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18C-040 BP-2023-1024 669 BRIDGE RD COMMONWEALTH OF ASSACHUSETTS Map:Block:Lot: 18C-040-001 CITY OF NORTH MPTON Permit: Alts Renovations • Repair PERSONS CONTRACTING WITH UNREG STERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUA NTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1024 PERMISSION IS HEREBY GRANTED TO: Project# REPAIR PORCH 2023 Contractor: License: Est. Cost: 12846 RHI CONSTRUCTI N 055236 Const.Class: Exp.Date: 01/18/20 4 Use Group: Owner: NAVI THOMAS P Lot Size (sq.ft.) Zoning: URB Applicant: RHI C NSTRUCTION Applicant Address Phone: Insurance: 128 RYAN RD 413-885-9038 7PJUB1K0603849923 FLORENCE, MA 01062 ISSUED ON: 08/03/2023 TO PERFORM THE FOLLOWING WORK: REPLACE FRONT PORCH IN SAME FOOTPRINT 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 l)rivena 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: • • >2 . ''l • Fees Paid: $83.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Jr<(\ The Commonwealth of Massachus. ;'`'A)). l (i 4110 W. Board of Building Regulations and Stand ), w R 6. Massachusetts State Building Code, 780 II M• 6: '�oti ►'CIP• TY roc, US Building Permit Application To Construct, Repair,Reno ate Or b- ... ;. . 'evised ar 2011 One-or Two-Family Dwelling "Yo,c;,oti 01otiG s This Wien For Official Use On y Building Permit Number:BP• ?"'.3" f° Date Applied: /400 f2',5 / am 5-3-2023 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 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 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: -1-6rc% .vac t(\ 't. 0'Nce ,N\-'fir- U\l Z. Name(Print) City,State,ZIP VA k)N - 9-01` L $3..5.3-1771 46M•(\kVVIOt i1-Corr^ No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Bripf Description of Proposed Work2: T-itx___ ` .0."\ vial,. ,N S 4 rmt_ SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ \Z'k L ,s 1. Building Permit Fee- $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(:tem 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Check Na0 1 ktheck Amount: 6.Total Project Cost: $ \Z\`(40,56 0 Paid in Full 0 Outstanding Balance Due: City of Northampton Massachusetts r' �e A4 DEPARTMENT OF BUILDING INSPECTIONS 1fir 212 Main Street • Municipal Building ' Northampton, MA 01060 PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR WINDOWS, DOORS,ROOFS,RENOVATIONS,ROOF MOUNTED SOLAR,ETC. 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specifications of proposed work(Digital and hard copy). 3. Construction Debris Affidavit filled out and signed by applicant. 4. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance. 6. Energy Conservation Compliance Certificate(new /replacement windows). 7. Home owner's License Exemption Form (if applicable). 8. Note any Special Permit requirements(if applicable). 9. Energy Code—all new construction (Gut/Rehab) requires a HERS Rater Affidavit 10. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton. SECTION 5: CONSTRUCTION SER ICES 5.1 Construction Supervisor License(CSL) Cr S—Q 51 kNC.\C)rt1 License N ber Expiration Date Name of CSL Holder V l.i'� ^ r� List CSL ype(see below) ��� No.and Street `L (— a Description `C'4 ^ \ Unrestricted(Buildings up to 35,000 cu.ft.) C, Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances /'Qi 1' I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) l --' S �i.3.• C �j�tVl�N ;I C Registration Number Expiration Date HIC Company Name or HIC Registrant Name • h.k cr. tt Z \I_.. % 'r‘�Cw04_v�- No.and Stre PM" U1U (-\\) .5'-4o Email address City/Town, 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 0 No . 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorizeC-t1 to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) 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. < NE-4 -3 \ Print Owner's or Authorized Agent'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.) Habitab e 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" ', .-.41.•,1\ The Commonwealth of Afassachusetts x=r a 1,,iim=F Department of Industrial Accidents ......t- '2,tolTr= , 1 Congress Street,Suite 100 'MAL; Boston, MA 02114-2017 - — www.mass.govidia 1%orkers'Compensation Insurance:‘ffidas it:Builders/ContractorsfElectricians/Plumhers. 11)HI.1-11..ED 111111 111L 1"I.1t.111111NG A11110R111. _kook alit I ti fo rin a lion Please Print lxgibls Name Odustuess;Orga mutton Individual); 5,-‘_C-- Adilress: \1 -1E .0— L-1 41— -- Cty,'StatefZip:IrtApttetk. N\A— 0 vli.\-- Phone P: Are you in raapio)cr?I'llorck the apprupriate box: • Type of project(required): la!3111 a cackler with . ........__employees(fa=din part-16mi.* 7. 0 New construction 20 I ant a bole pi-um-Jana or pannerstup and have no tmnrAnyet's n'orkt.ng for nu:in 8. NrCnodeling Wry capacity.[Nu workers'comp insurance rewired] . E De 30 I am a homeowner doing all wort mystif.[No worktas'comp_insurance reviinnal.j' 9Demolition 10 ri Building addition 401 am a harricoveltba and will be harm ntradon to conduct all work on my property, I will moure that all COransoun either hare workers'compensation insurance or are sole I I E3 Electrical repairs or additions proprietun with iau employees, 121j Plumbing repairs or additions idara a 1.,atera1 tuntractur and I have hued the sub-contracuns Listed an the anatimil sheet. 1 3{DRoof repairs nIt'IC Alb•tiL911.12diAll 1134,e C113phireeli and base workers'comp.insurance,: 14.n Other ()a We ant a outpuration and its officen have marmot their right of cactription per?Ail c, 132.41(1).anti we have nu employees.[Nu workers'CtIltlp_isnot:awe required.j 'Any applicant that ebestit box al snug Am fill out the section below thins inn their',sinker,'compensation policy rnlortnalhon t IFkantowners who submit tins affetlabit abdicating they are'laving all work and theta hire outside'cusaracteei mint submit a new affaias it indicating such„ 1Contracturs that check this box must attached an additional shtvt show ing the name of the sidi-commax-,and'tate v.lictber or WI&mit entaies ILO* ,inplolite-, It r..he Nub-euntrai.[Ort I.U.00 Carr.10.,CC",014) 1111A prtoilikir v,L,rlers*camp.pilicy nimiber I am an employer that is providin,e workers'compensation insurance far my employees. Below is the polity and job site information. [flaw-awe Compitaly Name: "\<\(\i'l ` (0'A\iNA-I\- o _ Policy#or Self-ins. Lie.41: Expiration Date Job Site Address: (i cp . CiAdc.„4...... 0.-6,--4,?..--- citystak.lip: Attach a cop of the workers'compensation policy declaration page(showing the polics number and expiration date). Failure to secure coverage as required under MCiL c. 152. §25 A is a entntrial %/dation punishable by a fine up to SI.500.00 andlor one-year impnsonment.AS well as civil penalties in the form°fa 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 OtYke of Investigations of the DIA for insurance erate verification I do hereby certify under the pains d penalties ier' y the ' formation provided above Is true arid correct Sionature: Ihte: Phone : t..31/4\'‘)—IsTS--- tc.) ) ", Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1. Board of health 2.Budding Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6,Other Contact Person: Phone 4: City of Northampton ,,t,. t,.e f/ Massachusetts �f, k '11, ;, tE DEPARTMENT OF BUILDING INSPECTIONS .,, } 212 Main Street • Municipal Building �a -- Northampton, MA 01060 V-` 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: a�S\ ck ` V tD The debris will be transported by: ---s\--7 Name of Hauler: � 1` U•-(' Signature of Applicant: Date: 3\-`z-3 City of Northampton (. 4 v;. Massachusetts f }, 1 i� 3 , t° DEPARTMENT OF BUILDING INSPECTIONS `,.. ,.':y 212 Main Street • Municipal Building �.re^'� Northampton, MA 01060 9 $ HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born_(insert month, day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners' exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this day of , 20_. (Signature) t Estimate 128 Ryan Road Florence.MA 01062 Date Estimate# 416%2023 1966 Name/Address Tom Navin-Mike O'Neil 669 Bridge Road Northampton,MA 01060 Terms Project On receipt Navin-O'Neil front porch Description Shores for beams and girders 2 Ea Demo existing front porch 1 Ea General excavation by hand 2CY Column footings 2 CY Backfriling by hand 2 CY Pressure-treated 6 x6 for support for floor structure 2 Ea Pressure treated deck framing 104 SF Pressure-treated timber 4 in.x 4 in. 2 Ea Unfinished Douglas fir flooring 1 in.x 4 in.,tongue and groove 104SF Wall stud framing 2 x6 PT 75 LF Cedar shingles, 16 in..5 in.exposure 2 SQ Tongue and groove for inside porch 87 SF Tapered wood columns and porch posts IEa Recycle fees 1Ea Building permit fees 1 LS Project material,labor,subcontract Material.per job Total Phone# E-mail Signature (413)885-9038 tomfu;rainhome.net Page 1 Estimate 128 Ryan Road Florence.MA 01062 Date IC= =Mal Name!Address l om Navin•Mike O'Neil 669 Bridge Road Northwnpton,MA 01060 Terms Proved On receipt Navin-O'Neil fruit pore* Description • tabor,per job Subcontract.per job *Project Subtotal *Project Total Total $12-84650 We propose to hereby to furnish material and labor-complete in accordance with the above s ecih:a bons.for the sum teat Payments to be made as follows:half of full total upon acceptance,one quarter of full total upon the start of the pro ect and the full balance due upon completion.All material is guaranteed to be as specified.All work to be completed in a manner according to standard practices.Any alterations or deviations from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the esiimasc. All agreements contingent upon strikes,accidents or delays beyond our control.Owner to cam}fire.tornado.and other neces ry insurance. Acceptance of Proposal will commence with the home owners signature.Prices,specifications and conditions arc satisfactory and are hereby accepted upon signature.Rainbow Home Improvement is authorized to do the work as specified and to be paid as specified. Phone# E-mail �----� Signature -- (-i3i885-9038 torn iaainhome.net Page 2 ® DATE(MM/DD/YYYY)AC'� AC� CERTIFICATE OF LIABILITY INSURANCE 08/01/2023 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 NAME: Susar Fleury THE HILB GROUP OF NEW ENGLAND LLC ((A/CC.Nly.Ext): (413)250-8652 FAX (A/C, E-MAIL sfleury hil ADDRESS: � bgroup.COm 120 Turnpike Rd INSURER(S)AFFORDING COVERAGE NAICI Southborough MA 01772 _INSURER A: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B: RHI CONSTRUCTION INC INSURERC: ' INSURER D: 128 RYAN RD INSURER E: FLORENCE MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER: 917017 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 ADDL SUBR POLICY EF= POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLALIAB OCCUR . • EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH STATUTE AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A 7PJUBOW34849923 01/18/2023 01/18/2024 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. 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. 210 Main St AUTHORIZED REPRESENTATIVE C�.:s Northampton MA 01060 Daniel M.Croiny,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD r r......„rn \ Ll1'.°7/L 1 ,-=.„.„„ •,, ,,,, , „„.„,,..- „..,,,..„. ,,,,,,, ,.,. ,,,,, -.--I f ®gg , ,41".'::,,* „„, _ „__ ,„„ ,_ .....) sLit 3 ki ON471\"on C.,\LioN,to" ",,ram, .. ,�„�<„�,',,1�'i Fn, `,T? ii"';i'�,,a.•;•.`4 '.; 5Ga,.. e • � L a / re F F ":,r'.�,£N':^,^o;'<�%'<�<or 9 , �"r.-"."/'� .,�"� ,.:E: 7 ,„ '-r,r, ;ate;',.# ,iFie "'�f'.,%�..4"°','''�'r;%E'�,%`,;�, .">;�." ,1€^s':1;, '�',�',0rv . Sent from my iPhone