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16B-001-047 BP-2022-1296 34 BRIDGE RDUNIT 47 COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 16B-00I-047 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-2022-1296 PERMISSIONIS HEREBY GRANTE TO: Project# DECK Contractor: License: Est. Cost: 10800 BEAUDRY HOME IMPROVEMENT CSL108605 Const.Class: Exp.Date:03/20/2023 Use Group: Owner: CHILSON TIMOTHY E& TRICIA L C REY Lot Size (sq.ft.) Zoning: WSP Applicant: BEAUDRY HOME IMPROVEMENT Applicant Address Phone: Insurance: 117 FERRY ST (413)320-1348 6S6OUB2E863000 EASTAMPTON, MA 01027 ISSUED ON:10/11/2022 TO PERFORM THE FOLLOWING WORK: NEW DECK 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: 1%7 Fees Paid: S70.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ,-1 C _ OCT 11 1 , The Commonwealth of Massachus is 2 2 '° Board of Building Regulations and Sta dard M IC P LI�Y Massachusetts State Building Code, 7 CNik ro u Di^!r inJsa cT US Building Permit Application To Construct, Repair,Renovate Or e ° A 0 oaeov-lu ed ar 2011 One-or Two-Family Dwelling This Section For Official Use Only (3 Building Permit Number: '- -. I Date App'ed: 7— idJN Building Official(Print Name) / Signature ate SECTION 1:SITE INFORMATION 1.1 Prow.94 Atdr f 6 L 1.2 Assessors Map&Parcel Numbers 1.1 a Is this an accepted(treet?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard I Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system Cp Check if yes❑ SECTION 2: PROPERTY OWNERSHIP', � ,1 2.1 Owner' Record: ,C)C1 CGxte AL , 1i dim fir' /r ✓/ - 0 ) 0bo Name(Print) City,State,ZIP 's,i1 6r, l 9.q a 91 S- ,?$ 'DI i7 tCskYtLf V1 jD , g rna;\'col\ No.and Street Telephone alma 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 Specify: fV} ) De c Brief Description of Proposed Work'-: �dn 5-1't)1G4W r1v't )klJ R �' in513t, + SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 4,c0V I. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ //'' ll 0 Standard City/Town Application Fee i W 0 Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Total All Feesi D Suppression) 6c Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 10 r 7 co 0 Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Su ervisor License(CSL) 1 /1 c O$ill(,� (j4(� License Number Exratio ateI, -3 Name of CSL Holder 1 11 F'� Si- List CSL Type(see below) Ut No.and Street Type Description --a.5t L y\ I /� O J Q ) U Unrestricted(Buildings up to 35,000 cu.ft.) J ?V /T V R Restricted 1&2 Family Dwelling City/Town,State,ZIP r M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Re 'stered Home.I Improvement Contractor(HIC) 11) (0 7 C, (SeG►l d r n- T owned-- HIC Registration Number Ex•irati n Date HIC Company N e or IIC Registrant Name I 11- e► s - . col 0 yu hoO, Qj No.and Strew , A 7�/, c Emai address E a smPNY\ MI- o i0 -3 t`� V-13 y xV 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 provid6 this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... No........... ❑ 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 fV Ci:AVAki Ga11t(,L to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic gnature) Dat 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. TCq C r-fA o d o )� Print Owner's or Author d Agent's Na a(Electronic Signature) D to 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.) (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 r Department of Industrial Accidents _ 1 Congress Street,Suite 100 MI MI. :_=1I _ Boston, ,1l_A 02114-2017 7t 4 www.muss goi'/dia U uii:rr,'( umpensatiun Insurance:Af iidan it:Builders/Castraetors(Electricirnsi'Plumbers. '10 BE l iLt:1)N 11'll'f llb: PERMUTING AUTNURI I'1_ :tnplicant Information /�vt�1 Ins. n Please Print Let±ibly Nattte(Buaness.Orpanvauun 1nJt+.Jiu : bCua `�■.t///ut/G'►1y }- Address: 17 Fend $f c - mgyp tr\ f/U1/- o J 0a7 cite State Zip:_ Phone#l: 413-3)-0 - )3 V O Ira�wu as cmphty re?t beta the appropriate Iran: Type of project(required): 1 am a employer with I employees Ilion and or part-tirne'' 7. New construction In I Jut a ode pn,prictu or ptutnaship and have no mirkwyces working our me in X. (J Remodeling any capacity.(Nu ousters comp.ntruranee nominal" 9. ❑Demolition 1.711 am a homowincr doing all work myself.(:vu wawriaas"comp an,urarwe napind.(" lop Building addition a.❑I ant a la,nta,twwis,and will he hiring aanar.ek,n It..ctnJur t ale work on on property.. I will ensure that all contractors either have workers'comp ncation abutanar w are sole 11a Electrical repaint or additions proprietors with tru eatapluyeta_ 12.0 Plumbing repairs additi 0 I am a pcowral a:unuactor and I have honed the.tab-contuse tors hstrd t n ih. attached shirt_ These seat.-,;txruacttta have anrio),:cs and haae astelcr>'cawrrp.na urarn l4.S)dter c.^ 13 Roof repairs ^^II 6.a Ike arc a cugwaKation and its.all een hat a exercised Lawn nght ut e.wemption per MCiL c. p� Qui)U 152.;11-tt.and we lave no employees.(Evo workers'oaarrn insurance rcgwn.'t.) `And applicant that clunks box s1 must also till out the',odiunheehaw showing their worriers'etompentatioapolies information. Ilinnala nem*he submit this rittittav it antic along they an:doing all work mad thea hire uabidc cum:Kim%mum submita Iwo atiutasreandicattngstock. -4lmtracIon that ehccl tins box rust attached an nallrtia,ral enact showing*lesion tithe sub-cwrdra eruis and data:wta►aher arum Horse attitiesl have employees It the huh-etxnrecta.r s haac c,ckplowces,they NMI pWOti et►en wawrtues'Eon*,policy rrtaah@_ I um an employer that is providing workers'ro pensation insurance faraq employees. Below is the policy and lob site in formation. In,ttranc ( tnIvan Nance: Q I 1 Policy#t or Self=ins.Luc.* (05 V 0 u 6 L p(93OOO Expiration Date: �3 Job Site Address: Pper(lat )U I�(/� Cut± State Zip: .046 VYl h 01060 Attach a copy of the workers'coenpeion polio'declaration pageishowing the policy number and ra date). Failure to secure coverage as requited under MGL c, 152.§25A to a criminal c iolation punishable by a fine up to$ ,5UU.OU andior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a line of up to _OO a day against the t uolator.A copy of this statement may be Forwarded to the Office ice of Investigations of the DM for" 'unsure coverage verification. I do hereby t-ertilj-under the pains and penalties of p jury that the information provided above is true unlearnt-E. SiYg'nature: /l/e/, ()ate: l V/Gv Plnwnc : Y l 3 - 3 2 - 13 y / �� Official use only. Do nut write in this area,to be completed by cite or town official ('it or Town: Permiti''Licrnse#� Issuing.tuthorit (circle one): I.Board of Ilealth 2.Building Department 3.('ityi'Town Clerk 4.Electrical Inspector S.Mouthing Inspector 6.Other Contact Person: Phone#: 1 City of Northampton oaY"�Mp ,: S •.. Si N. /er • MassachusettsFr). 7 W A i {t,;F DEPARTMENT OF BUILDING INSPECTIONS Iz r,"` '. 212 Main Street • Municipal Building J� ' 1 Northampton, MA 01060 �SNjy p ‘`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: \/4 Jk iQecJi Ahll14141P--\On vT\A- The debris will be transported by: Name of Hauler: p TGkAr ,� Signature of Applicant: ` `, / Date: *42/i ,acoR ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ‘ee ./ 10/04/2022 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 CONTNAME: Deb Deb Sheldon FINCK & PERRAS INSURANCE AGENCY INC (ac°.No.Exq: (413)527-3000 FAX No):_ _ E-MAIL ADDRESS: dsheldon@finckandperras.com 6 CAMPUS LANE INSURER(S)AFFORDING COVERAGE NAIL! EASTHAMPTON MA 01027 INSURER A: HARTFORD UNDERWRITERS INS CO 30104 INSURED INSURER B: BEAUDRY MATTHEW INSURER C: DBA BEAUDRY HOME IMPROVEMENT INSURERD: 117 FERRY ST INSURER E: EASTHAMPTON MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER: 821075 REVISION NUMBER: i 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 INSD wvo POLICY NUMBER M,'POLICY EFF POLICY EXP LIMITS (MDD/YYYY) (MMIDD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S _ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) S _ N/A PERSONALBADVINJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY JECT LOC PRODUCTS-COMP/OP AGG S OTHER: I S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident)! $ HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAB _ OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE N/A AGGREGATE S DED RETENTIONS S WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY . STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE YrN E.L EACH ACCIDENT $ 100,000 A OFFICER/MEMBER EXCLUDED? WA WA 6S60UB2E86300022 05/04/2022 05/04/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 100,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main St AUTHORIZED REPRESENTATIVE Northampton MA 01060 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD .4C0® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD""") `....� 10/04/2022 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 CONTACT ONT CT Elizabeth Gerballo,CISR.CPIA Finck&Perras Insurance Agency tnc PHONE (413)527-5520 I FAX 527-5970 (A/C,No.Ext): tA1C,N01 (413) 6 Campus Lane EMAIL bcarballo@finckandperras.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC• Easthampton MA 01027 INSURER A: Safety Insurance 39454 INSURED INSURER B Matthew Beaudry Beaudry Home Improvement INSURER C: 117 Ferry St INSURER D: INSURER E: Easthampton MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2210406771 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. IN8R AUDL SUBHr POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INS() WVD POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYYI LIMITS, X COMMERCIAL GENERAL LIABILITY 1,000 000 EACH OCCURRENCE S CLAIMS-MADE n OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) S 10,000 A _ BMA0021095 01/14/2022 01/14/2023 PERSONAL&ADV INJURY ..t' 1,000,000 GENLA0GREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY PRO 2.000,000 JECT LOC PRODUCTS-COMPIOP AGO S OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident! ANY AUTO BODILY INJURY(Per person) S OWNED —SCHEDULED BODILY INJURY(Per accident) AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE $ OED RETENTION S 4 WORKERS COMPENSATION PER I ERA AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED' ❑ NIA E.l EACH ACCIDENT (Mandatory In NH) E L DISEASE-EA EMPLOYEE S (I yes.descnbe under DESCRIPTION OF OPERATIONS below E L DISEASE•POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace la required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main St AUTH EPRESENTATIVE Northampton MA 01060 { ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD kiln Q i A O O+t Cfca-d d A vc)40 qk')-k- 4,4,‘ i \ Rtax A21, 4d/6-A- irzot4 ,,q, s"s181 ,:, lirto hm\x) sinAru ,O)t,‘A II cii_.. At -, ----------7 ?/11( 1) '1114-(v‘Wv1-3- 0� 'Qr y VOA Ns14 t ' / Il --4 . ,...____.±- ,/, ', K,F \-\- v or II %h ►, `of r ?F-: `-4k-'- pvd ) m ,, u,tivacAC o A dr 0 = 454: 1,11 �. d� nU � ��� S troOr) 01 xf, I VT • \ 01\ 1 -- --"451)01 5 J-4:2rCr‘94 i- n$, sicoguyp3Ad 4* 0i s q-4-* `() "a6 s