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32C-201 (7) B ' 2022-0979 89 WILLIAMS ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-201-001 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-2022-0979 PERMISSIONISHEREBYGRANT I TO: Project# PORCH REPAIR Contractor: ` License: Est. Cost: 9000 ALVIN HALL 042574 Const.Class: Exp. Date:06/26/2024 Use Group: Owner: M STEINFELS AMINA Lot Size (sq.ft.) Zoning: URC Applicant: ALVIN HALL Applicant Address Phone: Insurance: 109 WEST ST 413-687-7766 HADLEY, MA 01035 ISSUED ON:08/15/2022 TO PERFORM THE FOLLOWING WORK: REPAIR 2ND FLOOR 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 VIOL. TION OF ANY OF ITS RULES AND REGULATIONS. Signature: I • II, >2 T-1'1 • I � l Fees Paid: $65.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVE The Commonwealth of Massach efts W Board of Building Regulations and S n AUG 1 2 2022 iC ALITY Massachusetts State Building Code, 7 0 C E Building Permit Application To Construct,Repair, eno ter iar 2011 One-or Two-Family Dwellinlg---__ NORTHAMPTON!MA01p�0 NS Thjs Section For Official Use Only Building Permit Number: BP- a+ 7 / Date Applied:...-, 2 it„,4„,„ • b i ,,, Building Official(Print Name) Signature i e SECTION 1:SITE INFORMATION 1.1 PrFA17 tyc�d s,: 1.2 Assessors Map&Parcel Numb /4 S Se 1.1a Is this an accepted street?yes /./..; Map Number Parcel Number 1.3 Zoning Informattion: 1.4 Property Dimensions: Zoning District j�"'F 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 (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Di9osal System: Public Private El Zone: — Outside Flood Municipal On site disposal system ❑ • Check if SECTION 2: PROPERTY OWNERSHIP` 2.1 Owner'of Record: /4 M I N A Sienv it L S Nog-iii A M P i o t4 , r\AA. 01 0 6 c, Name(Print) City,State,ZIP L r 89 WILLIAMS S1" 1It3 s8B - 1279 0.ni.CI eir1rt-IS ® QMQII .Com No.and Street Telephone Email Address J SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Owner-Occupied ,1 Repairs(s) Alteration(s) 0 Addition 0 1 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': 12-5-pA 1 R !L x 15 f1 N 6s PO RGH - 2 N D F I,d o tZ f: FLAG L P -e.k i6..16 AND F1zAMlr16 RE 1A/ra/2CEME Jr/P. P<1//a S SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 0 o U . v o 1. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ A✓A ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ /VA 2. Other Fees: $ 4. Mechanical (HVAC) $ Mt List: 5.Mechanical (Fire $ M� di Suppression) Total All F ' Check No. +V'Check Amount: /V'' Cash Amount: 6.Total Project Cost: $ 9- 0 0 O. o u 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License CSL) CS _o v2 P 7 y . ).. ,/ V i 4 /0 // License Number 7 Ex atio ate Name of C L Holder /0 /AeS # st List CSL Type(see below) _a No.and Street `/ (`'(/ Type Description a'A d lty ,474 d/a/3r U Unrestricted(Buildings up to 35,000 cu.ft.) / J R Restricted 1&2 Family Dwelling City/Town,State, / M Masonry RC Roofing Covering WS Window and Siding 1 °A SF Solid Fuel Burning Appliances */ " 67 l 77 a /Vj„ l/'q/ Mk// I Insulation Telep'lfone Email address '. t jwt D Demolition 5.2 RegisteredHome Improveme i t Coractor(HIC) A 7 /�1/ o /L tz_!�L / LL// HIC egistrattiionNuumbe atio to HIC C I ii'any ame or III gi '".1 t Name No.and Street C�V� Email adchiallt 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 a building permit. • Signed Affidavit Attached? Yes No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILD G P RMIT 1,as Owner of the subject property,hereby authorize )41 toacton myhal in all matters relative to work authorized bythis buildingermit lication. be halt p pp 4 tAi vvk NA Ste.i leeks 77 R /2 2-- 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 app•' tion is true and a c ate o the best of my knowledge and understanding. Print Owner'3`oGA thorized Agent's Name(Electronic Signature) D f . z_2--- at 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.IL) (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" • The Commonwealth of Massachusetts nt Department of Industrial Accidents =' Gt 1 Congress Street,Suite 100 Boston, M4 02114-2017 N'N'1t:macs.got'/dia 11ofkers'Compensation Insurance Aflidasit:BuildersiCoutlraet mbent. it)HE FI1.Et)N lilt I HI PER MI l LING AIiTI1ORITY. t licant information Please Print I ibis 111 Name I Business Organization Individual): ,� y'/ Address:—_+ I J t Ctt State Zip: 8 3 Phone#: y/3- C -7- 776 e • Are you an employer?('luck the app riatc ton: "1'y pe of project(required): I Q I am a engiloya with employed halt and or part-time)•• 7" New construction -s in a sole prupnrtur or partnership and hate no employed wurkmg for me in 8. O Remodeling any capacity [Nu workers'comp.insurance nyuired] 9. ❑ Demolition 3.�i ant a homeowner doing all work myself.No*odors*coml.atssuraaae fey tured.l 10 a Building addition 40 I am a hum:ow MA'and still be hiring contractors to conduct all work on nn prupeits. I w ill ensure that all contracturs either hate wtxkcra•compensation insurance or are rule I I CI Electrical repairs or additions ptupnetors w nth no employees 1_.Q Plumbing repairs or additions 50 I am a erural contractor and I base bared the sub-curwsetun listed on the attn.-bed sheet 6 130 Root repairs y these soh-contractors hate employees and'Woe sour►ors'comp.uuurance.- 14. Other ire .-u' 4 it/ N e are a etirpuraatiun anal its officers hate exercised their right of exemplum per Mt&c. i 152.;11 41.and vie lute nu uripluyecs.(No worker'comp_insurance required. R,�i n i e-44 ''��sile":"T 'Any appticartt that chucks bus al must also till out the section below showing their%inked'compensation pu s mlunriatiori 1 Htnn uu nets u h o salmi this aflidat li utdxatuip they are doing all work and then hue outside contractors must suhuut a new atti.fas it indicating such. It unlra.rors drat.heel.this hit must attached an adshtiunal sheet shuts mg the more ut the sub-cuntracturs and state whether or nut those ditties hate cmplutces It the soh- ontraeturs lust.enrpluytes.t11,7y must pnnide their v.orl.ers"a.rnp RJtcs number. I um an employer that is providing workers'compensation insurance for my employees. Helun-is the policy and job site information. Insurance Company Name. Policy;LI or Self-ins. Lie. : Expiration Date: Job Site Address: City.State Zip: Attach a copy of the workers'compensation policy declaration page(showing the polio} number and espiradon date). Failure to secure coverage as required under MMGL c. 152,§25A is a criminal violation punishable by a fine up to S1.500.00 and'or one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and u line of up chi S250.00 a day against the s tolator.A copy of this statement may be forwarded to the(Mice of Investigations of the DIA for insurance coverage verification. I do hereby rev ''funder t! ii ird a 'es of perjure'that the information provided abov is true and correct. Signature . rf�/ t)atc /0 Phone ' 6 s Official use only. Do not write in this area.to be completed by city or town official ('its or'town: Permit/license ti Issuing Authority (circle one): 1. Board of Health 2. Building Department 3.City[fawn Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton ?oatt,H2+ roti. S`9 '6..SI G Massachusetts v? ' •. g itii yt A s' `I DEPARTMENT OF BUILDING INSPECTIONS yJ ;�. , 212 Main Street • Municipal Building G .. O ti Northampton, MA 01060 YjP 317 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: V Vt/ R The debris will be transported by: n4 (Name of Hauler: d Signature of Applicant: Date: Ia 6/29/2021 lmguu4.Jpg -. Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Cons a4t .. 'visor t 9-si CS-042574 Expires: 06/26/202)1 It ALVIN M HALL 1N° ' 109 WEST ST v HADLEY MA 0.1035 4,..t., -0,- .,, Vitt ' Commissioner : 'e-e ° . r at viflin Actilet,ral , con 1'7'1 3 -66'7-‘ 7n 4 We (..�Gy///,I '/I//,(q(!/l C ,,,i ez4...if'el ,6 Office of Consumer Affairs & Business Regulation HOME IMPROVEMENT CONTRACTOR TYRE: Individual Registration, Expiration 16764E 10/12/ ALVIN M. HALL; ALVIN M. HALL , -C- 109 WEST ST HADLEY, MA 01035 Undersecretary httpsa(mail.google.com/mail/u/1/#inbox/FMfcgzGkXwNbgTvRgmGmKZJfgCsVnvzh?projector-1 1/1 r -.1 �� DATE(MMIDDlVYYY) ACT )RI CERTIFICATE OF LIABILITY INSURANCE ' - D5/02/2022 THIS ERTIF1CATE 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 NAMEACT Susan Fleury CIC CISR CPIA King&Cushman Inc PHONE (413)584-5610 FC Na (4'3)584-9-3'22 ' " A1CNo,Exit: _ _ P.O.Box 447E-MAIL sfleury@kingcushman.com ADDRESS: 176 King Street INSURER(S)AFFORDING COVERAGE NAIC X Northampton MA 01061 INSURER A: National Grange Mutual Insurance Co INSURED _ -__ INSURER B; Alvin Hall — INSURER C 109 West St. INSURER D � INSURER E: Hadley MA 01035 INSURERF: COVERAGES CERTIFICATE NUMBER: CL225204765 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -ADM SIM LTR TYPE OF INSURANCE POLICY YY POLICY EXP �-..,____. INSD WVD POLICY NUMBER MM/DD/YYYV MM/uD/YYYY LIMITS x COMMERCIAL.GENERAL LIABILITY EACH OCCURRENCE $ 1000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES LEaoccurren) $ 500,000 MED EXP(Any one person) S 10,000 A MPP6994G 04/24/2022 04/24/2023 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE s 2,D00,000 iII4 PRODUCTS-COMPIOPAGG f POLICY Iris LOC2,000,000 OTHER GOAL $ 25,000 AUTOMOBILE LIABILITY COMBINED SINULs LIMI1.�.. S rEe accident) ANY AUTO BODILY INJURY(Par person) $ OWNED SCHEDULED BODILY INJURY Per accident) S CAUTOS ONLY AUTOS H0t° ERI-irIAMAGr- HIRED NON-OWNED P r AUTOS ONLY 1 AUTOS ONLY ,{_Per:Imam) s -------_----_'-- r_ �__. .. $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION 1PER I--- -!�� - AND EMPLOYERS'LIABILITY Y/N I 5T TI tTF 1 FRS ANY PROPRIETOR/PARTNER/EXECUTIVE 171 N/A E L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? ---�-- (Mandatory In NH) If yes,describe under E L DISEASE-EA EMPLOYEE S DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ ESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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