31B-155 (4) BP-2023-1260
11 TRUMBULL RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31B-155-001 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-2023-1260 PERMISSION IS HEREBY GRANTED TO:
Project# ADD DECK 2023 Contractor: License:
Est. Cost: 10500 MICHAEL PRIGNANO 104390
Const.Class: Exp.Date: 01/08/2024
Use Group: Owner: STUBBS SUSAN L&BARRY GOLDSTEIN
Lot Size (sq.ft.)
Zoning: URC Applicant: HILLSIDE BUILDERS & REMODELERS
Applicant Address Phone: Insurance:
121 WEST STATE ST 413-218-5247 HIWC241467
GRANBY, MA 01033
ISSUED ON: 09/12/2023
TO PERFORM THE FOLLOWING WORK:
ADD 8X10 DECK
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: '
1► k ( cf
I/
Fees Paid: $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
/1 Fp T
The Commonwealth of Massachu\' `9<2614
Office of Public Safety and Inspections yq( ,1,,,
Massachusetts State Building Code(780 CMR) 'nl.'/ticA
Building Permit Application for any Building other than a One-or Two-Fa ing
c s
(This Section For Official Use Only)
Building Permit Number: d3' 120 Date Applied: Building Official:
SECTION 1:LOCATION
►L -CraNbut1 • ivu fh an fv& /k v L 06c)
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 0 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 II No 0
Is an Independent Structural Engineering Peer Review required? Yes 0 No 0
Bria Description of Proposed Work
ran1 fcL✓ e K lc') clicIt on rs;ci6f. Silt of bvvsc .
5� w -x����v� P� .fi ne �
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)
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❑ 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 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 ❑ HA IIB ❑ IIIA ❑ IIIB ❑ IV VA 0 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 0
Public 0 Check if outside Flood Zone 0 Indicate municipal 0 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: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No 0 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
Nange and Addr ss of Property Owne
Ue- 5 -vb 6 s h 'rokbug Ajar r AA.
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
si✓e- 6M4 c 413_ ti -7 -)-° i' - - ç+r4b$( cecviceAe d 1
Title Telephone No.(business) Telephone No. (cell) e-mail a ress - Qt
If applicable,the property owner hereby authorizes: .•JJ
/`t ce l ?rll 0 n-( lif-' 4t 5 f- &ran `y /14og 0 l a 2?
Name Street Address City/Towh 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 CI.
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 K;d e &i;/kr
C pany Name
•
/CiftqL1 Pry CIANA o GqO (4 3?o Ut\ f i c*) GSL
Name of Person Responsible for Construction 'cense No. and Type if Applicable
V - kAksf S+ e 5{-- -i'vnL 7 )vl otol)
Street Address (City/Town State Zip
LC? �iC 7 - - pr; J(1cnc) e9M at, /• cc//,
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 13 No D
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ 10 t 5 UQ Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate muruipal fator)=$ .
3.Plumbing $ 6U
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ IC)/ cCk) (contact municipality)and write check number here 3 O g 7
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/'irth (
is true and accurate to the best of my knowledge and understanding.
rr,ciikeyNo C,c (l 4rcic f tJr' /3- i5 (/7
Please print and ign itl Telephone No. Date
1 4 U'es- I-e S� G-r'-n4y A- O( c03? P ;ZQ \c €�n1,c1.cd?
Street Address City/Town State Zip Eail Address
Municipal Inspector to fill out this section upon application approval:
Name Date
CITY OF NORTHAMPTON
SETBACK PLAN I lI1tj(\
MAP: LOT:
LOT SIZE: l Cr
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
to0
Aftkd Qj tO
9ecrk
PdraiN
FRONT SETBACK
FRONTAGE
___,..-', HILLBUI-01 DALDRI H
ACORO CERTIFICATE OF LIABILITY INSURANCE DATEIMWDDnrrre
7/24/2023
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.
tf 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).
CONTACT
PROOUCER NAME.
Haberman Insurance
PHONEFAX
95 Ashley Ave WC,No.Ext):(413)781-7000 IA/C.Noy(413)733-9545
West Springfield,MA 01089 AoDRss info@habermaninsurance.com
NSURER(S)AFFORDING COVERAGE NAIC a
'NSURER A Preferred Mutual Ins. Co. 15024
INSURED +NSURER B NorGuard Ins Co 31470 __
Hillside Builders&Remodelers LLC INSURER C
121 West State Street. Suite#5 INSURER D
Granby.MA 01033
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 I
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
TYPE OF MSURANCE Ate'SUER POLICY NUMBER POUCY EFF POUCY EXP O
aLHa�lt INSO VrYO (MMIDD/YYYYI IMMIDD[YYYY1UNI
A X COMMERCIAL GENERAL LABILITY EACH OCCURRENCE S 1'�,000
'LAWS-MADE X OCCUR X X BOP0100727499 10/4/2022 10/4/2023 DAMAGE WEa EN D ! $ 50,0001
MED EXP IMyonesom, S 10,000
par
PERSONAL&ADV INJURY S 1'O00'000
GENL AGGREGATE,MIT APPUES PER GENERAL AGGREGATE S 2,000,000
POLICY X JECT LOC PRODUCTS-COMPIOP AGG S 2r000,0001
OTHER S
A AUTOMOBILE UMMUTY COMBINED SINGLE MIT
Ea acc,der+ri S
ANY AUTO PCA0100300284 10/21/2022 10/21/2023 BODIL r INJURY person) S 1,000,000
ONMED X SCHEDULED
tyros ONLY AUTOS BODILY INJURY(Par aocwn S
X Offi ONLY X make P120PE DAMAGE $
Per S
A X UMBRELLA LUa X OCCUR EACH OCCURRENCE $ 2.000.000
EXCESS UM! CLAIMS-MADE uC0130611999 10/4/2022 10/4/2023 AGGREGATE s 2.000.000
DED X RETENTIONS 10,000
— 5
PER OTH-
ANO B wanton
EMPLOYERS'UABIUTY Y r N X -- .
STATUTE ER
ANY PROPR)ETOR/PARTNER/EXECUTIVE HiWC486165 6r24l2023 6/24/2024 500,000
Filiris as N N A EXCLUDED" E L EACH ACCIDENT S
in FM) E I. DISEASE-EA EMPLOYEES 500.�
a under eesc be uer
DESCRIPTION OF OPERATIONS Deo. E L DISEASE POLICY LIMIT $
500,000
DESCRIPTION OF OPERATIONS'LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule.may W attached l more space is requiradl
:IL and its Subsidiaries are named as Additional Insured In regards to General Liability on a Primary and non-contnbutory basis applies. revised CMi♦CBIa.
CERTIFICATE HOLDER CANCELLATION
THE
SHOULD ANYEXPIRATION OF THE ABOVEDATE DESCRTHEREOIBF EDNOTICE aOLICIESWILL BE CANCELLEDBE BEFORE
ACCORDANCE WITH THE POLICY PROVISIONS. DELIVERED IN
AUT OORIZED REPRESENTATIVE -
LDS t A,
ACORD 25(2018/03) ---- -
The ACORD name and logo are registered marks 9of ACORD ORD CORPORATION. All rights/pseryed.
11 Trumbull Road new deck/ramp
All Pressure treated framing and decking/railing
12" sonotubes 48" deep
6x6 posts notched for 2-2x10 beam
Ledger attachment to house with flashing
16" on center 2x10 Framing
4x4 posts for railings, blocked in and bolted
-2x2 baluster.typical
4 post.lyp- --2x6 or 5,4 board rail cap.attach to guard post with
4x
4x NOT NOTCH —•—e-0'faidaaMM �q —
11 , (3)#12 by 3'long screws or(3)16d threaded nails
DO r with 0.148 nominal diameter
i ' 2x4 top and bottom.
minimum
kl attach to guard post with
•
t2(8d threaded nails or
1 - - I � (2)=8 wood screws a2•%i
-' -- reerereer _ long on inside lace
xxxs
minimum nominal 2x8
Y.�elm min _ - __--.. rim or outside joist
'- 1211/2'diameter openings snail not albw attach balusters at top and bottom
•through-bolts the passage of a a' with(1)#8 wood screw or(2)8d
and washers diameter sphere post-frame threaded nails with
0.135'nominal diameter _
-m joist or
Figure 14.Genanl Attachment atLWper Board to Band Joist or Rim Joist. outside fast
leniencemunrq 1 Meow"° at Wooer
,Its a m4asYal4iy
arm;Wad wei—a� eeeeiroU car el ody llefMd and .' .f
elates:o orevent wale.rms.,
wrap b bend pc t' wow and root flush on too sloped joist hanger.
or r•rerfos.!1 conbnurAs rlesvmg
OW ma pot M irc pastor minimum vertical
hemp. capacity of 625 lbs.
Thu`: Eleck;.s-rsi see JOIST HANGERS
S Mr�i tor more requirements
24:srTaw 1.Tdo•nea-iso
y� fvaws or ATTACHMENT WITH HANGERS
mail
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City of Northampton
``,, ,llir�i s�. s,o
Massachusetts `1 ';
t ie 1.7) i
I� t DEPARTMENT OF BUILDING INSPECTIONS - :
$1" x�. * 212 Main Street • Municipal Building cD:
Northampton, MA 01060 'yti. 117��J
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: \fo1/e y Rcyc /145 >3(-/ tI10" 1�l
The debris will be transported by:
Name of Hauler: / fll ''l °K t[Vc 4 .A.5
Signature of Applicant: Date: 7/iiik3
The Commonwealth of.I1assachusens
(' Unlit. it/• _ 1d-� Department of Industrial Accidents
_
_.�_ =. 1 Congress Street,Suite 100
r
• _' '_ y Boston, MA 02114-201
ate• t www.mass.gov/dia
%t o,Ler.' ( ornpens etion Insurance.tffidas it: Builders('ontractorstElectricians:Plumbers.
I(► 141- III h I)NM I II 1111 P4.R‘111-I 1M(::U UIORI l.
lfinlicant Inte�nna(inn i'Icast Print Lt+;ihis
Naftle it:hotness Orkt urtt.,n huhsidu.e 1. (••(•••( ,� Pci kie !r
Address: t>( W of F
State/Zip: G[`-i& L y / la\ aC)3i Phone r: `f(2 )-( ' 5 2 c 7 .
Are you an rmphtser?('1tttkthe appropriate tint: 1 s ix of project 1 required i
1.21i ant a entplosty with f e;•rnplo)ces ttul►and ur part-time i• 7. CI \tH construction
:0 1 ant a too:pneptectur or puma-ramp and hate no ernpkhtso working for me in 11. RcmutkIinc
am iap..aty l`iu workers'euntp.eresurantc n lturtd t
s0 I am a tummy*net doing all wink myself I\o*otk..s'comp ussurane ny lured j
9. El tkmolition
n
4.0 I am a homay.net and*ill he Meng::vat:a tor, ind my.rutt all%irk on property It.ill
10 a Building addition
imsun that all eontt h'r CAM halt workers't.rtttenution ertsurante or an sine I I.O Electrical repairs or additions
pntpneit.n i nth nu employees
1213 Plumbing repairs or additions
S 1 am a gt.nral contractor and l has hind the sub-cunttatturo listed on the attached sheet
These t.ibtuntractun has employees and hat warners'hump. insurance. 130 Root reps
14.�thet (QC 'l
h.D He an a eorpuratton and as officer.hat.:exercised their right of exemption pet NH&i _..
132.tt lilt.mind we hate no eng+luscts.I V'wutkets'eon".insurance nymnd.I
•'tn applwant that checks has al must also fill out the secti.m helot.sk u rig then wields.'compensation policy ent.rnausrn
kh,n eostnts tshto submit this AITidasu indicating they asc doing all work and then hue outside eontra.tors must sahmnt a new af'i.la%it endwattng such
•t veniactort that check tint has must atta.•hed an additional shot shin.my the n.inw of the suh-.ontra.t.rs and state whether or not those entities hate
.nttslutccs It the wb-cunerauttrs hate eiripknees.then must pro,id.::It c .t,akc. ..•r•tt. r,.r,• r.unl>i
l am an employer that is providing warAers•compensation insurance for my employees. Below is the'policy and job siteinformation. 1.4--A (-4-tALAJ,
Insurance Company Name. voici-
PoIiu) tt ur Self-ins.Lie. 4vresC"i D C - Expiration Date: 7
Job Site Address: v C T w41.J", ( (its State Lip. /vdr S
ira op Attach a c y of the w rs orke 'compen.a it olic, declaration page(showing the polio number and etp on dote).
I Failure to secure coserage as required un.l.r \1l01. c. 152. ;25A is a criminal s tolation punishable by a tine up to SI.500.00
and or one-scar imprisonment.as ss ell as cis it penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a
das against the s tolator. A copy of this statement may be firm arded to the Oflicc of Insestigattuns of the DIA for insurance
eoserai.e %er:t....'t. I:
do hereby e, r 1 under the a ns Ind penalties of e • jun that the'infiermutietn providedhert•e•is true and t orrerI.
Signature � I t. 1/ 3
Phone = ( (? )/(
Official use.loth. Do meet write in this area. hi be ein►lnlrh•el hi e itr or tenth nfJie iu!
( its or I ossil: Permit Licen.t
Issuing.luthorits (circle unei:
' I. Board of'Ilealth 2. Buildintv, Department 3.tit. Iinsn( Ierl 4. Electrical Inspector 5. Plumbint Inspector
6.Other
Contact Person: Phone�: