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23A-225 (3) BP-2024-0456 105 NONOTUCK ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-225-001 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-2024-0456 PERMISSION IS HEREBY GRANTED TO: Project# Contractor: • License: Est. Cost: 0 JOSEPH DENETTE 113824 Const.Class: Exp.Date: 12/30/2024 Use Group: Owner: CLAY SARAH Lot Size (sq.ft.) Zoning: URB Applicant: JOSEPH DENETTE Applicant Address Phone: Insurance: 102 ALDRICH ST (413)563-5759 GRANBY, MA 01033 ISSUED ON: 04/18/2024 TO PERFORM THE FOLLOWING WORK: REPAIR STAIRS TO 2ND FLOOR DECK, NEW RAILING ON FRONT PORCH 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: /06.42. Fees Paid: S65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner , . .` 1 s 2024 The Commonwealth of Massachusetts NI) ' 1 l oard of Building Regulations and Standards FOR *Cle ssachusetts State Building Code, 780 CMR MUNICIPALITY -� o=r INSPr1 sQ USE ?'; ntdttit 'eirnt p lication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 6,''-2. cf.--(7(...c0 Date A plied: 4v11v (ZS /7/ y-1 Z021/ Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers /bS //4fri Ic ,e— 1.1 a Is this an accepted street?yes Y 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: Zone: _ Outside Flood Zone? PublicMunicipal On site disposal system 0 J� Private 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of R cord: s&rah ,/reRte i 170, Name(Print) City,State,ZIP /OS— frtionYeAd 47fige94 � lad? / _. ,aAe E i aft,(E No.and Street Telephone E t Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 1121 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': /� ,Se...o,.ee -case, 66.4 e ). t� 1 on eidy.4 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ SOdd,a) 1. Building Permit Fee: $ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ N ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 4", 2. Other Fees: $ 4.Mechanical (HVAC) $ /// , List: 5.Mechanical (Fire � Suppression) $ Total All Fees: $&.5,o 0 Check No. Check Amount: 6.Total Project Cost: $ cilia DU 0 Paid in Full 0 Outstanding Balance Due: City of Northampton Massachusetts ,?�'` ._ `4 ,i f€ DEPARTMENT OF BUILDING INSPECTIONS i` 212 Main Street • Municipal Building •+fit_ ?'' -" � `� Northampton, MA 01060 p3'gt, 4, 1'' 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. I' r SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Cs^l11 400201 c7l�S' z7p 7 e- License Number Expiration Date Name Holder fool 4/6 °l i� List CSL Type(see below) el No.and Street (J� �/ Type Description /� /f� 3 U Unrestricted(Buildings up to 35,000 cu.ft.) ( 2 „F - ��v� R Restricted 1&2 Family Dwelling City/Town, tate,ZIP M Masonr y RC Roofing Covering WS Window and Siding / SF Solid Fuel Burning Appliances f/2 ler 'Ei4 17ezi/:C491-fl I Insulation Telephone Email address D Demolition 5.2Registered Home Improvement Contractor(HIC) /96.197 cJa E ( '/f t> HIC Registration Number x iration Date HIC Company Name oy HIC Registrant Name No.and Street Email address ee0.43 .03-563-.S7s9 Cityy/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 kir 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 authorize 41..5-r f2 to act on my behalf,in all matters relative to work authorized by this building permit application. ,ce2f4A 1/7/3/10.9 Print Owner's Name electronic Signature) Date SECTION 7b: OWNER1 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. ;74i 2 i 5/7, 7.5/ 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.) 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" 'to l .. h.C.N.- The Commonwealth of Massachusetts — Department of industrial Accidents „... - 1 Congress Street,Suite 100 ...._ Boston, MA 02114-2017 ... ...., WWIStinass.govldia -.--t-5 - 11 takers Compensation Insurance Affidavit: Builders./ContractorsfEtectricianstPlurithers. to HE FILED V4 fill THE PERAWIll'ING At 1/10121 IN. Applicant Information Please Print Legibly e-----,, Name 413usitiessi0.rgantzation'iniltx Awl : %/gas. 9-2, ,4 ...47oejeVi .: _ z Address:1z3k CityiStatelZip: /"'a,4-.4‘, dig ,0/$433 Phone #: <//3 Are yam an employer?t'heck Me apprupriate box: 1)pe tif project(required): 1,0 I am a employer watt .employees(fall and or parg-timet.• 7. j New construction 2.• 4,1,/ lam a sok:proprietor or pannership and have nii employees working for use in g. El Remodeling any capacity.[No um-hers'comp.miainmee roil awed.) 9.. 0 Demolition 30 I am a homeowner doing all work myself.[Na lkotkers`comp.mummy ri..quired.r I 0 D Building addition 4.1:3 tam a hunsCOWItia=Id will be boring contractors go conidiso all work.on tiny mirperry. I will entam:that all L-olgirainors either haw workers'eornp‘msabent insurance or arc WIC 1 1 C Electrical repairs or additions propnetora wish no employe 12.1:1 Plumbing repairs or additions .11:3 1 am a general eummetor and I have hired the sub-contractor.hated on the attache.'sheet, I 3.0 Roof repairs these sab-eontraegors haxe employees and brave workers'comp,insurance,: .Vi- 402ii, ti.0 Vt'e air a coaporanon and As officers ha e exercised diva night of exemption SAW 14 ]Othere.-534 t per _e. J5.2,§1{41,anti we have no employees.[No workers'cOltip.113bUrane.0 TetilaCrett.I 'Any applicant that check%box al must also fill out the wcfaint&ivy.'Awl?,in:r.h,nr ,t oli,-:,'compensation policy rafixinagion t Romeo%tiers who submit this affidavit isitheatimi they are doing all Work am.1 then idle outside contractor's must s ubuut a new affida‘ig indicating :Contractors that cheek this box muai attached an additional sheet showing the name of the sub-contractors and'Eat .r not dam:crimes lta,_ e rtiplo,„ee, ligisc sub-coni: aura II1L c cniFlo:,.,:c,.!he', ntuNi rrm.ILL'V.1,17. .%vi koc-;sx ilir policy number. I am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: — Policy 4 or Self-ins.Lie. til Expiration Date: Job Site Address: City/State'Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to set-Aire coverage as required under MGL c. 152. §25A is a criminal violation punishable by a tine up to$1.500.00 andlor one-year imprisonment.as Well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day against the violator_A copy of this statenwnt may be tbrwarded to the Oflice of Ins est4.1ations of the DIA for insurance coverage verification. I do hereby certify wider the pains and penalties of perjarr that the infOrmation provided above is true and correct. Signature:. 1129,04rZ7. si..."4-1- .."-' Date CiA.-<`7:3^e-lAj6 Phone 4: 'e'l 3- -<-4 3- S-759 .. > Official use only. Do not write in this area,to be Lomplefed by city or town official City or Town: Permit/License# Issuing Authority (circle one): I. Board of health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other ('ontact Person: Phone#: , ,_. N City of Northampton u ‘. Sic Massachusetts /. 'i y DEPARTMENT OF BUILDING INSPECTIONS s 212 Main Street • Municipal Building t "d c, Northampton, MA 01060 �s� a;� CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: . Location of Facility: Ate/ Q,(7 / / 023V C`Q$:T 2ie9,7/ // / ll‘ah lek)i lig .s1,'60 The debris will be transported by: Name of Hauler: Jam. � /?p A Signature of Applicant: Date: /.��Azi City of Northampton Massachusetts w' r,,3 DEPARTMENT OF BUILDING INSPECTIONS a- • 212 Main Street • Municipal Buildings -�- Northampton, MA 01060 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT 1, (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) Client#: 22843 DENJO2 ACORD.o.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/08/2024 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 Samantha DeSantis NAME: Baerman-Jubinville Ins. Agency PHONE 413 538-8293 -"a- 413 538-5970 (A/C,No,Ext): (AM,No): 39 Lamb Street ADDRESS: samanthad@jubinville.com P.O. Box 789 INSURER(S)AFFORDING COVERAGE NAIC South Hadley,MA 01075 INSURER A:Pm/forted Mutual Insurance Company INSURED INSURER B: Joseph E. Denette INSURER C: Joseph E Denette Jr - INSURER D: 102 Aldrich Street INSURER E: Granby, MA 01033 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)_ LIMITS A GENERAL LIABILITY BOP0100728322 02/01/2024 02/01/2025 EACH $1,000,000 PRE X COMMERCIAL GENERAL LIABILITY EaEooau ence) $50,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PET LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION IWC STATU- I OTH- AND EMPLOYERS'LIABILITY 1 TORY LIMITS IER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101.Additional Remarks Schedule,if more space is required) - These are the limits at policy inception CERTIFICATE HOLDER CANCELLATION City of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Inspector ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main St#100 Northampton, MA 01060 AUTHORIZED REPRESENTATIVE C.4{,s,,‘„ R. ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S38939/M38938 SBD