17A-135 Office of Consumer Affairs and _usiness Regulation
--" 10 Park Plaza Suite 5170
Boston, Massachusetts 02116
Horne improvement Contractor Registration
Reqistration: 171504
Type: DBA
Exp;ration: 3/2612014 T 222547
a, 0 HOME REMODELING
CHARLES THOMPSON
997 TINKHAM RD
. -
IVILBRAHAM, MA 01095
Update Address and return card. Mark reason for change.
Address E — Renewal -, Employment Lost Card
5,:: 1C "21E,
,7,443 ywea
Office o Consumer Affairs & Business Regulation License or registration valid for indiviclul use only
, IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Regtstrat on: 171504 Type: Office of Consumer Affairs and Business Regulation
Expiration: 3126/2014 DBA 10 Park Plaza - Suite 5170
SPAon,, MA 02116
C-1-)ME REMODELING:
THOMPSON
TiNKHAM
_ _
1,11...SSAriAM, MA '..)1095 Undersecretary Not valid without signature
.�:......
A
-----"N ® CERTIFICATE OF LIABILITY INSURANCE J DATE 2 0 z
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 POUCIES
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 certlficate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER P 617- 924 -1100 Fax 617 - 926 -2162. NNMEE: _
Bradley S. Michels Insurance r .EM), P 617- 924 -1100 _ ] ( Fax 617-926-216
19 Main Street @ AD M D A RESS: _ —
Watertown, MA 02472 INSURER!) AFFORDING COVERAGE NAIC s _
Robert Tuttle �._ INSURER Arbella Insurance Company _
INSURED INSURER B : AIM Mutual.. Inc.
J & C Home Remodeling INSURER C : _ T
997 Tinkham Road eeSURERD:
Wilbraham, MA 01095 INSURER E :
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON 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.
ADM BURR POLICY EFF POUCY EXP
LIR TYPE OF INSURANCE IRK STUD POLICY NUMBER ( MIDD/YYYTTI 1 ! MIDDP/TYYI LIMIT
GENERAL LIABILITY EACH OCCURRENCE $ 1.000.000
A DAMAGE TO RENTED nr�
1 COMMERCIAL GENERAL LABILITY PREMISES (Ea ncrJarax:e) f 100.000
1 CLAIMS-MADE [] OCCUR TBD2012 06/21 /2012 06/21/2013 MED EXP (Any one person) $ 5.000
PERSONAL & ADV INJURY f 1.000.000
- GENERAL AGGREGATE $ 2.000.000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2.000.000 -,
i POLICY ri 28-T ri Lac $
AUTOMOBILE UABLITY COMBINED SINGLE UNIT f
Me accident] ANY AUTO { ! BODILY INJURY (Per pelam) $
ALL OWNED SCHEDULED { BODILY INJURY (Per accident) $
AUT AUr03
HIRED AUTOS AUTOS (Per PROPERTY DAMAGE f
$
- UMBRELLA LUtB OCCUR EACH OCCURRENCE $
EXCESS UAe CL*UMS -MADE AGGREGATE S DED l
' _ RETENTION f f
WORKERS COMPENSATION / ( WC SA TU - 1 OT H-
AND EMPLOYERS' LJABIJTY Y / N ♦ TPttRY J t IM ITC FR
B OFFICER/MEMBER EXCLUDED'/ ECW1VE 1 N' NIA TBD2012 06/21/2012 06/21/2013 E.L EACH ACCIDENT $ 100.000
(Mandatory M NH) E.L. DISEASE - EA EMPLOYEE $ 100.000
DESCRI T1ON OF OPERATIONS befog E.L. DISEASE - POUCY LIMIT f 500.000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 1e1, Additional Remade SehedWS I more space Is required)
For operations to be performed at Hathaway Farms, 73 Barrett Street, Northampton, MA 01501. Spear
Management Group, Inc. 319 Southbridge, Auburn, MA / Hathaway Farms Townhomes of 73 Barrett Street,
Northampton, MA / Hathaway Farms Townhomes Limited Partnership, 319 Southbridge Street, Auburn, MA /
Spear Hathaway LLC, 319 Southbridge Street, Auburn, MA are listed as additional insured for liability. This is
based on $1,000,000 per occurance/ location limit.
CERTIFICATE HOLDER CANCELLATION
Spear Management Group, Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
A Massachusetts Corp ACCORDANCE WITH THE POLICY PROVISIONS.
319 Southbridge Street
Auburn, MA 01501 AUTHORIZED REPRESENTA ■
I
®1988- COR , C ON. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACO
li
f ufl Name: ~`. "" ..... . DAV1' W COR EIRA
ender"
-r Name:
• • ress: 98 RAPE S t R T TS a I II.,..�.n. . .- ,....
ddress 2:
qty: Chicopee
tate: MA
� '• •ie: 01013
nt red :t?
icense No CS-072783 License Type: ` Construction Supervisor
`rcfession: Bui Licenses Date of Last Renewal: 1/27/2012
ssu►e Date: 21 120 0 Expiration Data: 1/6/20t4
loans*, Status: Active Today's Date: 7/20/2012
econry License:
soirig Susrness As:
- e - r: information
Na P emu,= ise ! fo r=n� �.
s r '•li ° inf.rr •
•
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : f) C c, !'`r rt.. t µ- C r) 8
License Number
(L, c , -,per k, I C. a—= > PA.
•
Address Expiration Date
Signature Telephone •
9. Registered Home Improvement Contractor: Not Applicable ❑
--• \ r Vb e 1 C � , � U P . ', S V ��, ,�/'v 11 �... f 1 5A
Company Name Registration Number
Address cI Expiration Date
9 °t'\ 1 . +�tCLn .. �c�- � TelephoneL i I (•)' - A*,`F
SECTION 10- 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. • I Signed Affidavit Attached Yes No ❑
•
11. Home Owner Exemption •
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own 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 homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to .
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ ( Replacement Windows Alteration(s) ❑ Roofing
Or Doors El •
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [EI Siding [0] Other [0]
Brief Description of Proposed
Work: 5 r (7 ray I - N 1 , , i R/. A. = . -v,''' -k 0+r ,..J evc.-c
Alteration of existing bedroom Yes a No Adding new bedroom Yes ) C, No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a. If New house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories? •
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1 ` ..tC/ C C Pf , o z�. as Owner of the subject
Prop
hereby authorize Y?SiX42 t '
to act on my be in m ers relative to work autlibrized by this building permit application.
Signature of Owner Date ,
1, Q \■ ( - ,,''. ‘ _v c ,( -'-- , as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
S d under the pains and penalties of perjury.
i cr z 1
Signature of Owner /Agent Date
Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location)
A. Has a Spe al Permit /Variance /Finding ever been issued for /on the site?
NO DON'T KNOW 0 YES
IF YES, date issued:' •
IF YES: Was th permit recorded at the Registry of Deeds?
NO DON'T KNOW 0 YES
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO '
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excav tion, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
•
Department use only.
I -- = City of Northampton tat of P rrrr�t
uilding Department Curb Cut /Dr Pert
AUG - 3 2012 212 Main Street ewer) p cAvall Availability Room 100 WaterIU ell Availabilityy
nE OF c:.TC, _" Northampton, MA 01060 1"etsof Structuf
NORTHAMI- _ . ..A 0 � 060
�
ptiori 41 587 -1240 Fax 413- 587 -1272 Pla#tSite Plan ` � s
Other Specify I" '}..
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Pro ert Addres This section to be completed by office
S lU Ma Lot Unit
F (0 1.,e. ce 444 D( 062 Zone Overlay District
Elm St. ,District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Rec r
` �Z\-Ci4A ai800 30.14c -f-b)a{-4JTf 2‘(_S deg F %J'eAce /)1/k
Name Currentg A�; -`y (2\k Telephone S
Signature
2.2 Authorized Agent:
C V.—L. - tt \ N. �• k r `� `� ^� , .� �` ._ n <.. { (, , � 1„ r t, ,M m4
Name (Print) Current Mailing Address: C.tc"S
- , t - ..-_, ° - 1, t - 5 - - k t - (n 9 3 (
SignatGr e \`� -.) Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant .
1. Building 3 7 (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6) - ) S c , U r.
3. Plumbing Building Permit Fee
•
4. Mechanical (HVAC)
5. Fire Protection /
6. Total= (1 +2 +3 +4 +5) Check Number , 41 '',3.-
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
•
245 CHESTNUT ST BP- 2013 -0134
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A - 135 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ROOF BUILDING PERMIT
Permit # BP- 2013 -0134
Project # JS- 2013- 000217
Est. Cost: $8750.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Groin J & C HOME REMODELING 72783
Lot Size(sq. ft.): 23478.84 Owner: SOUTH CHESTNUT LAND TRUST C/O RICHARD ABUZA
Zoning: URA(100)/ Applicant: J & C HOME REMODELING
AT: 245 CHESTNUT ST
Applicant Address: Phone: Insurance:
997 TINKHAM RD (413) 324 -6930 WC
WILBRAHAMMAO1095 ISSUED ON:8/6/2012 0:00:00
TO PERFORM THE FOLLOWING WORK: STRI P & SHINGLE ROOF
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeT Date Paid: Amount:
Building 8/6/2012 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner