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17A-117
BP-i022-1661 22 CLAIRE AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-117-001 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-2022-1661 PERMISSION IS HEREBY GRANT D TO: Project# 2022 RENO Contractor: License: Est. Cost: 150000 107919 Const.Class: Exp.Date: 09/24/2023 Use Group: Owner: H. YOUNG, HOLLY Lot Size (sq.ft.) Zoning: RI/URA Applicant: THE TUCKER GROUP LLC Applicant Address Phone: Insurance: 60 SCHOOL ST (413)387-7381 7PJUB-4N82783-2-21 HATFIELD, MA 01038 ISSUED ON:12/30/2022 TO PERFORM THE FOLLOWING WORK: MUDROOM ADDITION AND KITCHEN/BATH RENO, NEW WINDOWS/DOORS 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: (PL Fees Paid: $975.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 0l< File #BP-2022-1661 APPLICANT/CONTACT PERSON:THE TUCKER GROUP LLC 60 SCHOOL ST HATFIELD, MA 01038(413)387-7381 PROPERTY LOCATION 22 CLAIRE AVE MAP:LOT 17A-117-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $975.00 Type of Construction: MUDROOM ADDITION AND KITCHEN/BATH RENO, NEW WINDOWS/DOORS New Co nstruction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: )( Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay n AN3„: 1 a a2, Si ture of BuildingOfficial Date � Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. I� .. ...f ,,.: . ..,_ ___. . 1 . The Commonwealth of Massachusetts / 1 � ,�� ),, Board of Building Regulations and Standatds DECS 2 7 2022 i C FOR _\ 'I Massachusetts State Building Code,180 CMR L>+SE Building Permit Application To Construct,Repair,Renovate 0,4 R ised Mar 2011 1` ECT,rr One-or Two-Family Dwelling '' n,,,,,, ' This Section For Official Use Only Building Permit Number: 8P .2.2 •/O / Date Applied: el i a • . :��, 6 : I' 3o _2 Building Official(Print Name) I Signature l Dat SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers y2 C-,rt aA. 4 E a fi41.0411 KA thto 1p Z 1?A i l l -o n 1.1 a Is this an accepted street?yes X 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 Zo1 26.7j' 151 741.5' 2i'' (00r't 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public 01 Private 0 Check if yes❑ Municipal t14 On site disposal syste 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: �, 1� `1,1 t),) 6t FIrt9,r�.r c.�1 i�lA o\b 6 L Name(Print) City,State,ZIP 22 (LAIR-F, AN . 113- bh -6o25 Lill Ea tilp(cA,Wkk , co"^ 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) 0 Alteration(s) tfl Addition III Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': ikvV orr� k4•D1hn1--1 Av,-9 yntcli+,o i 6irrA P44•4b1 .L. I'C(.• 0(No W 1.,Q"a5 Aq I-)cr DA9 012, j ct.. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 51 Iwo ,...01. Building Permit Fee: $• Indicate how fee is determined: 2.Electrical $ w 0 Standard City/Town Application Fee 11 1 170t7 • ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ (ft IyesJ. `4 2. Other Fees: $ 4. Mechanical (HVAC) $ 2 1 000 ,,A. List: 5.Mechanical (Fire $ c) 9�, Suppression) n. Total All Fees: $ �h eck No.pig Check Amount: 6.Total Project Cost: $ lrj 0 1 0op.`o Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) G4)- 0 1 1 t l Zu Z'3 MA fh7 Ir`, . . iv1.u) License Number Expiration ate Name of CSL Holder l_O ` r List CSL Type(see below) No.and Street Type Description AP Unrestricted(Buildings up to 35,000 Cu.ft.) Cfat JVIA b l 0 3 v R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding r� ,r _II SF Solid Fuel Burning Appliances 4111-JY!' 1? N `f t 4�d&(�wt V i101 G • 60 IM I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvementp� � Contractor(HIC) 11"l 1 c Al 24 1C1t- GAR- b6 ?0 LLC• HIC Registration Number Expirat on Date HIC Company Name or HIC Registrant Name + PP vAk• I 619 IAA No.and Street Email address 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 .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 t-• 1>itSD h& to act on my behalf,in all matters relative to work authorized by this building permit application. Ll, lok)U?tr . 1-7 201, 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. •--hl-e i v. flk t V .n) zL 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 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" Commonwealth of Massachusetts Division of Professional Lacensure Board of Building Regulations and Standards Cons#ruttit t visor CS-107919 L'iptres:09/24/2023 THOMAS OAPMUN 60 SCHOOL STREET ,,, HATFIELD MAC 01038 144p:sr VW') Coffimissioner iltrieQA al t.4. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Str t- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC F e 't[ation: 179682 THE TUCKER GROUP LLC. "'"____ E -tion: 08/27/2024 D/B/A DADMUN DESIGN&CONSTRUCTION 60 SCHOOL ST ts` t77:7vik .. HATFIELD, MA 01038 0 _ ,, Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENTCONTRACTOR expiration date. If found return to: TyPt Office of Consumer Affairs and Business Regulation Registfat efl ;.Expiration 1000 Washington Street -Suite 710 179E82 08/27/2024 Boston,MA 02118 THE TUCKER GROUP L,C D/B/A DADMUN DESIGN&Op4STRUCTION THOMAS DADMUN 60 SCHOOL ST /��ef .i`2Gc HATFIELD,MA 01038 Undersecretary Not valid without signature IDD/YYYY) E(MM ACICJ, ri CERTIFICATE OF LIABILITY INSURANCE DATE 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 Scott King,CIC NAME: King&Cushman Inc. [TOM (413)584-5610 l F (413)584-9322 P.O.Box 447 EfC skin t Not ADDRESS: 9 kI n gCUSh m a n,COm 176 King Street INSURER(S)AFFORDING COVERAGE NAIC Y Northampton MA 01061 INSURER A' National Grange Mutual Insurance Co INSURED _. ....___ .-----.............___. INSURER B The Tucker Group LLC,DBA:Dadmun Design&Construction INSURER C; 60 School St INSURER D INSURER E: Hatfield MA 01038 INSURER F: COVERAGES CERTIFICATE NUMBER: CL22111405023 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 CONTRACTOR 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. IN R ADOL'SOBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I�SD WVD POLICY NUMBER (MMIDD/YYYY) )MMIDD/YYYY) LIMITS `x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCERENTED $; 1,000,000 CLAIMS-MADE x OCCUR PREMISGES�Eaaccmrerre) $ 500,000 MED EXP(Any one person) $ 10,000 A MPT4694Q 11/13/2022 11/13/2023 PERSONAL aADVINJURY $'. 1,000,000 GEN'LAGGREGATELIMITAPPLIBSPER; GENERAL AGGREGATE $I 2,000,000 l POLICY J P ri LOG PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER FITRV $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea aciident) ANY AUTO BODILY INJURY(Per person) $ OWNED -SCHEDULED BODILY INJURY(Per accident) Si AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per ecciderd) UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ - I WORKERS COMPENSATION STATUTEPER oTH- I ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.,EACH ACCIDENT OFFiC>ERIMEMEIER EXCLUDED? N I A (Mandatory In NH( E.L..DISEASE-EA EMPLOYEE If yes,describe under 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 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. AUTHORIZED REPRESENTATIVE / ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts r Department of industrial Accidents _= 1 Congress Street,Suite 100 Boston,MA 02114-2017 Jy?t S 4 WWW.mtrss.gov/dia %takers'('ompensanon Insurance Affidavit:BuildersiConiractorsdEkctrieiansIPlumbers: TO RE FILED'WITH'CiHE PERMITTING ING Alj'1'il0ftt'1'Y. Annlicant laformatiiott Please Print l.rt<iblh Name tliusiriess'Organer..atton tniividual): T -fi 1rx.4t.. . Cvit.0J �. �. Address: (Q O StA6,I, b r• } P` 0,r11 A o to Phone#: 4112 - 3b/'135 bu the t(h AType S project(rc4��=Are'you an entptiayer'.' heck 1.0 t ant a et:clo ver with employees Hull and or part-tinrl` 7. 0 New construction 20 d am a sole proprietor in pwtnenftip and have ne employees corking tor me in S. 5g Remodeling arty capacity [Nu wurlen.comp.insurance required] 9. J Demolition 30 I am a hosneuv.am doing all wort myself:[No workers`comp_insurance required" -r.C3 i am a ltunreowna and will be hiring eoiaraetota to conduct all work on my pauperty. 1*till 10 Building addition rmury that all contractors either have workers'compensation insurance Of are sole 1 I.C3 Electrical repairs or additions proprietors with rao employees. 12.®Plumbing repairs or additions SJ^ 1 arse a general cunttactut and 1 lase hired actors the sub-rentracs busted on the attached sheet. 13 Roof repairs t{"." these sub-contractors hate employees and have winters'rump.'wormer." 6©We are a corporation and its officers have exeneised their neeof exemption per Wit c. 14. Other 134 41(4).and we hale no crnphro s.[Alv workers'comp insurance required. *Any applicant that chocks box=l must atuso fill out the section below show Mg their wuterx'cAMnypens.attun policy utfvrmatiom Homeowners ners who submit tins affuhasit indicating they are doing all s'.urk and then hire outside cx.vntrac 'r unm..t submit a SEW aff davii inrheating%theft. '(.untraeturs that cheek this box must attached an additional sheet show My the name of the artla-av„snttaa.Lori ams.=tare V,'aartheit ear sot there mutate,hai.c employees if rim. I.contractors ha'.c etriplox4X.N.they trt4st pros orkers cntanp trolls'.manlier. !am an employer that is providing workers'compensation insurance for my employees_ Below is the policy and job site information. Insurance Company Name: '� \U u 12.S Policy if or Self-ins.Lic.fl: 1 l. i�7 ' fJ')1 72 L "2 2 Expiration Date: L(Z(4 f Li)Z'1 Job Site Address: 2 i CAA C4* At, (. State WI(i.GnyGte el01o(�2 Attach a copy of the workers'compensation policy declaration page(showing the policy number sod espi date). Failure to secure cov era ge as required tinder MGL . 152. **25A is a criminal violation punishable by a fine up to$1 .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 50.00 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. _ I da hereby cured der the pain,and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: `�l'1J"1J U1. 1 13 Official use only. Do not write in this area,to be completed by city or town official City or Town: PertniteLiceuse it Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Ekctrkal Inspector fi. Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton o aS S !t tip•. sti ic. Massachusetts �?' x <,., v cs;, i -x' DEPARTMENT OF BUILDING INSPECTIONS ,5 1' 212 Main Street • Municipal Building v, a^ti, \ ,,, . 1`,y � Northampton, MA 01060 •ri, •7t1 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: The debris will be transported by: Name of Hauler: w t ' 4- A ti'+ 1 t [-itrflk,t,0 itil A 4/ P ( Signature of Applicant: o ^^^-- Date: I L1ti1 1202Z DADMUN Design + Construction Project Address: SubContractor List 22 Claire Ave 12/27/2022 Florence, MA 01062 Subcontractor: Has Employees: Yes No Geryk Plumbing & Heating X James Elkins Electrician X Alexander Leonardi X All Seasons Heating X SDL Home Improvement X Northern Granite X Rightway Drywall X Executive Painting X Dion and Sons Flooring X Cortina Tile X