The URL can be used to link to this page

24A-024 (19) BP- 022-1495 89 RIDGEWOOD TERR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24A-024-001 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-2022-1495 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: Est. Cost: 10800 CHRISTOPHER SPAGNOLI 104569 Const.Class: Exp.Date: 03/29/2024 Use Group: Owner: E VOSS PAUL B &SUSAN Lot Size (sq.ft.) Zoning: URB Applicant: GRATEFUL DEVELOPMENT INC Applicant Address Phone: Insurance: 38 LARIVIERE AVE (508)332-8298 SOLE PROPRIETOR THREE RIVERS,MA 01080 ISSUED ON:11/15/2022 TO PERFORM THE FOLLOWING WORK: STRIP AND RE-ROOF 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:g „ 9 I. � r' s 'I . Fees Paid: $80.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner / 'cl\--- The Commonwealth of Massachusetts ,ilw, Board of Building Regulations and Stanlards 4/01/ FOR Massachusetts State Building Code, 7oClXI c S�O MUNICIPALITY IUSE LITY Building Permit Application To Construct,Repair,Renovate sj- •lish a 2c Revised Mar 2011 One-or Two-Family Dwelling rye^��"<^,, This Section For Official Use Only [3 p' 1,."'SAi f Building Permit Number: .�.2'/�gr Date Applied: 4 ig_/JO 4-.e:6S ii-/5-&22._ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property ddress: i 1.2 Assessors Map&Parcel Numbers 1.1a Is this an accepted street?yes no Map Number , 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 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 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY AI Vail / OWNERSHIP' 2.1 Owner'4 of eSV.J / VPr g IA 1 ^„_ J/; / / Name(Print) City,State,ZIP e lam,' `w0,v l II.e rr1,e,G No.and Street U Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'-(check all that apply) New Construction 0 Existing Building ir Owner-Occupied Art Repairs(s) l Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': RI, q (LLif fe,.� /fir-f 71— J' a,,,/L 1741-1 SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ /D ;(� 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ / ❑ Standard City/Town Application Fee ❑Total Project Cost3 (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: tio, Check No. )5)21 Check Amount: 0 0 6. Total Project Cost: $ 0 Paid in Full , 0 Outstanding Balance Due: ,„ City of Northampton 0 - sir ,,r r .„.../,44-04.,1 Massachusetts 4101100tt"-. --Ap.-,----. ��. :, �, ci DEPARTMENT OF BUILDING INSPECTIONS ,1. `' 212'Main Street • Municipal Building ‘,3 INorthampton, MA 01060 ss i, ti';"' NOV y 4 2Q22 DE NO F BUILDING INSPECTION HAMnrnN Mg S PROCEDURE-FOR OBTAINING A BUILDING PERMIT FOR WINDOWS, DOORS, ROOFS, RENOVATIONS, ROOF MOUNTED SOLAR, ETC. 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specifications of proposed work (Digital and hard copy). 3. Construction Debris Affidavit filled out and signed by applicant. 4. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance. 6. Energy Conservation Compliance Certificate (new /replacement windows). 7. Home owner's License Exemption Form (if applicable). 8. Note any Special Permit requirements (if applicable). 9. Energy Code —all new construction(Gut/Rehab) requires a HERS Rater Affidavit 10. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton. SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS — /9J.% `]/j c /yj L'I i t,'I 1,,, a,,� i /I License Num 0 Expirration Datte� `Name of CSL Ho a �7 t lv/-V Avg List CSL Type(see below) No.and Street f /� Type Description 71v , I ON2ri U-t 1-, Y M'� alop e � Unrestricted(Buildings up to A000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding r �j n SF Solid Fuel Burning Appliances J dp �7d oce- 4pa fc 2��r t Ccit I Insulation Telephone Viai ddress D Demolition 5.2 egiste fred/Home Improvement Contractor(HIC)i. / G r>��/ 7� f G /`Cf--� L,/JG"►4/ %l, Tppan) HIC(Registration Number xpiration D to Co pan Name or HIC Regi ayI Name N .a d Stre t ?f mai l add 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 f the building permit. Signed Affidavit Attached? Yes No . 0 SECTION 7a:OWNER A HORIZATION 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 a cati 's true and accurate to the best of my knowledge and understanding. .. ` 'nt Owner' orized Agent's Name(E ec ode-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 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.) (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 3. "Total Project Square Footage"may be substituted for"Total Project Cost" .;\ The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 wwuttnass.govidia Workers'Compensation insurance Affidavit:BuildersiContractorstElectricions/Plumbers. U)RE FILED Wall THE PERMUTING ATTIIORITY. Applicant Information Please Print Legiblv Name i ausinessiOrganizationliadividuaW 1Ye-f. ,/(„, I-- r- lcitlf1-0,1./ 6ThV 71 41-6 Address: 04 t Al--","ifeit Pit, ..e„_. . . . Ciry/StatetZipL_Lilnijy2 Ci- 0 607j Phone#: 0- ', Aritaiii Lin emptuier,t'heck the appropriate We: Type of project(required): a ernploym With /p erriploves(hitt aladior part-timer„* 7. 0 New construction 20 lain a sole proprietor or puriamship and hate flu employees working for me 32 8 Remodeling any L4paciry.[No workers comp.tristiramcV required] 9. El Dcfttiolition 310 tarn a ibarrwo*Iter titling all work myself.[No work.ers"comp.insurance seipireiLl' 4.0 10 El Building acklition lam a kOmo,Avner and will be hiring contractors b.)otrothla an Work on my miserly. I will ensure that all contractors either have workers'compensation nerarance or me sole I I.0 Electrical repairs or additions proprietors*ith no employeet 12.0 Plumbing repairs or additions 50 4 am a Viral contractor and I hires hired the sub-contractors listed on the attached stet 13 tie 'out repairs I/Wit Atibm.'Ontractens haw employees and have workers`comp.tmintufbe0-: 14.I Other 6.E3 We am a corporation and Its officerN haVe,eXercised their right of exemption per WI.c. 152„41(4),and we haw nu ariplirce.s.ENO workers'comp.insurance reigiareill "*Any applicant that checks bew 41 snafu also till out the iectrim Ix lo,4.11:10,°,iris their woricrs's:orupens;itom policy reformation .4*Homeowners who submit this affidavit indicating they are douts ail work and theta hire outside eeeuraetors must submit a neve affislat,it ardicatuts such. l'Contractors that check des box must=wired an additional sheet showing the name of the sutwernarieters and state whether or nut those mums base employees If the aultwcontracturs!woe mreploy>eta,they must pros,ide their workers'camp.pills.-: nturiber „. /am an employer that is provisting workers"compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: _ Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: —1vs.."I i C te ity/Sta Zip: Attach a copy oft w i orkers cute 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 punisha- -.ble by a fine up to$1.500.00 =tor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 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. ..., Ida hereby cerW male e pains and penalties of perjury that the information provider,above is true and correct. na -----., Phone#: c----a • . ).7, -06V70q9 .. . ,... IOfficial use oak. Do not write in this area.to he completed bi city or town official , 1 City or Town: Permit/License a issuing Authority(circle one): I Board of-Health 2,Building Department 3.t Ityrfoon Ckrk 4.Electrical Inspector S.Plumbing Inspector 6.Other . t Contact Person: Phone 4: City of Northampton Massachusetts * DEPARTMENT OF BUILDING INSPECTIONS qw 4 212 Main Street • Municipal Building 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: L Jk /114— Zr4-€//9 The debris will be transported by: Name of Hauler: 11 fh /-)/5 a ,/s ( I Signature of Applicant: Date: ///// /e),/, City of Northampton irrg Massachusetts I DEPARTMENT OF BUILDING INSPECTIONS Ds �„ir 212 Main Street • Municipal Building Northampton, MA 01060 �'' «•• ��`�� HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born_ (insert month, day, year), herry depose and state the following: 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners' exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this day of , 20 . (Signature) Acc)REP DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 06/27/2022 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 PAULINE MAUDSLEY NAME: DUNN INSURANCE INC PHONE o Est): 860-262-4036 FAX No): 198 S MAIN STREET ADDRESS: PAULINE@DUNNINSURANCEINC.COM INSURER(S)AFFORDING COVERAGE NAIC# MIDDLETOWN CT 06457 INSURER A: CRUM&FORSTER INSURANCE INSURED INSURER B: PROGRESSIVE HERITAGE INVESTMENT GROUP LLC INSURER C: EVANSTON INSURANCE COMPANY 28 HAMPDEN PLACE INSURERD: TRAVELERS INSURANCE CO INSURER E: WINDSOR CT 06095 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 LTR TYPE OF INSURANCE �gp WVD POLICY NUMBER DL SUBR POLICY EFF POLICY EXP LIMITS (MM/DD/YYYYt (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A X X BAK53335-2 08/13/2021 08/13/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B XOWNOEDONLY X AUTOS SCHEDULED 03288304 02/24/2022 02/24/2023 BODILY INJURY(Per accident) $ AUTS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) I �/ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 C EXCESS LIAB CLAIMS-MADE 33162102 02/24/2022 02/24/2023 AGGREGATE $ 2,000,000 DED RETENTION$ $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY D OFF CER MEM ER XCLU ED?ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N N/A 6R428229 05/26/2022 05/26/2023 E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If es,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ROOFED RIGHT AMERICA LLC ACCORDANCE WITH THE POLICY PROVISIONS, 429 W BODEN STREET AUTHORIZED REPRESENTATIVE PAULINE MAUDSLEY MILWAUKEE WI 53207 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD