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38A-012 (2) BP-2023-0463 31 CHAPEL ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38A-012-001 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-2023-0463 PERMISSION IS HEREBY GRANTED TO: Project# NEW OFFICE BUILD Contractor: License: Est. Cost: 285000 SUNWOOD BUILDERS 065400 Const.Class: Exp.Date: 06/25/2024 Use Group: Owner: CORP SUNWOOD DEVELOPMENT Lot Size (sq.ft.) Zoning: URB Applicant: SUNWOOD BUILDERS Applicant Address Phone: Insurance: 84 POTWINE LN (413)259-1000 WMZ80080056582022 AMHERST,MA 01002 ISSUED ON: 04/25/2023 TO PERFORM THE FOLLOWING WORK: CONSTRUCT NEW OFFICE BUILDING 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: 0; . 33rAeir Fees Paid: $1,255.60 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner ( RECEIVED _7 � I � The Commonwealth of Massachusett n 1 8 2023 Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Tier ► I lit‘ , �.` TH,1,.T.,C)N.M4nIr O (This Section For Official Use Only) Building Permit Number:. 3- 4 03 Date Applied: Building Official: / /� SE ION 1:LOCATION (3I Vr/rc1 o/ /1/04 ir, AM 0/060 No.and Street City own ZipCode Name of Building(if applicable) 36A-- g PP ) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 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: Are building plans and/or construction documents being supplied as part of this permit application? Yes % No 0 Is an Independent Structural Engineerin Peer Review equ' ed? � Yes No ' Brief Description of Propos W rk: 1��.'r�� ui'�d.'d d's'D �B 9 , 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.) OOVO Total Area(sq.ft.)and Total Height(ft.) abf 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 ❑ F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 5-2❑ U: Utility❑ Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB 0 IIA 0 IIB ❑ IIIA ❑ IIIB 0 IV ❑ VA 0 VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply' Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: A trench will not be Licensed Disposal Site 0 Public Check if outside Flood Zone Indicate municipal 0 required 0 or trench or specify: Private 0 or indentify Zone: or on site system❑ permit is enclosed 0 Railroad right-of-wa . Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable Is Structure within airport ap oach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No? 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 N e and Address of Property Owner/ p biMWO0c,� Oeveh yo riu1T U4 f oiroixi kif, /44r671 AO o/oGbz Name(Print) No.and Street City/Town Zip Pro eity Owner Contact Information: / L of.�i)�N 1/3 - /000 43-S6 �v1rwoJ cofirca67ifc,T Title / Telephone No.(business) Telephone No No. (� e-mail address If applicable,the property owner hereby authorizes: 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 0. 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) 6iiJ Pcri l3-(I1G- o/1( eilAW Oc �icoalc,J M a-oaitoo N � ' trant)� le hone k4o. e-mail ad s Re 'stralon u ber :Porii/iff e.., HI ....irIftee6Y; 0/000e re.4 Street Address City/Town State Zip Discipline E pira on Date 102IGeneral Contractor e.2 I vil u Iec Com y Name tj/.�1 yerr /08301 Name f Peso Res onsib a for Construction License No. and Type if Applicable rio/W/irci javc/ �fiadral AO D/ Street Address City/Town State Zip / 4'/ -0' /000 i,(3 - �-_�16W— 6l1Wood e coirvca. 1 rn) 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 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$A000 1.Building $ r% 000 � Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ 0O0 appropriate municipal factor)=$ . 3.Plumbing $ 000 ( [.O 4.Mechanical (HVAC) $/0/0O0 Note:Minimum fee=$ l5 (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ 01000 00 (contact municipality)and write check number here 37la`/ SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I ereb attest under the pains and penalties of perjury that all of the information contained in this application is true and a ra,i to best of my knowledge and understanding. ; _,,// (/ SAID/Pert Owner 4f ___ Ply,.p ' t ri: me / Ti Telepho No. Dale rfwiire/M tiAers'T" 0/0Oe1 5 vrwoJ oaddid Street Address City/Town State Zip Email Address e a1 _ Municipal Inspector to fill out this section upon application approval: ' �� � I c �j Name Date CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: -CANUNY UVLIV tIV I MT vrsi r. r.�r i_.. moo.-...,-- 6 f r TO ARCHITECTURAL DRAWINGS qi n cf-' FOR MORE DETAILS (TYP) • I --___ P R Ti ♦ _ f ' � Sri - : •J• +-' '` \ • . •'. •.A.. ..vi.- •t•. • 0 •t - RE . N f ii) cL.b•6 o' '..v....' . . I ;• ', N * /9S :1N:::' . s r • 4. •o ls •S) .........:-.y 0' $. ._ " �I RAMP - FREE STANDING ,� 'S� WALL �� ADA ACCESSIBLE . / PARKING SPACE W/SIGN FRONTAGE ' ZONING REVIEW-PLANNED VILLAGE TYPE(AINMAUMM REQUIRED PROPOSED/EXISTING L $Platt on Yrt�IV PeCti NOWT TAM rt. 140 rt. R 07. Of 7 tANS ant 21,4 R IEVESQUE A55OCIATE51! :, M D .D SORE RaD.. Data p�.le see.005 Im.Au.se.011 /AVYYIi N()iF5 AU*EU.. I. SOE CONTRACTOR.ALL REFER TOR[MALNIND PLAN SET FOR 0F04NATON REGARDING W.4I 5 ANCIgi SITE uIOIIT. fledl411•1 J.R S..I.BE NC WC COMRACTORS N. N MN xGPOs O.W,OL sra sw LOAN tr SEED MIEN F.�sIR,G LLPB rPROPOSED MONOLOWIC CONCRETE PRIR,TO N O pSCMDR 00 BR1Wi5 I0.0 s OVIR TOR KH r O �aMA: YMIYnt w/O SRENK iM + SiMvuW tr CJ YmI iNE rwlECt M.]MNEH AND VHDYUE ARM wSrAu x tr CURB RB W/os R[vEN SITNIMMT E CONONOTOR 06 TO tInGtM•w COMMIRCATE MN 05C CR PAMLT.M/DENSBW (TI DB,„TUEs R trSEEDNS I — .DRwR Itr B 5 NON ROM i. W.NAGF AND PAVEMENT MARKING NnTPR < CANOPY ON.iD w ][CN.wvpuWtHcs vMnOSm Bwlwos. imxG AWE Mine Q rn SER..a PARKING UT.AS SNOW,ANGINA.PPROO.SPACES.STOP MOD_ CO AL • FOR WORE m.AS mb, PRINC"' a IOCOOR w ININ =11.o SPA.ice. LANE,J.TR YFIC PN"..,`E`.vw.`caroms TO MD.Mr.RE e a ..PO al1 'rPE'r p �..is"--1: -mm ICaa� "''U©67 � •„�.�i�l it z soap B,� SE I,.ME Noma N W a ��.• Ate• 1 EPAE•M YAMS •:MA oil PAWNS Mu.MES MILL NE W.DE Q N la o A 3. T.STATE SM ESNO CODE A.AM REOURENENTS ARO As SNOW ON RE RA. w �� k ,l 0, .MASS w arm 1 LOIN tr SEED Iiiiii ={ -Ae 4 YTP'` r ® ��° , AGGESSB+um rxnrsQ L E mp sTII.m nAF•mT•) ♦ ((•�� '°?o�tr • I neLNo�Nc ALL r.,m..NCEs.a BVLaNG slw.L.wuc ro s:I a.O1pNGA"`' rc1,t0,O Lb m ADM..ACCOSIOLE ROUTS DAN DE REDO.. PRaosto L // ‘I a ® ;' wAu """"` °ii040101-.... ----— \ , AFFECT'T ME A`A CE Un R o ANY C.NLES TO NE PPO SEO Budw 11�iw;WOI.o O 00 m� !-- NAAII,T A( - 4'�i"-,. 4.. ` STALL oAMweE wm SW REwu.Oxs NH RI DETAIL TM REDU.NENTS OF ur PA.o Saul. m J / A.B[CONTRACTOR roe Q Ma PROPOSED L INCLOSLA R i o ..:, Rom) rtmom.SrACE W[ w/SrcN J Ill ARE uNDER cow.ORNMS.PP AND MI ANR ' T.' PARNING ' ° n .110101". -066.1 t " y o•. ,cr. INNSITINI r"EPr P err cow. mPERn �� 1.116 Easnnc AND BuTo .11t4, .SCOW P.m. wwls.DlA D_ FMOrasr M/vcR 4 SOYA .\ \\ /� P TERDPoscD mws - pa AS RE DE MEACCOP „ 3 .•M...ail. Mom ....,. tl-- -- -- ...a PERMNTTING C a City of Northampton �r Massachusetts a�+7'• •Nte F. C it DEPARTMENT OF BUILDING INSPECTIONS y� rro .,• Jy spy ,a I�, .-, - ;.' 212 Main Street • Municipal Building ,4*, • 0C "„„' Northampton, MA 01060 •��..,^• 51 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: / aofflp 16-1c-r- j Location of Facility: Vag gc-616/Mk, ( / aS olort cc lVo///7 Torl� /�/7 0/060 The debris will be transported by: Name of Hauler: 370flw001 ? o,/G/cr S Signature of Applicant: Date: - - The Commonwealth of Massachusetts Department of Industrial Accidents YT i� 1 Congress Street,Suite 100 Boston,MA 02114-2017 wwtw.mass.gov/dia 1%urkers'Compensation Insurance Affidavit:Builders/Contractors1Ekctrieianst/Plumbers. TU BE FILED writs ti THE PER%11 Fl r%t;,►t't Ht1R1`t'1'. Apphcuut Information Please Print Leeihi. Name(Business'Organization1 dividual): 0Vr/ll{/00d chIGtcc6. Address: N Po7Wit�G� City/StatelZip=1Yt 7,t1G(6� fl 0/Oat Phone#: 4(5 "or.9 /000 Ate yea so ertplalrer?Check die appropriate bat: Type of ,jean(required): !Aram a employer with !( employees(full aodir pram-bane*_% 7. New construction 20 I am a sole proprietor or paitnership and have no eirgiltiyees working for me in 8. Q Remodeling any capacity.[No Wurkens'coop.insurance nnluin 1.1 9. D Demolition 3 I am a homeowner awing all'work myself.trio wakes'comp.rmuranee requinstr 10 Building addition 4.C3 I am a horrittowner and win be hiring contractors au euoduct all wok on troy property. I will erasure that all cunara-aurs either litre*Wien'eungormsation imamate or are sole 110 Electrical repairs or addition, proprietor%with no en»lrknyee% 12.0 Plumbing repairs or additions 5 I am a general contractor and I have Most*the saib-caratracaars listed can the attached%beet. These sib-euntraeturs have employees and have workers'wimp.ioon:mec. 13.0Roof repairs 6 We are aco rporatioa and its utlauers have exercises*their right of cxanaaptiarn per M(iL c. 14.0 Other_ p 152,;1 M and we have no midgets.[No workers'swap.insurance nstuicdi j *Airy applicant dust checks boa tt1 iron also Man cut Uri section below showing their workers'coimpermation policy iafonnatioa. t tloneowrtss who rtbmit this atradwit Indianian they arc doing all work and then hie outside ewntrscurs catch stiimit a nevo affidar it indicating such. :Contraeturs that cheek die hot tutna attacked al additional sheet%bowing the mane of the saeb-coidracturs arid state whether lir nut those entities have employers. if the sub-enmraesurs hate employees they mama provide their worker'wrap..policy number. ant an employer that is providing wos Ae rs"compensation insurance for nay employees. Below is the policy and job site information. Insurance Company Nance: Policy#or Self-ins.Lie.#: W if 800802 8o/Q,,A Expiration Date: (3/4 Job Site Address: V/N aeke � 67/ CitylStatelZip: t oie, 0 Attach a copyof the compensation policydeclared's! (showing the policy number 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 and/or one-year imprisonment,as well as civil penalties in the form ofa 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 coverage verification. I do hereby eerie t'an »r tit mins and penalties alpequrt'that the information provided above i true and correct Signature: Date eke afr3 Phone: 4/6"/ / / Q Official use only. Do not write in this area,to be completed by city or town official (it', or To..a: Perotit/l icense# Issuing Authority (circle one): I.Board of health 2.Building Department 3.('ithTFowa Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: DATE(MM/DD/YYYY) AC Ro® CERTIFICATE OF LIABILITY INSURANCE 04/14/2023 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 CONTACT Kathy Parker NAME: Alera Group,Inc. PHONE (413)586-0111 FAX (413)586-6481 IA/C.No.Extl: (A/C,No): Webber&Grinnell Division E-MAIL kparker@webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Selective Ins Co of Southeast 39926 INSURED INSURER B: Selective Ins Co of S Carolina 19259 Sunwood Builders,Inc.,DBA:Sunwood Development Corp. INSURER C: A.I.M.Mutual/A.I.M. 33758 Attn:Shaul Perry INSURER D: 84 Potwine Lane INSURER E: Amherst MA 01002 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2341420187 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED . CLAIMS-MADE X OCCUR PREM SES(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 15,000 A S2399055 03/04/2023 03/04/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY [ 1 e T n LOG PRODUCTS-COMP/OPAGG $ 2,000,000 $ JEC OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED A9108082 03/04/2023 03/04/2024 BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED �/ NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) Medical payments $ 5,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB ,CLAIMS-MADE S2399055 03/04/2023 03/04/2024 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 500 000 , ANYETOR/PARTNER/EXECUTIVE NIA WMZ80080056582022A 05/22/2022 05/22/2023 E.L.EACH ACCIDENT $ , OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Northampton is listed as additional insured with respect to liability as per the terms and conditions of the policies. RE:31 Chapel Street Northampton MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 240 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 IJ1G-.---D yl 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD