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16C-038 (2) 370 SPRING ST BP-2019-0505 GIs#: COMMONWEALTH OF MASSACHUSETTS MQ Block: 16C-038 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2019-0505 Proiect# JS-2019-000824 Est.Cost: $18308.00 Fee: $123.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: WRIGHT BUILDERS 106505 Lot Size(sa.ft.): 291764.88 Owner. REMICK SCOTT W&ANNE O SCHLERETH Zoning:URA(lO0)/WSP(3D/ Applicant. WRIGHT BUILDERS AT: 370 SPRING ST Applicant Address: Phone: Insurance: 48 Bates St (413) 586-8287(116) Workers Compensation NORTHAMPTONMA01060 ISSUED ON:10/25/2018 0:00:00 TO PERFORM THE FOLLOWING WORK:MINOR RENOVATION TO CHANGE A STUDY TO A BEDROOM 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: FeeType: Date Paid: Amount: Building 10/25/2018 0:00:00 $123.50 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0505 APPLICANT/CONTACT PERSON WRIGHT BUILDERS ADDRESS/PHONE 48 Bates St NORTHAMPTON (413)586-8287(116) PROPERTY LOCATION 370 SPRING ST MAP 16C PARCEL 038 001 ZONE URA(100)/WSP(31)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid V S Typeof Construction: MINOR RENOVATION TOKUN-r2EETUDY TO A BEDROOM New Construction Non Structural interior renovations Addition to ExistingL Accessory Structure Building Plans Included: Owner/Statement or License 106505 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 Demolition Delay 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. MEMO To: Louis Hasbrouck Northampton Building Dept. Date: 10/24/18 From: Linda/Wright Builders Re: Permitting for: Remick Residence—Remodel 370 Spring Street Florence, MA 01062 Hi Louis, Regarding initial plan review items: 1. Smoke and CO per current code because you're adding a bedroom. Code has changed a little since 2001. See plan notes (attached) Existing devices are in place. Our electrician will confirm they are photoelectric type and revise as needed to meet current code. 2. Spring St does have sewer, but if the house is on a septic we need a plan to show the Heath Department. The system needs something like 330 gal per day capacity for 3 bedrooms. Confirmed the house is on city sewer. 3. Size of bedroom window; double hung min 20" x 24" clear opening, casement minimum 5.7 sf. Confirmed existing double hung window has min 20"x 24"clear opening. Best regards, Linda Gaudreau Wright Builders Department use only City of orth 3mpton Status of Permit: OCT 2 4giin Dep rtment Curb Cut/Driveway Permit 212 ain treet Sewer/Septic Availability. I `l. m 1 0 Water/Well Availability ofc ORTHAMPTO�Wr�tiN��n, A 01060 Two Sets of Structural Plans AMPT phone -06t-124U ax 413-587-1272 PIot/Slte Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWA'O FAMI}LY DWELLING SECTION 1 -SITE INFORMATION (� r " t BAMv v 1.1 Property Address: This section to be completed by office S�b SIA N6- 5-- Map 0C- Lot 0 � 7 Unit T '� �G w1� Zone Overlay District t� 1_ Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: sKo— 0-"JA 32a SPS N�- sr.T�-tom R �c.E Name(Print) Current Mailing dr / v w Telephone )ignZra�F 2.2 Authorized Ascent: Name(P' ���r�,/`/' ' Current Mailing Address:b f M 03 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS ti G• 7c Y�. Item Estimated Cost(Dollars)to be Official Use Only completed by permit ap licant 1. Building ' f �O O (a)Building Permit Fee 2. Electrical tO / (b)Estimated Total Cost of Construction from 6 3. Plumbing 1 O• �, Building Permit Fee 4. Mechanical(HVAC) X11 5. Fire Protection 6. Total=0 +2+3+4+5) D Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) P��� b-�n� )tJc� Section 4. ZONING All Information Mus�Be fl plated. Permit an Be DeniedaDue To Incomplete Information Existing Proposed Required by Zoning This column to be fille ' by Building Departm Lot Size Frontage Setbacks Front Side L: R: L: Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking S es olume&Location) 110, A. Has a Special Permit/Variance/Findi ever been issued for/on the site? NO Q DONT KNOW YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO '�< DONT KNOW © 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 ® NO 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 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,expavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YESQ NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [E:3] Decks [Q Siding[C7] Other[C] Brief Descriptiop of Proposed Work: Alteration of existing bedroom Yes k No Adding new bedroom X Yes No Attached Narrative Renovating unfinished basement Yes _ No Plans Attached Roll -Sheet 6a.If New house and or addition to existina housina, 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. Dimensio e. Number of stories? f. Method of heating? Fi aces 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 w nds? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or ar floor below finished grade k. Will buildin nform to the Building and Zoning regulations? Yes No. I. S c Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I '�" as Owner of the subject property hereby authorize to act on my behalf, in all ft relative to work authorized by this building permit application. �✓ �� Z !S ig re of Owner Date I, V' P-1,v 14 &f( Voey-a as Owner/Authoriz Agent ereby declare that the statements and information on the foregoing application are true and accurate,to the best o my knowledge an belief. Signed under the pains and penalties of perjury. Print a r "al tcc)) Signator of ner Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Constructi'o�n�Supervisor: Not Applicable ❑ Name of License Holder: v' (—� " 1 �y "ry r "f/T1"/" 16 4y JC License Numb r 1 Address Expiration Date M, a, Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ I1 A�her ti vPef-s `ib 1 S-3 to Company Name Registration Number 0 6�dn Address p� ^ Expiration Date Telephone �o�l 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 bui ing permit. Signed Affidavit Attached Yes....... No...... ❑ The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information I,, Q Please Print Legibly Name(Business/Organization/Individual): Address: 0 B Ste• City/State/Zip: d P Phone#: Are you an employer?Check the appropriate boa: Type of project(required): 1.E]I am a employer with employees(full and/or part-rime).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $.Remodeling any capacity.[No workers'comp.insurance required.] 3.[:]l am a homeowner doing all work myself.[No workers'comp,insurance required.]t 9. El Demolition 4.[:]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10E]Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ p Roof repairs These sub-contractors have employees and have workers'comp.insurance.* 6.[:]We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[:]Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#1 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. ,�t Insurance Company Name: (- A • vA-L, Policy#or Self-ins.Lic.#: MUc►�D�,0005 311,, v`>0 I a K Expiration Date: 3 Job Site Address: 110 5[!"�,1-6- .ST, City/State/Zip: 0/Ob oPl'"' Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce under t ains and peen es of per' ry that the information provided abov is true and correct. Si ature: - Date: Phone#: I i 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: AC40® CERTIFICATE OF LIABILITY INSURANCE DATE3/22/2D/YYYY) 03/22/2018 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(les)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 Jenna Rodrigue,CISR Elite NAME: IX Webber&Grinnell PHONE (413)586-0111 C No): (413)586-6481 8 North King Street E-MAIL jrod6gue@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC A Northampton MA 01060 INSURERA: Arbella Insurance Group 17000 INSURED INSURER B: A.I.M.Mutual Wright Builders,Inc. INSURER C: Attn:Jonathan Wright INSURER D: 48 Bates Street INSURER E: Northampton MA 01060 INSURER F: COVERAGES CERTIFICATE NUMBER: Master 2019 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLILTR TYPE OF INSURANCE INSO WVD POLICY NUMBER MMIDD EFF MSD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A 8500068268 03/01/2018 03/01/2019 PERSONAL&ADVINJURY $ 1,000,000 GEN-LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO-ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 fl OTHER: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY (CEO acddentMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A OWNED XSCHEDULED 1020070845 03/01/2018 03/01/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY Per accident PIP-Basic $ 8,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE 4600068266 03/01/2018 03/01/2019 AGGREGATE $ 5,000,000 DED I X1 RETENTION$ 10,000 $ WORKERS COMPENSATION Q X STA UTE ERH AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICERIMEMBEREXCLUDED? � NIA MCC20020005342018A 03/01/2018 03/01/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Informational Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD City of Northampton ' Massachusetts ' DEPAM NT OF BUILDING INSPECTIONS �. 212 Main Street •Municipal Building u Northampton, MA 01060 XV, 3 jig° Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: -3 9 b �R , (Please print house number and street name) Is to be disposed of at: V�Z�j �.�y c� NGr� �� ��Am�t�r� �• �art"�t (Please print nam and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) ", �( ii A ' Sig re of ermit Applicant or bwner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. Commonwealth of Massachusetts ® Division of Professional Licensure 7' Board of Building Regulations and Standards Constructlibn'Supervisor CS-106505 L'Apires: 11/01/2019 ANN MONICA-LE ^, �{ 231 WEST HA EY RWAqV CHARLEMON MA 018 Commissioner 4 Un Construction Supervisor any use group which contain less than S 000 cuNcf�(991 cubic Meters)of enclosed Space. FaBure to possess a cum edition of the Massachusetts She BuiWinFgar ode is cause tar re1roc�on of this license. Call(6 17)727 ^wM�"a ss.gov/dpl ' 1. Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, M usetts 02118 Home Improv car Registration Tyw carpmadw Regisira don: 101.536 WRIGHT BUILDERS, INC. 48 BATES STREET !� tk 061Z5/�2U NORTHAMPTON,AAA 01060 F �4 rL�M Svlb UpdMMe Address and Retum Card., SCA 1 6 20M-W17 J/Jd N>/s1Y770/X/JiC6l!/i O�✓s77Ok1¢r/kIJA[fe1 Office of Consumer Affairs 3 Business Reguia6on HOME IFAPRO ENT CONTRACTOR Reglabradon valid for individual use only before the axpratIf found mturn to: ExWradon Office of Consurnand Business Regulation _ 0612512020 1000 Washingtonuite 710 1 Y WRIGHT BUIL Boston,P988p.' JONATHANA. 48 BATES NORTHAMPTON,MA Y1060 UndemeaeUuy valid without signature n 17 jt a O- q laa fb Uyda ..�' � ,r q%' If'l� �1�ri�l°�� �,,,.•�41Q �5� F� r�`14t '4�' XZ/j'�j�a i4�;1 '� a�'Y a Ing I i' q ns'ft y�4 n t � n 6 T-1 0i AH ' H a • Q�tc-+`r wc-E-� I ,� x � � � f � o < .X v,—; g p W� N t�+dt w�bSzsfv-' [ . Mum ry o mZ ���I�-.�c�mak,. ( �y����+� � " � _ 3 v� • Owner: rzw g� Lao-'tIT 5FLAtAl'r 4 Project Name: — WC)0© X.1 sm Location: Giizic, cN Co N l�-M EX�� RUA;— .. � s J .. . .of D _ ,�. s A Ot> 15 Date: s { Revisions. PL •. � . � � �—��-�.t� w tet+. , - - . It�-e o Scale: �- vp : or as noted. Approvals: Sheet No. . `� 0f