energy Raters of Massachusetts 80 Primary Water Heating: Residential Water Heater•Electric•3.7 UEF 2 Woodlawn Street Amesbury,MA 01913 70 House Tightness: 1.5 ACHSO 978-270-3911 ,o•---.:.w 60 /Ventilation: 75 CFM•25 Watts �'; sc �� elr Duct Leakage to Outside: Forced Air Ductless r ft.um,M 30 This Home Above Grade Walls: R-28 9'4- ,P4' 20 Ceiling: Attic,R-59 n".,. Zero Energy Window Type: U-Value:0.3,SHGC:0.3 Home 0 Foundation Walls: R-16 Adin Maynard,Certified Energy Rater -411P' `"'ra` Framed Floor: R-44 Digitally signed:7/19/22 at 7:47 AM e kot ro a Ekotrope RATER-Version:3.2.4.2952 The Energy Rating Disclosure for this home is available from the Approved Rating Provider. Energy savings calculated without modifications to the energy model.(As Modeled) This report does not constitute any warranty or guarantee. • 2018 IECC R-406 Projected Energy Rating Index Report Property Organization Energy Rating Index Information Builder:Allen Guieil Company:HIS & HERS Energy Efficiency Projected Rating Address:99 Water St, Leeds, MA 01053 Phone:4136588784 Rating No: Rater:Adin Maynard Rater ID (RTIN):9463452 Date Rated:2022-07-15 Estimated Annual Energy Consumption* Rated Home Calculated Energy Use Rated Home Cost($/yr) (MBtu) Heating 18.9 $1,330 Cooling 0.6 $43 Water Heating 2.4 $170 Lights &Appliances 20.2 $1,422 Photovoltaics ' 0.0 $0 Total 42.2 $3,048 'Based on standard operating conditions ERI with PV:51 ERI without PV:51 Annual Estimates Electric(kWh):12,351.1 CO2 Emissions(Tons):7.9 Natural Gas (Therms):0.0 Maximum Energy Rating Index:61 This Home's Energy Rating Index:51 PASS This home M:ETS the Energy Rating Index Score requirement of 2018 IECC R-406 for Climate Zone 5. It MEETS all of he requirements verified by Ekotrope. Mandatory requirements are summarized on the 2nd page of this report, tome of which are not verified by Ekotrope. N:me: Adin Maynard Signature: Organiza ion: HIS&HERS Energy Efficiency Digitally signed: 7/19/22 at 7:47 AM Rating Provider Data and Seal Company:Eneryy Raters of Massachusetts Address:2 Woodlawn Street Amesbury, MA 01913 Phone#:978-270-3911 •?,' No.1998-136 Fax#: p ,pro CAf D rllr�~ To determine if a provider is properly accredited go to:www.resnet.us/professional/programs/search_directory (Projected. Confirmation required.) Climate Zone 5 Mandatory Requirements Provision Numb•r Topic Compliance Decision 2009 IECC Table 402.1.1 Building thermal envelope minimum insulation levels and PASS or 402.1.3 maximum fenestration U-factor and SHGC R401.3 Post a permanent certificate listing the level of efficiencies Certificate required for CO installed in the house R402.4.1.2 Envelope air leakage maximum leakage rate FAIL R402.4.1 /Table Comply with air sealing and insulation requirements in Table Checklist required for CO R402.4.1.1 R402.4.1.1 R402.4.4 Rooms containing fuel-burning appliances PASS* R402.5 Maximum fenestration U-factor and SHGC (U-Factor)PASS (SHGC) PASS R403.1.2 Heat pump controls PASS* R406.2 Ducts outside of conditioned space to be insulated to a minimum PASS* of R-6. R403.3.2 Duct sealing on all ducts PASS* R403.3.3 Duct testing for ducts in unconditioned space PASS* R403.3.5 Building cavities not used as ducts. PASS* R403.5.1 Heated water circulation and temperature maintenance systems PASS* comply R403.5.3 Hot water pipe insulated to R-3 PASS R403.6 Mechanical ventilation meeting the requirements of the IRC or PASS* IMC. Outdoor air and exhaust dampers installed R403.7 ACCA Manual J and S conducted for all heating and cooling I ACCA forms required for permit systems. R403.8 Systems serving multiple dwelling units to meet the mechanical PASS' requirements of IECC commercial code R403.9 Snow melt and ice system controls installed where applicable PASS* R403.10 Pools and permanent spa energy consumption meet PASS* requirements for heaters, time clocks and covers R403.11 Portable spas meet the requirements of APSP-14. PASS* R404.1 High efficacy lights installed in 90%of permanently installed PASS fixtures. *This is a projected rating.These items must eventually be field-verified by the Rater, Field Inspector, Code Inspector,or Builder. Ekotrope RATER-Version 3.2.4.2952 IECC 2018 ERI compliance results calculated using Ekotrope RATER's energy and code compliance algordhm Ekotrope RATER is a RESNET Accredited HERS Rating Tool.All results are based on data entered by Ekotrope users. Ekotrope disclaims all liability for the information shown on this report. Building Specification Summary HIS Property Organization Inspection Status HERS 99 Water St HIS & HERS Energy Effici, Results are projected Leeds, MA 01053 Adin Maynard 4136588784 Erickson residence Builder Allen Guiel Building Information Rating Conditioned Area PI 2.634.00 HERS Index 42 Conditioned Volume[ft'J 32,031.00 HERS Index w/o PV 42 Thermal BoundaryArea[ftz] 7.251.95 Number Of Bedrodms 4 Housing Type Single family detached Building Shell Ceiling wl Attic I R60, 16"cell 4-24 flat; U-0.017 Windows(largest)I U-Value: 0.3, SHGC: 0.3 Vaulted Ceiling I None Window/Wall Ratio 10.13 Above Grade Walls I Infiltration 11.5 ACH50 2x6 , 16oc R21, FG, G1 + R6.6 ZIPR 1.5"; U-0.04 Duct Lkg to Outside I Forced Air Ductless Found. Walls 12.5"TherMax ISO_ R15.8; R-16 Total Duct Leakage I Untested Framed Floors I R36,2" PSF , R3OFG,10-16>garage; R-44 Slabs I R10 under all; R-10 Mechanical Systems Heating Air Source Heat Pump • Electric• 11 HSPF Cooling Air Source Heat Pump • Electric• 19 SEER Water Heating Residential Water Heater • Electric•3.7 UEF Programmable Th rmostat Yes Ventilation Syste 75 CFM • 25 Watts Whole House Fan N/A Lights and A pliances Percent Interior LSD 100% Clothes Dryer Fuel Electric Percent Exterior LED 100% Clothes Dryer CEF 3.0 Refrigerator(kWh/yr) 691.0 Clothes Washer LER(kWh/yr) 125.0 Dishwasher Efficiency 270 kWh Clothes Washer Capacity 4.5 Ceiling Fan None Range/Oven Fuel Electric Ekotrope RATER-Version 3.2.4.2952 All results are based on data entered by Ekotrope users.Ekotrope disclaims all liability for the!nformabon shown on this report. Componeht Loads HIS Property Organization Inspection Status HERS 99 Water St HIS & HERS Energy Efficii Results are projected Leeds, MA 01053 Adin Maynard 4136588784 Erickson residence Builder Allen Guiel Heating & Cooling Loads 14 12 11 10 8 6 4 m 2 2 0 mom 11 -2 -4 -6 -8 -10 Above-Grade Infiltration & Slabs & Roofs Ducts Windows & Foundation Internal Walls Ventilation Floors Doors Walls Gains Hea ing • Cooling III Ekotrope RATER-Version 3.2.4.2952 All results are based on data entered by Ekotrope users.Ekotrope disclaims all liability for the information shown on this report. 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:Individual Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 104444 07/13/2024 Boston,MA 02118 ALLEN R.GUIEL ALLEN R.GUIEL 63 CHESTERFIELD RD „,o.,;; ':4N WILLIAMSBURG,MA 01096 Undersecretary Not vale without signature Commonwealth of Massachusetts Division of Occupational Licensure Wi Board of Building R ulTations and Standards I Con a. s y r7rt S (visor CS-054248 * < pires:04/12/2024 ALLEN GUIE a 63 CHESTERFIELD ;" O WILLIAMSBURG Commissioner ,', y 7-1..- . The Commonwealth of Massachusetts ►,_'`v, .l, Department of Industrial Accidents _M!_ 1 Congress Street, Suite 100 < Boston,MA 02114-2017 W�_T r• www.mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name:Guiel Construction Address:f3 Chesterfield Road City/State/Zip:Williamsburg, MA 01096 Phone #:413 268 9200 Are you an employer?Check the appropriate box: Business Type(required): 1. I am a employer with 2 employees(full and/ 5. ❑Retail or part-time).* 6. ❑Restaurant/Bar/Eating Establishment 2.Cl I am sole proprietor or partnership and have no 7, ❑Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers'comp. insurance required] 8. El Non-profit 3.❑ We are a corporation and its officers have exercised 9. 0 Entertainment their right of exemption per c. 152,§1(4),and we have 10.❑Manufacturing no employees. [No workers'comp. insurance required]** 11.❑Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with Ito employees. [No workers'comp. insurance req.] 12.0 Other Building and Remodeling *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: Hartford Underwriters Insurance Co Insurer's Address: PO Box 4614 City/State/Zip: Buffalo, NY 14240-4614 Policy#or Self--ins.Lic. # 6S60UB-9F66069-2-22 Expiration Date:04/27/23 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,a00.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby • ,under th\+,ins and pe ies of perjury that the information provided above is true and correct. Signature: ��\ Date: O") - a Phone#:413 289 9200 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4. Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia AC�® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 7/22/2022 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 The Dowd Agencies, LLC PHONE Diane LaFleche FAX 226 Russell Street, Suite B lac.No.EXt):413-53444 (A/C,No):413-536-6020 Hadley MA 01035 ADDRESS: dlafl 8 7eche@dowd.com _ INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:Utica First Insurance Company 15326 INSURED ALLERGU-01 INSURER B:Commerce Insurance Company 34754 Allen R. Guiel dba Guiel Construction INSURER C:Hartford Underwriters Insurance _ 30104 63 Chesterfield Road INSURERD: Williamsburg MA 01096 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:703590255 REVISION NUMBER: THIS IS TO CERTIFY TIHAT 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 SUBR POLICY EFF POUCY EXP LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY ART3000145300 4/22/2022 4/22/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $50,000 MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X TO LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY RVT614 2/22/2022 2/22/2023 COMBINED SINGLE LIMIT $1,000,000 (Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED 1, X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED x NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY ._ AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION UB9F660692 4/27/2022 4/27/2023 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE Y N/A E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Allen Guiel is excluded under the Worker's Compensation policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Northampton 212 Main Street Northampton MA 01060 AUTHORIZED REPRESENTATIVE 44/4 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD City of Northampton Massachusetts - `/, y !G DEPARTMENT OF BUILDING INSPECTIONS F �; 1.•� 212 Main Street • Municipal Building * Northampton, MA 01060 S� 1/:)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: J (2(Zaf C[\ . Y1011ZTS 4P1 The debris will be transported by: Name of Hauler: ,l`c� '� �C 1Q, ( lk. 7 1 au �a Signature of Applicant: kiA Date: -)\ fi N <tte ',goosed Inside 90 Deg Corner 110' — — iRD RfeV Gr a `\'`\qY �,lSI'MI�����������CEIM-— NAIL rw vNr IIr7.`;/ ,os r Z00®®®®®®�[ii '', UNIT ALL 111.4 — •L4�.��_: „"a„- L_ a PPG - W- i`fl�11©� ©� IERNO - - �I i)EasF:/:�AIAA�KNRm� Wm11 2. 2A ®®®®®nnriOmlo RAIL UNITI PLKE FIRST COURSE �� ._....Vie fAYYYYEAB^••, p ��� ttU91 /CORN S" •roll9see Grade _ /i Ja 17 O� f �- e � .� O ER • • Batton of N�� ��/�/ 95' MUM—B A Awl. (SEE 00AA) ORMN TAE n ( _I I 110 �I I _I —� STAl PROPOSED RETAINING WALL WALL CROSS SECTION I I- _ I n ELEVATION VIEW NR ro • FACING WALL SCR1eI H-1••10'V-1'•5' CORNER L INSIDE 90' ' TOTTO SGME 14/..' ..,4\p‘ , Minimum Concave Ratline Wall MelpYi TeYI a of Rene.Radius o et mm l 3 8' %14 J IT IP • ,{. -6 IV; 1/2 5 1'Y 6 —- 146• 2. ...Dery+. 102M B 14C 1gR. Al LOWEST COURSE. 1�•I.. WIYW RAMS OCCURS RADIUS INCREASES)'PER COURSE , i ABpI[.AS SHOWN ON TABLE• . W 1 MINIMUM CONCAVE RADIUS 6SF UNITS / ' • �. x 11 N9!Ig xA E . 141111 ,I 1111? �� U'h er `� STONE STRONG 24SF UNIT STONE STRONG 24SF TOP UNIT �S /i STONE STRONG F END UNITNOT TO SCAL NOT To E Bo Rol To=u E le siio ��I �I RETAINING Quantities ALL STONE STRONG 3SF UNIT STONE STRONG 3SF TOP UNIT 1e�`,III\ ,A�`.�I ,. : i: / 3 SF -IB bike STONE STRONG 90• CORNER UNIT COLNEER�000LLUMN I0IDBENI -s ak a NOT TO sc. STONE STRONG 6SF UNIT STONE STRONG 6SF TOP UNIT TOTAL SF OF VALE FACE-621 so fA NOT TO SE.. NOT TO SCAB NOTES: I. WALL TO BE CONSTRUCTED TO LINE AND GRADE PROVIDED BY ARROW CONCRETE BASED ON FIELD MEASUREMENTS AND ILLUSTRATED HEREON FOR LOCATION FOR ME PROJECT AT 99 WATER STREET-LEEDS.MASSACHUSETTS 2 EXCAVATION(OMITS FOR INSTALLATION Cl'THE RETAINING WALL SHALL CONFORM TO OSHA STANOARUS CONTRACTOR IS RESPONSIBLE FOR CLASSIFICATION OF SOIL IN ACCORDANCE WITH OSHA STANDARDS AND MAINTAINING APPROPRIATE SLOPE LATRACK REQUIREMENTS. ADDITIONALLY CONTRACTOR IS RESPONSIBLE FOR VERIFICATION OF PROPERTY LINE BOUNDARIES AND OBTAINING APPROPRIATE PERMITS OR EASEMENTS AS NECESSARY TO COMPLETE INSTALLATION OF THE RETAINING WALL. CONTRACTOR IS RESPONSIBLE FOR MAINTAINING THE BEARING AREA OR THE EXISTING WALL OR ANY ABUTTING STRUCTURES AND CROWDING ANY SUPPORT REQUIRED �YKLTq�. 3.CCKFILL BEHIND WALL TO BE FREE-DRAINING BACKE,.SHALL BE WELL-GRADED COMPACTIBLE AGGREGATE MEETING THE FOLLOWING GRADATION.1.-INCH INCH MAXIMUM PARTICLE SIZE.50-85X PASSING/A.SIEVE.0-IOW PASSING/200 STEWCOMPACTED TO 95X OF STANDARD . S4TAa:. ! M! RETAINING WALL CONSTRUCTION PLAN A. UMT at TO CONSIST OF CRUSHED STONE OR COARSE GRAVE(MEETING THE FOLLOWING SPECIFICATION: 2"-75 TO T00B'PASSING;I•-J5 TO TOOT PASSING;/A- TO TO BOW PASSING;/10-5 TO 25X PASSING:/40-0 CO 10X PASSING;/200 0 TO 5X PASSING. `I UNIT nu.ro BE USED AS Become DIRECTLY BEHIND WALL.WITHIN ALL wars,AND AS BASE COURSE 1 'w.',.„ STONE STRONG RETAINING WALL 5. SUBGRADE UNDERLYING LEVELING PAD.SHALL CONSIST OF FIRM.DRY.UNDISTURBED NATURAL SOILS OR FREE-DRAINING FILL COMPACTED TO 95W OF MAXIMUM DRY DENSITY DETERMINED IN ACCORDANCE IBM STANDARD PROCTOR TEST(AVM 0-698). SUBGRADE ro BE CAPABLE of 99 WATER STREET J..(100 PSF GEARING CAPACITY IT)BE VERIFIED BY QUALIFIED ENGINEER IN FIELD LEEDS, MASSACHUSETTS • y.,..,WAIT wu1 FE I STAINER IN ACEMHLWCE in.MANUFACTURER'S SPECIFICATIONS. OATEN _REVISIONS_DATE, _ REVISIONS DATES DRAWN BY ). FOUNDATION DRAIN TO DAYLIGHT AT LOW-POINT OF WALL OR CONNECT TO A CLOSED DRAINAGE SYSTEM. WALL BLOCK TO BE CUT OR CORED IN FIELD TO ALLOW FOR DRAIN PIPE TO EXTEND THROUGH FACE OF WALL. SEE DETAIL PROVIDED HEREON .Bf}B/P[ •..�..... B FENCE/GUARDRAIL IS TO BE INSTALLED WHERE REQUIRED BY CODE OR PROTECT PLANS FENCE/GUARDRAIL TO BE INSTALLED IN ACCORDANCE WTM MANUEACIUREW'S RECOMMENDATIONS. ACTUAL DESIGN OF FENCE/GUARDRAIL BY OTHERS PROJ. NUMBER CHECKED BY 22-355 e.. 111,S141LL.P. 9. IF SITE CONDITIONS ARE DIFFERENT THAN THOSE ASSUMED FOR DESIGN,GIRL CONNECTION LIE SHOULD BE NOTIFIED AND THE HNIIY OF THE DESIGN LUm AM - E 10 CONTRACTOR IS RESPONSIBLE TO MAINTAIN ALL EROSION CONTROL MEASURES REQUIRED BY CODE-CIVIL CONNECTION.LLC.IS NOT RESPONSIBLE FOR EROSION CONTROL MEASURES OR APPLICATION OF FINISH SLOPE TREATMENT. SHEET Raman roN. eaPum n.CIVIL CONNECTION.LLC. ARROW CONCRETE PRODUCTS 1 OF 1 GRAB.,GSIIIEETCTT N moos ott c r,_Y:'M eW T