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14-006 (2) BP-2022-0711 390 KENNEDY RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 14-006-001 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-2022-0711 PERMISSIONISHEREBYGRANTED TO: Project# Contractor: License: Est. Cost: WRIGHT BUILDERS 065521 Const.Class: Exp.Date:01/25/2024 Use Group: Owner: DEROSE PETER L Lot Size (sq.ft.) Zoning: WSP Applicant: WRIGHT BUILDERS Applicant Address Phone: Insurance: 48 Bates St 413586-8287 MCC20020005342021A NORTHAMPTON, MA 01060 ISSUED ON:06/15/2022 TO PERFORM THE FOLLOWING WORK: RETAINING WALL 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: $530.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEI VE / , The Commonwealth of Massac,usett. SUN 7 4 Board of Building Regulations an. Stan,.rds 2Q2Z OR Massachusetts State Building Coda, 786.9:•; IPALITY NORT 6UI�DING I SE Building Permit Application To Construct,Repair,Renopypsoc nt�evis d Mar 2011 One-or Two-Family Dwelling �L • This Section For Official Use Only Building Permit Number: , — 1// Date Applied: Ia it i 10, :: Ui eBuildin Official(Print Name) I Signature SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 390 Kennedy Road Leeds, MA 01053 14 006-001 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: WSP Single Family Use 121,968 SF 2100' 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 20' 150'+ 15' 70'+ 20' 200'+ 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private MI Zone: _ Outside Flood Zone? Municipal 0 On site disposal system Ca Check if yes® SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Florence and Peter DeRose Leeds, MA 01053 Name(Print) City,State,ZIP 390 Kennedy Road (413)230-9273 fderose@crocker.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other L41 Specify: Retaining Wall Brief Description of Proposed Work2: Deconstruct existing retaining wall. Relay new stones.Trenching for stone wall bed. Install landscape fabric and traprock. Relocate electrical meters. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 67,638 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 8,025 ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 0 2. Other Fees: $ 4.Mechanical (HVAC) $ 0 List: 5.Mechanical (Fire $ 0 Suppression) Total All Fees: $� 4 .1 T Check N ~J �Ch k Amount: J VCash Amount: 6.Total Project Cost: $ 75,663.00 0 Paid in Full 0 Outstanding Balance Due: $75,G63/1o00 = 75•663 75-. (t)63 ,$ LS7 = cqo-d0 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-065521 1/25/2024 Steven Barrett License Number Expiration Date Name of CSL Holder 97 Federal Street List CSL Type(see below) u No.and Street Type Description Belchertown, MA 01007 U Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-586-8287 sbarrett(awright-builders.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 101536 06/25/2024 Wright Builders, Inc. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 48 Bates Street _ nwright@wright-builders.com No.and Street Email address Northampton MA 01060 413-586-8287 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 Il 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 Wright Builders, Inc. to act on my behalf,in all matters relative to work authorized by this building permit application. Peter DeRose 6/14/2022 Print Owner's Name(Electronic 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. Wright Builders, Inc 6/13/2022 Print Owner's or Authorized Agent's Name(Electronic Signature) I)ate 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.) 4,724 (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) 2.914 Habitable room count 4 Number of fireplaces 1 Number of bedrooms 2 Number of bathrooms 3 Number of half/baths 0 Type of heating system Warm Air Number of decks/porches 3 Type of cooling system Heat pump Enclosed 1 Open 2 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton Massachusetts mow?• L._ e� 1 �� 'f 41W- DEPARTMENT OF BUILDING INSPECTIONS z girir 212 Main Street • Municipal Building Northampton, MA 01060• SSpyVjN�J 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: The debris will be transported by: Name of Hauler: J&J Trucking -Williamsburg, MA 01096 Signature of Applicant: Date: (1 /./ Z The Commonwealth of Massachusetts Q 1. Department of Industrial Accidents =4N1�= 1 Congress Street,Suite 100 '4,, Boston, MA 02114-2017 www.mass.gov/dia 11urkers' Compensation Insurance Affida it: Builders/Contractors!ElectriciansiPlunthers. It)BE FILED ern THE.I'ER.M I ITIN ;AUTHORITY. Anglicant Inforutation Please Print Levihlt Name(Husiness.'organization'individuall: Wright Builders, Inc. Address: 48 Bates Street City/State/Zip: Northampton, MA 01060 Phone#: 413-586-8287 Are you an employer?Cheek the appropriate box: Ty pe of project(required): 1.®I am a emptovcz with_. 22 employees(full andPor part-time).' 7. 0 New construction 2�1 am a sole proprietor or partnership and have nu employees worsting for me in 8. Remodeling any capacity.[Nu workers'comp.ursunm r required.] 9. ❑ Demolition 30 I am a homeeowne.r doing all work myself.[No workers'comp_insurance required.]' n❑ Building addition 4.O 1 am a homeowner and will be hiring camtractors to emnduer all work on nry prutnmty_ I will ensure that all contracturs either have%writers'compensation insurance or arc sole 11.Q Electrical repairs or additions prupnctors with no employees. 12.0 Plumbing repairs or additions 5Ci 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet_ These sub.euntractors have employees and have workers'comp.insurara:e. 13❑Roof repairs 6.0 We are a eoapurnlion and its officers have exercised then right of exemption per MGL e. 14.Q Other New retaining wall t 5?§t(4),and v.c/lase no employees.[No workers'comp.insurance required.] 'Any applicant that checks box a1 must also fill out the section below showing their a urkers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hnc outside contractors must submit a new affidavit indicating such. :Contractors that check this boa must attached an additional sheet showing the name of the subcontractors and state whether or nut Close entitles have c mpluyces. If the sub-contractors have employees.they must provide their workers"comp.policy number. I am an employer that is providing workers'compensation insiarance for my employees. Below is the policy and Job site information. Insurance Company Name: A.I.M Mutual Ins. Co Policy#or Self-tins.Lie.#: MCC-200-2000534-2021A Expiration Date: 3/1/2023 Job Site Address: 390 Kennedy Road CityiStateiZip: Leeds,MA 01053 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 tine 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 forwarded to the Office of Investigations of the DIA for insurance coverage Verification. I do herein-certify d t tins and llrnrrltir.,of perjury that the information provided above is true and correct Signature: I3a1c: // b - Phone#: (y/3) rain- a o2 Sl Official am..only: Do not write in!Iris area.to be completer)b,l city or town official City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2.Building Department 3. .Town Clerk 4.Electrical Inspector 5. Plumbing Inspector (i.Other Contact Person: Phone#: WRIGBUI-01 KAYLA ,a►coRn CERTIFICATE OF LIABILITY INSURANCE DATE(M 2/2s/202YYY) 2o22 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 NateCT Kayla Marie Drinkwine Phillips Insurance Agency,Inc. PHONE 413 594-5984 FAX 97 Center Street (A/C,No,Ext):( ) (A/c,No):(413)592-8499 Chicopee,MA 01013 n DRIESS:kayla@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:EMC Insurance Companies 21415 INSURED INSURER B:Massachusetts Employers Insurance Company Wright Builders,Inc. INSURER C: 48 Bates Street INSURER D: Northampton,MA 01060 INSURER E: 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRINSD WVD IMM/DD/YYYY1 (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6D18616 3/1/2022 3/1/2023 DAMAGETORENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL$ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: EMPLOYEE BENEFI $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) X ANY AUTO 6Z18616 3/1/2022 3/1/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSR ONLY AUTOS BODILY INJURYp (Per accident)j - AUTOS ONLY AUTOS ONLY (Per accident)DAMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE 6J18616 3/1/2022 3/1/2023 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE ER MCC-200-2000534-2021A 3/1/2022 3/1/2023 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ /M OFFICEREMBEREXCLUDED7 N N/A --- -- - _ - (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 I 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 Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE jivyjl ' ^,� ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 390 Kennedy Road Leeds,MA 01053 —Scope/Specifications Electrical Scope: • Re attach wiring for Air Conditioner after relocation from existing. • Relocate (2) 200Amp electrical meters to house side or post 15ft off existing wall face. Stone Work: • Deconstruct existing retaining wall, catalog and mark for relayment. • Trench 20' for new electrical conduit from house to meter position. • Stone wall bed compacting 1.5"traprock in 8"lifts • Dry lay wall corbelling up from a 4 wide to two wide at the top. • Lay Miragrid landscape fabric every 3 ft extending a minimum of 10' back into the hill. • Fill and compact against wall with 1.5"traprock and landscape fabric in 8" lifts. Fountain/Pool: • Remove existing waterproofing rubber liner, clean and grind away any loose debris and adhesive coating. • Fix Misc. tiles that have chipped or broken around pool. 7 • 611 `` 4,by Ned- Q Jill"! -0:01 e r\\ .7 OPTION)110 b' CUMiN 1- bc.Prrit442 Wes-Le /0 g�C,fiC�IES QI%IN • - 0/ log„ 0I a. Sell I �� f .. . Chem name. 11 Pro)ect Locanon. �,t,.�7 •--yy�� rnrn ^^� '� •.r LEEDS MA- 1 W IJ.1t.L •tl '_► Drawn by. '-'�� STONE&DESIGN LLC - PtolectDesctlpl:or.. 66a........ tt a RAms-toNtorsiGNeGMAIt.COA4 Watt.. BAMSIONLDESIGN.COM l QESN��.b xal« �� .,1 `i (413)-537-4153 .�Y .. r a.. toq'/tz.