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24C-031 (7)
BP-2023-0986 76 NORTH ELM ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24C-031-001 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-2023-0986 PERMISSION IS HEREBY GRANTED TO: Project# DEMO GARAGE/ ADD NEW 2023 Contractor: License: Est. Cost: 209800 WILLIAM TUROMSHA 000515 Const.Class: Exp.Date: 02/15/2024 Use Group: Owner: A. MURPHY, DAVID Lot Size (sq.ft.) WILLIAM J TUROMSHA DESIGN & Zoning: URB Applicant: CONSTRUCTION Applicant Address Phone: Insurance: 11 WILLIAMS ST (413)575-7846 NORTHAMPTON, MA 01060 ISSUED ON: 07/28/2023 TO PERFORM THE FOLLOWING WORK: DEMO GARAGE AND EXCAVATE FOR NEW FOUNDATION. BARN YARD TO INSTALL NEW GARAGE 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: Fees Paid: $368.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner File #BP-2023-0986 APPLICANT/CONTACT PERSON:WILLIAM J TUROMSHA DESIGN &CONSTRUCTION 11 WILLIAMS ST NORTHAMPTON, MA 01060(413)575-7846 PROPERTY LOCATION 76 NORTH ELM ST MAP:LOT 24C-031-001 ZONE THIS SECTION FOR OFFICIAL USE 0 Y: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $368.00 Type of Construction: DEMO GARAGE AND EXCAVATE FOR NEW FOUNDATION. BARN YARD TO INSTALL NEW GARAGE New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan Driveway Grade% THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFRMATION PRESENTED: 10 OD Ad KV, INFORMATION Approved Additional permits required(see below) ) PLANNING BOARD PERMIT REQUIRED UNDER:§ • RfiPLACi 11G 2 R,ki Intermediate Project: Site Plan AND/OR Special Permit With Site Plan T -i 41I\S D i Raa Vet Major Project: Site Plan AND/OR Special Permit With Site Plan F4 LLF1J Rr I'F- ZONING BOARD PERMIT REQUIRED UNDER: § SMALL1 k-ThAU CXIS1l)J) Finding Special Permit Varia nce* 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 1! I,' r 1/?0,3 Sign.?ure of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden 10 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. ✓G chi „ 4 The Commonwealth of Mass. hu •tts i Q ' �,�,1 Office of Public Safety and Inspectio - n ''');(,,,,, a/o,� 6' • I t, '' Massachusetts State Building Code(780 CMR) '�V Building Permit Application for any Building other than a One-or , .' Dwelli Q�" (This Section For Official Use Only) ti MgoFep, Building Permit Number:,?' ' £ Q Date Applied: Building Official: �°sO"As SECTION 1:LOCATION 1` Noirn-L EUI cr. NoRTRAM13Tett-I aIo o No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here Dir or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition❑ Demolition Cif (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 Er No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No llil Brief Description of Proposed Work:REM o Li E RErtau. %ATIoiu eF nQigtvwl. aA L E (TIME. Ff ta,.ON `7NE dt VOW- aARA&t ) EKCArvp-he rag NE la Fos.14na.Ts 094. NEW PRE yak Gs&A IC +o IL ER,ECr€t' hi/ "Il-te HAqu Yokes SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Checkhere if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ ' Existing Use Group(s): "Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing 't r FL.Proposed Ir._ • No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) PM sf 'Ia° SF Total Area(sq.ft.)and Total Height(ft.) ►$y 0 SF 2Y' O" SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2❑ 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 1: Institutional I-1 0 I-2❑ 1-3 0 I-4❑ M: Mercantile 0 R: Residential R-ID R-2 0 R-3111 R-4 0 S: Storage S-1 0 S-2❑ U: Utility Olt Special Use 0 and please describe below: Special Use Description: NE 1.l ic,AFi{ac,E SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ Iv El VA VB ❑ 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 till Public El Check if outside Flood Zone V Indicate municipal Ell required 0 or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: 1 MA Historic Commission Review Process: Not Applicable t$ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No$1 Yes 0 No Et SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s):_ Type of Construction: Woo a FRAME Does the building contain an Sprinkler System?: NO Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner j11 in P`IIR 'Hy 7 3 U ri-1 ELK NORTN1l'-t prow Cl lnba Name(Print) No.and Street City/Town Zip Property Owner Contact Information: OWNER. tt3 - -S;ao WJ -530- 2245 bAuto. MURpA`Jaa'CDmCAsT.HET Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: W I l it art Tu Ro n+5 MA I f kl,ll,sa••.s se77R-ts ST Mo hilt n f Tbki 111p n io ha 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 . 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 ! i WM .j. tuRovsAA 1 ESI6t4 1- CAWS-Tau ell oM Company Name f )AhlAfa •, ..1 I4-IotnmskA (SLOObS,S Um l01}2Z Name of Person Responsible for Construction License No. and Type if Applicable la Will,,.,li SrREFT NOILTRAJ-.p-TaN MA_ 15/e1.0 . Street Address City/Town State Zip • N13 -.Sig- YooS 1{/3 ,57.5- 78414 WM/ROMSNA Gorki 'iL. - Gang. Telephone No.(business) Telephone No. (cell) e-mail addres SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT (M.G.L.c.152.§ 5C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents m It be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuanc of the building permit. Is a signed Affidavit submitted with this application? Yes 0 No 111 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs: (Labor and Materials) Total Construction Cost(from Item 6) +$ 1.Building $ ii 9_$O ., °° I Building Permit Fee=Total Constructio• ost x• . sert here 2.Electrical $qz 00•m° appropriate municipal fact. )=$36$, °! 3.Plumbing $ Z8 00.e o 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to C,T'r a F N o RT14,4 tpTo H 6.TotaI Cost $ 2a t4 8 00. e° (contact municipality)and write check number here 9.3.a 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 accurate to the best of my knowledge and understanding. Wtii,Art T- IttR,orvSPA LIig /btcm..sl.•-. Gg,e,2aL.. CDH17 <Tost Y13 -S3S as414 Please print and sign name Title Telephone No. Wll/eAPIs SW-SET P - Date 1I No�Rr''+�� 17I14 O�OG a 47�i•eorksl+A 8 1111w.6 •Go/11 Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: ,U , ' l ‘i. p1. a 3 HLName Date CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: O.91 ACRES REAR LOT DIMENSION:____ REAR YARD 45 p'° SIDE YARD 36v-O" LL _J ...,.a..�._6_i3.4 s . NEE 1►1 GP U.. SIDE YARD i 21 —4 • EL!A STRe'ET FRONT SETBACK 72'0" FRONTAGE 68 '-®'• __ City of Northampton oPY;x ti.0 Massachusetts /4•�' is • `fit DEPARTMENT OF BUILDING INSPECTIONS �� i s;. rf 212 Main Street • Municipal Building _t--+ Northampton, MA 01060 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: VP.Uk* 'REcy Liuc The debris will be transported by: Name of Hauler: 11.13PJJ3WIN Signature of Applicant: /, 9. 1 s Date: 26 •'TuL1 •2013 The Commonwealth of Mttssanhusetts Department of Industrial Accidents �j 1 Congress Street,Shire 1 0 .t t Boston, MA 02114-2017 wow smiss.goi d a % urkers'Compensation insurance Alrtdas it:Bulitters.+4:o trLtctors,ElectricianstPlunthers. TO DE FILED yirrta Tut.PERM irrING. t rttt}Korn. Applicant Information Please Print Les.+ihla Natne wustnes.s Organization.Individual.:. itn 3'...muto.„,04 , 'DI§S%N *Co J ucikoI . Address: .•.1J_.4llltf<ern _ City/State/Zip:f� pmpmntr_t11A_ _ otoLo .__ Phone#: 'y..� . Qui *loos Are ye retl employee Cheek the apprrpriaac loctt<; gtg Type of project(required): 1.0 1 am a entplo er*rib employees(full meteor port-timeL_• 1 7. New construction l and a xtic proprietor or paflnrship and have no employees working for nu mr H. sJ Remodeling any capretty.(No worker: cutup.n aut:lt w mnred.i , 9. El Demolition 1.iln a litimel,N tun doing all wurk myself.It`s*micas'comp.insurance required j' 1 O 0 Building addition lam a hotocois geY and 4'4111 he haring ucrnerae1utn to conduct all wok unlrty pmerp.rty. I c'.ifl • .-neon:that all carntru'lun either have worker:,'c..rettpensallun insurance in as,rule I I.73.Eiettricti I repairs or additions prupneters a ith no employees. 1_D Plumbing repairs or additions sal I ant a utrrlu:ral contractor lend 1 laic hired the sub-c Inurcturs Ii.rcd un the antrefied shed. 'lltesc sub-cumlracturs l�i s r employees and bay e u etrkenr..amp.tnulanutcc. I Ktwf rep tics I4.Q Othei h.0 We an:a v riperauun and its officers haveextsrised their mph.'Of exemplum per!ail c. 1:C1 i 1i41.and we have no etnplu}ecs.IVu workers'comp.insurance.required.' •Any.applicaui that cheeks but al must also till out the v ction Ir.luu showing their workers'cunt{eruatiun ltuli.y iaiartnatien. • t Homeowners who sut'nit this atliJaait indicating.the}are doing all work and then hire cttitside et.ntrruturs mte+t submit a new affuttaa it intliratu,g atr:h. :Contractors that check this bt'A must attached an additional sheet shun Mg the name Of time'surrenntraetas.and.state w hetbe'r of MA(lathe%Min0.-.a have employees. If tlr.suls-cuntraerur,hale.cligaluuecs.the) must pre ide their n.orken'.xrgmp.polio.nuaml,:i I am an empdutrer that is pro►iding workers'compensation insurance for o y e+mplo ee.s. Below is the policy and fob site in/Ormation. Insurance Company Name:_ . Policy It or Self-ins. Lic.#: Expiration Dane: Job Sae Address: 4t. NoRTH ELM it Alhp+b mA Cilia:State Zip: 010(ao 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 a:. 152.*2SA is a criminal violation punishable by a fine up to S1,500.00 andor one-year imprisonment,as.a‘-oil as civil penalties in the norm of a STOP WORK ORDER and a tine otup tw S250.OD a day against the violator.A copy of this statement may be forwarded to the Ot$die of Investigations of the DEA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that mire in formruion provided above is true and correct. Si vnature: � . f i.,cra4.sii.a_ Phone 4: '1/3 S & YooS Official use only. Du not write in this area.to be completed by city or anon,of f lr'int City or Town: PertuitiLiceuse Issuing Authority (circle one): I. Board of Health 2.Building Department 3.CityfTown Clerk 4.Eke cat Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Client#: 1457939 BARNYAR ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM!DD/YYYY) 08/29/2022 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kristin L.Tellar USI Insurance Services LLC PHONE (A/C No,Eat):855 874-0123 I FAX (NC,No): 203 634-5701 530 Preston Avenue E-MAIL SS: Usictcertificates@usi.com CT 06450 INSURER(S)AFFORDING COVERAGE NAIC# 855 874-0123 INSURER A:LM Insurance Corporation 133600 INSURED - - --- - - -- INSURER B:Liberty Insurance Corporation 42404 The Barn Yard Enterprises,Inc. -- --- -- - ---- --- - -- 9 Village St INSURER C:Employers Insurance Company of Wausau 21458 INSURER D:Liberty Mutual Fire Insurance Company 23035 P.O. Box 89 -- — — — — Ellington,CT 06029 i 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 ADDLSUBRi --- POLICYEFF POLICYEXP - LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM)DD/YYYY) (MMIDD/YYYY) LIMITS A X I COMMERCIAL GENERAL LIABILITY 1TB5Z11B8C573 8/28/2022 08/28/2023 EACH OCCURRENCE $1,000000 r , CLAIMS-MADE X OCCUR ROEM�C�FE�jQ occurrence)_ s100,000 .._..__. MED EXP(Any one person) $15,000 _ PERSONAL 8 ADV INJURY I$1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE +$2,000,000 POLICY I_�ECOT- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: _ I $ A AS5Z11 B8C573 8/28/2022.08/28/2023 A1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X ANY AUTO - i BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY __ AUTOS BODILY INJURY(Per accident) $ v HIRED NON•OWNED AUTOS ONLY I X AUTOS ONLY PROPERTY DAMAGE I$ — (Per accidents — — — B X UMBRELLA LIAB IX OCCUR TH7Z11B8C573 8/28/2022 08/28/202 EACH OCCURRENCE ,$5,000,000 EXCESS LIAB l 'CLAIMS-MADE AGGREGATE TE I$5,000,000 DED I X j RETENTION$10000 _ - f1$ WORKERS COMPENSATIONPER C' AND EMPLOYERS'LIABILITY Y/N WCCZ11 B8C573 08/28/2022• 08/28/202 X I STRTU E IFR 4 I ANY PROPRIETOR/PARTNER/EXECUTIVEr I E.L.EACH ACCIDENT $500 OOO OFFICER/MEMBER EXCLUDED? I Y I N I A 11(Mandatory in NH) -. E.L.DISEASE-EA EMPLOYEE $500,000 I If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S500,000 D .Equipment Leased/ i YU2Z11B8C573 08/28/2022 08/28/202 195,000 Ded 1,000 • Rented DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION Evidence of Insurance • 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 JRE�PRESENTATIVE 9h ,L+L-C 1 Bad.-- ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S37154080/M37101331 RXTCH . �~` T `�� -' ` . _' � . is _� i � ' may' ;• ` �'. _„--- s a ,g�`: to ''' r-- `l .,az - _•,.__1 a-.- „w '.+r" .4e" • ,. 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