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30A-084 BP-2024-0293 7 HIGH MEADOW RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30A-084-001 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-2024-0293 PERMISSION IS HEREBY GRANTED TO: Project# ADDITION 2024 Contractor: License: Est. Cost: 167825 KEITER CORPORATION 102457 Const.Class: Exp.Date: 06/20/2024 WOODSON, WENDY W. &POGGENPOHL, ERIC H. Use Group: Owner: TRUSTEES Lot Size (sq.ft.) Zoning: SR/WSP Applicant: KEITER CORPORATION Applicant Address Phone: Insurance: 35 MAIN ST, 2ND FLOOR (413)586-8600 MCC20020005382022 FLORENCE, MA 01062 ISSUED ON: 03/22/2024 TO PERFORM THE FOLLOWING WORK: NEW 1 STORY ADDITION 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: $1,091.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner Z c,t( c/ File #BP-2024-0293 APPLICANT/CONTACT PERSON: �� v"tki PROPERTY LOCATION 7 HIGH MEADOW RD MAP:LOT 30A-084-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $1,091.00 Type of Construction: NEW 1 STORY ADDITION 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 INFORMATION PRESENTED: !/Approved Additional permits required(see below) For all projects that need additional reviews +.1:4::;:E as checked below,please see the Office of Planning& Sustainabilitv Permit page or scan here - fit' '; 7,437 PLANNING BOARD PERMIT REQUIRED UNDER:§ 0 T Intermediate Project: Site Plan AND/OR _ Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* 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 // 2 3- z1 zorti Signature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to 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. �C , The Commonwealth of Massac�huset s:•.e '? J • E , Board of Building Regulations and Standq',4-, 8 ('. R €: Massachusetts State Building Code, 780 C 4.�, <'De, / ICI E ITY Building Permit Application To Construct,Repair,Renovate O(t5 ish a /Revis d Mar 2011 One-or Two-Family Dwelling '':zoFc,:. This Section For Official Use Only o,vS Buildin Permit Number: 1 '1 elf" a43 Date Applied: ';/' l 3• Z Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 7 High Meadow Lane, Northampton, MA 01062 30A 30A-084-001 1.1 a Is this an accepted street?yes 0 no 0 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: WSP 103,237 SF 125 FT 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 40 FT >100 FT 30 FT +/-62 FT 60 FT >100 FT 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public El Private❑ Zone: _ Outside Flood Zone? Municipal❑✓ On site disposal system 0 Check if yes!: SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Eric Poggenpohl and Wendy Woodson Northampton, MA 01062 Name(Print) City,State,ZIP 7 High Meadow Lane 413-374-5041 eric©photodesk.com No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction El Existing Building❑ Owner-Occupied❑ Repairs(s) ❑ Alteration(s)❑ Addition n Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work':New 1 story addition to an existing single-family residence.Art studio with crawl space frost wall foundation on south side and connector addition. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $153,445 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ 6,080 ❑Total Project Cost3 (Item 6)x multiplier 167.825 x 6.5 3. Plumbing $ 0 2. Other Fees: $ 4.Mechanical (HVAC) $ 8,300 List: 5.Mechanical (Fire $ 0 Suppression) Total All Fecs: $ Check No.(f ta) Check Amount: $1,091. Cash Amount: 6.Total Project Cost: $167,825 EPaid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-102457 6/20/2024 Scott Keiter License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 35 Main Street No.and Street Type Description FlFlorence, MA U Unrestricted(Buildings up to 35,000 cu.ft.) orence,Town,State,A 01062ZIP R Restricted 1&2 Family Dwelling CityM • Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-586-8600 skeiter@keiter.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 175168 4/28/25 Keiter Corporation HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 35 Main Street skeiter@keiter.com No.and Street Email address Florence, MA 01062 413-586-8600 City/Town,State,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 Q✓ No 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 authorize Keiter Corporation to act on my behalf,in all matters relative to work authorized by this building permit application. Scott Keiter 03/18/2024 Print Owner's Name(Ele onic 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. ru Scott Keiter 6s 03/18/2024 Print Owner's or Authoriz 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.) 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" t City of Northampton Massachusetts ��'� WY tti 1 DEPARTMENT OF BUILDING INSPECTIONS S ( ' ' : 212 Main Street • Municipal Building 0& _...4 Northampton, MA 01060 .y`,' ''4 `4 '�*•C 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: Valley Recycling Location of Facility: 234 Easthampton Road, Northampton, MA 01060 The debris will be transported by: USA Waste Name of Hauler: USA Waste _________rp__4z Signature of Applicant: Date: 03/18/2024 Contractor may, without prejudicing any other remedies Contractor may have, give written notice of termination of the Agreement to Owner and demand payment for all completed work and materials ordered through the date of work stoppage, and any other reasonable loss sustained by Contractor, including Contractor's profit and overhead at the rate of twenty percent (20%)on the balance of the incomplete work under the Agreement. Thereafter, Contractor is relieved from all other contractual duties, including all Punch List and warranty work. RIGHT TO TERMINATE CONTRACT If the work is stopped or delayed,either in whole or substantial part, for a period of thirty(30) days under an order of any court or other public authority having jurisdiction,or as a result of an act of government and due to your fault or negligence, or as a result of an act within Owner's control;or if the work shall be stopped or delayed either in whole or substantial part, for a period of thirty(30)days due to Owner's failure to make a payment on time, or make Contractor feel insecure, or if Owner should commit a material breach of any of Owner's responsibilities or obligations under this Agreement, then Contractor may, upon giving Owner seven (7) days written notice, terminate this Agreement and recover from Owner payment for all work performed; for any unpaid costs of and fees for the work; for any liability, obligations, damages, commitments, and/or claims that Contractor may have incurred or might incur in good faith in connections with this Agreement, as well as receiving payment for Contractor's attorney's and legal fees and all lost anticipated gross profits on the work not performed as of the date of the termination. NOTICE Notice will be deemed if delivered in hand or if sent by certified mail, return receipt requested,to the address listed on the front page of this Agreement. ARBITRATION THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN TH.E EVENT THE CONTRACTOR HAS A DISUPUTE CONCERNING THIS CONTRACT, THE CONTRACTOR MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION,SERVICE WHICH HAS BEEN APPROVIED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF, CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN MASS.GENERAL LAWS,C.142A. KEITER CORPORATION OWNER (CONTRACTOR) p*DocuSignedby: 50,ey -. A .4„ Fwb 26, 2024 fc. po ,foca, '�-- M4.3.014J164?F... By Scott Keiter,Chief Executive Officer Date Date Date NOTICE THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLEMENT INITIATED BY THE CONTRACTOR. THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOi.1.1TION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE yes SK Contractor Owner �____ DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. THIS IS A LEGALLY BINDING AGREEMENT. IF THERE ARE ANY PROVISIONS WHICH YOU DO NOT UNDERSTAND, YOU SHOULD CONSULT WITH AN ATTORNEY BEFORE SIGNING. KEITER CORPORATION OWNER (CORPORATION) r--OocuSigned t ' a_e -a/ 2.,„,z Feb 26, 2024 fr;G port tnioL, By Scott Keiter,Chief Executive Officer Date C Date ADDENDA & EXHIBITS The following exhibits and addenda have been attached to this Agreement and as such are included as part of this agreement: Exhibit I SOW_020524 Poggenpohl CD Budget Exhibit 2__Drawings 240116 HIGH MEADOW CD PRICING SET Exhibit 3_Poggenpohl Schedule 2.7.24 Exhibit 4__Poggenpohl Logistics Plan Exhibit 5_Poggenpohl Logistics Detail Exhibit 6_Poggenpohl SSSP Exhibit 7_Evidence of Insurance 2023 -2024_ Keiter Corporation Owner Information: Email Eric:cric@photodesk.com Email for Wendy: wwoodson(camherst.edu Owner Phone: 413-374-5041 r--os fP 12 SK Contractor Owner The Commonwealth of Massachusetts t. > Department of Industrial Accidents g w» : 1 Congress Street.Suite 100 "1 —"' ' Boston, MA 02114-2017 via* poy. )cwtt'ntass.gov/dla Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PE101I'I l t ;A1J'IIIORITY. Applicant Information Please Print Leeihly Name(IffusiacssIkgarnautiotntndiaiduat):Keiter Corporation Address: 35 Main Street CityiState/Zip:Florence, MA 01062 Phone#: 413 586-8600 I Are)ou an empl.ytr2 Cheek the appropriate boat Type of project (required): l 13 I am a employ x with 83 employees(full and'or part•time).• 7. New construction 201 am a soli proprietor or oartr rshin and have nto entatoVe s working for me in K. Q Remodeling any capacity (No workers'coanp insurance tequinttd) 301 am a heinuso rater lining all work myself.(No wonter3 comp.irnu:.tnce required.)' 9. El Demolition 4.0 1 am a honeownet and will be hiring o.ntraetors to conduct all work on my property I will 10 a Building addition ensue%lift;all monsoon either have workers'tyrtrpenssboa insuranx or are sole I I.� Electrical repairs or additions pntprietoa with rna employees. 12.:Plumbing repairs or additions 50 I am a several contractor and 1 Isavc kited the sub-contractors listed on the attached sheet. 13❑Roof repairs These sub.eonlractors late employees and Iacomp"e workers'comp rnsuraree• P 6.0 We are a corporation and its officers ha%a exercised their rigs;of exemption peer AfUL 14.0 Other 152.¢1(4).and we have no employees.[No workers'comp.insurance required) *Any applicant that chocks"b x sl mist also till out the section below showin them+orkers'compensation policy infxrnation. t tiomeowne:.s veto submit this affidavit indicating they arc doing aft work and then hire outside eon:ract.ra must submit a new affidavit indica5ng such. :Contractors that cheek this box must attached an additional shed showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have etrgttcyiea.they must providk their workers'comp policy number. l am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. MA Employers/AIMInsurance Company Name Policy#or Self-ins. Lie.#:MCC20020005382023A Expiration Da:e:6/11/2024 Job Site Address: 7 High Meadow Lane CitYt Star Zi Northamp ton, MA 01062 '` P: _.._ __. Attach a copy of the ssorkers'compensation policy declaration page (showing the policy tiumber 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 5250.00 a day against the violator.A copy of this statement may be fsrwarded to the Office of Investigations of the DIA for insurance coverage eritication. I do hereby certify under the pains and penalties alperjury that the information provided above is true and correct. Sionantre: `: Date: 03/18/2024 Phone#.413-586-8600 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): I. Board of Health 2. Building Department 3.Cityll`own Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other ACORN® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/30/2023 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 Cyndie Henderson CISR,CPIA NAME: Alera Group,Inc. (PAHONr o,E:t): (413)586-0111 FAX No): (413)586-6481 (A/C, Webber&Grinnell Division E-MAIL chenderson@webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA: Selective Ins Co of S Carolina 19259 INSURED INSURER B: MA Employers/A.I.M. 12886 Keiter Corporation INSURER C: Attn:Scott Keiter INSURER D: 35 Main Street INSURER E: Florence MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER: Master Exp 2024 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 SUBR POLICY EFF POLICY EXP LIMITS LTRINSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RD CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 15,000 A S2265567 06/01/2023 06/01/2024 PERSONAL 6ADVINJurty $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JE LOC PRODUCTS-COMP/OPAGG $ 2,000.000 OTHER: _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED A9105217 06/01/2023 06/01/2024 BODILY INJURY(Per accident) $ _ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _ AUTOS ONLY (Per accident) Medical payments $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS-MADE S2265567 06/01/2023 06/01/2024 AGGREGATE $ 10,000,000 DED X RETENTION$ O ' WORKERS COMPENSATION X STATUTE X ER OTH AND EMPLOYERS'LIABILITY Y/N 1,000,000 B ANYPROPRIETOR/PARTNER/EXECUTIVE N/A MCC20020005382023A 06/11/2023 06/11/2024 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? I 1000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ , If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Waiver of Subrogation can be obtained should Insured win the bid for project. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN "" Evidence of Insurance "" ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. 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H Hf a t.: ■ y OC 0 0 g .. .t$ N Sol In�'�a __ I . : O U 2 m U OMz—1.-,'2, c2 'A e no, N e *** FOR REVIEW*** o VERIFY ALL CHECKED ITEMS PRIOR TO ORDERING Meese cal:with any a.eat ono 00 concern 4001032.60119 debt depth changed Beam sires dinged Iran speclfcatlon deist dtrectbn changed Steel to flitch beams by others moueed "Joist series charged FWN beams deeper than floor Pants Joist spacing charged Verify Post and or column locations Beams added for structural reasons "Posts added(see notes on plat • II Mid span bodging ittammendN s,,est!.:Wits aM 1'-ti:n ie+ym• Verily design coterie 0 ! 'been used ME BC FRAMER .'Note high deflect Verify i naming at fireplcr.ace Connection by others ref 0 ::Verily framing at stairwell " . ROOF AND HEADER LAYOUT 7 Additional information required to complete Joist layout X Shop drawing Is an estimate only,not for construction i 04'D." -Based on truss roof system BY OH sk+aa,ra:...........__._�___..__. D,xe:................._..._.._......... 6'77G_.,roS.A....................._..... ALL JOIST AND BEAM SIZES ARE TO BE REVIEWED AND APPROVED PRIOR TO ORDERING MATERIALS AND STARTING CONSTRUCTION. rhos' ,,