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38A-070 (10)
BP-2023-0862 163 GROVE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38A-070-001 CITY OF NORTHAMPTON Permit: flits Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARAF1TY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0862 PERMISSIO IS HEREBY GRANTED TO: Project# 2023 FRONT ENTRANCE Contractor: License: Est. Cost: 5800 ALISHA PHILLIPS 106378 Const.Class: Exp.Date: 02/26/202 Use Group: Owner: PEEPL S GABRIEL Lot Size (sq.ft.) Zoning: URB Applicant: AXIOM LANDSCAPE & HOME IMPROVEMENT LLC Applicant Address Phone: Insurance: 40 PINE VALLEY RD (413)320-9669 WCC5005020083 FLORENCE, MA 01062 ISSUED ON: 07/03/2023 TO PERFORM THE FOLLOWING WORK: REMOVE CONCRETE STEPS AND ROOF, INSTALL NEW WOOD STEPS & 'X6 DECKING POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Airing 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 NOR] HAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I I Ili, ' s . >2 . cg�i , , Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner J C Ind z The Commonwealth of Massachusetts : L Board of Building Regulations and Standards FOR 0 o Massachusetts State Building Code, 780 CMR MUNICIPALITY USE N o Bu Iag Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 El One-or Two-Family Dwelling This Section For Official Use Only Buildik bber-2023'-OR(D2— Date Applied: J,ljip /Koss ,� 6.-30-?07 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers IG3 G'u-t s it/tt1IIVA,r 12A _07O.O0 1 1.1 a Is this an accepted street?yes x- no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 13 .AV.aere. 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 JL1 1 ` /3s'P} 65 1.6 Water upply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Publi Private 0 Zone: _ Outside Flood Zone? MunicipaOn site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record:�oq brit 1 f /l'S Ale/ 9 '/,- w fl4}- o/OGa Name(Prin City,State,ZIP 161 6/014 51'c t/ 1113 - 113-7s23 9 f t't pits e 1,414,% Cow► No.and Street Telephone J I Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s)'Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': &f,' Aei f.f t Film f Sf f o 1 S� t 0,--c.s s --c. to ptt/t' fit' f // /4cif 14,/' Z PI Ivtr.,. .r-'I6 . ' /f pi SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ s ti00 1. Building Permit Fee: $ Indicate how fee is determined: t 0 Standard City/Town Application Fee 2. Electrical $ 0 Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire OPT $ Suppression) Total All Fees: $ 651 Check No.olCo7iCheck Amount: Cash Amount: 6.Total Project Cost: $ 5 t etc(do ok Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) G S , /v 03 7 (z�L quail A A 1 !IS 41 i,t ///�S License Number Expiration Date Na e of CSL Ijolder 4// IliIli //7 a D A pt List CSL Type(see below) T • No.and Street Description F( tei Ce , °/v!(� ll Unrestricted(Buildings up to 35,000 cu.ft.) ( �/J J / Restricted 1&2 Family Dwelling City/Town,State,ZIP M Mason ry RC Roofing Covering WS Window and Siding III3.31-v-96/9 a r x,.�►/qa ay it a( SF Solid Fuel Burning Appliances V Jitt,, 1,(a.) I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) (� 4yl G O2/0(,�ZG Z.S— r ^ / v Xt .41• � SCIA- I_ Hatt.a 1�Q� K4v71 �'`G HIC Registration Number Expiration ate HIC Com an Name or''HHIC Re istrant N me /� // (0p 1iwl I/S/r`y, ad `7X/IN1/4NC/QNG bs/K $ 'e. No. and Street AA Email address q i N Fly/ C.! /l h4 G/MCZ 32.G- 94L 9 ./ 0/4i/- Cci 7 City/Town,Sftate,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: OWN R AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT A r ry � b 7f I,as Owner of the subject property,hereby authorize PT�t SI at "Y4c riff/l4 .1 to act on my behalf,in all matters relative to work authorized by this building permit application. co(2s 1 2023 Print Owner's Name(Electronic e ignature) 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. c_.,_ 4 / z,3/ 7-3 Print Owner's or Authorize ent'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" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD (19 5 .I/ I �� 11,t,,,se. 3Sr rP SIDE YARD �9�w SIDE YARD 3 y f• FRONT SETBACK FRONTAGE City of Northampton Massachusetts 41 I_ ''e 1 c �' 4. ; DEPARTMENT OF BUILDING INSPECTIONS 7.. }y `�' ' 212 Main Street • Municipal Building yJ CDC �7 Northampton, MA 01060 {%y,,•.. j`'�0 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: I/ MLocation of Facility: V / G G �7 6/7„, The debris will be transported by: Name of Hauler: 4 Ytcol - 1/5Ca % M11 Mku JRA /`L/Ai, ,t Signature of Applicant: -)pate: / Zj ACORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE T (M /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 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 Fe Trudell NAME: Clayton Insurance Agency, Inc. A�No.EXtI (413)536-0804 FAX NO): (413)534-7874 1649 Northampton Street MAF1ss: ftrudell@claytoninsurance.net INSURER(S) AFFORDING COVERAGE NAIC If Holyoke MA 01040 INSURER A:Safety Insurance Company INSURED INSURER B:AIM Mutual Insurance Company Axiom Landscape And Home Improvement LLC INSURER C: 40 Pine Valley Road INSURER D: INSURER E: Florence MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER:23 MASTER 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 EFF POLICY EXP LIMITS LTR INS1) WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 A CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ BMA0028548 1/11/2023 1/11/2024 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENII AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY PRO JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A - ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 5907002 1/11/2023 1/11/2024 BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? 1 N/A B (Mandatory in NH) WCC5005020083 4/17/2023 4/17/2024 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE: Gabriel Peeples, 163 Grove Street, Northampton, MA 01060 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF NORTHAMPTON THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BUILDING DEPT. ACCORDANCE WITH THE POLICY PROVISIONS. 212 MAIN STREET, #100 NORTHAMPTON, MA 01060 AUTHORIZED REPRESENTATIVE chael Regain/Fri' %y<<d•:. / 12 % ,, ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) The Commonwealth of:f'lassachusetts �' ` , .t Department of Industrial Accidents _fie= a 1 Congress Street,Suite 100 le aw�t Boston, MA 02114-2017 ,t. ,4;`' ti'rvti naass.gow'dia 11urkers'Compensation Insurance. I1idavit:Builders'ContractorsfE:lectriciansll'lunibers. To HE FILED‘S I I li f llE:PE:RMI rl IM:AtI'IHORITY. \trplicant Information Please Print Leeihls Name 113usmess+OrganmZationrindividuall: Al „A III°t,�f rq� t- // i Ji/'L' Q. I Leo Address: 11 U joirC fr'//t' ij City/State/Zip: llla LPN C e " P'14 0/O&2 Phone#: y� - 3ZG — cl6 ty 3 Are you employer?Cheek the appropriate hot: Type of project(required): I am a employer m proprietor tw orf partnership aru!have anchor part-tiara).• 7. New construction 1f/_ '.'0 pr Pp F no employees working fur Inc in 8. 1,72. tiodeling any capacity.(No workers'comp.insurance required.) fr❑ Demolition .0 1 am a homeowner doing all work myself.[No workers`comp.imuram.-e required.)' 10 0 Building addition 40 I am a homaeowre-r and will be hiring coraractursto conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or an sole 1 1.0 Electrical repairs or additions proprietor,with nu employees. 12.0 Plumbing repairs or additions 50 I am a general contractor and I have hired the sub-contractors listed on the anadte+d sheet_ 131:11 Roof repairs These sub-contractors have employees and have workers'comp.insurance.: h.❑Vile are a corporation and its officers have exercised their right of exemption per bdtiL c. 14. Other 152.,§1(4i,and we have no employees.[No workers'comp.insurance required.] "Amy applicant that chocks bur a I must also till out the section below showing their workers'compensation policy information. ►ttomoswnen who submit this of idai it indicating tlky are doing all work and then hire outside contractors must submit a new affidavit indicating such. 1C untracton that check this box must attached an additional sheet showing the name of the sub-contractors and state w hciher or not those e,nities lane employees. lithe sub-currtracturs have eirgrloy'ecs.they must provide their workers'exsrnp.policy Number_ I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: _ S14e ._ in f y'97 C t Policy#or Self-ins.Lie.#: .G,7 ocO2.00 S3 Expiration Date: Job Site Address: if63 6/ft'r S7L /4t'1mp/i d City,State/Zip: °IUL a Attach a copy of the ssorkers'compensation rV a policy declaration page Ishossin2 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 and+or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DR for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si_n.ttuic: teat.. (/ Z 3/ Z3 ['honer:: 1//3 -- 3ZC/ - 966 5 Official use only. Do not write in this area,to he completer,hI'city or town official ('it► or Town: Permit/License:r Issuing:Authority (circle one): I. Board of Health 2.Building Department 3.Cityrfown Clerk 4.Electrical Inspector 5. Plumbing Inspector G.Other Contact Person: Phone#: Please provide all information/specifications that apply to your proposed deck/porch project. 11X6 ❑ T tal Square Feet of Deck/Porch: fc3 7 SF ❑ Height of Deck/Porch Surface from Adjacent Grade: ft. in. Footings: Concrete: Depth: ft. in. Width: 55 in. ❑ Helical Metal Pile E How Many Footings? 3 ❑ Post Dimensions: Cl' in. (x) y in. ❑ Beam Dimensions: in. (x) in. Max.Span: ft. in. ❑ Ledger Board: Dimensions: in. (x) in. Attachment Method: ❑ Lag Bolts ❑Other} IX Joists: Dimensions: cL in. (x) in. Span: ft. in. On-center Spacing: /Coin. ❑ D king Boards: ❑Wood Composi o Other Dimensions: in. (x) in. Railings and Balusters: o Wood VC ❑Other Height: ft. in. Space Between Balusters: in. Does the project include continued use of a pre-existing roof or construction of a new roof? ❑Yes o If Yes, please provide the following information: •Total Square Feet of Pre-existing or New Deck/Porch Roof: SF • Rafter Dimensions: in. (x) in. Rafter Span: ft. in. • Post/Column Dimensions: in. (x) in. • Beam Dimensions: in. (x) in. Beam Span: ft. in. Does the project include continued use of pre-existing stairs or construction of new stairs? ❑Yes No If Yes, please provide the following information: • Width of Pre-existing or New Stairs: ft. in. • Riser Height: in. •Tread Depth: in. i 1 "gaps Cap rail --- •.. st han _-- ri 'c rail Ledger Bridgin p Viking .�' io 1 , ff . ..*1---;:..414,:,„ . -. :-1,' , ;,. 1 9, ._ fr `read . � '4a < .I '-- Riser �.- —111 ,-», J �cster i Rim joist :` ` .,,. Rim Rail post N; ';'`joi n st Post ' Post 1 , /"Stringer , Beam anchor ,,,. , Concrete footing Note: • Ledger board installations must include use of approved flashing at the ledger board/building connection. • Ledger boards must be attached with approved fasteners installed according to prescriptive code requirements or manufacturer's instructions. •Approved post anchors,joist hangers, post/beam ties, hurricane ties, and all similar connection hardware shall be installed at all appropriate structural connection/attachment locations. •All structural wood elements, including decking, must be pressure treated or naturally durable wood,or made of an approved decay and weather-resistant material • Rim joists perpendicular to beams must be doubled •