Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
32A-216 (4)
69 POMEROY TER BP-2017-1207 GIS#: COMMONWEALTH OF MASSACHUSETTS Mao:Block: 32A-216 CITY OF NORTHAMPTON Lot -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGLLcc.1144/2�A) Category: INSULATION BUILDING PERMIT Permit# BP-2017-1207 Project# JS-2017-002035 Est.Cost: $3000.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Grouo: ENERGIA LLC 92540 Lot Size(sq. ft.): Owner: MORRIS JOANNA A Zoning: URC Applicant: ENERGIA LLC AT: 69 POMEROY TER Applicant Address: Phone: Insurance: 242 SUFFOLK ST (413)322-3111 WC HOLYOKEMA01040 ISSUED ON:4/25/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATION -ATTIC FLOOR OPEN BLOW CELLULOSE 4" TO R49 WALLS DENSE PACK CELLULOSE 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 ft 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: FeeType: Date Paid: Amount: Building 4/25/2017 0:00:00 $100.00 212 Main Street, Phone(413)587-1240.Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File k BP-2017-1207 APPLICANT/CONTACT PERSON ENERGIA LLC ADDRESS/PHONE 242 SUFFOLK ST HOLYOKE (413)322-3111 PROPERTY LOCATION 69 POMEROY TER MAP 32A PARCEL 216 001 ZONE URC THIS SECTION FOR OFFICIAL USE ONLY: : PERMIT APPLICATION CHECKLIST NCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out / Fee Paid Typeof Construction: INSULATION-A IC F OR OPEN BLOW CELLULOSE 4" TO R49 WALLS DENSE PACK CELLULOSE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 92540 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:¢ 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 D- •lition D- . #nr 25-- Sig • o u ng lffi ml 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. Version1.7 Commercial Building Permit May 15,2000 Department use only _ — City of Northampton Status of Permit j Building Department Curb Cut/Driveway Peng - 212 Main Street Sewer/Septic Availability AFR 4 Room 100 WaterNYed Availability orthampton, MA 01060 Two Sets of Structural Plans _\__.. pbej�e 4 3-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 69 Pomeroy Tem Map 3a4 Lot a./Ca unit Northampton, MA 01060 Zone Overlay District Elm St.District GB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Joanna Moths 69 Pomeroy Tea. Northampton, MA 01060 Name(Print) Current Mailing Address'. (617)459-3026 Signature Y!e T1ur[cO -�O^fi\ Telephone 2.2 Authorized Agent: Tom Rossmassler/Energia LLC 242 Suffolk St. Holyoke,MA 01040 Name(Print) Current Mailing Address: (413) 322-3111 Signature Telephone SECTION 3-ESTI TED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $3,000.00 (a)Building Permit Fee 2. Electrical $000 (b)Estimated Total Cost of Construction from (6) 3. Plumbing $000 Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection $0'0 4,9I /�- 7 6. Total=(1 +2+3+4+5) 'S Odn- 00 Check Number 4, T`D `VV This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date Versionl.7 Commercial Building Permit May 15,2000 SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations 0 Existing Wall Signs 0 Demolition Repairs Additions ❑ Accessory Building El Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other 0 Brief Description Insulation- Attic Floor Open Blow Cellulose 4" to R49 Walls Dense Pack Cellulose Of Proposed Work: SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A-1 ❑ A-2 ❑ A-3 ❑ 1A I ❑ A-4 0 A-5 0 1B ❑ B Business 0 2A ❑ E Educational ❑ 2B I ❑ F Factory 0 F-1 ❑ F-2 0 2C ❑ H High Hazard 0 3A I ❑ I Institutional ❑ I-1 0 1-2 0 1-3 ❑ 3B ❑ M Mercantile 0 4 ❑ R Residential 0 R-1 0 R-2 0 R-3 0 5A 0 S Storage 0 S-1 0 S-2 0 5B 0 U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) a 1° 2nd 2nd 3m 3rd 4m 4m Total Area(sf) Total Proposed New Construction(sf) Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public 0 Private 0 Zone Outside Rood ZoneD Municipal 0 On site disposal system Version 1.7 Commercial Building Permit May 15,2000 S. NORTHAMPTON ZONING 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 oa Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW 0 YES 0 IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading.excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: N/A Not Applicable D Name(Registrant). N/A Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): N/A Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Torn Rossmassler Not Applicable D Company Name. Energia LLC Responsible In Charge of Construction Tom Rossma sler Address (413) 322-3111 Signature Telephone Version!.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes O No O SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Joanna Morris as Owner of the subject property hereby authorize Tom Rossmassler/Energia LLC to act on my behalf, in all matters relative to work authorized by this building permit application. SF_G- 'p&2MtT IEk T FI-O 04/21/2017 Signature of Owner Date Tom Rossmassler 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. Signed under the pains and penalties of penury. Tom Rossmassler Print Name 04/21/2017 Signature er/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Rower, Tom Rossmassler 92540 License Number 242 Suffolk$i. Holyoke, MA 01040 09/02/2017 Address Expiration Date (413)322-3111 Signature Telephone SECTION 13-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 O No O ® r BUILDING PERMIT AUTHORIZATION FORM w1Cr � E Q11l1 G J ,owner of the property located at (Owner's Name,printed) GC} Vcrr G ler(acC' Ncr +hCMrt)r, M/+ cicCe (Property Street Aress) (City/Town) hereby authorize Thomas Rossmassler of Energia, LLC. to act on my behalf and obtain a building perms to perform insulation/weatherization work on the above named property Owner's Signature Telephone Number 1t- rq . -°1 Date The Commonwealth of Massachusetts Department of Industrial Accidents I. —5l = 1t,= Office of Investigations ,J_ 600 Washington Street — Boston,M4 02111 —'t www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Energia, LLC. Address: 242 Suffolk Street City/State/Zip: Holyoke, MA 01040 Phone#: 413-322-3111 Are you an employer?Check the appropriate box: Type of project(required): 1.El I am a employer with 24 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8, ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance., 9. 11]Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their ILD Plumbing repairs or additions myself [No workers' right of exemption per MGL Y comp. 12.1: Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.® Other Insulation comp.insurance required.] *My applicant that checks box ft I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: HDI - Gerlinq America Insurance Company Policy#or Self-ins. Lic.#: EWGCR000186816 Expiration Date: 7/1/2017 Job Site Address: co R Pnr ttrota to cc• City/State/Zip: ts.10c\anttrn QtOf tMW Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). OiOIpO Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D for insurance coverage verification. I do hereby certt& der the pains and penalties of perjury that the information providedA•�hove iS true and correct Signature: Date: Z/ Phone ft: 4 3-322-3111 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. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: A O IJ CERTIFICATE OF LIABILITY INSURANCE �5J2MMi0oN""' 016 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; IT the certificate holder Is an ADDITIONAL INSURED,the poiicyfes)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 fights to the eart(flcata holder In lieu of such endorsements). PRODUCER tattle"Mary Conroy James J. DoWd and Sons Insurance Agency Inc. FAX 14 Bobala Road EXa:413-53&-7444 (AIC,NPI: Holyoke MA 01040 ES:mconvov dowd.Com CUSTOMER HT ENE.RT.LC-01 _ INSURERS)AFFORDING COVERAGE NAICe INSURED INEUR RA:RDI-QPrlinq AEIerica Insurance Compal Energia, LLC INSURER Et:Torus National Insurance Company 25496 242 Suffolk Street HOlycke HA 01040 RIMIER c: INSURER D: INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER:2034052479 REVISION NUMBER: THIS IS TO CERTIFY THAT THE PoLICIES OF INSURANCE LISTED EIEtOW HAVE SEEN ISSUED TONE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO TO ALL HE TERMS IEXCLUSIIONS AND CONDITIONS OF SUCH THE INSURANCE AFFORDED HOWN MAYppH�CAYVV�EPpPBEENI RRJEpDU�CCED BY PHEREIN ID CLAIMS OBJECT 1119 IYPE OF INSURANCE ,mae WOK POLICY NUMBER RNNDIYYYY POmD1YYYY) LIMITS MM A GENERAL MOUE( Y Y roccR009186b16 /112016 1/1/2417 EACH OCCURRENCE 61,040.000 DAMAX.t NGN(CU O X COMMERCIAL GENERAL LIABILITY ,REMISES IEa HAA.Nouse WO,Doo CLAIMS,MAOE n OCCUR MED EXP(My one person) PERSONAL a ADV INJURY 51.000,000 GENERAL AGGREGATE 52.000.000 OWL AGSRF.GATEoWATAPPLUES PER: PRorpiCTS.COMMA AGE 52.000,000 POLICY X Tart LOC $ A AUTOMOBILE UABIUTY Y Y PSGCR000:06e16 7/1/2026 7/)/201] COMBINED SINGLE LIMIT 51.000,000 (Ea accident) ANY AUTO SO OILY INJURY(Perpason) E ALL OWNED AUTOS — " DUULY INJURY{Porfl¢Meyl) S X SCHEDULED AUTOS PROPERTY GARAGE ' T HIRED AUTOS IPUr acddent) 5 X NON.OWNED AUTOS _ S .... X UMBRELLA LUe _ OCCUR Y Y 85393N15021.3 7/1/2016 7I1f30.17 EACH OCCURRENCE 41,000,000 EXCESS 1.1A9 I CLAMS-MADE AGGREGATE 51,000,000 _ DEDUCTIBLE __ S E RETENTION $10.000 A ',YDR{{ERBLDNPSNBANIN Y EM.CR0003868167/1/2016 7/3/2017 X TOay°Masi OER TR. ARDERSURJT ABY Y ANYPRCPRIEROPRIETORIPAttMEINEXE¢rtNC N!A Et-EACH ACCIDENT 31.000,000 OFFICER/MEMBER BER EXCLUDE"; IMMdelpry In NH) E.L.DISEASE-EA EMPLOYEE 53.000,000 IIyO de TiCN uOdEr Og6LRIPTION OFQPFRATIGN6 SHAW E.4 DISEASE-POLICY OMIT 51.000.000 • DESCRIPTION OF OPERATIONS I1.00AT1ONSf VEHICLES IMNINA ACM Wt,AddlttaWRemarka SthedWadfmorUpett Is requlmdl CERTIFICATE HOLDER CANCELLATION 30 SHOULD ANY THE ABOVE DESCRIBEDPOLICIES CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTION WILL BE DELIVERED ED IN ACCORDANCE WITH THE POLCY PROVISIONS, AUTHORIZED REPRESENTATVE row 414,fp. 01888.2005 ACORD CORPORATION. All rights received, ACORD 25(2008H}e} The ACORD name and bgo are registered marks of AGGRO Your oral Energy Efficiency Esperf ©_ItorqtaUS,corn April 18, 2017 Commissioner Hasbrouck RE: Request for Waiver I request that you grant a modification to waive the requirement for control construction for 69-79 Pomeroy Terrace in Northampton because the work is of a minor nature, will not affect health, accessibility, life and fire safety, or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work. All work will be completed within the prescriptive requirements of 780 CMR. Thank you for your consideration. "Mass Amendments, sections 107.1 allows for an exclusion from control construction for this project" Please feel free to contact me by telephone at (413) 326-1860 or by email at tomrna EnergiaUS.com. Respectfully, Tom Rossmassler President & CEO r - 11 - u o tee , 'o o e ' if 0 , I ner•ial .com CrY" „ S /r./1, Aur/6 ---------- - a. k.�'—� Office of Consumer Affairs&BSness Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Exxpistraaon 165169 Type: Office of Consumer Affairs and Business Regulation piration 1/112010 LLC 10 Park Plaza Suite 5170 Boston,MA 02116 ENERGIA LLC THOMAS ROSSMASSLER 242 SUFFOLK STREET ls,.=s.vf„—` HOLYOKE,MA 01040 Undersecretary Not valid without signature i . Massachusetts Department of Public Safety ®-r Board of Building Regulations and Standards License: CS-092540 Construction Supervisor THOMAS BROSSMASSLER 100 MAIN STREET g HATFIELD MA 01030 c NI....-4r n Expiration: Commissioner 0 910 212 017