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23B-035 (20)
BP-2023-0391 61 LOCUST ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23B-035-001 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-2023-0391 PERMISSION IS HEREBY GRANTED TO: Project# 2023 ROOF REPAIRS Contractor: License: Est. Cost: 13358 DANIEL CARNEY 99798 Const.Class: Exp.Date: 08/19/2023 Use Group: Owner: DELRO LLC Lot Size (sq.ft.) Zoning: NB Applicant: DP CARNEY CONSTRUCTION INC Applicant Address Phone: Insurance: 34 HORSE SHOE CIRCLE (413)543-4803 R2WC366890 WARE, MA 01082 ISSUED ON: 04/03/2023 TO PERFORM THE FOLLOWING WORK: REMOVE 6 SKYLIGHTS &REROOF, INSULATE, DRYWALL AREAS WHERE SKYLIGHTS REMOVED 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. Sign g I. • . . (Pi Fees Paid: $100.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts iIOffice of Public Safety and Inspections Massachusetts State Building Code(780 CMR) a Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number:1- =(W►I Date Applied: Building Official: SECTION 1:LOCATION 61 Locust Street Northampton 01060 Wohl Family Dentistry No.and Street City/Town Zip Code Name of Building(if applicable) 23(3- 3S-oc2g Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify:roofing Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No 0 Brief Description of Proposed Work:1.Block off work area with 6 mil poly and tape.2.Remove 6 skylight windows and dispose of properly in an onsite container.3.Strip trim and roofing immediately surrounding skylights.4.Install roof decking.5.Install roof singles in affected area,weaving into existing shingles over ice and water shield.6.Apply foam insulation board on interior of roof decking to match existing.7.Finish interiorp/with drywall and compound.8.Mill and install wood trim.9.Paint all installed drywall and trim. r f/'��4x11 11 I y7 s k,'1 e L'f- i- ( tniyti SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-I 0 I-2 0 I-3 0 I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA El IB ❑ IIA ❑ IIB 0 IIIA ❑ IIIB ❑ IV 0 VA 0 VB SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Trench Permit: Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Dis osal Site 0 Public 0 Check if outside Flood Zone 0 Indicate municipal 0 A trench will not be P required 0 or trench or specify:Casella Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Holyoke,MA Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable 0 Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Delro LLC 61 locust street Northampton 01060 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: info@wohlfamilydentistry.com Chris Steed or Carina Wohl 413:586-6180 _ - cwsteed17@gmail.com Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: D.P. Carney Construction, Inc. 34 Horseshoe Circle Ware, MA 01082 Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here CI. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor D.P.Carney Construction,Inc. Company Name Daniel P.Carney CS-099798 08/19/2023 Name of Person Responsible for Construction License No. and Type if Applicable 34 Horseshoe Circle Ware MA 01082 Street Address City/Town State Zip 413_543 _3150 413 575 8047 dpcarneyroofing@gmail.com Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes 0 No CI SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ 13,358.00 Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ 3.Plumbing $ i 4.Mechanical (HVAC) $ Note:Minimum fee=$ `£)O (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $13,358.00 (contact municipality)and write check number here*ay'O 33 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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 . .to to . e best f my knowledge and understanding. Joann Carney ��—�/ President 413 543 3150 Please print and sign n., Title Telephone No. Date 34 Horseshoe Circle Ware MA 01082 dpcarney45@comcast.net Street Address City/Town State Zip Email Address 3'37402.5Munici al Inspector to fill out this section upon application approval: /72 Name Date D.P. CARNEY CONSTRUCTION, INC. "We Have the Cure for Flat Roof Problems." 34 Horseshoe Circle,Ware,MA 01082 CSL-#099798 08/19/2023 Office&Shop-Tele:413-543-3150 Toll Free:800-580-1270 Fax:413-543-4803 HIC-#121178 4/11/2024 E-mail:dpcarney45@comcast.net E-mail:dpcarneyroofing@gmail.com PROPOSAL Proposal#050-23 Date: March 23, 2023 Name: Chris Steed Wohl Family Dentistry Street: 61 Locust Street City/State/Zip: Northampton, MA 01060 Contact: Chris Steed C: 413-588-1305 0: 413-586-6180 E-mail: cwsteed17@gmail.com Project Name: Skylight Removal, Roofing, Decking and Interior Work, 61 Locust Street,Northampton, MA We hereby propose to furnish the materials and perform the labor necessary for the completion on the above project by: 1.) Block off work area with 6 mil poly and tape. 2.) Remove 6 skylight windows and dispose of properly in an on-site container provided by D.P. Carney Construction, Inc. 3.) Strip trim and roofing immediately surrounding skylights. 4.) Install roof decking. 5.) Install roof shingles (match as well as possible) in affected area, weaving into existing shingles over ice and water shield. 6.) Apply foam insulation board on interior of roof decking to match existing. 7.) Finish interior with drywall, and compound. 8.) Mill and install wood trim. 9.) Paint all installed drywall and trim. Notes: - Includes Building Permit - Due to volatile and projected manufacturers' material costs on May 1, a proposal/contract signed by April 25, 2023, will guarantee this price, allowing us to order material in advance. For the sum of Dollars—($13,358.00)—Thirteen thousand three hundred fifty-eight dollars -Page 1 of 2- ACo CERTIFICATE OF LIABILITY INSURANCE °"TE`"M°°""n ik.... 3/28/2023 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 CONTACTNAME: Eric Mason THE MASON AGENCY INC PHoN AMC.N.EP.faa 1NC,Nar._J413 569-2308 504 College Hwy E w-"DREss; themasonagenc1@american-nationai.com Southwick,MA 01077 INSURERLSJAFFORDINGCOVERAGE om NAICS INSURER A: FARM FAMILY CASUALTY INSURANCE 13803 INSURED INSURER B: Lallberte Builders Inc INSURER C: INSURER D: 11 Berwyn Street Ext INSURER E South Hadley,MA 01075 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 lADOLSIDIRT POLICYEFF POUCV EXP TYPE OF INSURANCE i LTR IiINSD.WVO l POLICY NUMBER fMMIDO/YYYYI IMMDDJYYYYI LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE S 1,000,000 _. NTED CLAIMS MADE X OCCUR PREMISES I'}sacwrren.._�._ PREMISES{Ea occurrence) $ ._._ 100,000 I X Business Owner's Policy MED EXP(Any one person) k$ 25,000 A Y Y 2001X1618 3/7/2,023 13/7/2024 PERSONAL IL ADV INJURY t S 1,000,000__ CENT.ACORECATE LIMIT APPUEB PER. GENERAL AGGREGATE S 2 000,000 POLICY ], I LOC . � PRODUCTS COMP/OP AGG t$ 2,000,000 AUTOMOBILE uABIUTY COMBINED SINGLE LIMIT 's OTHER $ t__.. IEancXJdor ANY AUTO I E BODILY INJURY(Per pnceon) S .-. . 100 000_ A I _AUTTOS ONLY X II AUTOS D I SCHEDULED AU Y 1 Y j 2001c8662 ` 10111/2022 ': 10/11/2023 BODILY INJURY{Per occident) $ _300 000 -_XHIRED I NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY X I AUTOS ONLY • (Per acGdpnO S 500000, I ! I s 50,000 UMBRELLA LIAB 'OCCUR I - EACH OCCURRENCE S 100,000 EXCESS LIAB 1T _ CLAIMS-MADE ' •AGGREGATE S f ISO , ,RETENTION S S WORKERS COMPENSATION PER ! OTH- AND EMPLOYERS'LIABILITY Y/N 1 I STATUTE.1_, ER .,�,T, - _.__. _..._....._...... Z ANY PROPRIETOR,PARTNERIEXECUTIVE 1 ELEACH ACCIDENT $ 400 000 A DEFICER,MEMBER EKG.UOEDL f N I!N/A 2001 W9178 5/29/2022 5/29/2023 i(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S i b00 D00 a._. _ If you,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 . DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule.may be attached If more space is required) D.P Camery Construction Inc.,Is Included as Additional Insures for both ongoing and completed operations on a primary and non contributory basis on the General Liability,Auto and Excess liability policies.Waiver of Subrogation in favor of D.P.Construction Inc.is included on the GL,Auto and Excess Liability. Location is 61 Locust St.Northampton CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DP Carney Construction,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 34 Horseshoe Circle ACCORDANCE WITH THE POLICY PROVISIONS. Ware,MA 01082 AUTha D REPRESENTAT .0000.11. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD City of Northampton ? µ titi5 SAC a ; � MassachusettsSt DEPARTMENT OF BUILDING INSPECTIONS Sft �� 212 Main Street • Municipal Building Vy%., �b RC ++s Northampton, MA 01060 s�`h' ."A'N 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: Casella of Holyoke, 686 Main Street, Holyoke, MA The debris will be transported by: Name of Hauler: USA Waste and Recycling, Inc. Signature of Applicant:-! Date:31X a3 Deli° % ....----.7. The Commonwealth of Massachusetts Department of Industrial Accidents PI 1 Congress Street,Suite 100 •=u . sna, ,,,, 1., , Boston, MA 02114-2017 ..,- 1 ." Mew.mass.govidia --t .- ll'orkers'Compensation Insurance Affidavit:Builders/ContractorstElectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annlieant Information Please Print Legibly Name(LluittnessiOrgantration,Iniintdual): D.P. Carney Construction Inc. Address: 34 Horseshoe Circle , . City/State/Zip: Ware, MA 01082 Phone#: 413-543-3150 — Ara you an employer?Cheek the ippraprtate bas: Type or project(required): 1.3 I AM a employee with 15 .emp/oyees tfall and'or part-tone)• 7. 0 New construction I am a Urie propnetor or pommels/op and have no employees ssotiortF tot cis:tn 1L 0 Remodeling any capscoy,No%mixes'comp maw-luxe mowed.) 30 I am a homeowner doing an%Verb,myself.[No winters aimp,insurance r 9. 0 Demolitionaptsrall' 4 0 I anti horrionsvier and 14111 be haul cow-wn o to conduct all weak on ins property. 100 Building addition I will ensure nun an contraeturs mato 160.e workers'annarnsation insurance ur ale solc 11 a Electrical repairs or additions propnetors with no employees. 12.0 Plumbing repairs or additions 50 I am a imaml cuntsactur and 1 has c humd the soh-contractoni tined on the attached sheet 13 El Roof repairs These sub-contraetarti hoe,...uiployees and has c workers'comp.insurance.: 6.0 We 4re a corporation and no officers hose exercised their right oresanprien per hitil c, I S2,§1(4),and we have nu employees.[No wi.akers'camp.insurance valuated" •Any applicant that cheeks boa s I most also rill out the section ham'bowing their workers'compensation pulley intognution 'tiununwnen.who submit this grain it indwating they are(hung all work and nr,:n hoc maxi&common,*mum Inbruil a new.1illkl.P.I{inilk.atsig itri:it ;Contraction that check this boa must attached an alabliunal sheet awning tbc rum.:oldie ustrouraacturs and*Lai:i lurtircr or not livr.i:entiln-,Balsa auployeo,. It the sub-aintractors howc curio),ees.illes,ntosi pros'tic they NA ot I.ms•,on(il policy rtionitv; I ant an employer that is providing worLers'compensation insurance far my emiduyees. Below A the'whey and job site information. Insurunce Company Name: Berkshire Hathaway Guard Insurance Companies _ Policy#or Self-ins.Lic.#: R2WC366890 Expiration Date: 11/15/2023 Job Site Address: 61 Locust St. City/Slide/Zip: Northampton, MA 01060 Attach a copy of the workers'compensation 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 fine up to S1,500.00 andlur one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cov crat.:e verificat ion 1 do hereby , utter the pal nd pen aides of perjury that the Information provided above Is true and correct St_ nature: Dtc 31a9 1 93 Phone#: 4 -543- 150 Official use only. Do not write in this area,to be completed by city or town official City or Town: PerniitiLicense# Issuing Authority(circle one): I. Board of Health 2. Building Department 3,CitylTown Clerk 4.Electrical Inspector S.Plumbing Inspector i6.Other t i Contact Person: P hone#: ' _ THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingto . treet- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration $ # C""� i Type: Corporation IZI = edis#ration: 121178 D.P.CARNEY CONSTRUCTION,INC. f; � Expiration: 04/11/2024 34 HORSESHOE CIRCLE ; . `"" WARE,MA 01082 f 4 ,, ,.. Update Address and Return Card. 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:Corporation Office of Consumer Affairs and Business Regulation Registration ' Expiration 1000 Washington Street -Suite 710 121178 04/11/2024 Boston,MA 02118 D.P.CARNEY CONSTRUCTION,INC. 1----- , DANIEL P.CARNEY ) tt7/11--- 34 HORSESHOE CIRCLE G;l, ry /�y<!. •*c' WARE,MA 01082 Undersecretary Not valid wit out signature Commonwealth of Massachusetts Board of BuildingDivisionofProfe Regulations and Standards Cons ju l$ti t pfvisor . t CS-099798 spires:08/19/2023 DANIEL P CIRNE. - f 1 34 HORSESHOE Cl' WARE MA 01 o)2 't` �ISw 3 rl ‘3`'�� Commissioner ('j > fi. 516ni.LA:. • Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)7273200 or visit wµw.mass.govldpl