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32A-078 14A&B, 16B & 20B GRAVES AV I0 4-a, l(& +2013 dR WEs AV BP-2023-0631 'V COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-078-00f, 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-2023-0631 PERMISSION IS HEREBY GRANTED TO: Project# DECKS 2023 Contractor: License: Est. Cost: 40000 JUSTIN KASUNICK CS-110035 Const.Class: Exp.Date: 05/10/2024 Use Group: Owner: WALKER NORMAN R Lot Size (sq.ft.) JUSTIN KASUNICK DBA COMPASS POINT Zoning: URC Applicant: PROPERTY MANAGEMENT LLC Applicant Address Phone: Insurance: 10 BRAEBURN RD (413)522-4126 46 WEC AMOYUO SOUTH DEERFIELD, MA 01373-1103 ISSUED ON: 05/15/2023 TO PERFORM THE FOLLOWING WORK: REMOVE AND REPLACE DECKS TO EXISTING FOOTPRINT AT 14A, 14B, 16B,20B 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: F 0 TWity Fees Paid: $280.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner y , The Commonwealth of Massachusetts / Office of Public Safety and Inspections 0z, Massachusetts State Building Code(780 CMR) �T,aciir� Building Permit Application for any Building other than a One-or Two-Family Dwelling Rtispt Ci J ; (This Section For Official Use Only) Building Permit NunibeiP6n •0i ) Date Applied: Building Official: SECTION 1:LOCATION N .an Street City/ own Zip Coe Name of Building(if applicable) ' ,,vb,!6b,206 Grouts 5t. N�� .,� oie61 _nn Assessors Map# Block#and/or Lot # 3n "0 7/ SECTION 2:PROPOSED WORK Edition of MA State Code used T ` If New Construction check here 0 or check all that apply in the two rows below Existing Building 1/ Repair a Alteration 0 Addition 0 Demolition 6Y(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 0 No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No IV Brief Description of Proposed Work: Airc,Pxs 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) 3 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 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2 0 I-3 0 I-4 0 M: Mercantile 0 R: Residential R-ID R-2 Il ' 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 0 IB ❑ IIA ❑ IIBCD/ IIIA ❑ IIIB ❑ IV 0 VA ❑ 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: Public 13/ Check if outside Flood Zone �/Indicate municipal F� A trench will not be Licensed Disposal Site 0 Private 0 or indentify Zone:_ or on site system 0 required 0 or trench or specify: permit is enclosed 0 Railroad right-of-way)�,, Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable i1Y Is Structure within airport app5oach 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 O1 1NER AUTHORIZATION Name and Address of Property Owner ilia) 1441, •16 LS►VI 11) A anIOVV, put- NzAL0 �� 6061 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: ( `'� ���-vac, 1-113-3 ate(1 165 - �rZN-�o an vu�•e h Q t� cjr t,\..o . Title UU Telephone No.(business) Telephone No. (cell) e-mail address If a licable,the operty owner hereby authorizes: .� ri Cl (CJtS 1 0,,r114.6uvvt-k-o-r1/4 Ne‘ °l U(oZ> Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all mallets 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 inthe code)as required. 10.1 Registered Professional Responsible for Construction Control (the professional coordinating document submittals) i Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State ip Discipline Expiration Date 10.2 General Contractor 53 I A cr. Compan Name .J Jd $ $ AStit4 L C.S ,//00 35-- Name of Person Responsible for C `'�truction Licensean No. d Type if Applicable �� ' 0/02 Street Address City/Town State Zip V13 -SSZZ- ti 26 t,i.4 PA • etwv Telephone No.(business) Telephone No.(cell) a-ma' address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAV T(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit flout the MA Department of Industrial Accidents must be compl and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildin permit. tl 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)=$ ' _ 1.Building $ 1D Building Permit Fee Total Construction t x I tsert here 2.Electrical $ appropf municipal factor) $ 7.�. 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minim fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check pays le to 6.Total Cost $ 410 j t>•%0 (contact municipality)and write check number here_CO 2 q ___ SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains a enalties of perjury that all of the information contained in this application is true and accurate to the best f my knowledg understanding. -S 1N 14 0��''3 -szt- q1 6��g/Z3 Please print and signname / Title Telephone o. Date S 0 A �MAAA-a IW� — S. .et c+al -- 1 -e,A minSfport►f M-t,,, Street Address City/Town State ip Email Address Municipal Inspector to fill out this section upon application approval: 'C1AIt`_ A. 0_._ Name • Da I CITY OF NORTHAMPTON. SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton .S13 rr ,�r�j S,s ~: si ft. Massachusetts Awl <e ,r c: DEPARTMENT OF BUILDING INSPECTIONS y sny � l 212 Main Street • Municipal Building % ` D. --'4 Northampton, MA 01060 st jY •‘1 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: gvN94Location of Facility: `�' The debris will be transported by: Name of Hauler: e-N9 VAV h $› C;\7 110A f I"0 Signature of Applica t: Date: /iL3 The Commonwealth of Massachusetts Department of Industrial Accidents m t= .t 1 Congress Street,Suite 100 G `i.� n ':Y� Boston. MA 02114-2017 ,,'=, wwn mass gov/din y1. %%takers'('atmprnsatinn Insurance Affidat,it:Builder riUantraetorsfElectrieians Plutubers. '1 U BE FILED WITH THE PER.%11777NG Al I h URl 11. .lpplicant Information Please Print Letibls Name une st)ganuttue Itiiivill CoVA,pY 5. OOi, nW fm0N77vJ Address: 1,0 IA 42zr A %.... 4 cityrsiate/zip: S.nc.a..-CN..14,wvA 012.43 Phone . '113- s it. -N 1 Z6 .____ . . Are y.r ate eY11p1w cr'.'t heel.list appra,prnatc ion Type of project(required): L int a enapk.r ea w 1th / 4.3110.31.etf(toil;eta OE part-ratan I..' 7. 0 New construction LEI 1 ant a xole pnrt,rietta t,t y itnc:41p amid hay n., n ex 44 ottani: tot MC ua lt. Tfremutleling any carwciry.(Nu an often'comp.insurance required.) 9. 12/Ikmolttion 30 I ant a honnowvan down all wort tnywal.[No w.nkets'comp insurance r-eluirc i..l Ill J Building addition tt itt,4rj 1 a :a lioo*n a and,A all lie hiring otrt raaiurs toconduct alL nark on my Inapt iy. I will moan:that all ananntun.ith.-r lane wuvtcc,":nwtapeac.,.;tavof:cat.urant:c to sae isle 110Electrical repairs or additions prstptacta.ts with no eanpltrytx+_ 12.0 Plumbing repairs or additions 3,t. I men a 0 55 sal canu-.n:tur And I la t4 c hired the wb-c.mtractori hareJ on tln.attached,hest. (hc,c:wb,e,,ntta.tur%Erase:ItIVI Ncc,and basal'stir ei! coanp.anourane .' I3. Root'repairs rt.0 Vs.are a eanl.c.ratitnn and it,.officer,ha,,c erase-iv.xtthick night of+ex-mown pet kta.L.e. 1 Othei I% till).and wt lta,e no trni•loyei,i%t,la Mono'comp.an,ua anee required.! . "Ain applicant that na is bus=I must atku till out thin meeiiut 11 k,u show ire their w urkCI','ca,rtg,cnaattun policy trditnnattatn. lkri, a,wcaer.s bu,Monet this Alban it uaalitatatap/lacy are doting aft wunb.and then hue outran:ca,ttttactut,mint,snout a new Adidas it intlti.allrar such. C crnUacturs that eltc:lt tha,bus mutt attached an additional,hind sta n err ilia rain:iii mire ruts-ca'araitu i,anti st:ttc wlaIhca ea not hors:aaatiti:'.base unpluyaes_ It die sub-contras i s halo:caar9*luyix,.thcs sweat prod:their notion'snartp.pubes number.. I am an employer that is providing ttwrAers"compensation insurance for my employees. Below is the policy and.job site information.CJJ �f -e/l / 1 Insurance Company Name: e t/ ,1Stwts w . Policy#or Self-ins.Lie.*: /1 6 1'1— I.zpiratia:,n 1)ate:?f//...f 23 _.. Job Site Address: G NA L V tab E tits State lip: I/ALAfMQUA,I W's bi06 Attach a copy of the workers'compensation policy declaration page(showing the polio number and expiration date). Failure to secure cos eraee as required under MGL e. 152.§25A is a criminal s"citation punishable by a tine up to$1.500.0 0 and-Or one-year imprisonment.as well as cis,i1!Ismaili• t the fiber)of a STOP WORK()RI)LR and a tine of up to$250.00 a day against the s lol:ttor.A copy of this statement n } ' forwarded to the Office of Ins cstigations of the DIA for insurance coverage s iriticatiun. I do hereby certify under the ins and pent t of perjury-that the information pros ides/2 /45 abo ' true and x rorre -L Date. tt 44124 Official use only. Do not write in this area.to be t•tantptt ted by city or town official. ('its or Town: Permit/License# Issuing,Authority(circle one): I.Huard of llealth 2.Building Department 3.Cityrfown Clerk 4.Electrical inspector i.Pluuthint Inspector 6.Other Contact Person: Phone$a: -a►4[ (k f CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 02/051202 3Y) 023 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 be endorsed. If SUBROGATIONIS 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 BIN INSURANCE HOLDINGS INC/PHS NAME: 46507827 PHONE (866)467-8730 FAX (A/C,No,Ext): (AIC,No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL# INSURED INSURER A: Hartford Fire Insurance Company 19682 Justin Kasunick DBA Compass Point Construction INSURER B 10 BRAEBURN RD S DEERFIELD MA 01373-1103 INSURER C: INSURER D: INSURER E: 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MMIDDIYYYYI (MMIDDIY YYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- LOC PRODUCTS-COMP/OP AGG JECT OTHER: AUTOMOBILE UABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS AUTOS _ HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS UAB CLAIMS- AGGREGATE MADE DED RETENTION$ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY YIN E.L.EACH ACCIDENT $100,000 A PROPRIETOR/PARTNER/EXECUTIVE I NI A 46 WEC AMOYUO 07/12/2022 07/12/2023 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $100,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below _ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION For Informational Purposes SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 10 BRAEBURN RD BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED S DEERFIELD MA 01373-1103 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �aeOL,?c " Caa&aeue • ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1 N►1.l I 1 �� - ! cr raw rC Mat"f l'I is P1 GIx4 Tr I)AS Z MA K O,AW INN tettAR 3oks/f Vo,Nyvs N I .*. , 'eli wrNo• �c� F��A.� ri 12►` so t,tt. gist. 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